Why do Omanis go abroad for medical treatment?

Oman wants to become a medical tourism destination, but before that can happen it has to find out why so many people, often at the expense of the state, go to another country for medical treatment. Suggesting that for their own country there are some negative aspects of medical tourism worldwide, experts in Oman have stressed the need for comprehensive studies on the growing tendency among their people to go abroad for medical treatment.

Oman wants to become a medical tourism destination, but before that can happen it has to find out why so many people, often at the expense of the state, go to another country for medical treatment.

Suggesting that for their own country there are some negative aspects of medical tourism worldwide, experts in Oman have stressed the need for comprehensive studies on the growing tendency among their people to go abroad for medical treatment. Professor Lamk Al Lamki of Sultan Qaboos University Medical Journal (SQUMJ), says that the quality and safety of medical treatment abroad has to be analysed and it should be under the scrutiny of the medical professions and the Ministry of Health in Oman, “Many Omani patients go abroad as outsourced patients. 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.”

In SQUMJ, Professor Lamk points out that there is a major lack of systematic data about health services provided abroad, not only for Omanis, but also for citizens of many other countries, “More organised studies are needed and specifically outcome studies. Research into the delivery of healthcare has not yet adequately evaluated the case of medical tourism. 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.”

He also raises concerns that patients may not be able to endure travel, or may not have inherent resistance to some of the diseases in the host countries. He underscores the need to have better scientific studies on the impact of medical tourism on the healthcare services of the source and destination countries as well as on the patients themselves, “We need more statistics on the rate of complications. Many medical tourists are satisfied, but satisfaction does not always parallel good outcome. Often, satisfaction can simply be a result of good service. The outsourced patients, or those who are sent by the government, are often dissatisfied with the total experience compared to the true self-financed medical tourists. That is why an institution has to be accredited for good medical care with a good quality assurance programme rather than just good service.”

Professor Lamk says that patients going abroad need to get good advice. The World Tourism Organization’s Global Code of Ethics for Medical Tourism says medical tourists should have the same rights as citizens of destination countries. He suggests that this is not always the case.

A real concern from Professor Lamk, is that outbound medical tourism can effect the source country’s health care system. Oman may become complacent by being able to send its citizens abroad for certain procedures and thus fail to develop the appropriate national services. He cites the development of positron emission tomography scans in Oman as an example of this.

Prof. Lamk has ethical concerns. He argues that doctors should examine the risks and discuss these with the patient, but patients must have the final say in decision-making.

Another ethical consideration is that each country may have a different standard of medical ethics. For example, what is considered experimental therapy in one country, like stem cell therapy, is routinely used in the private institutions providing care for medical tourists in other countries.