Dental & Medical Tourism
It’s No Vacation
Traveling abroad for health reasons is a tradition that has a long history. In previous centuries, the well-to-do flocked to mountainside spas to take restorative mineral baths, sought balmy climates to relieve various ailments, and journeyed to faraway cities for innovative medical treatments. Today, going abroad for health care is often called medical tourism, and it’s a globalized, multi-billion-dollar industry. In some instances, affluent patients are seeking out the finest medical care available anywhere in the world. In other cases, people from developed countries are choosing to have medical procedures — such as cosmetic surgery and dental treatments — performed at a lower cost in the developing world. Certainly, no country has a monopoly on good medical care; however, it’s important to realize that there are pros and cons to this kind of traveling.
How popular has medical tourism become? According to one travel facilitator, about 1.2 million Americans ventured abroad for medical care in 2014; of those, roughly half will go for dental procedures. The top worldwide destinations for medical travel include Costa Rica, India, Israel, Malaysia, Mexico, Singapore, South Korea, Taiwan, Thailand, Turkey… and, not surprisingly, the United States — for top-quality specialists and state-of-the-art facilities. But according to a poll from the market research firm Software Advice, the main reason Americans give for traveling abroad is the significant cost savings they are promised.
It is undoubtedly possible to get good dental care in many different parts of the world — and even to find dentists and doctors who trained in the U.S. working in their home countries. But if you’re thinking about going abroad for dental treatment, there are several things you should be aware of.
Perhaps the major medical risk of receiving treatment in a foreign country is that treatment standards may not be as high as they would be at home. For example, every dentist in the U.S., after graduating from an accredited dental school, must pass national and state examinations before he or she can begin to practice; specialists need years of additional training above and beyond the standard curriculum. In other countries, however, educational standards can vary widely, and accreditation may be far easier to obtain.
Additionally, some common practices that help ensure the safety of patients in the U.S. may be lacking abroad. Sterilization, vaccination and infection control procedures may not be up to U.S. standards, potentially increasing medical risks. In some regions, the blood supply is not well screened; medications may be adulterated; and the materials and workmanship of dental implants or crowns may not be the same high quality that would be expected at home.
Lost in Translation
Another challenge for the medical tourist is difficulty in communication. Language barriers can make it harder to know exactly what to expect during and after a procedure, or whether any questions you ask are understood. This can lead to misunderstandings about treatment, or problems with your care. It may be difficult for foreign health care providers to access and comprehend a patient’s complete medical history; likewise, complete documentation of the treatment provided abroad is often lacking — which can create problems when you get back home. Patient confidentiality and privacy may also be compromised.
Even if it doesn’t impact your treatment, not being at ease with the language or culture can make things difficult and uncomfortable; especially so if you’re also recovering from a dental procedure. The lack of transparency that sometimes occurs can also lead to misunderstandings about covered services and costs — meals, rooms, amenities, and other charges. This sometimes causes the travel budget to grow beyond what was planned.
It’s Not a Holiday
When you’re relaxing by the seashore, an afternoon can feel like a week; it isn’t that way with dental or medical tourism. Many who go abroad for dental treatment aren’t prepared to spend enough time to complete entire multi-stage procedures. Getting dental implants, for example, often involves several office visits spaced over a couple of months. This means that they may need to have related procedures done in different countries by different dentists. Alternately, some decide to have all their dental work done in a short time frame. That may not be ideal in terms of quality, or overall well-being. Insufficient time for recovery is also a concern; while there may be a picturesque beach nearby, many find they would simply prefer to recover at home. In fact, the U.S. Centers for Disease Control (CDC) advises patients to “avoid ‘vacation’ activities such as sunbathing, drinking alcohol, swimming, taking long tours, and engaging in strenuous activities or exercise after surgery.”
Many who go abroad for dental treatment aren’t prepared to spend enough time to complete multi-stage procedures, which often involve several office visits spaced over a couple of months.
After you return home, if there are any problems or concerns with the treatment, it’s usually impractical to go back to the doctor who performed it. However, it is possible to find a U.S. dentist who will manage your follow-up care. A guiding ethical principal is that patients have freedom of choice in electing where and when to have medical and dental procedures performed. According to a policy statement of the American Dental Association, “The ethical dentist will treat the patient who has received dental treatment outside the United States in the same manner as he/she would treat a patient who has transferred their care from any other practice, irrespective of the fact that the treatment performed outside of the United States might or might not be substandard and, in some instances, a possible detriment to the patient’s health.”
But there’s one thing to keep in mind: The cost of re-treatment, when necessary, is the responsibility of the patient — and it can end up being substantial. One of the major benefits of establishing a “dental home” at a practice near you is that it assures you continuity of care: this means that you have a dentist who sees you often, knows your dental (and personal) history, and can help you maintain good oral health and receive comprehensive care.
The Joys of Travel?
If you’re a globe-trotting adventurer, the myriad aggravations of travel, both small and large, won’t cause you to lose much sleep. But if traveling makes you tense, having a medical procedure done in a foreign country will probably just add to your worries. Being far from home, family, and friends means that your “vacation” may not be very restful. In addition to the usual minor hazards, any travel risks for particular countries or regions — such as those covered in advisories from the Department of State — should be factored in to your decision of whether or not to go.
It doesn’t happen very often, but if something does go wrong with a medical procedure in the U.S., there are many avenues for recourse. These include professional societies, state regulatory and licensing agencies, and (as a last resort) the legal system. But many foreign countries don’t offer the same protections to patients; in fact, your rights as a patient will vary widely depending on where you are treated. That’s why it is essential to understand your rights before you go abroad.
Know Before You Go
In today’s globalized economy, medical tourism is a phenomenon that is receiving increased attention. A host of businesses, both at home and abroad, are doing their best to entice people to travel for the purpose of receiving lower-cost medical care. While it is possible to receive excellent dental care in many parts of the world, patients need to become educated not only about the potential benefits of medial tourism — but also about the risks, and the alternatives available — before deciding to have dental or medical treatment abroad.
If you do plan to go, you should ensure at the very least that that all health care providers and facilities are properly accredited; that you have a complete written statement of services to be provided and charges incurred; and that all your medical records are readily available. There are several good on-line resources, including the CDC’s “Yellow Book” Health Information for Travel; the section on medical tourism can be accessed at http://goo.gl/75iWBk.