What do the AMA guidelines for Medical Tourism mean?

They are a set of principles that are a balance between the acknowledgment that this industry exists, is here to stay and a need to meet their member's concerns. Medical Travel and tourism are future competitors with general US medical practice. The industry is not large enough to be a business concern, but it is predicted to grow to that point.

The guidelines are available at the AMA website. It is worthwhile to discuss them. The first one: Medical Tourism must be voluntary. Yes I agree voluntary, but who or what company would force this option upon an unwilling client? Forced care overseas is a recipe for a medical and public relations disaster. So I agree voluntary, but the Medical Tourism industry has ethical participants.

In the second, third and fourth, there are important issues that are discussed. It is very important for many reasons to have Joint Commission International or International Society for Quality in Health Care certification. These two bodies ensure that facilities are using the right process and procedural mechanisms to ensure patient safety. The countries and facilities have the same quality assurance that we do or a different, but equivalent, process for assurance. This is important to the longevity of the industry. They are benchmarks that help us interpret important safeguards across cultural, political and language barriers.

The next two are intimately tied together. Follow-up care must be financed and coordinated prior to departure. A less well defined one: coverage for travel outside the US for medical care must include the costs of necessary follow-up care upon returning to the U.S. I am a strong proponent of aftercare. It is essential that this is available to the patient. Who should pay for the cost of after care is a more difficult question. Should the insurance company who receives the financial benefit of success care rendered abroad? Should the patient who is uninsured seeking the care overseas at a steep discount to the price a U.S. physician and hospital would charge? Should the destination facility be responsible for this fee? Should the facilitators? The premise is medically correct, aftercare should be available upon return. The business aspects of who pays for are open for discussion.

Physician outcome data and HIPAA Compliance issues are reasonable requests as goals. We do not have full transparency on specific physician outcomes and do not fully enforce HIPAA in the U.S. that is our goal, to move the country in that direction. It is the right goal for everyone. Our colleagues abroad may feel it is unreasonable to ask for a perform better than we do on our own metrics. But the goal is valid.

The last one we fully embrace at Premiere Medical Travel. First and foremost is the healthcare. We have taken a particular stance in calling ourselves medical travel and not medical tourism. We believe tourism highlights the tourism component too much. For simple procedure or health check ups, this is feasible, but to recover from major surgery while on safari is unreasonable. Health first, experience next and everything should follow properly.

In general the AMA has it right in our view. There are some gaps in expectation and performance domestically on the aftercare, payment, outcome measures and HIPAA issues that warrant further examination. We can only expect others to perform at the level we set, embrace and enforce for ourselves.

Travel Safe, Be Well.

Jim McCormick, MD
Premiere Medical Travel Company, LLC
818.917.6189