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ACS Releases Statement on Medical and Surgical Tourism

ACS advises surgical patients who seek treatment overseas to actively seek out quality health care providers


CHICAGO (May 8, 2009): The number of patients seeking medical and surgical care overseas has grown in recent years, prompting the American College of Surgeons (ACS) to study the issue and to develop an official “Statement on Medical and Surgical Tourism.” The ACS statement “was developed with the patient’s interests in mind,” according to James Unti, MD, FACS, a medical associate with the ACS Nora Institute for Surgical Patient Safety. “It is important that individuals considering health care services outside the U.S. become informed of the potential risks and complications as well as the medical, social, cultural, and legal implications of receiving such care,” Dr. Unti advises.

The statement was approved by the College’s Board of Regents, its official governing body, in February 2009 and was published in the April 2009 issue of the Bulletin of the American College of Surgeons.

The College recognizes that as surgical care has become more readily available in a wider global market, some patients are choosing to pursue medical treatment abroad for a variety of reasons. Among those reasons are the real or perceived lack of services at home; limitations on access to certain specialists imposed by payor or regulatory agencies; and lower costs of care. However, seeking care abroad involves a number of risks that the ACS has carefully considered in adopting its nine-point position statement.

Key principles of the statement, developed by the ACS Committee on Perioperative Care, are consistent with the College’s longstanding advocacy position of promoting an environment of optimal care for the surgical patient.

For those who chose to seek surgical care abroad, the College:

  • encourages patients to seek care of the highest quality.
  • encourages patients seeking elective treatment abroad to select health care institutions that have met accreditation standards established by recognized accrediting organizations.
  • encourages patients to seek care from surgeons and anesthesiologists certified in their respective specialties through a process equivalent to that recognized by the American Board of Medical Specialities in the United States .

“The College is committed to help surgical patients receive the highest level of care,” explained T. Forcht Dagi, MD, FACS, Vice-Chair of the ACS Committee on Perioperative Care. “It urges patients to seek surgeons certified by the American Board of Surgery or its equivalent; to select institutions accredited by the Joint Commission or a similar, internationally recognized accrediting body; and to make specific arrangements for continuity of care and follow-up care at home,” he said.

The statement also provides advice on obtaining overseas medical records before patients travel home; prompts patients to consider the special risks of traveling internationally following surgical and anesthesia services; and expresses ACS’s support for payors assuming responsibility for coordination and reimbursement of any follow-up care required once patients return to the U.S. Moreover, the statement expresses the College’s opposition to mandatory referral practices outsides the U.S. “unless such provisions are clearly and explicitly stated in the insurance contract and accepted by the subscriber.”

The entire ACS position statement on medical and surgical tourism can be viewed online 

In addition, “Medical tourism: The new world of health care globalization,” by James Unti, MD, FACS, appears as the cover story in the April 2009, Bulletin of the American College of Surgeons. The full text article appears online at:

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About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 79,000 members and is the largest organization of surgeons in the world. For more information, visit


Sally Garneski 

Cory Suzan Petty