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Plastic Surgery in the Dominican Republic: Is the Cheap Cost of Medical Tourism Worth the Risk?

First Posted: Feb 21, 2014 04:06 PM EST
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Plastic Surgery

Photo : United States Navy/Wikipedia

In the past, medical tourism was reserved only for the very rich, or for celebrities who wished to keep their under-the-knife travails secret from the prying eyes of the general public. Today, for a variety of reasons, medical tourism -- especially in the Dominican Republic -- has become increasingly popular, and is in fact affordable for all budgets... but is it all its cracked up to be?

The recent trend is for people to travel from developed countries to third world countries for medical treatments because of cost consideration, though the traditional pattern still continues. Another reason for travel for medical treatment is because some treatments may not be legal in the home country, such as some fertility procedures.

The medical treatment which some people seek and obtain in a foreign country include elective procedures as well as complex specialized surgeries such as joint replacement (knee/hip), cardiac surgery, and cosmetic surgeries. Some people go abroad for dental surgery or fertility treatments. The main reasons for fertility tourism are legal regulation of the some procedure in the home country, or lower price. In-vitro fertilization, donor insemination and surrogacy are major procedures involved. People with rare genetic disorders may travel to another country where treatment of these conditions is better understood. However, virtually every type of health care, including psychiatry, alternative treatments, convalescent care and even burial services are available.

Over 50 countries have identified medical tourism as a national industry, including the Dominican Republic.

One of the biggest "pros" of having your surgery done abroad is, of course, the cost. As a for-instance, a family member of mine is getting a fat transfer -- to put it simply, she's getting fat taken from one part of her body (her stomach) and having it transfered to another part of her body (her butt). The total cost for EVERYTHING -- flight to and from the Dominican Republic, surgery, and after-care with all meals and drinks included -- is $1400, or $700 per person (she's required to take someone with her to assist in after-care). That same surgery, if she were to have it in Atlanta, Georgia, would cost upwards of $15,000 for the surgery alone.

So, of course, it's nice to be able to go abroad and have surgery -- while enjoying the exotic beaches of the Dominican Republic -- without having to worry about mortgaging your house in the process. (It's not just cosmetic surgery that's a money-saver when you go abroad: the average cost of a dental implant in the United States is about $3,000; in India, you can get the same surgery for under $1,000.)

Another good thing to consider when going abroad is that there's almost no waiting period to get the surgery you want. It's almost a walk-in type procedure, in that regard.

In addition, you needn't worry about getting "lost" in the country -- many people go through medical tourism facilitators, who take care of everything from beginning to end for the prospective client.

Of course, as with any surgery, there are drawbacks to the procedure, as well.

Some countries, such as India, South Africa or Thailand, have very different infectious disease-related epidemiology to Europe and North America. Exposure to diseases without having built up natural immunity can be a hazard for weakened individuals, specifically with respect to gastrointestinal diseases (e.g. Hepatitis A, amoebic dysentery, paratyphoid) which could weaken progress and expose the patient to mosquito-transmitted diseases, influenza, and tuberculosis. However, because in poor tropical nations diseases run the gamut, doctors seem to be more open to the possibility of considering any infectious disease, including HIV, TB, and typhoid, while there are cases in the West where patients were consistently misdiagnosed for years because such diseases are perceived to be "rare" in the West.

The quality of post-operative care can also vary dramatically, depending on the hospital and country, and may be different from U.S. or European standards. Also, traveling long distances soon after surgery can increase the risk of complications. Long flights and decreased mobility associated with window seats can predispose one towards developing deep vein thrombosis and potentially a pulmonary embolism. Other vacation activities can be problematic as well -- for example, scars may become darker and more noticeable if they sunburn while healing.

Also, health facilities treating medical tourists may lack an adequate complaints policy to deal appropriately and fairly with complaints made by dissatisfied patients.

Differences in healthcare provider standards around the world have been recognised by the World Health Organization, and in 2004 it launched the World Alliance for Patient Safety. This body assists hospitals and government around the world in setting patient safety policy and practices that can become particularly relevant when providing medical tourism services.

If there are complications, the patient may need to stay in the foreign country for longer than planned or if they have returned home, will not have easy access for follow up care.

Legally speaking, receiving medical care abroad may subject medical tourists to unfamiliar legal issues. The limited nature of litigation in various countries is one reason for the lower cost of care overseas. While some countries currently presenting themselves as attractive medical tourism destinations provide some form of legal remedies for medical malpractice, these legal avenues may be unappealing to the medical tourist. Should problems arise, patients might not be covered by adequate personal insurance or might be unable to seek compensation via malpractice lawsuits. Hospitals and/or doctors in some countries may be unable to pay the financial damages awarded by a court to a patient who has sued them, owing to the hospital and/or the doctor not possessing appropriate insurance cover and/or medical indemnity.

(Remember how Kanye's mother died? Let me remind you: she died from complications as a result of surgery that she had in Brazil.)

There can be major ethical issues around medical tourism. For example, the illegal purchase of organs and tissues for transplantation had been alleged in countries such as India and China prior to 2007. The Declaration of Istanbul distinguishes between ethically problematic "transplant tourism" and "travel for transplantation".

Medical tourism may raise broader ethical issues for the countries in which it is promoted. For example in India, some argue that a "policy of 'medical tourism for the classes and health missions for the masses' will lead to a deepening of the inequities" already embedded in the health care system.

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