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Save & Change Lives

Through medical mission trips, international medical relief provides access to sustainable community and public health education and medical services to underserved and vulnerable communities across the globe that will improve the health, wellness, and quality of life of those populations most in need. join the mission, relief efforts ongoing for ukraine , give or go volunteers and donations needed for ukraine relief in belgium, impact aid tracker.

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Affecting Change in the World in a Sustainable Way

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International Medical Relief provides sustainable capacity building and direct relief efforts. On our medical mission trips, everyone plays a vital role in saving and changing lives. Our international medical corps of volunteers provides comprehensive large and small scale clinics offering life-saving interventions and high impact training to vulnerable communities around the globe. According to the World Health Organization, approximately 5.3 million children die of preventable diseases each year that could be saved through access to focused, scaleable education, treatment, and diagnoses. With careful integration of the United Nations Sustainable Development Goals, our work creates a blueprint for communities to reach their greatest level of success. We invite you to be the good you wish to see in the world.

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Medical Tourism Patient Survey

The Medical Tourism Association, in collaboration with the International Healthcare Research Center, has gathered critical insights into why patients are increasingly choosing to travel for medical care. This comprehensive 31-page report sheds light on the decision-making process, motivations, and concerns of medical tourists, focusing on aspects like the search for superior medical expertise, trust in healthcare providers, cost-effectiveness, and the appeal of innovative treatments. These findings are crucial for healthcare providers looking to tailor their services to meet the evolving needs and expectations of patients globally, ensuring not only the highest standards of care but also building the essential trust and confidence that underpins the decision to seek medical treatment abroad.

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MedicalTourism.com is a free, confidential, independent resource for patients and industry providers. Our mission is to provide a central portal where patients, medical tourism providers, hospitals, clinics, employers, and insurance companies can all find the information they need. Our site focuses on patients looking for specific knowledge in the fields of medical tourism, dental tourism, and health tourism.

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Interested in a particular destination? Check out our destinations guides with detailed information: from tourist attractions, restaurants, and hotels to top-ranked healthcare providers and doctors.

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Frequently Asked Questions (FAQ)

Your particular lifestyle, the medical tourism destination, and the type of medical tourism procedure you will be undergoing will dictate, to a large degree, how much money you will be spending. In general, the farther away your medical tourism destination the more you will pay for airfare. So, for example, expect to pay more if you are flying from Dallas to Bangkok, Thailand, than you would for a flight to Monterey, Mexico. At the same time, you also need to take into account that some medical tourism destinations are more expensive than others. So even if a particular country is cheaper to travel to, you will need to factor in the relative cost of “living,” in comparison to another medical tourism destination.

What about your lifestyle preferences? Do you plan to stay at a five-star hotel or are you comfortable “roughing” it at a local bed and breakfast? Some adventurous souls prefer to immerse themselves in the local culture and will literally live on a shoestring budget. Most everyone else though will tend to fall somewhere between the Holiday Inn and Club Med. The type of medical tourism procedure or medical tourism treatment you are undergoing will also play a large part in your decision of where to stay and what you will do. A medical tourism patient undergoing open heart surgery or a knee replacement will require extra care and very comfortable conditions after leaving the hospital. Not the case for someone coming for a dental bridge or an eyelid lift. Wherever you decide to stay, make sure it serves your needs as a medical tourism patient.

Many of the expenses of a medical tourism trip will be the same as those of a “normal” trip or vacation. At the very minimum you will need to budget for airfare, hotel accommodations, transportation requirements and meals. Sightseeing tours and souvenirs are also a real possibility, particularly if you are traveling with a companion.

Although there are many benefits associated with medical tourism, there are also certain risks that must be weighed before making a final decision to travel abroad.

Varying standards and Medical Tourism

Varying standards with regards to hospitals and physicians can be a problem if you are searching for options within multiple countries with dozens of hospitals. Each country will have its own licensing and certification protocols which may vary significantly from your own country. As you have no way of actually visiting the hospital or meeting the physician prior to your trip, you will have to do research to make sure hospitals are accredited and surgeons are licensed. MedicalTourism.com offers a wealth of information and tools that will make this job much easier.

Travel after surgery

Traveling long distances after surgery also poses certain risks such as deep vein thrombosis (DVT) and pulmonary embolism. DVT may be defined as a blood clot that forms in a vein deep in the body. If the blood clot breaks off and travels through the blood stream to the lungs, a pulmonary embolism may occur which is potentially fatal. Using simple preventive measures, however, medical tourism patients can reduce the chance of blood clotting and increase their likelihood of surgical success.

The Centers for Disease Control and Prevention (CDC) recommends:

• Getting up and walking around every 2 to 3 hours.

• Exercise your legs while you’re sitting

• Drink plenty of water, and avoid drinking anything with alcohol or caffeine in it.

Additionally, medical compression stockings and anti-clotting medications such as Warfarin and Heparin, may be prescribed by physicians for high risk medical tourism patients.

Minimal legal recourse in case something goes wrong

It is important to remember that if you do have a serious complication, other countries' malpractice and liability recourses may be different from those in your own country. Also keep in mind that some hospitals may require a medical tourism patient to sign a legal waiver stating that if they do file a lawsuit over the surgery, the lawsuit must be adjudicated in the country where the medical procedure was performed.  

Coordinating appropriate aftercare once you come home

This is one the biggest concerns for medical tourism patients considering traveling abroad for surgery. What happens if I have a complication once I return home? Who will I turn to? Will my doctor even see me? These are valid questions that must be addressed by the hospital you are seeking care at.

Make sure to inform your primary physician that you will be going overseas and try to get him or her involved in the process. You may also want to try and schedule a call between your primary physician and your international doctor to discuss your case.  This is wise not only at a medical level (you want your international physician to know as much as possible about your case history), but also has the potential to establish trust between both parties, making your physician empathetic toward your situation and wanting to be an active participant in the success of your procedure.

Presently, and in order to minimize potential complications, many international hospitals and physicians do maintain close contact with their medical tourism patients once they have returned home. Therefore, you should not feel shy about contacting them if you feel something is wrong. At the very least your overseas physician can offer recommendations about what medications to take, who to see, or possibly even explain details of your condition to another doctor.

In medical tourism, a Familiarization Tour or Fam Trip is a trip organized by a public or private entity seeking to showcase the healthcare and tourism assets in a certain region, country or city, in order to attract new business (usually in the form of patients). Fam trips are often organized by the tourism board, medical tourism cluster, or by a Destination Management Organization (DMO) representing a destination. Participants in the Fam trip are typically buyers of medical tourism services such as foreign governments, insurance companies, employers and medical tourism facilitators. They are vetted in advance and usually have all their travel, accommodation and maintenance fees covered during the trip.

Sometimes referred to as medical tourism agencies, or a medical travel facilitator, these are companies that, as their name suggests, act as facilitators or intermediaries for patients seeking treatments in other countries or regions.

Medical Tourism Facilitators have played an important role in promoting the growth of medical tourism, and for many medical tourism patients, represent their first face to face contact with the concept of medical tourism.

Over the last 10-15 years, thousands of these companies have popped up, most sporting names synonymous with health and travel. They function much like a travel agency, requesting and obtaining passports, booking flights, and arranging a medical tourism patient’s lodging, transportation and tours. The key difference, of course, is that they also serve as the liaison or mediator between you and the international hospital and doctor. In effect, it is the facilitator’s job to repackage the medical provider’s service offering, make it more appealing, and then guide you along the medical tourism process.

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We work in rural areas and neighborhoods where few others go. Our trips may be the only health care these communities receive.

A Life-changing Experience

We go to give, but what we get back is immeasurable.

FFP nursing/medical trips provide important benefits to those served and those serving! Many local people lack access to healthcare due to inability to pay for treatment and transportation. Our goal is to bring a team to the communities where we work several times a year to provide some continuity of care. We use an EMR to help track patients. The experience is so powerful   that many who first come as students on a trip ask to return yearly as providers with a team to continue their service.

Where do our teams work?

FFP medical teams typically provide mobile medical clinics in the largest available structure in the community, usually schools or churches. The communities prioritized are in impoverished urban neighborhoods, small towns or rural areas where people have little access to medical care due to distance, lack of funds or both.

How is the clinic organized?

Large rooms are organized into examination areas. Desks are provided for the providers and chairs and benches for the families.

The FFP Country Medical Director and local physicians supervise our teams to ensure decisions are consistent with country medical practice and to facilitate patient follow-up. FFP also provides qualified translators for the non-English speaking providers.

Patients are seen in family groups up to five people (often mother or aunt with children). Anyone is the community is eligible to see a physician for free regardless of ethnicity, race, gender, socioeconomic status and creed. Priority is given to the sick.

Where practical, our FFP staff registers patients the day before and gives them an appointment time. This avoids families waiting long periods in the hot sun and worrying if they are going to see a provider.

We establish a temporary pharmacy with a variety of OTC and prescription medications including analgesics, antihistamines and anti-infectives such as antibiotics, anti-fungals and anti-parasitics. All medicines are provided free of charge. Urinalysis and pregnancy testing are usually available.

Students on trips typically work in small groups with a translator to perform a history and physical assessment. Students then review the case with the faculty. Through this experience they learn a great deal about culture, local needs and receive valuable clinical experience.

Other team activities

Teams may also offer health education in the local language during the clinics which is vital for wellness. Teams commonly also provide soap, toothbrushes and other important materials to maintain good health.

A tour of a local hospital and/or a visit to an orphanage to provide activities for children may be part of the itinerary.

A trip to see natural beauty of the country (e.g. the beach, a hike to a waterfall) and/or a cultural visit is usually included. There may be additional costs associated with these excursions.

Additional FFP Features

FFP provides full-time, year-round bilingual staff who are with the team 24/7. The lodging is comfortable mission housing, usually bunk beds and shared bathrooms. All bedrooms are air-conditioned. FFP cooks are used to cooking for North Americans and food is healthy and delicious.

The in-country fees cover the following: transportation (beginning at the airport upon your arrival), lodging, food, purified water, security, translators, mobile medical clinic set-up, and supervising physician(s). The fees do not cover personal purchases, beach costs and excursions.

How to join a trip

Most teams are formed and lead by a nursing or medical school from the US. Organizations can reserve dates and bring their own team, ideally of 15 or more.

In addition, we provide the opportunity to join one of several open trips to Haiti and the Dominican Republic lead by our FFP staff. These trips are available for nurses, physicians, physician assistants and other medical professionals (including students). There is also one FFP Christian trip to Kenya each year that has a medical care focus.

More details of these opportunities can be found on the sign-up for a trip page. Email [email protected] for information.

Dominican Republic: Length of trips, number of clinics and number of team members affect the per person cost. Contact Wendy at [email protected] for details.

The in-country fees cover the following: transportation (beginning at the airport upon your arrival), lodging, food, purified water, security, translators, mobile medical clinic set-up, use of an EMR, medicines provided at the clinics, and supervising physician(s). The fees do not cover personal purchases, beach costs and excursions.

Cancellation policy:

• There is a non-refundable $250 per person deposit ($500 for Kenya).
• For cancellations >60 days before trip, FFP will refund donations above the non-refundable deposit.
• For cancellations within 2 weeks of the trip, refunds of donations, not including the non-refundable deposit will depend what has already been spent on trip materials, etc.  Most likely all of the funds will have been spent.

"The people in these countries really need the help and I felt as if I had made a difference in their lives, especially the children. I will be coming back.”    Liliya Kasko RN

Working Together Hand in Hand

One Nurse At A Time

10 Best Medical Mission Trips 2023 & 2024: Make a Difference

Medical mission trips present a fantastic opportunity for individuals, particularly those in the healthcare sector, to utilize their skills and expertise for the betterment of the world. Even for those who aren’t healthcare professionals, there’s still a vast array of volunteering opportunities in developing nations.

This blog post will serve as a guide, highlighting 10 notable medical mission trips taking place in 2023 and 2024. We will delve into the various types of mission trips, and the advantages of being a volunteer, and provide insights on how you can select a trip that matches your interests and skills.

Exploring the Diversity of Medical Mission Trips

A medical mission trip is essentially a short-term volunteer program enabling you to extend healthcare services to those in need in underprivileged nations. These trips are orchestrated by various entities such as churches, hospitals, and non-governmental organizations (NGOs).

The nature of these medical mission trips can be diverse. Some are aimed at providing essential healthcare services like vaccinations, treatment of common diseases, and wound care. In contrast, others are centered on more specialized care like surgeries, dental services, or mental healthcare.

Benefits of Volunteering

There are many benefits to volunteering on a medical mission trip. These benefits include:

• Making a difference in the world. Medical mission trips are a great way to use your skills and experience to help people in need. You can make a real difference in the lives of people who would not otherwise have access to healthcare.
• Gaining new skills and experience. These trips can be a great way to gain new skills and experience in the medical field. You will have the opportunity to work with experienced healthcare professionals and learn new techniques.
• Experiencing a new culture.  Medical mission trips are a great way to experience a new culture and learn about different ways of life. You will have the opportunity to meet new people and learn about their customs and traditions.
• Growing personally and spiritually. Healthcare mission trips can be a great way to grow personally and spiritually. You will have the opportunity to reflect on your own life and values, and you will learn about the importance of compassion and service.

How to Find the Right Mission Trip for You

There are a few things to consider when choosing a medical mission trip. These include:

• Your skills and experience. What are your skills and experience in the healthcare field? If you’re a doctor, you’ll need to find a trip that offers clinical opportunities. If you’re a nurse, you might be interested in a trip that focuses on providing basic medical care.
• Your interests.  What are your interests in the medical field? Are you interested in working with children, women, or the elderly? Are you interested in providing specialized care, such as surgery or dentistry?
• Your budget. Mission trips can vary in price. Some trips are very affordable, while others can be quite expensive.
• Your schedule.  How much time do you have to commit to a medical mission trip? Some trips are only a few days long, while others can last several weeks.

Once you’ve considered these factors, you can start your search for the right medical mission trip. There are a number of resources available to help you find a trip that’s right for you. You can search online, talk to your church or hospital, or contact an NGO that organizes these trips.

10 Best Medical Mission Trips 2023 & 2024

Here are 10 of the best medical mission trips in 2023 & 2024:

1. Project Medishare: Haiti

Project Medishare is a non-profit organization dedicated to providing healthcare services to the underserved population of Haiti. The organization conducts various medical mission trips, opening opportunities for doctors, nurses, and other healthcare professionals to volunteer their services.

You can participate in tasks ranging from basic healthcare provision to specialized care, depending on your expertise.

2. Global Brigades: Guatemala

Global Brigades organizes health, dental, and engineering brigades to serve in developing countries. For those interested in medical volunteer work, they offer numerous mission trips to Guatemala.

These trips are tailored for different healthcare professionals, including doctors, nurses, and other healthcare staff, and they focus on improving local healthcare infrastructure and providing necessary medical services.

3. AmeriCares: Kenya

AmeriCares, a global non-profit, extends medical care and relief services to needy populations worldwide. They coordinate a variety of mission trips to Kenya , allowing doctors, nurses, and other healthcare professionals to provide vital healthcare services in underserved regions.

Their work often involves treating common illnesses, conducting health education, and improving local healthcare facilities.

4. Doctors Without Borders: Sierra Leone

Doctors Without Borders is an international medical humanitarian organization renowned for providing healthcare assistance to people affected by conflict, epidemics, disasters, or exclusion from healthcare. Among their numerous programs, they organize medical mission trips to Sierra Leone, creating opportunities for healthcare professionals to provide critical care in a country still recovering from a prolonged civil war and an Ebola outbreak.

5. Children’s Heart Foundation: Honduras

The Children’s Heart Foundation is a non-profit that focuses on providing cardiac care to children in developing countries. They run several medical mission trips to Honduras.

These trips are ideal for doctors, nurses, and other healthcare professionals specializing in cardiac care, as they will be directly involved in providing life-saving treatments to children with heart conditions.

6. Project Hope: Tanzania

Project Hope is another global non-profit that extends medical assistance to those in need. They organize a variety of mission trips to Tanzania , offering opportunities for healthcare professionals to volunteer their services.

The range of healthcare services provided during these trips depends on the needs of the communities served and the expertise of the volunteers.

7. Partners in Health: Peru

Partners in Health is a non-profit that focuses on providing medical services to people in need in developing countries. Their mission trips to Peru allow healthcare professionals to volunteer their services and provide much-needed healthcare to underserved communities.

8. Habitat for Humanity: Nepal

While known for building homes, Habitat for Humanity also organizes medical mission trips to Nepal. These trips provide volunteers with an opportunity to offer care to individuals in need while contributing to the construction and improvement of homes and community facilities.

9. Smile Train: Peru

Smile Train is a non-profit dedicated to providing cleft lip and palate surgery to children in developing countries. They organize medical mission trips to Peru, where healthcare professionals can volunteer to provide surgical services and other healthcare to children affected by cleft lip and palate conditions.

10. International Medical Corps: Rwanda

International Medical Corps is a global non-profit that provides to people in need in developing countries. They offer a range of mission trips to Rwanda, creating opportunities for healthcare professionals to volunteer their services in communities that lack sufficient healthcare infrastructure and resources.

Additional Tips

Planning and participating in a medical mission trip is a substantial commitment. Here are some additional tips to consider as you embark on this journey.

Commence Your Research Early

Medical mission trips are diverse and numerous. Starting your research early gives you ample time to identify a trip that aligns with your skills, interests, and schedule.

Evaluating multiple options will also allow you to find a mission trip that meets your budget and other personal needs.

Consult Your Doctor

If you have any health concerns, it’s essential to discuss them with your doctor before committing to a medical mission trip. Such trips often involve physically strenuous activities and exposure to different climates and environments, which may pose health risks.

Obtain Necessary Training

Depending on the nature of the medical mission trip, you might require specific training. For instance, if your trip involves surgical procedures, you may need certification in basic life support (BLS). Other specialized healthcare areas may also require additional training or certification. Be proactive in understanding and acquiring these prerequisites.

Prepare for Challenges

Embarking on a medical mission trip means stepping out of your comfort zone. Be ready for long working hours, limited resources, and encountering cultural differences. While these aspects can be challenging, they also offer profound opportunities for growth and learning.

Embrace Learning Opportunities

Medical mission trips provide a unique platform to learn from other healthcare professionals and the community you serve. Be open to absorbing new information and techniques, and respect the local customs and traditions. This openness to learning will not only enrich your professional skills but will also contribute significantly to your personal development.

How can I apply for these medical mission trips?

You can apply for these medical mission trips by visiting the respective organization’s website and filling out the application form. Make sure to submit all necessary documents and meet the application deadline.

What qualifications do I need to join a medical mission trip?

The qualifications vary depending on the specific mission trip. Generally, you should be a healthcare professional or a student in a healthcare-related field. Some trips may also accept non-medical volunteers.

What is the duration of these medical mission trips?

The duration of the medical mission trips can range from a few days to several months, depending on the specific program and the needs of the community being served.

Are these medical mission trips safe?

Yes, the safety of volunteers is a top priority for all of these programs. However, as with any travel, there are inherent risks. It’s important to follow all safety guidelines provided by the organization.

Do I need to speak the local language?

While knowing the local language can be beneficial, it is not always a requirement. Many mission trips provide translators. However, learning basic phrases can enhance your experience and interaction with the local community.

Can I earn continuing education credits (CECs) or units (CEUs) by participating in these trips?

Some medical mission trips offer the opportunity to earn CECs or CEUs. You should check with the specific program or your professional licensing board for more information.

Medical mission trips are a great way to make a difference in the world. They offer the opportunity to use your skills and experience to help people in need, gain new skills and experience in the medical field, experience a new culture, and grow personally and spiritually.

I believe that everyone has the potential to make a difference in the world. If you’re looking for a way to use your skills and experience to help others, I encourage you to consider volunteering on a medical mission trip. It’s a truly rewarding experience that can change your life.

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Medical Tourism

A comprehensive guide to selecting a trustworthy medical tourism company.

Medical tourism has become an increasingly popular choice for individuals seeking affordable and high-quality medical treatments abroad. However, the success and safety of your medical journey greatly depend on the medical tourism company you choose to work with. Selecting a reputable and trustworthy company is crucial for a smooth and satisfactory experience. In this comprehensive guide, we will explore essential tips to help you find a reliable medical tourism company.

Understand the Importance of Accreditation

In the realm of medical tourism, accreditation serves as a vital indicator of a company's commitment to quality and patient safety. Look for internationally recognized accreditations such as JCI (Joint Commission International) or ISO (International Organization for Standardization). These certifications ensure that the medical tourism company adheres to rigorous standards, protocols, and best practices.

Verify Certification of Medical Travel Professionals

Certified Medical Travel Professionals (CMTPs) play a crucial role in guiding patients throughout their medical travel journey. The Certified Medical Travel Professional program is a recognized certification that demonstrates a professional's expertise in the field. Ensure that the medical tourism company employs CMTPs who possess the necessary knowledge and skills to provide comprehensive assistance and support.

Assess the Range of Services Offered

A reputable medical tourism company should offer a wide range of services to cater to diverse patient needs. Evaluate whether the company provides comprehensive assistance, including pre-travel consultations, treatment planning, travel arrangements, accommodation, and post-treatment follow-up. A holistic approach ensures a seamless and stress-free experience for patients.

Scrutinize Patient Reviews and Testimonials

Patient reviews and testimonials provide valuable insights into the experiences of previous medical travelers. Check reputable online platforms and forums to gauge the overall satisfaction level of patients who have used the services of the medical tourism company you are considering. Pay attention to reviews that address factors such as quality of care, communication, and overall support.

Evaluate Transparency and Communication

Transparent communication is vital when dealing with a medical tourism company. Assess whether the company provides clear and detailed information regarding treatment options, costs, potential risks, and expected outcomes. A reliable company will address all your concerns, provide transparent pricing, and maintain open channels of communication throughout your medical journey.

Consider Destination Expertise

A reputable medical tourism company should have in-depth knowledge and experience in the chosen destination. They should be well-versed in local regulations, medical facilities, and healthcare providers. Ensure that the company has established partnerships with renowned hospitals and clinics, offering a wide range of specialties to meet your specific medical needs.

Seek Recommendations from Trustworthy Sources

Consulting trustworthy sources such as healthcare professionals, friends, or family members who have had successful medical travel experiences can be invaluable. They can provide insights, recommendations, and firsthand accounts of their journeys, helping you make an informed decision when choosing a medical tourism company.

In conclusion, Choosing a reputable medical tourism company is paramount to the success and safety of your medical travel experience. By assessing factors such as accreditation, certifications, patient reviews, transparency, destination expertise, and seeking recommendations, you can make an informed decision. Remember to prioritize quality, patient safety, and comprehensive support throughout your medical journey. With careful consideration and research, you can find a trustworthy medical tourism company that meets your needs and ensures a positive and successful medical travel experience.

To receive a free quote please click on the link: https://www.medicaltourism.com/get-a-quote

Patients are advised to seek hospitals that are accredited by Global Healthcare and only work with medical tourism facilitators who are certified by Global Healthcare Accreditation or who have undergone certification from the Certified Medical Travel Professionals (CMTP). This ensures that the highest standards in the industry are met. Click the link to check out hospitals accredited by the Global Healthcare Accreditation: https://www.globalhealthcareaccreditation.com/

It is recommended that consumers do not share their personal and confidential information on random medical tourism platforms as they may not be secure. Consumers must be cautious when disclosing their private information as some organizations may not protect their privacy and could misuse their information. Additionally, there are agencies that may prioritize their commissions over the well-being of the patients. Consumers should avoid choosing the cheapest price and instead make a thorough comparison across multiple facilitators to make an informed decision.

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The Medical Tourism Magazine (MTM), known as the “voice” of the medical tourism industry, provides members and key industry experts with the opportunity to share important developments, initiatives, themes, topics and trends that make the medical tourism industry the booming market it is today.

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Short-Term Medical Service Trips: A Systematic Review of the Evidence

Short-term medical service trips (MSTs) aim to address unmet health care needs of low- and middle-income countries. The lack of critically reviewed empirical evidence of activities and outcomes is a concern.

Developing evidence-based recommendations for health care delivery requires systematic research review. I focused on MST publications with empirical results. Searches in May 2013 identified 67 studies published since 1993, only 6% of the published articles on the topic in the past 20 years. Nearly 80% reported on surgical trips.

Although the MST field is growing, its medical literature lags behind, with nearly all of the scholarly publications lacking significant data collection. By incorporating data collection into service trips, groups can validate practices and provide information about areas needing improvement.

With globalization, there has been significant growth in short-term medical service trips (MSTs) from high-income countries (HICs) to low- and middle-income countries (LMICs). Although MSTs deliver significant amounts of care, relatively little attention is given in the medical and public health literature to the impact of these interventions on the populations being served. The following review offers a step forward by addressing this gap with a systematic analysis of the existing empirical work and suggestions for further study.

According to the World Health Organization, the highest proportions of the global burden of disease fall on the regions that also suffer significantly from physician shortages. 1 A growing group from HICs aims to address both medical and surgical unmet needs in LMICs through MSTs, sometimes referred to as medical missions.

For purposes of this review, MSTs are defined as trips in which volunteer medical providers from HICs travel to LMICs to provide health care over periods ranging from 1 day to 8 weeks. Both faith-based organizations and non–faith-based organizations facilitate these trips, a feature that will be discussed in more detail later. Team composition can range from members of academic departments from a single institution to collections of individuals affiliated only by friendship, geography, or the organization facilitating the trip.

Authors of several published articles have noted that MSTs as a form of aid do not address the primary sources of the health care problems in the developing world: poverty and overstretched health care infrastructure. 2–4 There are, however, significant resources, financial and human, dedicated to MSTs annually. Although there is no central monitoring group or agency for MSTs, conservative estimates that do not take into account opportunity costs for the volunteers place the annual expenditures at $250 million. 5 With expenditures of this magnitude, questions naturally arise about the return on investment. If noteworthy returns exist and organizations are simply not measuring or reporting them, then this can be remedied. If the returns do not exist and the missions continue, an ethical dilemma may be emerging.

