Patient safety the first casualty with medical tourism

Medical tourism is booming, with around 15,000 Australians travelling overseas for medical treatment every year. Many of these procedures involve cosmetic or dental work but other treatments are increasingly popular: joint replacements, eye procedures, bariatric surgery, fertility treatment and even organ and stem cell transplants.

Historically, the main motivator for medical tourism has been price the same procedure overseas can cost a fraction of what it does in Australia, even when travel costs are taken into account. Long waiting times for procedures in the Australian public system and the relentless pursuit of physical perfection also drive people to look at options overseas.

The industry has become more sophisticated and mainstream, with Australian companies now offering all-inclusive packages. Even the private health insurers are getting in on the act — in 2014, NIB started its Options service which offers packages on overseas cosmetic and dental treatment. NIB says facilities it uses undergo a review and accreditation process, which they claim is benchmarked against Australian standards.

There are, however, significant issues with the industry. In March 2015 Australian woman Evita Sarmonikas, 29, died after she travelled to the US border town of Mexicali to undergo buttock implants. Incidents such as Ms Sarmonikas death highlight the problematic side of medical tourism.

Key issues with medical tourism

First and foremost, any medical treatment carries risks and complications that can be much harder to manage on the other side of the world. Treatment regulation and clinical standards may not be of a high standard, which can pose problems with a countrys ability to deal with potentially life-threatening complications of the treatment. It may be one thing to guarantee the procedure, but does the treating facility have access to appropriate post-surgical critical-care facilities if things go wrong?

Another issue is continuity of care. It is likely to be harder for a treating doctor in Australia to obtain information about the way the procedure was performed, what equipment was used and what post-operative treatment was provided. This may delay or complicate further treatment once the patient returns to Australia.

Likewise, patient consent may be compromised when Australians undergo medical procedures in countries where they dont fully grasp the foreign language.

Medical tourism may also place an unnecessary burden on the Australian health system if people are accessing further treatment via Medicare. For example, there may be the possibility for antibiotic resistant infections to spread, as other countries may have fewer evidence-based protocols around antibiotic use and infection control.

Regulations and insurance

There are currently no international agreements or frameworks that regulate medical tourism, nor is there specific regulation of Australian companies offering overseas packages.

Finally, legal issues arise when treatment has been performed overseas. Private health insurance may not cover you, and it would be extremely difficult to take legal action in the event of a complication — some countries do not even allow legal action when things go wrong. It may also create problems when trying to access things like income-protection insurance.

Given the potential for further health problems and complications, compromised insurance cover and the possible impact on the Australian public health system, those considering travelling overseas for medical procedures should carefully consider whether the benefits outweigh the dangers.

Tom Ballantyne is a senior associate in Maurice Blackburn's Melbourne office.

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Tom Ballantyne

Maurice Blackburn Melbourne
Tom Ballantyne is a Principal Lawyer and the head of Maurice Blackburn’s medical negligence department in Victoria. He is a Law Institute of Victoria Personal Injury Accredited Specialist, is listed in the prestigious Doyles guide, and is the Australian Lawyers Alliance Victorian President. Tom sees ...

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