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More Trouble in the Fantasyland of Medical Tourism

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Fantasy forest. Photo by Brenda Clarke/Flickr.

Is The Grass Greener for Foreign Medical Care?

There is a strange expectation that Medical Tourism holds the answer to what is wrong with American medicine: long waits, shortages of doctors, costs that are completely out of control, poor treatment and a sharp decline in the number of doctors who are willing to go into medicine.

It’s true. Doctors are leaving medicine in droves while the corporations make more money than ever at the expense of both the patient and the doctor. We have written about this extensively. There is plenty wrong with healthcare in America. Hardly surprising, the overhead costs under Obamacare are expected to explode by more than a quarter of a trillion dollars over the next decade. But be forewarned: the expectation that you’ll receive a higher quality of care abroad is likely to be a resentment waiting to happen.

Santa Fe, New Mexico, 28 May 2015

By Dr. James Goldberg, Author of The American Medical Money Machine: The Destruction of Healthcare in America and the Rise of Medical Tourism

“Why I will never allow my child to become a doctor in India”

This May 15, 2015 blog post by Dr. Roshan Radhakrishnan was brought to my attention through colleagues who became aware of his warnings after going viral via a mention by the BBC. I encourage a full read of it. Dr. Radhakrishnan talks about how the same situation in India is progressing and why fewer and fewer Indians are going into the field of medicine. Doctors there already face the fact that they will always be swamped with patients beyond the logical human capacity in India.

India produces some of the finest minds on the planet. It’s heartbreaking to read what’s happening. Here’s a short excerpt to make some comparisons:

I wish it were JUST about losing your family life, working twice the allotted hours and taking home the pitiably disproportionate salary though. But sadly, it isn’t even that anymore. Now, it is about getting home in one piece. From stopping patients from dying, the medical field is now being forced to worry about not being killed by the patients bystanders.

The essence of being a doctor—to do the best we can to heal—is being taken away from us because now we need to be on the defensive. You remember that cute little thing we’ve been talking about called selfless social service? Guess what? It comes with riders, apparently.

- Selfless service means you do the extra hours because the hospital is perpetually understaffed.

- Selfless service means you take home a call centre worker’s salary because the healing you do is a service, remember?

- Selfless service means you adjust with the lack of drugs and instruments available and still save people because there is no other hospital nearby.

- But that line stops there. If the patient collapses while in your care, suddenly all these boundaries vanish.

What Dr. Radhakrishnan is describing is yet another aspect of the dark side of Medical Tourism.

As foreign hospitals and their US enablers attempt to attract American patients, there is an uprising against going into medicine in the very countries that are seeking to lure patients—called medical tourists—into their countries for what they term “affordable and quality medical care.”

The reality is that foreign trained doctors are under the same corporate pressures that doctors are experiencing here in the US. What’s more, care received at a foreign hospital is NOT regulated by any international body and there is NO legal recourse in the instance of a mistake or wrongdoing. You are on your own.

Speaking of enablers, Josef Woodman, the author of the popular Medical Tourism (propaganda) book, “Patients Without Borders,” says things are just fine abroad. His guest post on AARP’s blog, “Good News: Your Medical Options Now Include Latin America” is rife with misleading and unsubstantiated claims (emphasis mine):

Recently, leading private hospitals in Mexico and Costa Rica have been awarded full accreditation by the US-based Joint Commission International (JCI), the same agency that accredits hospitals like Johns Hopkins, Cleveland Clinic, and Mayo here in the US.

With all the negativity surrounding the current state of healthcare in the US, it’s easy to give in to feelings of helplessness and victimization. Yet, with more than 400 American-accredited hospitals around the world, and so many Americans now adopting medical travel as a component of their healthcare program, it’s empowering to know that you do have options.

Yes, Mr. Woodman, I look forward to seeing you flying off to Costa Rica or India to have your heart cut open. Shame on you for attempting to put a dress on a pig. Spewing this illusory reality, for which I am sure you are well paid, you lead people into a medical fantasyland full of terrible dark dangers. You make Medical Tourism look like a door prize!

You encourage patients to seek care elsewhere without revealing the fact that these foreign hospitals are not regulated. Oh, many do have the Joint Commission International Gold Star of accreditation. But when you carefully look at what this means, that Gold Star is a business proposition, entered into for personal gain, unregulated and without any obligation of the foreign hospital to comply with the JCI rule book (which they BUY). You make it seem as if the hospitals have the stamp of approval of the US government, but they do not.

You promote a money making proposition which has nothing to do with patient safety and in the interests of good medicine. And, sir, you do it with a smile on your face. What’s so joyful about sending people into peril? Have you read what’s going on with doctors in India who work for your beloved JCI hospitals?

Yes, I have attacked you before and will continue to do so. You spin lies without caring for those who may well suffer terrible consequences. I have been a personal witness to this trickery and have been contacted by thousands around the world who have suffered based on the kinds of illusions you propagate.

My response to Dr. Radhakrishnan

Hello Dr. Roshan,

Thank you for being so candid about conditions in the Indian healthcare industry. The situation in the US is even worse.

Students must sustain debt for their education while reimbursement rates from the insurance cartel continue to decline—all at the expense of patients and their doctors.

Instead of enjoying the respect of being at the lead of the intellectual elite, doctors here in the US have been deemed to be called “providers”. The insurance, hospital corporations and pharmaceutical industries have never been more profitable and the cost to the patients never higher.

The expectation is that by 2025, there will be a shortage of 90,000 doctors in the US, and that’s probably a conservative estimate.

We do not have a socialized or publicly-funded education system and the incentives for giving up a reasonable balance between life and profession simply does not make sense to a reasonable person. The suffering is shameful: doctors are paid less and less and patients are paying more and more.

India has attempted to attract patients from around the world, yet with a declining population of your brightest and best turning away from medicine, unsuspecting patients are jumping out of the frying pan and into the fire.

International medicine, which many US corporations have a great interest in, are the beneficiaries. Patients walking into treatment centers globally are expecting excellent care when in fact they are subjecting themselves to unregulated and unspeakably low levels of esteem and respect.

This cannot last. It is unsustainable.

You might want to consult my website and read my book, The American Medical Money Machine: The Destruction of Healthcare in America and the Rise of Medical Tourism.

With respect to the medical warriors who have given their lives to save lives, I salute you.

Dr. James Goldberg
The United States



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