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What is medical tourism traveling for healthcare explained.

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Medical tourism is nothing new. People have been seeking more affordable, sometimes higher-quality care for as long as humans could cross borders. In today’s world that usually means travel to foreign countries for a wide range of medical procedures from elective surgeries like liposuction and rhinoplasty to advanced care for complex medical conditions like cancer and fertility treatments. And it’s a multibillion dollar market that continues to grow with globalization.

There are as many alternative medical offerings as there are destinations in the world – giving people countless reasons to seek medical care away from home.

These often include pursuing more affordable treatment options to accessing specialized medical expertise that is not available locally to combining medical procedures with a luxury travel experience. And admittedly, in some cases individuals may opt for health travel because specific treatments are not recommended locally, have long wait times or for desired anonymity.

But to dispel any misconceptions about medical tourism, not all medical travel is for cosmetic surgery procedures such as breast augmentation, liposuction, facelifts and rhinoplasty. While those are popular, it may come as a surprise that dental procedures, heart valve replacements, fertility treatments and orthopedic surgeries are standard in the medical tourism industry . And according to the CDC , many seek more stigmatized care such as substance use rehabilitation and even physician-assisted death abroad because of cultural differences and acceptance.

What To Know Before You Go

There are many risks, big and small, to pursuing care outside the traditional and highly regulated U.S. system. And it’s important to note that even some small perceived risks carry great weight. For example, language and cultural barriers might seem insignificant at first, but will certainly influence the treatment experience and post-operative care. What is considered standard in one place, may be unacceptable in others.

Differences in healthcare regulations and standards across countries may lead to discrepancies in the quality of care and patient safety, necessitating thorough research and due diligence before choosing a health provider abroad. Common complications include infection, inadequate training and lack of follow up protocol. Additionally, managing post-operative complications and follow-up care from a distance can be challenging, especially when returning to the patient's home country for ongoing medical support. This makes planning and preparation crucial steps for a successful medical tourism trip, ensuring patients make informed decisions and have a comfortable experience throughout the journey.

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Thorough research into accredited medical facilities, experienced providers and patient reviews it is possible to find a reputable destination that aligns with the patient's specific medical needs. But, one must also understand the legal and ethical considerations surrounding medical procedures in their chosen destination, including medical malpractice laws and patient rights. This is where planning and proactive actions come into play.

Arranging travel logistics, including flights, accommodation and transportation, plays a pivotal role in creating a seamless and stress-free medical tourism experience for patients and their accompanying companions. But with the right care providers, treatment plan, facilities and travel goals patients can achieve all their objectives.

One can often save a substantial amount of money, even when factoring in travel and accommodation expenses, compared to undergoing the same procedures in their home country. Further, medical tourism provides access to specialized treatments and medical expertise that may not be readily available in the patient's home country. This can be particularly beneficial for individuals seeking advanced or experimental procedures for specific medical conditions.

Depending on country of origin health travel additionally offers the advantage of shorter wait times and the option to combine necessary medical procedures with a leisurely, often luxurious, travel experience, offering a unique opportunity to recuperate in a new, exciting and relaxing environment.

Where To Go And What To Do

Unfortunately, medical care costs and the health insurance industry in the U.S. have pushed many Americans beyond their means . Although it can be frightening and uncertain to explore options outside the regulated system, each day more and more people are choosing - or are forced - to do so. And countries around the world are stepping up to meet the demand.

For example, countries like Thailand, Brazil and South Korea are renowned for their expertise in cosmetic surgery and attract a significant number of international patients seeking these procedures. For dental treatments many go to Mexico, Hungary or Costa Rica. Those looking for assistance with fertility often travel to Spain, India and the Czech Republic. In contrast, Germany, Malaysia and the United Arab Emirate are top of people’s lists for orthopedic surgeries.

No matter what one is seeking in their exploration abroad, it’s vital to remember that healing time, post-operative care and self-awareness are essential to recovery and safety. This is in addition to all the pre-travel research, validation and planning that must take place. Any kind of medical treatment outside the U.S. poses a risk to the traveler.

But with that knowledge one cannot deny that medical tourism offers a range of attractive services from cosmetic surgeries to complex procedures like organ transplants or cardiac surgeries that can save travelers from prohibitively high costs or long waiting times in their home countries. Destinations with advanced medical infrastructure and skilled health professionals can capitalize on this by promoting their services to international patients, providing not only medical expertise but also opportunities for travel and recuperation in attractive destinations. Although challenges such as varying quality standards, language barriers and post-operative care logistics remain valid concerns for those considering medical tourism, the barriers for seeking care outside the United States are reduced every day.

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Why Patients Are Turning to Medical Tourism

Statistics, Benefits, and Risks

Planning Ahead

Frequently asked questions.

Medical tourism is a term that refers to traveling to another country to get a medical or dental procedure. In some instances, medical tourists travel abroad seeking alternative treatments that are not approved in the United States.

Medical tourism is successful for millions of people each year, and it is on the rise for a variety of reasons, including increasing healthcare costs in the United States, lack of health insurance, specialist-driven procedures, high-quality facilities, and the opportunity to travel before or after a medical procedure.

According to a New York Times article from January 2021, pent-up demand for nonessential surgeries, as well as the fact that many Americans lost their health insurance during the coronavirus pandemic led to a surge in medical tourism once other countries re-opened.

However, there are specific risks that come with traveling overseas for surgery. If you're thinking of pursuing a medical procedure in another country, here's what to know about the benefits and the risks.

Medical Tourism Benefits

The most common procedures Americans go abroad for include dental care, cosmetic procedures , fertility treatments, organ transplants , and cancer treatment.

This is not to be confused with having an unplanned procedure in a foreign country due to an unexpected illness or injury.

Among the reasons a person might choose to go abroad for a medical procedure are:

Lower Costs

Medical tourists can save anywhere from 25% to 90% in medical bills, depending on the procedure they get and the country they travel to. There are several factors that play into this:

• The cost of diagnostic testing and medications is particularly expensive in the United States.
• The cost of pre- and post-procedure labor is often dramatically lower overseas. This includes labor costs for nurses , aides, surgeons , pharmacists, physical therapists , and more.
• High cost of malpractice insurance—the insurance that protects medical professionals against lawsuits—in the United States.
• Hospital stays cost far less in many overseas countries compared to the United States. In other words, quality care, hospital meals, and rehabilitation are far more affordable abroad for many people.

For someone who doesn't have insurance , or someone having a procedure that is not covered by insurance , the difference can be enormous.

Popular Countries for Medical Tourism

Dominican Republic

South Korea

Culture and Language

Many immigrants prefer to have treatments and procedures done in their country of origin—a sensible decision, considering just how much language barriers alone can affect the quality of their care.

Furthermore, at least 25% of immigrants and noncitizen residents in the United States are uninsured, compared to 9% of American citizens. Children with at least one noncitizen parent are also more likely to be uninsured.

Practicalities aside, many people choose to have their procedure done in their country of origin simply because it allows them to be close to family, friends, and caretakers who can assist them through their recovery .

Insurance Incentives

Some insurance companies have started promoting medical tourism. The reason behind this is simple: savings for the insured means savings for the insurance provider and vice versa.

Several insurance providers, including Aetna have programs specifically geared at promoting safe medical tourism. Some insurance providers even offer financial incentives for medical tourism, like discounts on medical bills .

That said, many insurance companies will not pay for surgery performed outside of the country unless it is an emergency.

Luxury and Privacy

Medical tourism is a lucrative business for many countries, and much of the money brought in by medical tourists is reinvested into the local economy and health infrastructure.

The effect of this is apparent in the spa-like luxury that some foreign hospitals offer, providing medical tourists the opportunity to be pampered during their stay for a fraction of the cost they would pay at home.

Some facilities offer hospital rooms that are more like a hotel suite than a traditional hospital room. Other hospitals offer one-on-one private nursing care, which is far more generous and attentive than the staffing ratios that most hospitals allow.

