Medical Tourism: The Not-So-Fun Vacation

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When Sandy Pradas’ dentist advised $7,000 worth of dental work, Pradas thought of the yoga retreats she’d led to Costa Rica. “I knew that a lot of people went there for dental work as well as other procedures, so I started doing research.” She found that for $3,200 she could get all her dental work done, plus take a two-week vacation.

It sounds like the perfect solution. Take an exotic vacation while getting a fabulous bargain on medical care. Pradas, like many other patients, was happy with the results. But when things go wrong, the consequences can be painful and costly.

The Big Picture 

The term “medical tourism” refers to residents of one country traveling to another country to receive medical care. Usually people do this because of cost savings, access to procedures not available in their home country or for better quality care. “Domestic medical tourism” means traveling from one city to another within the home country for medical reasons.

According to the Centers for Disease Control, U.S. travelers commonly go abroad for orthopedic, cosmetic surgery, cardiac surgery, oncologic care, and dentistry. Popular destinations include Thailand, Mexico, Singapore, India, Malaysia, Cuba, Brazil, Argentina, and Costa Rica.

“Over 100 countries are seeing trends of patient travel,” says Renee-Marie Stephano, president of the Medical Tourism Association. “You will find inbound to the U.S. people from all over the world come for care.” The Medical Tourism Association is an international non-profit trade association for the medical tourism and global healthcare industry. According to the MTA’s annual survey for 2015, 65 percent of those traveling for medical procedures  were not covered by insurance. Patients spent between $3,600 and $7,600 per medical travel trip, and required a savings of $4,900 to $8,600 to deem  it worthwhile.

Services 

The demand for services changes according to medical advances and availability in different countries, and what insurance plans cover. According to the National Association of Dental Plans, 114 million Americans have no dental insurance. Many dental plans max out at $1,500 per year. Patients Beyond Borders, which publishes medical tourism guides, lists Mexico, Costa Rica, Thailand and Hungary as top countries to visit for dental care. Since cosmetic surgery is paid out of pocket, it’s also a natural for medical tourism.

Laws influence medical travel. “Medical tourism with transgender folks has decreased recently, since certain laws have made insurance coverage for gender-confirming surgeries much more accessible in the US,” says Cadyn Cathers, a psychological assistant with the Los Angeles Gender Center. “Most often people were traveling to Thailand for vaginoplasty (creation of a vagina in transgender women) and to Serbia or Belgium for phalloplasty (creation of a penis in transgender men).” Cathers reports that most of his patients’ experiences traveling abroad for medical procedures has been positive, although some have experienced complications after returning home.

Stem Cell Therapies

Doctors use stem cell therapy to treat a wide variety of conditions. The FDA warns that some uses are unproven and may produce false hope in patients. Also, not every country regulates stem cells for safety, potency and purity.

“There are still many stigmas against it, since most people think the stem cells come from babies,” says Alan D. Vojtech, chief marketing officer for Innovations Medical in Dallas. “The reality is that stem cells are pulled from the patient’s own body fat now, and the cell counts are much higher than anyone expected.”  The cells are used to grow cartilage in patients’ knees, shoulders and other joints, Vojtech says, and to heal arthritis, neuropathy, COPD, ALS, and MS. At $6,000 for the first visit and $2,000 for boosters, the cost is much lower than in many parts of the world. Most of their patients are from Mexico, but they also see people from the Middle East and Dubai.

Plastic Surgery

Plastic surgery traffic goes two ways—both in and out of the U.S. People come to Innovations Medical from Canada, Mexico and Europe for a procedure called “fat transfer.” One patient traveled from Qatar for a Brazilian butt lift. “Patients used to ask for J-Lo’s butt,” Vojtech says. “Now they laugh when we mention her name.  Patients want a butt like K. Michelle or Kim Kardashian post-baby. For years, patients have been paying us to remove their saddlebags, but now they pay us to give them the biggest saddlebags.” He’s also seen an uptick in men requesting butt lifts.

According to Dr. Anthony Taglienti, a plastic surgeon at Marotta Plastic Surgery Specialists in Smithtown, New York, some of the most common plastic surgeries to get abroad – and most commonly botched – are abdominoplasties, liposuction and Brazilian butt lifts. “Most plastic surgeons in the United States will not remove more than 5 liters of lipoaspirate from a patient during a single procedure,” he says. More than that, and “large fluid shifts can lead to pulmonary and cardiac issues, especially in a patient with any significant underlying medical comorbidities.”

Guidelines

So how should the savvy consumer protect him or herself while undergoing medical treatments abroad? The first step is research. Prospective patients should know exactly what procedure they need. This sounds obvious, but Dr. Taglienti has seen many patients who got abdominal liposuction when they really needed an abdominoplasty (tummy tuck) for their desired results.

Checking the certifications of both the doctor and the institution is vital. Where was he or she educated? Is she board certified? Does he belong to international organizations? Also find out how much experience the doctor has doing the type of procedure you desire. Just because he’s a wiz at butt lifts does not mean you want him reconstructing your nose.

Communication is key. When you’re undergoing medical procedures, you don’t want to struggle to understand somebody who doesn’t speak your language. Find out ahead of time the language proficiency of the medical staff abroad.

As Pradas, owner of Joyful Heart Yoga, mentioned at the beginning of this article, some medical tourists combine a procedure with a vacation. But it’s crucial to factor in recovery time. In Pradas’ case, she spent an entire day in the dentist’s chair, then had to wait 10 days for the crowns to be made. “So I traveled around the country. My teeth hurt for a couple of days, but it wasn’t too bad.”

Some procedures will require a clean, quiet place to rest rather than sightseeing, shopping and sampling local cuisine. The CDC website advises patients not to fly for at least a week following abdominal or chest surgery, lest you increase the likelihood of blood clots. The American Society of Plastic Surgeons also says to wait a week before flying post-face-lift, and to avoid swimming, sunbathing, drinking alcohol or taking long tours. Kind of takes the fun out of the medical vacation.

Of course, on a medical vacation fun is optional and safety is mandatory. As communication between countries improves and the internet allows people to compare medical costs across borders, medical tourism will continue to grow. This is one area in which being a prudent consumer could save your life.

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