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Robotic Surgery Expert Weighs In On Overseas Da Vinci Prostatectomies

Tue, 09/15/2009 - 6:09am

In light of the economy and rising unemployment, people are looking to cut costs wherever they can. As the costs of many surgeries and procedures continue to rise in the US, many are looking for cheaper alternatives abroad. This big business is known as "medical tourism," and often promises healthcare options at a fraction of the cost as in the United States. However, this is one area where bargain shopping is not recommended, counsels Dr. David B. Samadi, Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center in New York City.

According to a recent article, robotic prostatectomies are now being performed for the first time in Mexico for less than half of the price in the United States. To date, thirty successful robotic prostatectomy surgeries have been performed in the first few months.

"The key to true success in robotic prostatectomies is volume," says Dr. Samadi, who has successfully performed over 2,000 prostate cancer surgeries in his practices. The other key is experience. But experience in robotic surgery is simply not enough. A surgeon must be trained in the traditional open and laparoscopic surgery as well as robotics. "There is a chance that the robot could fail, and the surgeon has to switch over to another modality to complete the operation, and this is only possible with experience," cautions Samadi.

Medical certification and licensing is not governed in foreign countries as strictly as the United States. Foreign doctors may be qualified, but it is vital to look into their credentials and references. This research is difficult to conduct from afar. The process is further complicated when dealing with foreign medical associations and regulations, especially when the medical facilities are privately owned.

Another important factor to consider is what happens if something goes wrong, and how, if at all, the patient is protected. Medical malpractice and negligence are extremely difficult to resolve in a foreign country. Medical tourism patients have very little legal leverage. Even if a patient is successful in the legal battle, there is no mandate for the physician to pay the settlement. This is what makes overseas procedures so inexpensive.

A patient's private medical insurance may not apply abroad, and rarely are financing options available, which are important factors to consider. Even if the procedures are cheaper than those in the United States as some providers claim, a patient still has to come up with 100% of the payment prior to the procedure. Additionally, the patient is also responsible for their post-surgical care, which often includes a visiting nurse, physical therapy and lodging, resulting in higher costs. If a problem arises after surgery, it is often too costly to return to the original surgeon, so patients have to seek care at home in the US. These visits may require further treatment, which increases their costs. In the end, the savings may not be all that substantial, if any.

Robotic surgery is a relatively new technology with a steep learning curve, so it is not offered in many hospitals. And while it is very costly, most patients have insurance coverage. For those that do not, hospitals, such as Mount Sinai, work with insurance companies or offer affordable financing options. "Being concerned with insurance coverage or worrying about how to pay for treatment should be the last thing on the patient's mind," says Dr. Samadi, "The priority is quality of life, which means getting the best care that offers a high cure rate and reduced side effects."

 

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