Medical Tourism Research Group

Receive updates for this collection

The Medical Tourism Research Group is based at Simon Fraser University (SFU) near Vancouver, Canada. Its research is ongoing, so please check on this collection from time to time to see their latest work. If you have questions about the research, please send an email to: medtour@sfu.ca

Medical tourism involves international travel with the intent of addressing medical care needs of the traveler that occurs outside of arranged cross-border care. Such medical care is usually paid for out-of-pocket. Specific interventions include necessary surgeries, cosmetic surgeries, reproductive treatments, organ transplantation, and travel for experimental treatments such as stem cell transfers and CCSVI treatment for multiple sclerosis. The research team is particularly interested in Canadians’ travel for elective surgeries that do not involve purchased human organs.

An Overview of Guatemala's Medical Tourism Industry - Version 1.0

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2013
Document type: 
Report
File(s): 

Canadian Family Doctors' Roles and Responsibilities toward Outbound Medical Tourists - "Our True Role Is ... within the Confines of Our System"

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2013
Abstract: 

ObjectiveTo explore how Canadian family doctors understand their rolesand responsibilities toward patients who seek health care abroad.DesignSix focus groups were held with family doctors across BritishColumbia to explore their experiences with and perspectives on outboundmedical tourism. Focus groups were digitally recorded, transcribed, andsubsequently thematically coded to discover common issues and themesacross the entire data set.SettingFocus groups were held with family doctors in 6 cities inBritish Columbia that provided representation from all provincial healthauthorities and a range of urban contexts.ParticipantsA total of 22 currently practising family doctors participatedacross the 6 focus groups, with groups ranging in size from 2 to 6participants (average 4 participants).MethodsThematic analysis of the transcripts identified cross-cuttingthemes that emerged across the 6 focus groups.Main findingsParticipants reported that medical tourism threatenedpatients’ continuity of care. Informational continuity is disrupted beforepatients go abroad because patients regularly omit family doctorsfrom preoperative planning and upon return home when patients lackcomplete or translated medical reports. Participants believed that theirresponsibilities to patients resumed once the patients had returned homefrom care abroad, but were worried about not being able to provideadequate follow-up care. Participants were also concerned about bearinglegal liability toward patients should they be asked to clinically supporttreatments started abroad.ConclusionMedical tourism poses challenges to Canadian family doctorswhen trying to reconcile their traditional roles and responsibilities with thenovel demands of private out-of-country care pursued by their patients.Guidance from professional bodies regarding physicians’ responsibilitiesto Canadian medical tourists is currently lacking. Developing these

supports would help address challenges faced in clinical practice.

Document type: 
Article

Promoting Social Responsibility amongst Health Care Users: Medical Tourists’ Perspectives on an Information Sheet Regarding Ethical Concerns in Medical Tourism

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2013
Abstract: 

Background

Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medical tourism industry on third parties. This paper explores the feedback from former Canadian medical tourists regarding the use of an information sheet to address this knowledge gap and raise awareness of the safety and ethical concerns related to medical tourism.

Results

According to feedback provided in interviews with former Canadian medical tourists, the majority of participants responded positively to the information sheet and indicated that this document prompted them to engage in further consideration of these issues. Participants indicated some frustration after reading the information sheet regarding a lack of know-how in terms of learning more about the concerns discussed in the document and changing their decision-making. This frustration was due to participants’ desperation for medical care, a topic which participants frequently discussed regarding ethical concerns related to health care provision.

Conclusions

The overall perceptions of former medical tourists indicate that an information sheet may promote further consideration of ethical concerns of medical tourism. However, given that these interviews were performed with former medical tourists, it remains unknown whether such a document might impact upon the decision-making of prospective medical tourists. Furthermore, participants indicated a need for an additional tool such as a website for continued discussion about these concerns. As such, along with dissemination of the information sheet, future research implications should include the development of a website for ongoing discussion that could contribute to a raised awareness of these concerns and potentially increase social responsibility in the medical tourism industry.

Document type: 
Article
File(s): 

Knowledge Brokers, Companions, and Navigators: Qualitatively Examining Informal Caregivers’ Roles in Medical Tourism

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2013
Abstract: 

Introduction

Many studies examining the phenomena of medical tourism have identified health equity issues associated with this global health services practice. However, there is a notable lack of attention in this existing research to the informal care provided by the friends and family members who typically accompany medical tourists abroad. To date, researchers have not examined the care roles filled by informal caregivers travelling with medical tourists. In this article, we fill this gap by examining these informal caregivers and the roles they take on towards supporting medical tourists’ health and wellbeing.

Methods

We conducted 21 interviews with International Patient Coordinators (IPCs) working at medical tourism hospitals across ten countries. IPCs work closely with informal caregivers as providers of non-medical personal assistance, and can therefore offer broad insight on caregiver roles. The interviews were coded and analyzed thematically.

Results

Three roles emerged: knowledge broker, companion, and navigator. As knowledge brokers, caregivers facilitate the transfer of information between the medical tourist and formal health care providers as well as other staff members at medical tourism facilities. The companion role involves providing medical tourists with physical and emotional care. Meanwhile, responsibilities associated with handling documents and coordinating often complex journeys are part of the navigation role.

Conclusions

This is the first study to examine informal caregiving roles in medical tourism. Many of the roles identified are similar to those of conventional informal caregivers while others are specific to the transnational context. We conclude that these roles make informal caregivers an integral part of the larger phenomenon of medical tourism. We further contend that examining the roles taken on by a heretofore-unconsidered medical tourism stakeholder group sheds valuable insight into how this industry operates and that such knowledge is necessary in order to respond to the health equity debates that surround this particular global health services practice.

