Medical tourism studies track ethics, risks and effects
A team of researchers from Simon Fraser University is studying the booming medical tourism industry and its impact on both patients and health services.
The growing trend in health care involves patients from more economically developed countries flocking to developing countries to receive treatment for everything from elective cosmetic procedures to complex surgeries such as organ transplants and reproductive treatments, controversial stem-cell procedures and multiple sclerosis liberation therapy.
That includes rising numbers of Canadians seeking orthopaedic surgery in Chennai, India to bypass wait lines at home or get procedures not readily available in Canada such as hip resurfacing.
SFU health researchers Valorie Crooks established the SFU Medical Tourism Research Group (MTRG) to examine the issues given “a surprising lack of academic research” into the industry’s size, its ethics and risks and its effects on developing countries’ local health services.
“We’ve found that many Canadians are relying on informal testimonies and anecdotal information from the internet to make important decisions for surgical care,” says Crooks, who, in 2008 was the first Canadian researcher to receive a Canadian Institutes of Health Research (CIHR) grant to study the subject.
The study also sheds light on how and why Canadians are engaging in medical tourism.
“People believe Canadians are going abroad because of waiting lists and Americans are going because it’s cheaper, but our research shows that it’s more complex than that,” says Crooks.
“There are issues of procedure availability and procedures not covered under Medicare, while others go because they’re concerned about the quality of care here in Canada. It’s not black and white.”
The group’s first study served as a platform for three more CIHR-funded studies examining a variety of issues related to medical tourism.
Medical tourism studies target costs, risks and community impact
- A three-year study is examining the roles, risks and responsibilities of caregivers who often accompany medical tourists. “There’s no consideration for the costs of a traveling companion’s accommodation and transportation, their unpaid labour to assist the patient, their time and the risks they may be exposed to,” says Crooks, an associate professor of health geography. “We need to think about these individuals and the role they play. They’re giving their unpaid labour to advance this industry.”
- A $520,000 CIHR operating grant will fund the investigation of medical tourism’s impact on local health-care services. “There’s a lot of speculation that medical tourism is great for the locals because it brings in money and jobs,” says Crooks. “But on the other hand it shifts the focus to high-end surgeries and facilities for treating international patients. “There’s very little evidence one way or the other to prove these two theories.”
In April, Crooks and health sciences researchers Jeremy Snyder and Craig Janes will travel to Mongolia with group member Jeremy Snyder to explore the impact on local health services when affluent Mongolian citizens travel abroad for health care.
Mongolian health sciences grad student Tsogtbaatar Byambaa, who inspired the research wants to know more about their outcomes and the long-term impact on the country’s health system.
The researchers will also travel to Mexico, Guatemala, Barbados and India over the next year to complete their research.
- Snyder is using a CIHR Catalyst grant to research and develop an ethical “buying guide” for Canadians thinking of traveling for medical services. The guide will address such issues as the potentially negative impact medical tourism could have on local communities. “Medical tourism might direct resources away from low-income settings or redirect health personnel,” says Snyder.
As well, tourists undergoing procedures abroad such as a kidney transplant may return home requiring expensive on-going treatment “that burdens people in Canada waiting in queue,” he says.
Snyder and Crooks are working with the Michael Smith Foundation on a policy paper for B.C.’s health ministry to help articulate what the government’s responsibilities should be for patients returning home after international treatments.
“There are numerous stories of people returning home with very high care needs,” says Crooks, adding she is committed to publishing her group’s research in open access journals. We’re just touching the edge of the iceberg regarding issues related to medical tourism.”