A broken nose had left him with a deviated septum that made
breathing difficult -- especially at night.
Lundstrom and his wife, Shannon, run a picture-framing business
in Federal Way. As small-business owners, they have health
insurance, but their coverage isn't great. An $8,000 deductible
means they pay out of pocket for most doctors visits.
When Lundstrom learned his surgery would cost upward of $10,000,
he started thinking outside the boundaries of U.S. health care.
He became one of an estimated tens of thousands of Americans
traveling abroad as part of a fast-growing but controversial
phenomenon known as medical tourism. Although the practice has
become wildly popular, it also has prompted words of caution from
experts who say going to another country for medical care can be
risky.
To be sure, there are excellent facilities throughout the world,
but the standard of care and infection control can vary. If
something goes wrong, a patient's legal recourse could be limited by
a lack of malpractice laws. And what about follow-up care?
But given the exorbitant -- and ever-rising -- cost of health
care in the United States, the search for cheaper options can make
sense, especially for the estimated 46 million Americans who
don't have insurance.
"I don't think it's necessarily bad. I think it's a reality. But
it's completely unregulated, which kind of makes me worried," said
Dr. Ann Marie Kimball, professor of global health at the University
of Washington. "It's a phenomenon of our new mobility that I think
we have to catch up with. We're woefully behind."
Earlier this month, Sen. Gordon Smith, R-Ore., held hearings on
the subject and called for the creation of an interagency government
task force to study potential safety issues for U.S. patients.
"This trend of traveling abroad for medical care raised a lot of
questions, most importantly patient safety," Smith said in a
statement.
But for Lundstrom, the experience was entirely positive. With the
help of MedRetreat, a Washington, D.C.-based business that arranges
trips overseas for medical procedures, the Lundstroms traveled to
Malaysia in May. Phil had his surgery, plus a physical and a
colonoscopy. Shannon had a mammogram and a full physical. They
stayed in a top resort and toured the island.
The whole trip cost less than $4,000 (they used frequent-flier
miles for their plane tickets).
"We're just telling everybody we know about this because we're
just so sick of this high cost (of health care) that doesn't have to
be," Shannon Lundstrom said.
Although no solid numbers exist to track the popularity of
medical tourism, companies that arrange the trips say their business
is booming.
The combination of tourism and medical care also means big money
for countries such as India and Thailand, both of which aggressively
market their hospitals to foreign customers.
The trips are touted by foreign hospitals and agencies that
arrange them in the U.S. and Europe as a budget medical option and
an exotic vacation all in one. Web sites feature couples lounging in
hammocks, sunsets on the beach, temples and parrots.
Procedures generally cost between 50 percent and 80 percent less
than they do in the United States, said Sabrina Bharaj, spokeswoman
for MedSolution, a Vancouver, B.C. -based company that arranges
medical trips.
In the past several years, trip organizers say, more patients
have been pursuing not just elective and cosmetic surgeries, but
also medically necessary procedures, including hip and knee
replacements, angioplasty and hysterectomies.
MedRetreat offers a menu of 183 procedures in seven countries --
India, Thailand, Malaysia, Brazil, Argentina, Turkey and South
Africa.
The Lundstroms had heard from friends about successful medical
care in other countries, but when they saw a feature about the trend
on the CBS program "60 Minutes" last fall, they started thinking
about the option more seriously.
"We've been hearing about overseas medical treatment from friends
who've spent 10 years sailing around the world," Shannon Lundstrom
said. "The seed was planted that way."
MedRetreat recommended a plastic surgeon in Malaysia who went to
college in Walla Walla and medical school at Harvard University. He
practiced in the United States for 25 years before returning to
Malaysia, Lundstrom said.
"The thing I really liked about (MedRetreat) was that they had
been to all these places," Lundstrom said.
The Lundstroms said MedRetreat called to follow up after they
returned home and connected them with a liaison while they were in
Malaysia.
"It's not as if you come home and they don't know your name,"
Shannon Lundstrom said.
MedSolution's package includes transportation to and from the
airport and all related medical costs, including the surgeon,
anesthetists, nurses, operating room and intensive care.
The company is paid by the hospital for bookings.
The Vancouver, B.C., company also insists a patient's primary
care provider be informed and provide medical records to surgeons in
other countries.
"We want them to see their family doctor and let them know what's
going on," Bharaj said.
Phil Lundstrom said he wasn't concerned that his local doctor
didn't communicate with the surgeon in Malaysia.
"I pretty much knew it was probably going to be a straightforward
thing," Lundstrom said.
But what if it's not?
"I think you have to ask the disastrous questions," said the UW's
Kimball. "The first question would be, what if it doesn't work? What
happens? What if there are complications from anesthesia?
"Say you die on the table. What happens then? ... What about an
autopsy, culpability, damages? What about my family?"
Jeff Schult, author of "Beauty From Afar," a guide to medical
tourism, said legal options vary according to each country's
malpractice laws.
"My sort of blunt advice is that if your primary concern in going
to a doctor, surgeon or dentist is whether or not you're going to
have legal recourse if you don't like the work you get, you
shouldn't go overseas," Schult said.
In May, The Providence (R.I.) Journal reported that a Rhode
Island woman died of a blood clot in India four days after she
received a breast reduction and tummy tuck. She found Wockhardt
Hospital in Bombay online and arranged with the hospital for her
trip.
Her sister, Elizabeth Wright, said she didn't blame the hospital,
according to The Journal. "It was a freak accident," Wright said.
"I truly believe that. They did not do a bad operation."
Bharaj of MedSolution said it would be up to the family to
arrange for their loved one's remains.
"Obviously we would assist them with anything," said Bharaj, but
deaths are "not something we've looked into. It's not something that
we've ever foreseen happening or planned for."
BUYER BEWARE
Medical tourism is a largely unregulated industry, so prospective
customers should take a "buyer beware" attitude and get as much
information as possible:
