In one of the previous posts I explained to you medical tourism dangers and risks associated with poor hygiene and sanitation standards and risks related to drugs and blood products abroad. If you haven’t read, I encourage you to do so- click. In this post I would like to continue this topic, but concentrate more on possible complications of the medical procedure and ethical, legal issues related to undergoing treatment abroad.
I have already mentioned that travelling by plane after surgery might not be safe (especially on long distance). It can cause pulmonary embolism, deep vein thrombosis and blood clots. If you are at risk of thrombosis you should talk to your doctor about your plans. There are methods to reduce risks of thrombosis like: drinking a lot of water during the flight and walking on the airplane. Even if you have risk factors, the risk of developing thromobosis as a consequence of flight is low and no cases related to medical tourism have been already described. [1,2] American Society of Plastic Surgeons suggests waiting before flying home 5- 7 days after body surgeries and 7- 10 days after face surgeries. 
If you travel back home by airplane after surgery your surgeon should fulfill and sign a medical care document. The form of this document depends on the airline, but it has to state that your condition allows flight.
Usually there are several follow up visits after the surgery and they are of great importance. During follow up visits the doctor assesses whether the patient follows post operation instructions and if the healing process goes well. Unfortunately one of the biggest limitation of medical tourism is difficulty in organising follow up visits. Patients may face problems with contacting the surgeon/clinic abroad after the surgery. Follow up visits may not be included in medical service abroad. Sometimes patients don’t want to travel abroad „only” for follow up visits, because it eg. generates costs, takes time etc. Patients have to realize that proprer care after the surgery is very important. No matter if the medical offer abroad includes follow up visits, medical tourists should organize them in their place of residence too. They should do it before the medical travel. In case of problems with organizing visits abroad they will have domestic specialists available.
If you undergo a medical procedure, there is a risk of complications and unsatisfactory results. The reason for this may be eg. negligence of medical team, communication gap between patients and doctor and many more. The problem is that in case of malpractice it is often difficult to receive compensation abroad. Patients’ rights and the rules governing the responsibility of medical personnel may be different. Asserting your rights could be very expensive and take a lot of time. It may be also very tiring (both mentally and physically), especially if patient suffer from serious complications after the procedure. Patients who have complications resulting from medical procedures abroad may become the responsibility of the domestic healthcare system. There are doubts about demands on doctors for providing aftercare for medical tourists. Some doctors don’t want to treat complications and perform the revision surgeries for medical tourists. Patients who have complications resulting from medical procedures in developing countries could be embarassed. It could result in delaying in seeking medical help and as a result of negligence requiring more money from public healthcare system.
When you travel abroad you should also take into consideration differences in cultural aspects, religion etc. In case of complications you may be treated in a different way that you would be in your home country, due to ethical and religious differences.
When you are choosing your destination for medical travel you should take into consideration safety issues. Before you choose medical tourism destination you should check if there are internal conflicts, increased risks of attacks etc. Countries with an unstable situation may offer really great deals for medical tourists, because local problems cause the currency to collapse. It means that prices for foreigners may be really low. However, if you have concerns about your safety it is definitely not worth the risk. Safety first!
1. NHS. When can I fly after surgery. http://www.nhs.uk/chq/Pages/2615.aspx?CategoryID=69
2. Neil Lunt, Richard Smith, Mark Exworthy, Stephen T. Green, Daniel Horsfall and Russell Mannion. Medical Tourism: Treatments, Markets and Health System Implications: A scoping review. OECD http://www.oecd.org/els/health-systems/48723982.pdf
3. American Society of Plastic Surgeons. Cosmetic Surgery Tourism Briefing Paper. http://www.plasticsurgery.org/news/briefing-papers/cosmetic-surgery-tourism.html?RenderForPrint=1
4. Penney K, Snyder J, Crooks VA, Johnston R. Risk communication and informed consent in the medical tourism industry: a thematic content analysis of Canadian broker websites. BMC Med Ethics. 2011 Sep 26;12:17. doi: 10.1186/1472-6939-12-17.
5. Crooks VA, Turner L, Cohen IG, Bristeir J, Snyder J, Casey V, Whitmore R. Ethical and legal implications of the risks of medical tourism for patients: a qualitative study of Canadian health and safety representatives’ perspectives. BMJ Open. 2013 Feb 8;3(2). pii: e002302. doi: 10.1136/bmjopen-2012-002302. Print 2013.
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