The Wild West of Medical Care Abroad

A would-be "accreditation" program shows how easy it is to become confused.

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Take a quick look at these two emblems. Displayed online, both are supposed to convey trustworthiness to patients considering a trip to another country for medical care. Do they look similar?

The sources of the seals are very different. The seal on the right is from the Joint Commission International (JCI), which accredits hospitals abroad for safety and quality. It's an arm of the Joint Commission, which is tasked by Congress with accrediting U.S. hospitals. The other is from the Medical Tourism Association (MTA) a trade group based in West Palm Beach, Fla. Its members include foreign hospitals, health insurers, and "facilitators," a specialized category of travel agencies that arrange and book medical trips abroad.

The MTA seal is part of an accreditation campaign hatched last month after a year of study, says Jonathan Edelheit, the group's president (who says I'm the first person he's heard from who thinks the seals look similar). It's aimed mostly at identifying facilitators that are diligent about sending patients to hospitals with good records in treating foreigners. "We see problems with patients who don't have the right experiences," says Edelheit. Facilitators should not be sending patients to hospitals that don't have enough staff fluent in English, for instance, or that don't adequately protect the confidentiality of medical records, he says. "We want to have a standard in place that patients and insurers can see." Later, credentialing will be made available to hospitals.

But can a trade group "accredit" organizations that are involved, even if only indirectly, with healthcare? After the program was announced and featured on the MTA Web page, JCI President and CEO Karen Timmons resigned from the MTA's board of advisers. "I think they got ahead of themselves," Timmons says. "We are in the Wild West right now" in bringing discipline to the untamed and booming overseas healthcare market, "and JCI has been in business many years to improve quality and safety."

Edelheit says that after the accreditation program appeared on the MTA website, "the advisory board came back and told us no, no, you can't accredit." So "accreditation" has become "certification." But until this afternoon, as I wrote this post, the gold seal still included "accredited," and a link on each Web page directed users to a list of accredited organizations. (There aren't any, since the program hasn't actually started.) Thanks to the quick ministrations of a Web programmer, there are no more references to accreditation.

The seal probably will change as well. "It is very close to our seal," says Timmons. "There probably will be some confusion"—such as that expressed by a JCI-accredited hospital that contacted her for clarification. Edelheit disagrees. "I don't see how any patient, insurance company, employer, or others would somehow confuse that logo as being similar to JCI," he wrote in an E-mail. But he promised to check with the advisory board about altering it.