Sunday, October 15, 2006

Medical "Tours"

"Hey doc, I've been having this chest pain when I walk a few feet. It's getting so bad I can barely walk from my bed to the bathroom."

"Really? Hmm. *click* I see from your chart, Mr. Smith, that you don't have health insurance. *click* And you have six kids. *click* But you have been working steadily at McDonalds for the last 10 years. *click* oh, and you have an ample supply of nitroglycerine."


"Well congratulations, Mr. Smith! You've qualified for an all inclusive Medical Tour to India!" * Tah dah * goes the computer. "Just think: an all-inclusive package with airfare, surgery, un-air-conditioned transportation to and from the medical facility, bottled water, 8 nights of accommodations, and tour of the Taj Mahal, all for the low-low price of $10,812!!"

"But I can't er, walk, too far."

"Oh, now, don't be a party pooper, Mr. Smith. Imagine the opportunity for world travel! There's nothing like flying cheek-to-cheek in economy comfort in the airplane both to and from your destination for the quick 23-hour flight! Isn't that worth the little chest pain you'll get carrying your bags on board? And think of the return trip with those leg wounds you'll have! You know, the ones where they harvest the veins to bypass those nasty little blockages. You'll be the entertainment for your entire row!"

"But my family..."

"There, there, Mr. Smith. Don't worry about them! They'll be so happy you've taken this Tour. After all, you'll be saving them thousands of dollars while basking in the.... er, wait, it's June ... well, the monsoons there won't be too bad. And when was the last time you saw rain like that? I mean, come on, Mr. Smith, be a player!"

"But they won't be there for me...."

"You don't need their support, Mr. Smith, it's just a tiny surgery. No biggie, Mr. Smith. Or, er, I hear they have companion fares if you get an American Express platinum card, Mr. Smith. You know: buy one airfare, get the other one free... can I interest you?" * Holds up the American Express brochure to Mr. Smith *


"Sure! And the best part, Mr. Smith, I've heard your employer will pay you money for taking this trip: they'll give you 20% of the cost savings they receive compared to what it would cost you here in the States! Wouldn't the kids like something special for Christmas?"

"Wow. I had no idea..."

"And that's just the beginning. The cows on the street, the incredible traffic, rickshaws, lack of center lines on the roads, it all makes for one thrilling and entertaining ride to and from the hospital! And the water. Oh, the water there. It's sparkling fresh - from the bottle, of course. But if you're the daring type, heck, try a little of the native water. You're sure to have some fun, then! Oh, but you'll need one more medication."

"What's that?"



"Just a little something to help with those nasty mosquitos. No big deal, really."

"Thanks, doc." Suddenly, Mr. Smith's chest tightness grows a bit at rest. "Er, doc, I'm having some of that chest pain again."

"Have any of those nitro pills, Mr. Smith? Try throwing one under your tongue, we wouldn't want you disqualified from your trip now, would we?"

"Gosh, no, doc!" Scrambling, he finds his nitroglycerine tablets and pops one under his tongue. Minutes later, he's breathing better. "Thanks, doc."

"Hey, no problem, Mr. Smith. Glad I could help. I mean, who needs medical care when there's Medical Tours! Bon voyage!"



Anonymous said...

Doc, I think yer gonna love this one:

The procedure is done at a non-US hospital by the patient's own surgeon. This solves the continuity of care problem and the doc gets a vacation too. Neat solution for the multitude of doctors who have spare time.

John Fembup

DrWes said...


Thanks for sharing! Now I know where I can go for Christmas!...

Damn, maybe this ain't so bad after all, I mean, does this mean I avoid all liability there?? No malpractice, a few mosquito bites, a quick pacer implant... hey, what could be better? But how much would I get paid - if the pacer implant costs $1250 - and it takes a day to get there, a day to do the surgery, and a day to get back, there ain't much financial incentive...

But more fun, who is this "Joint Commision International?" Seems they're a bunch of clipboard-carrying nerds who have lent their name to this endeavor in an attempt to sound credible and "improve medical care." But what are their credentials? What are their standards? Are THEY accountable for poor care if it's delievered?

I wonder if anyone from the AMA or Congress is concerned about this...

Anonymous said...

Doc, I only know what the website says, and would not actually claim that as "knowledge".

BTW, I'm the manager of benefits for an organization whose name you would instantly recognize - and we have a fair number of employees outside the US. The issue of "medical tourism" crops up for us not only with respect to US employees but also international employees interested in, e.g. two weeks at Phuket in Indonesia or convalescence on a beach in Thailand after surgery at Bumrungrad Hospital.

I am skeptical of this and so far am not proposing any change to our plan to recognize or encourage use of such facilities except for local employees who would use them anyway. I must admit PlanetHospital has an interesting idea, but I don't see it working with a large volume. At the same time, international competition for patients is a fact, it won't go away, and it will be interesting to observe the response in the US.

John Fembup

Anonymous said...

Whatever anyone might say, the trend is here to stay. You must recognize that a problem exists with the current healthcare system in the US and people are seeking solutions. if there was no problem, no one in their right state of mind would consider traveling for surgery. BTW, how many cases of botched or wrong-sided surgery have you heard of in India? The physicians performing the surgeries in those hospitals are mostly US or British trained. In other words, you are making fun of your own training.

Anonymous said...

"if there was no problem, no one in their right state of mind would consider traveling for surgery."

I think that overstates your case and is not correct.

People of means who seek services not covered by insurance - for example cosmetic surgery, or experimental therapies not yet approved or widely accepted in the US - have a clear financial incentive to seek the best deal they can find elsewhere. Hospitals of comparable quality to those in the US, together with first-rate medical staffs, now exist in many countries and such treatments can be obtained there at less cost than in the US.

This does not prove the presence of a problem - unless you consider the exclusion of these services from insurance policies to be the problem. Or unless you are willing to concede that medical care in the US is overpriced.

John Fembup

Anonymous said...

I don't know about you all - but I"M willing to "concede that medical care in the US is overpriced."
I'm leaaving for Thailand on the 27th to finally get my teeth taken care of. There's no way I could do it here.

Mary Ann Wuebker
Hailey, Idaho