Medical tourism: what are the risks?

Heading overseas for surgery may be gaining popularity, but it’s important to weigh up the risks.

Health Agenda magazine
November 2017

According to researchers at the University of Technology Sydney, Australians spend $300 million a year on elective procedures – mainly cosmetic surgery – overseas. This is somewhat encouraged by the growing number of tourism operators offering ‘sun and surgery’ packages to destinations across South-East Asia.

“Patients are drawn by the ability to access procedures at a fraction of what they would cost in Australia,” explains Dimitra Dubrow, a principal in medical negligence at Maurice Blackburn Lawyers.

However, the initial estimated costs may not be what you end up paying, especially if something doesn’t go as planned.

Some countries are known to offer patients medical care with similar outcomes and standards to Australia. But going overseas for surgery can have significant medical, financial and legal ramifications and increasingly health professionals are expressing concern.

Care and complications

The Australian medical system offers one of the highest standards of care in the world, which means most of us take competent, well-regulated medical institutions for granted. Not all countries have such stringent standards, particularly with cosmetic surgery.

In some cases, the consequences of dealing with an inferior medical system can be severe, says Dr James Savundra, president of the Australian Society of Plastic Surgeons. He cites cases where Australians have died following botched cosmetic surgery overseas. “And there are certainly many Australians who need remedial surgery back in Australia after unsuccessful operations in other countries.”

Dr Savundra also warns that an increasing number of patients are going to Australian hospitals with infections after having elective surgery – breast augmentation, in particular – in South-East Asia.

The unknown risks of overseas surgery

Unfortunately, there’s a lack of quality data relating to the risks of overseas procedures. Professor I. Glenn Cohen of Harvard Law School, author of the medical tourism book Patients With Passports, says that “the nature of medical tourism makes actual data collection on care quality and adverse outcomes difficult to obtain.”

Prof Cohen says that published data relating to medical tourism outcomes is hard to trust because it’s rarely collected by impartial third parties, leading to much lower official figures than are suggested by the numbers of ‘fix-up’ treatments more reliably recorded when the patient returns home.

“[Reported] numbers should be taken with a heavy grain of salt,” he writes. “Much of the data is based on self-reporting by destination country governments or hospitals.”

Even if you travel to a country with a similar standard of care as Australia’s, you may have problems with routine follow-up treatment back home.

“There may be effects on the continuity of care, as it’s likely harder for a treating doctor in Australia to get information about procedures and post-operative treatment from another country,” says Dubrow, who’s represented several Australians whose medical tourism surgery went wrong.

Cost context of surgery overseas

While the cost of your procedure may be cheaper overseas, your final bill may be close to – or even more than – what you’d pay in Australia. Some foreign hospitals only quote the surgeon’s fee in advance, and then inform patients of facility, anaesthesia, medication and medical test costs shortly before the procedure.

Accommodation and flights should also be factored in. Recovery from surgery can take from 24 hours for a superficial cosmetic procedure to 42 days for intra-ocular (eyeball) surgery.

Standard travel insurance doesn’t cover medical tourism. So if things go wrong, you may have to pay huge amounts of money in overseas hospital bills or medical evacuation flight costs. Additionally, Australian private health insurance doesn’t cover overseas procedures and may not cover follow-up treatments if they’re required when you return home.

Do your research

Of course, not all medical tourists regret venturing overseas. Melbourne-based personal trainer Jonathan Kok travelled to Thailand in 2015 for abdominoplasty (tummy tuck) surgery. “I’d lost over 50 kilos, and so I had quite a bit of excess skin left,” he says.

Kok conducted extensive research on medical systems and booked all aspects of the trip himself, not through a tourism operator. By being selective when choosing his doctor and care, he saved less money than some other medical tourists but he was happy with the care he received.

If you do decide to engage in medical tourism, the clear message from patients and health practitioners alike is to treat the process seriously, not as a holiday, advises Dr Savundra.

“Despite a growing number of reports in the media of poor or disastrous outcomes and, sadly, even deaths, people are still rushing into [surgery] with little consideration for their safety, often putting financial considerations ahead of their health,” he says.