The American Medical Association recognizes overseas medical care

By publishing its guidelines on overseas medical travel in 2008, the American Medical Association has recognized the role that overseas medical procedures plays in meeting the U.S. healthcare needs. While the guidelines are somewhat brief, and aimed more towards insurance providers and employers, they do also provide individuals some additional guidance in choosing whether or not to pursue overseas medical options.

The guidelines themselves say:

NEW AMA GUIDELINES ON MEDICAL TOURISM

The AMA advocates that employers, insurance companies, and other entities that facilitate or incentivize medical care outside the U.S. adhere to the following principles:
(a) Medical care outside of the U.S. must be voluntary.
(b) Financial incentives to travel outside the U.S. for medical care should not inappropriately limit the diagnostic and therapeutic alternatives that are offered to patients, or restrict treatment or referral options.
(c) Patients should only be referred for medical care to institutions that have been accredited by recognized international accrediting bodies (e.g., the Joint Commission International or the International Society for Quality in Health Care).
(d) Prior to travel, local follow-up care should be coordinated and financing should be arranged to ensure continuity of care when patients return from medical care outside the US.
(e) Coverage for travel outside the U.S. for medical care must include the costs of necessary follow-up care upon return to the U.S.
(f) Patients should be informed of their rights and legal recourse prior to agreeing to travel outside the U.S. for medical care.
(g) Access to physician licensing and outcome data, as well as facility accreditation and outcomes data, should be arranged for patients seeking medical care outside the U.S.
(h) The transfer of patient medical records to and from facilities outside the U.S. should be consistent with HIPAA guidelines.
(i) Patients choosing to travel outside the U.S. for medical care should be provided with information about the potential risks of combining surgical procedures with long flights and vacation activities.

Some thoughts and comments on these guidelines:

With regard to international accrediting bodies – the Joint Commissions International (JCI) is probably the most well known, having accredited over 200 hospitals. However, many European hospitals and many smaller clinics do not have JCI certification. Other well known accrediting bodies are the Trent International Accreditation Scheme (U.K. based) and Accreditation Canada, and others accredited by the International Society for Quality in Health Care, listed here (http://www.isqua.org/isquaPages/Accreditation.html).

In addition to accreditation, asking the hospital which overseas insurance companies cover procedures done at that hospital provides another quality check. Then verify this information by contacting the insurance company, even if the insurance company is outside your home country.
That being said, there are quite a number of non-accredited overseas hospitals that are higher quality than accredited domestic hospitals. So use accreditation as one of multiple checks or measures of a hospitals quality.

As with any medical procedure, but more so when these procedures are performed away from home, it is important to understand whether local follow-up care is likely to be required after the procedure, and to identify a local doctor or physician that will provide this care.

Legal recourse outside your home country, if it exists at all, will typically be much more complicated (that means you’ll get less, if anything, when you sue) than in the U.S. or your home country. Of course, the more limited abuse of overseas legal systems is part of what keeps overseas medical costs more affordable. So this is a bit of a trade-off.

While outcome data is very valuable and can give you an idea of success rates, getting access to outcome data is not straight forward. Singapore asks its hospitals to report outcome data, so the information is readily available. However most countries don’t require their hospitals to provide such data. Furthermore, there are no standards for what should and should not be included in outcome data – outcomes can be artificially inflated by dropping just a few cases.

With regard to the travel risks of combining surgical procedures with travelling overseas, most doctors will be able to comment on this, but do ask both your local doctor, the overseas doctor, and your medical travel facilitator if you are working with one.

Finally, your best bet is probably to speak with people that have used the overseas hospital for the procedure you are contemplating. Ask the hospital for referees or references, and search the internet for blogs, forums and discussions about the procedure you’re considering.

Selecting a doctor or facility is not easy, but in the world we live in, it’s often true that the best medical care available may be outside your home country.

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