Surgery in Mexico, Spain, and Canada: What you really need to know before going out of the country for surgery

In part 1 of this two-part series discussing traveling to get medical care, or medical tourism, we discussed the considerations for traveling within the United States for routine medical care. In this article, we talk about going to other countries to obtain medical care.

Yes, you can leave the country, see new things, and fix a problem at the same time. Many times, you’ll save thousands.

You’ll find the most common procedures people seek out are dental surgeries, cosmetic surgery (breast augmentation and reduction tops this), fertilization treatments, hair implant surgery, cardiac surgery, cancer treatment, and holistic treatments. But there is a lot more to the decision to look elsewhere for more affordable, quality care.

Why Leave The Country for Medical Care?

Over the past ten years, more and more people are leaving the United States to obtain healthcare, prescription medications, and elective surgeries than ever before. Patients Without Borders shows that the medical tourism industries in Mexico and Canada have increased every year over the past ten years.

Very few regulations exist to govern leaving the country for medical care. Often, your doctor at home may not recognize the work done if you leave the country. Standards vary in different places, so you have to be careful about where you choose. 

It's not all bad news, however. For the most common elective surgeries, like knee surgery, many people find they save money by going to a different country. For example, in 2012, a person could travel to France ($700), obtain a hip replacement surgery ($12,000), and spend two weeks recovering in a grand hotel with meals delivered ($5,800) for half of what it would cost to obtain hip replacement surgery in the US ($42,000). 

Pricing has changed and become more obscure, so more current figures are challenging to obtain. Sometimes, the correlation isn’t even comparable. For example, for fertility and cancer treatment, US doctors are limited as to what they can recommend and prescribe. However, in Europe, dozens of natural treatments work together. Several cancer centers base their treatments on minimal chemotherapy and place emphasis on detoxification, herbal supplementation, and other traditional modalities. 

Imagine going to a resort to obtain a fertility treatment, relaxing and taking care of yourself, rather than forcing your body into submission with powerful medications. Can you see why some people choose this route?

Sometimes, paying out of pocket for an out-of-network provider, or traveling out of the country sometimes is less costly than the deductible and out-of-pocket costs of sticking with your local doctor. Of course, you do need to factor in what the insurance pays, but you won’t know that real cost until you get the bill. 

Finding Quality Surgeons in Foreign Countries

Two top organizations exist to help patients find quality physicians and high standards of care. Patients Without Borders and the Medical Tourism Associationwere both established to provide regulations and requirements for the doctors and facilities the handle the increasing medical tourism.

So many people in the United States are shocked at the standards that exist in foreign countries in both good and bad ways. 

For example, in the famous Harry Potter movies, the medical facilities were filled with long rows of beds. While the atmosphere the movie suggested this was set up sometime in the early 1900s, many Americans who find themselves in need of hospitalization in the UK find this is actually normal, standard care. Private rooms are only now becoming more popular in Europe and Asia.

On the opposite end of the spectrum, Japan has increasingly modern and private facilities. Their cleanliness practices and respect for privacy outshine the strictest American standard.

So, who decides what good quality of care is?

Facilities reviews by Patients Without Borders and the Medical Tourism Association meet specific standards for cleanliness, professionalism, and success rates. Beyond that, you need to ask the following questions:

·      Do the doctor and staff speak English, or your native language, fluently? If not, will a translator be available? If not, may I bring my own?

·      What are your requirements for follow-up care?

·      What do I need to do before the procedure?

·      How many nurses or systems will you be using?

·      What can I expect at your facility?

·      Can I talk to some of your previous patients? Especially those who came from out of the country?

·      What will happen in an emergency?

The doctors who have higher standards of care will gladly provide this information. Nearly every practice that takes in medical tourism patients has a website that highlights their facilities. Of course, it’s always your right to leave any of the facilities up to your standards.

Risks and Concerns of Leaving the Country For Surgery

Additional concerns arise when looking at foreign facilities, especially one that you don’t have the opportunity to visit before you make your appointment.

First, you have to talk to your doctor to see if you're healthy enough to travel. You can’t go away if going away is going to cause more problems.

Certain medical conditions preclude traveling, flying, or long-distance car rides. Many blood conditions, bleeding disorders, and clotting factors prevent airplane travel. Additionally, many types of surgery will require you to stay grounded because of the risk of blood clots. In the case of hip surgery, you may be required to remain an extra 2 to 6 weeks in a foreign country because of this risk.

As we discussed earlier, standards around the world are not the same as they are in the United States. In some cases, they’re much better. In some cases, we would question the safety of the facility.