Over the past 20 years, publications describing MSTs have largely aimed to promote models of health care delivery in these settings. The pressure to develop practice guidelines has created some standardization in care, but the lack of critically reviewed empirical data continues to be a concern. Assumptions that the safety and acceptable risk or rates of complications from HICs are automatically transferable to MSTs are unwarranted and could be dangerous. 6

The lack of evidence is particularly concerning when one considers the vulnerable nature of patients living in LMICs. 2 Under the best circumstances, MSTs address an unmet medical need with high-quality care. Under the worst circumstances, they serve, as one author states, as an opportunity for physicians to practice techniques for the treatment of conditions that are less common in the developed world. 7 This example is extreme and is unlikely to play a role in the justification for most contemporary MSTs, but the possibility is concerning. One report in the faith-based literature (of an evangelical short-term mission trip in this case) suggested that some trips may benefit the volunteer as much as or more than the recipient of aid as well as potentially costing the hosts valuable time and resources. 8

Martiniuk et al. recently provided a starting point in the review of MST evidence; however, they included articles with mixed goals and did little to assess the quality of the articles presenting empirical data from MSTs or their participants. 9 The authors described benefits associated with MSTs, including personal gains for the volunteers and an increased sense of solidarity between the recipients and volunteers. They went on to identify common criticisms of MSTs, namely questions about efficacy or impact and unintended consequences.

The present review differs in several ways. First, it specifically targets publications with empirical results based on intentional data collection regarding activities associated with MSTs. These empirical results include work discussing treatment interventions, cost-effectiveness, quality assessment and assurance, or the perspectives of MST participants and target communities. Second, it addresses the assessment of quality. Third, the final section of this article suggests a framework drawn from the existing literature and its remaining gaps for the minimum data collection requirements necessary to expand the evidence base for MSTs.

Investments in MSTs continue to grow while their impact remains largely unmeasured. This demands a critical review and illustrates the need to measure the quality and impact of MSTs. 2,5,10–13 Analyzing the status of existing empirical evidence will help to establish some basic guidelines and a research agenda for future work in this area. Scholarship in the fields of social psychology and tourism also addresses aspects of MSTs; however, this review focuses solely on the medical literature.

This review follows the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines for constructing the review methodology. 14 The aim is to standardize the reporting of reviews. PubMed and ISI Web of Knowledge were the primary sources for identifying relevant publications ( Figure 1 ), using queries for the medical subject headings “medical missions, official” and a “medical missions” topical search for each engine, respectively. After adding limitations for English-language publications, I limited the pool further to those articles with a date of publication between January 1, 1993, and May 15, 2013. Exclusionary terms (e.g., “not dental” and “not disaster response”) narrowed the data set. Finally, I used the terms “study” or “analysis” to identify publications with the empirical level of analysis to establish evidence for MSTs.

Literature search for research on short-term medical service trips (STMSTs): January 1, 1993–May 15, 2013.

To be included in this review, publications had to report on work performed in association with a short-term MST. I defined short-term as trips with a duration of less than or equal to 2 months. Because the intent for this work was to focus on the available evidence produced by these publications, it includes only publications with intentional data collection regarding procedures, patients, volunteers, or the MST literature.

A review of the full-text versions of each publication determined inclusion. In some cases, the abstracts did not reveal enough information to accurately characterize the publication; therefore, a subsequent review of the full-text article was necessary to assess for exclusionary characteristics. Finally, I reviewed the bibliographies of the included articles to identify additional publications missed by the previously described methods. I then subjected these to the same process of inclusion and exclusion analysis.

I collected authors and the date and journal of publication from the final list of studies. This was followed by the collection of study-specific data including focus (literature, patients, participants, equipment, community, or cost-effectiveness), medical specialty or subspecialty, nature of the trip (surgical, medical, or both), study design, sample size, location, duration of the trip, affiliated organizations, and the terms used to refer to MSTs.

The search process identified 1164 unique publications. Abstract reviews reduced the number to 112 for full-text review. As noted by other authors, one significant limitation on searches for this literature base is the diversity of terms used to refer to seemingly the same activity. 15 I identified more than 45 terms used to refer to MSTs ( Table 1 ). The final group of publications included 67 studies for the quantitative and qualitative analysis.

TABLE 1—

Terms Used in Publications to Refer to Medical Service Trips From Literature Search: January 1, 1993–May 15, 2013

Note . DENCAP = dental civilian aid/assistance projects; MCMO = medical civilian–military operation; MEDCAP = medical civilian aid/assistance projects; MEDRETE = medical readiness training exercise; MOOTW = military operations other than war; OHDACA = overseas humanitarian disaster and civic aid.

When one considers the entire eligible group of publications on the topic of MSTs, these studies represent a mere 5.7% of the more than 1100 publications on the topic in the past 20 years. Figure 2 illustrates the increase in annual publications on this topic in recent years. The peak of 15 publications per year occurred in 2012. The most common journal for these reports was the World Journal of Surgery with 15% of the publications (10 of 67).

Medical service trip publications by year (included and excluded), from literature search: January 1, 1993–May 15, 2013.

The results presented here synthesize the emerging and diverse nature of the MST literature. Results are organized around a series of questions that this literature attempts to answer. There are obvious gaps in the scope of the questions posed here. Moreover, much of the data generated by these publications lacks adequate support to answer fully these questions. Thus, the review closes with a proposal for the basic data points that participants in MSTs could collect during their efforts to answer the bigger yet still unanswered questions.

In spite of a diverse group of study designs, nearly all of the publications (98%) represent low-level evidence when judged against standard research design evaluation tools. Nearly two thirds of the publications can be classified in 3 groups on the basis of their study design. The largest proportion of the studies (49%) employed a retrospective study design or simple descriptive statistics to report their findings. Quality improvement or quality assurance projects represent the second most common among the published reports, with 9 studies (13%). Surveys of individuals that volunteer on MSTs and organizations that operate MSTs represent 10% of the publications.

Although the included articles all contained empirical results based on the use of systematic data collection, approximately one third of the studies did not describe their data collection process and 70% failed to describe approval from institutional review boards or their equivalents, leaving it unclear whether the organizations affiliated with these publications had their efforts overseen by an institutional review board. Most organizations freely reported the frequency of the procedures or visits that occurred during an MST (essentially outputs), but the data fail to include demographic characteristics such as socioeconomic status of patients or even gender and age distributions. 16 These are the most basic elements required to describe patient populations for the majority of scholarly literature.

Characteristics of MSTs That Publish Empirical Findings

This group of publications represents the broad scope of activities and locations in which MSTs are performed. With the exception of Antarctica, every continent is represented as either a provider or a recipient of care, with the majority of the recipients being distributed across regions of Africa, Central and South America, and Southeast Asia. Some publications (24%) describe individual trips to a single location. 17–32 Others (34%) describe multiple trips to single countries. 3,9,33–53 Finally, the last group (42%) describes multiple trips to multiple countries that in some cases are completely unrelated to one another. 5,6,15,54–78

The fields of optometry, medicine, pharmacy, and surgery were represented. Nearly 81% (54 of 67) of the studies reported on surgical trips, with 17 of the 54 referring specifically to cleft lip and palate interventions. Thirty-one percent (n = 21) of the publications included pediatric care. Trip duration ranged from 1 day to 8 weeks. Patient sample sizes varied considerably ranging from a single case to up to 8151 patients. Thirty-six (56%) of the 64 studies included reported a sample size of 200 or smaller.

Reported Magnitude of MST Efforts

Magnitude can be defined as both the financial expenditures and the volume of procedures associated with MSTs. According to 2 publications, respondents indicated that the total costs of MSTs ranged from $12 600 to $84 000 per trip (mean ranging from $22 650 59 to $34 400 5 ), and conservative estimates for annual expenditures from teams departing from the United States totaled $250 million. 5

McQueen et al. published the results of their survey of medical service organizations and reported that the organizations perform 223 425 surgical cases per year. 70 Many of these organizations and others may be focusing on maximizing the number operations in a short-term setting at the potential expense of quality of care. 78 Approximately 13% of the organizations surveyed provided more than 1000 cases per year. 70 Again, with estimates of expenditures from the United States alone reaching one quarter of a million dollars and with hundreds of thousands of patients treated annually, questions naturally arise about the return on investment.

Cost-Effectiveness in Low- and Middle-Income Countries

An increased focus on the publication of projects that measure the cost-effectiveness of their interventions is a promising and emerging trend in the development of the evidence base for MST activities. 17,45,67 Three publications used cost-effectiveness analysis as a mechanism for evaluating the efforts of MSTs. Two of the 3 cost-effectiveness studies reviewed cleft lip and palate surgeries performed by 2 organizations. 45,67 As noted in the article by Moon et al., both their study 45 and the previous study by Magee et al. 67 concluded that intervening surgically for cleft lip and palate patients represents a cost-effective intervention with a cost per disability-adjusted life year (DALY) of $68 and $34, respectively.

The third cost-effectiveness study evaluated orthopedic surgical trips to Nicaragua and comparably defined the interventions as cost-effective, but at a much higher investment level of $352.15 per DALY averted. 45

Factors That May Limit the Evaluation of MSTs

The contributions of some of the included publications are limited because of the lack of priority for research among medical service organizations and the absence of standardized evaluation tools. Medical service organizations do not regularly include research as a part of their goals.

A survey of 10 international volunteer organizations revealed specifically that they see it as a luxury or side project that yields limited benefits to their mission. 78 Maki et al. contributed a tool for use with MSTs 5 ; however, only 1 of the 21 publications subsequently citing this article described using the proposed tool in any form. 60 Current evaluative measures fail to assess any unintentional harm resulting from MSTs. 2

Reasons Why People Participate in MSTs

Numerous publications, including those from scholars in business, economics, sociology, and tourism, have explored the motivations of volunteers participating in MSTs. Some have claimed that participation in an MST provides an opportunity for personal development, and others have reported an opportunity to promote diplomatic relations. 60 Beyond the article by Chiu et al., 60 only the literature discussing the work of military MSTs explicitly addresses the concept of diplomacy.

Withers et al. reported emotional benefits, as well as career and professional benefits derived from participation in MSTs. 53 Panosian and Coates asserted that the global perspective emerging in students that have matured in the era of globalization materializes in the form of MSTs throughout the US medical education, from aspiring medical students to the postgraduate level. 79 Although they may get these same emotional benefits, they also hope to gain exposure to medical care, show a compassion for the less fortunate on their medical school application, and gain connections in the field. 53

Personal connections to the mission of an organization play a role in a volunteer’s interest, and the emotional experiences draw volunteers together creating relationships that extend beyond the trips. 53 Relationships and the volunteer’s ability to feel valuable and useful are reportedly among the most important factors in motivating volunteers to return for future MSTs. 53 Withers et al. also reported that only 1 of the 30 interviewees discussed a religious or spiritual reason for volunteering. 53

Role of Religion or Faith-Based Organizations

From the 19th century through the early 20th century, MST efforts appear to have been predominantly faith-based. Current efforts, however, are increasingly secular. 80

Among the reviewed literature, Internet searches of the organizations described revealed that only 18% (12 of 67) of the publications refer to activities performed in conjunction with a faith-based organization. This is lower than the 33% of faith-based organizations represented in a survey of 40 medical service organizations from 2010 59 ; thus, the proportion of faith-based organizations reported in this review may slightly underrepresent the proportion performing these activities overall. 53

Role of Education in MST Activities

Medical service organizations often tout reciprocity for their public image in the form of bilateral education—that is, providers from HICs learning from providers in LMICs and vice versa. Therefore, education has 3 forms on these trips: (1) education of students from HICs by providers from HICs and LMICs, (2) education of providers in LMICs by providers from HICs, and (3) education of providers from HICs by providers from LMICs.

Two studies from this review focused solely on the education of pharmacy students or surgical trainees resulting from MSTs. 57,58 Both studies reported a strongly positive experience and the second claimed to be the first to demonstrate the ability of an MST to provide positive training in cultural competency. The concept of cultural competency is a key training item for the Accreditation Council for Graduate Medical Education. Campbell et al. argued that some residency training programs in the United States could use MSTs as a mechanism for meeting that training competency. 58

Almost half (48%) of the included studies indicated that their trip included an educational component or exchange aimed at increasing the medical knowledge of local providers or community members. Several of these publications discussed the third educational form loosely, but they fail to formally evaluate or measure this practice. Compiling results from 3 studies that included surveys of medical service organizations reveals that respondents reported an educational or training component in 43%, 59 60%, 5 and 89% 70 of trips.

Publications associated with various international partnerships between providers in HICs and LMICs included the term “independence” when referring to local provider achievements. 36,41,44,46,52,61,73,74 Independence seems to mean that the providers achieve a level of competence that reflects the observable ability to safely manage patients and treat them in a manner equivalent to the quality achieved in HICs. All of these partnerships began as MSTs, or MSTs continually support and augment the care provided by local providers. All but 1 evaluated their ability to establish independence among the local providers (although they failed to include descriptions of methods for evaluating it). The publications reported on relationships that ranged in length from 2 to 15 years. Although there is not a clear timeline to independence, publications describing partnerships lasting 10 years or less at least showed independence in postoperative management. The 2 publications reporting relationships of greater than 10 years showed a mixed level of independence. 52,73 One reported complete independence at 15 years and one reported independence at 75% of their sites 14 years into the relationships. 44

Patient Outcomes From MSTs

When asked about patient outcomes and the processes in place for the collection of patient outcomes, volunteers or the organizations that facilitate MSTs reported 1 to 3 days of follow-up and surgical trips included follow-up ranging from 1 day to 1 week. 5 Surveys by Maki et al. and others revealed that 60% to 80% of organizations tracked morbidity and mortality data. 5,70,78 This is in stark contrast to the standards in HICs that track this information and in some cases pay providers according to performance on these measures.

