trip to surgeon

Medical tourism: What you need to know about traveling for plastic surgery

• Madison Freeman | ASPS Staff
• Friday, January 13, 2023

From four-inch stilettos and old-fashioned corsets to procedures like leg lengthening, there's no doubt people will go to extremes to feel beautiful. Not only will individuals go to extremes, but they might actually go to the ends of the earth just to get the work done at a better price. For years, many Americans have traveled across the globe to places like Mexico, Brazil, Thailand and more for medical care.

And if you've paid attention at all to plastic surgery in the media, you are probably familiar with the idea of medical tourism. While you may think of medical tourism purely as flying to another country for procedures like gluteal fat grafting (hence the common name, Brazilian butt lift), that's just not the case.

We spoke with three members of the American Society of Plastic Surgeons to learn the negatives and positives of medical tourism.

What is medical tourism?

Medical tourism broadly refers to the idea of traveling for a medical procedure either internationally or domestically.

"Most commonly, I think a lot of people associate it with international travel, but it could also be domestic as well," said Joe Hadeed, MD, FACS , who has practices in Beverly Hills and Miami. "And oftentimes, the reasons why somebody would want to travel can vary, but usually, it's due to cost. They're really trying to find the cheapest deal out there for the procedure that they're interested in."

Cost is a major consideration when it comes to medical care, whether that be fixing a bump on your nose or getting rid of those forehead wrinkles you hate seeing in the mirror every day. And given the high cost of some medical care in the United States, it can be tempting to go elsewhere.

"In a lot of countries, it's cheaper because they offer package deals," said Hadeed. So, for example, not only will the price of the surgery be included, but also the hotel stay and any nursing care afterward. And even with the cost of travel, it's still significantly cheaper in a lot of instances compared to if they were to go to a local plastic surgeon.

What are the risks?

While you might get a bargain up front on a procedure you want done, that doesn't mean it's safe or even the cheapest once all of the costs are included. You might even end up spending more than anticipated if complications arise. When you are traveling for surgery, it's important to research your surgeon beforehand, think of the risks and ask questions about preoperative and postoperative care. Before you even buy your plane ticket to have the surgery you desire, ask yourself questions like, "will I need someone to take care of me after the operation?" and "are there risks that come with traveling after surgery?" The answer to both? Yes.

"I think what is really important is to ensure that if you are traveling domestically for a surgery, that you have identified somebody in your own community that can help care for you after," said Danielle DeLuca-Pytell, MD , a board-certified plastic surgeon out of Troy, Michigan. "Because when you have surgery in another state and you develop a problem, that's not the right time to be figuring out who can help perhaps drain your seroma. It would be logical if you were having surgery in another state for that particular surgeon to perhaps call somebody locally and have an arrangement."

And while every plastic surgeon will have their own list of postoperative instructions, if you're plastic surgeon doesn't speak with you on this prior to your surgery, that's a major red flag.

"So, Miami, for example, it's a big problem because they have a lot of, colloquially referred to them as chop shops or plastic surgery factories where patients will come in, oftentimes, they won't even meet the surgeon until the day of the procedure," said Hadeed. "And then they're discharged from the care of the clinic with no postoperative instructions, no follow-up care. A lot of times they don't even see their surgeon again. And they're sent back home and there's no appropriate follow-up care. They're told if they have any complications to go to the nearest emergency room, and patients are just left out to dry and essentially fend for themselves. So, it's a big problem."

If you're traveling for surgery whether that be out of the country or domestically, to a place like Miami, "one of the risk factors that amplifies that is being immobilized for a long period of time," said Darren Smith, MD , a New York City board-certified plastic surgeon. "So, we think the risk of that is most amplified for the six-week period after a surgical procedure, but you can also amplify the risk of that by being immobilized shortly before a surgical procedure. So, in an ideal world, you'll have someone travel to your surgical center in advance of their procedure and then make sure they're well hydrated, they're up and they're mobile so that you're not actually starting your operation on somebody who's already at increased risk for venous thromboembolism."

The importance of doing your research

First and foremost, when you are getting a procedure done in the United States, there are standards in place to make sure you are getting the safest, most quality care. "And while there are certainly countries and cities around the world with similar standards, we just aren't as familiar with them," said Smith. "So, it really becomes something where the patient has to really dot their i's and cross the t's."

Now, with an ample amount of information online and patient reviews and before and after photos scattered throughout platforms like TikTok and Instagram, it can be hard to know where to find a safe and qualified plastic surgeon, especially if you go abroad. But there are steps you can take to make sure you are getting the best care possible.

"You need to, again, go back and make sure they're the equivalent of board certified where they are," said Smith. "You need to look at what kind of preoperative and postoperative care is in place. And you need to make sure that there's a very safe system for you to be present locally after your procedure. And then there has to be a system in place for follow-up when you get back home because surgery is not just the two or three hours on the table, it's the month before and two months after the procedure."

Red flags to look for

Medical tourism has been around for decades, but with the constant influx of new information and different body trends on social media every few years, knowing the facts can be difficult. So, regardless of where you are getting your procedure done, there are some red flags you want to look out for.

"If they don't have the opportunity to meet with the surgeon who's actually performing the procedure before the day of surgery, I would say that's a huge, major red flag," said Hadeed, adding that oftentimes patients who go to so-called "plastic surgery factories" never even meet with a medical provider.

Smith agrees, stating, "They're kind of like sales companies. And you call their central call center, and they'll have their office in Ohio, they'll have their office in New Jersey, and so on… And then they'll use the word provider, you won't know if it's a plastic surgeon, a gynecologist or a physician's assistant, and you may not know until you show up."

This begs the question: How do prospective patients find a board-certified plastic surgeon that is going to give them the best care possible?

"The real kind of difficult thing is that there's only transparency at the highest and safest levels," said Smith. "If you're a member of ASPS, you're a board-certified plastic surgeon, you're required to have transparency. But if you're not, nobody's enforcing any of this."

Getting plastic surgery is a life-changing decision, and in some instances, the surgery you choose to get will affect you in one way or another for the rest of your life. So, if you do choose to get plastic surgery, make sure you are going to a qualified board-certified plastic surgeon. And as always, if you are getting plastic surgery make sure you are doing it for you.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area .

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Why Patients Are Turning to Medical Tourism

Statistics, Benefits, and Risks

Planning Ahead

Frequently asked questions.

Medical tourism is a term that refers to traveling to another country to get a medical or dental procedure. In some instances, medical tourists travel abroad seeking alternative treatments that are not approved in the United States.

Medical tourism is successful for millions of people each year, and it is on the rise for a variety of reasons, including increasing healthcare costs in the United States, lack of health insurance, specialist-driven procedures, high-quality facilities, and the opportunity to travel before or after a medical procedure.

According to a New York Times article from January 2021, pent-up demand for nonessential surgeries, as well as the fact that many Americans lost their health insurance during the coronavirus pandemic led to a surge in medical tourism once other countries re-opened.

However, there are specific risks that come with traveling overseas for surgery. If you're thinking of pursuing a medical procedure in another country, here's what to know about the benefits and the risks.

Medical Tourism Benefits

The most common procedures Americans go abroad for include dental care, cosmetic procedures , fertility treatments, organ transplants , and cancer treatment.

This is not to be confused with having an unplanned procedure in a foreign country due to an unexpected illness or injury.

Among the reasons a person might choose to go abroad for a medical procedure are:

Lower Costs

Medical tourists can save anywhere from 25% to 90% in medical bills, depending on the procedure they get and the country they travel to. There are several factors that play into this:

• The cost of diagnostic testing and medications is particularly expensive in the United States.
• The cost of pre- and post-procedure labor is often dramatically lower overseas. This includes labor costs for nurses , aides, surgeons , pharmacists, physical therapists , and more.
• High cost of malpractice insurance—the insurance that protects medical professionals against lawsuits—in the United States.
• Hospital stays cost far less in many overseas countries compared to the United States. In other words, quality care, hospital meals, and rehabilitation are far more affordable abroad for many people.

For someone who doesn't have insurance , or someone having a procedure that is not covered by insurance , the difference can be enormous.

Popular Countries for Medical Tourism

Dominican Republic

South Korea

Culture and Language

Many immigrants prefer to have treatments and procedures done in their country of origin—a sensible decision, considering just how much language barriers alone can affect the quality of their care.

Furthermore, at least 25% of immigrants and noncitizen residents in the United States are uninsured, compared to 9% of American citizens. Children with at least one noncitizen parent are also more likely to be uninsured.

Practicalities aside, many people choose to have their procedure done in their country of origin simply because it allows them to be close to family, friends, and caretakers who can assist them through their recovery .

Insurance Incentives

Some insurance companies have started promoting medical tourism. The reason behind this is simple: savings for the insured means savings for the insurance provider and vice versa.

Several insurance providers, including Aetna have programs specifically geared at promoting safe medical tourism. Some insurance providers even offer financial incentives for medical tourism, like discounts on medical bills .

That said, many insurance companies will not pay for surgery performed outside of the country unless it is an emergency.

Luxury and Privacy

Medical tourism is a lucrative business for many countries, and much of the money brought in by medical tourists is reinvested into the local economy and health infrastructure.

The effect of this is apparent in the spa-like luxury that some foreign hospitals offer, providing medical tourists the opportunity to be pampered during their stay for a fraction of the cost they would pay at home.

Some facilities offer hospital rooms that are more like a hotel suite than a traditional hospital room. Other hospitals offer one-on-one private nursing care, which is far more generous and attentive than the staffing ratios that most hospitals allow.

Medical tourists who seek that added layer of privacy can find it abroad. Many can return home from their "vacation" without anyone knowing they had a procedure at all.

Vacation in a Foreign Country

Medical tourists often take advantage of their stay in a foreign country to travel for pleasure by scheduling a vacation before or after their procedure.

This is an especially inexpensive way to travel to a foreign country, especially if their insurance provider is paying for the flight and the cost of staying is low. 

While it seems logical to recover on a beach or in a chalet by the mountains, keep in mind that it's important not to jeopardize your recovery.

Swimming isn't recommended until your incisions are completely closed. You may not feel up to doing much more than napping in the days following your procedure, either.

Don't let your vacation disrupt your recovery. Any time you have a procedure done, especially a surgery, it's important to listen to your body, take your medications as directed, and follow your doctor's recommendations closely.

Bypassing Rules and Regulations

Some travelers seek surgery abroad to bypass rules that are set in place by their own government, insurance company , or hospital. These rules are typically in place to protect the patient from harm, so getting around them isn't always the best idea.

For example, a patient may be told that their weight is too low to qualify for weight loss surgery . A surgeon in a foreign country may have a different standard for who qualifies for weight loss surgery, so the patient may qualify overseas for the procedure they want.

Talented Surgeons

Surgeons in certain countries are known for their talent in a specific area of surgery. For example, Brazilian surgeons are often touted for their strong plastic surgery skills .

Whereas in the United States, insurance companies might only cover cosmetic procedures if it is medically necessary, cosmetic surgery is often free or low-cost in Brazil's public hospitals—giving cosmetic surgeons there ample practice.

Thailand is reported to be the primary medical tourism destination for individuals seeking gender reassignment . It is often easier to qualify for surgery and the cost is significantly reduced. Surgeons are performing the procedures frequently, and as a result, many have become quite specialized in them.

It is often surprising to many medical tourists that their physician was trained in the United States. Not all physicians are, of course, but a surprisingly high percentage of them working in surgery abroad are trained in English-speaking medical schools and residency programs and then return to their home country. These physicians often speak multiple languages and may be board certified in their home country and a foreign country, such as the United States.

Medical tourism isn’t limited to countries outside of the United States, either. Many people travel to the United States for medical care due to the country's cutting-edge technology, prescription medication supply, and the general safety of healthcare.

Medical Tourism Risks

The financial and practical benefits of medical tourism are well known, and you may even know someone who had a great experience. Nonetheless, the downsides of medical tourism can be just as great if not greater. Sometimes, they can even be deadly.

If you are considering a trip abroad for your procedure, you should know that medical tourism isn't entirely without obstacle and risks. These include:

Poorly Trained Surgeons

In any country—the United States included—there will be good surgeons and bad. And just as there are great surgeons abroad, there are also some surgeons who are less talented, less trained, and less experienced.

Regardless of what procedure you are getting or where, you should always do some preliminary research into the surgeon or physician who will be treating you as well as the hospital you will be treated at.

In the United States, it is fairly easy to obtain information about malpractice lawsuits , sanctions by medical boards, and other disciplinary actions against a physician.

Performing this research from afar can be challenging, especially if you don't speak the local language. Yet countless people take the risk anyway, without knowing whether the physicians who will treat them are reputable.

A physician should be trained in the specific area of medicine that is appropriate for your procedure. For example, you should not be having plastic surgery from a surgeon who was trained to be a heart doctor. It isn’t good enough to be a physician, the physician must be trained in the specialty .

Prior to agreeing to surgery, you should also know your surgeon’s credentials : where they studied, where they trained, and in what specialty(s) they are board-certified. Do not rely on testimonials from previous patients; these are easily made up for a website and even if they are correct, one good surgery doesn’t mean they will all be successful.

Quality of Staff

Nurses are a very important part of healthcare, and the care they provide can mean the difference between a great outcome and a terrible one.

A well-trained nurse can identify a potential problem and fix it before it truly becomes an issue. A poorly trained nurse may not identify a problem until it is too late. The quality of the nursing staff will have a direct impact on your care.

Once again, it's important to research the hospital staff where you will be having your procedure done. Read the reviews but don't trust them blindly. If you can, seek out a recommendation from someone who can vouch for the medical staff where you will be going.

Quality of the Facility

While researching healthcare facilities for your procedure, you want to learn not just about the quality of the facilities themselves, but about the country's healthcare system as a whole.

In some countries, there is a marked distinction between public hospitals and private hospitals. In Turkey, for example, private hospitals are considered on-par with hospitals in the states, while many locals will advise you to steer clear of public hospitals if you can.

You will also want to seek out facilities that are internationally accredited. In the United States, the Joint Commission evaluates hospitals and certifies those that provide safe, quality care. The international division does the same for hospitals outside the United States.