Medical tourists who seek that added layer of privacy can find it abroad. Many can return home from their "vacation" without anyone knowing they had a procedure at all.

Vacation in a Foreign Country

Medical tourists often take advantage of their stay in a foreign country to travel for pleasure by scheduling a vacation before or after their procedure.

This is an especially inexpensive way to travel to a foreign country, especially if their insurance provider is paying for the flight and the cost of staying is low. 

While it seems logical to recover on a beach or in a chalet by the mountains, keep in mind that it's important not to jeopardize your recovery.

Swimming isn't recommended until your incisions are completely closed. You may not feel up to doing much more than napping in the days following your procedure, either.

Don't let your vacation disrupt your recovery. Any time you have a procedure done, especially a surgery, it's important to listen to your body, take your medications as directed, and follow your doctor's recommendations closely.

Bypassing Rules and Regulations

Some travelers seek surgery abroad to bypass rules that are set in place by their own government, insurance company , or hospital. These rules are typically in place to protect the patient from harm, so getting around them isn't always the best idea.

For example, a patient may be told that their weight is too low to qualify for weight loss surgery . A surgeon in a foreign country may have a different standard for who qualifies for weight loss surgery, so the patient may qualify overseas for the procedure they want.

Talented Surgeons

Surgeons in certain countries are known for their talent in a specific area of surgery. For example, Brazilian surgeons are often touted for their strong plastic surgery skills .

Whereas in the United States, insurance companies might only cover cosmetic procedures if it is medically necessary, cosmetic surgery is often free or low-cost in Brazil's public hospitals—giving cosmetic surgeons there ample practice.

Thailand is reported to be the primary medical tourism destination for individuals seeking gender reassignment . It is often easier to qualify for surgery and the cost is significantly reduced. Surgeons are performing the procedures frequently, and as a result, many have become quite specialized in them.

It is often surprising to many medical tourists that their physician was trained in the United States. Not all physicians are, of course, but a surprisingly high percentage of them working in surgery abroad are trained in English-speaking medical schools and residency programs and then return to their home country. These physicians often speak multiple languages and may be board certified in their home country and a foreign country, such as the United States.

Medical tourism isn’t limited to countries outside of the United States, either. Many people travel to the United States for medical care due to the country's cutting-edge technology, prescription medication supply, and the general safety of healthcare.

Medical Tourism Risks

The financial and practical benefits of medical tourism are well known, and you may even know someone who had a great experience. Nonetheless, the downsides of medical tourism can be just as great if not greater. Sometimes, they can even be deadly.

If you are considering a trip abroad for your procedure, you should know that medical tourism isn't entirely without obstacle and risks. These include:

Poorly Trained Surgeons

In any country—the United States included—there will be good surgeons and bad. And just as there are great surgeons abroad, there are also some surgeons who are less talented, less trained, and less experienced.

Regardless of what procedure you are getting or where, you should always do some preliminary research into the surgeon or physician who will be treating you as well as the hospital you will be treated at.

In the United States, it is fairly easy to obtain information about malpractice lawsuits , sanctions by medical boards, and other disciplinary actions against a physician.

Performing this research from afar can be challenging, especially if you don't speak the local language. Yet countless people take the risk anyway, without knowing whether the physicians who will treat them are reputable.

A physician should be trained in the specific area of medicine that is appropriate for your procedure. For example, you should not be having plastic surgery from a surgeon who was trained to be a heart doctor. It isn’t good enough to be a physician, the physician must be trained in the specialty .

Prior to agreeing to surgery, you should also know your surgeon’s credentials : where they studied, where they trained, and in what specialty(s) they are board-certified. Do not rely on testimonials from previous patients; these are easily made up for a website and even if they are correct, one good surgery doesn’t mean they will all be successful.

Quality of Staff

Nurses are a very important part of healthcare, and the care they provide can mean the difference between a great outcome and a terrible one.

A well-trained nurse can identify a potential problem and fix it before it truly becomes an issue. A poorly trained nurse may not identify a problem until it is too late. The quality of the nursing staff will have a direct impact on your care.

Once again, it's important to research the hospital staff where you will be having your procedure done. Read the reviews but don't trust them blindly. If you can, seek out a recommendation from someone who can vouch for the medical staff where you will be going.

Quality of the Facility

While researching healthcare facilities for your procedure, you want to learn not just about the quality of the facilities themselves, but about the country's healthcare system as a whole.

In some countries, there is a marked distinction between public hospitals and private hospitals. In Turkey, for example, private hospitals are considered on-par with hospitals in the states, while many locals will advise you to steer clear of public hospitals if you can.

You will also want to seek out facilities that are internationally accredited. In the United States, the Joint Commission evaluates hospitals and certifies those that provide safe, quality care. The international division does the same for hospitals outside the United States.

Once you have a few options for potential facilities, you can start to investigate specifics. For one, you should find as many pictures and reviews of the facility as you can. Ask yourself whether the facility is state of the art or whether it seems dirty and outdated.

You will also need to find out if the facility has ICU level care available, in case something goes wrong. If not, there should be a major hospital nearby so that you can be transferred quickly.

To learn more about a healthcare facility, consider joining expat groups on social media for the city or country you will be traveling to. Ask the group for recommendations, or inquire about any positive or negative experiences they may have had at a particular facility.

Flying Home After Surgery

Any surgery comes with risks, including infection and blood clots . Flying home increases the risk of blood clots, especially on long-haul flights that are longer than four hours.

Try to avoid flying home in the days immediately after surgery; waiting a week will decrease the chances of developing a blood clot or another serious complication during the flight.

For longer flights, plan on getting up and walking up and down the aisles each hour to improve blood flow in your legs. You might also benefit from wearing compression socks with your doctor's approval.

If you are taking blood thinners or are at-risk of blood clots , be sure to talk to your doctor about how you can reduce your risk of blood clots after your procedure and while traveling.

Furthermore, you should know the symptoms of blood clots and stay alert.

Unplanned Illness

Any time you travel abroad, you run the risk of catching an illness that you have never been exposed to or that your body is not prepared to fight off. This is especially a concern when spending time in a foreign hospital.

If you have a sensitive stomach, you may also want to think long and hard about having surgery abroad. The food is often very different in foreign hospitals, and in some areas, there is a risk that even the water will be upsetting to your body.

Having diarrhea or postoperative nausea and vomiting makes for a miserable recovery experience, especially if you do not have a friend or family member nearby who can help you through it.

Before you travel abroad, check with your doctor to see if you need any vaccines to travel to your destination or if there are any foreign illnesses you should be aware of. Picking up an illness abroad, particularly after your surgery, can potentially be life-threatening.

Language Barriers

If you are having surgery in a country where English is not the primary language, you will need to make preparations in order to be able to communicate with the staff.

You may be pleasantly surprised to learn that the staff speaks your primary language well. If not, then you will need to consider how you will make your wishes and needs known to the surgeon, the staff, and others you will meet.

Whether you are at home or abroad, remember to speak up and advocate for yourself to make sure your needs are met. If you don't speak the local language, download a language translation app on your smartphone and don't hesitate to use it to communicate your needs. Hiring a translator is another option.

A Word About Transplant Tourism

Transplant tourism is one area of medical tourism that is strongly discouraged by organ and tissue transplant professionals in multiple countries. Most international transplants are considered “black market” surgeries that are not only poor in quality, but ethically and morally wrong.

China, for example, the country that is believed to perform more international kidney transplants than any other country, is widely believed to take organs from political prisoners after their execution.

In India, living donors are often promised large sums of money for their kidney donation, only to find out they have been scammed and never receive payment. Selling an organ in India is illegal, as it is in most areas of the world, so there is little recourse for the donor.

Then there is the final outcome: how well the organ works after the surgery is complete. With black market transplants, less care is often taken with matching the donor and recipient, which leads to high levels of rejection and a greater risk of death. Furthermore, the new organ may not have been screened for diseases such as cytomegalovirus , tuberculosis , hepatitis B , and hepatitis C . It is often the new disease that leads to death, rather than the organ rejection itself.

