The Wild West of Medical Care Abroad

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Payday Loan of AL 3:17AM May 01, 2009

Dear sir
I have heard rumours that JCI is suing for copyright and trademark infringement. Is there any substance to this?

hector gonzalez 8:46AM March 04, 2009

One issue which comes up time and time again here is that accreditation is equated almost totally with the activities of JCI.
Monopolies are never healthy, and when it comes to establishing if a hospital or a healthcare provider are fit for purpose, there are British options available, such as the Trent International Accreditation Scheme, and Australian options such as ACHSI. Both schemes are based in countries with first rate healthcare systems.
Intending medical tourists would be well-advised to look at all of the safety-related data when considering if a particular hospital is an appropriate and safe place for them to utilise. Thinking about the "Wild West" theme, given the recent serious political difficulties in Thailand and India (both countries seeking to develop medical tourism), they would also be well-advised to look at the US State department’s web site before travelling to any country.
Incidentally, the issue of ISQUA sometimes come up when accreditation is being discussed. IDQUA is simply an international society that assesses certain factors around the functioning of accreditation schemes themselves, and does not possess any particular status. It does not, for example, look at ethical factors around the accreditation process. The existence of variety is fundamentally valuable in any aspect of life and business, and the important factor for any accreditation scheme is that is honorable and ethical in its approach, that it encourages openness and a willingness for hospitals and their staff to share good practice with each other for the overall benefit of all patients, and does not price itself beyond the reach of the majority of hospitals, thus ensuring that hospitals and patients are not denied access to good quality accreditation simply on financial grounds. Patient safety surely cannot hinge on profit-based motives alone - this would not be ethical.
The MTA and IMTA have encouraged plurality in hospital accreditation, and this is not only to be welcomed, it is to be applauded.

Safe hospital accreditation for all 11:13PM December 13, 2008

Thanks, Avery,
I appreciate your article very much. As an owner of a medical tourism company, I have sincerely wondered about the "need" for a regulatory association. I shiver every time I think about it. The profits in the industry are low enough without more hands being held out for doubtful reasons, and God knows we don't need any more paper work than we already have. I think your article points clearly to the motivation of MTA's creators. Sad, really, they should be putting their efforts somewhere else more productively.
Sorry, but I have never been comfortable with MTA, as I think it's an attempt to create a "need" where one simply does not exist, and if it were to ever come to full fruition (gasp!) look out for the regulators who would drive all but the big three out of business. Competition is for the good of the customer, not the other way around! The open Internet with people willing to tell what their experience was like from A-Z creates no need for MTA.
Donal

Don of IN 1:16PM September 01, 2008

As a one-time provider, seasoned healthcare consultant, and lifelong patient, I nodded and smiled at the predictable knee-jerk reaction of JCI and other "authorities" to MTA's patient-centric initiative. In-store clinics, healthcare facilitators/advocates, and other progressive ideas receive the same treatment. Ask a typical patient about JCAHO and you will receive a blank stare. While JCAHO has achieved some meaningful quality benefits at hospitals nationwide, patients usually have little to no choice in the hospital they will visit for non-elective procedures or emergencies. That hospital's JCAHO scores are hopelessly uncoupled from the patient's decision-making process.
Costs for elective procedures are so exorbitant (or impossible to get up front) that patients elect medical tourism instead. Based upon the stonewalling patients experience when trying to deal directly with US hospitals, they are unlikely to approach a foreign hospital directly. Therefore they are highly dependent upon facilitators. That makes facilitators the patient-facing entities, not JCI-accredited hospitals.
MTA is providing a valuable service to patients in an area (medical tourism) that is far past its early stages. US providers and their associated professional bodies have not stepped in to help patients, preferring to advocate their own interests instead. It's time for the old guard healthcare "experts" to take off the blinders and realize that the US healthcare system is hopelessly broken. Bandaids, committees, and reactive policies will not solve it. Some proactive international thinking based upon what is truly best for the patient just might. Thanks to MTA for a good start.

G.H. of AZ 2:30PM August 28, 2008

In health care, organizations are accredited but individuals are certified. For example, the Accreditation Council for Graduate Medical Education (ACGME) accredits residency/fellowship programs in the US; the member boards of the American Board of Medical Specialties (ABMS) certify individual physicians as "Board certified." Perhaps "approved" or "recognized" might be a more appropriate word for what the MTA is really doing--and that's a lower bar than "accreditation."