Make sure allyour doctors have available allof the information about various prescription medications you take. In some countries, that information is not accessible, or the drug may be unknown. Doctors in foreign countries might not understand the mix of prescriptions you’re on, which could cause dangerous interactions.

On top of that, you may be prescribed medications in foreign countries that are not available locally. In Germany, doctors have thousands of herbal and alternative medications available that are banned in the US (but are often sold as supplements). If you don’t check before surgery, you could be without a part of your recovery treatment.

This is the grip the pharmaceutical companies have on the doctors and hospitals. Between controlling what the doctors see for new treatments and lobbying in Congress and the FDA, they were able to get thousands of supplements, herbs, and other alternative medicines banned. Now, doctors aren’t aware of over half of the medical knowledge that exists in the rest of the world!

You can learn more about these historical trends leading to skyrocketing healthcare costs while decreasing services in my book Health-Wealth for You: 11 Steps to Save Big & Live Healthy.You’ll also find money-saving tips for the most common medical procedures and visits. 

Every country has vaccine requirements that you must follow before you’re able to travel to that country. In some cases, that means you need a certain number of vaccines administered in a specific time frame. In other cases, having received a vaccine, such as a flu vaccine, actually may prevent your entry into another country or prevent you from acquiring the medical services. (Were you ever told that the flu vaccine requires you to avoid medically compromised individuals for two weeks after getting the shot?)

Finally, specific medical procedures have been restricted in certain countries. Recently, the UK prohibited elective surgeries for over 20 different standard surgeries, among these includes our example of hip surgery, breast reduction, and surgeries to reduce reproductive pain. Some facilities may accept you on a cash-only basis and allow you to get the treatments that natives cannot. However, you're more likely to be passed over in favor of local patients.

Steps To Consider Medical Tourism to Save Money

As you begin to look at the various options for traveling to another country to obtain medical services, keep in mind a series of questions, make sure this is the correct decision for you. Additionally, be sure to discuss the options with your regular physician. They may have concerns specific to your medical needs that would be beneficial for you to ask the new facility.

If your doctor is against you traveling for medical treatment to another location in the United States or even out of the country, be sure to listen to the reasons why. Some doctors may take offense do you traveling to obtain the surgery, while others may have justified concerns. You will have to decide if your doctor is looking out for your safety.

Here's a list of questions that you need to answer fully before seeking out medical treatment in a foreign country.

·      Are you healthy enough to travel?

·      Can you speak the language or will you have an interpreter? 

·      Is it something your doctor would support?

·      How will you handle recovery and follow-up appointments?

·      What will your loved ones and family do during this time?

·      Are you protected from theft and violence?

·      Is this a vacation or medical trips?

Finally, keep in mind the cost of the treatment. Since your insurance will not be covering the medical aspect, you may be expected to provide payment before the procedure. Very few foreign hospitals or doctors will bill you for service.

On average, you can expect to spend $4,000 to $6,000 per visit to obtain simple medical procedures. This can include travel costs, food, and lodging. These costs increase dramatically as you have family members traveling with you, or you have to leave employment to obtain the medical procedure. Having enough savings to cover your medical costs and time off of work is essential.

Unlike obtaining medical procedures in the United States with your approval of your doctor, you may not be able to receive the Federal Medical Leave Act (FMLA) benefits. Employers may see this as a voluntary cosmetic procedure and may not approve the time away from your job. Remember, FLMA requires paperwork to be submitted by your doctor to obtain benefits. Without your doctor's support, you have no support.

“In the past few years, Americans are definitely more willing to go overseas and now appreciate that there is quality there,” said Jonathan Edelheit, the chief executive of the Medical Tourism Associationtold the New York Timesin 2013. 

In the coming years, we're going to see more travel to foreign countries and around the United States to obtain specific services. There are many reasons for this, including the decreasing number of doctors, health insurance costs, the exorbitant price of running a hospital, and increasing specialization.

If you choose to leave the country or even your state to obtain medical procedures, be sure to have all of the details that we discussed in these two articles before making your final decision. It can save you money to travel to obtain medical procedures, but there are many logistics you have to look at.

Dr. Josh Luke is a hospital CEO, celebrated keynote speaker, award-winning Futurist, Founder of the not-for-profit Health-Wealth and author of the book series including Health-Wealth: Is healthcare bankrupting your business? andHealth-Wealth for You: 11 Steps to Save Big & Live Healthy (both Amazon #1 Best Sellers). Dr. Luke delivers engaging and entertaining keynotes that teach audiences simple concepts on how individuals and companies can save thousands on healthcare. For more information, please visit www.DrJoshLuke.com.