Saturday, March 23, 2013

MEDICAL TOURISM: APPROACH WITH VIGILANCE

In recent years, medical tourism has become an option increasingly available to potential plastic and cosmetic surgery patients. These potential patients often imagine that inexpensive, high-quality surgical care can be obtained by traveling outside the U.S. Add to that the price-conscious "savviness" of the internet coupon generation, and the options increase exponentially.
In the age of global digitalization, outsourcing of various business practices has become commonplace. Beginning with the export of information technology and call center jobs, outsourcing has now extended its reach to include medicine, surgery and even plastic surgery. Several developments have facilitated this trend. Prohibitive health care costs at home, increasing denials of insurance claims and decreasing provider reimbursement rates, increasing overall demand for plastic surgery, long waiting times, and lastly, and perhaps most importantly, cost savings, have all contributed.
Medical tourism is marketed on the basis that health care can be off-shored much like the production of computers and cell phones or the provision of professional services such as bookkeeping and accounting. Good surgical care, however, involves more than just the technical act of surgery itself. It requires extensive and careful preoperative consultation, deliberate formulation of reasonable treatment plans, and implementation of proper postoperative care. Yet, such goals are unlikely to be achieved when patients don't spend the proper amount of time recuperating, and return home with no plan for follow-up care.
That's not to say there are not qualified plastic surgeons abroad. The ASPS is the world's largest organization of board-certified plastic surgeons and the Society has members in more than 70 countries around the world. But all too often I consult with patients who haven't seen an ASPS Member Surgeon and tell me lamentable stories of "plastic surgery gone wrong" abroad. The informed consent process, a standard component of patient-physician communication in the United States, involving full disclosure of risks and benefits of treatment, is virtually non-existent. Most of the time, the patient cannot even recall the name of the surgeon, or even identify him/her in person preoperatively. In order for choices to be made in a meaningful and appropriate manner, patients need to receive accurate and comprehensive information. Inadequate communication before surgery, and the seemingly non-existent culpability, lead some patients to have procedures performed in facilities that would not meet U.S. standards.
When considering the cost savings purported to be an attractive feature of medical tourism, one must always consider the added costs of revisional surgery and medical care incurred with the potential for adverse outcomes. These costs increase when one considers the increasing frequency of surgical complications incurred with surgery in health care settings that may not meet the standard of care. Medical travelers often purchase cosmetic surgery packages without physician consultation and without knowledge of the medical implications to their health and well-being. Medical tourism companies and destination health care facilities, often owned and operated by non-physicians, benefit from maximizing profits without the necessary medical knowledge, legal responsibilities, and unfortunately, regret either. All in all, elective plastic surgery is a big decision, and just like any other surgery, comes with risks. While traveling to exotic locales may seem enticing, it may be difficult to assess the training and credentials of surgeons outside the U.S. Use the ASPS Find-a-Surgeon tool to search for qualified plastic surgeons in the U.S. and around the world to ensure the safest experience possible.