Fred Lenhoff of IL 12:31PM August 27, 2008

I take issue with the notion of medical tourism being judged as somehow akin to the "Wild West". I have personally visited multiple hospitals in Costa Rica, India, Singapore and Thailand and can say without hesitation they are finer, on-balance, and far more welcoming than anything available in the U.S.
In my opinion, the real rodeo action takes place here where, generally speaking, a patient has no idea whatsoever, of the procedure cost, the quality of the facility, the skill of the surgeon, the ratio of nurses-to-patients, whether they will be treated respectfully, patient mortality and/or post-operative infection rates, et cetera. It's worth noting too, that over half of the bankruptcies--some 1.5 million per annum--are filed each year in the U.S. due to having to shoulder exhorbitant healthcare costs with no abatement in sight.
Factors such as these largely account for the growing number of people traveling overseas to obtain healthcare services and which, according to Deloitte, will reach 16 million people by 2017.
As for the MTA, I know Mr. Edelheit and Ms. Stephano, both of whom are dedicated to bringin about and insuring this nascent industry develops--and presumably, continues to do so--quality and professionalism standards as it matures, all of which will serve the needs of patients considering obtaining healthcare abroad.

Jack Lundberg of OH 7:29PM August 24, 2008

The MTA’s certification program was created for medical tourism facilitators, for which there currently are no standards. Some facilitation companies are former travel agents, timeshare companies, patients, or entrepreneurs, now creating physician networks for sending patients overseas, some with little developed in terms of protocols or best practices.
The MTA fielded over a hundred calls and emails this year alone from new facilitators looking to start their businesses; double that amount from patients not knowing how to find a facilitator that was more than a website; and a surprising number of complaints and painful tales about facilitators that either directly or indirectly put patients at risk.
The media seeks comments from people in the “quality” sector of healthcare to create controversy where there is none. MTA certification is not about the quality of medical services as clearly stated from the beginning.
If the members of a trade organization seek to set standards for themselves, publish those standards, be evaluated annually by an unbiased third party and then be certified to those published standards, why not? This provides yet another level of transparency for prospective patients about the “medical tourism services” being offered.
MTA’s certification program is created through the input and experiences of their members and is offered to its membership on a voluntary basis. Instead of quality experts and media talking about who should do it, what it should be called and what logo is being used, it would make sense to ask those who derive a benefit from it. Ask the facilitators, new and established, whether they need protocols, standards, best practices and certification, and whether they need it now to distinguish themselves from those that do not. More importantly, ask the patients today looking for healthcare overseas whether they would derive a benefit from it now.
As a non-profit membership organization, should the MTA ignore the expressed requests and interests of our members? Shall we sit like others, paralyzed by their own over analysis and obsession with criticism? Shall we wait another year debating a name, and collect hundreds more emails and telephone calls and dozens more patient with negative stories?
International healthcare is not the wild west as this article alleges. It is a shame that American arrogance would lead to such a conclusion. This is about providing top services to patients who have placed their faith and the autonomy in healthcare selection in the hands of others. They are traveling today and many cannot wait for tomorrow.

Renee-Marie Stephano of FL 2:55PM August 24, 2008

The underlying question here is whether the MTA's actions will benefit patients.
Patients (aka medical tourists) really have two main options in planning their overseas medical procedures- go through facilitators (kind of like medical tourist travel agents), or deal directly with the hospital. Both provide value, but either way the patient wants to know more about the hospital. Personally, I'm more interested in the certification of the hospital, such as JCI or the Trent International Accreditation Scheme provide, than in certification of the facilitator.
I sincerely hope the MTA can create a meaningful accreditation program that brings real value to the end consumer. I'd encourage the MTA web site to provide more specific information about what accreditation means to the consumer. In reviewing the web site, most of the language I found seemed focused on marketing benefits a certified organization would receive rather than objective standards a patient could expect a certified organization to meet.
Meanwhile, consumers should know they have choices - and they should do their own research. Sites like Global Doctor Options (http://www.GlobalDoctorOptions.com) and the U.S. News World Hospital Finder are certainly a helpful first step in this regard.
Regardless, the medical industry is going to undergo many changes in the coming years. Doing any kind of business across international borders is complex, and any actions the MTA or other organizations take in promotion of overseas healthcare options are likely to be imperfect. The MTA actions may be imperfect, but the real question is whether patients (or medical tourists) will benefit from these actions. At this point, it's probably too early to tell.

Global Doctor Options 4:47AM August 24, 2008

What is misleading about the above story, is the logo posted in this story for the MTA is NOT the logo on their website. The logo actually says Certification not Accreditation. Also, if you look at their company logo, it's the same except the certification logo is gold. Doesn't seem like they tried to confuse, they just used their own logo in a different shade. Sound's like someone has a hidden agenda. The MTA has been doing lots more positive things for the medical tourism industry than anyone else, so why all the backlash? I am going to their upcoming congress in San Francisco in September and considering joining the MTA. Even that event seems to do more for the industry than anyone else has done. Maybe you should go and then you'll have something worth writing about.

jack welsh of MO 7:42PM August 23, 2008