Finally, transplant surgeons are often reluctant to care for a patient who intentionally circumvented the donor process in the United States and received their transplant from an unknown physician.

It is important to arrange your follow-up care prior to leaving your home country.

Many physicians and surgeons are hesitant to take care of a patient who received care outside the country, as they are often unfamiliar with medical tourism and have concerns about the quality of care overseas.

Arranging for follow-up care before you leave will make it easier to transition to care at home without the stress of trying to find a physician after surgery .

Just be sure to inform your follow-up care physician where you are having your procedure done. After you return, they will also want to know what prescription medications you were given, if any.

What are popular countries for medical tourism? 

Mexico, India, Costa Rica, Turkey, Singapore, Canada, and Thailand are among the many countries that are popular for medical tourism.

How safe is medical tourism?

Medical tourism is generally considered safe, but it's critical to research the quality of care, physician training, and surgical specialties of each country. There are several medical tourism organizations that specialize in evaluating popular destinations for this purpose.

What countries have free healthcare? 

Countries with free healthcare include England, Canada, Thailand, Mexico, India, Sweden, South Korea, Israel, and many others.

A Word From Verywell

If you are considering medical tourism, discuss the risks and benefits with your doctor, and consider working with your insurance provider to arrange a trip that balances financial savings with safety. (Also, before you embark on a trip overseas for your procedure, make sure you are financially prepared for unexpected events and emergencies. Don't go abroad if you don't have enough money to get yourself home in a crisis.)

A medical tourism organization such as Patients Without Borders can help you evaluate the quality and trustworthiness of healthcare in various countries. Making sure a high level of care is readily available will lead to a safer, more relaxing experience.

Centers For Disease Control and Prevention. Medical Tourism: Getting medical care in another country . Updated October 23, 2017.

University of the Incarnate Word. Center for Medical Tourism Research .

Patients Beyond Borders. Facts and figures .

Kaiser Family Foundation. Health coverage of immigrants . Published July 2021.

Paul DP 3rd, Barker T, Watts AL, Messinger A, Coustasse A. Insurance companies adapting to trends by adopting medical tourism . Health Care Manag (Frederick). 2017 Oct/Dec;36(4):326-333. doi: 10.1097/HCM.0000000000000179

Batista BN. State of plastic surgery in Brazil .  Plast Reconstr Surg Glob Open . 2017 Dec;5(12):1627. doi:10.1097/GOX.0000000000001627

Johns Hopkins Bloomberg School of Public Health - Global Health Now. Brazilians' risky right to beauty . Published May 2018.

Chokrungvaranont P, Selvaggi G, Jindarak S, et al. The development of sex reassignment surgery in Thailand: a social perspective .  Sci World J . 2014 Mar;2014(1):1-5. doi:10.1155/2014/182981

The Joint Commission. For consumers .

Centers for Disease Control and Prevention. Blood clots and travel: what you need to know . Reviewed February 2021.

Hurley R. China harvested organs from political prisoners on substantial scale, says tribunal . BMJ . 2018 Dec;363(1):5250. doi:10.1136/bmj.k5250

Ambagtsheer F, Van Balen L. I'm not Sherlock Holmes: suspicions, secrecy, and silence of transplant professionals in the human organ trade . Euro J Criminol . 2019 Jan;17(6):764-783. doi:10.1177/1477370818825331

Centers for Disease Control and Prevention. Transplant Surgery. Key facts . Reviewed January 2019.

By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.

Medical tourism

• 1.1 Childbirth
• 2 Generic medications
• 3 Destinations
• 4 Important considerations
• 5 Stay safe

Typically, medical tourism involves residents of high-income countries seeking medical treatment in low-income countries; often the costs are much lower. The reverse also happens; residents of less-developed countries may travel to a place with more modern hospitals and better-trained staff.

Residents of countries with national health care schemes – such as Canada and Great Britain – may travel to avoid the long waiting times which elective procedures sometimes have in those countries. Others may travel for work not covered by insurance; many insurance schemes do not cover cosmetic surgery or gender reassignment operations, Canadian health care does not include dental, and so on. Also, couples are increasingly seeking fertility treatments abroad.

Residents of countries with heavily-regulated pharmaceutical and healthcare systems may seek treatments not approved within their home countries, but approved in countries with different regulatory systems. This includes exotic treatments with limited to no scientific backing. These instances of medical tourism can be highly risky, or serve as a last-ditch effort when other treatment options have been exhausted.

Availability of good low-cost medical services can also be a factor in selecting a destination for working abroad , studying abroad and especially retiring abroad .

Possible benefits [ edit ]

The most obvious benefit is lower cost of treatment. All the professional services — doctors, dentists, optometrists, physiotherapy, lab tests, hospitals, etc. — are generally cheaper in low-income countries. Many related items, such as eyeglasses, dentures or common drugs, are also usually cheaper. However items that have to be imported, such as dental implants or certain drugs, may actually be more expensive.

Many travelers incorporate a holiday along with the treatment as they may need time to recover after surgery or have their progress monitored through other treatment, and vacations also tend to be cheaper than vacations in their home country. Some even retire abroad in an area where they can get good cheap treatment.

Medical tourists sometimes can avail themselves of the best doctors and hospitals of a foreign country. The hospitals/clinics in medical tourist destinations may also be credentialed in first world countries and doctors are sometimes graduates of first-world medical schools.

Waiting lists are sometimes shorter in another country, for those with the means to pay. For example well-heeled Canadians may jump the queue at home by buying treatment in U.S. private hospitals, where specialised care can be had quickly – if money is no object.

Residents of jurisdictions which criminalise abortion may find their options less restricted elsewhere; for example, after the 2022 U.S. Supreme Court decision upholding state laws severely limiting the legality of abortion in some U.S. states, residents of the affected states immediately started traveling to other states for legal abortions. The same is happening across national borders.

Medical tourism also gives people a chance to incorporate local therapies — India's yoga and Ayruvedic medicine, Thai massage, traditional Chinese medicine, etc. — with their ongoing treatments.

Childbirth [ edit ]

If your country, or the country you're visiting, uses jus soli as a basis for citizenship, your child's birthplace will affect their eligibility for a passport. For instance, a citizen of Point Roberts , Washington who rushes to the nearest hospital to give birth is free to apply for baby's first Canadian passport with little more than their newly-minted British Columbia birth certificate ― even if they are not themselves Canadian. They may also want to visit their home country's embassy or high commission (in this case, the US consulate in Vancouver ) to register a birth abroad. Conversely, if a Mexican girl espouses a Canadian boy who was born abroad to parents serving in Canada's Cold War NATO deployment to Lahr , West Germany any of their children born abroad will not be Canadian citizens.

Birth tourism may allow a way around immigration laws or circumvention of mainland China 's one-child or two-child policies; jus soli countries (where anyone born in the country without diplomatic immunity is entitled to birthright citizenship) are the preferred destinations. The number of countries offering jus soli , especially on an unconditional basis, is dropping, but notably includes the United States and Canada . Australia for example abandoned unconditional jus soli in 1986, as did Ireland and France. Outside the Americas, jus sanguinis (citizenship by "blood" or descent) is most common. Some countries offer conditional jus soli ; Australia and the United Kingdom offer jus soli if at least one parent is a legal permanent resident at the time of the child's birth, while China offers jus soli if both parents are stateless and legally settled in China at the time of the child's birth.

In some cases, the foreign hospital or medical facility is actually geographically closer. This can have unintended consequences; many Campobello Island ( New Brunswick ) kids have Maine birth certificates as it's the only point reachable year-round by bridge, but that dual citizenship leaves these "border babies" liable for U.S. income taxes for life while living as Canadian citizens in Canada . A few decades back when the US military used conscription, these kids could be drafted.

