Medical Tourism: Caveat Emptor/Buyer Beware!

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Medical tourism is all the rage. Someone has a big healthcare problem and is a long waiting list. He/she finds a modestly priced procedure in an exotic location with no waiting list. The medical tourism company will immediately book the travel and the procedure. No problem. Just give us your credit card and start packing.

Kim Hansell at BHH Benefits, a leading employee benefits consultancy in Stoney Creek Ontario, asked me about medical tourism. I suggested that the rule is buyer beware.  The important thing is to get beyond the headlines and understand how it really works.

Here is a case study:

Jill and her husband Ben winter in Florida. Jill developed a minor meniscal tear of her knee. She saw a very competent knee surgeon who recommended an arthroscopic repair. Ben put down his Amex card and paid $5,000 for the procedure. When Jill was on the operating table she developed an abnormal heart beat. After the procedure she was sent to the cardiac care unit (CCU) for treatment of her arrythmia with cardioversion (external shock). The cost for the 18 hours in the CCU and the treatment was $38,000. Ouch! There might have been some double counting but that will be resolved by the lawyers.

The learning is that complications can cost much more than the planned purchase of the medical services.

Joshua is an active twenty-something Canadian who is teaching English in South Korea. He injured his knee in a volleyball game and tore his anterior cruciate ligament. He saw a local knee surgeon who recommended a repair. He likes his job in Korea and does not want to miss time off work. His father suggested that he retain Rupert Case Management Inc. (RCM) to arrange for a knee repair in Toronto.  Joshua, who is strong willed, decided to get the repair done in Korea with the unknown surgeon. No idea of surgical outcomes. No idea of the surgical technique to be employed. No idea of infection rates in that hospital. No idea of rehab post-operation. No idea of out of pocket costs if there are complications.

If Joshua develops an infection with a super-bug, he will spend the next year or two being treated in various hospitals and wandering why he didn’t ask us to find the right surgeon in the right Canadian  hospital.

The learning is that it is important to learn as much as possible about what is being offerred and to get beyond the headlines.

The medical tourism companies are in the business of booking your trips and your procedures. They earn a commission on the travel and (likely) on the procedures. In fact, the have a conflict of interest. They do not really care if the patient is getting the right procedure.They pay their rent by booking trips and procedures.

Here is an example:

Victor is a seventy something client with a long history of back issues. He has had three prior back procedures for spinal stenosis ( a tight boney canal that compresses the spinal cord).  He continues to have pain. He wants a solution.

The neurosurgeon at a large U.S. center suggested a spinal decompression. A Canadian neurosurgeon suggested spinal decompression plus fusion of several vertebrae. RCM arranged for a third spinalsurgeon to assess his back. He is very experienced having done several thousand back procedures. He suggested that Victor needed a new hip. It was clear that Victor should not have a back procedure if he was having pain from a worn out hip.

If Victor went to a medical tourism company, he would get a spinal procedure whether he needed one or not. The medical tourism company has a conflict of interest.

Rupert Case Management (RCM) provides an intelligent matching service for these clients who want to travel for a procedure or treatment. RCM determines in detail what the client’s needs are and matches those with the capabilities of the provider ( doctor) and the hospital. RCM is not conflicted. We work for the client in seeking the best outcome possible.

Summary: If you are planning to travel for treatment, then be sure to be fully aware of what you are getting into and call Rupert Case Management for our “intelligent matching” service.