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I. What Are Medical Tourism Responsibility and Accountability Standards, and Why Do They Matter?

There aren't any, and that's why they matter.

At its heart, medical tourism is nothing special, and a medical tourist is not so different from any other person seeking healthcare. Of course everyone's body, everyone's story, is different. But at the end of the day, what we all want to live the best, longest, healthiest lives that we can. Some of us can do that with the medical resources that are near us, and some of us cannot. Maybe we have a condition for which treatments are still experimental. Maybe treatment near us is unaffordable. Maybe the treatment we seek is controversial where we live, but accepted somewhere else. There's nothing wrong with any of this. Every local medical system is different, no one solution will work for everyone, and all of today's accepted medical treatments were experimental once.

But all of this variety and ambiguity has led to a really scary situation where, just like the patent medicines 100 years ago, people can say pretty much whatever they want, sometimes performing unsafe medical procedures, because it doesn't seem like there are any negative consequences for them at all.

Medical travel can help people find treatments they need, that they might not get otherwise. But due to the weakness of some countries' patient protection laws, not to mention haziness of international jurisdiction, it's incredibly important that all medical travelers maintain a large amount of skepticism, and use that to seek proof of responsibility and accountability in a potential healthcare provider.

II. Example: Stem Cells

Stem cells are a perfect example of the tension between the controversial versus contra-factual, and real medicine versus quack medicine.

Stem cells offer a lot of hope, and a lot of legitimate promise, especially in the field of regenerative medicine. However, real, reliable, effective treatments are hard to develop. Any trustworthy practitioner, the kind that you want to go to, will be excited by the possibilities, but also afraid of the risks, the possible deaths or disabilities, for which they would ultimately be responsible. This is why it takes such a long time for cutting-edge treatments to become readily available.

Embryonic stem cells are controversial because they raise questions about when human life begins. People's answers will vary considerably depending on their religious, philosophical, and cultural beliefs. But it's important to know that a large amount of stem cells do not come from embryos. For example tissue-specific stem cells, such as blood-forming (or hematopoietic) stem cells in the bone marrow, can be used in cancer treatments because they can give rise to red blood cells, white blood cells and platelets. Their use raises no questions about the beginning of human life. Nonetheless, because of the controversy in this subject, it's reasonable to expect that there will be medically legitimate stem cell treatments that will not be available in all countries or communities, and some people will choose to reject the cultural mores of their neighbors and travel in order to receive this treatment.

But the controversy and misunderstanding behind stem cells has apparently given rise to a lot confusion, text-normaling to fake treatments and false advertising, especially in countries that don't have strong patient protection laws. Treatment peddlers know they can say whatever they want, because most people don't actually know what stem cells are, because some people will pay them for it, and because nothing bad will happen to them over it.

The good thing about medical tourism is that you can find medical care that is not offered to you in your home country. The bad thing about medical tourism is that sometimes the treatment is unavailable for a good reason.

Just because a treatment is being sold, just because it's not illegal, does not necessarily make it safe or effective. In some ways medical tourism is a lot like the days before the FDA, before patient protection laws, when people would make any claim about any substance, saying and selling anything to make a quick buck. If you want to benefit from the increased options that are open to you through international medical travel, you also need to take the extra effort to make sure you're not being scammed.

III. Questions to Ask Your Doctor

To combat the rise of fake medicine and false advertising, the The International Society for Stem Cell Research (ISSCR) has come up with information you should look into if you are considering a stem cell treatment. Though they are talking specifically about stem cell treatments, their suggestions are good guide for any kind of medical tourism treatment and inspired the bulk of the following list.

Questions you should as your doctor before committing to any medical treatment include:

  • How many times have you performed this procedure? How many times have there been complications? Has this data been published?
  • Is the treatment routine for this specific disease or condition?
  • What are the alternative treatment options for my disease or condition?
  • What is the scientific evidence that this procedure could work for my disease or condition? Where is this published?
  • Is there any independent oversight or accreditation where the treatment will be done?
  • What are the possible benefits I can expect? How will this be measured and how long will this take?
  • What other medications, special care, of follow-up, might I need?
  • What are the risks of the procedure itself, and the possible side effects both immediate and long-term?
  • Is the clinic adequately prepared to handle emergencies such as a serious allergic reaction?
  • What are the costs of the treatment? What does this include? What other costs will I incur?

IV. Questions to Ask Yourself

You don't need to understand medicine to select a good medical travel treatment, just don't ignore what you already know about the world, and always look for the simplest, most likely, explanation.

Things you should look for, and example questions you should as yourself before committing to any medical treatment, include:

  • Balanced Perspective: Are they giving me a nuanced idea of the both the benefits and risks I can expect, or are they just telling me what I need to hear to get me in the door?
    Does this sound too good to be true?
  • Proportionality: If they can really do everything they say they can, as well as they say they can, why is their clinic so small? Why, of all the doctors in all the world, are they the only ones doing it this way? Is there a good explanation for why they can offer this treatment at this price?
    Does this sound too good to be true?
  • Transparency: If their results are so miraculous, why haven't they published them? Wouldn't they want to brag about their amazing discovery? Wouldn't they want to heal the world with what they know? Or are they afraid that letting other doctors and scientists look at their practices would show that their claims are false?
    Does this sound too good to be true?

There are acceptable answers to all of these questions. A doctor that is upfront about the bad news, as well we the good, is one you can trust. Countries where the rent is low, cost of medical school is low or even subsidized, wages are lower, and the prices of medicine is negotiated, can often perform equivalent medical treatments for a fraction of the prices other countries can. Accredited facilities and doctors who publish and study their outcomes are more trustworthy than the ones that avoid public scrutiny. If your doctor is good at what he or she does, they shouldn't be afraid to tell the medical community about it.

But if they're telling you they can solve all of your problems, if they're acting like they know something that no one else in the entire medical community knows (unlikely), or that they don't want to share their knowledge with their peers... something doesn't sound right. They're probably not being honest with you.

In general, always ask yourself: Does this sound too good to be true? If you can't get a good answer to these questions, it probably is.

V. Basic Standards of Responsibility and Accountability

At Well Traveled, we try to strike the balance between encouraging patients to seek out all options available to them and empowering patients to be their own health advocates, but not to the point of enabling dangerously irresponsible fake medicine and false advertising. At the same time, it's impossible for anyone but a properly trained professional to really know the difference, and with a data set as large as ours, it's impossible to guarantee the quality of every facility, the truthfulness of every claim. For that reason, we have come up with our own Basic Standards of Responsibility and Accountability. All prospective medical travelers should look for these in a potential healthcare provider, and we invite site users to notify us if they believe a facility listed on this site violates these principles.

    Basic Standards of Responsibility and Accountability in Medical Travel Facilities and Practitioners:

  • Seeks out third-party oversight, in the form of vigorous, preferably international, accreditation. In countries where accreditation is not common, facility and practitioners are active and accepted into medical community.
  • Practitioners are respected in the field, ideally through publication in legitimate medical periodicals. Skills are kept current, as evidenced by frequent participation in trainings, seminars, and other opportunities for professional growth.
  • Publishes verifiable data, and cites reputable sources when making claims.

Holding medical facilities and healthcare practitioners to these Basic Standards of Responsibility and Accountability is one way of being smart and staying safe while being well traveled.