The days that the family general practitioner decided  which medical treatment is ideal for a patient and who this patient is referred to, are long gone.

Today, patients increasingly make their own decision based on what they perceive is best for them. They will then venture onto a quest trying to find the right physician who will provide the desired treatment.

This trend can particularly be observed in the medical travel industry.

Again, not a day goes by, that I don’t receive a patient’s request asking for a treatment that might not be ideal for him or her. Yet, due to their internet research, the patients are convinced that their choice is the right one.

A difficult situation… if it is obvious that the treatment the patient seeks is not ideal, it is the only right thing to inform the patient accordingly.  On the other hand, it is often difficult to change a patient’s opinion which they have developed through their research. There is a high risk that the patient will go elsewhere, until the patient finds what he or she is looking for.

We have struggled with this dilemma for some time, however, we now have made the decision that we will not offer any treatment to a patient, that our doctors believe is not right for them. The rational is simple; a treatment has a higher success rate when it is used with the right indication. Wrong indication and the success rate drops off dramatically and with that the rate of unsatisfied patient increases.

Who wants unsatisfied patients?

Thus, and in order to ensure that the patient receives the correct treatment adequate pre-screening is required. Anyone involved in pre-screening a medical tourist should consider it his or her  responsibility to adequately preview the patient’s medical file and point the patient towards the appropriate medical doctor.

However, often it is not clear what type of treatment a patient really requires.  In these cases, and in order to prevent disappointed patients due to a change of plan when they arrive at the treating center it may be advisable to establish communication between the doctor in the patient’s home country and the treating physician in the destination country.

Not only does this approach ensure that the medical history and relevant medical is communicated quickly and professionally between the two experts, it also ensures that the physician at home (the one the patient is most likely going to see after treatment abroad) is aware of the course of treatment from the beginning. The underlying rational for this philosophy is that medical travel does not end when the patient boards the plane to fly home; it ends when the patient has fully recovered.

An example: A patient from the UK travels for bariatric surgery in Germany and receives a gastric sleeve operation. Surgery and initial recovery period go well. Before return home, the patient receives dietary guidelines for the first few weeks, instructions to visit the GP immediately upon return home, what blood test to undergo and at what time, etc.  However, the patient is not compliant, does not adhere to the dietary instructions, the GP is unaware of the patient’s medical trip. He discovers a vitamin B12 deficiency some 12 months after the obesity surgery in Germany by accident.

In an ideal world the GP would have been involved in the medical trip already before departure, would have been informed about the medical institution the patient is travelling to, the surgeon performing the procedure, the follow up requirements and contact details of the bariatric surgeon back in Germany, in case of any questions. This is simple and straight forward and yet, in many cases it simply does not happen.

Why does this communication not take place? Most likely because no one actively initiates and drives such communication. The patient doesn’t because he or she might not see the necessity, the GP doesn’t because they might be unaware of the medical travel, and the surgeon abroad doesn’t because he may also be unaware of the need. The German doctor will write a discharge letter in German which concludes their part of the treatment.

A third party might be required to drive and motivate this communication to occur.

This task falls into the area of responsibilities of a good medical travel consultant who should establish communication links between the treating doctor abroad and the follow up physician at home so that the recovery can occur as part of a controlled process rather than being left to chance.  In addition, the communication should not rely on highly sophisticated technologies or computer software, but on those technologies that both patients and physician can use with ease and sufficient expertise.  Finally, all this needs to be done while maintaining relevant patient data protection regulations.

Other responsibility of a medical travel consultant include assisting the selection of the appropriate specialist, facilitating appointments and treatment schedules, collecting  relevant medical data, reviewing the case together with the specialists, managing the actual trip, communicating with family members, and planning the follow up process at home of which communication between the care providers is of high importance.

Only through this holistic approach to medical travel, can medical travel be a safe alternative for treatment at home, should treatment at home not be an option.

With medical travel on the rise, general practitioners will have to be prepared to “deal” with the returning patient. In order to do this, information and communication is required. Both patients and follow up physicians may benefit if a third party who is involved in (and oversees) the entire medical trip drives relevant communication between international healthcare providers.  Such increased communication will make medical travel a safe option for the patient, provide GPs with new and high quality alternatives for patient referrals and make the follow up back  at home adequate for the treatment the patient has received abroad.

Finally, the local health insurances benefit from such improved communication. It should reduce the risks of patients coming back from a “wild medical journey” developing complications. Such complications may lead to expensive and urgent emergency treatment.

Learn more about medical treatment in Germany

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