Health care is a hot topic these days... where to get it, how much it costs, and the quality of services are people’s main concerns.
Nearly every person in the U.S. is a consumer of health care at one time or another... whether you only get routine “maintenance”, or you require ongoing or sporadic medical treatment, you know that sometimes you can feel lost in the system.
Medical tourism is when a person travels to another country for medical care. Residents of the U.S. common travel to Mexico, Canada, Central America, South America, or the Caribbean in search of medical treatment.
Why can’t get the treatment right where they live?
There are a few reasons why a patient might choose to seek treatment outside the country:
- They believe the procedure or treatment will cost less overseas.
- They would feel more comfortable with a provider who shares their culture or speaks their native language.
- They are seeking treatment or a procedure that is unavailable or is not approved in the U.S.
However, what happens if something goes wrong? In the U.S., we have a clear system of liability for medical malpractice cases. Although each state has a slightly different set of rules for medical malpractice lawsuits and how much a plaintiff can recover, you can’t expect to follow the same laws if you need to sue a foreign provider for malpractice or fraud.
What are the most common risks associated with medical tourism?
The CDC lists a number of risks that are associated with seeking medical care abroad.
Certainly, there is a risk of infection for any medical procedure, regardless of where you have it performed. However, other countries might not follow the same sanitary and risk-mitigation protocols as are required in the U.S., which can result in an increased likelihood of a wound infection, bloodstream infection, donor-derived infection, or a disease like hepatitis B or C or HIV.
Countries like India, Thailand, Malaysia and Costa Rica have higher instances of tuberculosis, amoebic dysentery, and other diseases than the U.S., and patients who seek care there are more vulnerable.
Quality of care.
Not every country has the same requirements for credentials and licensing of medical professionals. Some countries also don’t have the same level of protection against counterfeit medicines and low-quality medical devices.
Like infectious disease, antibiotic resistance is a concern anywhere—including here. However, it’s a bigger problem in some countries than others and there have been instances of drug-resistant bacteria causing disease outbreaks among medical tourists.
If you’re traveling to a country where you don’t speak the primary language, things could become complicated. You might become confused when communicating with doctors or nurses about your medical history, medication dosages, or other important information.
Flying can increase your risk for developing a blood clot. The CDC recommends that you wait 7-10 days after a surgical procedure, including face or eyelid surgery or laser treatments, before flying. Changes in atmospheric pressure in a plane can cause serious complications.
Continuity of care.
You might be fortunate enough that your treatment is a “one and done” situation and you never need any further care. But if there are complications or any follow up is required, it could be difficult to get the appropriate treatment. If the procedure performed abroad is not routinely done in the U.S., you might have a difficult time finding a physician who knows how to diagnose and treat the resulting complications.
Can I sue a foreign doctor for medical malpractice?
It’s not impossible to sue a foreign doctor for malpractice related to a procedure or treatment you received abroad, but it’s not easy. When you leave the U.S., you are no longer protected by the American legal system. In order to file a lawsuit against a foreign doctor in a U.S. court, you need to establish that the doctor had sufficient contacts with the U.S. in order for the U.S. to exert its jurisdiction.
In other words, the doctor would likely have had to have some type of business relationship within the U.S. or be actively seeking U.S. patients in order for the court to be able to “reach” them abroad.
Even your case can meet this standard, there are other considerations. Some countries do not recognize a foreigner’s right to sue their citizens. If you are able to sue and are successful, you still might not ever be able to collect your judgment (the money you’re owed) from a foreign defendant.
In short, you could try to pursue a lawsuit against a foreign doctor or other medical professional, but the process will be lengthy (years to decades), costly, and complex.
When does a U.S. doctor have responsibility for follow-up care from medical tourism?
Your doctor can’t be held liable for mistakes or complications caused by a doctor abroad.
However, the American Medical Association (AMA) sets forth guidance for physicians for how handle a patient who is considered or has opted to pursue treatment through medical tourism. (source)
These recommendations include:
- A physician should be open to discussing a patient’s concerns about their medical care, and be alert to signs that the patient might be considering seeking care abroad.
- Be knowledgeable about medical tourism and provide the advice and guidance a patient needs in order to make an informed decision.
- If a patient informs a doctor in advance that they are going to seek medical care abroad, the doctor should advise the patient about whether they will be able to provide follow up care. If not, they should advise patients of where they might seek other options for care.
- A physician should offer non-judgmental advice and professional guidance to a patient seeking medical tourism care. The physician should advise a patient if they think it’s not in their best interest to seek care outside the country.
Medical insurance coverage for medical tourism procedures
Many patients who seek health care abroad do so because they are uninsured or underinsured. However, some insurance companies are beginning to provide “first-person” insurance that a patient may purchase before they travel. A claim would be handled without an attorney and would follow U.S. laws and is paid in U.S. dollars.
If you’re considering medical tourism and would like to have it covered by your insurance, that’s a conversation to have with your specific insurance company. Be sure to read carefully the terms of the policy, what the limits are, and if there is any recourse available if you suffer injuries as a result of a medical procedure abroad.
Role of your local doctor in medical tourism
There are a few ways your local physician can and should be involved in your treatment abroad. First, get an opinion, diagnosis, and suggested treatment plan. Your doctor will tell you whether they think you’re fit to travel and if the treatment you’re intending to receive is appropriate for your condition or needs.
Second, you’ll need your local doctor to share your medical chart with the foreign provider.
Third, ask your doctor if they are willing and able to coordinate your care when you return home. You should try to have your local doctor be in contact with the foreign provider so that the foreign provider can share your medical records back to your local physician.
Be sure that when you ask your foreign provider to send your records to your U.S. doctor, they are in a format and language your doctor will understand. If the records aren’t in your doctor’s primary language, be sure to have a medical translator help with that transition so the records are accurately translated and handled.
What are my legal rights after medical tourism health care?
It would be difficult to bring a claim against a foreign provider once you return to the U.S.
The AMA adopted an ethics policy in 2018 regarding how domestic doctors should treat patients as relates to medical care they received abroad. In part, the policy says that a doctor should, “[r]espond compassionately to requests for follow-up care from returning patients who had not consulted the physician before seeking care abroad, and carefully consider the implications before declining to provide nonemergent follow-up care.”
If you believe that you’re the victim of medical malpractice from treatment received outside the U.S., you should contact an attorney who is familiar with not only medical malpractice lawsuits, but also international law.