A New Kind of Travel: When Medical Treatments are Paired with Resort Getaways
John Wilkinson took a vacation this past January unlike any other already under his belt. Along with his wife, Wilkinson travelled to a resort nestled along the Bay of Bengal, situated in the north-eastern part of the Indian Ocean. While their fifteen-day, oversees excursion involved the typical shopping, sightseeing, and beach-worshipping, it also involved a stay at a private hospital. Wilkinson travelled to India to get a new knee.
At 72-years-old, this Prince George, British Columbia resident says, since his surgery, he is back at the activities he feels he should be doing: Wilkinson says he was shovelling the snow from his driveway this past winter; he has been mowing his lawn on his own since spring; and he takes his dog for a daily six- to eight-kilometre walk. Pre-surgery, Wilkinson says he could barely tolerate moving around.
“My knee, it was just hurting all the time,” says Wilkinson, “Pain, pain, pain. The kind of pain that would wake you up at night. The type that will go on and on unless something is done.”
Wilkinson’s doctors in Canada agreed something needed to be done: “My specialist told me exactly what my family doctor had said,” begins Wilkinson, “that I needed a full kneecap replacement on my left knee.”
After waiting nearly seven months to have a consultation with a BC surgeon, Wilkinson learned he must continue to wait—this time for an undetermined period of time, until the local hospital called with an opening for a surgery time. Following advice he had gained from the BC Government’s Surgical Wait Times web site, Wilkinson asked his surgeon whether there was another specialist in the vicinity who could perform his knee replacement surgery sooner. In August 2005, Wilkinson heard from another specialist’s office. Not surprisingly, says Wilkinson, the news entailed more waiting.
“They said they would call me by the end of the year with a consultation time,” says Wilkinson. By the end of 2005, Wilkinson’s pain had worsened to the point where, he says, it had begun to “take all of the fun out of life.”
Medical tourism involves travelling to other countries for medical procedures and treatments. The persons who help arrange these procedures, acting as liaisons between patients and hospitals, are often referred to as medical travel agents or medical brokers.
After seeing a television documentary about medical tourism, Wilkinson says he was ready to find out more about the possibility of paying for surgery. Together with his wife, Wilkinson shopped around. The initial search revealed only high-priced options: prices ranging from C$18,500 (at a clinic in Montreal, Quebec) to US$30,000 (in Portland, Maine).
An internet search for medical travel agents led Wilkinson’s wife to the Health Trips web site, which boasts “complete treatment in weeks” and “affordable medical treatments.” According to a May 2006 issue of Maclean’s (which offers a complete user’s guide to private medical care in Canada) Health Trips is one of eight medical travel agencies in Canada. This Ottawa-based agency operates under Director of Marketing, Amalor Lewis, and his daughter, founder and Director of Operations, Atrisha Lewis.
As with other medical travel agencies, Health Trips operates through partnerships with specific hospitals, particularly with hospitals in Europe and India. Although Health Trips provides some details about a “German Collaborative Private International Hospital” located in India on its web site, Lewis explains why the web site neither precisely names the hospitals nor their doctors: Health Trips makes its profit through the commission it receives for making patient reservations.
The Process
After patients contact Health Trips to express their interest in travelling abroad for a health care procedure, Health Trips sends patients a step-by-step outline, which provides an overview of the process.
According to a sample outline (designed to give interested persons an idea of what to expect should they decide to undergo medical treatments in India), there are four main steps:
Step 1: Patients send Health Trips their medical information, which, in turn, is forwarded to the receiving hospital so that a preliminary medical opinion and price quote can be attained.
Step 2: Patients are informed they must obtain a valid visa (for travel to India) and arrange their air travel. Although Health Trips is available to facilitate this step, clientele may choose to make visa and travel arrangements on their own.
Step 3: The receiving hospital requires patients pay a deposit to secure their surgical date and room. The full balance is required upon arrival at the hospital. Patients may cancel their surgical treatment at any time, with a monetary penalty (an administration fee, and potentially, a cancellation fee).
Step 4: Upon arrival, patients are received at the airport and escorted to their hospital. An agent (working in partnership with Health Trips) acts as the liaison officer throughout the stay. Patients are initially met by a General Physician and Surgeon for pre-surgery assessment and evaluation. Post-surgery, patients work with a physiotherapist in India to facilitate recovery. At a suitable stage in recovery, patients may engage in shopping, sight-seeing, and other travel packages.
The entire process typically takes about a month, says Lewis. If a patient calls today, however, Lewis says he can often book a reservation for surgery within seven to 10 days. Patients can take longer before decided to book—using the extra time to talk directly with foreign doctors, review the physician’s credentials, read patient testimonials, and simply ask further questions.
Although Lewis says he is a business man, he says this line of work stands apart: “This is not about a sales pitch,” says Lewis, “patients must be comfortable with their decision.”
Sample costs
Although costs vary (depending on procedure, for example), Wilkinson’s costs provide a sample. The following costs are approximated and reflect the costs for a patient and guest:
Surgery package*: C$6,500
Air Travel: C$3,800
Immunizations: C$1,000
Visa: C$130.00
TOTAL: C$11,430
*Package includes: total knee replacement, up to 15 days hospital-stay (with private, shared room for patient and guest); required drugs and medicines; lab tests, diagnostics such as x-ray, MRI, CT (if necessary), post-operative care (in India); doctor’s professional charges; diet (for patient); and physiotherapy. The above pricelist does not include laundry, telephone charges and other travel expenses.
The potential drawbacks for paying for health care treatments outside of Canada
There are notable issues associated with medical brokering, which patients should consider before opting to pay for health care outside of Canada. The issue which tends to stand out is that of payment. Patients are often expected to pay cash (without the possibility of reimbursement) for medical treatments and procedures abroad. In this case, Wilkinson opted to pay out-of-pocket rather than continue his wait on a BC surgical wait list.
Even if money is no object, there are factors worth considering. According to a June 2004 CBC News Online story on medical tourism, for example, “most of the countries that offer medical tourism have weak malpractice laws, so the patient has little recourse to local courts or medical boards if something goes wrong.” The same story highlights follow-up care as a potential downside of medical tourism. Patients who return to Canada post-surgery may require follow-up care, which becomes the default responsibility of Canada’s public health care system.
Of course, there are notable benefits to medical tourism as well.
“If you asked my wife,” says Wilkinson, “she would say she took a grumpy old man to India and came back with a happy man.”
Wilkinson was so changed by his medical travel experience that when asked whether he would do it over again, he is quick to reply.
“Yes. And, I would recommend it to anyone. Anyone who is fed up with waiting in Canada. I wouldn’t hesitate.”
Although Wilkinson is willing to pay for health care, he does not think Canada should move to a parallel private system. Recent research evidence suggests a move towards such a system would not only fail to reduce wait lists, but could actually increase wait times for health care in Canada’s publicly funded system.
Many would argue that paying for health care is, in fact, contradictory to the principles underlying Canadian health care, which are based on need, rather than ability to pay. As opportunities for traveling beyond our border become more accessible and affordable, however, Canadians may find themselves in the position of weighing their willingness to wait against their willingness to pay for health care.
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