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Medical tourism taking wing as U.S. patients fly abroad for treatment

posted March 5, 2017 12:00 a.m. (CDT)
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by / Eric Lindquist. bio | email

  • con_Dental_2_030517
    Contributed photo | Enlarge
    - Dental clinics marketing to tourists line the street in Nuevo Progreso, Mexico, where Holly Heldstab of Eau Claire sought major dental care five years ago. Though such medical tourism is a growing trend, the experience was disastrous for Heldstab, who has spent more than she saved trying to fix problems that arose from her poor treatment in Mexico.
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Seeking new ways to cope with high health care costs, more Americans are heading abroad to cure what ails them.

The concept goes by different names — medical tourism, destination medicine and medical travel — but the goal of this multibillion-dollar industry is usually the same: to get quality health care at a lower price than is available in the United States.

“We have access to great care here in the United States, and if people had their druthers and money was no object, they’d stay here for medical care,” said Josef Woodman, founder and CEO of Patients Beyond Borders, a company that provides information and advice for consumers considering medical travel. “But there’s a whole lot of people who can’t afford the out-of-pocket costs here.”

That’s why Woodman estimates that between 1.2 million and 1.5 million Americans now travel to other countries annually to receive everything from heart surgeries and hip replacements to face-lifts and dental care. That number, comprised primarily of people who are uninsured, underinsured or facing high deductibles, has grown by 18 to 30 percent a year since he wrote the first edition of his guidebook, “Patients Beyond Borders,” a decade ago.

Mexico is the No. 1 foreign destination of American medical travelers.

So at the same time President Donald Trump is talking about building a wall to keep illegal immigrants from entering the United States from Mexico, hundreds of thousands of Americans, including some from the Chippewa Valley, are flocking south of the border annually in search of cheaper medical care.

A tale of two


Two Eau Claire residents who sought dental care in Mexico in recent years returned home with vastly different conclusions about the wisdom of their decision.

For Dennis Reinke, 69, his trip to Cancun two years ago delivered everything he hoped: a nice getaway to a beautiful destination, high-quality care and a pocketful of savings.

But Holly Heldstab, 45, reported that the savings she initially celebrated later evaporated when the treatment she received turned into a mouthful of problems.

Reinke hatched plans for his journey after learning the price for a pair of crowns, some fillings and accompanying dental work he needed was about $2,700. As a veteran traveler who long has been aware that dental care was available in other countries for a fraction of its price in the U.S., Reinke decided to look into the possibility of medical travel.

“I was willing to explore Mexico, Southeast Asia or Eastern Europe,” said Reinke, a retired social worker. “All three had excellent services at about one-third the price I was quoted here.”

After doing significant online research about quality and cost and reading many personal reviews of providers, he settled on pursuing care from a practice called Ocean Dental in Cancun, Mexico, in part because it’s such an easy destination to reach. It offered added comfort that he’d been to Cancun before and the clinic was operated by a graduate of the University of Michigan School of Dentistry.

“I operate from the premise that health care and dental care are generic products that you should be able to purchase in the marketplace based on their cost and quality,” Reinke said. “For these foreign clinics that compete, it’s a very efficient marketplace.”

When he arrived, the waiting room was filled with Americans and Canadians, including many snowbirds who seek dental care at the clinic every winter. The equipment and materials all appeared to be top-notch, he said, and the clinic even arranged to transport him to and from his four appointments over a week.

Beyond the dental work, what made Reinke smile was the bill: $800.

“The results were good, and I haven’t had any problems. If I need any major work in the future, I wouldn’t hesitate at all to go back again,” Reinke said, noting that his wife has made it clear she likes her Eau Claire dentist and would never consider such an option.

No mas!

The medical travel experience was far different for Heldstab, who chose to go to one of a slew of dental and medical clinics with big signs marketing to Americans in Nuevo Progreso, Mexico, just across the Rio Grande River from Progreso, Texas.

The clinic she attended, relying primarily on referrals from relatives in Texas and their friends who had seen dentists in Nuevo Progreso, was only a few dozen steps from the customs station at the foot of a bridge between the two nations.