Generic medications [ edit ]

Another reason for seeking treatment abroad can be the lower cost or better availability of some medications.

One conspicuous example is Americans going to Canada to obtain insulin at roughly a tenth of the US price. There may be complications; getting a prescription from a Canadian doctor may not be either quick or cheap, getting a Canadian pharmacy to fill a US prescription might require extra documentation, a prescription might not cover a long-term supply, and if you do get, say, a six-month supply then you need to worry about shelf life. Your doctor is likely the best source of advice.

As a general rule common drugs, e.g. most things on the WHO list of essential medicines , will be considerably cheaper in low-income countries. On the other hand, imported items such as dental implants and newer or more unusual drugs are often more expensive. There may also be differences in prescription rules; for example in China, Viagra (or a Chinese copy?) and many antibiotics are available over-the-counter.

In the Philippines, Viagra and Cialis are often sold by vendors walking around tourist areas; the same guys have items with obviously bogus Rolex and Rayban labels, so while they are cheap (about a dollar a pill if you bargain well), buying drugs from them may be quite risky. Caution is required here since these drugs affect the circulatory system and can be quite dangerous for some men; talk to a doctor if you are considering them.

One blatant example of an enormous price difference is Harvoni (ledipasvir/sofosbuvir) for treating Hepatitis C. Previous treatments involved injections, often had quite nasty side effects, and gave only about a 60% chance of curing the disease; Harvoni was the first (about 2011) of a new generation of drugs that are taken by mouth, have fewer side effects, and cure well over 90% of patients. Unfortunately, in the US it is patented and sells for about $1000 a pill, over $80,000 for the usual treatment of 12 weeks at one pill a day. At least two other drugs with similar properties are now on the market and cost less, but still in the tens of thousands. Many insurance schemes — including the British National Health, Canadian provinces, and many insurers in the U.S. — will not pay for these treatments unless you are desperately ill, so some patients go untreated and may spread the disease.

India refused to grant the Harvoni patent on grounds it contained no significant original work — the key part of the research was done at a British university — and in India the whole 12-week course of treatment costs about $1000. This is not some dubious knock-off from a 'pirate' vendor; the Indian companies involved are large and reputable, and are licensed by the original developer. A 12-week vacation in India, including air fare, good hotels, and Harvoni treatment might cost roughly what the treatment alone would in the US or Europe, and other countries such as Egypt and Bangladesh also have Harvoni at low cost.

For other things, the issue may be availability rather than cost. It can take years for a new or experimental treatment to prove its worth and obtain regulatory approval, and it may be approved in some countries long before others. The dengue fever vaccine , for example, was approved in Mexico , Brazil and the Philippines in late 2015 but in the US not until 2019. Cuba has a lung cancer treatment called CimaVax that (as of mid-2017) is available only there and in a few other Latin American countries; other countries are running tests but are unlikely to approve it soon. Such treatments do have some scientific evidence of safety and effectiveness, but they should be considered risky since they have not yet undergone the full analysis required for worldwide approval. Again, consult your own doctor or an appropriate specialist at home.

Beware of bogus treatments which may be on offer in countries with weak regulations, poor enforcement, or easily bribed officials. A conspicuous example is laetrile or amygdalin , a purported cancer cure that is both ineffective and dangerous but vigorously marketed. Some quacks offering it have been prosecuted in the US, and at least one has set up a clinic in Mexico. A general rule is that if any "miracle cure" makes claims that seem too good to be true, then it is almost certain that they are indeed not true. Beyond that, check with your own doctor.

Destinations [ edit ]

Some popular medical tourism destinations worldwide are:

• Argentina : Russian birth tourists who used to take Miami , Florida for granted as a flag of convenience have started turning up in Buenos Aires as one of the few Western locations where Russian flights (and their passengers) are not rapidly becoming persona non grata in the wake of the Russian Federation's unprovoked 2022 invasion of Ukraine . Visa requirements are lax in comparison to Canada , the United States of America or other popular destinations; the medical care is good and an Argentine-born child gives the parents an easier path to applying to immigrate to Argentina.
• Costa Rica : Joint Commission International accredited private hospitals, state-of-the-art-equipment, proximity to the United States and Canada, English-speaking medical personnel, highly trained doctors, dentists, oral surgeons, and cosmetic surgeons with costs generally up to 70% of what would be paid in the United States.
• Greece : Greece is becoming increasingly popular as a destination for high-quality cosmetic surgery especially for patients from the United Kingdom. Because Greece is a member of the European Union, its health industry is kept to a good standard and under thorough checks and safety regulations. In the private sector the Metropolitan Hospital in Athens is regarded as being the best in Greece, and the plastic surgeons associated with that hospital are among the best. Greece is also traditionally regarded as a popular tourist destination and therefore its tourism and service sectors are well-developed. The widespread knowledge of English language among the general population is also an advantage.
• India : Especially for heart surgery, hip resurfacing, dental, cosmetic surgery and high end surgeries. English as a primary language is also an advantage.
• Singapore : Has highly accredited hospitals and a very high-quality infrastructure, but more expensive than its neighbours Malaysia and Thailand
• Thailand : Low labour costs resulting in lower treatment costs. Some Thai hospitals have a lot of experience with gender reassignment surgery.
• Hong Kong : High quality infrastructure and good quality doctors with high English proficiency.
• Mexico : Dental care is the best deal here. Because Mexico borders the United States, Americans in border states visit for dental care and minor checks out of convenience. The quality in Private Clinics and Hospitals is just about the same as in the U.S. Los Algodones , on the border with Arizona and California, is so well-known for dental tourism that it's been nicknamed "Molar City". Prescriptions, eyeglasses, cosmetic surgery, and even major surgeries will all cost significantly less in Mexico than in the U.S. (or other countries). Pharmacies catering to Americans are common in Tijuana and border cities near Texas . Mexican pharmacies often charge 90% less than U.S. pharmacies. The Farmacias Similares chain specializes in even cheaper generics. Some medications that require prescriptions in the U.S. can be purchased over the counter in Mexico.
• Turkey : Istanbul is inexpensive by US and European standards for in vitro fertilization, optometry, cardiology and cosmetic procedures such as hair transplants.
• South Korea : Known for being the world leader in cosmetic surgery.
• United States : By far the world's leading nation in medical research, with the most cutting-edge treatment methods and infrastructure available to those who can afford it. The downside is that consultation and treatment costs are the highest in the world. Also a popular birth tourism destination due to the fact that all people born in the U.S. (other than those whose parents are on diplomatic posting) are automatically granted citizenship under the US 14th Amendment. Saipan , Northern Mariana Islands is popular for visitors from China as its visa policies are more lax than the continental US .
• United Kingdom : If you can afford it, Harley Street in London remains an area where medical specialists can be consulted for a substantial fee.
• Canada : With a high standard but significantly lower cost, Canada is a popular medical tourism destination for Americans living near the border. While foreigners are not covered by Canada's universal healthcare system, the cost of drugs in Canada, even uninsured, can be as low as 1 ⁄ 10 the price in the United States.

– and more recently, Brazil , Brunei , Colombia , Cuba , Malaysia , the Philippines , South Africa , Qatar and the United Arab Emirates

Important considerations [ edit ]

First, consider whether the treatment you are planning is the right for you. If you were denied the treatment, the denial may have had a good reason. Are you sure it will help you? What risks are there? Have you gone through all preliminary examinations or will they be done at the destination? Will the hospital back off if they find that you, in fact, shouldn't be treated in the planned way? Do you need to commit to lifestyle changes or training programmes that will continue after your return? If so, you should have the needed support at home.

Be sure you are allowing enough time in your travel to receive follow up care. You may need to stay days or weeks beyond the date of the medical procedure itself. Be realistic about the finances of medical tourism. Sure the medical treatment itself may be cheap. But when you add on airfare, hotels, taxis, restaurants – all in an unfamiliar city – the actual cost may be close to what you would pay at home.