Once you have a few options for potential facilities, you can start to investigate specifics. For one, you should find as many pictures and reviews of the facility as you can. Ask yourself whether the facility is state of the art or whether it seems dirty and outdated.

You will also need to find out if the facility has ICU level care available, in case something goes wrong. If not, there should be a major hospital nearby so that you can be transferred quickly.

To learn more about a healthcare facility, consider joining expat groups on social media for the city or country you will be traveling to. Ask the group for recommendations, or inquire about any positive or negative experiences they may have had at a particular facility.

Flying Home After Surgery

Any surgery comes with risks, including infection and blood clots . Flying home increases the risk of blood clots, especially on long-haul flights that are longer than four hours.

Try to avoid flying home in the days immediately after surgery; waiting a week will decrease the chances of developing a blood clot or another serious complication during the flight.

For longer flights, plan on getting up and walking up and down the aisles each hour to improve blood flow in your legs. You might also benefit from wearing compression socks with your doctor's approval.

If you are taking blood thinners or are at-risk of blood clots , be sure to talk to your doctor about how you can reduce your risk of blood clots after your procedure and while traveling.

Furthermore, you should know the symptoms of blood clots and stay alert.

Unplanned Illness

Any time you travel abroad, you run the risk of catching an illness that you have never been exposed to or that your body is not prepared to fight off. This is especially a concern when spending time in a foreign hospital.

If you have a sensitive stomach, you may also want to think long and hard about having surgery abroad. The food is often very different in foreign hospitals, and in some areas, there is a risk that even the water will be upsetting to your body.

Having diarrhea or postoperative nausea and vomiting makes for a miserable recovery experience, especially if you do not have a friend or family member nearby who can help you through it.

Before you travel abroad, check with your doctor to see if you need any vaccines to travel to your destination or if there are any foreign illnesses you should be aware of. Picking up an illness abroad, particularly after your surgery, can potentially be life-threatening.

Language Barriers

If you are having surgery in a country where English is not the primary language, you will need to make preparations in order to be able to communicate with the staff.

You may be pleasantly surprised to learn that the staff speaks your primary language well. If not, then you will need to consider how you will make your wishes and needs known to the surgeon, the staff, and others you will meet.

Whether you are at home or abroad, remember to speak up and advocate for yourself to make sure your needs are met. If you don't speak the local language, download a language translation app on your smartphone and don't hesitate to use it to communicate your needs. Hiring a translator is another option.

A Word About Transplant Tourism

Transplant tourism is one area of medical tourism that is strongly discouraged by organ and tissue transplant professionals in multiple countries. Most international transplants are considered “black market” surgeries that are not only poor in quality, but ethically and morally wrong.

China, for example, the country that is believed to perform more international kidney transplants than any other country, is widely believed to take organs from political prisoners after their execution.

In India, living donors are often promised large sums of money for their kidney donation, only to find out they have been scammed and never receive payment. Selling an organ in India is illegal, as it is in most areas of the world, so there is little recourse for the donor.

Then there is the final outcome: how well the organ works after the surgery is complete. With black market transplants, less care is often taken with matching the donor and recipient, which leads to high levels of rejection and a greater risk of death. Furthermore, the new organ may not have been screened for diseases such as cytomegalovirus , tuberculosis , hepatitis B , and hepatitis C . It is often the new disease that leads to death, rather than the organ rejection itself.

Finally, transplant surgeons are often reluctant to care for a patient who intentionally circumvented the donor process in the United States and received their transplant from an unknown physician.

It is important to arrange your follow-up care prior to leaving your home country.

Many physicians and surgeons are hesitant to take care of a patient who received care outside the country, as they are often unfamiliar with medical tourism and have concerns about the quality of care overseas.

Arranging for follow-up care before you leave will make it easier to transition to care at home without the stress of trying to find a physician after surgery .

Just be sure to inform your follow-up care physician where you are having your procedure done. After you return, they will also want to know what prescription medications you were given, if any.

What are popular countries for medical tourism? 

Mexico, India, Costa Rica, Turkey, Singapore, Canada, and Thailand are among the many countries that are popular for medical tourism.

How safe is medical tourism?

Medical tourism is generally considered safe, but it's critical to research the quality of care, physician training, and surgical specialties of each country. There are several medical tourism organizations that specialize in evaluating popular destinations for this purpose.

What countries have free healthcare? 

Countries with free healthcare include England, Canada, Thailand, Mexico, India, Sweden, South Korea, Israel, and many others.

A Word From Verywell

If you are considering medical tourism, discuss the risks and benefits with your doctor, and consider working with your insurance provider to arrange a trip that balances financial savings with safety. (Also, before you embark on a trip overseas for your procedure, make sure you are financially prepared for unexpected events and emergencies. Don't go abroad if you don't have enough money to get yourself home in a crisis.)

A medical tourism organization such as Patients Without Borders can help you evaluate the quality and trustworthiness of healthcare in various countries. Making sure a high level of care is readily available will lead to a safer, more relaxing experience.

Centers For Disease Control and Prevention. Medical Tourism: Getting medical care in another country . Updated October 23, 2017.

University of the Incarnate Word. Center for Medical Tourism Research .

Patients Beyond Borders. Facts and figures .

Kaiser Family Foundation. Health coverage of immigrants . Published July 2021.

Paul DP 3rd, Barker T, Watts AL, Messinger A, Coustasse A. Insurance companies adapting to trends by adopting medical tourism . Health Care Manag (Frederick). 2017 Oct/Dec;36(4):326-333. doi: 10.1097/HCM.0000000000000179

Batista BN. State of plastic surgery in Brazil .  Plast Reconstr Surg Glob Open . 2017 Dec;5(12):1627. doi:10.1097/GOX.0000000000001627

Johns Hopkins Bloomberg School of Public Health - Global Health Now. Brazilians' risky right to beauty . Published May 2018.

Chokrungvaranont P, Selvaggi G, Jindarak S, et al. The development of sex reassignment surgery in Thailand: a social perspective .  Sci World J . 2014 Mar;2014(1):1-5. doi:10.1155/2014/182981

The Joint Commission. For consumers .

Centers for Disease Control and Prevention. Blood clots and travel: what you need to know . Reviewed February 2021.

Hurley R. China harvested organs from political prisoners on substantial scale, says tribunal . BMJ . 2018 Dec;363(1):5250. doi:10.1136/bmj.k5250

Ambagtsheer F, Van Balen L. I'm not Sherlock Holmes: suspicions, secrecy, and silence of transplant professionals in the human organ trade . Euro J Criminol . 2019 Jan;17(6):764-783. doi:10.1177/1477370818825331

Centers for Disease Control and Prevention. Transplant Surgery. Key facts . Reviewed January 2019.

By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.

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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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When Summer Travel Includes Surgery; Mayo Clinic Expert Offers Tips for a Safe Trip

Sharon Theimer

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Flying is as safe as ground travel after chest surgery, Mayo study finds

Don’t travel alone. If you are traveling by car, you will need to have someone else to drive you in the early period after your operation; work with your physician to determine when it is safe for you to drive again. You will likely need to have someone else lift your luggage; if you are traveling by air, avail yourself of services that provide that, or send your luggage ahead.

Walk every hour during your trip. Be as mobile as possible. In the days after surgery, the body is in an inflammatory state that makes a person more predisposed to blood clots , particularly in the legs, and especially if the blood isn’t flowing as well, Dr. Cassivi says.

“If you’re in the car, stop every hour and get out and walk around the car once or twice, to keep the blood moving,” Dr. Cassivi says. “If you’re flying, there are exercises in the airline booklets or that your doctors and nurses can teach you to pump your calves if you’re stuck in a middle seat. Try to get an aisle seat so it’s easier to get up and walk.”

Just walking up and down the aisle once or twice during a long flight or once or twice every hour is useful; it helps avoid the immobility that can lead to a blood clot, Dr. Cassivi says.

Stay hydrated. Dehydration raises the risk of blood clots after surgery. Airline cabin air tends to be dry. It’s best to drink water.

“Some of the other drinks – alcoholic drinks or carbonated beverages – can be somewhat less hydrating and you don’t get the same benefit for the volume of fluid you’re taking down,” Dr. Cassivi says. “Staying hydrated, especially during airline flight, is very important.”

Wear loose-fitting clothing. Binding up is not necessarily the best situation after surgery, unless specifically recommended by your surgeon, Dr. Cassivi says. Compression stockings are an example of tight-fitting clothing a physician may order to avoid blood pooling in the leg veins.

Consider supplemental oxygen. If you’re having significant problems getting enough oxygen, it would be smart to look at using supplemental oxygen – such as a portable oxygen tank – during your trip home. Patients showing signs of oxygenation problems in the hospital are usually sent home with supplemental oxygen, whether they are traveling by ground or air, Dr. Cassivi says.

Overall, travel home by air is as safe as ground transportation after surgery, says Dr. Cassivi, who presented research on it at the American Association for Thoracic Surgery annual meeting in Toronto in April. The study found that chest surgery patients heading home by plane were, like ground travelers, at a similar low risk for complications such as pneumonia , deep vein thrombosis , pulmonary embolism , or lung problems such as pneumothorax , a collapsed lung.

“And that speaks to a very important question that’s often managed by dogma or urban myth, hospital myth. We found that although it’s not a zero risk, the risk is low, and the risk is the same between ground and air travel,” Dr. Cassivi says. “So the old rules of staying put after your surgery for two to four weeks before flying home may not apply. And I think it opens the door for patients and their surgeons to look seriously at their individual situations and govern travel decisions by how well they’re doing.”

Each year, more than a million people from all 50 states and nearly 150 countries travel to Mayo Clinic for care.

“In general, travel after surgery can be done if it’s well-organized and thought out ahead of time,” Dr. Cassivi says.

About Mayo Clinic Recognizing 150 years of serving humanity in 2014, Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life. For more information, visit 150years.mayoclinic.org , MayoClinic.org or https://newsnetwork.mayoclinic.org/ .

MEDIA CONTACT: Sharon Theimer, Mayo Clinic Public Affairs, 507-284-5005, Email: [email protected]

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Fill out and submit the request form below and an agent will be in touch to help you plan a trip tailored specifically to your needs. Or call us at the numbers below to speak with an agent. We are here to support all patients with appointments at our Mayo Clinic campuses in Arizona, Florida, and Rochester.

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Our teams specialize in booking flights that can be easily changed if circumstances shift. We can also accommodate specific needs, such as in-flight oxygen, and secure discounts through our trusted travel partners.

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Traveling & Plastic Surgery: Guidelines for Traveling Safely

Summer travel is quickly approaching, and the need to travel may be increasing. For some, travel may be for leisure, for others it may include a trip to an out-of-town hospital for surgery. If you are planning on traveling after a plastic surgery procedure, our plastic surgeons will ensure that you are equipped with the knowledge and tools required for a safe travel before and after your surgery. Furthermore, here are some important guidelines for a safer, more comfortable travel home after surgery:

Don’t travel alone

After a plastic surgery procedure, a caretaker is always required. They will help transport you to and from surgery, as well as to your one day post operative appointment. It is imperative that you have a caretaker to record all post-op and medicinal instructions. Furthermore, if you are traveling you will likely need to have someone else lift your luggage and help with general movement.

Walk every hour during your trip

Be as mobile as possible. In the days after surgery, the body is in an inflammatory state that makes a person more predisposed to blood clots, particularly in the legs, and especially if the blood isn’t flowing as well! If your travels include flying, walking up and down the aisle once or twice during a long flight or once or twice every hour is useful can help avoid the immobility that can lead to a blood clot. Depending on your procedure, a compression garment may be provided if required to help with blood flow.

Stay hydrated

It is important to stay hydrated after plastic surgery in general, even when traveling! A couple of reason are that after surgery, anesthesia can stay in the body for a short period. Drinking plenty of water can help flush the anesthesia from the system. During recovery, many people also take pain medications that can cause constipation. Water helps the digestive system work more efficiently, reducing this uncomfortable side effect. Dehydration can even raise the risk of blood clots after surgery.

While traveling, it may be easier to forget to drink water consistently, especially due to the fact that sugary and alcoholic beverages are easier and more convenient to obtain. Although tempting, these types of beverages do not provide the same level and quality of hydration that can be obtained by drinking water.

Wear loose-fitting clothing

Binding up is not necessarily the best situation after surgery, unless specifically recommended by your surgeon. As previously mentioned, compression garments (a tight-fitting clothing) may be provided by our clinic to avoid blood pooling in the leg veins. However, it is important to come prepared with comfortable clothing such as pajamas or loose-fitting lounge wear for your post operative care as well as for traveling.

If you are interested in traveling to the greater Austin area for cosmetic surgery, it is vital to learn the safest way to travel to and from your destination, both comfortably and safely! Here is some more important i nformation curated by Synergy Plastic Surgery, exclusively for our out of town patients.

With multiple plastic surgery locations across Austin, Westlake, and Round Rock, TX, Synergy Plastic Surgery is your nearby destination for exceptional cosmetic results. Trust our team of board-eligible or board-certified plastic surgeons to deliver the care you deserve, the safety you rely on, and the results you’ve been dreaming of. Our office offers both in person and virtual complimentary consultations, schedule yours today!

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What It Takes to Be a Traveling Physician

Table of contents.

• 1. What Is a Traveling Physician?
• 2. The Pros and Cons of Working Locum Tenens
• 3. How to Prepare to Be a Locum Tenens Physician
• 4. What Types of Insurance Does a Traveling Physician Need?
• 5. Are Traveling Physicians Satisfied With Their Career Choice?
• 6. Can Being a Traveling Physician Help Your Career?

Some physicians choose to  establish their own practice  in their hometowns.

Many choose to work as employees of hospitals, clinics, and medical centers close to where they live.

Thousands of others decide to put their medical skills to use wherever there’s need, no matter how far from home that may be.

All physicians have a difficult job to do, but working as a traveling physician without a regular full-time job can be even more challenging.

So what does it actually take to be a traveling physician? Where do traveling physicians work? What are the ups and downs of traveling from place to place compared to working a full-time job in one location?

