ChesterCountyMedicine Spring 2018 - 32

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Medical Tourism
continued from page 31
Despite potential risk factors (Fig. 3), things are not
all bad or gloomy. The growth and economic importance
of the "industry" have attracted the interest not only of
international health professionals, but of other significant
"players" including lawyers, investors, economists, et al.
Some health insurance companies and large employers have
formed alliances with overseas hospitals to control costs and
assure quality of services. Several major American medical
schools have begun to develop joint initiatives with overseas
providers, such as the Harvard Medical School Dubai Center,
the Johns Hopkins Singapore International Medical Center,
and the Duke-National University of Singapore.
In addition, international healthcare organizations have
been developed in order to certify a level of quality for
healthcare providers and programs across multiple countries,
covering a wide range of programs such as hospitals, primary
care centers, medical treatment, and ambulatory care services.
The oldest of these, Accreditation Canada, goes back to
1968 when it first accredited the Bermuda Hospital. Since
then it has accredited numerous hospitals and health services
organizations in ten other countries. Britain has two other

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32 CHESTER COUNT Y Medicine | SPRING 2018

similar organizations, QHA Trent Accreditation, and GCR.
org. The creation of a set of International Patient Service
Standards in 2012 subsequently led to the establishment in
2016 of the Global Healthcare Accreditation Program which
is based in Florida and now has updated its GHA Standards
(for medical travel services) Manual to version 4.0 as of June
2017.
In the US the Joint Commission International (JCI), a
relative of the US Joint Commission, was founded in 1994
to provide education and consulting services to international
clients. Many international hospitals now see obtaining
such accreditation as a way to attract more American
patients, and some are looking to rank hospitals based on
patient-reported metrics. There is even now an International
Medical Travel Journal, which holds annual international
MT conventions in major cities around the world, provides
awards to providers in multiple different service categories,
and draws an international audience of legal, economic and
healthcare providers, reflecting the industry's increasing
global importance.
One final consideration: in 2008, the American Medical
Association put out a list of Guidelines on medical tourism,
which are worth reviewing (see Fig. 4), and with which any
physician seeking greater knowledge of this topic should
familiarize him or herself.
Fig. 4.: AMA's Guiding Principles on Medical Tourism
(a) Medical Care outside the US must be voluntary.
(b) Financial incentives to travel outside the US for medical
care should not limit the diagnostic and therapeutic
alternatives which are offered to patients, or restrict treatment
or referral options.
(c) Patients should be referred for medical care only to
institutions which have been accredited by recognized
international accrediting bodies (such as the Joint
Commission International or the International Society for
Quality in Health Care).
(d) Before 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.
(e) Coverage for travel outside the US for medical care must
include the costs of necessary follow-up care upon return to
the US.
(f ) Patients should be informed of their rights and legal
recourse before agreeing to travel outside the US for medical
care.
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