Medical Travel ~ Voice of the iPatient
I first became aware of the concept of Medical Tourism about three years ago. At my 40th high school reunion an old friend mentioned he had just returned from Costa Rica. “I hope you had a great vacation”, I said. He replied, “Yes, it was fantastic and I paid for it with what I saved by having my colonoscopy there.”
If You Have Medical Insurance, Why Travel Abroad?
Upon further questioning he told me his private insurance had a $3500 annual deductible and he had called several places clinics in his hometown of Atlanta, GA and received quotes that ranged from $2200 to $3400. Needless to say, whatever the cost, it was going to come right out of his pocket.
He researched alternatives and located a hospital in San Jose, Costa Rica that quoted him a price of $500 for the procedure. Further investigation on his part revealed that the hospital was accredited by Joint Commission International which definitely helped him feel more comfortable about traveling to another country for diagnostic testing.
Within a month he was on a plane to San Jose where he was met at the airport by a representative of the hospital, taken to his hotel, and given instructions for the upcoming test. The next day he had his coloncopy at the hospital, reviewed the results with the gastroenterologist who performed the procedure, and then left for the beach with his medical records in hand.
After five days at a beach in Costa Rica he flew back home. Total cost of the medical care, airfare, lodging, and all other expenses was $2100. When I saw him at the reunion he still had his tan.
Traveling for Healthcare ~ My Experience
The concept of traveling outside one’s community for wellness and healthcare services is nothing new. Patients travel based on such reasons as economics, better access, or perhaps the location of specialist. Over the past few decades we have seen the rise of a phenomenon in which patients are able to travel the globe in search of health care options.
I have a name for these medical travelers. I call them International Patients or iPatients for short. An entire industry has emerged to provide support and resources to iPatients and I wanted to experience what was being offered. As someone with a background in health care my expectations are very high and are based on over thirty years of health care delivery in both hospitals and medical practices.
I’ve done my share of taking care of patients as well as being a patient. My trip abroad for health care was not based on one of the usual motivators for an iPatient. I have adequate insurance and access to extremely high quality health care in my home town of Asheville, NC.
I didn’t need a knee replacement and my Medical Travel journey was not based on an urgent medical condition. It was simple curiosity, personal and clinical, that led me to schedule my trip. I’m not saying my trip was typical, but I would like to describe it to you.
I chose to schedule an Executive Physical with a large private hospital in Costa Rica that has a long history and reputation for caring for iPatients. I checked to make sure they had received and maintained an active certification from an international accreditation body.
By email I contacted the hospital’s international department and requested information about scheduling an outpatient appointment. Within two hours I received a reply outlining the process, cost, and included suggestions about scheduling. The promptness of the response was just the first of many surprises that lay ahead.
I was assigned a case manager who became my primary contact through the entire process. I let her know I didn’t need to be met at the airport. I scheduled an appointment and we made arrangements to meet in three weeks in the lobby of the hospital on a Tuesday morning at 8 AM. She handled the scheduling of all my appointments.
The Executive Physical I had scheduled included lab work (chemistry and urinalysis), chest x-ray, ultrasound of the abdomen, EKG, bone density testing, and consultation with a physician. Upon arriving at the hospital I met my case manager who directed me first to the laboratory.
Since some of my lab work required fasting for twelve hours she arranged for that to occur first and then directed me to the cafeteria for breakfast. She provided me with a coupon for the meal. I was grateful to finally be able to eat. The omelet was excellent. Next was the chest x-ray which took almost no time and then on to the ultrasound.
This was another big surprise. Being from the United States, I’m used to technicians doing these types of diagnostic procedures. In this case it was a physician. As he performed the ultrasound he drew my attention to a computer monitor and showed me exactly what he was seeing and how it looked.
He covered it all in his real time review: kidneys, gall bladder, aorta, prostate, liver, and spleen. When we were through he dictated a formal report on the ultrasound and the chest x-ray into my electronic health record. My case manager then gathered me up and took me for bone density testing which took less than 10 minutes and then I was on to my session with a physician.