Here’s everything you need to know about being a traveling physician. From what it takes to become one to where to find work as a traveling medical professional.

What Is a Traveling Physician?

Traveling physicians work as locum tenens physicians. These physicians travel from state to state (and sometimes abroad). They fill in during another physician’s absence or provide additional care when there is more of a demand for medical care than there is supply.

When physicians are away on medical, family, or maternity leave, it’s common for a traveling physician to take their place for a while.

From board-certified surgeons to hospitalists, nurse practitioners to physician assistants, medical professionals looking for a new employment opportunity can often find work as traveling physicians. No matter what your medical specialty may be, a locum tenens position can become available at any time.

According to the 2018 FSMB Census of Licensed Physicians , there are 985,026 actively licensed physicians in the United States. Approximately 50.2% are employed  in hospitals and other healthcare settings. About 44% run their own practices or work as a partner in a practice. Roughly 5-6% of all physicians work as independent contractors and prefer locum tenens work.

In 2019, approximately 52,000 physicians worked in locum tenens positions. Some physicians look for locum tenens work in or near their hometown, but many choose to become traveling doctors and work in any place they’re in demand.

Related: Balancing Acts: Navigating Physician Moonlighting for Physicians in Residency & Practice

The Pros and Cons of Working Locum Tenens

With so many licensed physicians choosing to work locum tenens, you can be sure that it has its fair share of benefits and pros. But for some medical professionals, the traveling physician lifestyle can take some getting used to.

Here are the biggest pros and cons of working as a traveling physician.

PRO: Flexibility

One of the biggest perks of working locum tenens is flexibility. Therefore, you get to decide where you want to work. You can choose full-time or part-time positions. You don’t have to make a long-term commitment or sign a multi-year employment contract.

Working as a traveling physician can also be a great opportunity for a  new physician  who isn’t ready to settle in one place or hasn’t been able to find a full-time job.

PRO: The Opportunity to Travel

The most obvious benefit of working as a traveling physician is the opportunity to travel and live, albeit temporarily, in different places. Maybe you want to visit Nevada ? New York ? Virginia ?

Physicians may choose locum assignments in the town where they grew up, in the city where they went to college or  medical school , in their favorite vacation spot, or in a place they’ve never visited.

Locum tenens work can be rewarding from a professional standpoint and a personal desire to travel and explore.

PRO: The Chance to Explore Different Work Settings

Debating if you should work in an emergency room or urgent care center?

Not sure if you’d be happier working in a small family practice or a large medical group?

Working as a traveling physician gives you the option to work in a variety of different workplace settings.

Locum assignments are available in hospitals, private practices, community clinics, and all other types of medical centers. They are also available in large metro areas, small cities, rural areas, and underserved regions.

This makes traveling positions perfect for physicians who want to try out different workplaces and/or aren’t quite sure where they want to settle down.

PRO: A Better Work/Life Balance

Compared to steady, full-time work, the flexibility that comes with locum work often allows for a better  work/life balance .

Some traveling physicians choose to work back-to-back assignments. Others prefer to take time off between jobs, affording them more time to spend with family and friends or pursue hobbies and interests.

PRO: Career Independence

Locum tenens physicians are  independent contractors , which allows you to enjoy career independence.

As an independent traveling physician, you can enjoy all of the benefits of a self-employed physician — including the opportunity to  reduce your tax burden  by deducting business expenses. You can also choose your own insurance policies and create your own schedule.

Most locum positions will require you to work a set schedule and number of hours per week, but traveling physicians have the option to accept or refuse any job that comes their way. If the workload or schedule doesn’t meet their needs, they have the freedom to pass on the opportunity and find one that better suits their lifestyle.

PRO: Networking Opportunities

The more you travel and work in different locations, the more physicians and administrators you can network with.

The broader your network, the easier it will be to get referrals to future physician jobs. This is helpful whether you continue to work as a traveling physician or decide at some point that you’re ready to work in one permanent location.

PRO: Higher Salary

Of all the benefits of working as a traveling physician, the most enticing one is likely the potential for a bigger salary.

Pay rates vary depending upon how many years of experience you have and the demand for physicians  in your specialty . According to CHG healthcare, traveling physicians that work full-time earn an average of $32.45 per hour more  than physicians working in permanent positions.

CON: Less Stability

Some locum contracts can be as short as a few weeks, while others may require you to be away from home for several months. Some traveling physicians find it challenging to spend long periods of time away from family members and loved ones.

Locum staffing agencies can help you book travel arrangements and obtain short-term leases. However, you’ll have to get accustomed to not sleeping in your own bed every night. In the beginning, working on the road can cause some feelings of instability.

Working in different states can also make it more difficult to estimate how much you’ll owe in federal and state income taxes. It can take some time getting used to earning a fluctuating salary and paying different percentages in taxes.

CON: You’ll Need Your Own Insurance Coverage

As an independent contractor, you are responsible for paying for all your own insurance policies, including health insurance. Most physician-employees have health insurance through their employer, but traveling physicians cover the entire cost of health insurance on their own.

Besides health insurance, you’ll also need the protection of  malpractice insurance ,  disability insurance , and  life insurance  — all of which you’ll have to pay for on your own.

However, there is a positive to this:

You and you alone get to choose the exact policies you want.

CON: Not All Specialties Are in Demand

While it is possible to find locum tenens work in any medical specialty, physicians in the following areas are consistently in demand:

• Family medicine
• Obstetrics and gynecology
• Emergency medicine
• Internal medicine

Why do we have a link for internal medicine here but not the other specialties?

The demand for locum tenens physicians is on the rise, particularly for physicians in these areas of medicine.

Physicians in other specialties sometimes have a more difficult time finding consistent locum assignments.

Dive in deeper by reading:  The Pros and Cons of Physician Locum Tenens

How to Prepare to Be a Locum Tenens Physician

Preparation

So how exactly does one prepare to become a traveling physician?

The first step is to prepare mentally.

Frequent travel and long periods away from family and friends can take their toll. It’s essential to mentally prepare for a traveling physician’s lifestyle. (Also, note that if you choose to work sporadic assignments, your overall yearly salary could be far less than that of a full-time physician.)

Before you can start working as a traveling physician, you’ll also need to consider the logistics.

You must  obtain a state license  to practice medicine in any state that you wish to work in. If you intend to work in multiple states, it can be beneficial to become a  compact physician  and seek multi-state licensure through the IMLC.

Rather than looking for locum positions on their own, travel physicians can benefit from working with a locum staffing agency.

Why is This?

Because locum staffing agencies can find you consistent work and assist with the logistics of working on the road.

Locum staffing agencies work with providers ranging from small medical practices to broad hospital networks. Meaning they usually have a large pool of available positions to choose from. If you want to work consistently, agencies can set you up with your next job while you’re finishing up your last.

Agencies can also help with the process of credentialing and assist you in finding housing and booking travel arrangements — unavoidable aspects of travel jobs.

See also:  How to Work with a Physician Recruiter

What Types of Insurance Does a Traveling Physician Need?

As we mentioned earlier, traveling physicians are independent contractors, and independent contractors carry their own  individual insurance policies .

Locum tenens physicians will need their own:

• Health insurance – protects against exorbitant medical bills and medical services
• Disability insurance  – protects your future income if you become too ill or disabled to work
• Life insurance  – protects your loved ones and helps you to establish financial independence
• Malpractice insurance  – protects your assets and your medical license

Every physician, traveling or employed in a permanent position, should carry these individual insurance policies. Before you choose to work as a traveling physician, be sure you have all four insurance policies in place.

Related:  Understanding Your Physician Independent Contractor Agreement

Are Traveling Physicians Satisfied With Their Career Choice?

There’s no question that physicians are experiencing more burnout and are less happy about their jobs post COVID-19 than before it. With all the demands that the pandemic has put on the healthcare system, that’s to be expected.

Before the COVID-19 pandemic, 69% of all physicians  reported being “happy” with their work/life status. Since the pandemic, that number has dropped to approximately 49%.

But for locum tenens physicians, those numbers vary quite a bit.

There isn’t much hard data on how many traveling physicians are satisfied with their work. Yet, we can draw some conclusions based on what makes physicians dissatisfied and how traveling physicians don’t necessarily have the same concerns.

Physicians are generally happier when they can focus on:

• Providing top-quality medical care
• Spending more of their time on patient care
• Spending less time on administrative work and navigating the bureaucracy of the healthcare system that employs them

Traveling physicians have the unique opportunity to minimize work burnout for a variety of reasons.

One reason is that they can dictate their schedules and have the flexibility to take more time off when needed. Another reason is that temporary assignments typically require more focus on patient care and less time spent dealing with the administrative constraints of the healthcare system .

Can Being a Traveling Physician Help Your Career?

While the lifestyle of a traveling physician is not for everyone, working locum tenens can be quite beneficial to a physician’s career.

In addition to flexibility, a better work/life balance, and higher pay, traveling positions also offer the opportunity for career exploration, which can be an invaluable asset to a physician’s career.

As a traveling physician, you’ll have the chance to test out different workplace settings.

If you work as a traveling physician early in your career, this can help you decide:

• Which populations you want to provide care to
• What cities and states allow you to feel most valued
• Where you feel most confident and comfortable providing patient care

More than Money

Physicians don’t go into the medical field simply for the money; it’s impossible to overlook the feel-good factor of working as a physician. Traveling physicians get the chance to test out various places and serve different populations until they find the ones that feel most rewarding to them.

It’s also important to recognize the fact that traveling physicians don’t have to be traveling physicians forever. Licensed physicians can, at any point, decide to give up their locum positions in favor of a permanent one.

In some cases, full-time positions and long-term employment contracts may  become available at the end of a locum assignment. If you demonstrate your ability to provide excellent patient care, a short-term assignment as a traveling physician can result in a full-time opportunity.

Need help with state licensing? Check out our Medical Licensing library !

Conclusion 

Whether you’re a primary care physician or work in an in-demand specialty, physicians in most areas of medicine have the option to take locum tenens assignments whenever they want.

Just be sure to protect yourself with life, disability, and malpractice insurance.

It doesn’t matter what type of physician you are — every medical professional needs to protect their license, family, future income, and financial assets with insurance.

For more guidance on how to choose the right insurance policies,  contact Physicians Thrive .

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About the Author

Naples Travel Agency

Medical tourism: traveling abroad for medical procedures.

According to a recent post by Insider, a Seattle photographer was recently traveling abroad in Italy when she cracked a tooth on an especially hard nut. While it needed immediate medical attention, she was worried about what the bill would be with a foreign medical procedure. After a few hours of treatment, rather than spending $1,000 as she would have in the U.S., the total cost was around $17.

Not all people receiving medical care while abroad stumble across it as this Seattle Photographer did. It’s quite common nowadays to travel abroad for medical treatment. In fact, it’s so popular that it’s been given the term, Medical Tourism. Here is a brief guide on medical tourism, why you may want to consider it for your next medical procedure, and what you should consider while preparing for long term travel abroad.

The Benefits of Traveling Abroad for Medical Procedures

The American Healthcare system is notorious for being expensive. And it doesn’t help that many Americans can’t even afford health insurance as it is. Considering that, its no surprise that many people are choosing to travel abroad for medical procedures. Many people have found that traveling abroad for medical procedures results in a significantly lower bill. There are even a few insurance companies that offer incentives for medical tourism due to the dramatic cut in costs. Whether it’s for something as simple as aesthetic procedures and injections or a large scale medical surgery, you can often find a much more affordable and equally high-quality medical option abroad.

Lower Costs

The cost of surgery in other countries is dramatically different from the cost of the same surgeries in America. Especially for people that are looking to get cosmetic surgery, that wouldn’t be covered by insurance in the U.S. the difference can be huge.

But why are costs so low abroad compared to America? Rest assured that it has nothing to do with the quality of care and treatment that you’ll be receiving, but rather the cost of labor. Cost of labor for nurses, doctors, and surgeons is dramatically lower abroad which means that your bill will be lower as well. Even medical malpractice insurance is significantly cheaper abroad. This is something you will want to check on and get ahead of time in case of an emergency.

Incentives From Insurance

Some insurance companies have started to offer incentives for medical tourism to help save themselves money. For example, Blue Cross and Blue Shield have a program where someone seeking medical treatment abroad will be assigned a case manager that arranges for travel and accommodations for the patient and a companion as well as making arrangements for medical care and treatment after the procedure. Other companies offer discounts for the amount a patient has to pay out of pocket if they travel abroad for treatment.

Some companies, however, will not pay for medical treatment outside of the country unless it’s an emergency situation, such as that of the Seattle photographer discussed earlier. If you’re thinking about preparing for long term travel for a medical procedure, make sure to check with your insurance company beforehand to ensure that they will continue to cover costs abroad.

Specialists

Many people choose to travel abroad for medical treatment specifically to seek out specialized surgeons and doctors. Surgeons and doctors in other countries are often known for specializing in a specific field of treatment. For example, Brazilian surgeons are known for their impressive plastic surgery skills. Brazilians are also rumored to be more likely to have plastic surgery done than any other country so, Brazilian doctors have plenty of opportunities to practice. The country even has a procedure with its name it in, the Brazilian buttock lift .

Many surgeons in foreign countries have trained and attended medical school in the United States and then return to their home country to practice, which means that a high percentage of foreign specialized surgeons speak English. If you’re preparing for long term travel to seek out a specialized surgeon abroad, make sure you do the proper research to find your best option.

Preparing For Medical Treatment Abroad

While the Center for Disease Control (CDC) views medical tourism as a risky choice, they have a list of recommendations to consider when preparing for long term travel and foreign medical procedures:

• Visit a travel medicine provider four to six weeks before your trip to talk over safe travel procedure and any risks traveling with your specific condition could cause.
• Make sure your current medical issues are under control and that your health won’t be jeopardized further by traveling.
• Check the qualifications of the providers that will be performing your procedure abroad. Make sure to account for the fact that credentials are obtained differently in each country.
• If you’re going to a country where you don’t speak the language, have a translator or another means of communication prepared so you can easily communicate with your doctors.
• Take copies of all of your medical records and prescriptions in case the internet is not available when you need them. Get copies of your new records before you return home.
• If you’re planning for vacation activities before or after your procedure, make sure to check that they are permitted per your specific treatment.
• Arrange for long term care or follow up care in your home country before you leave.