In this review, 13 of the 67 publications (19%) reported mortality in a total of 59 patients. Nearly half of these (n = 30) were likely the result of progression of the disease being treated or a comorbidity. Five died from unknown causes. Four deaths were attributable to sepsis, allergic reactions, or a blood transfusion reaction. Two deaths reportedly resulted from complications associated with pre-existing conditions that patients failed to report preoperatively. 6 One case of malignant hyperthermia was reported in this group of publications. The remaining deaths related largely to cardiopulmonary complications in operative cases for various cardiac conditions.

For our purposes, outcomes are classified in 2 ways: early and late. I defined early outcomes as the immediate postintervention or perioperative periods ranging from zero to 7 days. I defined late outcomes at minimum as 8 days after treatment or as the period after the trip on which the patient received initial treatment.

Among the 50 publications (75%) focusing on the patients of MSTs, only 26% (n = 13) reported late outcomes. The length of follow-up included in these publications ranged from approximately 3 months to 7.6 years. The proportion of patients included in those follow-up statistics ranged from 14% to 84%. The remaining 74% (n = 37) of publications excluded any documentation of outcomes or they were limited to early outcomes.

One qualitative study aimed to establish the feasibility of collecting late outcomes in cleft palate patients. 49 This study presents a unique view into the world of these patients in some cases years after their surgeries. These patients received care from numerous groups and the results do not represent outcomes for one specific intervention. 49 Most notably this publication revealed that patients and their families attribute multiple benefits to surgical intervention despite the absence of the HIC standard level of follow-up care for speech and swallow therapy.

Noma describes an often fatal rapidly spreading and invasive gangrene with edema of the face originating from an ulcer of the mucous membrane and extending outwardly to destroy bone and soft tissue in surrounding regions. 81 In HICs, interventions for noma may have failure rates as high as 73%. 56 Bouman et al. reported complications in 64% of patients and outcomes that were classified as “bad” in 41%. 56 This article presented data regarding early outcomes alone.

How Those Affected by MSTs Perceive Teams and Activities

Green et al. provided the first empirical evidence regarding the perception of people directly and indirectly connected to the work of MSTs in Guatemala. 3 This interview group (n = 72) was composed of health care providers, family members of patients, government officials, foreign medical providers, and nonmedical personnel that work with or around MSTs. One Guatemalan physician indicated that medical service volunteers inaccurately perceive that everyone is poor, thus relieving them from the need to assess the socioeconomic status of patients. 3 The authors covered a few benefits that Guatemalans attribute to MSTs including providing necessary specialty services to patients, education for local providers, and donations of supplies, but even the benefits they described came with strong caveats about problems that may result from improperly distributing services and materials. The authors also explored unintended consequences of the actions of MSTs and attributed causality largely to a lack of knowledge of the surrounding medical and sociological environment.

Reeve et al. used open-ended survey questions to explore the beliefs and expectations of patients and families receiving care from MSTs for cleft lip or palate. 29 The patients expressed that they believed that the surgery would make a dramatic difference in their lives and that their primary goal for the surgery was improving their speech. According to the authors, most informants inaccurately perceived the origins of the developmental disorder. Finally, the primary concern for patients’ parents going into surgery was pain management.

Deonandan et al. described an MST aiming to improve health literacy among tribal people in Guyana awaiting care from their team. 40 The MST identified a basic disconnect between some of the ideas expressed in public health messaging and the knowledge base of the community. Although many describe the presumed benefits of repeat trips to an area, only Jewell described the phenomenon of gender empowerment as a benefit. 21 The observation of female involvement in the MST prompted women to express feelings of a new ability to move toward gender equity. 21 This empowerment differs from the standard definitions employed in the United States, but nonetheless the presence of the MST and the distribution of authority on the team across both genders promoted female empowerment in this setting.

Outputs vs Outcomes of MSTs

Because of their study design and isolated data that may be difficult to reproduce, one group of publications (n = 18) has extremely limited generalizability and benefit for the MST knowledge base. These studies did not include any assessment of the outcomes of interventions. In some cases, they reported on early clinical outcomes associated with morbidity and mortality that occurs during the stay of the team, but intervention efficacy remained absent from their discussions. In the Methods section for some of these publications, there was little or no information about the data collection process or any analysis plan. The focus of the Methods section in these articles was the model of delivery or the intricacies of the setting of the MST.

Among the medical interventions (n = 2) in this group of publications, one described the utilization of a needs assessment in the planning process for their MST, but there was no description of the tool. 25 This represents the only publication in the entire group of 67 that explicitly mentioned employing this practice. This group also elected to focus on only 2 conditions (hypertension and parasite infection). Outcomes related to these goals are not available. One publication focusing on nonsurgical patients described the conditions observed and the interventions performed for these patients. 9 There are no outcomes associated with this publication. None of the publications relating to surgical care (n = 16) from this subgroup included outcomes beyond the perioperative period, and they failed to provide much information beyond descriptive statistics for specific MSTs.

Reporting outputs rather than outcomes appears to be the default approach for quantifying the value added to the communities and individuals served by MSTs. This criterion, however, falls short of the measures used to identify high-quality evidence-based medicine. In some cases, the included publications relied on personal judgments or anecdotes to support their conclusions. This weak form of evidence has the potential to overshadow some of the more promising work in this field. Most of the questions raised in the Results section are unanswered by the included publications, and more research is necessary to strengthen the evidence available. The assessment of process output data, without assessing the short-term or long-term impacts of MSTs, 82 precludes the ability to measure efficacy of interventions performed.

Aiming to assess the quality of the evidence in some cases justifies the use of a standardized hierarchical evaluation tool. For instance, the tool developed by the US Preventive Services Task Force classifies evidence on the basis of the employed study design, with randomized controlled trials representing the highest level of evidence. However, because of the emerging nature of this body of literature, distinctions based on study design have limited benefits. The assumption with that form of evaluation is that authors have unified research questions and are aiming to move up the hierarchy with their work. In the case of the wide-open nature of the MST literature, authors are not united in their research questions nor study designs to advance the scientific rigor of their efforts.

Students and Trainees as Volunteers

The motivations and expectations of MST volunteers may be as diverse as the trips in which they participate. The enormous number of available MSTs, their short-term nature, and the relatively low cost associated with travel makes MSTs a common choice to fulfill the desire for international experience among students and nonstudents alike.

Some disparities research argues that cultural competence plays a role in the quality of care provided to minority populations. 58 That assertion prompted academic medicine to encourage training in cultural competence. Some institutions utilize MSTs as a mechanism for cross-cultural training and integrate these programs into their medical education curriculum. The sample sizes and limited scope of the work regarding the relationship between MSTs and educational benefits limit conclusions at this point.

The answers and conclusions from a limited survey of pharmacy students participating in MSTs are largely unrevealing about the motivations and expectations of the students. They note that experiences on the trips have a positive impact on participants, but the brevity and close-ended form of the survey does not allow for an exploration into specifics about how they will put those positive experiences into action beyond possibly traveling on another trip. 57 The overwhelmingly positive responses among surveyed surgical trainees raises concerns about bias, particularly social desirability. 58

Students and trainees may elect to participate in MSTs for reasons similar to those of nonstudents, but their motivations also may include the desire to receive career and professional benefits. 53 There is a limited number of studies assessing the impact these trips have on the life trajectory of students, their participation in future mission-related activities, or the actual benefits of the social capital on their academic pursuits. Another gap exists in the literature regarding MST organizations and their view of the role they play in medical education process.

Education Through Partnerships

The term partnership should not imply reciprocity between providers from HICs and those from LMICs. The intention behind every partnership appears to be the education or training of surgeons and other providers in communities with limited access to specialty care. In some cases, these partnerships bring patients that local providers refer to HICs for treatment. One organization that sends children to the United States for care cites this as a far more expensive model, increasing costs 10-fold. 74 That contrast prompts most organizations to opt for traveling to countries to train local providers in operative techniques utilized in HICs. Evaluations of the outcomes of that training yield mixed results and seem to require an extended, possibly 15 years or more, presence and partnership to ensure quality.

Many partnerships also include the donation of materials and durable medical equipment. One publication notably reports the inclusion of biomedical engineers in their traveling teams as a way of managing donated equipment that often falls out of repair. 74 This addition is often absent from MSTs and has been the source of published concerns historically. 83

Faith Communities and MSTs

In the mid-1880s, to pursue their mission of caring for the soul, the mind, and the body, the Catholic Church began sending missionaries throughout the world, establishing churches, schools, and hospitals. 80 Such origins may lead to the assumption that faith is motivational for volunteers. Although the assumption may have validity, there is limited evidence for it in the published literature reviewed here. Surveys of medical service organizations reveal a higher proportion of faith-based activities than the 18% of publications included in this review. This is almost certainly a publication bias related to the absence of organizational motivation to publish findings in the medical literature.

The absence of informants describing religious reasons for participation raises some interesting questions about whether the majority culture of medical service is outside the faith-based community, if there is change in the comfort with discussing religion, or if this simply an anomaly among the groups that are participating in research. There is no known work comparing outcomes or the impact of faith-based MSTs versus secular efforts.

Creating and Implementing Evidence in MSTs

There is no shortage of opinions about the ideal framework for an MST, but there is a significant shortage of evidence to support any particular framework. 10 By developing or planning MSTs that include data collection in the mission, practitioners can begin to address some of the concerns and validate the practice or provide information about areas that need improvement.

Maki et al. attempted to address this gap by creating a tool for use by MSTs 5 ; however, for unknown reasons, this tool has not been widely implemented or its use has not been subsequently published. One possible explanation for the apparent lack of adoption of this tool could be that the dissemination of the instrument failed to reach the organizations that could put it into action. Another explanation could be that the organizations faced challenges with its implementation that reduced the return on investment for the process to an unfavorable level. Regardless of the reason, tools for organizations to evaluate their work remain a need.

Critics argue that because of the lack of research on structure, process, or outcomes, a fraction of the care provided as a part of MSTs in the developing world has any evidence base at all. 84 Implementing evidence faces significant challenges in this health care delivery model. First, it assumes that providers are aware of evidence-based practices and only treat patients that fall under the spectrum of populations covered by guidelines. Second, it assumes that providers will deliver medical care in a standardized manner including the provision of continuous or follow-up care by either the group or a local provider. Finally, it assumes that they will perform outcome analyses. By definition, MSTs do not typically deliver care under this model.

The primary goal for medical service organizations is health care delivery and these organizations do not commonly prioritize the collection and subsequent evaluation of data. 71 Delivering care without understanding the impact or the outcome of that care presents ethical challenges. 2 Long-term outcome measurement is difficult, but necessary. 49 The consensus for the ethical challenges of MSTs is that there should be no assumed ethical immunity solely based on the altruistic nature of these efforts. 2

Guidelines and Unintended Consequences in MSTs

In some cases, experts and workgroups are establishing guidelines and standards for humanitarian health care delivery. The dissemination and implementation of these standards again faces challenges related to the unregulated and uncoordinated nature of these activities. Chapin and Doocy expressed a concern about their finding that only 25% of respondents were aware of the World Health Organization Guidelines for Drug Donations. 59 Reflecting that absence of knowledge, 20% of the respondents reported that they did not leave their donations with qualified medical professionals or health organizations. Drug accountability may be tightening globally and the practice of leaving behind medications is receiving a growing level of scrutiny.

The ethical concerns raised by critics, such as Crump, DeCamp, and others, suggest a need for ethical standards that will guide the work toward measurable benefits in light of the inherent risks. 85–90 There is a need for objectives and long-term plans developed in coordination with recipient communities. 78

Outcomes Associated With MSTs

Bureaucrats, consumers, and researchers commonly measure the quality of health care on the basis of patient outcomes, defined according to recovery, restoration of function, and survival. 91 Morbidity and mortality associated with treatments are standard; however, changes in the quality of life resulting from medical interventions are rarely measured in this literature.

Although it is not safe to assume that health care providers are solely responsible for these outcomes, their actions play a role in the process and represent an opportunity for inquiry. Patient outcomes are the most concrete measure of quality, but they are among the least commonly described concepts in the MST literature. Outcomes in this literature may also refer to the impact on the volunteer, on the patient relative to the cost, and on the local health care providers.

Determining Outcomes and Success

The challenges of medical resource shortages come to bear in discussions of patient outcomes. Following patients or obtaining reports regarding the outcome of the interventions performed by MSTs after a team departs remains uncommon and requires intentional effort and resource allocation. 49 The challenges are inherent with the transient nature of the patient population and the distances traveled to seek care from service teams. Most teams do not have the ability or data to attest to their psychological, financial, or sociological impact.

