New Frontiers: Medical tourism brings potential for big business but poses big questions

“When it comes to ENT, a lot of the patients are coming to us because the doctors domestically are not giving the treatment that they want or they’re not able to solve the problem,” he said. Rupak cited the example of a patient who claimed that doctors in the U.S. were not able to mitigate pain and irritation that followed a septoplasty. The patient finally went to Singapore, where a surgeon removed bony chips around the anterior ethmoidal nerve.

“This train’s going down the track whether doctors want to participate or not. It’s happening all around the world.”

—Arlen Meyers, MD, MBA

Arlen Meyers, MD, MBA, professor in the department of otolaryngology at the University of Colorado Denver Anschutz Medical Campus and co-founder of the medical tourism company MedVoy, said the company handles three or four trips a month. Dr. Meyers and others who run medical tourism companies say the care experienced by traveling patients is usually as good as, or better than, the care found by patients in the U.S.

But Dr. Keckley, who attends conferences and talks to officials with medical tourism companies about their procedures, had the impression that the degree to which the so-called intermediary companies credential foreign providers and coordinate care is “woefully modest.” He didn’t name specific companies.

“It’s not an industry that has taken seriously yet managing outcomes and managing safety,” he said. “In our next study of this, we’ll dig very deeply into clinical processes.”

Raj Joseph, co-founder and CEO of the medical tourism company MedVoy, said that is a “very general statement … At the end of the day, it depends where you are going and which provider within the country you are going [to see],” he said. “We just try to work only with Joint Commission International-accredited hospitals or American Board-certified physicians and focus heavily on continuum of care.”

Follow-Up Care

Dr. Meyers said American doctors, including otolaryngologists, are all over the map when it comes to dealing with patients who have had procedures performed abroad. “There are some doctors that have the feeling that, ‘Look, if you didn’t come to me for your initial care and you went overseas to get it, now you show up at my office, I don’t want to have anything to do with you,’” he said. “There are other doctors that say, ‘Well, if you want me to help you identify a provider overseas, O.K., I’ll have a conversation with that person, I’ll provide records, I’ll establish some sort of pre-post-op care kind of thing, and I’ll be happy to help you.”