While some people choose to travel abroad for cheaper medical treatments , others accidentally discover the lower pricing when they’re injured or get ill on vacation and have to get emergency treatment, just as the Seattle photographer mentioned previously. You shouldn’t always count on this though. Different countries have different healthcare systems.

Popular Medical Procedures Abroad

Some of the most popular medical procedures to travel abroad for are:

• Breast Augmentation
• Hair Transplant Surgery
• In Vitro Fertilization (IVF)
• Cosmetic Dentistry
• Oral Surgery
• Liposuction
• Cancer Treatment
• Orthopedtic Surgery
• Weight-Loss Surgery
• Plastic Surgery

Travel Tips

Besides the lower costs for medical treatment, many people choose to travel abroad so they can combine their treatment with a vacation. Many foreign countries count on tourism and travel to help bring funds in. Even in the U.S., 2.7% of gross domestic product is attributed to travel and tourism. Here are a some important travel tips you should consider when preparing for long term travel.

Entertainment

While you may have to take some downtime after your procedure, depending on the severity of the treatment, you should also take time to plan for entertainment while you’re abroad. When preparing for long term travel, you want to ensure that you have taken full advantage of the opportunities you find at the destination you’ll be visiting. Whether it’s before your procedure or after, your trip should be about both your mental and physical health. Taking time to relax and enjoy a new place should be priority number two, after your health of course.

One of the most popular things people do when going abroad is checking out the new cuisine. Take some time to check out a restaurant or two in the area you’re visiting. When preparing for long term travel, make sure to study out the cultures of the area you’ll be traveling to as they can often be quite different and even strange compared to what you may be used to.

For example, if you’re traveling in Italy, you may want to stop at a pizzeria to try a locally made margherita pizza . Food is an important part of Italian culture, but their “norms” may be very different from your own. They eat late, so if you’re looking for a restaurant to dine at around 5:30 pm, you may be out of luck. Restaurants generally open around 7 pm for dinner and even then, it doesn’t start to get really busy for an hour or so.

Many people choose to visit a hair salon while on vacation to experience different beauty treatments. Similar to why people choose to travel abroad for medical treatment, beauty treatments abroad are often less expensive than in the United States. Women can get hair extensions put in, high-quality hair cuts and coloring, and other beauty treatments for a much lower cost. But it’s not only women that seek it out. Barbershops abroad often have unique facial treatments for men when they are getting shaved. If you’re preparing for long term travel abroad, make sure to check out any hair salons or barbershops that will be in your area to experience a relaxing and fun beauty treatment.

If it’s your first time in an area, take advantage of the popular tourist destinations in the area, but don’t forget to branch out. Many people traveling abroad are surprised to find beautiful and exciting sights and attractions that are not included in the typical list of tourist activities for a given area. By all means, see the known and beautiful architectural buildings and landscapes, but take some time to go off the beaten path and look for hidden treasures. Try a restaurant in a more residential part of a town. Ask the locals what their favorite part of a city is. You’ll never know what you’ll find until you look.

When preparing for long term travel, you’ll want to spend some time finding proper lodging for your trip. You may consider a hotel, Air BnB, or even a hostel. Take into consideration the type of medical procedure you’ll be traveling for when you plan your lodging. For example, if you’ll need a day or so of quiet and rest after your treatment, a hostel is not the option for you. If you’re just getting a small, quick procedure, you may be able to save some money staying at a hostel as you won’t need as much quiet and privacy afterward. Regardless, you’ll want to have lodging properly squared away before you even get on the plane.

If you’re staying at an Air BnB, make sure to clean up after yourself. If you really make a mess, you may want to hire a commercial cleaning company to come in after you to make sure you don’t leave a problem for the host. Live by the rule, “leave the place better than you found it” and consider how you would feel if you were opening your own home.

Don’t forget to take advantage of the amenities that may come with your choice of lodging. If there are inground swimming pools at your hotel, take some time to relax and take a dip. If your Air BnB has tools like a coffee or espresso maker, you can save a bit of money by making your own coffee rather than buying it at a cafe. Remember though to be a gracious guest and leave everything you use in good condition. If you use the pool at your hotel, don’t leave used towels laying around, store them in the proper place. If you use a coffee maker at the Air BnB you’re staying at, properly clean it after use.

In Conclusion

If you are preparing for long term travel abroad for medical care, make sure you consider all of your options and plan accordingly for your trip. If done right, your trip will not only a great way to save money on a procedure but a beautiful memory that you’ll have for years to come </p.

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Best International Destinations for Plastic Surgery [2023]

The plastic surgery industry is booming at an unprecedented rate. Currently, the market size is valued at approx.  66 Billion(USD) . Realizing the potential revenue that can be earned from it, more countries are opening their doors to all sorts of affordable beauty procedures. Governments are investing in building excellent healthcare infrastructure, minimizing costs, and even subsiding to promote their country’s cosmetic tourism sector. So which country should you visit? To help you decide, we have prepared a list of the best medical tourism destinations for plastic surgery.

Table of Contents

The most popular procedures for cosmetic surgery abroad, why choose brazil, popular hospitals in mexico, price of common plastic surgery procedures in brazil, why choose mexico, price of common plastic surgery procedures in mexico, why choose costa rica, popular hospitals in costa rica, price of common plastic surgery procedures in costa rica, why choose panama, popular hospitals in panama, price of common plastic surgery procedures in panama, why choose india, popular hospitals in india, price of common plastic surgery procedures in india, why choose thailand, popular hospitals in thailand, price of common plastic surgery procedures in thailand, why choose south korea, price of common plastic surgery procedures in south korea, why choose turkey, popular hospitals in turkey, price of common plastic surgery procedures in turkey, why choose colombia, popular hospitals in colombia, price of common plastic surgery procedures in colombia, why choose spain, popular hospitals in spain, price of common plastic surgery procedures in spain.

• Cost saving 
• Luxury and personalized care 
• Specialized medical procedures 
• Vacationing at a foreign country 

Paying for Medical Procedures in Other Countries

Things to consider before you get plastic surgery abroad, frequently asked questions.

The popularity of cosmetic surgeries has grown exponentially over the last decade. It used to be the case that only women opted for such procedures. But circumstances have changed. Now, men in increasing numbers are looking for various cosmetic surgeries abroad. In fact,  men account for over 13% of the total cosmetic surgeries  performed worldwide.

For women, the popular surgeries are:

• Breast Augmentation
• Liposuction
• Hair Removal
• Eyelid Surgery
• Breast Lift
• Nose Surgery
• Breast Reduction

For men, the popular surgeries are:

• Gynecomastia
• Ear Surgery
• Face Fat Grafting

Best Medical Tourism Destination for Plastic Surgery

The countries listed below are a few of the most renowned destinations for reconstructive and cosmetic surgeries. We have also included a list of the popular hospital and the cost of common procedures available in the country.

Brazilians obsession with beauty has skyrocketed the popularity of Brazil’s plastic surgery industry. According to the  International Society of Aesthetic Plastic Surgery (ISAPS) , Brazil ranks 2nd in performing most plastic surgeries globally. Though Brazil offers all types of procedures, the most popular ones are Breast Augmentation and Liposuction. It is also home to the Brazilian Buttlift that is famous for its sculpted and natural-looking figure.

Brazil offers some of the best plastic surgeons found globally . You can find numerous board-certified surgeons with 15 to over 20 years of experience, each specializing in specific types of surgeries. Many private hospitals have modern equipment and facilities that adhere to JCI standards. And because of the favorable exchange rate, the cost of medical expenses is very cheap.

• Hospital Sao Rafael – Sao Paulo, Brazil
• Hospital Jayme da Fonte – Recife, Brazil
• Passy Clinic – Rio de Janeiro, Brazil
• Clinica Athena – Curitiba, Brazil
• Leger Clinic – Rio de Janeiro, Brazil
• Breast Augmentation – $3,500
• Liposuction – $3,000
• Face Lift – $5,500
• Breast Reduction – $4,000
• Nose Surgery – $3,00

Mexico is probably the obvious choice for most Americans looking for plastic surgeries. Hospitals are located just outside the southern border, and the prices are lower by at least 30% to 70%.

Although cosmetic surgeries are the most sought-after procedures, it isn’t uncommon to see patients flying across the border for simple dental checkups. Medical expenses in the US are notoriously high, due to which Americans consider Mexico as the go-to choice for all sorts of medical needs.

Certified hospitals dedicated to foreign patients are located close to the US borders, making it easy for Americans and Canadians to fly here in a very short time. Also, Mexico has many JCI accredited hospitals with board-certified surgeons trained in the US or other European countries. Regarding the price, surgeries like Liposuction will cost you around $3,000 in Mexico, in contrast to $5,000 being charged in the US. Complicated procedures like Heart Bypass will cost you over $100,000 in the US vs. around $27,000 in Mexico.

• Hospital CIMA Hermosillo – Sonora, Mexico
• Hospital Angeles – Tijuana, Mexico
• Hospital Star Medica – Chihuahua, Mexico
• Obesity Control Center – Tijuana, Mexico
• Face Lift – $4,250
• Breast Augmentation – $3,800
• Tummy Tuck – $6,500
• Liposuction – $3,00
• Rhinoplasty – $3,200

With an expat-friendly infrastructure and international standard medical system, Costa Rica is amongst the most beautiful biodiverse countries you can visit. The country is quickly gaining traction for its cosmetic treatments, specifically in Breast Augmentation and Liposuction.

Costa Rica may not be the cheapest destination in terms of medical expenses, but its healthcare system is one of the best in all Latin America. Here, you will find some of the best board-certified surgeons and excellent private hospitals for cosmetic procedures.

Costa Rica’s healthcare stands in 7th position in the  global healthcare index , and the quality is on par with the US medical system. Any surgeon operating in the country needs to be certified, which reduces the risk of medical malpractices. Hospitals also need to meet set criteria before they can offer their services. Also, the country is primarily an ecotourism destination, so you can easily combine your medical travel with beautiful eco-friendly vacations.

• Hospital CIMA – San José, Costa Rica
• Hospital Clínica Bíblica – San José, Costa Rica
• Facelift – $4,600
• Rhinoplasty – $3,500
• Breast Augmentation – $2,700
• Tummy Tuck – $3,900
• Male Breast Reduction – $2,00

If you prefer staying in city environments and don’t want any cultural shocks, Panama will be a great option for affordable plastic surgeries. The country is very well modernized, and you will find all the facilities and amenities you’d expect in a city environment.

Doctors in Panama are known to provide very personalized care. They will even give their personal contact and come to visit you in your hotel if needed. This level of personal care is not common in other destinations. Also, the prices for cosmetic surgeries are at least 50% less when compared to the US. For example, you can expect to pay $2,000 for a facelift, which, in the US, will cost you around $10,000.

The top hospitals in Panama usually have affiliations and are recognized by Internationally accredited organizations. The Panamanian government has also placed local accrediting organizations to certify hospitals for their services. If you prefer JCI accredited hospitals, then there are currently two available in the country. Panama is also a very safe country for tourists in terms of both personal safety and tourism.

• San Fernando Hospital – Vía España, Panamá, Panama
• Hospital Punta Pacifica – Panama City, Panama
• Face Lift – $2,000
• Breast Augmentation/Reduction – $3,100
• Liposuction – $2,500
• Buttocks Augmentation – $3,500
• Nose Surgery – $1,500
• Chemical Peel – $450

India was already a major player in the Asian medical tourism market. But with the government’s amendment on medical visa policies, it has become much easier to travel here for medical treatment. Now instead of 60 days, patients can stay up to 180days for medical treatment.

The costs of cosmetic surgeries are one of the cheapest in India. Popular surgeries like Breast Augmentation can go as low as $1,300, and Liposuction can cost you around $800.

Despite the medical costs being so cheap, healthcare quality is comparable to the US healthcare system. Doctors here are highly trained and uses advanced medical procedures to conduct their treatment. Local accrediting organizations are in place to certify surgeons and hospitals, but foreign patients can also choose from the 36 JCI accredited hospitals available in the country. India is also a safe tourism country with a large English-speaking population. And considering the cost of living and medical expenses, it is one of the cheapest countries in Asia.

• Fortis Memorial Research Institute(FMRI) – Delhi, India
• Global Hospital – Mumbai, India
• The Cosmetic Surgery Institute – Mumbai, India
• BLK Super Specialty Hospital – New Delhi, India
• Breast Augmentation – $1,300
• Liposuction – $770
• Thigh Lift – $1,300
• Strip Hair Transplant – 0.7 $ per Graft
• Tummy Tuck – $1,300
• Gynecomastia – $700
• Nose Surgery – $310

Thailand is not just a general tourism country. Its medical tourism industry has been booming rapidly over the past decade, especially in the cosmetic sector. Most plastic surgery institute in Thailand will offer a comprehensive range of procedures starting from simple to complex reshaping services. Gender resignment surgeries are the most notable ones in the country. The most commonly performed surgical procedures are Eyelid Surgery followed by nose surgery and Breast Augmentation.

Many of the best doctors in Thailand are certified by American and European medical boards. There are over 35 JCI accredited hospitals, all of which are private hospitals. Also, living in Thailand is very cheap compared to other tourism destinations. It is also common to find packages that include both sightseeing and medical treatment.

• Bumrungrad Hospital – Bangkok, Thailand
• Bangkok Hospital Pattaya – Bangkok, Thailand
• Yanhee Hospital – Bangkok, Thailand
• Breast augmentation – $2,600
• eyelid correction – $1,100
• Buttock implant – $4,000
• Cheek implant – $1,200
• Nose reshaping – $1,200
• Forehead lift – $1,400
• Hair transplant – $1,000
• Tummy Tuck – $3,000

South Korea

The K-pop culture in South Korea is a big influence on the country’s plastic surgery industry. With both men and women opting for various cosmetic surgeries, South Korea is quickly becoming the global plastic surgery capital. In fact, the country has the highest rate of plastic surgeries done per capita, with  13 cosmetic surgeries done per 1000 people . South Korea isn’t the cheapest destination for beauty and reconstructive procedures. Still, it is amongst the best in terms of offering medical facilities, state-of-the-art equipment, and international medical expertise. 