Document type: 
Article
File(s): 

A Reality Check on Medical Tourism

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2013
Document type: 
Other

Friends And Family Roles and Responsibilities Abroad

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2013
Document type: 
Article

Informing Canadian Medical Tourists

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2013
Document type: 
Report
File(s): 

“Do Your Homework…and Then Hope for the Best”: The Challenges that Medical Tourism Poses to Canadian Family Physicians’ Support of Patients’ Informed Decision-Making

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2013
Abstract: 

Background

Medical tourism—the practice where patients travel internationally to privately access medical care—may limit patients’ regular physicians’ abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors’ typical involvement in patients’ informed decision-making is challenged when their patients engage in medical tourism.

Methods

Focus groups were held with family physicians practicing in British Columbia, Canada. After receiving ethics approval, letters of invitation were faxed to family physicians in six cities. 22 physicians agreed to participate and focus groups ranged from two to six participants. Questions explored participants’ perceptions of and experiences with medical tourism. A coding scheme was created using inductive and deductive codes that captured issues central to analytic themes identified by the investigators. Extracts of the coded data that dealt with informed decision-making were shared among the investigators in order to identify themes. Four themes were identified, all of which dealt with the challenges that medical tourism poses to family physicians’ abilities to support medical tourists’ informed decision-making. Findings relevant to each theme were contrasted against the existing medical tourism literature so as to assist in understanding their significance.

Results

Four key challenges were identified: 1) confusion and tensions related to the regular domestic physician’s role in decision-making; 2) tendency to shift responsibility related to healthcare outcomes onto the patient because of the regular domestic physician’s reduced role in shared decision-making; 3) strains on the patient-physician relationship and corresponding concern around the responsibility of the foreign physician; and 4) regular domestic physicians’ concerns that treatments sought abroad may not be based on the best available medical evidence on treatment efficacy.

Conclusions

Medical tourism is creating new challenges for Canadian family physicians who now find themselves needing to carefully negotiate their roles and responsibilities in the informed decision-making process of their patients who decide to seek private treatment abroad as medical tourists. These physicians can and should be educated to enable their patients to look critically at the information available about medical tourism providers and to ask critical questions of patients deciding to access care abroad.

Document type: 
Article
File(s): 

“You’re Dealing with an Emotionally Charged Individual…”: An Industry Perspective on the Challenges Posed by Medical Tourists’ Informal Caregiver-Companions

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2013
Abstract: 

Background:Patients engage in medical tourism when they privately obtain a medical care abroad. Previousresearch shows that many medical tourists travel abroad with friends and family members who provide supportand assistance. Meanwhile, very little is known about this important stakeholder group, referred to here ascaregiver-companions. In this article we examine the challenges that can be posed by caregiver-companions andthe overall practice of informal caregiving in medical tourism from an industry perspective. Specifically, we reporton the findings of interviews conducted with international patient coordinators (IPCs) who work at destinationfacilities. IPCs come into regular contact with caregiver-companions in their professional positions and thus areideally suited to comment on trends they have observed among this stakeholder group as well as the challengesthey can pose to medical tourists, health workers, and facilities.Methods:We conducted 20 semi-structured interviews with 21 IPCs from 16 different facilities across ninecountries. Topics probed in the interviews included caregiver-companion roles, IPCs’and others’interaction withcaregiver-companions, and potential health and safety risks posed to medical tourists and caregiver-companions.Thematic analysis of the verbatim transcripts was employed.Results:Although most participants encouraged medical tourists to travel with a caregiver-companion, manychallenges associated with caregiver-companions were identified. Three themes best characterize the challengesthat emerged: (1) caregiver-companions require time, attention and resources; (2) caregiver-companions candisrupt the provision of quality care; and (3) caregiver-companions can be exposed to risks. IPCs pointed out thatcaregiver-companions may, for example, have a negative impact on the patient through cost of accompanimentor inadequate care provision. Caregiver-companions may also create unanticipated or extra work for IPCs, asadditional clients and by ignoring established organizational rules, routines, and expectations. Furthermore,caregiver-companions may be susceptible to stresses and health and safety risks, which would further deterioratetheir own abilities to offer the patient quality care.Conclusions:Although caregiver-companions can pose challenges to medical tourists, health workers, and medicaltourism facilities, they can also assist in enhancing best care and offering meaningful support to medical tourists. Ifcaregiver-companions are open to collaboration with IPCs, and particularly in the form of information sharing, thentheir experience abroad can be safer and less stressful for themselves and, by extension, for the accompanied

patients and facility staff.

Document type: 
Article
File(s): 

Beyond Sun, Sand and Stitches: Assigning Responsibility for the Harms of Medical Tourism

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2013
Abstract: 

Medical tourism (MT) can be conceptualized as the intentional pursuit of non-emergency surgical interventions by patients outside their nation of residence. Despite increasing popular interest in MT, the ethical issues associated with the practice have thus far been under-examined. MT has been associated with a range of both positive and negative effects for medical tourists' home and host countries, and for the medical tourists themselves. Absent from previous explorations of MT is a clear argument of how responsibility for the harms of this practice should be assigned. This paper addresses this gap by describing both backward looking liability and forward looking political responsibility for stakeholders in MT. We use a political responsibility model to develop a decision-making process for individual medical tourists and conclude that more information on the effects of MT must be developed to help patients engage in ethical MT.

Document type: 
Article