By Ron Johnson, M.D., F.A.C.S., Chief Medical Officer, Satori World Medical

It has been almost a year since the American Medical Association addressed the issue of “medical tourism,” travel for medical care outside of the US. The AMA supports patient choice, wants it to be informed choice, sees many advantages in medical care outside the US and an opportunity to learn from international competition and recommends principles to provide the best care possible. Now the American College of Surgeons has issued a statement on medical and surgical tourism.

The American College of Surgeons (ACS) is a scientific and educational association of surgeons that was founded in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical education and practice. The ACS currently has over 76,000 members, referred to as “Fellows,” including more than 4,000 Fellows in other countries, making it the largest organization of surgeons in the world. The ACS Committee on Perioperative Care developed a statement on medical and surgical tourism that was approved by the Board of Regents, the ACS governing body, at its February 2009 meeting. (To read the full statement, go to the Bulletin of the American College of Surgeons, Volume 94, Number 4, pp. 18-27.)

The American College of Surgeons’ statement, along with the AMA guidelines, together provide an important set of principles for consideration by patients, employers, insurers, and other third-party groups responsible for coordinating such travel outside of the country. The ACS has adopted the following position with respect to medical tourism.

1. The ACS encourages patients to seek care of the highest quality and supports their rights to select their surgeons and health care institutions without restriction.
2. The ACS encourages its Fellows to assist all patients in reaching informed decisions concerning medical care, whether at home or abroad.
3. The ACS advises patients to consider the medical, social, cultural and legal implications of seeking medical treatment abroad prior to deciding on a venue of care.
4. The ACS encourages patients electing to receive treatment abroad to seek care at health care institutions that have met the standards for accreditation established by recognized accrediting organizations, i.e. Joint Commission International (JCI), Trent International.
5. The ACS encourages patients electing treatment abroad to seek care from surgeons and anesthesiologists certified in their specialties through a process equivalent to that established by the member boards of the American Board of Medical Specialties.
6. The ACS encourages patients receiving treatment abroad to obtain a complete set of medical records prior to returning home, and follow-up care at home should be organized prior to travel whenever possible.
7. The ACS encourages patients contemplating medical tourism to understand the special risks of combining long international flights and certain vacation activities with anesthesia and surgical procedures.
8. The ACS opposes the imposition of provisions for mandatory referral of patients by insurers to health care institutions outside the US, unless such provisions are clearly and explicitly stated in the insurance contract and accepted by the subscriber.
9. The ACS supports the view that payors referring patients for mandatory treatment abroad should be responsible for the coordination and reimbursement of follow-up care in the US, including the management of postoperative complications, readmissions, rehabilitation and long-term care.

Medical tourism is a rapidly growing, world –wide industry, and its continued expansion could have significant implications for health care delivery in the US. The Statement on Medical and Surgical Tourism drafted by the American College of Surgeons was developed with the patient’s interest in mind.