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Don't Dismiss Foreign Healthcare
-- Frank Gillingham, MD

Many Americans are surprised to learn that excellent medical care is available in much of the world. The advice and recommendations expatriates receive abroad may be different from what they receive in the US--but different doesn't necessarily mean wrong.

Here are three points to keep in mind:
The World Health Organization's Rankings
In June, 2000 the World Health Organization published a comparison of 191 health systems around the world, using five indicators of quality. The report concluded that France provides the best overall healthcare followed among major countries by Italy, Spain, Oman, Austria and Japan. The U.S. ranked only 37 out of 191 countries studied (in part because of the large number of uninsured, which the study considered). The important point to remember is that many countries have terrific healthcare systems.

Many expatriates are pleasantly surprised by their experiences
The quotations below tell the whole story.
"I myself am a native U.S. citizen and was completely trained in the U.S. I would venture to say, that if you find the right doctor, prenatal care is even more complete here, with ultrasound explorations at every visit, all the diagnostic testing...." HTH Obstetrician, Barcelona, Spain.

"It is common that medical doctors visit patients homes, provide care and decide if the person needs referral to a specialist or hospital admission." HTH Gastroenterologist, Buenos Aires, Argentina.

"I'm impressed with the medical care, doctors, and medical plan options in Germany. It is, from my experience, better than many U.S. options. There is coverage here for more preventive care, massage, acupuncture.... Plus, when you are actually ill, you are written out of work and required to stay home and rest. They take getting well seriously and don't want people at work ill." Expatriate, Berlin, Germany.

"Speaking particularly of US citizens, they think that outside the US, medical attention is not good and that is not the case. We have excellent medical facilities and very well trained physicians, moreover, the personal attention given to our patients is far superior to what they get at home. HTH General Surgeon, Mexico City.

"My mother's friends here cannot believe it when I tell them about you. 'He answers his own phone? You never had to wait in the office? He came to your house? He took time to discuss [your daughter's] eating habits?' The medical care situation here [in the US] is of course very good, but rather impersonal." Expatriate, in letter to HTH Pediatrician, Milan.
Variation in Medical Care Exists Everywhere--Even in the United States.
The way medical conditions are diagnosed and treated varies significantly across geographic areas in the U.S. Researchers at Dartmouth Medical School, for example, have documented the following:
  • Patients with coronary artery disease who live in Redding, California or Bloomington, Illinois are 2 to 3 times more likely to undergo bypass surgery than patients who live in Santa Rosa, California or Grand Junction, Colorado.

  • Men with early stage prostate cancer who live in Salt Lake City are four times as likely to have their prostate removed than men who live in Manhattan.
So keep in mind that different doesn't mean wrong. There is at least as much "Art" as there is "Science" in much of medical care. The doctor you find abroad might be a terrific practitioner of both!

Additional points
Members of the HTH Healthcare Community make the following additional comments.
"Do not expect a similar type of medical management as that available in the USA. European approaches can be variable but very effective." HTH Urologist, Dublin, Ireland.

"...Outside the US borders not everything is jungle, not all doctors are ignorant, and not all hospitals are a pigsty." HTH General Surgeon, Sao Paulo, Brazil.