Speaker 1: Well, a growing number of Americans are traveling internationally to seek medical care as medical tourism to Mexico is on the rise, obviously, as we learned this past week, it also comes with risks.

Speaker 2: Yes. Four Americans were kidnapped last week. Two of them died. One of them was just trying to get a cosmetic procedure done in Mexico. And joining us now is Fox 5 medical contributor, Dr. Richard Shafu. Thanks for joining us. Great to see you. You know, we hear about this all the time, people trying to save a little bit of money on these types of procedures that, you know, obviously you can get here. What are the most common procedures that we're seeing people cross the border for?

Speaker 3: So Maria, almost any kind of cosmetic procedure, you can imagine, although commonly it's body procedures, like tummy tucks, breast procedures, could be face procedures, laser treatments. So a whole host of procedures, weight loss, surgeries, dental work. So it's a quite a wide spectrum of procedures that patients will cross the border.

Speaker 1: So what's the difference in costs? Maria said you save a little bit of money, but it means a lot of money, one. And two, you know, tell us about those risks, because obviously you don't play by the same

Speaker 3: rules. No, exactly. So yes, and that's why if you look at statistics from like 2008, 2009, and 2017, we're seeing probably over a million Americans have crossed the border to go, you know, to other countries, especially obviously to Mexico, which borders us. And the problem, Andrew, is there are numerous risks that are associated. I think it's very difficult for the average consumer to understand that they've now gone to a foreign country. So how do you determine whether the doctors that you're seeing are qualified? Is a facility licensed or certified? What does that mean within that specific country? And then importantly, if something does go wrong, what are the facilities like that will care for you and your care long term? The other issue that we've seen, our American Society of Plastic Surgeons has done a great public service, I think, for people to go on plasticsurgery.org, because it discusses this issue. We're seeing a lot of people coming back with these unusual, what we call opportunistic infections. And these are very unusual infections that will occur in some of these countries that can be, one, very difficult to diagnose, and number two, can be very difficult to treat. Some of these require multiple surgical procedures. So someone, say, for example, going for a tummy tuck to some country and comes back here and gets an overwhelming infection with an unusual organism, could spend weeks to months in a hospital, undergo multiple reconstructive procedures, and maybe never end up having the ultimate outcome that they wanted. And some insurance policies will not cover the complications of cosmetic surgery. So it only costs more than... Way more, exactly.

Speaker 1: Had they just done it the other way.

Speaker 2: Yes, at the end of the day. You know, sometimes people travel because some procedures, some prescriptions, things like that, they're not available here. So really, why are people doing that? What's the reason for it being approved in one country and not here?

Speaker 3: That's a good question. I don't think I really have a good answer for that. I mean, obviously, in different countries, there are different regulatory issues. We have a very strict regulatory program here with the FDA. And the reason that we have the FDA is to protect the public, to protect us all from unscrupulous practitioners, from medications that may not meet certain healthy standards. But when we go to other countries, the regulations may be quite different. And so, it's really hard. You're really, in a sense, comparing apples with oranges.

Speaker 1: Yeah, those regulations, a lot of people don't like, but they keep us safe, right? That's the point.

Speaker 3: They do. And I think the other issue, Andrew, is what recourse does a patient have who has an outcome that's gone south, so to speak? What is the legal system like, and can you maneuver that in a foreign country? That can be all complicated.

Speaker 1: Things you might not understand very well. All right, so let's say somebody hears Dr. Shafu on Fox 5 and says, I hear ya, but I'm going for it anyway. It's a really great deal. I trust this guy, trust this woman, whatever the case may be. What suggestions do you have for people who are still willing to take that risk and go

Speaker 3: through that? So, I think, as long as you're willing to take the risk, then you want to make sure that you're seeing a board-certified plastic surgeon. So make sure that whatever country you're going to, there are standards within each country to make sure that who you really are seeing, number one, is a physician, because as we know, in some countries, you can kind of get away with pretending to be a doctor, and we've seen some of that recently in the media. So number one, you want to make sure you're seeing a board-certified MD, plastic surgeon. Number two, you want to know, is there any licensing or regulatory qualities that have made that facility safer? Who's giving you your anesthesia? Probably a question most patients don't think to ask. Is the surgeon giving the anesthesia? Big red flag. Is the nurse giving the anesthesia? Big red flag. Should be a board-certified anesthesiologist. And then, what happens if something goes wrong? Are they privileged in a local hospital? Can they go in? What is that local hospital's care really like? And then, what follow-up is needed? Am I going to be able to follow up with this doctor? Is it going to be an issue for me if I've traveled thousands of miles away, and I come back and I have a problem? Obviously, we're not going to go back and travel that long distance again. Do you have a physician or a surgeon in your community that you know that you trust that can follow up with you?

Speaker 2: It's your body. It's your health. It's your life. Cover your bases. It's your life.

Speaker 3: Yes. Do your research. Exactly. It's not like a souvenir.

Speaker 2: You just can't turn it back if you don't like it. All right.

Speaker 3: Thank you for joining us.

Speaker 2: Thank you. All right.