International symbol of medicineDespite the rapid rise in medical tourism over the past five years, the vast majority of Americans remain reluctant to travel outside of the United States for medical care even if it means saving thousands of dollars.  Perhaps the main reason is concern about the quality of medical care, and the lack of universal credentialing and certification of foreign facilities and physician providers. (Read what Travel & Leisure has to say about the benefits vs. risk of medical tourism.) That may soon change, however, as at least two nonprofit organizations have begun tackling the formidable task of qualifying those who market medical care to an international audience.

The better known of the two organizations is the Joint Commission International.  The JCI has accredited 300 public and private health care organizations in 39 countries since 1999. These organizations include hospitals, ambulatory care centers, clinical laboratories, primary care services and disease or specific condition care centers using international best practice standards. It does not, however, investigate the practices of individual physicians or allied health professionals, or provide ratings based on consumer feedback.

The more recent entry into the medical tourism space is the Medical Tourism Association, also known as the Global Healthcare Association. According to their website, the MTA is the “first international non-profit association made up of top international hospitals, healthcare providers, medical travel facilitators, insurance companies, and other affiliated companies and members with the common goal of promoting the highest level of quality of healthcare to patients in a global environment.”  Although this organization is designed to promote the interests of its members, it does collect and disseminate consumer driven data to insurance companies and prospective patients.  In an attempt to remain credible, they attest to transparency in quality, pricing, and patient safety.  They claim that their information is “unbiased with regard to patient outcomes.”

Anyone contemplating travelling abroad for medical care should contact these organizations for information, and, while we aren’t in a position to endorse their credentialing methods, we would advise prospective medical tourists to give some weight to their findings. We would also note that there are many places in the world that have yet to come under their scrutiny.


About The Author

Frank Gillingham, M.D. serves as Chief Medical Director for HTH Worldwide. Frank has led HTH Worldwide's international business development efforts in Europe and Canada and has been a guest speaker at international business conferences and has authored a series of articles on travel medicine, including pieces on travel information available on the Internet and the role of physicians working with travel insurers. Frank is a Board-Certified Internist and Emergency Medicine Specialist. He is also a private emergency physician in Southern California and a former emergency department director and member of the UCLA emergency department staff. Frank completed residency training at Los Angeles County/USC Medical Center, received his M.D. from Albert Einstein College of Medicine and his B.A. from the University of Pennsylvania .


  1. Good post mate!! Keep ’em flowing!

  2. One of the things missing completely is the benefits of personal medicine in the US, in which patients actually receive personal attention. Dr. Norman Makous (doctor for some 50-60 years) has written a book talking about just that, called “Time to Care.” It’s not about the current legislation, but about the changes that have happened in the care of patients and how that should be fixed. And the legislation fails to address the key issues in the book, which is HOW we provide medical services! His point of view is that having an independent primary care physician at the heart of the person’s medical care is a proven, effective and an ethical method of monitoring care, and it reduces unnecessary and expensive tests that drive up costs. Very thought-provoking — and the kind of medicine I want.

  3. These credentialing and privileging mechanisms ensure the continuing technical proficiency of and adherence to ethical standards by medical doctors, and thus, promotes the quality and safety of patient care.


  4. First, full disclosure: I work for Bumrungrad International, a JCI accredited hospital in Thailand.

    Although in 2002 we were the first JCI accredited hospital in Asia, there are others appearing. In fact, the quality of care in Asia is usually nothing what people in Western countries sometimes envision it.

    In fact, you can see images of our facility at:

    which will give people a better indication of the level of care which is possible in Asia.

    There are 3 significant reason patients would come to Asia for health care:

    1. Cost
    2. Higher quality care than available
    3. Short waiting times

    In terms of cost, I can’t go into much, as we all know that one reason people would come is for the cost. However, we can give you cost information based on real invoices for over 40 procedures:

    Outside of the US, there is a significant part of the world which does not have access to quality care. And in many countries, including the US, it may take months to have a procedure done.

    Finally, there are ways to view the actual certifications of the doctors themselves. Potential patients can always go to the hospital’s website to get a list of the doctors and their certifications, for example:

    We do believe in, and have seen a significant amount of, medical tourism as a concept, especially as a way to both save money, and to be able to have important procedures done in a timely manner.

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