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Medical Tourism from Australia

19th October 2015

Medical tourism is a rapidly growing and increasingly popular enterprise involving Australians who travel abroad for selected medical treatments. Each year thousands of Australians will travel overseas to undergo various procedures.

Medical tourism is a rapidly growing and increasingly popular enterprise involving Australians who travel abroad for selected medical treatments. Each year thousands of Australians will travel overseas to undergo various procedures.
The true number of medical tourists is unknown, but a 2010 Government report (1) stated there were 12,800 Australian medical tourists in 2010, growing at a rate of 14% per year, well above the growth rate for all tourists (2% per year). In 2013 the ABC program PM quoted more than 15,000 Australians per year travelled for cosmetic surgery alone. (2)
The most commonly visited countries for Australians are Singapore, India, South Korea, Thailand, Malaysia, Germany, Costa Rica and Mexico. (1) The quality of treatment is not standardised between these first and third world countries.
Patients seek medical treatments, surgeries and dental procedures overseas for many reasons. These might include lower costs, shorter waiting times, availability of packages including travel with treatment(s), group travel with treatments, and the ability to combine treatment with a recuperative holiday.
The most common treatments being marketed to Australians are: (3)

  • Cosmetic surgery, for example, breast and buttock implants, facelifts, nose and ear surgery, liposuction
  • Dentistry, such as dental implants, dentures, crowns, whitening
  • Cardiology and cardiac surgery, including coronary bypass, valve replacement, coronary stents
  • Orthopaedic surgery, including hip and knee replacements and other joint surgery
  • Bariatric surgery, such as gastric bypass and gastric banding
  • Fertility treatment, including in vitro fertilisation (IVF)
  • Organ transplants and cell or tissue therapies, for example, stem cell treatments
  • Ophthalmological procedures, such as laser eye surgery and lens implants.

Less commonly people travel for controversial treatments such as surrogacy and gender reassignment surgery, or experimental therapies not approved in Australia.
Problems arise when the procedures go wrong or patients have post-operative complications. Some facilities, particularly in third world countries, do not have the expertise to deal with life-threatening complications. All surgery and anaesthesia involve risks such as cardiac dysfunction, haemorrhage, blood clots or allergic reactions, and the doctors may not have resuscitation experience.
In March 2015 a 29-year-old Queenslander, Evita Sarmonikis, died during buttock-implant surgery in Mexico. (4) An initial autopsy reported the cause of death as cardiac arrest. The Mexican government wanted to cremate her body, but her family refused and demanded a second autopsy. This revealed the cause of death as four punctures to her right lung. (5) Evita’s death may have been preventable if stricter controls governing her surgeon had been in place. According to reports, her surgeon was “stood down” by his college pending a complete investigation, and the hospital where the procedure was performed has been closed.
Surgical complications such as wound breakdown and infection are more difficult to follow-up and treat once a patient has returned from overseas. Infection rates are higher and may involve bacteria that are resistant to antibiotics. Continuity of care and access to medical records become difficult for the patient’s doctors back home, and treatment may be delayed or inappropriate.
Adequacy of informed patient consent overseas is questionable because of language barriers. Patients should be counselled as much as possible before they make the decision to travel to undergo elective surgical procedures. Printed patient information detailing pros and cons of procedures is invaluable to their decision-making and ability to give informed consent. However, patients may not visit their GP, surgeon or dentist beforehand to discuss their intentions, which means the opportunity is missed.
If a patient is unhappy with the outcome of surgery, it is difficult to obtain corrective surgery or any redress for unsatisfactory treatment. Most travel insurance policies do not cover such procedures, and Australian cosmetic surgeons increasingly do not want to “pick up the pieces of a botched job”. (6)
Recently, private insurance company NIB has started a service known as ‘NIB Options’ to recommend accredited clinics overseas with qualified cosmetic surgeons and dentists. They do not, however, offer health insurance for this. (7)
Medical tourism may, at first glance, seem like a cheaper and faster option for patients wanting to have elective surgery and restorative or cosmetic procedures. However, travelling overseas for such treatments does carry significant risks to patients and should not be undertaken lightly.
Dr Venita Munir

References

  1. Medical tourism in Australia: A scoping study. 15 August 2011 Department of Resources, Energy and Tourism, Deloitte Access Economics Pty Ltd
  2. Young Australian women going overseas for cosmetic surgery. 21 January 2013. Australian Broadcasting Corporation PM: www.abc.net.au/ pm/ content/ 2013/ s3673600.htm [Accessed 5 October 2015]
  3. Leggat P, Medical Tourism Australian Family Physician Vol. 44, number 1, 2015, pp 16-21
  4. Lewis D, Evita Sarmonikas: Family of woman who died during Mexican cosmetic procedure calls for tougher regulations. 22 April 2015. Australian Broadcasting Corporation News http://www.abc.net.au/news/2015-04-21/family-of-evita-sarmonikas-call-for-greater-industry-oversight/6409802 (Accessed 5 October 2015)
  5. Dobeson S, Revealed: How Gold Coast woman Eva Sarmonikas really died during surgery 9 June 2015. MyGC.com.au http://www.mygc.com.au/news/how-gold-coast-woman-eva-sarmonikas-really-died-during-surgery/ (accessed 19 October 2015)
  6. Ratbone J, Hard truth of medical tourism gone wrong. 2 April 2015  Business News Australia  http://www.businessnewsaus.com.au/articles/hard-truth-of-medical-tourism-gone-wrong.html (Accessed 5 October 2015)
  7. NIB Options http://www.nib.com.au/nib-options/about (Accessed 5 October 2015)


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