The 13 studies that included a measurement of late outcomes all related to surgical interventions, and there seems to be no data regarding the late outcome of any intervention performed by a strictly medical team. In some cases, the best follow-up available is the vital status of patients, but a few of these publications do attempt to evaluate the efficacy of the intervention.

Focusing largely on fistulas and cleft palates, the bulk of the outcomes literature falls under the auspices of general or plastic surgery. A few of these reported outcomes are bad enough to raise serious concerns. Preconceived ideas about the risks and benefits of surgery have a sociocultural component, particularly in the context of plastic or reconstructive surgery. Patients and their families have beliefs about the origins of congenital conditions, concerns about the reconstructive procedures, and expectations for the outcomes of the intervention. Understanding the role of the MST to address the perceived origins of conditions in a culturally sensitive way may provide another opportunity to reduce the marginalization of the affected.

Cultural awareness is one of the most important parts of defining successful patient interactions and surgical interventions. Learning that parents fear the pain for their children more than other factors allows providers to concentrate on that aspect of the consultation to alleviate their fears. 29 Realizing that speech outcomes were the primary interest for patients allows surgeons to manage the expectations for each individual procedure. 29

Although the aesthetic changes resulting from this type of surgery may provide a dramatic background for fund-raising efforts, aesthetic outcomes, though important to the patients, were less significant than speech outcomes in their definition of success. 29 Speech assessments after cleft lip and palate surgeries were seldom completed and, when they are completed, may reveal unsatisfactory results. 49,63 Operative success in HICs does not stop with satisfactory aesthetics and MSTs should find creative ways to match that standard.

Although organizations aim to provide high-quality care, evaluating outcomes should be universally included in their activities. 70 Yeow et al. summarized the aims of surveyed organizations, and conducting research was considered by most to be a luxury only. 78 The combined results from publications included in the present systematic review report a total of 59 deaths in association with the care provided during MSTs. Simply assuming the care provided is safe and has minimal risks is no longer adequate for these activities.

Comparing Outcomes in Light of Expenses

Recent trends in global health evaluation employ cost-effectiveness analysis to compare interventions and their ability to address the United Nations Millennium Development Goals. These goals aim to increase access to high-quality cost-effective care in LMICs. Comparing the cost-effectiveness of interventions associated with MSTs assists with resource allocation decisions. Disability-adjusted life years serve as the unit of analysis for comparative purposes by accounting for the years of life lost because of disease or injury. These calculations have been widely utilized in public health and health economics.

Interpreting the cost per DALY of interventions introduces subjectivity when determining their cost-effectiveness, especially as they relate to MSTs. The World Bank established guidelines for these determinations in 1993, approximating $150 per DALY as the cutoff for determining cost-effectiveness. 45 Although the costs vary substantially, 3 publications in this review reported their interventions to be cost-effective even though one nearly doubles the World Bank cutoff. 18,45,67 There are limitations to this type of work, but it does represent a promising area for comparative evaluation of MSTs. The basic data necessary for these calculations should include diagnoses and treatments (already collected by most teams), costs for the hosts and volunteers for all treatment and follow-up activities, and a measure of the costs for patients including opportunity costs associated with missed income from work. Decisions about cost-effectiveness may translate to comparisons between trips within organizations or they could relate to comparisons of the costs to employee local providers rather than the standard MSTs. Both raise questions about sustainability, and the limited cost-effectiveness data for MSTs leaves these issues open for debate.

The diversity of terms associated with MST activities in the published literature increases the likelihood of underestimating the number of eligible articles. This review was limited to English-language publications, which may have created a selection bias if we consider the global nature of these activities. This review is also limited to the medical literature, which may exclude notable work in other fields of study.

Conclusions

The popularity of MSTs is increasing along with publications on the topic; however, nearly 95% of all publications lack any significant data collection and the outcomes from the interventions that do exist are not well understood. The MSTs that travel to LMICs are largely unregulated and often lack evaluative procedures. Unfortunately, because of the largely disorganized and diverse nature of these efforts, health care providers choosing to participate in these activities are largely left to their own impetus to participate in evaluative data collection and critical process or activity reviews. The vulnerable nature of the patient populations served by MSTs raises frequently discussed ethical concerns including the provision of care within the regular scope of practice of the provider 92 and the adoption of standards comparable to those of routine research with human participants. 2 The self-imposed standards for MSTs should also include basic critical reviews powered by data collection and evaluation.

Collecting data about the quality of care from patients served by MSTs is a challenge and only a few organizations have shown the initiative to publish the data they collect. Organizations may be evaluating their efforts for internal quality improvement, but the volunteer nature of these efforts and the absence of incentives for publication may mean that these results are not widely disseminated. If these reports do exist, their dissemination could benefit MST efforts in general by allowing others to learn from successes and failures of similar groups.

Evaluation of cost-effectiveness is relatively new to the MST arena. Relative comparisons to United Nations standards may be problematic and the value of these assessments may be limited to internal comparisons between trips for medical service organizations. The educational benefits and impact on cultural competency from these trips for students may represent a relatively easy area for objective evaluation in the future.

An emphasis on evaluation is warranted to improve the planning, implementation, and outcomes of MST investments. Furthermore, the limited number of publications describing rigorously evaluated MSTs may lead to the conclusion that the data do not exist and further support the historical criticisms of these activities.

Suggested Data Elements

There is a need for comprehensive data collection and outcome assessment to justify, quantify, and verify the impact of MSTs. Organizations and volunteers participating in MSTs should at minimum collect data related to patient demographics, the socioeconomic status of the patients including their household income and liabilities, the availability of regular care in the community, and the cost of delivering the care provided by the MST. Information regarding the outcome of the intervention performed by the MST is pivotal for decision-making and quality improvement.

Future research in the area of MSTs needs to focus on the development or implementation of materials or instruments capable of measuring the psychological, financial, and sociological benefits or costs of interventions in this setting. At this point, I am not aware of any validated and reliable instruments capable of this assessment.

Acknowledgments

I would like to thank Mary K. Zimmerman, PhD, Sarah Finocchario-Kessler, PhD, MPH, and Robert H. Lee, PhD, for reviewing the draft of the article and making helpful suggestions.

Human Participant Protection

No protocol approval was needed for this study as it is a review of previously published research.

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Medical Tourism: Travel to Another Country for Medical Care

Traveling to another country to get medical care can be risky. Learn about the risks and how to minimize them.

Traveling Internationally for Medical Care

Each year, millions of US residents travel to another country for medical care which is called medical tourism. Medical tourists from the United States most commonly travel to Mexico and Canada, and to several other countries in Central America, South America, and the Caribbean.

The reasons people may seek medical care in another country include:

• Cost: To get a treatment or procedure that may be cheaper in another country
• Culture: To receive care from a clinician who shares the traveler’s culture and language
• Unavailable or unapproved procedures: To get a procedure or therapy that is not available or approved in the United States

The most common procedures that people undergo on medical tourism trips include dental care, cosmetic surgery, fertility treatments, organ and tissue transplantation, and cancer treatment.

Medical Tourism Can Be Risky

The risk of complications depends on the destination, the facility where the procedure is being performed, and whether the traveler is in good health for the procedure(s). Other issues that can increase a traveler’s risk of complications include:

Infectious Diseases.  All medical procedures have some risk of infection. Complications from procedures performed in other countries include wound infections, bloodstream infections, donor-derived infections (in the case of transplantations or transfusions), and diseases such as hepatitis B, hepatitis C, and HIV.

Antimicrobial resistance.   Highly drug-resistant bacteria and fungi have caused disease outbreaks among medical tourists. Antimicrobial resistance happens when germs develop the ability to not respond to drugs such as antibiotics used to treat infections. Antimicrobial resistance is a global problem. Healthcare facilities in another country may not have adequate infection control practices and medical tourists could be at risk for getting a drug-resistant infection.

Quality of Care. Some countries’ requirements for maintaining licensure, credentialing, and accreditation may also be less than what would be required in the United States. In some countries, counterfeit medicines and lower quality medical devices may be used.

Communication challenges. Communicating with staff at the destination and healthcare facility may be challenging. Receiving care at a facility where you do not speak the language fluently could lead to misunderstandings about your care.

Air Travel.  Flying after surgery can increase the risk for blood clots, including  deep vein thrombosis . Delaying air travel for 10-14 days following major surgeries, particularly those involving the chest, will minimize risks associated with changes in atmospheric pressure.

Continuity of Care.  Travelers may need to get health care in the United States if they develop complications after returning. Follow-up care for complications might be expensive. Treatment might be prolonged and might not be covered by your health insurance.

How You Can Minimize Medical Tourism Risks

Research the clinician and facility.

• Check the qualifications of the clinician who will be doing the procedure and the credentials of the facility where the procedure will be done. Accrediting groups, including Joint Commission International, DNV GL International Accreditation for Hospitals, and the International Society for Quality in Healthcare, have lists of standards that healthcare facilities need to meet to be accredited. Please note that all surgeries carry the risk of complications and accreditation does not guarantee a positive outcome.
• If you go to a country where you do not speak the language, determine ahead of time how you will communicate with your clinician and others who will be caring for you.

Before you travel

• Get a pretravel consultation. See your healthcare provider or a travel medicine clinician at least 4–6 weeks before the trip to discuss general information for healthy travel and learn about specific risks you may face because of your health status, the procedure, and travel before and after the procedure.
• Obtain international  travel health insurance  that covers medical evacuation back to the United States.
• Find out what activities are not recommended around the time of the medical procedure, such as swimming or hiking, and plan accordingly.

Maintain your health and medical records

• Bring copies of your medical records with you, including results of lab tests and other tests related to your condition and care. Inform the medical staff at your destination of allergies you may have.
• Pack a  travel health kit  with your prescription and over-the-counter medicines in their original packaging. Bring enough medicine to last your whole trip, plus a little extra in case of delays. Also, bring copies of all your prescriptions and a list of medications you take, including their brand names, generic names, manufacturers, and dosages.
• Get copies of all your medical records from the medical facility at your destination before you return home. You may need to get them translated into English.

Arrange for follow-up care before you travel

• Identify where you will be staying immediately after the procedure.
• Make sure you can get any needed follow-up care in the United States. Follow-up care for medical complications can be expensive and might not be covered by your health insurance. Travelers considering procedures outside the United States should understand the potential financial costs associated with follow-up care or emergency care in the event of complications, review their health insurance policies to determine what, if anything, is covered and plan for the possibility of paying for additional care out-of-pocket.
• Supplemental travel health insurance may also be available to cover follow-up or emergency care from procedures received abroad.

Related Resources

• CDC Yellow Book: Medical Tourism
• American Medical Association Ethical Guidance on Medical Tourism
• Organization for Safety, Asepsis, & Prevention's Traveler’s Guide to Safe Dental Care
• The International Society of Aesthetic Plastic Surgery guidelines for travelers
• International Travel (US Department of State)
• Your Health Abroad (US Department of State)

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Passing Thru Travel

Top Destinations for Health and Medical Tourism in 2024

Posted: February 15, 2024 | Last updated: February 15, 2024

Health and medical tourism has become increasingly popular in recent years, with many people traveling abroad for high-quality medical treatments, wellness retreats, and alternative therapies. These destinations offer top-notch medical services and a chance to recuperate in a relaxing environment. This guide takes you through 15 global destinations renowned for their medical and wellness services.

Bangkok, Thailand

You’ll discover a world-renowned center for medical tourism in Bangkok where cutting-edge healthcare meets affordability and exceptional service. As you navigate the city, you’ll find state-of-the-art hospitals and clinics offering a wide range of medical treatments, from cosmetic surgery and dental care to comprehensive health check-ups. These facilities are known for their highly trained medical professionals, many of whom have international experience and qualifications.

The allure of Bangkok for medical tourism isn’t just in the cost savings but also in the opportunity to recuperate in a vibrant city known for its rich culture, delicious cuisine, and warm hospitality. Whether you’re exploring the bustling streets, relaxing in a luxurious hotel, or enjoying a tranquil recovery by the picturesque Chao Phraya River, Bangkok provides an ideal setting for both your medical and travel needs. You could even head to one of the southernmost islands, such as Koh Samui, for rest and recuperation.

Services: Cosmetic surgery, dental care, and wellness retreats.

Insider’s Tip: Many hospitals offer packages, including post-treatment recovery in luxury accommodations.

How To Get There: Fly into Suvarnabhumi Airport, served by many international airlines.

Budapest, Hungary

Budapest has carved a niche for itself in the world of medical tourism, particularly noted for its excellent dental care and historic thermal baths. Here, you’ll find top-notch dental clinics offering a range of services at prices significantly lower than in many Western countries without compromising on quality or expertise.

Beyond dental care, Budapest is famed for its thermal baths, sourced from natural hot springs, known for their therapeutic properties. These baths are not just about relaxation; they’re a traditional form of wellness deeply ingrained in the city’s culture. While benefiting from affordable, high-quality medical services, you also get to immerse yourself in the charm of a city that seamlessly blends its rich history with a vibrant contemporary lifestyle.

Wandering through Budapest’s grand architecture and along the Danube, you’ll experience this beautiful city’s unique blend of wellness and culture.

Services: Dental care and thermal baths for wellness.

Insider’s Tip: Schedule visits to thermal baths for natural healing.