My consultation with the physician took well over an hour, proceeded at a leisurely pace, and was conducted entirely in English. He performed an EKG and reviewed it on the spot. A thorough physical exam followed, as complete as any I have ever had. He then turned to a computer monitor and brought up my electronic record.
Every test performed that day was there. He reviewed the ultrasound, lab work, and bone density results with me in great detail and answered all my questions. He asked probing questions about my medical, social, and family history. At the end of our session he made a few lifestyle recommendations; drop a few pounds and get more exercise.
My case manager next took me to the financial department where I received another big surprise. The entire process including all procedures, tests, and physician consultation was $520 which I paid with US currency. As we were walking to the exit I casually asked if I could have the medical records that were generated that day.
Within 10 minutes I had them all which included copies of the actual ultrasound, EKG, bone density and chest x-ray images, lab results, interpretations, and the final summary from the physician. My report was in Spanish and I requested it to be translated into English so I could give it my provider in the US. I received the English translation three days later via email.
The next day I decided to visit a major dental clinic that specialized in treating patients from the US and Canada. I scheduled an appointment for an assessment and cleaning. When I arrived at the clinic I was amazed at first by the flat screen television in the waiting room and then by the view of the mountains from the dental chair.
I received a full set of x-rays, digital photographs, diagnostic gum testing, and then a cleaning. Although there was a technician present, everything was actually performed by the dentist who spoke excellent English. My visit ended with a review of all images and findings. My final bill, in total, was $110 which I paid in US currency. Ninety-eight percent of their clients come from the US and Canada. I can see why.
In many ways I’m sure my foray into medical travel was not typical. I went to experience the process and receive diagnostic and preventive services. Most iPatients travel to receive treatment for existing problems. It was very clear to me that the two healthcare providers I chose to visit had ample experience in the care of patients who were from another country.
Many of the problems I thought I would encounter by being an iPatient simply did not exist. There was no problem scheduling appointments based on my convenience. Everyone, from the health care professionals to the scheduling and billing staff, spoke English. I was able to obtain all my medical records to bring home.
Waiting times were minimal. Complimentary access to computers with internet was widely available. The hospital had Wi-Fi, which I used with my laptop to communicate with my wife by using SKYPE. A case manager helped keep me on track through numerous appointments. I could go on and on but I think you have the picture.
In summary I must say that all my expectations were exceeded. I received high quality and personal health care and at an amazing value in pricing. I do not know if my experience is at all representative of what iPatients typically experience in terms of support.
However, I can say without reservation that I was truly surprised at the level of service and value I received. I was not expecting that. I look forward to looking deeper into some of the other aspects of what an iPatient can expect. What about rehab facilities after a knee replacement?
What about lodging for a fellow traveler of an iPatient? What about complicated dental work that could take several weeks in total? How do services in other parts of the world compare with Costa Rica? I look forward to exploring all aspects of the robust and maturing field of medical travel and I can see why it has become a valid option for many iPatients.
About the Author
Jim Tate, President and Founder of the Medical Travel CommissionTM www. medicaltravelcommission.com, has a 30 year history in health care delivery in both Inpatient and Ambulatory environments. He has worked directly with over 135 Health Information Technology organizations on their projects and has led numerous health care system implementations in the United States and Asia.
Jim has worked across borders, languages, and cultures with health care clients in the US, India, Pakistan, China, Ireland, Scotland, Israel, South Korea, Sri Lanka, and Peru. Jim founded The Medical Travel CommissionTM out of a need for a neutral entity to bring credibility and transparency to the Medical Travel industry and advocate for patient safety and support.
The need for Medical Travel Certification is driven by the expanding phenomena of patients seeking health care outside their community for economic or accessibility reasons. The Medical Travel Commission has developed a certification process that includes reviews, audits, and recommendations based on Best Practices for hospitals who are addressing the needs of Medical Travel.
International travel in pursuit of health care options has the best chance of delivering on the promise of safety and economy if backed by a clear set of standards. All rating criteria are directly traceable to patient care and support. The MTC certification brings credibility to countries that promote national Medical Travel initiatives, improves the care and services delivered by hospitals, and assists in the constant improvement in the experience and outcomes for patients.