South Korea’s technological advancement is portrayed in their medical sector. The quality of their equipment and availability easily surpasses many Asian destinations. South Korea is also known to have dedicated facilities for international tourists. Getting bi-lingual staff and comprehensive services shouldn’t be an issue. Hotel accommodations, transportations, and recuperation packages are also widely available. You can possibly spend your post-operative care in a luxurious hotel, and the price will still be lower than in the US.

• Banobagi plastic surgery – Seoul, South Korea
• Sarang Plus Hospital – Seoul, South Korea
• Jk Plastic Surgery – Seoul, South Korea
• Eyelid Surgery – $2,000
• Breast augmentation – $7,000
• Facelift – $6,000
• Nose Surgery – $4,000
• Liposuction – $4,000
• Hair Transplant – $6,000
• Breast Surgeries – $8,000
• Laser Skin Therapy – $4,000

Turkey is considered a hub for affordable medical and cosmetic tourism in Europe. It is mostly sought-after by European and American nationalities. According to a 2019 report, Turkey’s medical tourism sector generated about $1.6billion in revenue.

In Turkey, procedures such as anti-aging treatments are very popular amongst patients over 40 years of age. Cosmetic procedures, in general, are around 50% to over 70% cheaper in most private hospitals. Also, the government has taken various initiatives to improve its medical tourism sector. Many medical facilities will offer packages that include shuttle services, hotel accommodation, and attractive travel packages. Also, you can easily find highly discounted airplane tickets.

The government is very strict in terms of its healthcare standards and who can offer medical services. To be eligible for service, a surgeon needs to undergo many years of extensive training and also need to become a member of the Turkish Society of Plastic, Reconstructive & Aesthetic Surgery. Medical centers are required to maintain strict quality implementation and medical standards set by the government. These strict regulations make Turkey a safer destination for plastic surgeries.

• Hisar Intercontinental Hospital – Istanbul, Turkey
• Derindere Hospital – Istanbul, Turkey
• Lokman Hekim Esnaf Hospital – Fethiye, Mugla, Turkey
• Face Lift – $3,000
• Breast Reduction – $3,200
• Nose Surgery – $2,500
• Mommy Makeover – $9,000

Medical tourism is not new to Colombia. The country has been promoting its cosmetic and other Healthcare services for several years. Being a South American country with solid security and great vacation spots, it continues to attract international patients from all over the world.

Colombia’s cosmetic surgeries are equally popular amongst locals as it is with foreigners. Surgical procedures most common in Colombia are Breast Augmentation, Liposuction, and Eyelid Surgery. For non-surgical procedures, the common ones are Botulinum Toxin, Hyaluronic Acid, and Hair Removal.

The healthcare system relating to plastic surgery is very well established. As of 2019, there are at least 1,100 plastic surgeons in the country. So finding surgeons for cosmetic procedures won’t be an issue. Plus, the prices are far less than the US and Canadian hospitals.

• Centro medico imbanaco – Cali, Colombia
• Hospital universitario de san vicente fundación – Medellín, Colombia
• Liposuction – $2,000
• Buttock Enlargement – $3,100
• Tummy Tuck – $4,200

Spain has a reputation for having one of the most efficient healthcare systems in Europe. Healthcare in Spain is continually improving, and as of 2021, the country is ranked 4th in the global medical tourism index. In Europe, Spain is particularly popular for its plastic surgeries. There are over 1,000 plastic surgeons available in various parts of the country. Prices are also very low from many other UK, European, and American countries. In addition, medical centers offer attractive discounts and packages combining surgery with holiday tours for medical tourists.

Being a mainstream tourism destination, Spain has all the necessary facilities in place to serve foreign tourists. To make tourism more accessible, the government allows US and Canadian citizens to travel to Spain without any visa and stay up to 3 months. Regarding the cost of cosmetic surgeries, you can save around 20% to 50% of the total cost.

• Vithas Xanit International Hospital – Malaga, Spain
• Grupo Hospitalario Quirónsalud – Madrid, Spain
• Centro médico quironsalud teknon – Barcelona, Spain
• Breast Augmentation – $3,600
• Face Lift – $5,400
• Liposuction – $1,800
• Nose Lift – $2,900

Benefits of getting plastic surgery abroad

Getting plastic surgeries through medical tourism can be considered a gateway for people willing to receive affordable and quality treatment that aren’t feasible in their home country. Depending on which country you are from, the benefits you receive will vary. Below, we have mentioned some of the benefits you would receive by choosing plastic surgery abroad. 

Cost saving

Cost-saving is the biggest reason why people travel abroad to get plastic surgeries. Patients can easily save from 20% to 80% of what they would normally pay back home. Also, insurance generally doesn’t cover plastic surgeries, and paying such high cash out-of-pocket isn’t financially viable. So, patients usually opt for foreign treatments. 

Luxury and personalized care

Foreign hospitals usually offer patients to be pampered during their stay at a fraction of the cost. Top medical centers offer hospital rooms that feel more like a hotel suite rather than a typical hospital cabin. By paying slightly extra, you can get one-on-one care with a private nurse, translator, higher staff ratio, and more. 

Specialized medical procedures

Certain countries specialize in specific areas of surgery. For instance, Brazilian surgeons are known for their Butt lifts and precise sculpting skills. Thailand is considered a primary destination for gender reassignment surgeries, and Mexico is known for providing a wide range of plastic surgeries at an affordable cost while complying with international standards. 

Vacationing at a foreign country

Patients take advantage of their stay in a foreign country by traveling to various local tourism destinations. Often patients will schedule a vacation before or after their procedure. Purchasing vacation plans from a tourism company will be ideal if you intend to stay for several days.  Note : although it seems logical to spend the recovery in an island resort, it is important that you do not risk your recovery. So, plan wisely. 

Payment procedures will vary between countries. Some may accept credit cards and bank checks, while others may require you to pay in cash. So before you make your travel plan, talk to the hospital about their payment procedures. Ask them what payment methods they accept and exactly what amount of money you have to pay for your treatment. Also, you may have to stay in the country for a month or longer, depending on your recovery. So consider the cost of travel and accommodation accordingly.

Millions of people are getting cosmetic surgeries done and have seen amazing results, but there are scenarios of medical misconduct in whichever country you visit. You need to make sure you are getting treated by professional surgeons and from a properly accredited hospital. So, before you start planning your vacation, here are some important things you need to consider.

• The surgeon needs to be board-certified. They can ensure that all the risk minimization steps are taken into consideration.
• Are you physically fit for the surgery? Cosmetic surgeries are not for everyone. For example, surgeries like tummy tuck require the patient to be in a healthy condition. If you have too much fat in your body, you cannot get the surgery.
• Know what you need to pay. Consult with the surgeon and talk in detail about the total cost of the procedure.
• Ask the surgeon about his previous work. See the before and after photos of patients that the surgeon has operated on.
• The surgeon needs to speak English fluently.

Can I trust a plastic surgeon abroad?

You can trust a board-certified surgeon. Go to the ISAPS website to find certified surgeons. Practitioners associated with them are put through rigorous training as per international standards.

How to know the cosmetic surgery clinic abroad is of the highest standards?

The clinic you choose needs to have accreditation from a reputed international organization. There are many accrediting bodies, but the ideal one would be Joint Commission International (JCI). JCI is considered a gold standard for accrediting medical centers globally. Clinics accredited by such organizations mean that they are capable of maintaining and serving international-level medical care.

Is cosmetic surgery abroad safe?

As long as the surgeon is board-certified and the hospital has international accreditation, cosmetic surgery abroad is safe. We’d recommend avoiding public hospitals regardless of which country you visit. That’s because public hospitals usually don’t offer the level of care you will receive in a private hospital.

Why go abroad for cosmetic surgery?

Cosmetic surgeries, in general, are very expensive, and insurance companies usually won’t cover these procedures. You will have to pay out-of-the-pocket for it. So by getting these procedures done abroad can save you a lot of money.

There is no right or wrong in deciding which is the best place to go for plastic surgery. All countries mentioned above have great hospitals and medical infrastructure to serve foreign patients. Which country to choose depends entirely on your preference and how you want to spend your medical vacation. In short, if you have taken all the safety precautions, you should have a pleasurable during your stay in the country.

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What's It Like to Be a Traveling Orthopedic Surgeon?

— locums orthopod sonya sloan, md, talks pay, lifestyle choices and operating while pregnant.

by Sophie Putka , Enterprise & Investigative Writer, MedPage Today April 29, 2022

Sonya Sloan, MD, is a traveling orthopedic surgeon, a locum tenens physician, an author, a speaker, and a mother. In her work across the U.S. for more than a decade, she has seen and treated just about everything. She was also the first African American female intern in general surgery and the first African American female orthopedic surgery resident at the Baylor College of Medicine in Houston.

Sloan holds a regular contract with an Indian Health Service hospital on the Navajo reservation in New Mexico, where she treats multi-generational families with an eye toward cultural sensitivity and mutual respect. Her journey hasn't been without its roadblocks, and she'll be the first to tell early-career doctors what they can do to overcome theirs -- and blaze their own trail in medicine.

MedPage Today sat down with Sloan to learn more in an interview, which has been edited for length and clarity.

I've written a bit about travel nursing, but not locum tenens. So how did you decide to do this at first?

Sloan: There's only 6% women in orthopedic surgery. And as far as African American women, there's less than 100 of us in the country. So we're like 0.7% of the 30,000 that are out there practicing.

So residency was pretty hard -- a very white, male-dominated field that wore on me, and so I had difficulty getting pregnant, and I had a miscarriage and couldn't even talk about it. And then when I almost finished, I was told that I had to do extra months for the time that I took off from maternity leave.

Which was fine; I didn't care, but after I finished, I took a practice here in Houston -- it's right near Baylor -- and got blackballed. Basically, I did not get business, either consults in the hospital, or being referred out to some of my partners or the guys at a different practice that had trained me. And so I'm like, 'This is not what I want to do. I don't want to kill myself trying to get business.'

What are the other options? I still wanted a life, I still wanted to spend time with my child, I wanted more children. It became a lifestyle choice.

My husband is a pastor. We have a very large church here in Houston -- over 5,000 members and I do a lot with that. I had a couple of nonprofits that I wanted more time with. Being a full-time orthopod was not going to allow me to do that. So locums was an option. They gave me the opportunity to do all things, if you will.

The only problem was at that time in 2006, 2007, when I first started, it was not accepted in the surgical field. It was more of a 'How dare you? That's not a real job. What are you doing?' kind of thing.

And now fast forward 15 years, I'm pretty much a well-sought-out orthopod for locums as well as a speaker for locums and how to build the lifestyle that you want for medical students and residents. So, everything has worked out for my benefit, but it was really a choice of lifestyle for me.

It's interesting that you mentioned lifestyle -- can you say a little bit more about how it actually works? Wouldn't it be hard to travel a lot and have that unpredictability, or can you make your own schedule?

Sloan: So you do make your own schedule. When I first started, I took a 3-month job in the middle of Kansas in the winter, no less, and Sarah [my daughter] was 15 months old, and so I took her with me.

When I went up there, one of the nurses had a nanny. That was great. She would even come to my hotel when I was on call so I didn't have to wake Sarah up, when I had to go in in the middle of the night. I had to either take people with me, like a nanny a couple of times, or I found resources where I was.

The other ones, I would just go for a weekend or 1 week, and because my husband has a great job as well, I would be able to hire people here. So we had a full-time nanny usually. It has had its ups and downs.

I choose now not to do more than a week or 10 days at a time, just so I'm not away from them too long, because their activities are so much right now. My daughter is about to be a senior next year in high school and I don't want to miss any of those moments with contracts that I can avoid. But at the same time, it affords me the ability to go and work a week and make a month's salary and I can be home the other 3 weeks out of the month.

Do you get the sense that more people are kind of curious about doing locums? Are there more doctors taking on this lifestyle?

Sloan: You've got the millennial crowd that definitely has started to look in that direction. When I was in residency, I was the last class that had unlimited work hours. But around 2003 the ACGME, the Accreditation Council for Graduate Medical Education, enforced the 80-hour work week for safety reasons. So that group started looking at lifestyle and quality of life, which was different from residency training from when I was there.

It has lended itself to a different type of doctor. You have doctors that don't want to be in a hospital for 3 days straight. And there's doctors that say, 'I just want to work part time and I want to be a mom,' or 'I want to be a dad who's able to be around my family.'

You definitely have the entrepreneur physicians now, like myself, where we have side hustles, everything from the telemedicine that really has boomed during COVID, but also other things that they're doing business-wise that have nothing to do with medicine. This newer generation has [leaned toward] a quality of life and lifestyle choices where there's not so much burnout.

What do you tell people who are curious about locums? What are the pros and the cons?

Sloan: So right now, the pros definitely would be, if you're just now coming out and you're not obligated or tied down to a spouse or children, or even have to worry about a huge amount of debt, which can be deferred as well, take the time to travel.

Because you go to undergrad, you go to medical school, you go to residency, and you come out and you start working, and you have no downtime. You have no time to have a real life. It's a great time to explore, to travel, to do some other things in the interim while you're trying to figure it all out. A lot of people will feel like they have to come out and start right away because of boards or whatever else. So I'd say that's the advantage. You basically are a creator of your own fate at that point.

And then the other thing is, it's big money. It's actually pretty decent money if you can negotiate and you're not shy to negotiate. I learned early, they need you -- you don't necessarily need them, so you can negotiate up or down. Even the government contracts. I've been one of the few that have been able to negotiate up on a government contract, which is really hard to do, but because you didn't have an orthopod that was willing to travel into trauma, you can negotiate.

