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On June 16 2008, the American Medical Association (AMA) released its Guidelines on Medical Tourism, which set out to provide parameters for implementation of medical tourism and the processes that should be involved. 

These guidelines are not revolutionary but they provide a very valuable set of concepts that we all can develop to create a solid foundation for medical tourism. The Medical Tourism Association supports these guidelines and intends to communicate with the AMA to develop them further. From its inception, the MTA has as its primary tenet a focus on transparency in quality and pricing communication and education. 

We regularly improve the aftercare programs of our members and reduce the risk of liability for members by promoting transparency in legal documentation. The majority of AMA guidelines are common sense, meaning it seems obvious that patients shouldn't be forced to go overseas, that their aftercare should be resolved prior to traveling, and that the proper disclosures should be made to the patient as to legal rights and risks. 

Patients absolutely should have the right to review information about their proposed surgeons' experience and outcomes and also the hospitals' statistics. The new patient is an educated patient and the medical tourism industry is driven by these educated patients. This is why transparency is so important. This is the principal mission of the MTA's Quality of Care Project where patients can compare a hospital's quality of care based upon unified indicators and a uniform methodology. 

One problem with the AMA's guideline is found at the subheading wherein medical care should only be given by healthcare providers accredited through internationally recognized accrediting bodies. The problem with this is there are smaller clinics and facilities in the US that are not accredited by the Joint Commission, yet acceptable for care. The AMA is implying a higher accreditation standard than found in many places here in the US. 

It is rare for a plastic surgery clinic or smaller clinic, for instance, to seek accreditation in the US. But the vision of the statement is absolutely correct meaning AMA's desire to ensure that patients are only traveling to hospitals of the highest quality of care. 

One problem is their referral to accredited bodies such as ISQUA because ISQUA accredits accreditation systems and not hospitals. I believe they meant to say an accreditation system accredited by ISQUA is sufficient. In July after almost a year of research and gathering input from its membership, the Medical Tourism Association is launching a Medical Tourism Certification program specifically to provide information to patients about international patient services offered by Medical Tourism Facilitators. 

This is not designed to certify quality but will serve as a source of information about the international patient services offered to foreign patients. This will include things like languages spoken, informed consent forms, transparency in pricing, transparency in legal recourse, and more. 

As the industry grows and more hospitals receive international accreditation for quality, it becomes increasingly difficult for patients to know whether a hospital is right for them. If the hospital has an international patient department, does that hospital also provide outcomes for its surgeons' transparency regarding legal recourse privacy protection for medical records? What about medical tourism facilitators? Are they more than just a website? Do they have protocols in place to assist patients with appropriate aftercare facilities? Do they provide assistance for aftercare? Are they transparent regarding the price of their services? 

The certification for Medical Tourism Programs is valuable in assisting patients, employers, and insurance companies identify which hospitals and facilitators have benefits suitable for them. The Medical Tourism Association Certification is not an identification of the quality of the surgeons or the facility outcomes, rather it focuses on the international patients' services and protocols currently being utilized and marketed to foreign patients. The certification system will focus on the Medical Tourism aspect and is not intended to certify quality or to replace any accreditation system. This new MTA Certification system focuses on accreditation systems currently in place.

Where is the Medical Tourism Industry Headed?

The AMA advocates that employers, insurance companies, and other entities that facilitate or incentivize medical care outside the U.S. adhere to the following principles: 

1. Medical care outside of the U.S. must be voluntary. 

2. Financial incentives to travel outside the U.S. for medical care should not inappropriately limit the diagnostic and therapeutic alternatives that are offered to patients or restrict treatment or referral options. 

3. Patients should only be referred for medical care to institutions that have been accredited by recognized international accrediting bodies (e.g. the Joint Commission International or the International Society for Quality in Health Care). 

4. 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. 

5. Coverage for travel outside the U.S. for medical care must include the costs of necessary follow-up care upon return to the U.S. 

6. Patients should be informed of their rights and legal recourse prior to agreeing to travel outside the U.S. for medical care. 

7. Access to physician licensing and outcome data as well as facility accreditation and outcomes data should be arranged for patients seeking medical care outside the U.S. 

8. The transfer of patient medical records to and from facilities outside the U.S. should be consistent with HIPAA guidelines. 

9. Patients choosing to travel outside the U.S. for medical care should be provided with information about the potential risks of combining surgical procedures with long flights and vacation activities.

About the Author

Renée-Marie Stephano is Chief Operating Officer and a Founder of the Medical Tourism Association Inc., an international non-profit organization that serves international healthcare providers and medical travel facilitators in the global healthcare industry. Renée-Marie is an attorney licensed to practice law in the states of Florida, Pennsylvania, and New Jersey and has a background in litigation and health law. She is also Editor of the Medical Tourism Magazine a monthly journal serving the global healthcare industry by free subscription at Renée-Marie may be reached at

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Disclaimer: The content provided in Medical Tourism Magazine ( is for informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. We do not endorse or recommend any specific healthcare providers, facilities, treatments, or procedures mentioned in our articles. The views and opinions expressed by authors, contributors, or advertisers within the magazine are their own and do not necessarily reflect the views of our company. While we strive to provide accurate and up-to-date information, We make no representations or warranties of any kind, express or implied, regarding the completeness, accuracy, reliability, suitability, or availability of the information contained in Medical Tourism Magazine ( or the linked websites. Any reliance you place on such information is strictly at your own risk. We strongly advise readers to conduct their own research and consult with healthcare professionals before making any decisions related to medical tourism, healthcare providers, or medical procedures.
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