Seeking sun, sand and surgery
When Saskatoon resident, Sue Maruk, injured her shoulder while vacationing in California, she was told she had a six-month wait until the required surgery could be performed back home. In unbearable pain, she opted to have the procedure in nearby Mexicali, Mexico, where she was treated within days. The care was second-to-none according to Maruk, who was discharged a day after the surgery with positive results.
Maruk is one of many Canadians looking beyond the northern border for medical care ranging from dental crowns to hip replacement surgery. Their search is often due to frustrations over unbearable wait times, expensive elective procedures, or the desire for a specialized treatment unavailable at home.
Their concerns are not unfounded. A 2015 Fraser Institute report on medical waiting times indicated that the median waiting time between referral from a general practitioner and receipt of treatment is 18.3 weeks. For orthopedic surgery, it stretches to 35.7 weeks. Treatment abroad is often immediate and, for elective procedures not covered by the province, costs can be significantly lower.
The demand has spawned a thriving medical tourism industry that offers procedures spanning experimental to routine across the globe. Consider Los Algodones, a small Mexican town that specializes in dental work. Situated a short walk across the Arizona border, it is said to have more than 300 dentists vying to clean up tourists' ailing smiles.
For Maruk, going to Mexico was the right choice. "I have nothing but high praise for the entire crew and hospital," she explained. "Everybody is happy to be working and they always have time for the patient." The orthopedic surgeon who performed the surgery even played a video of the operation with her, explaining it step-by-step.
Of course, not every medical treatment abroad has a happy ending. A few Google searches expose reviews ranging from shining endorsements of clinics in Costa Rica to stories of botched surgeries in Tijuana. Selecting the right place and practitioner for treatment can be challenging.
Adele Kulyk, CEO of Global Healthcare Connections, advises against relying too heavily on online research when investigating medical care abroad, claiming that practitioners can range from highly qualified to sloppy and untrained in just about any destination. Her third party service helps patients find medical facilities and treatments across the world. In fact, her company helped coordinate Maruk's shoulder surgery in Mexico.
Making an informed decision, while challenging, is imperative for patients whose health is at stake. There are a number worth considering when seeking medical treatment abroad that can help ensure a successful outcome.
1 – Consider working with an established medical tourism facilitator. A good facilitator will vet all medical service providers, check certifications, read all reviews, visit the facility, and ensure an English speaking coordinator is available at all times. Additionally, don't be afraid to ask if the facilitator is paid by the medical provider abroad.
2 – Question everything as if this is for the most beloved family member since, often, patients will overlook caring for themselves but will advocate for others.
Suzanne Garber, producer of the documentary, GAUZE: Unraveling Global Healthcare and CEO of Gauze, which describes itself as the world's largest database of hospitals outside the United States, likens the process to purchasing an automobile. "Consider how much research you put into buying a car. How much more important is performing due diligence on your health or undergoing the knife?"
3 – Be certain there are as few language barriers as possible. Perhaps the intake coordinator speaks English, but what about the nursing staff who will manage the recovery? A translator may be necessary throughout every step of the way in a country where few people speak English.
4 – Be aware that travel insurance is unlikely to cover costs associated with medical tourism. Consider purchasing medical travel and medical complications insurance coverage that covers the costs of complications that may arise up to six months after the treatment. Be sure to read the fine print: Will patients have the option to be treated in Canada or must they return to the country where the surgery was performed?
5 – Advise the general practitioner at home about plans to be treated abroad to help ensure the doctor-patient relationship remains respectful and intact after the procedure to aid with recovery.
"In our experience, when approached properly, explaining the situation to the doctor can be very beneficial for the individual," Kulyk explained. "If you step outside of their care and then return, expecting things to carry on, it's important to be thoughtful of everyone involved."
6 – Be informed and realistic about the recovery, such as how many days or weeks of rest are required before travelling home and for follow-up care. Maruk's follow-up care on her shoulder was monitored through email exchanges with the orthopedic surgeon who operated on her.
"My physiotherapy lasted five months. I would regularly email him my progress and he would personally respond by two in the afternoon that same day," she said, describing the process as very positive.
Doing one's homework is key to making an informed decision on medical care abroad. This often requires asking difficult questions that Canadians aren't accustomed to asking given that the doctor-patient relationship has been traditionally based on complete trust in the practitioner. Such assumptions aren't necessarily ideal when considering procedures in another country. And, coordinating one's own care is uncharted territory for most people.
"I advise people to consider the source of information gleaned about procedures and facilities," explained Garber. "Is it a hospital marketing department printing those glossy brochures or is it accredited by a certain governmental body?"
Clearly, there is no easy path or guarantee of success. Nonetheless, interest in travelling for treatment is not likely to wane as waiting times at home continue to grow (The Fraser Institute claims this year's wait time is 97 per cent longer than in 1993 when it was 9.3 weeks.)
Pablo Castillo, CEO of Medbrick, is trying to eliminate some of the fear and stigma attached to medical tourism. He is the founder of Destination Health, Canada's medical tourism trade show, which held its second annual show this past September in Ottawa.
"This show is about empowering people with healthcare options and they need support from healthcare providers," explains Castillo. With coveted procedures such as bariatric surgery and facelifts offered in other countries for a fraction of the cost at home, and zero wait times, it's a subject worthwhile of discussion.
The main message to all potential medical tourists is the same across the board. Do the necessary research to make the most informed decision possible. The tropical paradise outside the hospital window is a nice perk, but as Kulyk reminds anyone travelling south for treatment, "In most instances, the concept of sand, sun, and surgery is not realistic." In other words… Don't plan any day trips to the beach.