The Price of Medical Tourism

The Legal Implications of Surgery Abroad

Steven P. Davison, M.D., D.D.S.; Kylie D. Hayes, M.B.A.; Gabrielle LaBove, B.S.; Peter Shaffer, B.S.

Disclosures

Plast Reconstr Surg. 2018;142(4):1075-1080. 

In This Article

Abstract and Introduction

Abstract

Medical tourism, or traveling abroad to obtain medical services, has evolved into a global health care phenomenon, with over 15 million U.S. patients each year seeking medical care internationally, representing a $50 billion dollar industry in 2017. Speculation and media fascination about the growing industry, diverse destinations, and rationale behind the medical tourists is rampant; however, the legal implications of tourism medicine, particularly when it goes wrong, are often unclear. On the international stage, accreditation agencies are limited in scope and practice, legal jurisdiction is difficult to establish, and the enforcement of rulings is nearly impossible. Patients seeking tourism medicine have little legal recourse and shoulder all the legal burden.

Introduction

Medical tourism, or traveling abroad to obtain medical services, has evolved into a global health care phenomenon, but what occurs if the operation that costs you 4 percent of the American price results in 100 percent of the potential complications, or even death? In the July of 2017 issue of Plastic and Reconstructive Surgery, Adabi et al. focus on the population health implications of medical tourism, citing case reports, the financial impact, and the burden tourism medicine places on society.[1] This article aims to expand on the population health research conducted by Adabi et al. and to further discuss the legal implications of medical tourism and the patient's potential rights (Figure 1).[2]

Figure 1.

Cost estimation for spending by outbound U.S. medical tourists. U.S. dollars spent on outbound medical tourism is following a positive trend, with an estimated growth of $30 billion from 2012 to 2017 alone. Conservative lower bound estimates suggest a leveling off of the industry growth, whereas upper bound estimates suggest continued exponential growth.

Historically, patients from underprivileged areas with little access to advanced medical care would travel to modern urban areas where there existed more sophisticated technology and more temperate climates. In the current model, a reverse flow is the trend, in which patients from highly developed countries travel to less developed ones.[2,3] Patients are seeking cost saving alternatives to elective or experimental procedures that are not available in their home country.[4] Recent immigrants with strong ties to their home countries are also being added to the medical tourism ranks.[5] Often, there is a mirage of safety in which the appeal of cultural comfort clouds appropriate skepticism on standard of care. In the next 25 years, more than half of the U.S. workforce will be second- or third-generation immigrant Americans who may be more comfortable with the family and medicinal culture abroad (Figure 2).[2]

Figure 2.

Ten-year projection (in millions) of outbound patient flow. The number of Americans seeking medical services internationally is projected to continue rising.

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