New Frontiers: Medical tourism brings potential for big business but poses big questions

They seem to be simply following patient tastes. In PlanetHospital’s first year, 2002, just two patients were sent overseas. By 2006, that number reached the hundreds. Now, the company says it has arranged about 3,600 trips overall.

“The first three or four years, there was a fear factor,” Rupak said. But now, he said, “it’s past the tipping point. Now when you tell somebody about going abroad for surgery, somebody’s either heard of it or they know a friend who’s done it.”

Liability Issues

Glenn Cohen, an assistant professor at Harvard Law School who has written papers on medical tourism, said doctors who provide follow-up care to patients treated abroad may be at a heightened risk of getting sued if something goes wrong with a procedure done on foreign soil.

“Because they’re likely going to be very unsuccessful in suing the foreign provider, the patient has a higher incentive to sue you instead,” Cohen said. “Imagine a patient has a surgery abroad and then comes back and needs a second surgery. The idea of trying to unscramble the eggs, and figure out which was which in terms of who caused the injury, is difficult. And the insurance company, which is often in control of a lot of the malpractice litigation for doctors, may have a strong incentive to settle the case.”

He advised physicians to make sure their insurance policies will protect them in such cases.

There is also the potential liability involved in referring patients to foreign physicians, Cohen said. Doctors may have the same “duty of inquiry” that they have when referring patients to other physicians in the U.S., being careful not to refer to doctors who are known to be incompetent, are substance abusers or are otherwise ill-suited to care for patients.

More insurance companies are now agreeing to reimburse for medical care received abroad, but they differ greatly when it comes to what they’ll pay for. Dr. Meyers said coverage ranges from plans that don’t cover medical tourism procedures at all to those that treat it as out-of-network care to those that cover the care completely.

Just a Fad?

Dr. Keckley said his organization will be exploring the degree to which medical travel is being encouraged by consumers themselves and how much is promoted by insurance providers and employers. To continue to grow, though, the industry must be fixated on safety, he said.