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Medical tourism is a multibillion-dollar, unregulated industry. Medical tourists are motivated to travel for different reasons. Some go after their friends and family have done so and have good results. Others don’t have dental or health insurance or want procedures not covered by insurance, like cosmetic surgery.
Further, medical tourists are often drawn to shorter wait times and fewer medical requirements before surgery. But the most common motivation is to avoid the high treatment costs in the U.S. Dental implants, for example, cost around $3,000-$5,000 in the U.S. but only $1,300 in Costa Rica. The cost savings seem like a no-brainer unless something goes wrong.
“If there is any significant problem, that patient’s paying double or triple what they would have paid if they had just had it done [at home] and not had a problem. The revision surgeries are usually just as much or more. And often, it’s not a single procedure. That’s just the money aspect of it,” said Mark A. Jabor, M.D., a plastic surgeon certified by the American Board of Plastic Surgery and the American Board of Otolaryngology. “That’s not considering the loss of work, pain and suffering.”
“In fairness, it’s hard to know how many get problems; not everyone that goes overseas has a problem. But, I do care for a lot of patients who have had problems,” he continued.
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Rules and regulations
Dental offices crowd the small town of Los Algodones, Mexico, which thrives off the Americans who cross the border for treatment.
AFP via Getty Images
“When people tell me, ‘I can get things cheaper overseas,’ I say, absolutely you can, because of the difference in regulations. If you have it done and it goes well, great! All is good. However, if something goes bad, I have often seen [providers overseas] say, ‘Good luck to you; I’m sorry you had a problem, have a good life.’ I see it happen a lot,” explained Jabor.
Medical facilities like hospitals, surgery centers and provider offices in the U.S. must follow many rules to keep patients safe. The medical staff need proper training. The FDA must approve products and procedures. Tools must be stored and cleaned correctly. Everything that touches a patient must be as safe as possible.
Organizations like the Joint Commission regularly check to ensure safety rules are followed. If they find problems, the medical facility must fix the problems immediately or be closed. According to Jabor, “There’s less oversight in other countries; it tends to lend itself to potential abuse.”
All surgeries have risks. Patients might get blood clots, stitches opening up, asymmetrical healing in cosmetic procedures, or complications requiring extra surgeries. But medical tourists have a much higher risk of developing infections due to the need for more oversight.
Between 2018-2019 medical tourists were victims of an outbreak of antibiotic-resistant bacteria. A surgery center in Tijuana, Mexico, did not have the correct equipment to ensure that tools were cleaned entirely between patients. The dirty tools passed dangerous bacteria to patients.
Once the outbreak was discovered, the CDC warned U.S. residents not to have surgeries at the facility. Unfortunately, many were unaware and still had their procedure at the unsafe facility. The risks go beyond dirty equipment.
“I see techniques and things [and think] why would they do or use that? I think it goes back to [the lack] of oversight. The main issue overseas is they can do what they want. No one ever taps them on the shoulder every once in a while and says, ‘Hey, you know what, I’m not sure this the best technique, and you may want to correct it or, you know, your license could be in jeopardy.’ So there’s no real incentive to change,” said Jabor.
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Struggles upon returning home
Patients who return home with poor results can struggle to get help. “I have a lot of people tell me, ‘My friends all went to this person, and everyone had great results, look what happened to me.’ And I’m, like, you know, that can happen. And I ask them, ‘Well, why don’t you go back to the doctor?’ They reply, ‘He doesn’t want to see me anymore,’” noted Jabor.
Once overseas doctors stop providing care, finding doctors in the U.S. is often quite challenging.
“Some problems are just not fixable, to be quite honest. A lot of doctors [say], ‘I don’t need that headache, [they] chose to go over there, [they] can find someone else.’ I’m usually pretty generous about it. And I feel bad you know? So I see the patient, see if I can do something,” said Jabor.
When people in the U.S. have bad results, they can seek legal help with the damages. But this is only sometimes realistic for medical tourists.
“People say, ‘I can sue the doctor.’ You’re going to sue a doctor in a foreign country? You’re not even a citizen of that country, there is no chance you’re suing that doctor. You have you have no recourse. Just know that going in. If you know that, accept those facts, and are willing to roll the dice, go for it.”
“But I think the problem is people don’t really consider all the [risks] because [they’ve] heard the horror stories, but [think] ‘that happened to somebody else.’ It’s never a problem until it happens to you,” Jabor added.
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Preventing problems
A patient will always be their own best advocate. While it can be tempting to try to seek out the cheapest price, saving money should not be the objective at the cost of long-term health. Even without complications, consumers need to be mindful of hidden costs.
Advertised prices for procedures may not include airfare or accommodations. Patients should not travel for 10 days after abdominal surgery to avoid complications related to cabin pressure changes. The added costs may leave the final cost similar to what costs would be at home.
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It’s essential to research the facilities in question. Take the time to ensure that the facility where the procedure is to take place is accredited to be safe, and know that websites may not advertise if they are not accredited.
This research should continue beyond the surgery location alone, said Jabor. “Patients need to do a little bit of research into the doctor and their background, and what their actual qualifications are. I went to college and medical school, and then I did seven years of residency training afterward to become a plastic surgeon.”
“Some people do other sorts of training and then will say that they’re a plastic surgeon. But when you can’t produce the same results, you know, that’s a problem.”
He continued, “That’s the big difference between medical tourism and having [a procedure] done in the United States. When I have a problem with a patient, I’m obligated as a physician to care for that person. If there is a problem, that doesn’t mean that it’s over, and the patient takes off and finds their care.”
“[We] stick with the patient and do our best to see them through. If it’s more than we can handle, we recruit other doctors to help. It’s never well, you know; good luck to you,” said Jabor.
Melanie Gutierrez is a freelance writer and registered nurse with an unquenchable thirst for knowledge and sharing what she’s learned. She’s been connected to the healthcare world her entire life as the daughter of a medical assistant. When not writing or working at the bedside, she keeps busy as an Army spouse and enjoys spending time with her cats and crafting. You can find more of her work at NurseMelWrites.
This article is reprinted by permission from NextAvenue.org, ©2023 Twin Cities Public Television, Inc. All rights reserved.
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