Medical Tourism—A Linguistic Approach (Part I)

Medical tourism is a hot healthcare trend, with hundreds of thousands of people choosing to leave their countries for medical procedures each year.

But what is it? Medical tourism can be defined as the practice of seeking medical treatment in any area but one’s home area. There are three types of medical tourism:

1. Outbound -- U.S. citizens going elsewhere for treatment
2. Inbound -- people from outside the USA coming here for treatment
3. Intra-U.S. -- people seeking treatment outside their home region (Intra-U.S. medical tourism is very common but will not be discussed in this report)

In Part I of our report, we discuss the linguistic considerations of outbound medical tourism, and in Part II, we discuss the other side—inbound medical tourism. Both present unique linguistic challenges for healthcare providers and consumers.

Medical tourism is not a new industry, but it is growing rapidly. According to a 2008 Deloitte study, over 750,000 Americans chose to have procedures done in another country in 2007, and over 400,000 non-U.S. residents came here for procedures in 2008. It’s obvious that this trend will continue as patients become more educated about the options available to them.

Part I: Outbound

Medical mystery novelist Robin Cook chose outbound medical tourism as the subject of his latest book, Foreign Body. The plot revolves around mysterious deaths of American medical tourists in India, and while the occurrences in the book are far-fetched, India’s popularity as a medical destination was not a fabrication.

We must first ask the question, why would Americans fly all the way to India, or any other foreign country for medical treatment?

The first reason to look at is cost. Costs of procedures in India average 80% less than the same procedures would cost in the United States. Thailand, Singapore, Brazil, Costa Rica, Hungary, Singapore, Malaysia, and South Africa also attract a sizable number of United States citizens for medical procedures each year. And in all of those places, one can save anywhere from 50 to 80 percent on procedures. As the Centers for Disease Control states in its 2010 Yellow Book, “a heart bypass in Thailand costs $11,000 compared to as much as $130,000 in the U.S. Spinal fusion surgery in India at $5,500 compares to over $60,000 in the U.S.” Therefore, even with travel costs added in, Americans going abroad stand to save quite a bit of money.

The second consideration is quality. Despite our preconceptions that health care in other countries may be somehow inferior to the care we have access to in America, the quality of health care in popular medical tourist destinations is generally quite good. In fact, the same Joint Commission that accredits organizations here in the United States has an international affiliate (Joint Commission International) which has accredited 250 hospitals in 36 countries. Brazil, for example, has 12 JCI-accredited organizations.  

According to the Deloitte 2008 Survey of Health Care Consumers, 38% of those surveyed “would consider having an elective procedure in a foreign country if I could save 50% or more and be assured the quality was equal or better than in the U.S." Obviously, the demand exists, and any inhibitions Americans have had at one time about care abroad are being outweighed by the overwhelming value.

Linguistic Issues Affecting Outbound Medical Tourism

As if it weren’t difficult enough to understand medical terminology in English, imagine how hard it would be if your doctor didn’t even know English! There are no statistics on this, but it is likely that if asked, potential medical tourists would cite the problem of language as a possible barrier. Therefore, it is imperative that participants on both ends of the transaction (the patient and the service provider) be proactive. Language issues must be anticipated and worked through before any firm plans are made.

Here are some ways that patients, travel coordinators and healthcare providers can benefit from professional translation services:

Research: When a patient is deciding which foreign hospital, and which doctor, to select for a procedure, the JCI recommendations are helpful. But if a patient wishes to go deeper into the doctor’s résumé, work history, or record with the national board, then a translator may be necessary to interpret the findings. The same goes for the hospital’s track record.

Translation of Records: Patients will need thorough and accurate translations of their medical records before and after the procedure. This includes charts, test results, insurance documents, laboratory results, instructions upon discharge, and countless other documents. Having an experienced translation firm like Avantpage perform these translations ensures that the foreign medical staff has a complete picture of the patient’s health, and the patient’s home doctor will understand exactly what occurred overseas after a procedure is over.

Interpreting Services. Patients will also need to communicate orally with non-English-speaking medical staff. While many overseas medical professionals were trained in the U.S. and therefore speak English, others will require use of an interpreter. Avantpage would be able to provide an on-call interpreter designated for your particular project who is also familiar with health care terminology. Telephone and even video interpreting are both common solutions.

Language Testing. Finally, if hospitals are interested in certifying that their providers are highly skilled in other languages, they can order proficiency testing. High scores on an objective test will show that their facility has staff equipped to communicate with English-speaking patients in case an interpreter is not available.

Click here for Part II of this report, in which we examine the linguistic implications of inbound medical tourism.

Resources:

• Brunette, Gary, MD, et al. CDC Health Information for International Travel 2010: The Yellow Book. Mosby Ltd., 2009
• Medical Tourism: Consumers In Search Of Value. Deloitte Center For Health Solutions. 2008
• Joint Commission International

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