Next, involve your home doctor in your plans! Having major surgery in a faraway country is not a decision you should take lightly. Research – what sort of questions should you ask your doctor about this procedure? How is the procedure typically performed, and will it be done this way where you travel? Who credentials doctors and hospitals in your destination country, and what credentials do your intended providers have? You should also determine what level of follow up care your procedure may require – in the days, weeks, and even years after the procedure. Who will provide this follow up care?

If a specialised procedure entails possible medical complications, your budget should permit a follow-up trip to your distant specialist.

Not all medical tourism is enjoyed by patients travelling away from their home country, or travelling to a third world region. For instance, migraine surgery is performed only in the US, and attracts patients from the Middle East and Africa, since their surgeons aren't able to perform this. If you are considering travel from within your country or outside of it, be sure to explore all of your options. Seek assistance from many sources in locating the right doctor and the right country.

Don't be surprised if insurance which would have fully paid for a medical procedure at home refuses to cover (or only partially covers) the same treatment abroad. Even within the same country, some provincial health insurance plans only reimburse what they would have paid in-province, leaving the traveller out-of-pocket. Insurers are also likely to refuse to cover transportation. Border crossing can also be complicated by the need to carry prescribed medicines; a prescription validly issued by a practitioner in one country may be meaningless in another.

Patients seeking treatment for mental health conditions , communicable disease or street drug addiction may encounter issues with immigration authorities if travelling internationally. "I'm Toronto mayor Rob Ford and I'd like to see a Chicago doctor about my crack cocaine problem" is the wrong thing to tell the US border patrol, unless the intention is to immediately turn back to seek medical treatment in-province. Gravenhurst is charming this time of year?

Consider the languages you speak and what is spoken in your country. In some countries, such as Singapore, Malaysia, India, the Philippines and South Africa, most educated people speak English. This can be an important consideration. Having a common language is not necessarily enough, though, if it is not the native tongue for both of you ("fluently" can mean different things), or you or the personnel speak it with a strong accent or with a strange jargon. There may be subtle nuances you'd better be able to convey and understand.

Make sure that you will get sufficient documentation on the treatment, such that it can be used for follow-up care at home.

Lastly confirm, and double check, your plans. How can you contact family members while abroad? Do you need a special visa or proof of ability to afford treatment in order to enter your destination country?

Stay safe [ edit ]

In the past, some discredited or bogus doctors set up shop outside U.S. borders to promote dubious or dangerous treatments or outright scams (alleged cures for cancer, lengthening body parts, etc.). Medical tourism today is far removed from these scammers but one must still be vigilant. At the very least, see a trusted doctor in your home country and discuss your plans for overseas treatment.

Reputation counts in medical treatment overseas. Look for top quality hospitals and clinics with well known doctors.

If anything goes wrong, don't be surprised if your local doctor is reticent to do anything to attempt to "fix" the work done by your foreign practitioner. This is a medical liability issue; local doctors fear lawsuits if an attempt to repair another surgeon's bungled procedure makes things worse.

Realize that, should a worst-case scenario occur, your legal avenues for making a malpractice claim or filing a lawsuit will be greatly reduced and often nonexistent. Freedom from frivolous lawsuits and huge insurance premiums are one reason why some doctors choose to practice overseas and can offer low cost treatments. On the other hand, this type of legal environment makes seeking doctors of good reputation all the more important.

Travellers might be impaired during recovery; see travellers with disabilities .

See also [ edit ]

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Medical tourism

People traveling abroad to obtain medical treatment / from wikipedia, the free encyclopedia, dear wikiwand ai, let's keep it short by simply answering these key questions:.

Can you list the top facts and stats about Medical tourism?

Summarize this article for a 10 year old

Medical tourism refers to people traveling abroad to obtain medical treatment. In the past, this usually referred to those who traveled from less-developed countries to major medical centers in highly developed countries for treatment unavailable at home. [1] [2] However, in recent years it may equally refer to those from developed countries who travel to developing countries for lower-priced medical treatments. With differences between the medical agencies, such as the Food and Drug Administration (FDA) or the European Medicines Agency (EMA), etc., which decide whether a drug is approved in their country or region, or not, the motivation may be also for medical services unavailable or non-licensed in the home country.

Medical tourism most often is for surgeries (cosmetic or otherwise) or similar treatments, though people also travel for dental tourism or fertility tourism . [3] People with rare conditions may travel to countries where the treatment is better understood. However, almost all types of health care are available, including psychiatry , alternative medicine, convalescent care, and even burial services.

Health tourism is a wider term for travel that focuses on medical treatments and the use of healthcare services. It covers a wide field of health-oriented tourism ranging from preventive and health-conductive treatment to rehabilitational and curative forms of travel. Wellness tourism is a related field.

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Medical Tourism Patient Survey

The Medical Tourism Association, in collaboration with the International Healthcare Research Center, has gathered critical insights into why patients are increasingly choosing to travel for medical care. This comprehensive 31-page report sheds light on the decision-making process, motivations, and concerns of medical tourists, focusing on aspects like the search for superior medical expertise, trust in healthcare providers, cost-effectiveness, and the appeal of innovative treatments. These findings are crucial for healthcare providers looking to tailor their services to meet the evolving needs and expectations of patients globally, ensuring not only the highest standards of care but also building the essential trust and confidence that underpins the decision to seek medical treatment abroad.

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MedicalTourism.com is a free, confidential, independent resource for patients and industry providers. Our mission is to provide a central portal where patients, medical tourism providers, hospitals, clinics, employers, and insurance companies can all find the information they need. Our site focuses on patients looking for specific knowledge in the fields of medical tourism, dental tourism, and health tourism.

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Interested in a particular destination? Check out our destinations guides with detailed information: from tourist attractions, restaurants, and hotels to top-ranked healthcare providers and doctors.

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Frequently Asked Questions (FAQ)

Your particular lifestyle, the medical tourism destination, and the type of medical tourism procedure you will be undergoing will dictate, to a large degree, how much money you will be spending. In general, the farther away your medical tourism destination the more you will pay for airfare. So, for example, expect to pay more if you are flying from Dallas to Bangkok, Thailand, than you would for a flight to Monterey, Mexico. At the same time, you also need to take into account that some medical tourism destinations are more expensive than others. So even if a particular country is cheaper to travel to, you will need to factor in the relative cost of “living,” in comparison to another medical tourism destination.

What about your lifestyle preferences? Do you plan to stay at a five-star hotel or are you comfortable “roughing” it at a local bed and breakfast? Some adventurous souls prefer to immerse themselves in the local culture and will literally live on a shoestring budget. Most everyone else though will tend to fall somewhere between the Holiday Inn and Club Med. The type of medical tourism procedure or medical tourism treatment you are undergoing will also play a large part in your decision of where to stay and what you will do. A medical tourism patient undergoing open heart surgery or a knee replacement will require extra care and very comfortable conditions after leaving the hospital. Not the case for someone coming for a dental bridge or an eyelid lift. Wherever you decide to stay, make sure it serves your needs as a medical tourism patient.

Many of the expenses of a medical tourism trip will be the same as those of a “normal” trip or vacation. At the very minimum you will need to budget for airfare, hotel accommodations, transportation requirements and meals. Sightseeing tours and souvenirs are also a real possibility, particularly if you are traveling with a companion.

Although there are many benefits associated with medical tourism, there are also certain risks that must be weighed before making a final decision to travel abroad.

Varying standards and Medical Tourism

Varying standards with regards to hospitals and physicians can be a problem if you are searching for options within multiple countries with dozens of hospitals. Each country will have its own licensing and certification protocols which may vary significantly from your own country. As you have no way of actually visiting the hospital or meeting the physician prior to your trip, you will have to do research to make sure hospitals are accredited and surgeons are licensed. MedicalTourism.com offers a wealth of information and tools that will make this job much easier.

