Experts are pleading for regulation to protect patients’ health amid the growth in medical tourism, which has seen surges in bariatric and weight reduction surgery.
They’ve expressed concern that tourist numbers are increasing, according to data, despite the popularity of weight loss drugs – and in a commentary in BMJ Global Health, Dr Jessica McGirr (Obesity Research and Care Group, School of Physiotherapy, Royal College of Surgeons, Dublin/Imperial College London) and colleagues, note that growing obesity coupled with healthcare resource constraints have resulted in more people seeking treatment abroad.
While this largely unregulated industry offers quicker access to treatment, however, it carries potential safety, ethical, and legal risks, they write.
Although reliable data are in short supply, the wider medical tourism industry is worth more than $400bn annually, with anticipated year on year growth of 25%.
And despite access to weight loss drugs having been expected to curb some of the demand for weight reduction surgery, the numbers of medical tourists in search of bariatric surgery continue to rise, particularly as this is often cheaper overseas.
The out-of-pocket cost for this type of surgery done privately in the UK is around £10 000-£15 000, but £2 500-£4 500 in countries like Turkey.
The authors note that the largest global survey to date of providers of bariatric and weight reduction surgery shows that most patients (71%) self-refer.
They may therefore not have appropriate medical indication to undergo major surgery: ineligibility for this type of surgery in their home country is often cited by patients as a reason for accessing it overseas, they write.
There are other risks in opting for this type of surgery overseas, they add. Providers may not always be clear about the potential complication rates; there’s no preoperative and long-term nutritional, psychological, or other medical follow-up; and there’s often no multidisciplinary care, which is integral to appropriate case selection.
“When considering adverse outcomes, including anastomotic (surgical tissue join in the gut) leakage, sepsis, and even death, equally concerning is the absence of regulation to ensure that only accredited procedures are performed by appropriately qualified providers.
“Further concern arises in the context of medical tourism ‘packages’, where patients are offered multiple procedures within the same trip, which are often accompanied by financial incentives,” they add.
There are also ethical issues to consider, they point out, highlighting the results of a provider survey which shows that nearly a third of respondents believed the consent process was “inappropriate” while 14% believed that patients were personally responsible for surgical complications.
“The need to regulate the (bariatric and metabolic tourism) industry to mitigate these safety, ethical, and legal risks for patients is essential.”
The financial and resource impacts of dealing with postoperative complications in returning medical tourists – and in those countries offering this type of surgery – of disinvesting in public health services to boost private sector trade, raise ethical questions, they add.
The authors suggest that bodies such as the WHO and the European Union, among others, should be involved in a global forum designated with the task of establishing regulation through transnational collaboration, which is essential to protect health and health equity.
See more from MedicalBrief archives:
UK’s NHS making millions out of medical tourism
SA ripe with potential for medical tourism growth
Be wary of medical messiahs with promises of salvation
The Bottom Line – the costs and risks of the butt-lift