Much has been written about the increasing number of Americans traveling abroad for medical care and surgery. Cost generally plays a role in such decisions, especially for senior citizens with limited discretionary income.
"I think it's an increasing phenomenon in the U.S. A lot of people do it for cost issues, especially if you don't have funding for a big surgery that you really need," says Dr. Steven Chang of RightHealth. "It is a viable option for a lot of people, but there are pitfalls you need to watch out for. You really need to make sure you do your research thoroughly."
Chang estimates that more than 100,000 Americans go overseas for medical care, primarily surgical procedures, each year. "The majority of the patients go for surgery abroad because surgery is very pricey here," he says. Mexico, Central America and South America are popular medical destinations.
According to the Medical Tourism Association's website, the approximate cost of a heart bypass in the United States is $144,000, whereas the same procedure costs $25,000 in Costa Rica, $14,360 in Colombia and $8,500 in India. A hip replacement that runs $50,000 in the United States would be $12,000 in Costa Rica and $8,000 in India.
Other examples listed are $2,000-$10,000 for dental implants in America, compared with $1,672 in Colombia, $1,000 in Costa Rica and $700 in India and $50,000 for a knee replacement in the United States, compared with $11,000 in Costa Rica, $7,100 in Colombia and $7,000 in India.
Chang notes that some doctors working overseas have been educated in America and that some countries recruit medical staff members from the United States. "In the Middle East, such as in Saudi Arabia, they actually send a lot of physicians to train in the United States and Canada. They actually heavily recruit American health care workers, physicians and nurses -- a lot of nurses -- to work abroad," he says.
Chang advises anyone considering going abroad for a medical procedure to research the options thoroughly before making a decision. One source of information is the Medical Tourism Association, a nonprofit international trade association whose membership includes top international hospitals, health care providers, medical travel facilitators, insurance companies and other affiliated companies and members whose goal is to promote the highest quality of health care to patients in a global environment.
Another source of information may be the individual's own insurance company, some of which have branches or subsidiaries that deal with medical procedures done overseas.
Also, you can check out the Joint Commission's website (http://www.JointCommission.org). It lists some international hospitals rated by American standards.
"You really have to do your own work," Chang says. "Read up on the hospital you are looking at. Find out about the doctors and the surgeon, and you probably want to consult with them first. If you have the money, it would be preferable to check out the facility in person, meet with the surgeon and get a sense of whether you think the person is competent." You want to find out how many surgeries he has done, his success rate and the complication rate. That is the big safety issue, he says.
Follow-up after surgery is another factor to be considered. Chang points out that surgical patients require follow-up, which can present a logistical problem for someone whose procedure is done in another country. "It's really not feasible for a lot of people to fly back to where they had their surgeries," Chang says. "Preferably, you would do the follow-up with the surgeon who did the surgery because that surgeon would know exactly what happened inside your body. If something goes wrong, the surgeon would be the best one to ask. Unfortunately, if you travel for surgery, you might not have that luxury."
He also advises patients to be truthful with their doctors about going abroad for surgery. "You could maybe arrange to go abroad for a surgery and plan to come back and immediately see your doctor, with your medical records. You can show your doctor what happened, give your doctor information about the doctors and surgery, and arrange to follow up with your doctor," Chang says.
Cancer is the one medical area in which Chang does not recommend people consider going overseas for treatment. "If it's a surgery that can be done -- and that's it -- such as a tonsillectomy or something that is more routine and doesn't require ongoing follow-up, that's one thing. If you are going in for cancer care, that is really difficult. People who have cancer have long-running relationships with their oncologists, with chemotherapy and radiation therapy," he says.