Travel after surgery

Traveling long distances after surgery also poses certain risks such as deep vein thrombosis (DVT) and pulmonary embolism. DVT may be defined as a blood clot that forms in a vein deep in the body. If the blood clot breaks off and travels through the blood stream to the lungs, a pulmonary embolism may occur which is potentially fatal. Using simple preventive measures, however, medical tourism patients can reduce the chance of blood clotting and increase their likelihood of surgical success.

The Centers for Disease Control and Prevention (CDC) recommends:

• Getting up and walking around every 2 to 3 hours.

• Exercise your legs while you’re sitting

• Drink plenty of water, and avoid drinking anything with alcohol or caffeine in it.

Additionally, medical compression stockings and anti-clotting medications such as Warfarin and Heparin, may be prescribed by physicians for high risk medical tourism patients.

Minimal legal recourse in case something goes wrong

It is important to remember that if you do have a serious complication, other countries' malpractice and liability recourses may be different from those in your own country. Also keep in mind that some hospitals may require a medical tourism patient to sign a legal waiver stating that if they do file a lawsuit over the surgery, the lawsuit must be adjudicated in the country where the medical procedure was performed.  

Coordinating appropriate aftercare once you come home

This is one the biggest concerns for medical tourism patients considering traveling abroad for surgery. What happens if I have a complication once I return home? Who will I turn to? Will my doctor even see me? These are valid questions that must be addressed by the hospital you are seeking care at.

Make sure to inform your primary physician that you will be going overseas and try to get him or her involved in the process. You may also want to try and schedule a call between your primary physician and your international doctor to discuss your case.  This is wise not only at a medical level (you want your international physician to know as much as possible about your case history), but also has the potential to establish trust between both parties, making your physician empathetic toward your situation and wanting to be an active participant in the success of your procedure.

Presently, and in order to minimize potential complications, many international hospitals and physicians do maintain close contact with their medical tourism patients once they have returned home. Therefore, you should not feel shy about contacting them if you feel something is wrong. At the very least your overseas physician can offer recommendations about what medications to take, who to see, or possibly even explain details of your condition to another doctor.

In medical tourism, a Familiarization Tour or Fam Trip is a trip organized by a public or private entity seeking to showcase the healthcare and tourism assets in a certain region, country or city, in order to attract new business (usually in the form of patients). Fam trips are often organized by the tourism board, medical tourism cluster, or by a Destination Management Organization (DMO) representing a destination. Participants in the Fam trip are typically buyers of medical tourism services such as foreign governments, insurance companies, employers and medical tourism facilitators. They are vetted in advance and usually have all their travel, accommodation and maintenance fees covered during the trip.

Sometimes referred to as medical tourism agencies, or a medical travel facilitator, these are companies that, as their name suggests, act as facilitators or intermediaries for patients seeking treatments in other countries or regions.

Medical Tourism Facilitators have played an important role in promoting the growth of medical tourism, and for many medical tourism patients, represent their first face to face contact with the concept of medical tourism.

Over the last 10-15 years, thousands of these companies have popped up, most sporting names synonymous with health and travel. They function much like a travel agency, requesting and obtaining passports, booking flights, and arranging a medical tourism patient’s lodging, transportation and tours. The key difference, of course, is that they also serve as the liaison or mediator between you and the international hospital and doctor. In effect, it is the facilitator’s job to repackage the medical provider’s service offering, make it more appealing, and then guide you along the medical tourism process.

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Medical Tourism

The allure of american healthcare: an overview of inbound medical tourism to the united states.

Inbound medical tourism to the United States has been growing rapidly in recent years, as more and more foreign patients seek high-quality medical care in the world's leading economy. According to a report by Patients Beyond Borders, the US is the top destination for inbound medical tourism, attracting more than 1.4 million patients annually and generating over $14 billion in revenue. In this article, we'll explore the benefits and challenges of inbound medical tourism to the US, the most popular procedures and destinations, and the impact of COVID-19 on the industry.

Benefits of Inbound Medical Tourism to the United States

Inbound medical tourism to the US has several benefits for both healthcare providers and foreign patients. For healthcare providers, it can generate significant revenue and boost their reputation in the global medical community. For foreign patients, it provides access to high-quality medical care that may not be available or affordable in their home countries.

One of the biggest advantages of inbound medical tourism to the US is the high level of quality and safety in American healthcare. The US is home to some of the most prestigious hospitals, medical centers, and healthcare professionals in the world, with cutting-edge technology and a focus on patient-centered care. Foreign patients are attracted to the US for medical treatment because of the reputation of American healthcare, and many choose to return for follow-up care or other medical procedures.

Challenges of Inbound Medical Tourism to the United States

While inbound medical tourism to the US has many benefits, it also presents several challenges. Healthcare providers and destinations need to be aware of these challenges in order to attract and accommodate foreign patients successfully.

One of the biggest challenges is the cost of medical care in the US, which can be significantly higher than in other countries. Foreign patients may be willing to pay more for high-quality medical care, but they still need to be able to afford the procedures they require. Healthcare providers need to be able to offer competitive pricing while still maintaining their quality standards.

Another challenge is the complexity of the US healthcare system, which can be difficult for foreign patients to navigate. Healthcare providers and destinations need to be able to provide clear and concise information about their services, pricing, and procedures to foreign patients in their native languages. They also need to be able to offer support and assistance throughout the entire process, from booking appointments to follow-up care.

Popular Procedures and Destinations for Inbound Medical Tourism to the United States

Inbound medical tourism to the US covers a wide range of medical procedures and destinations. According to Patients Beyond Borders, the most popular procedures for foreign patients in the US are:

• Cancer treatment
• Cosmetic surgery
• Orthopedics

The most popular destinations for inbound medical tourism to the US include:

The Impact of COVID-19 on Inbound Medical Tourism to the United States

The COVID-19 pandemic has had a significant impact on inbound medical tourism to the US, with many foreign patients unable or unwilling to travel due to travel restrictions and health concerns. According to a report by Global Healthcare Resources, inbound medical tourism to the US dropped by more than 60% in 2020 due to the pandemic.

However, as vaccination rates increase and travel restrictions are lifted, there is hope that inbound medical tourism to the US will rebound in the coming months and years. Healthcare providers and destinations need to be prepared to adapt to the new normal of the post-COVID world, with enhanced safety protocols, telemedicine services, and other measures in place to ensure the safety and well-being of both foreign patients and healthcare professionals.

Working with Global Healthcare Resources to Attract More Foreign Patients to the US

If you're a healthcare provider or destination looking to attract more foreign patients to the US for medical treatment, working with a healthcare consulting firm like Global Healthcare Resources can help you navigate the complex world of inbound medical tourism.

Global Healthcare Resources offers a wide range of consulting services for healthcare providers and destinations, including market research, business planning, marketing and management, and more. With our expertise and experience in the inbound medical tourism industry, we can help you attract more foreign patients, enhance your reputation, and generate more revenue for your healthcare services.

Inbound medical tourism to the United States is a growing industry with many benefits for both healthcare providers and foreign patients. While it presents several challenges, healthcare providers and destinations can overcome these challenges by offering competitive pricing, clear and concise information, and high-quality medical care and services. With the help of a healthcare consulting firm like Global Healthcare Resources, healthcare providers and destinations can tap into the lucrative inbound medical tourism market and succeed in the global healthcare industry.

If you're interested in learning more about how Global Healthcare Resources can help you attract more foreign patients to your healthcare destination or services, visit our website at https://www.globalhealthcareresources.com/medical-tourism-consulting . Contact us today to learn more about our consulting services and how we can help you tap into the growing inbound medical tourism market in the US.

