December 16, 2011 3:45 PM EST
As Oman positions itself as a medical tourism destination, the country faces a significant challenge: How to keep its own citizens from going abroad to seek treatments.
Medical tourism - using foreign healthcare - is one alternative that patients pursue typically to get cheaper or more advanced treatments not offered in their home country.
Worldwide, countries like Oman are working to dip into the medical tourism market expected to reach into the billions of dollars in the future, according to independent industry analyses. (Here and here).
Oman investors expect the demand in American, European and Middle Eastern medical tourists will grow. Apex Medical Group, a private corporation, announced in November it had acquired land to build a $1 billion medical city complex in Oman, a country of three million people.
The complex will include a 530-bed hospital along with several healthcare centers focused on education, prevention and even a resort.
However, between 2007 and 2009, Oman residents showed that they prefer medical tourism away from the motherland, too. As the number of visits increased in the three-year span, the number of visits per person decreased, according to statistics released by the government of Oman.
"Many Omani patients go abroad as outsourced patients," Lamk Al Lamki chief editor of Sultan Qaboos University Medical Journal told the International Medical Travel Journal Friday. "They are sent abroad by the government, when the necessary treatment or the specialist is not available locally. Sometimes locally available treatment is not trusted by the patients. Unless we have a good idea of the quality of the care that our patients are receiving abroad, their safety may be at risk. We need more statistics, better studies and better reporting systems. The question of who will look after these patients when they return, has not been answered, but it must be tackled."
Oman, controlled by a monarchy, began a public relations campaign to try to disuade medical treatments outside the country.
In the November issue of the Sultan Qaboos University Medical Journal, published from Oman, researchers surveyed 40 medical tourists from Al Dakhilya between March 2009 and August 2010 and recommended establishing a national database of medical tourists, accrediting tourism companies and mandating insurance against potential complications.
The researchers wrote that their non-representative sample size was small, with a response rate of 89 percent, partly because of the lack of follow up information on medical tourists.
Even the thin sliver showed disturbing results. In a third of those surveyed said that their treatment was ineffective.
The demand side of medical tourism remains controversial. Though independent reports in 2008 from analysts Deloitte and McKinsey concluded that the number of American patients seeking treatments abroad may be in the millions, an update in 2010 concluded that number was closer to in the thousands. In 2010, Deloitte concluded that 875,000 Americans were medical tourists. Plus, costs for certain procedures decreased in the U.S. after exposure to price discrepancies such as a hip replacement in India costing $8,000 compared with $40,000 in U.S. hospitals, according to Devon Herrick, analyst for the National Center for Policy Analysis.
"Research into the delivery of healthcare has not yet adequately evaluated the case of medical tourism," Lamki wrote Friday. "The issue of lack of data must be taken very seriously. Medical tourism has some benefits, but there are problems with it and, as doctors, we have to keep in mind our basic principles. One problem is poor or no follow-up care. After being in hospital for a short while, the patient comes home with, perhaps, complications of the surgery or side effects of the drugs. It is a surgical principle that every surgeon looks after his own complications and obviously that does not apply for most, if not all, patients who have been treated abroad. Many countries have very weak malpractice laws and thus patients have limited ability to complain about poor medical care."
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