ChesterCountyMedicine Spring 2018 - 30
Growing Threat, or
BY JOHN P. MAHER, MD, MPH **
ver the span of a physician's professional career, he, or
she, witnesses many changes. These may be desirable
and provide satisfaction, or just the opposite: - cause
anger and frustration at the "outside interference" into our
This author, for example, has lived through periods
of boom and recession, various wars and "police actions,"
consumerism and "community control," social medicine
and corporate practice, and (heaven help us all) the gradual
usurpation, regulation and control of the practice of medicine by
There is now another kind of change - not a new one by
any means - but one which has been growing steadily over
the past several years, without triggering any reaction from
individual practitioners albeit organized medicine has considered
it and offered guidance about it (see Figure 4., below), and while
numerous business, economic, and legal interests have latched
on to it with ever more interest.
The topic of "Medical Tourism" (a.k.a., "Medical Travel") has
been around for many years but, for a number of reasons, has
been out of the headlines and "below the radar" for most of us
for some time now. We are bombarded daily by the climate of
domestic politics, the media's obsession with such things as gun
violence, Russia's putative involvement in our elections, North
Korean nuclear threats, legalization of marijuana, etc., etc., ad
nauseam. It is no wonder then that seemingly unimportant
topics such as medical tourism get swept (not just to the back
burner but) totally out of the headlines entirely.
Nevertheless, Medical Tourism (hereinafter, MT) is
resurfacing with a vengeance, and individual physicians as well as
organized medicine should be paying greater attention.
According to numerous reports and websites, the number of
people traveling abroad to seek medical treatment of one kind
or another has been growing significantly in recent years and
30 CHESTER COUNT Y Medicine | SPRING 2018
seems to be part of a growing global trend. According to SFGate.
com, consumers are increasingly trying alternatives to their local
hospitals and doctors, and not just alternative or complementary
health approaches, but everything from going abroad for less
costly surgery to seeking quick, basic care at new clinics in
drugstores, malls, and big box discount stores. Several years back,
that same site reported that 750,000 Americans went abroad
for health care in 2008, and predicted that the number would
increase 10-fold (to 8 million) by 2010.
In fact, by 2011, over 11 million travelers left the shores
of the US in search of health care in different countries. In a
2016 report by VISA and Oxford Economics, the MT "industry"
was already valued at a staggering USD $100 billion, and was
projected to show compounded growth of 25% "year-over-year
for the next 10 years"! That report projected that an estimated 3
to 4% of the world's population will travel internationally for
healthcare and health-related treatment during that time.
The US Centers for Disease Control & Prevention (CDC)
notes that "many factors influence the decision to seek medical
care overseas. Some people travel for care because treatment
is cheaper in another country. Other medical tourists may
be immigrants to the US who prefer to return to their home
country for health care in a familiar culture. Still others may
travel to receive a procedure or type of therapy not available in
the US." The most common procedures which people undergo
on MT trips, according to CDC, include cosmetic surgery,
dentistry, and heart surgery.
From various sources, we see that common categories of
procedures which US medical travelers pursue during MT trips
include: orthopedic surgery, cosmetic surgery, cardiology (cardiac
surgery), fertility treatments, oncologic care, and dentistry.
Common destinations for US MTs include Thailand, Mexico,
Singapore, India, Malaysia, Cuba, Brazil, Argentina, and Costa
Rica (Fig. 2).