Heldstab, a state employee, said she thought the cheap care was a great solution after a local dentist told her it would cost an unaffordable $20,000 to $25,000 for the root canal and four crowns she needed.

But the trip went south shortly after she entered the clinic, where the dentists didn’t speak English and relied on an office worker for translation. The dentists ended up convincing her she needed even more work than planned, and she ended up getting four root canals and 11 crowns.

“I was in the chair from 10 a.m. to 1 a.m.,” Heldstab said. “I stopped counting at shot No. 27 of Novocain.”

The ordeal was painful, both physically and emotionally.

While she left feeling pleased she had so much done for only $3,500, her attitude quickly changed when she started having tooth problems and learned the Mexican clinic had used poor materials and hadn’t properly fitted the crowns.

“Since then I’ve lost three teeth, and it’s just one thing after another,” Heldstab said. “I still go to the dentist all the time to correct all of the bad stuff that happened in Mexico.”

In the long run, she said, the fixes will cost her significantly more than she saved in the first place.

“I would say that was definitely one of the worst decisions I’ve ever made,” Heldstab said. “I absolutely would not recommend it to anyone.”


brings comfort

The best way for health care consumers to avoid disasters such as Heldstab experienced is to arm themselves with as much information as possible, Woodman said, adding, “That’s why I wrote the book.”

Looking for facilities accredited by the Joint Commission International is a good start because that status indicates the same level of care and cleanliness as most U.S. hospitals, he said. The number of JCI-accredited hospitals in the rest of the world totaled only 27 when Woodman began his research but now exceeds 900 as standards rise and facilities compete for health care dollars, pesos, euros and other currencies.

Despite the occasional horror stories, which can happen anywhere in the medical field, Woodman said most Americans who seek care abroad don’t regret their decision and love the international style of treating patients like kings.

“The overwhelming majority of Americans who do travel for medical care return home healthy and happy to tell about their experience — and with a lot of extra coins in their pockets,” said Woodman, who has been pleased with dental care he received in Mexico, Costa Rica and Colombia.

Still, only a small percentage of Americans who could benefit actually cross an international border for care, and Woodman speculated that stems from fear of the unknown — whether that be foreign travel in general or the quality of medical care in other nations.

Weighing risks

Dr. Chris Johnson of Hillside Dental in Eau Claire said it’s disheartening to hear about experiences such as Heldstab endured and added that it should serve as a cautionary tale for folks considering medical care abroad.

“You could receive really good care and save some money, or you may have problems and need additional care and end up having the whole thing cost you more money,” said Johnson, a regional trustee for the Wisconsin Dental Association.

He advised patients who can’t afford recommended treatment to inquire about setting up a payment plan with their local dentist before hopping on a plane.

For those contemplating foreign treatment, Johnson suggested they do as much research as possible, evaluating the educational background and licensing of the provider and the infection control procedures used in the office.

Dr. Clyde Chumbley, chief medical adviser for the Wisconsin Medical Society, said the destination medicine phenome-

non is somewhat troubling, especially for complex operations such as transplants, because of additional risks related to different strains of antibiotic-resistant bacteria, variations in medical record-keeping, potential language barriers and even an elevated risk of blood clots from flying shortly after surgery.

Still, he didn’t go so far as to advise everyone against seeking care in other countries.

“If I had a relative call me and say they were thinking about having coronary bypass surgery done in India, I wouldn’t necessarily say, ‘You’re crazy,’ and tell them not to go,” Chumbley said.

But the retired gynecologist said he would ask any potential international patient where they were thinking about seeking care and encourage them to look up statistics on key quality indicators such as rates of success, death and infection.

While he understands the allure of saving big bucks on health care, Chumbley said such a decision shouldn’t be made lightly.

“It’s not something where you just say the cost is $5,000 less, so let’s go,” he said.

Woodman agreed, saying he’s really not a proselytizer anymore.

“At the end of the day,” Woodman said, “determining where you want to get medical care is one of the most personal decisions you can make.”

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