Exploring the Surge of Cosmetic Tourism: Trends and Considerations in Aesthetic Procedures Abroad

Holistic healing: exploring integrative medicine and wellness retreats, meeting the surge: the growing demand for knee replacement surgeries and advances in the field, innovations in medical technology: how cutting-edge technology drives medical tourism, stem cells have powerful anti-aging properties, new shift for thailand’s medical travel landscape as mta launches new moves, continue reading, best countries for stomach cancer treatment: a global perspective, ponderas academic hospital: elevating medical tourism with jci accreditation and personalized care, brno and south moravia - a hidden treasure of central europe, featured reading, dominican republic’s giant strides to becoming a global leader in medical tourism, exploring niche markets in medical tourism, medical tourism magazine.

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Medical tourism: A passport to wellness

The ups and downs of traveling abroad for health care.

By Ethan Bauer

Every year, millions travel abroad seeking health care they can afford. “Medical tourism” is an estimated $92 billion industry that is growing by 15-25 percent each year, promising cheaper access to dental implants, plastic surgery, fertility assistance and even exotic cancer treatments — and doubles as something like a vacation to countries like Thailand or Mexico. The practice has become common around the world, but it’s particularly cost-effective here; the average American pays more than $12,500 on health care each year, outpacing the citizens of any other wealthy nation by $4,000. Some insurance companies have embraced the practice, too, but the savings come along with new risks and potential complications. Is medical tourism a boon for the marketplace, or a symptom of something rotten?

Free-market triumph

Access to doctors and clinics abroad empowers Americans to make the best choices for their own health by introducing competition to a stagnant system, dramatically expanding a growing range of options. Consumers can save up to 80 percent of what they’d pay at home, according to Patients Beyond Borders, a North Carolina company that promotes the practice. For many, these savings constitute a lifeline.

“Our market has always been what I call the ‘working poor’ and they just keep getting poorer,” Josef Woodman, the company’s CEO, told The New York Times in 2021. “The pandemic has gutted low-income and middle-class people around the world, and for many of them the reality is that they have to travel to access affordable health care.” The differences in cost are most salient for elective procedures, like plastic surgery, fertility treatment and dental work, which are not usually covered by insurance.

Institutions and corporations can also benefit from even a quick jaunt into a neighboring country. In Utah, the public trust that insures state employees offers a “pharmacy tourism program,” flying clients to San Diego and shuttling them across the border to buy low-cost prescription drugs in Tijuana, Mexico. Or if they prefer, they can choose to travel to Vancouver, Canada. In 2021, researchers at the University of Chicago argued that even medical tourism to other markets within the United States could be the most cost-effective way to fill the gap left by vanishing rural hospitals. Less glamorous, perhaps, but utilitarian.

Some patients travel for personal reasons, like getting access to cutting-edge treatments or privacy for elective procedures like cosmetic surgery. “Many can return home from their ‘vacation’ without anyone knowing they had a procedure at all,” writes one registered nurse for the physician-reviewed health website Verywell Health. Others may travel for treatments that aren’t approved or allowed in the U.S., like stem cell therapy or other experimental procedures.

Despite the inevitable hand-wringing over quality of care, the independent nonprofit The Joint Commission has recognized over 1,000 medical facilities worldwide that meet its standards. The same organization has accredited American hospitals since 1951 and is the largest health care accreditor in the nation, so its approval carries weight.

Systemic failure

Medical tourism is an indictment of our nation’s health care system, masked in pleasant terminology. “I prefer the term ‘outward medical travel,’” writes MSNBC health columnist Dr. Esther Choo, “and would argue that (this industry) should remind us of how inaccessible health care is here and the lengths to which people will go to get the care they want or need.” Patients may not realize what they’re risking, whether at their own initiative or nudged by insurance providers. “Quality and safety standards, licensure, credentialing and clinical criteria for receiving procedures are not consistent across countries and hospitals.”

These are not academic concerns, but vital issues with life-threatening consequences. One analysis from the Centers for Disease Control and Prevention found that 93 Americans died between 2009 and 2022 due to complications from botched cosmetic surgeries in the Dominican Republic alone. The federal agency has also found outbreaks of antibiotic-resistant bacteria that were linked to medical tourism in Mexico and warns that the most common complications among medical tourists are infections.

Medical tourists seeking access to treatments that have not been tested and approved by regulatory agencies in the U.S. may not be aware of the risks they are taking with a practice that researchers at Canada’s Simon Fraser University call “circumvention tourism.” They warn of potentially enormous pitfalls, from shattered hopes to money-sucking quackery. “Individuals may be desperate for a cure and vulnerable to engaging in decision-making that’s predicated on hope,” they write, “without a full understanding of the likelihood of success.”

Perhaps the most common problems are the most obvious: Patients are traveling far from home to get treatment from doctors who cannot participate in long-term follow-up, often coming up against linguistic and cultural challenges. Much more prevalent than the risk of getting targeted by opportunistic criminals are these impediments to communicate their needs. “It might be a no-brainer,” observes Henry Ford Health, one of the largest health care companies in Michigan, “but if you don’t speak the local language, it might be difficult to explain any feelings of discomfort or apprehension as they come up.”

This story appears in the April 2024 issue of Deseret Magazine . Learn more about how to subscribe .

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Medical Tourism

I n this issue of the journal , D r . S aleh Al-Hinai and colleagues have published their results on a survey studying the medical tourism patterns of patients going abroad from the Al-Dakhilya Region of Oman. 1 They managed to obtain 40 responses to the 45 questionnaires they distributed. Basically, most of the results they obtained from the patients in their region who had sought treatment abroad were similar to those of other studies: 10% of the respondents went for treatment plus tourism, and 2.5% were healthy. Strikingly, 15% of the patients experienced complications after their treatment abroad and this is not an unusual finding in the literature. Only a few of the patient’s in Al-Hinai’s study used the Internet and the available medical tourism offices to obtain information on treatment abroad options instead the majority relied on word of mouth advice from friends. Most of the patients went to Thailand, and orthopaedic conditions were the most common indication for these patients to seek treatment abroad. This article is of special interest to Oman and should stimulate discussion on the advantages and disadvantages of going abroad for medical services. What are its advantages and disadvantages to the patients, and to Omani health services? Likewise, what are the advantages and the disadvantages to the host country?

Medical tourism is part of health tourism and it has a long-standing history, going back to thousands of years. Records show that in Greece, thousands of years ago, patients came to the healing god Asklepios in Epidauria. 2 At the same time in other countries, people used to travel to therapeutic spas and collect waters from holy shrines. Much more recently, in the 18th century, health spas were a common feature of medical tourism. Health tourism, which includes medical tourism, is generally defined as organised travel outside one’s local environment for the maintenance, enhancement, or restoration of an individual’s well-being in mind and body. 3 Medical tourism is regarded as more organised travel outside one’s natural health care jurisdiction. 4 Typically it is linked with engagement in leisure, businesses and other purposes. 5

There are several types of medical tourism, and they are classified in many ways. One such classification includes: 1) “Temporary visitors abroad” who go for either check-up or treatment; 2) “Long-term residents” e.g. people who move to a location better for their health like many Americans who go to Florida or the Caribbean; 3) “Medical tourist, from 2 adjacent countries who share common borders” and have agreed upon sharing health care, and 4) “Outsourced patients”—these are patients who are sent abroad by their government, as the neither necessary treatment nor the specialist is available locally. This last definition fits many Omani patients.

Why do patients go abroad? Jagyasi gave 5 major “factors” involved in decision making: affordable, accessible, available, acceptable and additional . 5 Affordable is probably the major reason and this is particularly true for patients from the well-off, developed countries like America and UK, where private health care is expensive, and some surgeries are not covered by their insurance. Available is often because the medical treatment they need is not available in their local areas or not trusted by the patients, as is often the case with Omani patients. Accessible applies more particularly to patients from countries where the waiting list is long, particularly to national health service patients in the UK and in Canada. In the UK, private health care may be available locally, but is expensive. Acceptable applies to services, which may be affordable, available, and accessible, but they are not acceptable in the patient’s own country for religious, political reasons or other social reasons. Additional refers to the availability of better care, perhaps better technology, or a better specialist, or simply better service and personalised care abroad compared to care in the home country.