One of the best contracts ever I did was in North Dakota, in March. It was a freakin' blizzard, -9 degrees. But I was the only orthopedic surgeon that was locums licensed in North Dakota willing to travel and do trauma for a 4-day stint. I was able to write my ticket and charge over $3,000 a day. And I sat in a hotel room and didn't do anything. So in 4 days, I made $12,000. So those are the times that you're like 'Okay, this was worth it. This was totally worth it.'

And then I took off another 2 months with my kids and we traveled, went to Hawaii. In medicine, we are so stuck in the tradition of, 'Okay, you've got to do X, Y, and Z and you've got to do it in one, two and three,' and everyone is in that hustle, this rat race. We have been on this wheel, and anyone that is outside that norm is either ridiculed or looked at, but now it is flipped. And it's like 'Yeah, no, that's not what I want to do.' So it's an ideal time.

Now, the downsides to locums would definitely be the large volume of money that you get in a short amount of time, because you're contract, right? People don't necessarily tell you or prepare you for making a quarter of a million dollars in 6 months. If you're working full time in ortho, you could possibly do that. So you're like 'What am I going to do?' And so then, you get an $80,000 tax bill. I got into trouble the first 2 or 3 years before we started figuring out we need to have an LLC [limited liability company] or an S Corp [subchapter corporation], where you are employing yourself.

All of that was not something we're taught in medicine. And then after I learned those things, then it's like, 'Okay, put money away into paying the government quarterly or in installments' and if you overpaid them, they pay you back. But these are hard lessons I learned, that no one told me because, again, not a lot of people are in locums. So that's what I would definitely say: the tax side of it, the business side of it, be smart about it. And then also negotiating for yourself. [The locums company] is trying to get you a job, but remember, they're also making money off of you.

It sounds like a really interesting lifestyle. If you don't end up working and you travel somewhere, you're just on call then?

Sloan: It's been very diverse. The first job I ever took, the one that was 3 months, it was a small town, level 2 or 3 trauma in central Kansas. It's very, very busy. They had big contracts -- like Tyson Foods was there -- so that was one of their big employers, and Walmart was there. You basically covered those entities, on top of anything that was on the interstate, on top of hospital employees, and then the town. So you were it.

The doctor that was there died, his partner didn't want to take call and was about to retire in like 3 months, and they were trying to onboard two new people. That was going to take 4 to 6 months. So in the interim they hired a locums person, and I was it. So I helped close out a practice as well as start up a new practice so these other people that came in could walk into it and it was functioning well. So that's one way of doing it.

Now, I'm on the Indian Health Service that's in New Mexico, and I go in one week out of the month. I see clinic on Monday and Wednesday; I do surgery on Tuesdays, Thursdays; I do post-ops on Fridays; and I cover the ER on the weekend -- I actually cover four hospitals on the weekend. If anyone needs surgery, I take them to surgery, and then I fly home Monday morning.

But now I've had that contract for almost 5 years, and I've only missed a few months. I have now three generations I've been treating. I've treated Grandma, the mom, and the kid.

This is an entity of people that really depend on trust and relationships because of what they've been through with medicine. Therefore, they love someone that is a return person, versus new people. So that has benefited me. I've gone other places. They just wanted me to cover the ER and I'd fly in, and Friday, Saturday, Sunday. In Kansas, I never got a call. Like I called the operator and was like, 'You do know I'm on call, right? I'm at the hotel if y'all need me.'

In Minot, North Dakota, I was 7 months pregnant and I operated all night long. I kid you not. It was one of the hardest locums jobs I ever did. But at the same time, I made probably almost $25,000 in a week because of the call schedule, because I was operating all night, and the way that we did the contract, after 8 hours of work, anything over that was $250 an hour. And they couldn't be limited because they needed the work. So it was a great week for me, and then I took maternity leave after that.

How did you stay awake?

Sloan: I was napping in between, I had snacks, and the nurses were great. This is another great thing with locums. If you're open to it, you meet so many different people in different places -- and very diverse. And that's not for everybody. Some people are creatures of habit and don't want change. But if you're amenable to new things and new people, and you have that personality that you can pretty much mesh with anybody, this is definitely something that's doable.

There's been places that the ER people and the nurses were feeding me or would tell me where to go eat in the town, or invite me over to their house, before COVID. It's like, 'Just come out and hang out, we want to have dinner with you, you're such a nice person.'

I've made great relationships and friendships -- still to this day, all across the country, which has been really good.

Sophie Putka is an enterprise and investigative writer for MedPage Today. Her work has appeared in the Wall Street Journal, Discover, Business Insider, Inverse, Cannabis Wire, and more. She joined MedPage Today in August of 2021. Follow

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Surgery for Expats Preparation Guide

Surgeries fall into two categories : emergency and elective. Doctors perform emergency surgeries to correct an urgent medical condition such as a stroke. In the event of an emergency, you usually cannot choose your health care provider or facility. For elective surgery, however, such as a joint replacement, you do have more control over the operation.

Read on for a full guide to surgery for expats. Get advice on everything from finding good insurance coverage to managing the risks associated with going abroad for surgery.

Why Are Expats Getting Surgery Abroad?

Why is there a need for surgery for expats? Patients might need a procedure due to a condition they developed after moving abroad. Or they might have chosen to wait and get surgery overseas for an issue they already had. This can be for reasons such as a change in symptoms or a new time off from work policy. Some expats may have surgery in a different country if it has a better quality of healthcare than the country they reside in.

Some people who are not expats undergo surgery overseas. This may be because other countries offer better care than their home country can provide. Surgery may be much cheaper abroad and patients can save up to tens of thousands of dollars in health care costs by crossing the border for an operation. Sometimes, the surgery a patient wants isn’t available or approved in their home country, so they seek care somewhere else. In other cases, their insurer may encourage them to go abroad for surgery.

Health Insurance and Going Abroad for Surgery

Travel insurance covers unexpected medical costs, but it does not cover going abroad for surgery. An international health insurance plan will cover surgery abroad. Here are the things to know before you get your surgery.

Make Sure Your Facility and Providers are In Network

Many expat insurance plans have facility and provider networks. If you use these networks, you will receive a higher level of benefits. In addition, your insurer may pay the bill directly, so you never have to worry about payment. If you know you need surgery, contact your insurer well in advance to determine where you will have the procedure.

Traveling to a Third Country for Surgery for Expats

If the medical care in your country of residence is not of the best standard, you may wish to travel to another country for surgery. If you do, you must make sure that your plan will allow you to have surgery in this country. In some cases, your insurer may encourage you to travel to another country with better medical care for surgery and recovery.

Obtaining Prior Authorizations for Surgery for Expats

Even if your insurance company has confirmed it will pay for a portion or the entirety of your surgery, it still may request a prior authorization (or a few) before you get wheeled into the operating room. The company typically wants to know the reason you and your doctor have chosen this surgery for your condition and that you’ve already tried less costly options. Some insurance companies, for example, may like to see that you’ve tried physical therapy for back pain before choosing surgery. Be prepared to have your surgeon and associated doctors send documentation about why you need the surgery in your new country and related details about your medical history.

Along with the actual surgery, your surgeon or doctor might order imaging exams for you to check on your health before, during or after the operation. Your insurance company may also want a prior authorization for these scans. The insurance company, for example, could authorize payment of a CT exam but not an MRI exam due to the cost. Your insurer may also ask about the type of facility you’ve chosen. Some insurance companies might ask you to go to an outpatient center rather than a hospital to save money. So before consenting to any treatments, make sure you know what your international health insurance will and will not cover in the country you’ve chosen to have surgery in.

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Finding a Doctor to Perform Surgery for Expats

After you’ve got a solid international health insurance plan in place, it’s time to either find, confirm or reevaluate your surgical team and facility. If you know you need surgery but are feeling unsure of where to go, your insurance company can help you find an in-network doctor and surgery center.

Surgical Certifications

While browsing or after choosing a provider, make sure to research the person. In the United States, for example, surgeons must be certified by a national surgical board approved by the American Board of Medical Specialties . If they’re board-certified in the U.S., it means the surgeons have successfully completed an approved residency training program and have passed a rigorous specialty exam. In the U.K., the General Medical Council maintains the List of Registered Medical Practitioners . Surgeons in the medical register have met the standards laid out by the GMC. The Medical Council of Ireland maintains a similar register . German surgeons are certified not on the national level, but instead in the region (Bundesland) where they practice. Some countries don’t require their surgeons to get board certifications or uphold such rigorous standards, so research the type of health care providers you’re about to trust.

Countries such as Singapore and Canada are known for state-of-the-art facilities and surgeons with advanced degrees while others have very loose regulations. Make sure you feel comfortable with the level of training surgeons receive in the place where you will receive surgery.

Ask Your Surgeon These Questions

No matter which country you have your surgery in, during your pre-surgery consultation, ask about:

• Previous training
• Academic qualifications
• Certifications and proof of the documents
• Outcomes of patients who underwent the same procedure
• The safety precautions taken at the operating facility

During the consultation call or initial appointment, make sure you review your full medical history with the team. It’s also important to share copies of your previous records from your doctor in your home country with the new surgeon. You should have a list of all medications you take as well.

The bottom line? You should feel confident in your surgeon’s abilities and the precautions the whole staff takes. You want to feel safe and happy with the outcome. So don’t be afraid to ask your doctor a full list of questions.

Risks Associated with Surgery for Expats

The country you choose to have surgery in could have great safety protocols in place and a solid track record. You could still, however, encounter some risks associated while going abroad for surgery.

Language Barriers

Before having surgery, if your care team doesn’t speak your native language, be sure to request an in-person translator. They will help you navigate the experience on the day of your procedure. This professional can also review and explain any documents the surgical team asks you to sign. It’s important to understand every step of the process no matter the language. So prepare for some assistance if you don’t speak the same language as your care team.

After surgery, health care teams typically recommend avoiding flying for a time. This is due to risk of blood clots and other complications. If you have plans to travel soon after the surgery, whether it’s for vacation or to visit home, evaluate your itinerary and talk to your doctor about your personal risks.

Care Continuity

Along with travel, if you relocate after surgery or seek care at a different place than where you had your procedure, make sure you have a coordinated post-care plan. Make sure you get all your discharge paperwork. Also get copies of your post-op labs and other tests to stay in good health after surgery is over.

You can usually have a positive experience undergoing surgery abroad if you do your background research, thoroughly review your own personal history and risks, and protect yourself financially through health insurance. If you have doubts about anything, contact your personal doctors or other health agencies to steer you in the right direction.

• Make Your Plan to Get Healthcare Abroad
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• International Hospitals for Expatriates

About Amanda Hoffman

Amanda D. Hoffman has been living a slow-travel, independent-location lifestyle since 2017, exploring more than 16 countries over 5 continents — and counting. From art to history to local political and social issues, she is always eager to learn about her surroundings and make new connections. As a rare disease patient and advocate, she has unique insight and interest in healthcare cost and access while traveling.

She is a writer, strategic communications consultant and owner of ADH Communications Consulting. Her career has roots in journalism and included private sector government consulting before transitioning to support national nonprofit organizations.

Amanda holds a bachelor’s degree in Journalism from American University’s School of Communication in Washington, DC, including a semester abroad at John Cabot University in Rome, Italy. More recently, she has completed multiple creative writing courses at Edinburgh University in Scotland — a country that keeps her coming back again and again.

When she’s not crafting her latest prose, you can find Amanda wandering through museums, catching live theatre, poring over fiction and poetry at bookstores, and soaking up the ambiance at cafes around the world.

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In My Own Words: Dr. Poore’s Trip to Vietnam

On March 7, 2024, myself and a group from our Division of Plastic Surgery began our journey to Nuoy Reconstructive International in Hanoi, Vietnam. The UW Cohort included faculty member Dr. Brett Michelotti, two chief residents and two research fellows. We were there through March 16 and during our time we performed operations at several hospitals, and taught the first Hanoi microsurgical training course.

Our team performed surgery across Hanoi and Ho Chi Min City. This included all aspects of reconstructive surgery, including upper and lower extremity reconstruction, craniofacial surgery, hand surgery, and cancer reconstruction. Each site involved a preoperative clinic, followed by surgical care and follow up. We only performed cases on patients who had an established Vietnamese surgeon to provide back up.

All in all, this trip was an incredible experience.

Dr. Samuel Poore is the Chair of the Division of Plastic Surgery.

“This trip has opened my eyes to what really matters in life and restored my faith in humanity.”

One World Surgery organizes surgical and primary care missions to its facility in Honduras, the Holy Family Surgery Center.

One World Surgery also leads primary care missions in the communities surrounding the site of its future surgery center and primary care clinic in the Dominican Republic.

Medical missions take place during the dates scheduled on our calendar, and specialties are pre-assigned. Most are weeklong missions (Saturday to Saturday). Some trips have roles completely reserved for volunteers associated with specific groups, while other trips have openings for the general public.

VOLUNTEER FOR A MEDICAL MISSION

Cost & requirements, application process.

Volunteers’ program fees make it possible for us to provide patients with high-quality care for free. A portion of every volunteer’s program fee is applied towards supply costs for patient surgeries and is tax-deductible. Program fees follow a family-based structure.

Program Fees

• $1000 for first participant (regardless of age)
• $500 for additional family member (includes spouses, adult children, and parents only)
• $250 for additional family member under 18 years

Program fees include food and housing for a one week mission, ground transportation in the mission country, and emergency medical and evacuation insurance. Fees are due 5 weeks prior to the medical mission.

Travel Costs

Volunteers are also responsible for their own flight costs. Roundtrip flights typically range $500-$1200, depending on time of year.   One World Surgery has partnered with travel management company Diversity Travel for medical missions travel bookings. We encourage volunteers to make travel arrangements through Diversity Travel as they offer extra flexibility and humanitarian fees. See details on booking with Diversity Travel here . 

Travel Request Form- Diversity Travel

Since program fees help in funding patient surgeries, we are unable to waive program fees or provide program fee reductions. We encourage those for whom the cost of attending a medical mission presents a financial challenge to fundraise for program fee or flight costs or to apply for a scholarship. Please see our scholarships and fundraising page for more details.

