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In search of standards

Article-In search of standards

National report — Organizations attempting to increase safety for patients seeking cosmetic procedures abroad include the Joint Commission International (JCI), the American Society of Plastic Surgeons (ASPS) and the Confederation for International Plastic Reconstructive and Aesthetic Surgery (IPRAS).

Commitment to care

"Things patients could do to improve the likelihood of good outcomes include seeking care in accredited hospitals and clinics," says Maureen Potter of JCI, which promotes international standards in areas including licensure, education and staff competency.

Currently, she says that 100 hospitals in 22 countries have met JCI's standards, which also include confidentiality and informed consent procedures comparable to American standards.

"Those hospitals have made a voluntary public commitment to quality of care and patient safety. That tends to lead to better outcomes," she says.

Accreditation a start

In preparing to seek care internationally, Ms. Potter says patients also should consider issues including translation services and references. In the latter area, she says if the hospital is accredited, "One would have some assurance that the physicians associated with it have the credentials, privileges and competencies" to perform the desired procedures.

As for JCI's liability standards, Ms. Potter says they conform to regulations within countries where hospitals are located. As such, she adds, "Some of those laws may not allow for litigation the way it's done in the United States."

In the area of discharge planning, she says JCI standards include requirements that patients receive education, medications and aftercare, as well as guidance and referrals where necessary.

"Often," she says, "patients will stay in the country through the acute period of postoperative care. Our standards require a referral mechanism for follow-up care" once patients return home.

The physician link

Similarly, Brian Kinney, M.D., says, "The IPRAS is working on a set of worldwide standards for cosmetic surgery tourism."

Along with setting requirements for specific procedures, he says, "We want to establish a link between doctors" so that physicians abroad can refer their American patients to American doctors for postoperative care, and vice versa. Dr. Kinney says this program likely will debut at the next IPRAS Quadrennial Congress, scheduled June 26-30, 2007, in Berlin.

Caveat emptor

The ASPS, on the other hand, released an April 2005 briefing paper on cosmetic surgery tourism.

"Although there are many skilled and qualified physicians practicing all over the world," the paper states, "it may be difficult to assess the training and credentials of surgeons outside the United States."

Other concerns it addresses include the possibility that, if complications or the need for revision surgeries arise, "Bargain surgery can be costly."

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