NEW AMA GUIDELINES ON MEDICAL TOURISM

On  June  16,  2008  the American Medical Association  (AMA) released  its  “Guidelines  on Medical  Tourism,”  which  set  out  to provide parameters for implementation of medical tourism and the processes that should be involved. 

These guidelines are not revolutionary, but they provide a very valuable  set of  concepts  that we  all  can develop  to  create  a  solid foundation for medical tourism.  The Medical Tourism Association supports  these  guidelines  and  intends  to  communicate  with  the AMA to develop them further.  From its inception, the MTA has as its primary  tenent, a  focus on  transparency  in quality and pricing, communication and education.  We regularly improve the aftercare programs of our members and reduce risk of liability for members by promoting transparency in legal documentation. 

The majority of AMA guidelines are “common sense,” meaning, it seems obvious  that patients shouldn’t be  forced  to go overseas, that  their after care  should be  resolved prior  to  traveling and  that the  proper  disclosures  should  be made  to  the  patient  as  to  legal rights and risks.  Patients absolutely should have the right to review
information about their proposed surgeons experience and outcomes and  also  the hospitals’  statistics.   The new patient  is  an  educated patient and the medical tourism industry is driven by these educated patients.  This is why transparency is so important. 

This  is  the  principal mission  of  the MTA’s  “Quality  of  Care Project,” where  patients  can  compare  a  hospitals  quality  of  care based  upon  unifed  indicators  and  a  uniform methodology.   One problem  with  the AMA’s  guideline  is  found  at  subheading  “c,” wherein medical care should only be given by healthcare providers
accredited  through  internationally  recognized  accrediting  bodies. The problem with this is there are smaller clinics and facilities in the US that are not accredited by the Joint Commission, yet acceptable for care.  The AMA is implying a higher accreditation standard than found in many places here in the US. 

It  is  rare  for  a  plastic  surgery  clinic  or  smaller  clinic  to  seek accreditation  in  the  US.    But,  the  vision  of  the  statement  is absolutely  correct, meaning, AMA’s desire  to  ensure  that patients are only  traveling  to hospitals of  the highest quality of care.   One problem  is  their  referral  to  accredited bodies  of  ISQUA,  because ISQUA accredits accreditation systems and not hospitals.  I believe they meant  to  say  an  accreditation  system  accredited  by  Isqua  is suffcient.

In July, after almost a year of research and gathering input from the membership,  the Medical Tourism Association  is  launching  a “Medical  Tourism  Certifcation”  program  specifcally  to  provide information  to  patients  about  international  patient  services
offered by Medical Tourism Facilitators.   This  is not designed  to certify quality, but will serve as a source of  information about  the international patient services offered to foreign patients.  This will include  things  like  languages  spoken,  informed  consent  forms, transparency  in  pricing,  transparency  in  legal  recourse  and more. As  the  industry  grows  and  more  hospitals  receive  international accreditation  for  quality,  it  becomes  increasingly  more  diffcult for patients  to know whether a hospital  is right for  them. If  the hospital has an international patient department, does that hospital also  provide  outcomes  for  its  surgeons,  transparency  regarding legal recourse, privacy protection for medical records?  What about medical  tourism  facilitators?   Are  they more  than  just  a website? Do they have protocols in place to assist patients with appropriate aftercare facilities?  Do they provide assistance for aftercare?  Are they transparent regarding the price of their services?

The  certifcation  for  Medical  Tourism  Programs  is  valuable in  assisting patients,  employers  and  insurance  companies  identify which hospitals and facilitators have benefts suitable for them.  The Medical Tourism Association Certifcation is not an identifcation of the quality of the surgeons or the facility outcomes, rather it focuses
on the international patients’ services and protocols currently being utilized and marketed to foreign patients.  The certifcation system will focus on the “Medical Tourism” aspect and is not intended to certify  quality  or  to  replace  any  accreditation  system.   This  new MTA  Certifcation  system  “complements”  accreditation  systems currently in place.

Where is the Medical Tourism Industry Headed?

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:
Medical care outside of the U.S. must be voluntary.  a. Financial incentives to travel outside the U.S. for medical  b. care  should  not  inappropriately  limit  the  diagnostic  and therapeutic alternatives that are offered to patients, or restrict treatment or referral options. Patients  should  only  be  referred  for medical  care  to  c. 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).

Prior to travel, local follow-up care should be coordinated  d. and financing should be arranged to ensure continuity of care when patients return from medical care outside the US. Coverage for travel outside the U.S. for medical care must  e. include the costs of necessary follow-up care upon return to the U.S.

Patients  should  be  informed  of  their  rights  and  legal  f. recourse  prior  to  agreeing  to  travel  outside  the U.S.  for medical care.

Access to physician licensing and outcome data, as well as  g. facility accreditation and outcomes data, should be arranged for patients seeking medical care outside the U.S.
The  transfer  of  patient medical  records  to  and  from  h. facilities outside  the U.S. should be consistent with HIPAA guidelines.

Patients  choosing  to  travel outside  the U.S.  for medical  i. care should be provided with information about the potential risks of combining surgical procedures with long flights and vacation activities.

Renée-Marie Stephano  is  Chief Operating Offcer  and  a Founder  of  the Medical Tourism Association,  Inc.,  an  international  non-profit organization that serves international healthcare providers  and medical  travel  facilitators  in  the global  healthcare  industry.   Renée-Marie  is  an attorney  licensed  to practice  law  in  the states of Florida, Pennsylvania  and New  Jersey  and  has a  background  in  litigation  and  health  law.    She is also Editor of the Medical Tourism Magazine, a monthly journal serving  the  global  healthcare  industry  by  free  subscription  at www.MedicalTourismAssociation.com. Renée-Marie may be reached at   Renee@MedicalTourismAssociation.com.