There are several reasons, related to above, why patients choose to become medical tourists. For the Americans and Europeans the attraction is value, i.e. affordability. For example the price of a coronary artery bypass graft (CABG) is $113,000 in the USA, but only $10,000 in India; heart valve replacements cost $150,000 in USA, but $9,500 in India, and knee replacements cost $48,000 in the States, but only $8,500 in India. 2 Most references quote the prices of surgery in India, Thailand and Singapore as only 5% to 10% of the prices in the USA. 6 A forecast by Deloitte Consulting published in August 2008 projected that medical tourism originating in the US could jump by a factor of 10 over the next decade. 2

However, besides the financial benefit, there are other advantages for a patient to have treatment abroad in a centre of excellence for certain conditions. Many of the countries seeking to develop medical tourism invite specialists from well-known health care centres such as Columbia and Cleveland Clinic, Mayo Clinic, Harvard Medical International, and are thus able to offer excellent medical care. Many of them are encouraged and supported by their host governments, e.g. India has introduced a special M-Visa category for medical tourists. 7 Malaysia’s Ministry of Health has formed a special national committee for the promotion of health tourism. This has contributed to the reversal of the geographical trend of medical tourism. In the past, patients from the east were travelling to the west to get the best medical treatment. Now, patients from Western developed countries, travel east to developing countries for the best medical and technologically advanced health care. Eastern Europe has now joined the bandwagon including Hungary and Poland which are popular for dental work.

However, there are several problems with medical tourism as discussed by several agencies and scholars. 8 , 9 These include poor or no follow-up care. After being in hospital for a short while and having a vacation, the patient comes home with, perhaps, complications of the surgery or side effects of the drugs. It is a surgical principle that every surgeon looks after his own complications and obviously that does not apply for most if not all patients who have been treated abroad. Many countries have very weak malpractice laws and thus patients have limited ability to complain about poor medical care. Medical tourism also affects the host countries with the problem of internal brain drain, whereby all good doctors give up serving the public sector to go into the exotic, private health centres, which serve the medical tourists. Thailand’s Bumrungrad Hospital, which treats about more than half a million international patients a year, is a major source of internal brain drain, leading to a political discussion within Thailand and a National Public Radio (NPR, USA) special programme on the shortage of Thai doctors in Bangkok because of the higher pay offered by Bumrungrad. 10 Thus, globalisation impacts world health care, both in the host and the donor countries. 3

There are other risks which medical tourism poses to patients. For example, patients may not tolerate travel very well, or may not have inherent resistance to some of the diseases in the host countries. 6 We therefore need to have better scientific studies on the impact of medical tourism on the health care services of the source and destination countries as well as on the patients themselves. We need more statistics on the rate of complications. The article in this issue of this journal reported a 15% complication rate; 1 granted we do not know how severe those complications were, but that is what needs to be studied. A survey was carried out by the British Association of Plastic, Reconstructive and Aesthetic Surgery. They received responses from 203 out of 325 members. 4 A total of 37% of them had seen a patient in the National Health Service with complications arising from overseas cosmetic surgery. In another survey in the UK, 60% of complications were of emergency nature requiring inpatient admission. 4 Americans and Europeans now realise that they need to analyse the impact of medical tourism—beneficent or maleficent—on the patients and the country’s health care system.

Many medical tourists are satisfied, but satisfaction does not always parallel good outcome. Often satisfaction can simply be a result of good service. It is of special interest to note that “outsourced patients,” those who were sent by the government are often dissatisfied with the total experience compared to the true self-financed medical tourist. 4 That is why an institution has to be accredited for good medical care with a good quality assurance programme rather than just good service. Now more and more of the provider institutions try for accreditation by either the Joint Commission International (JCI) or Trent or for Canadian accreditation. The JCI has accredited Wockhardt Hospital in India and several other institutions.

Patients going abroad need to get good advice. According to the World Tourism Organization’s Global Code of Ethics for Tourism, tourists should have the same rights as citizens of destination countries. 11 Unfortunately, that is not always the case and that is another potential source of problems. For example, personal data is stored electronically and may not be treated as confidentially as the patients have a right to expect. We have no control over that when patients go abroad. Another major problem is informed consent, is it always informed?

A further potential significant problem with medical tourism is that sometimes it impacts the source country’s health care system. A source country may become complacent by being able to send its citizens abroad for certain procedures and thus fail to develop the appropriate national services. The development of positron emission tomography (PET) in Oman is an example of this. This has been delayed for years now as patients are simply sent abroad for PET imaging. Sending patients abroad is not only costly to the government, but it also dilutes the political support and the will to develop certain essential national services. This situation often helps create a 2-tier system in the destination country whereby the local population receives second-class treatment while medical tourist gets much better treatment in the more sophisticated, well-equipped, state-of-the-art hospitals.

Among the disadvantages of medical tourism is the one related to health insurance companies, who may refuse to cover a patient going abroad for legitimate reasons, or may actually encourage patients to go abroad if the treatment is cheaper, but then not cover the airfare and other expenses. The other side of the coin is that there is now pressure on insurance companies to cover the cost of all overseas treatment and this may mean raising premiums—yet another negative side to medical tourism for some patients.

The organisations that provide accreditation need to consult with each other and establish a uniform, or at least a fairly similar level of accreditation to ensure that the patient is the winner. They can do that only if they share experiences, ideas and methodology. One of the problems of medical tourism is that it generally raises the cost of health care in the host country. For example, India claims that they are improving the services for the local citizens by having more tourists and improving the health care in those tourist centres. But, the truth is that in most places, and certainly in almost all small towns and villages in India, they do not have even labour rooms and people suffer from severely overcrowded hospitals where patient bed space is both under as well as on the bed. This is exacerbated by the internal brain drain of hospital administrators and of doctors described above.

One of the major concerns related to medical tourism is the ethical aspects of treatment. 8 These should be examined and the risks discussed with the patient, but, on the other hand, it is important that patients have their own autonomy in decision-making. Beneficence and nonmaleficence are the basis of medical ethics. Thus it is our responsibility to promote patients’ welfare, treat them with justice and improve their health while we avoiding harming them. These ethical principles are not easily upheld in the delicate balance of commerce versus medical ethics. Another aspect of medical ethics is the ownership of responsibility for treating the complications of the treatment given abroad. Another ethical consideration is that each country may have a different standard of medical ethics. For example, what is considered experimental therapy in one country, like stem cell therapy, is routinely used in the private institutions providing care for medical tourists in other countries. Likewise, the medical ethics related to organ transplantation differ from country to country. While most countries do not allow the involvement of money in organ donation, it is a common practice in some countries, and donors can even be a living non-relative. The Declaration of Istanbul on Organ Trafficking and Transplantation Tourism, 2008, has condemned organ transplant tourism. 12

It is the responsibility of the medical profession to stop the trend of treating medicine and health care like goods and services traded in business. 13 , 14 Burney has pointed out in SQUMJ that medical tourism may receive “uncalled for treatment”. 15 The quality assurance trend in health care has introduced the term “consumer” to describe patients in an effort to improve the quality of care in hospitals. Unfortunately, the term “health consumer” is now misused in the business of delivery of health care.

The quality and safety of medical treatment abroad has to be studied and questioned and it should be under the scrutiny of the medical profession and the Ministry of Health in Oman. Unless we have good grip on the quality of the care that our patients are receiving abroad, their safety may be at risk. We need more statistics, better studies and better reporting systems. The question of who will look after these patients when they return, has not been answered, but must be tackled.

Thus, there is a major lack of systematic data about health services provided abroad, not only for Omanis, but, also for citizens of many other countries. More organised studies are needed and specifically outcome studies. Research into the delivery of health care has not yet adequately evaluated medical tourism. The issue of lack of data must be taken very seriously. Medical tourism has some benefits, but there are more problems with it and, as physicians, we have to keep in mind our basic principles of beneficence and nonmaleficence.