Medical Tourism: Trends, Certification, Opportunities

The purpose of this study was to investigate current trends in medical tourism, and in doing so, to determine whether there were roles for nurses that might require specialty training. A review of the literature revealed several rigorous studies in economics (Beladi, Chao, Ed, & Hollas, 2015; Connell, 2015; John & Larke, 2016; Johnston, Crooks, Snyder & Kingsbury, 2010) or legal discussions of issues (Burken, 2007; Reed, 2010). Fewer studies were published by and for nurses (Craig & Beichl, 2009; Moreira, 2013; Plonien & Baldwin, 2014). Most of the salient findings were derived from participant opportunities whereas a review of the literature provided a general definition of medical tourism (Ghanbari, Moradia & Ramazani, 2014; Massoud, Alireza, Mahmoud & Zahra, 2012) and some concerns about trends concerning legalization of marijuana and “marijuana vacations” having an impact on local Emergency Room capacity (Davenport & Pardo, 2016). A participant observation approach was used during a one-semester sabbatical to gather data beyond the literature review. The on-site encounters included meetings with medical tourism providers in Havana, Cuba (June and September, 2017) and San Jose, Costa Rica (September, 2017). Of special interest regarding medical tourism in Cuba was the practice of exporting medical services to other countries since having such an abundance of well-trained personnel would position that country to be an equitable provider of medical services to foreigners as well. In terms of equity, it appeared that no subtraction of services to the local population would be involved. A visit to the office of contractual oversight within the Cuban health care system validated that Cuba is a lively participant in medical tourism with consumers from many countries; a variety of specialty contracts are available. The visit to San Jose, Costa Rica revealed a consortium model where providers are offering bundled concierge, wellness and sightseeing packages for patients and companions. Additional observations were provided by attending the annual Medical Tourism Congress in Los Angeles, California in October, 2017. Findings from participant encounters included various models for service providers; how accreditation, privacy and risk mitigation are provided for consumer safety; emerging interest by insurers seeking lower cost procedures including roles for case managers; government “seed money” for provider start-ups in some countries; expanding specialties beyond aesthetics such as stem cell treatments for cancers; combining wellness and sightseeing in medical stays; and ways nurses can impact quality of service through practicing cultural competence, case management, risk management and where desired, certification in this specialty.