How To Get There: Fly to Budapest Ferenc Liszt International Airport.

Seoul, South Korea

Seoul is a global leader in medical tourism, especially renowned for its advancements in cosmetic surgery and dermatology. As you explore Seoul, you’ll encounter state-of-the-art medical facilities that offer a wide array of cosmetic procedures, from innovative skincare treatments to high-precision plastic surgeries, all performed by highly skilled doctors. These clinics often combine the latest technology with a personalized approach, ensuring both top-quality results and a comfortable experience.

The city itself, a blend of modernity and tradition, provides an exciting backdrop for your medical journey. Whether you’re recovering in a luxury hotel or exploring vibrant neighborhoods like Gangnam, known for its high concentration of clinics, Seoul offers a unique experience where cutting-edge medical care meets rich cultural exploration. This fusion of high-tech healthcare and dynamic urban life makes Seoul a compelling destination for anyone seeking medical services in a cosmopolitan setting.

Services: Advanced plastic surgery and dermatological treatments.

Insider’s Tip: Explore Gangnam district, known for its high concentration of clinics.

How To Get There: Fly into Incheon International Airport.

Find a serene and lush paradise that has become a sought-after destination for medical tourism, known for its affordable yet high-quality medical services in Costa Rica. As you explore this Central American gem, you’ll discover a range of medical offerings, from dental procedures to cosmetic surgeries, all provided in state-of-the-art facilities by experienced healthcare professionals.

What sets Costa Rica apart is its ability to combine medical treatments with a chance to recuperate in a tranquil, natural setting. Imagine recovering amidst the backdrop of rainforests, pristine beaches, and rich biodiversity. This harmonious blend of top-tier medical care and a peaceful environment enhances your recovery and offers a unique opportunity to experience the pura vida lifestyle for which Costa Rica is renowned. Your journey to wellness in Costa Rica is complemented by warm hospitality and the chance to indulge in eco-friendly and wellness-oriented activities, making it a holistic health and travel experience.

Services: Dental work and cosmetic surgery in a natural, tranquil setting.

Insider’s Tip: Combine your medical trip with a stay near the beach or rainforest for relaxation.

How To Get There: Fly into Juan Santamaría International Airport.

Mumbai, India

In Mumbai, India, you’ll find yourself in a bustling metropolis that has emerged as a key destination for medical tourism, attracting patients worldwide with its combination of high-quality healthcare and affordability. The city’s medical facilities are equipped with advanced technology and staffed by skilled healthcare professionals, many of whom have trained internationally.

Mumbai specializes in a range of medical fields, including cardiac surgery, orthopedics, and transplants, offering services at a fraction of the cost compared to Western countries. Beyond the clinical aspect, Mumbai is a city steeped in culture and history, offering you a chance to experience the vibrant life of one of India’s most dynamic cities.

Whether you’re exploring the bustling markets, soaking in the diverse cultural heritage, or enjoying the local cuisine, Mumbai provides an enriching backdrop to your medical journey, blending world-class medical care with the warmth and vibrancy of Indian hospitality.

Services: High-quality cardiac surgery, orthopedics, and alternative medicine.

Insider’s Tip: Explore Ayurvedic retreats for holistic wellness.

How To Get There: Fly to Chhatrapati Shivaji Maharaj International Airport.

Istanbul, Turkey

Istanbul is at the crossroads of East and West, a city that has become a prominent hub for medical tourism, especially known for its hair transplantation and cosmetic dentistry expertise. As you navigate through Istanbul’s unique blend of historical grandeur and modern sophistication, you’ll find numerous clinics and hospitals offering high-quality medical services at competitive prices.

These facilities are often equipped with the latest technology and staffed by experienced professionals who provide personalized care. Its rich cultural tapestry enhances Istanbul’s appeal as a medical tourism destination, with landmarks such as the Hagia Sophia and the Grand Bazaar. Here, you can seamlessly combine your medical journey with the experience of exploring one of the world’s most historically rich and diverse cities.

Whether you’re strolling along the Bosphorus or savoring Turkish cuisine, Istanbul offers a unique setting where a wealth of cultural and historical experiences complements advanced medical treatments.

Services: Hair transplantation and cosmetic dentistry.

Insider’s Tip: Post-treatment, enjoy recovery in a city steeped in history and culture.

How To Get There: Istanbul Airport or Sabiha Gökçen International Airport.

Sao Paulo, Brazil

In Sao Paulo, you’ll find yourself in a bustling city that’s increasingly becoming a hotspot for medical tourism, particularly known for its excellence in cosmetic and plastic surgery. As you navigate through Sao Paulo, the largest city in South America, you’ll discover a range of high-quality medical facilities that offer a variety of procedures, from minimally invasive treatments to more complex surgeries, all performed by skilled and experienced surgeons.

The city’s medical services are priced competitively, attracting patients from around the globe. Beyond the operating room, Sao Paulo is a vibrant metropolis brimming with cultural attractions, diverse cuisine, and dynamic nightlife. The opportunity to recover in such a lively urban environment adds an appealing dimension to your medical journey, combining top-tier medical care with the unique experience of exploring one of Brazil’s most dynamic cities.

Services: Cosmetic and plastic surgery.

Insider’s Tip: Brazil is known for its expertise in cosmetic procedures.

How To Get There: Fly into São Paulo–Guarulhos International Airport.

Barcelona, Spain

Barcelona beautifully marries cutting-edge medical facilities with the charm of a vibrant cultural hub, making it an increasingly popular destination for medical tourism. Known mainly for its advanced fertility treatments and cosmetic surgery, Barcelona’s medical centers boast state-of-the-art technology and highly skilled professionals, offering quality care at competitive prices.

As you embark on your medical journey in this city, you’re also treated to its rich architectural heritage, from Gaudi’s masterpieces to the Gothic Quarter’s winding streets. The city’s Mediterranean climate and inviting beaches provide a serene backdrop for recovery and relaxation. Whether you’re enjoying tapas on a sun-drenched terrace or strolling along the bustling Las Ramblas, Barcelona offers a holistic experience where an immersive cultural journey complements exceptional medical care.

Services: Advanced fertility treatments and cosmetic surgery.

Insider’s Tip: Take advantage of the city’s rich cultural and gastronomic scene during recovery.

How To Get There: Barcelona-El Prat Airport.

Tel Aviv, Israel

Tel Aviv is rapidly gaining recognition for its advanced medical treatments and state-of-the-art healthcare facilities. This vibrant coastal city offers a wide range of medical services, including cutting-edge cancer treatments and innovative medical technologies, attracting patients from across the globe. Tel Aviv’s medical institutions are known for their skilled professionals and personalized patient care, set within a competitive pricing framework.

Beyond healthcare, Tel Aviv is a lively, modern city known for its beautiful Mediterranean beaches, rich cultural scene, and bustling nightlife. The city’s warm climate and welcoming atmosphere provide an ideal environment for recovery and relaxation. As you walk along the beachfront promenade or explore the historic streets of Jaffa, Tel Aviv offers a unique blend of top-tier medical care and a lively urban experience, making it an attractive destination for medical tourists seeking both treatment and an enriching travel experience.

Services: Cutting-edge cancer treatments and medical technologies.

Insider’s Tip: Explore the Mediterranean coast for a relaxing recovery.

How To Get There: Ben Gurion Airport is the main international gateway.

Kuala Lumpur, Malaysia

Kuala Lumpur has established itself as a significant player in the field of medical tourism, offering an impressive array of healthcare services at highly competitive rates. The capital city of Malaysia, Kuala Lumpur, is home to numerous internationally accredited hospitals and clinics that provide a wide range of medical procedures, from complex surgeries to wellness check-ups, all performed by qualified and experienced medical professionals.

These facilities are equipped with modern medical technology, ensuring high treatment standards. Kuala Lumpur’s appeal as a medical tourism destination is further enhanced by its rich cultural diversity, delicious cuisine, and a blend of modern and traditional lifestyles. The city’s excellent infrastructure and English-speaking medical staff make navigating your healthcare journey and the city itself a smooth and comfortable experience.

Whether exploring the iconic Petronas Twin Towers or indulging in the local food scene, Kuala Lumpur offers a unique setting where quality healthcare meets cultural richness.

Services: Affordable and quality healthcare covering various specialties.

Insider’s Tip: Malaysia’s healthcare system is ranked among the best in the world.

How To Get There: Kuala Lumpur International Airport.

Singapore is a city-state known for its efficiency and modernity; you’ll discover a premier destination for medical tourism, renowned for its exceptional healthcare system. This bustling metropolis boasts state-of-the-art medical facilities that are among the best in the world, staffed with highly trained medical professionals who provide a wide range of specialized treatments and procedures.

Singapore’s hospitals are known for their high standards of patient care and cutting-edge medical technology, offering services from complex surgeries to preventive medicine. The city, known for its cleanliness and order, provides a comfortable and stress-free environment for your medical journey. As you navigate this cosmopolitan city, you can also enjoy its diverse cultural tapestry, lush green spaces, and a culinary scene that’s a melting pot of Asian cuisines.

In Singapore, your pursuit of health and wellness is complemented by the experience of a city that seamlessly blends traditional charm with a forward-thinking approach.

Services: State-of-the-art medical technology and facilities.

Insider’s Tip: Post-treatment, enjoy the city’s clean and organized environment.

How To Get There: Singapore Changi Airport.

Dubai, United Arab Emirates

Dubai is a luxurious and futuristic city that has rapidly emerged as a key destination for medical tourism. Known for its lavish lifestyle and architectural wonders, Dubai also boasts world-class medical facilities offering a range of high-end medical and wellness services. These facilities are equipped with the latest technology and staffed by top-notch medical professionals, catering to a variety of health needs, from elective surgeries to wellness retreats.

The city’s emphasis on luxury and comfort extends to its healthcare services, ensuring a premium experience for medical tourists. As you explore Dubai, you can indulge in its opulent shopping malls, stunning skyscrapers like the Burj Khalifa, and relaxing beach resorts, which make the perfect backdrop for a recuperative stay. Dubai’s blend of advanced healthcare, luxury, and a unique desert landscape offers a distinctive and indulgent medical tourism experience.

Services: Luxury medical treatments and wellness retreats.

Insider’s Tip: Experience high-end recovery facilities in this modern metropolis.

How To Get There: Dubai International Airport.

Los Angeles, USA

In Los Angeles, you’ll immerse yourself in a city that’s not just the epicenter of entertainment but also a growing hub for medical tourism. Known for its advanced medical treatments, particularly in specialties like oncology and cardiology, Los Angeles hosts a range of top-tier hospitals and clinics. These facilities are renowned for their cutting-edge technology and expert medical staff, ensuring you receive high-quality care.

The city’s diverse and wellness-focused culture complements your medical journey, offering numerous options for healthy living and recovery. As you navigate the sprawling metropolis, you can indulge in its unique blend of urban excitement and natural beauty, from the Hollywood hills to the serene Pacific coastline. Los Angeles provides an ideal backdrop for those seeking world-class medical treatment while enjoying Southern California’s vibrant lifestyle and scenic diversity.

Services: Advanced medical treatments, especially in oncology and cardiology.

Insider’s Tip: The city’s wellness culture is ideal for recuperation.

How To Get There: Los Angeles International Airport (LAX).

Tijuana, Mexico

Tijuana, just across the border from San Diego, you’ll discover a city that has become a go-to destination for medical tourism, especially known for its affordable dental care and bariatric surgery. This bustling border town offers quality medical services at a fraction of the cost typically found in the United States, drawing patients from all over North America. Tijuana’s medical facilities are modern and well-equipped, staffed by experienced and often bilingual healthcare professionals.

The city’s proximity to the United States adds to its appeal, providing easy accessibility for those seeking efficient and cost-effective medical treatments. Beyond its healthcare offerings, Tijuana boasts a vibrant culture, with lively markets, authentic Mexican cuisine, and a warm, welcoming atmosphere. In Tijuana, you can experience the benefits of affordable medical care while enjoying the rich cultural experiences that this unique border city has to offer.

Services: Affordable dental care and bariatric surgery.

Insider’s Tip: It is a popular destination for Americans due to its proximity and lower costs.

How To Get There: General Abelardo L. Rodríguez International Airport or cross the border from San Diego.

Vienna, Austria

Vienna is renowned for its classical music, stunning architecture, and, increasingly, for its high-quality preventive medicine and diagnostics. This elegant capital offers a range of sophisticated healthcare services, focusing on preventive care that emphasizes early detection and holistic treatment approaches.

Vienna’s medical facilities are world-class, featuring state-of-the-art technology and staffed by highly trained medical professionals. The city’s healthcare system is recognized for its efficiency and patient-centric approach, ensuring a comfortable and reassuring experience.

Beyond its medical offerings, Vienna is enchanted with its imperial history, vibrant cultural scene, and cozy coffee houses, making it an ideal destination for those seeking top-tier medical services in a serene and culturally rich setting. In Vienna, the pursuit of health is complemented by the opportunity to immerse oneself in a city steeped in history and renowned for its contributions to art and science.

Services: High-quality preventive medicine and diagnostics.

Insider’s Tip: Enjoy the city’s classical music scene and historical ambiance during your stay.

How To Get There: Vienna International Airport.

