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Editorial

Setting Industry Guildelines An Interview with Dr. Joseph Heymen Chairman of the Board of Trustees of the American Medical Association

Editorial

Dr. Joseph M. Heyman with the American Medical Association (AMA), Dr. Michael McGuire with the American Society of Plastic Surgeons (ASPS), and Dr. David Preble with the American Dental Association (ADA) spoke at the World Medical Tourism Congress about the Implications of Medical Tourism in American Healthcare.  


We asked Dr. Heyman about the AMA’s position and involvement with Medical Tourism.  He says, “As a starting point, we do not think medical tourism is bad.  We believe in a pluralistic system, where patients choose their treatment settings and providers.  If patients choose to go overseas; we support that choice.  We just want it to be as safe and of as high a quality as possible for patients.”

More people are traveling overseas for affordability, as the cost of care continues to increase in the United States.  The AMA believes that domestic conditions are actually facilitating the rising costs of healthcare.  There is inconsistent price transparency, cross-subsidization of hospital services, excessive regulatory costs and excessive costs from medical liability.  Health insurance protects against the unpredictability of medical expenses, but also insulates patients from the true costs of health care.


Diminishing language barriers, well trained quality conscious physicians, increasing numbers of the uninsured are all contributing to the globalization of health care.  Patients can travel overseas and receive the same quality of care at a more affordable price.  Heyman states, “In most cases, people are going to private health care systems in other countries.  The standard of living is a major factor that contributes to where people go.  


For example, if one travels to Thailand for medical care, it is much less expensive than in the United States.”  Lower wages, lower litigation costs, and less cost-shifting from those without health insurance to covered patients contribute to the lower prices globally.

The AMA believes strongly that when choosing to travel overseas for medical care, the institutions should be accredited by recognized international accrediting bodies such as the Joint Commission International (JCI) or the International Society for Quality in Health care (ISQua).  The Joint Commission International is a corporate partner of the AMA and Dr. Heyman serves on the board.  


He says, “The institution does not necessarily need to be accredited by JCI; but by an accredited organization that is equivalent in standards.”  Also, access to physician licensing and outcome data should be available to patients seeking medical care outside the US.  “In choosing care, people should be looking for organizations familiar with and who have access to this type of data,” recommends Heyman.

Another issue the AMA is concerned with is preoperative and postoperative care.  The AMA encourages the American public to become better informed about the need for preoperative and postoperative care.  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.  The patient should also take into consideration travel time.  


According to Heyman, “The patient must allow enough time post-surgery because of inherent risks involved in long air trips including embolisms.  Patients choosing to travel outside the US for medical care need to be provided with information about the potential risks of combining surgical procedures with long flights and vacation activities.  If the individual is well enough to travel, they are most likely well enough to have tourism before the surgery; rather than after it.  When traveling around, things can get thick.  One could have unforeseen side effects.”

“We live in a very litigious society.  Patients should be informed of their rights and legal recourse prior to agreeing to travel outside the US for medical care.  Employers, insurance companies, and other entities that facilitate or encourage medical care outside the US should inform and explain to the patient all the possible procedures,” adds Heyman.

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