A number of hospital corporations, investors and real estate groups have expressed an interest in or are already building clinics, hospitals and comprehensive medical communities around the world. Surely, these groups and organizations recognize that the ambience and aesthetic beauty of these facilities and/or medical communities will not only draw the patients, healthcare providers and staff to run the facilities, but will also aid in the overall wellbeing and healing power of the patient. Consequently benefits such as technological advancements trickle down to the local community as well, creating a win-win situation!
FIRST THINGS FIRST ~ CHALLENGES IN OVERSEAS MEDICAL TRAVEL
Differences in healthcare provider standards around the world have been recognized and medical tourism carries some risks that locally-provided medical care does not. The quality of post-operative care can also vary dramatically, depending on the hospital and country, and may be different from U.S. or European standards. The issue of “continuity of care” and “after care” has been a long standing concern with overseas medical procedures and care.
Long flights and decreased mobility in a cramped airline cabin are a known risk factor for developing blood clots in the legs such as venous thrombosis or pulmonary embolus, better known as “economy-class syndrome”. An array of post-op complications such as wound infections requiring IV antibiotics, dehydration, and the need for medications at a specific time could also add to problems for the medical tourist as they travel home by air.
By traveling outside of their home country for medical care, medical tourists may encounter unfamiliar ethical and legal issues. These legal avenues may be unappealing to the medical tourist. Should problems arise, patients might not be covered by adequate personal insurance or might be unable to seek compensation via malpractice lawsuits. Hospitals and/or medical providers in some countries may be unable to offer any sort of financial compensation.
The worst case scenario, in the event that a post operative issue arises and there is a gap or a lack of communications between the attending physician (destination physician) and the family physician (home physician) the patient may be in danger of having a problem once returning home, or even worse during their trip home. If the family physician is unaware of the patient traveling overseas (s)he may be unwilling to care for the patient once home and a post operative complication arises.
ENSURING CONTINUITY OF CARE
The issue here is continuity of care for the patient after they have traveled overseas for their medical procedure. To date, most of the industry literature has alluded to the fact that the patient makes the decision to travel overseas to have a medical procedure done, is recovering from that procedure and has now traveled home to do well. However the concerns of “after care” still remains.
One scenario which could provide a solution to the “after care” of the patient is a model in which either a medical provider or a group of medical providers, surgeons in most cases, form a corporation, identify a destination overseas and build a medical facility in that destination; perhaps even forming a partnership or affiliation with local providers in the destination, as well as government support where at all possible.
The facility would be built to internationally accredited standards, specifications and specialty. Hospital affiliations tend to result in higher medical knowledge and more thorough patient care. Major U.S. hospital systems, such as Johns Hopkins and Harvard Medical, are affiliated with hospitals in countries all around the world. Ideally the destination would be just a short distance, three to four hours, from the city of origin of the entrepreneurial medical providers, as well as their targeted patient population.
MEDICAL CONCIERGE PROGRAMS & U.S. PROVIDERS
As medical tourism continues growing the need for a Medical Concierge Provider becomes a necessity as well. The Medical Concierge Provider should be a mid-level provider such as a Physician Assistant who is educated in the same medical model as the Physician. Experienced Physician Assistants have the training, knowledge, education and communication skills necessary to assist in the care of the patient as they travel globally for their medical care.
The Joint Commission International (JCI) requires that international patients receive post-operative and after-care instructions in a language in which they can understand. Patients coming from English speaking countries such as the United States, England and others would benefit greatly by having a Medical Concierge Provider working on their behalf before, during and after their clinic or hospital stay.
Before the medical treatment is rendered, the Medical Concierge Provider would make contact with all physicians involved to review the pre-operative instructions and planned medical or surgical treatment. During the hospital stay the Medical Concierge Provider would be a patient advocate as well as ensure that the post-operative instructions were followed by the hospital medical staff. Upon discharge home the Medical Concierge Provider would write the discharge instructions and after-care plans making sure they are fully understood by the patient.
In addition the Medical Concierge Provider would be available to educate the hospital staff on the surgical procedures performed, the post-operative care expected for a successful outcome as well as the discharge and aftercare planning of the patient.
Through the insertion of a Medical Concierge Provider into this potentially confusing global equation, the patient, all involved medical providers and the treating facility or hospital will engage in seamless communications leading to the best possible outcome in patient safety and care.
About the Author
Mr. Cary has been a Physician Assistant for 36 years and has been active in both the clinical and educational aspects of the medical profession.
He held an Adjunct Faculty position at Penn State from 1987 to 1994 and the College of Southern Nevada from 1999 to 2006.
Currently he is on the Physician Assistant Advisory Committee at the Roseman University of Health Sciences. In addition Mr. Cary is on the Physician Assistant Advisory Committee to the Nevada State Board of Medical Examiners.
Mr. Cary is a co-founder and past president of The American Academy of Physician Assistants in Legal Medicine founded in 2000. He was on the Conference Education Planning Committee and in the Leadership Class of The American Academy of Physician Assistants, 2009 – 2011.
He is a co-founder of Cary and Associates, LLC and holds a position as Senior Partner. Mr. Cary is a member of the Medical Tourism Association and is interested in developing the concept of Medical Concierge Provider, Patient and Staff Education. He can be reached at medlaw_us@yahoo.com