Requirements

• Medical volunteers: must be currently licensed and working in the profession.
• Volunteers must be able to withstand up to 90 degrees F without air conditioning.
• In Honduras, volunteers should be able to walk approximately 1 mile to the surgery center and back each day.
• Dominican Republic:  Volunteers ages 16 and over are accepted at this time and must be accompanied by an adult. – U.S. passport holders : Passport must be valid for the duration of your trip. A visa is not required for a stay in the Dominican Republic up to 30 days. – Non U.S. passport holders : You are responsible for securing your own visa, if required for your country of citizenship. You are also responsible for confirming that your passport meets entry requirements and that you have proper documentation to reenter the U.S. (i.e. valid Permanent Resident Card).
• Honduras:  Volunteers under 18 must be accompanied by an adult. Children under 13 must be supervised by a non-clinical volunteer at all times. The recommended minimum age at attend a medical mission is 5 years old. – U.S. passport holders : Passport must be valid for 6 months past date of entry into Honduras. A visa is not required for a stay in Honduras up to 90 days. – Non U.S. passport holders : You are responsible for securing your own visa, if required for your country of citizenship. You are also responsible for confirming that your passport meets entry requirements and that you have proper documentation to reenter the U.S. (i.e. valid Permanent Resident Card).
• Late Cancellation Policy
• Refund Policy
• Rescheduled/Cancelled Medical Mission Policy
• Travel Policy

Participants wishing to withdraw from a medical mission or reschedule their trip must notify [email protected] by email at least 45 days prior to the trip. Any other method of notification (i.e. telling a surgery center administrator or fellow participant) is not considered official notice of cancellation or rescheduling.

Participants who do not notify [email protected] at least 45 days prior to the trip will be charged as $250 late fee. Medical emergencies or other extenuating circumstances may be considered differently.

Program fee payments are considered donations to One World Surgery, a registered 501c3 nonprofit organization in the United States. In accordance with IRS regulations, donations are nonrefundable. In the event of a trip cancellation (by the volunteer or One World Surgery), the volunteer may designate his/her funds to cover the costs of another volunteer or may apply the funds towards another One World Surgery mission within 12 months. This policy also applies to any third party donations made to One World Surgery in support of a volunteer’s program fee or flight costs. One World Surgery also does not provide any refunds for flight costs.

One World Surgery reserves the right to cancel or reschedule a mission without notice. We may cancel a medical mission if conditions in the mission country are deemed unsafe. We rely on information and recommendations from the U.S. Department of State, the Centers for Disease and Control and Prevention, NPH, and other local sources in making these decisions. In the event that a medical mission is cancelled or rescheduled due to unsafe conditions, participants will be offered the opportunity to move their registration to a future trip with openings within 12 months of the originally scheduled trip.

Volunteers are responsible for booking their own travel according to the guidelines outlined in the Trip Informational Packet provided upon application approval. All volunteers are required to use One World Surgery’s private transportation services.

Volunteers must email [email protected] no later than 30 days prior to the first day of the mission to request approval for any travel dates or times outside of those outlined in the Trip informational Packet. We cannot guarantee transportation for alternative flight plans/travel dates that have not been first approved by the Medical Missions team.

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Applications are accepted year-round. We recommend submitting your application at least 3 months before your trip to ensure you receive all trip reminders and have adequate time to prepare. Providers are required to apply by 8 weeks prior to the trip so that their medical credentials can be verified and submitted to the local ministry of health.

1. Complete the online application, via the link below, indicating your preferred medical mission dates and role. P roviders will now be required to submit a copy of their passport, medical diploma, medical licenses, and board certification at the time of application. You will immediately receive a submission acknowledgment email. You are not yet approved for a spot on the medical mission. Please do not purchase flights .

2. You will receive an email indicating whether or not your application has been approved (within 1 week for trips less than 3 months out, within 2 weeks for trips more than 3 months out). If approved, the email will contain a link to the informational packet for your trip (includes details on booking flights, immunizations, etc.) .

3. Purchase flights ( according to guidelines in the informational packet ) and schedule immunization appointments, if necessary.

4. Any time after approval, return to r eturn to your online application by logging back into your account   via the application link below t o complete follow- up forms, waivers and program fees. These items are due 5 weeks prior to the trip. The progress bar on your account will help you keep track of your progress. It is not necessary to complete all the items at once. You can return to the account at any time.

5. Volunteers will receive their first reminder email 3 months prior to the trip. Additional reminder emails will follow at the 2 month and 1 month marks. A pre-trip informational call will be scheduled a few weeks prior to your trip.

Trip Application

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Dear YO Info: Discovering a Complication Made By Another Surgeon

• Mark Complete

Dear YO Info:

I just started practicing and, given that I have a pretty open template, I am getting a lot of second opinion evaluations. A recent patient has persistent blurry vision after cataract surgery by another doctor in town. On examination, she had a best corrected visual acuity of 20/80; there was a vitreous strand to the surgical wound with a peaked pupil, a sulcus intraocular lens (IOL), and optical coherence tomography ( OCT) revealed macular edema. The operative note stated that the IOL was placed in the bag, and there were no complications. How do I approach counseling this patient? How should I tell the patient about what appear to be surgical complications that are likely contributing to her suboptimal visual acuity?

Stuck Between a Rock and Hard Place

Dear Stuck:

I agree — this is a delicate situation. The first thing you need to do is gather all pertinent facts and data. This includes a thorough patient history, a comprehensive ocular examination, a review of the prior ophthalmologist's medical and surgical records, and ideally, a verbal discussion with the surgeon. Think about how you would want to learn about your own surgical patient’s complication. I tell the patient that I would like to gather all information, and I personally call the surgeon to discuss it. 

Only after all this information has been gathered can the patient be properly diagnosed and fully informed. While you are waiting for all the information, offer advice and treatment. I often find myself answering the question, “Was this preventable?” or “How long has this been present?” I always deal with facts, which protects you and the surgeon: “Ma’am, I’m sorry that you’re not seeing the way you would like after cataract surgery. I’m not sure what you looked liked on your last examination with the surgeon, but today I see the vitreous strand, which can occur after a cataract surgery. To improve your vision, we have to do a laser to cut this strand and put you on some more eye drops.” 

You may even want to encourage patients to discuss questions about the prior physician’s care and treatment with the other surgeon themselves. If they push for more information, I often repeat myself: “I hear your frustration. This is what I am seeing today, and this is the path forward.” 

After reviewing all the information, remind yourself that your primary responsibility is to offer the second opinion which the patient is seeking, and to act in the patient’s best interest . Often, sympathetic and careful management is enough to mitigate a patient's dissatisfaction and avert malpractice litigation. 

Avoid remarks about the other surgeon’s procedure, like “I don’t know why they didn’t see this”; “I have no idea why they did that ”; or “I’d never do something like that!” You avoid this firstly because you may encounter unforeseen and unpredictable complications in your own career. Secondly, you’ll never know exactly what the other surgeon encountered intraoperatively. 

Take care of your patient. Watch what you say, and call your colleague. 

Evan Silverstein, MD Chair, YO Info Editorial Board

Read the Academy’s Code of Ethics :

• Rule 4. Other Opinions . Ophthalmologists should be cognizant of the limitations of his/her knowledge and skills and be willing to seek consultations in clinical situations where appropriate. The patient's request for additional opinion(s) should be respected.
• Rule 14. Interrelations Between Ophthalmologists . Interrelations between ophthalmologists must be conducted in a manner that advances the best interests of the patient, including the sharing of relevant information.

The American Academy of Ophthalmology's newsletter for young ophthalmologists (YOs) — those in training as well as in their first few years in practice.

YO Info Editorial Board

Evan Silverstein, MD — Chair Sruthi Arepalli, MD Grayson W. Armstrong, MD Liane O. Dallalzadeh, MD Cherie A. Fathy, MD Bradley S. Henriksen, MD L. Claire Peterson, FRCOphth, MBBS Dagny C. Zhu, MD 

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Young breast cancer survivor shares how fitness programs have helped her heal

by Liz Bonis, WKRC

CINCINNATI (WKRC) - Your personal prescription for managing a health condition might just be a trip to the gym.

Local 12 shares why doctors are now recommending patients to fight back with fitness.

Fitness programs have long been used for preventing health problems. Now, a young breast cancer survivor is sharing how it helps with healing, and it's all backed by science.

"I just felt a lump in the shower one day," said Cindy Oliver, breast cancer survivor.

That lump she discovered put her on a long road to recovery for an aggressive form of breast cancer.

"Which is triple negative breast cancer," said Oliver.

After surgery and treatment, Cindy, who's just 37 years old, was told her body was cancer free. But due to the after effects, her breast surgeon referred her to Ohio's Activate Brain and Body.

"I did notice that I was suffering from what they call chemo brain. [It's] like the brain fog, like my memory wasn't as sharp," said Oliver.

Activate is one of the first fitness facilities in the country to design "sports medicine" programs. It pairs physical workouts with brain workouts at the same time.

"In the simple gist of it, you have to elevate the heartrate. A lot of magical things happen in the brain, and then from that point on, you have to challenge your brain in a new way," said Chief Exercise Science Officer at Activate Brain and Body Adam Ortman.

Ortman said that he sees evidence every day here. He said it helps back up what a recent study by the National Institutes of Health showed. That this type of workout can not only keep an illness from coming back or getting worse, but it can also help those such as Cindy realize that while they can't change a tough diagnosis, there's still things you can do.

"I need to do these types of exercises to reduce risk of recurrence," said Oliver.

"There are things that you can do, and the earlier you start, the better it's going to be long term," said Ortman.

For Cindy, it's been life changing.

"The physical, the cognitive, the social, it's all helping me reduce that risk of recurrence that I still think about," said Oliver.

For ideal results, you usually need to work the body and brain about six to 12 months. Group sessions as opposed to one on one training can help control costs.

MOS Mission Trip to Colombia

Four MOS physicians participated in an annual mission trip to Buga, Colombia during the summer of 2018. The mission has been an annual trip for the last 25 years and through the work of the volunteers, many of the patients have experienced a great increase in their quality of life.

MOS physicians Dr. Ira Zaltz, Dr. Patrick Wiater, Dr. Jeff Settecerri, and Dr. Gregory Sobol were among several orthopedic professionals that visited the Buga, Colombia this summer. The annual trip has seen over 1500 clinic visits and 1200 surgeries over the nearly three decades of service. This includes the 60+ surgeries on 34 children this summer. Treated conditions included Syndactyly and Polydactyly, Cerebral Palsy, Blount’s Disease and Rickets among others.

In 1993, Colombia passed Law 100 which stated that all citizens, irrespective of their ability to pay, receive a health benefits package. According to the National Health Survey, before 1993, 24% of the population had health coverage; by 2007, more than 80% had some form of health coverage. Despite this law being passed, 15-20% still have no health coverage.

While the numbers vary by year, the team normally includes:

• 4-6 Pediatric Orthopedic Surgeons/Hand Surgeons
• 2 Anesthesiologists
• 8 Nurses/Surgical Technicians
• 2 US Ortho Residents
• 1 Colombian Ortho Resident

The local hospital donates two of their four ORs for one week for the mission. In return, the hospital and surgeons not only benefit from the training and collaboration, but they also receive donated equipment. The local surgeons don’t have the resources to provide free surgeries, but they do provide the follow-up care throughout the year.

On his experience Dr. Sobol had this to say, “It’s a life-changing experience, extremely rewarding and makes you realize and appreciate what I have, and how lucky and fortunate I am. I would strongly encourage anyone to partake in volunteer work, you get way more out then you put in.”

Visit Dr. Ira Zaltz, Dr. Patrick Wiater, Dr. Jeff Settecerri, and Dr. Gregory Sobol’s profile for more information on their specialty and credentials.

Jeffrey Settecerri MD

Gregory Sobol MD

Patrick Wiater MD

Ira Zaltz MD

Columbia Falls local returns to serve as Logan Health’s reconstructive surgeon

Dr. Thomas Wright at Logan Health in Kalispell on Thursday, March 21. (Casey Kreider/Daily Inter Lake) Casey Kreider

Former breast cancer patient Carol Church had almost given up hope on getting reconstructive surgery following her second battle with the disease. But it was by lucky coincidence that Logan Health had just hired Dr. Thomas Wright to specialize in plastic and reconstructive surgery, bringing top-of-the-line care to the area where he grew up.

Wright began his tenure at Logan Health Medical Center in Kalispell in August of 2023. With an emphasis on breast reconstruction, Wright said he enjoys getting to know his patients and learning how to best solve their issues.

Many of the surgeries he performs go to improve someone’s overall quality of life, particularly for recovered breast cancer patients who opt for a free flap surgery. Free flap surgery is a type of breast reconstruction where a tissue flap (including blood vessels, skin, fat, and sometimes muscle) is removed from one area of the body and is reattached to the chest to form a new breast mound, according to the National Cancer Institute.

“It's treating the trauma and the sense of well-being of patients who desire reconstruction —  occasionally, they're not candidates for implants and the free flap is a great option for those patients,” Wright said. 

For Church, it was the only option left. She had an expander put in her breast to prepare for a silicone implant, but it unfortunately got infected. This is common, especially for patients who have undergone radiation, according to Wright. He said implants are a fine option for many people, but free flap surgeries work well because of the procedure’s low risk of infection. 

After discussing the option of a free flap surgery with her doctor, Church said she hesitated to travel out of state for the procedure. But, she ended up having a great experience with Wright without having to travel far from home. 

“I don't know that I could have gone so far to get the surgery … I wouldn't want to be so far away from a surgeon that could fix it if something had gone wrong. So, this worked out perfectly,” Church said.

Wright became interested in reconstructive surgery during his time in medical school at the University of Washington. After growing up in Columbia Falls, Wright went on to attend Montana State University and graduated with the highest honors, according to Logan Health. He completed his residency in plastic surgery in Salt Lake City, then took on a one-year fellowship in microsurgery at the University of Washington. 

“It really appeals to me because you just have to think creatively to solve unique problems that different patients have. There's no patient that's exactly the same,” Wright said.

While Wright handles a lot of surgeries for former breast cancer patients, he also does any type of surgery that would require moving skin to a different area of the body. For example, he recently had a case to reconstruct the top of somebody's thumb to avoid it needing to be shortened. 

