New Trends in Global Medical Tourism in 2020
Global medical tourism often brings up images of people going across the Canadian border to buy cheap prescription drugs. However, there are growing global trends. People travel to and from other countries to get better care all the time. This is especially true for elective treatments such as plastic surgery. Some medical tourists are interested in lowering costs or jumping a long queue in their home country, while others are attracted by the high skills of a specific surgeon or hospital.
Some countries discourage medical tourism, while others consider it an important source of revenue. In fact, current trends include India openly seeking medical tourists, hoping to expand the industry to $9 billion by 2020. Large private complexes called “health cities” combine medical care with resort facilities and some people go to off-beat destinations to get minor or cosmetic procedures as part of a vacation. Here are some trends that you should worry about:
One of the issues with going overseas is communication. As medical tourism expands into destinations such as India, Brazil, and Malaysia, there is a decreased chance clinical staff will speak good English. Often the doctors will speak the language, but nurses and physician assistants may not. Misunderstandings are likely to increase if they are not fluent in English and/or you are not fluent in the local language.
Other countries have different standards for medication approval, and a foreign hospital might provide you with medicine not approved by the FDA. This can be of low quality. It can also cause problems when you return to the United States and are unable to get more of the drug. Your doctor will then have to transition you onto an alternative. In some cases, medical tourists have been given counterfeit drugs, especially in Southeast Asia, where counterfeit anti-malarial drugs have become a serious problem this year.
Lack of Proper Hygiene
Different countries have different standards of sanitation. Antibiotic resistance is a global problem, also, and may be worse in different countries. NDM-1, for example, an antibiotic resistance enzyme endemic in India and Pakistan has shown up in Canada because of medical tourism. Resistant infections can be serious or fatal. Also, if you are going to an exotic destination, make sure you get any vaccinations you need. Alternatively, choose a different destination.
Also check the country’s standards for screening blood supplies, in case you need a transfusion. Again, the best way to be sure is to go to an accredited facility. Look for facilities certified by the Joint Commission International, a US-based organization working to standardize and improve conditions in hospitals. (The JCI also requires staff who understand foreign languages and cultures and a variety of performance requirements).
Lack of Communication of Medical Records
Electronic medical records have reduced medical errors by a lot, but they are often not available overseas. In fact, you may have to make copies of all of your medical records with you. If there’s a language barrier, you may need to get your medical records translated. This can be an expensive process.
Hand carrying medical records carries with it an inherent risk. (Absolutely keep them in your carry on.) Also, make sure that you take prescription records that include the actual drug, not the brand name, as a foreign pharmacist may not understand which drug you are taking.
Difficulty Getting Information on Risks
It’s very hard to find out the death rate associated with global medical tourism. There have been very few studies. This means it’s even harder to find out death and infection rates for a specific country, procedure, or facility. Although hospitals in the U.S. also vary widely, it’s often easier to find out which are better and which are worse.
Medical tourism is important enough to be causing actual economic shifts. It used to be that people from developing countries went to America or Europe to get care not available in their home countries. As quality improves back home, the migration has reversed. The Asia Pacific has 43.7% of the global medical tourism market.
Traveling Can Slow Recovery
Some people may return to their home country before they are really ready to travel. In the worst-case scenario, this can cause blood clots which can even be fatal. It also makes it hard for domestic surgeons to provide continuity of care. When a patient returns from a trip, their own doctors may not have all the medical records they need.
Flying after surgery can also be dangerous, increasing the risk of blood clots. It can be prohibitively expensive to stay in a foreign country long enough to avoid this risk, as doctors often recommend not flying for as long as several weeks after some procedures.
It Can Be Hard to Sue a Foreign Doctor
Malpractice can be complicated. Many suits have to be filed in the place where the injury occurred, meaning that you have to file the complaint in that country, even if you are no longer there. On top of that, medical malpractice protections are much less robust. If suing in a U.S. court, the court may not have jurisdiction over the defendant. This is determined by a complicated procedure called a “long-arm statute”. The standard essentially requires that the foreign surgeon markets themselves in the United States or another home country regularly. The U.S. court may also dismiss the case on the grounds that it should be pursued in the other country.
Domestic Doctors Can End up With the Liability
The end result of malpractice suits can mean that patients sue their insurer or another organization that sponsored their travel. Alternatively, they could sue domestic physicians who gave them advice or provided follow-up care. While the domestic physician is not going to be liable for direct malpractice during the surgery, they can be sued for failing to meet standards of informed consent. This duty can extend to physicians who make a referral. That is, if the domestic physician doesn’t give all the information about the surgery and something goes wrong they might be sued, even if the practicing surgeon did provide the information.
There is no liability if the physician only performs postoperative care. As already mentioned, the domestic physician may not get all the medical records and may even be concerned about making a mistake and ending up on the hook not just for the damage they did but for damage did by the foreign surgeon. This can lead to doctors refusing to have anything to do with the entire thing.
Learn More About Global Medical Tourism
This is an emerging area of law. Indeed, doctors who refer patients overseas should be aware of the risk and should consult a lawyer. Most doctors feel that medical tourism threatens the continuity of care, but that their heavy involvement helps protect it, while adding to the risk of malpractice.
Medical tourism is here to stay. Doctors should consider carefully whether it is wise to refer a patient for overseas treatment. In some cases it may be the patient’s only financial option. To find out more about this and other factors related to global medical tourism, or about our medical equipment solutions, contact obp today.