The Bottom Line

Traveling for health and medical treatments combines the necessity of healthcare with the pleasure of experiencing new cultures and environments. Each of these destinations offers unique medical specialties.

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The post Top Destinations for Health and Medical Tourism in 2024 republished on Passing Thru with permission from The Green Voyage .

Featured Image Credit: Shutterstock / ArtFamily.

For transparency, this content was partly developed with AI assistance and carefully curated by an experienced editor to be informative and ensure accuracy.

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10 AARP benefits all seniors should know

By Angelica Leicht

Edited By Matt Richardson

Updated on: June 25, 2024 / 9:56 AM EDT / CBS News

As we transition into retirement and our senior years, our needs and priorities will typically experience a significant shift — as will the challenges we face, from healthcare concerns to financial planning, social engagement and maintaining independence. That's why, during this phase of life, it's crucial to find the right resources and support systems to help navigate these new circumstances.

Recognizing the unique needs of older adults, numerous organizations have emerged to cater specifically to seniors. These groups offer various services, from advocacy and education to discounts and social opportunities. Among these organizations, though, one name stands out: AARP.

AARP describes itself as a nonprofit, nonpartisan organization dedicated to empowering Americans 50 and older to choose how they live as they age. But while AARP's name recognition is widespread, many seniors — and even some long-time members — may not be fully aware of the extensive range of benefits and services the organization offers. So, if you're a senior who's been wondering what AARP can offer you, it helps to know some key membership benefits.

Find out how an AARP membership could benefit you here .

There are a few different benefits that seniors can access by joining AARP, including:

Insurance options

Having access to affordable insurance options becomes crucial during your senior years. And, that's one area where AARP shines. AARP offers a variety of insurance options tailored to seniors' needs, including supplemental health insurance, dental and vision coverage, life insurance , long-term care insurance and auto insurance . These insurance options are geared toward providing coverage for conditions that become more common with age, helping seniors maintain comprehensive protection without excessive financial burden.

Explore the many perks that come with joining AARP during your senior years .

Healthcare savings

Many seniors live on fixed incomes , making healthcare expenses a significant concern. But members of AARP can access significant discounts on prescription drugs, hearing aids and vision care, including glasses and contact lenses. These savings can be imperative for seniors living on fixed incomes, as healthcare expenses can be a major concern. And, by reducing the cost of essential health-related items, AARP helps seniors maintain their health and well-being without costing too much.

Travel benefits

Retirement often means more time for travel, but doing so can be expensive. To help, AARP provides travel-related discounts on hotels, rental cars and cruises, as well as a roadside assistance program and travel planning resources. These perks are particularly valuable for retirees, who typically have more time to travel but may be conscious of the related expenses. For example, these discounts can make it more affordable for seniors to explore new places and visit loved ones or offer peace of mind for those who enjoy road trips.

Financial services

Financial security is often a top concern for seniors. AARP members can ensure that their finances are in check by taking advantage of member perks like free financial health check-ups, identity theft protection services, unique credit card options with cashback rewards and discounts on tax preparation services. 

These offerings are beneficial because they help seniors address the financial security concerns many will face during that point in their lives. These services can, for example, help members manage their money more effectively and protect their assets, with identity theft protection being particularly valuable as seniors may be  targeted by scammers .

Technology assistance

In an increasingly digital world, staying connected is vital — and that's equally true for seniors. AARP can help provide that with access to tech support for computers, smartphones and other devices, as well as online learning resources for improving digital skills. This support can be invaluable because it lets seniors navigate new technologies, enabling them to stay in touch with family, access online services and feel more confident in their tech abilities, all of which is crucial for maintaining independence and connectivity.

Entertainment, shopping and dining discounts

AARP members can take advantage of the discounts offered at restaurants and at movie theaters or other entertainment venues. These benefits encourage seniors to stay socially active and engaged, which is crucial for mental health and overall well-being. And, by making outings and cultural experiences more affordable, AARP helps seniors maintain an active and fulfilling lifestyle.

Another benefit that AARP offers is savings at various retailers, both in-store and online, including discounts on groceries and everyday items. These discounts help seniors stretch fixed incomes further, allowing them to maintain their quality of life and afford both necessities and small luxuries. This can make a significant difference in seniors' day-to-day lives and overall financial comfort.

Legal services

Members of AARP also have access to free or discounted legal advice and assistance with estate planning and will preparation. Legal services can be prohibitively expensive, so these benefits make it easier for seniors to handle important legal matters, ensuring their wishes are properly documented and their rights are protected.

Education and career resources

Many seniors choose to work part-time or start new careers in retirement to earn some extra money . AARP can also help in this area. For example, the organization provides access to job boards specializing in age-friendly employers, online courses and skills training and resume review services. Taking advantage of these resources can, in turn, help seniors stay competitive in the job market and find fulfilling work opportunities, which can be financially and personally rewarding.

Fitness and wellness resources

Staying active is crucial for maintaining health and independence as we age, and it can be easier for AARP members to do that, as membership offers them access to gym membership discounts and wellness programs and resources. These perks make it more affordable for seniors to prioritize their physical and mental well-being, encouraging a healthier and more active lifestyle.

Home and auto services

Seniors can also get discounts through AARP on home security systems , moving services and storage and even auto repair discounts. These services address some common needs of seniors, from ensuring home safety to managing moves and maintaining vehicles, often at reduced costs. These benefits can be particularly helpful for seniors who are looking to age in place or those transitioning to new living arrangements.

The bottom line

An AARP membership can offer big benefits to seniors — including, but not limited to, the ones outlined above. So, if you're a senior who's been on the fence about joining, it can be a smart move to make between the discounts, the resources and the other perks an AARP membership offers. 

Angelica Leicht is senior editor for Managing Your Money, where she writes and edits articles on a range of personal finance topics. Angelica previously held editing roles at The Simple Dollar, Interest, HousingWire and other financial publications.

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HTH Travel Insurance Review: Is It Worth the Cost?

After spending seven years in the U.S. Air Force as an Arabic linguist, Carissa is now a freelance writer using points and miles to fund a four-year (and counting!) adventure. She previously worked as a reporter for The Points Guy. Her writing has since been featured in numerous publications, including Forbes, Business Insider, and The Balance. When she's not flying, you'll usually find her in a Priority Pass lounge somewhere, sipping tea and cursing slow Wi-Fi.

Megan Lee joined the travel rewards team at NerdWallet with over 12 years of SEO, writing and content development experience, primarily in international education and nonprofit work. She has been published in U.S. News & World Report, USA Today and elsewhere, and has spoken at conferences like that of NAFSA: Association of International Educators. Megan has built and directed remote content teams and editorial strategies for websites like GoAbroad and Go Overseas. When not traveling, Megan adventures around her Midwest home base where she likes to attend theme parties, ride her bike and cook Asian food.

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Table of Contents

What is HTH travel insurance?

What does hth cover, hth policy overview, what’s not covered by an hth plan, how hth compares to its competitors, how much is hth travel insurance, how to buy an hth policy, which hth travel insurance plan is best for me, does hth offer 24/7 travel assistance, how to file a claim with hth travel insurance, is hth travel insurance worth it, hth travel insurance recapped, star rating methodology.

HTH Travel Insurance

• Covers travelers up to 95 years old.
• Includes direct pay option so members can avoid having to pay up front for services.
• A 24-hour delay is required for baggage delay coverage on the TripProtector Economy plan.
• No waivers for pre-existing conditions on the lower-level plan.

HTH travel insurance provides plans for all types of travelers, including those going on a single trip, those looking for an annual policy, ship crew members, missionaries and students.

Combined with the ability to have your health care providers paid directly by your policy, this makes HTH travel insurance a good choice for many.

Why trust NerdWallet?

Our Nerdy editorial team aims to be a starting point in your travel insurance research. We default towards transparency and follow a comprehensive methodology for rating and reviewing travel insurance companies. Advertisers and advertising relationships do not influence our ratings. Learn more about our strict editorial guidelines .

Founded in 1997, HTH travel insurance provides coverage to more than 700,000 customers a year. HTH has policies offering wide range of coverage to many types of travelers, so odds are you’ll find a plan that suits your needs.

HTH’s travel insurance policies are underwritten by a few companies, including BCS Insurance Company, 4 Ever Life International Limited and Nationwide Mutual Insurance Company.

Among these, Nationwide Mutual Insurance Company is the most highly rated, scoring a Financial Strength Rating (FSR) of A (excellent) from credit rating firm AM Best. HTH’s remaining underwriters have an FSR score of A-, which is still considered excellent.

Many specialized HTH travel insurance medical coverage plans exist, though HTH travel’s insurance coverage still provides limited trip protections.

Generally speaking, here’s what you can expect when you purchase an HTH travel insurance plan:

HTH health insurance coverage : Covers doctor visits, inpatient visits, surgery and more, whether routine or an emergency. 

Medical evacuation : Reimburses costs for when your medical care requires evacuation to another location. 

Trip interruption : Covers costs for nonrefundable expenses as a result of your trip being interrupted. 

Trip delay : Pays for costs incurred as a result of your travel being delayed. 

Lost luggage : Reimburses you for loss, theft or damage to personal effects during a covered trip.

HTH’s policies have a broad array of inclusions. It offers five single-trip plans that fall into two main categories, medical and travel.

It also offers two annual travel insurance plans for specific kinds of travelers.

Some plans focus on medical care, whether or not you have a primary health insurance plan in the U.S. These provide high limits for medical care but limited and fixed benefits for trip protections.

Single Trip Option for Travelers with Primary Health Insurance.

Single Trip Option for Travelers Without Primary Health Insurance.

TripProtector plans, meanwhile, have a lower maximum on health costs and they cover only accidents or illnesses while you’re traveling, not routine care. At the same time, they provide more trip protections, which can be better for those on expensive vacations.

TripProtector Economy.

TripProtector Classic.

TripProtector Preferred.

Here's an overview of HTH's single-trip plan options and what is included.

Long-term travel insurance

HTH also offers long-term travel medical options for those who travel often or who are away for longer than six months.

HTH offers two types of annual plans:

Plans for standard or corporate travelers, called the Xplorer plan.

Plans for maritime crew members, missionaries and students, called the Navigator plan.

Both plans provide only medical coverage and don’t offer other trip protection benefits.

» Learn more: How does annual travel insurance work?

Add-on options

HTH doesn’t provide many options when it comes to add-ons. However, it's most expensive TripProtector Preferred plan allows you to purchase Cancel For Any Reason (CFAR) insurance, which will reimburse you for up to 75% of expenses if you cancel your trip.

Don’t want to shell out for travel insurance? A variety of travel credit cards offer complimentary trip insurance assuming you pay for the trip with your card.

» Learn more: The best travel credit cards right now

The coverage you’ll receive with an HTH plan will depend on which plan you’re purchasing. For example, TripProtector Preferred comes with rental car insurance , though none of the other available options do.

HTH’s medical-focused plans are also missing trip cancellation insurance , which is included on each of the TripProtector policies.

Whether you have pre-existing conditions included on your HTH plan is also going to depend on which plan you choose. TripProtector Economy and a Single Trip plan for those without health insurance do not have this option.

Beyond this, most travel insurance plans have specific exclusions to their coverage, including:

Activities when you’re under the influence of drugs or alcohol.

Extreme sports.

Named storms. 

Participation in athletic events. 

» Learn more: How to find the best travel insurance

On a 5-star scale, NerdWallet rated HTH 4.5 stars. Jump to see our methodology.

A sample trip for a 36-year-old traveler from Indiana to Canada for five days found that the cheapest HTH plan cost $146. If you were to spring for the premium plan, which increases your coverage limits, expect to pay $233.

When looking across multiple providers, the basic plan for the same sample trip ranges in cost from $10-$202. Note that price isn't the only differentiating factor. Coverage is not identical across plans; each company offers various levels of scope, limits and exclusions.

How much does HTH travel insurance cost? To find out the cost of various HTH travel insurance policies, we generated a sample quote for a 28-year-old from Nevada on a three-week vacation to Ireland, with a total trip cost of $4,700.

As you can see, HTH travel insurance costs much more when you add in greater trip protection benefits.

Purchasing an HTH travel insurance policy can be done online. To do so, you’ll first want to generate a quote on HTH’s website .

Before getting a quote, you’ll want to decide if you want more medical benefits or trip protections. Based on this, you can select Single Trip Medical or Trip Cancellation from the drop-down menu on the homepage.

Once you’ve put in all your travel information, HTH will generate quotes for each plan level. You can then select the one that suits your needs and check out with your new policy.

Consider comparison shopping

If you're not 100% sold on purchasing a plan from HTH, you can use a travel insurance aggregator to compare policies across multiple companies at once.

The HTH plan that best suits you will vary based on your needs. For example, if you anticipate having health needs while traveling abroad, you may want to opt for medical-focused plans.

But if you’re planning a more extended trip with many moving parts and want to be reimbursed for things like delayed luggage or missed connections, a TripProtector plan may be more appropriate.

Not everyone has the same needs when traveling, so not everyone should choose the same insurance policy. Here are some things to consider before purchasing a plan.

Look at coverage details

Scour your plan benefits to see what’s covered. If you won't need trip interruption insurance, don’t buy it. Similarly, depending on your health status, you may feel comfortable purchasing a less expensive plan with fewer medical benefits.