“We were able to think of a nice little local flap option to reconstruct, so that was a fun case. It's really anywhere on the body that needs more tissue, that’s what we specialize in. We never get into the bowels or the internal organs, it's usually skin soft tissue muscle, some bony reconstruction occasionally as well,” Wright said. 

He said the valley has had great plastic surgeons operating for decades, but what he brings to the table is the ability to do microsurgery. It’s a discipline in which specialized operating microscopes and precision instruments are used to repair intricate structures such as blood vessels and nerves less than a few millimeters in diameter, according to the American Society of Plastic Surgeons. 

“It's a really fun surgery and you get to intricately dissect blood vessels, you hook them up under the microscope, and you can solve some very complicated problems with this technique. I am the only microsurgeon in the state of Montana, they do offer this form of reconstruction in Bozeman, but they're bringing surgeons in from Texas to do it,” Wright said.

A 2021 article published in the Archives of Hand and Microsurgery said the first operating microscope was invented by Carl Zeiss in 1953. The limitations of the practice steadily decreased and have reached “a limitless level of today’s supermicrosurgery.” In addition to breast reconstruction, the surgery can achieve head and neck reconstruction, functioning free muscle transfer for certain types of muscle paralysis, vascularized bone flap transfer, complex wound reconstruction, digit replantation, nerve repair and lymphatic reconstruction.

He said microsurgery and the way it lends itself to the body’s ability to heal is one reason he was compelled to study this area of medicine. 

“It's what drew me to the field. The main thing you need to heal is a good blood supply, so doing free flaps with microsurgery is bringing good blood supply to the area, in addition to soft tissue to get things healed,” Wright said. “And offering a service like this to a hospital this size empowers other surgeons to tackle problems that they might not otherwise be able to tackle. Orthopedic surgeons might be capable of fixing a bone, but if they don't have somebody to provide good soft tissue, they might have to ship those patients out. So offering that service here in the valley keeps patients closer to home.” 

Many of his referrals are from Dr. Melissa Kaptanian, Logan Health’s breast surgical oncologist. But, he also gets referrals from other surgeons who need his help for certain aspects of a patient’s recovery, in addition to referrals from people’s primary care physicians. He said if someone believes they might be a good candidate for a reconstructive surgery, they can give his office a call. 

Learn more about Wright and find contact information for his office online at www.logan.org/provider/thomas-wright/. 

Reporter Taylor Inman can be reached at 406-758-4433 or by emailing [email protected]. 

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Roxanne, you may want to turn on the red light. 

Dr. Daniel Barrett, a plastic surgeon from Beverly Hills, California, said that people should be doing “red light therapy every single day” for healthier and younger-looking skin. 

Barrett posted a video to his TikTok , where he goes by @barrettplasticsurgery , talking about the benefits of red light therapy, which has since garnered over 280,000 views.

@barrettplasticsurgery Replying to @girlwithnoname007 Red light therapy is a game changer! 💃🏼🚨 I highly recommend daily red light use. #redlighttherapy #redlighttherapybenefits #redlight ♬ champagne season – Troy Ogletree

Barrett said he uses red light every morning and even designed a red light LED mask to specifically target the face. He sells them for a cool $348. 

“It’s been shown to improve collagen and blood flow to your skin. What that means is less wrinkles,” he gushed. 

He recommended people start by using his red light mask for up to 20 minutes a day. 

In addition to a red light setting, the mask has a blue light setting which is great for treating acne breakouts, as well as an orange light setting which he said helps surgical recovery. 

The red light setting “combats signs of aging, boosts cellular activity, and reduces the appearance of fine lines and wrinkles for a youthful complexion,” his website states. 

The Post reached out to Barrett for additional comment. 

The plastic surgeon is hardly the only doc to recommend red light therapy. A few studies have also shown that red light therapy may help with scars, burns, sun damage and even healing damage from acne.

But before you jump on board and shell out for the pricy product, know that red light therapy typically only works as long as you’re using it. In other words, if you’re hoping to minimize wrinkles, you have to keep using the device consistently. According to one study , results last about a month after you stop using red light therapy masks.

Just make sure you skip the red light wands — says Dr. Mark Strom , a popular TikTok dermatologist.

“It could be tempting to buy one of these red light wands, because they’re much cheaper than the full LED face mask,” Strom explained.

But there’s a catch. In order for red light therapy to work, it has to be the right wavelength and you have to leave it on your skin for a while — wearing a mask, for example. Smaller wands you wipe over your face ultimately won’t do much, Strom explained.

Commenters below Barrett’s post shared in his enthusiasm for red light therapy and also asked him questions. 

“Red light therapy is underrated 🫢,” one person said. 

“I love red light therapy!!” Another chimed in. 

“Is red light safe for anyone with melasma?” another asked. 

“I would treat the melasma first,” Barrett replied. 

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Houston transplant surgeon accused of altering records to deny patients organs; program suspended

A decorated transplant surgeon in Houston, Texas is being accused of depriving his patients of new livers by exploiting a government database and changing their records.

Dr. J. Steve Bynon Jr. has practiced medicine since 1981, and with "extensive experience in liver transplantation," he's performed over 800 procedures throughout his decades-long career, according to his bio on the Memorial Hermann-Texas Medical Center website.

The medical center said Bynon, a doctor in its liver transplant program, admitted to changing patient records, effectively denying them transplants, according to a statement Memorial Hermann shared with the New York Times on Thursday. The outlet also said Bynon is employed by the University of Texas Health Science Center in Houston while working at Memorial Hermann.

Bynon, 64, has been contracted to lead Memorial Hermann’s abdominal transplant program since 2011, his bio on the medical center's website says.

Memorial Hermann voluntarily inactivates liver, kidney transplant programs

While at the Memorial Hermann-Texas Medical Center, Bynon oversaw both the liver and kidney transplant programs, according to his bio. Both programs have been voluntarily inactivated while the medical center investigates the allegations against Bynon, the hospital told USA TODAY Friday in a statement.

"Over the past two weeks, we have been actively working with all impacted patients, families and caregivers from the liver and the kidney transplant programs," according to the medical center. "... Our primary priority is ensuring continuity of compassionate care for patients who were on the transplant program lists at the hospital."

Transplant care coordinators are contacting patients in both programs to look at further care options, including "a seamless transition to another transplant program, where necessary," the medical center said.

"We are working with the University of Texas Health Science Center at Houston to make the necessary changes that will allow for the quick reactivation of the kidney transplant program under a different physician leadership structure," according to the medical center's statement. "All program transplant physicians are employed by the University of Health Science Center at Houston and contracted to Memorial Hermann to provide physician services . "

The medical center's investigation is ongoing, and they "continue to cooperate with all regulatory authorities," according to the statement.

UTHealth Houston, Bynon helping with Memorial Hermann's investigation

UTHealth Houston , as the University of Texas Health Science Center in Houston is known locally, called Bynon "an exceptionally talented and caring physician, and a pioneer in abdominal organ transplantation," according to a statement emailed Friday to USA TODAY.

"According to the Scientific Registry of Transplant Recipients, Bynon’s survival rates and surgical outcomes are among the best in the nation, even while treating patients with higher-than-average acuity and disease complexity," the statement said. "UTHealth Houston is proud of the many contributions Dr. Bynon and his team have made to our university, our academic and clinical transplant programs, and to the field of transplant medicine."

Tiny Transplant Titans: Couple starts nonprofit while 1-year-old awaits new liver

UTHealth Houston's faculty and staff members, including Bynon, are helping with the "inquiry into Memorial Hermann’s liver transplant program and are committed to addressing and resolving any findings identified by this process," according to the statement.

When contacted by the New York Times by phone on Thursday, Bynon neither confirmed nor denied that he admitted to altering patient records, the outlet said.

Dr. J. Steve Bynon Jr.'s alleged conduct is 'highly inappropriate,' fellow doctor says

The U.S. Department of Health and Human Services (HHS) and the United Network for Organ Sharing are also investigating the allegations against Bynon, according to a statement obtained by the New York Times.

“We acknowledge the severity of this allegation,” the HHS statement said. “We are working diligently to address this issue with the attention it deserves.”

Dr. Sanjay Kulkarni, the vice chair of the ethics committee at the United Network for Organ Sharing, called Bynon's alleged conduct "highly unusual" and "highly inappropriate," according to the New York Times.

“They’re sitting at home, maybe not traveling, thinking they could get an organ offer any time, but in reality, they’re functionally inactive, and so they’re not going to get that transplant,” Kulkarni told the outlet.

Memorial Hermann patients were taken off of liver transplant waiting list due to death or serious illness

Last year, 14 patients at Memorial Hermann were taken off the center’s waiting list due to them either dying or becoming too ill, according to the Scientific Registry of Transplant Recipients , which evaluates transplant centers in the U.S. The mortality rate of people waiting for a transplant at the medical center was higher than expected, the researchers say.

A hospital spokeswoman told the New York Times that the medical center treated patients who were more severely ill than average.

Memorial Hermann performed 30 liver transplants and 132 kidney transplants in 2023, the Houston Chronicle reported.

It remains unclear how many patients were on Memorial Hermann's waiting list before both transplant programs were inactivated.

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We, the voters

'we created this problem': a pediatric surgeon on how gun violence affects children.

Destinee Adams

Michel Martin

Dr. Mikael Petrosyan, associate chief of general and thoracic surgery, poses for a portrait in his office at Children's National Hospital in Washington, D.C. on November 13, 2023. Eric Lee for NPR hide caption

Dr. Mikael Petrosyan, associate chief of general and thoracic surgery, poses for a portrait in his office at Children's National Hospital in Washington, D.C. on November 13, 2023.

Treating gunshot wounds on children was not what Mikael Petrosyan expected when he entered pediatrics.

Petrosyan has been working as a pediatric surgeon at the Children's National Hospital for more than a decade, and he has treated many children injured by guns.

He hasn't been able to save them all and has had to tell parents that their children have died from gunshot wounds.

"It's a devastating thing to do, to lose a child for something that has been caused by guns," Petrosyan said. "It's not an accident. It was totally preventable in many ways."

Last year, 106 juveniles were registered as gun shot wound victims in Washington D.C., and 16 of those incidents were fatal, according to the Metropolitan Police Department. Law enforcement in D.C. also recovered more than 3,000 firearms in both 2022 and 2023 .

Petrosyan says having to tell a parent their child has died from gunshot wounds is one of the most difficult parts of his job.

Gun violence, including homicides, suicides and unintentional injuries, is the leading cause of death among American children and teens, ages 1-19, according to the Centers for Disease Control and Prevention. Last year, 1,682 children and teens were shot and killed and 4,512 were injured — excluding the number of gun related suicides.

As Petrosyan sees it, the physical damage is just the beginning.

"There's a lot of damage, not just physical, but psychological and emotional," Petrosyan said. "I'm talking about families and people that are involved, not only parents, family, but also people who are treating the children. They are psychologically impacted significantly."

His colleagues are also feeling the strain to the point that some have stopped working temporarily for relief. Some are even considering early retirement or leaving the field altogether.

D.C. is seen from a window from Dr. Mikael Petrosyan's, associate chief of general and thoracic surgery, office at Children's National Hospital in Washington, D.C. on November 13, 2023. Eric Lee for NPR hide caption

D.C. is seen from a window from Dr. Mikael Petrosyan's, associate chief of general and thoracic surgery, office at Children's National Hospital in Washington, D.C. on November 13, 2023.

Petrosyan sat with Morning Edition 's Michel Martin to discuss his experience as someone who regularly witnesses the effects of gun violence on U.S. youth as part of our ongoing series, We, The Voters .

This interview has been edited for length and clarity.

Michel Martin: Little kids aren't — they're not supposed to be injured.

Mikael Petrosyan: They're not supposed to be injured. A lot of times they are bystanders. Most of the time they're innocent bystanders, 99.9% of the time. I'm not a politician, but we have to do better than what we have right now. It's not stable. It's not right. There's something we're not doing right.

We, The Voters

As gun violence looms over pennsylvania youth, local organizations offer safe spaces.

Martin: Most people don't go into pediatrics thinking we're going to be treating gun violence. I mean, it's just I think that's fair to say, right?

Petrosyan: Correct.

Martin: So, can you just talk about how it affects you and the people you work with, your colleagues, the nurses, the staff, the other doctors?

Petrosyan: It does affect us, operating on kids. It's a job that comes with stress. I have three young kids and I go home every day, and I worry about this every day. And I text my wife, 'Are they OK? Was the school OK?' It doesn't matter where you live. Every day I think about it. I drive here every day, I think about it. So, these are things that will never leave me. I wish it did. And it causes stress on everyone. People think you're a surgeon, you're tough, but there's a lot of things associated with it.

Martin: Is there something you particularly want people to know who don't see what you see?

Petrosyan: People have to understand that we created this problem. It wasn't there before. We've created it. So we have to do something, not just lock the guns. It's not just that. It's education. It's community involvement. It's improving the socioeconomic status of people, communities. We have to do better as Americans, as everyone, as a family.

The pediatric intensive care unit at Children's National Hospital in Washington, D.C. on November 13, 2023. Eric Lee for NPR hide caption

The pediatric intensive care unit at Children's National Hospital in Washington, D.C. on November 13, 2023.

When you lose a child on an operating table in an emergency room, it's devastating. You can't even talk or eat or do anything, many days. It's devastating, and I wouldn't want to wish on anyone. And imagine, as a parent, losing a child. How can you say to the parent that you lost their child? It's one of the most difficult things I've done in my career. It's when you go out there after the trauma resuscitation or an operation, and tell the parents, I'm sorry I couldn't save your child. It wasn't me that caused it, but I feel the responsibility that I wasn't able to save.

Martin: Can I ask you if you've ever thought about it? If you've ever thought, 'I can't, I can't do it. This has to stop?'

Petrosyan: Not yet. But it's getting there.

Lindsay Totty produced the audio story, and Jan Johnson edited the audio version. Destinee Adams wrote the digital story, and Obed Manuel edited the digital version.