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

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 thesesupports would help address challenges faced in clinical practice.