Think long term

How often do you travel? If you’re frequently out of the country, you’ll want to weigh the cost of purchasing multiple single-trip plans versus one annual plan. Do the math and see where you’d come out ahead.

Use existing coverage

Many travel credit cards offer travel insurance, though coverage levels will vary. To qualify for this complimentary insurance, you’ll need to pay for your trip using your eligible card. Common card benefits include trip interruption insurance, baggage delay reimbursement and emergency medical insurance.

HTH offers 24/7 travel assistance on its TripProtector plans. The issues with which HTH can help you range from prescription replacements and passport replacements to lost luggage retrieval.

You can contact HTH at 877-865-5979, 610-254-8771 or via email at [email protected] .

One of the best features of HTH travel insurance is its Direct Pay option. This allows your HTH policy to pay your medical costs directly to the provider, eliminating the need for a refund.

If you can't use a provider within HTH’s network and the one you choose won’t accept Direct Pay, it’s possible to submit a claim.

To do so, you’ll need to log in to your HTH account.

From there, you can fill out and submit the paperwork for your claim. This is also true of any trip protection claims you have, such as lost luggage or a trip delay.

Is HTH travel insurance good? You'll rarely find health care plans for travel abroad unless they’re just covering accidents and illnesses.

That’s what makes HTH’s medical policies stand out. The fact that HTH provides long-term policies for expats is another bonus, as many countries require that you provide independent medical coverage.

But its TripProtector plans are somewhat limited in scope compared with those from other insurance companies, plus they lack customization opportunities.

Overall, HTH may be a good option for you if you need to seek health care while traveling and don’t mind missing out on many trip protection benefits. Otherwise, you may want to look elsewhere .

HTH’s trip interruption and trip delay benefits can help reimburse the costs incurred by a flight cancellation.

If you use Direct Pay, you won’t need to file a claim since HTH will pay for your health care visit automatically. Otherwise, the time it takes to receive a refund can depend on a variety of factors, including what you’re claiming and the documentation you submit.

HTH travel insurance is secondary, which means it will pay out after other available insurance benefits.

Yes, HTH plans will cover COVID-19 costs.

HTH offers a few travel insurance plans depending on your needs, including options for single- and multi-trip policies. Before you buy a plan, be sure you’ve understood its coverage and costs, especially compared with other policies.

Travel insurance

NerdWallet's ratings for travel insurance companies take into account the following details about each insurer:

Scope of coverage.

Customizability.

Consumer experience and complaints.

The best travel insurers excel in all of these categories. They provide the information people need to make a purchase without any surprises along the way. They offer insurance at a fair price and allow customers to customize plans to meet their coverage preferences. They're also able to keep their customers happy throughout the relationship.

Data collection and review process

NerdWallet collects over a dozen data points for each insurer we analyze from their public-facing websites and third-party analyses. These data points are then compared against one another and against NerdWallet's standards for good travel insurance companies to determine a star rating.

Data is collected on a regular basis and reviewed by our editorial team for consistency and accuracy. Final star ratings are presented on a scale of one to five stars, where a one-star score represents "poor" and a five-star score represents "excellent."

The reviews team

The writers and editors behind NerdWallet's travel insurance reviews are insurance specialists who have had their work featured by or appear in The Associated Press, The Washington Post, The New York Times, the Chicago-Sun Times, U.S. News & World Report and the Society for Advancing Business Editing and Writing. Each writer and editor follows NerdWallet’s strict guidelines for editorial independence .

In addition to travel insurance, the team covers travel rewards programs, airlines and hotels.

Rating specifics

Our star ratings are weighted based on our editorial and professional opinions. We use the following weightings when rating travel insurers:

Scope of coverage (25%).

Customizability (25%).

Consumer experience and complaints (25%).

Cost (25%).

Scope of coverage ratings are based on assessments of a company’s standard protections, including:

Travel medical insurance.

Trip cancellation.

Trip interruption.

Trip delay.

Baggage and personal belongings, lost luggage.

Emergency medical assistance.

Emergency medical evacuation.

Emergency medical repatriation.

Accidental death and dismemberment insurance.

Rental car coverage.

Customizability ratings factor in coverage limit range (a fixed price or a percent of trip cost?), whether or not a policy has customizations available, and the number of bonus features. We consider the following services as above and beyond a standard policy:

24-hour assistance.

Pre-existing medical conditions coverage.

Extreme sport coverage.

CFAR add on availability.

Travel health insurance.

Interruption for Any Reason.

Travel Inconvenience.

Cancel for Work Reasons.

Electronics coverage.

Consumer experience ratings are based on provider reviews on Squaremouth.com. If the company is not in the Squaremouth database, we default to Google reviews.

Affordability ratings are based on the percentage of total trip cost a plan costs a policyholder. Less than 4% is considered excellent, whereas over 9% is considered poor.

How to maximize your rewards

You want a travel credit card that prioritizes what’s important to you. Here are some of the best travel credit cards of 2024 :

Flexibility, point transfers and a large bonus: Chase Sapphire Preferred® Card

No annual fee: Bank of America® Travel Rewards credit card

Flat-rate travel rewards: Capital One Venture Rewards Credit Card

Bonus travel rewards and high-end perks: Chase Sapphire Reserve®

Luxury perks: The Platinum Card® from American Express

Business travelers: Ink Business Preferred® Credit Card

on Chase's website

1x-10x Earn 5x total points on flights and 10x total points on hotels and car rentals when you purchase travel through Chase Travel℠ immediately after the first $300 is spent on travel purchases annually. Earn 3x points on other travel and dining & 1 point per $1 spent on all other purchases.

60,000 Earn 60,000 bonus points after you spend $4,000 on purchases in the first 3 months from account opening. That's $900 toward travel when you redeem through Chase Travel℠.

1x-5x 5x on travel purchased through Chase Travel℠, 3x on dining, select streaming services and online groceries, 2x on all other travel purchases, 1x on all other purchases.

60,000 Earn 60,000 bonus points after you spend $4,000 on purchases in the first 3 months from account opening. That's $750 when you redeem through Chase Travel℠.

1x-2x Earn 2X points on Southwest® purchases. Earn 2X points on local transit and commuting, including rideshare. Earn 2X points on internet, cable, and phone services, and select streaming. Earn 1X points on all other purchases.

50,000 Earn 50,000 bonus points after spending $1,000 on purchases in the first 3 months from account opening.

Child, 11, dies after medical emergency while on youth group trip to water park

ORANGE COUNTY, Calif. (Gray News) – An 11-year-old boy died unexpectedly Saturday after going to a water park with his youth group.

The Irvine Police Department posted on X that officials responded to Wild Rivers Waterpark to help with medical aid.

“A juvenile was transported to the hospital and sadly passed away,” the post read. “It does not appear the incident is water-related.”

The water park told KTLA in a statement the boy medical emergency outside of a pool.

“Our hearts go out to the boy’s family and loved ones during this difficult time,” KTLA said the statement read in part. “We ask that you keep them in your thoughts and prayers.”

A GoFundMe created to help the family identifies the boy as 11-year-old Titus Winiger.

“While the family is still waiting for more information or to understand why, we would like to meet them with love, support and a monetary donation that they may need during this time of sorrow,” the GoFundMe reads.

Copyright 2024 Gray Media Group, Inc. All rights reserved.

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Travel nursing demand declines, staffing agencies pivot

Healthcare employment agencies are reevaluating their strategies as interest in travel nurses wanes among both hospitals and workers.

It's another sign of the shifting needs of the industry since the height of the COVID-19 pandemic. Testing firms have laid off workers or folded. Telehealth companies have been challenged.

Related article: Health systems turning to ‘gig nurses’ to ease staffing issues

Employment firms, which quickly pivoted to create a marketplace for temporary clinical help amid pandemic-related staffing shortages, benefited from the lucrative hourly rates commanded by travel nurses — wages begrudgingly accepted by hospitals.

Now, however, employers are reducing their budgets for travel staff and spending more to recruit and retain permanent employees, which in turn is lowering demand and pay rates for contract workers. The shifting dynamics have required employment firms to make another pivot, adopting more technology to guide employers and helping workers manage their careers.

A survey of more than 3,300 registered nurses this month from employment firm Incredible Health found nurses' interest in travel positions have decreased by 22% from 2023. The report also found that 67% of health executives surveyed have not increased travel nurse positions in the last year. 

"With permanent nurse wages going up, as well as travel nurse wages going down, you're [going to] have more nurses who want to stay in permanent [positions,]"  said Dr. Iman Abuzeid, Incredible Health's CEO and co-founder.

In fact, many are taking a cleaver to contract labor spending. 

Franklin, Tennessee-based Community Health Systems said it spent an estimated $48 million on contract labor in 2024's first quarter. That compared with an estimated $85 million in the first quarter of 2023.

Similarly, Dallas-based Tenet Healthcare reported its consolidated contract labor expense made up 2.9% of its first-quarter spending on salaries, wages and benefits, compared with 6% in the year-earlier period.

"The reductions in costs reflect the disciplined approach that we take towards labor management," said Sun Park, Tenet's executive vice president and chief financial officer, said during an earnings call with financial analysts.

Agencies geared toward travel positions may have to pivot operations to stay in the game, according to Joel Tremblay, president of staffing company Medical Solutions.

For Medical Solutions, the key to staying ahead of the competition is keeping a pulse on what health systems and hospitals need in terms of staffing and continuing to adapt their business model accordingly, offering permanent, per diem or travel staff as needed. The company launched in 2001 as a travel nursing company and has since expanded to offer a broader range of healthcare staffing services. 

Incredible Health is banking on career-long services that include online support community, an artificial intelligence resume builder, salary estimators, continuing education and an online support community. 

Staffing company AMN Healthcare is investing in technology, including the use of predictive artificial intelligence to help its clients calculate their staffing ratio needs for the greatest possible efficiency.

"We really see a great need for that, for us to help give [clients] those insights and make their job easier with technology and predictive analytics," said Robin Johnson, AMN group president of nursing and allied solutions.

AMN found in its 2024 Nursing Leadership report that most nursing leaders are aiming for 72% of their nursing staff to be permanent employees.

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ACT budget invests almost $58 million in children's health services, including for new paediatric critical care team

Megan Beit's son Jon has spinal muscular atrophy – a condition which sees the muscles involved in movement progressively weaken and become wasted over time.

Because the specialists he needs to see regularly aren't available in Canberra, the family moved from the ACT to Bywong – near Lake George – to be closer to Sydney.

"We have to travel quite a lot," Ms Beit said.

"We've got two other children, so having to make sure they're cared for, the house is cared for, the animals are looked after whenever we have to go and travel – and it costs money every time we go to Sydney.

"Quite frankly it uproots our life every time.

"We've got to plan who's staying, if someone's staying at the hospital with him or in a hotel nearby, food — all of those things."

The Beit family have stayed at Ronald McDonald House in Sydney, where they say they often meet other families from the Canberra region.

"We all have the same story really: that we have to travel, that we have to do all of these things because we can't do it in our home city," Ms Beit said.

"We didn't realise how much we'd needed to be in Sydney, and we had to have the conversation about whether we move to Sydney or not.

"Ultimately we made the decision not to, because all of our roots are [in Canberra].

"But being a capital city we expected that some of that 'gold standard' treatment would be available here – and it's just not."

The ACT government argues Canberra's population simply isn't big enough to provide enough patients to make it a viable location for many paediatric specialists to practice.

A liaison service has already been established to help coordinate services and supports for families who need to travel interstate for treatment . 

'Starting to build more of those services here': Health Minister

Health Minister Rachel Stephen-Smith said the ACT budget, released today, includes an additional $58 million for paediatric inpatient care and community-based services.

Along with eight new paediatric beds at the Canberra Hospital, the funding will also go towards establishing a new paediatric critical care team.

"[The team will] be a bit of a bridge between what our teams are currently able to do and those children who need to be transferred to Sydney to provide that higher level of care for critically ill children," Ms Stephen-Smith said.

"We simply don't have the population here in the ACT and surrounding region to support a full paediatric intensive care unit.

"But we do know that we need to be able to support children who are deteriorating or in need of critical care at a higher level than we have been able to up until this point."

About $2 million will go towards expanding rehabilitation services for children with complex and chronic conditions, where care is shared between services in Canberra and interstate hospitals.

"We often see that children are delayed in their return from Sydney when they've had to receive that critical care for an illness or major trauma because there haven't been paediatric rehabilitation services in the ACT," Ms Stephen-Smith said.

"So this is the step towards starting to build more of those services here."

The Neonatal Intensive Care Unit and Special Care Nursery will receive $18 million for additional cots and the government also intends to set up a new location for community based paediatric services so families don't need to go into a hospital setting for treatment.

"That's part of listening to the community including through the kids interstate care project we did with the Health Care Consumers' Association some years ago, and we've continued to invest in the recommendations from that review," Ms Stephen Smith said.

While these measures mean Jon will still need to go to Sydney for treatment at least some of the time, Ms Beit said even small improvements would count.

"Even one trip not going to Sydney is a good thing for us," Ms Beit said.

"I think that other families as well will find that even that small amount of support can go a long way."

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