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• W2770618697 abstract "Sir: We thank Dr. Zavlin et al. for their interest in our article on the population health implications of medical tourism.1 Their perspective underscores the breadth of the term “medical tourists,” the different patient populations seeking medical care abroad, and how this phenomenon has transformed over the past few decades with globalization. Although without hesitation we acknowledge exceptional plastic surgeons that reside abroad, there is simply a lack of a standardized level of care in many countries. Patients need to be more selective and even more careful about their choice of surgeon. For example, although our research made the assumption that complication rates were the same abroad as in the United States, to develop a lower end estimate of the potential costs of medical tourism, as of now, we do not know the true complication rates abroad, and we likely will not in the near future. This lack of reporting along with increased legal laxity and lack of direct communication between surgeon and patient postoperatively all contribute to patients being at risk for not receiving the standard level of care they can expect from a board-certified plastic surgeon in the United States. In addition, medical tourism historically involved patients, typically those with higher financial means, traveling abroad to seek either a level of care that was not available at their country of origin or a procedure or approach that was not commonly performed. However, in our article, we describe a new and alarming increase in a different population of patients that are going abroad in hopes of cost savings. This is shown in our survey, where we note that for all patients in our case series, cost was their primary reason. There are two major differences between these two populations. First, the historical trend of the affluent patient traveling abroad for care is likely today much smaller than the population described in our article. Although there may be a reported number of 60,000 to 85,000 patients coming to the United States for care each year, an estimated 14 million patients from the United States go abroad for care. Second, cost is less of an issue for the historical medical tourist, who can expect to pay a cost that is much higher, as they are traveling abroad to seek care from an expert in the field, whether that is in the United States or internationally. Furthermore, our emphasis on postoperative care highlights how it can be compromised with increasing distance from the primary surgeon, language and cultural differences, and transfer of care from one nation to another. Few patients in our study were able to contact their primary surgeon. For patients excited about the prospect of surgery, it is easy to assume that complications are unlikely and that in the event of a complication, photographs and videos will suffice for an evaluation. The patients in our study had aggressive complications, and many required prompt surgical evaluation and management. In summary, the goal of our work is not to in any way discount the contributions and current work of our international collaborators and pioneers in plastic surgery, many of whom you have mentioned, and whose work we are all indebted to. Instead, we aim to highlight a growing trend of patients seeking care abroad to save costs, resulting in debilitating complications that demand aggressive and early treatment by surgeons in the United States and for which the financial burden falls on the national U.S. health care system. DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication. Kian Adabi, B.A.Evan S. Garfein, M.D.Oren M. Tepper, M.D.Montefiore Medical Center/Albert EinsteinCollege of MedicineBronx, N.Y." @default.
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• W2770618697 date "2018-03-01" @default.
• W2770618697 modified "2023-09-26" @default.
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• W2770618697 doi "https://doi.org/10.1097/prs.0000000000004160" @default.
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