Your Villa Magazine - Foothill Cities - April-June - 2023

Facial Artistry Gregory J. Vipond MD, Inc. Gregory J. Vipond, M.D., F.R.C.S.C. VIP Facial Artistry (909) 608-7770 drvipond@drvipond.org www.drvipondplasticsurgery.com 1601 Monte Vista Avenue Suite 200, Claremont, CA 91711 Dr. Gregory VIPOND New patients mention ‘ YOURVILLA ’ and receive $50OFF your first treatment! *Cannot be combined with others offers. Expires 6/30/2023 For this editorial, I wanted to write about a topic that has been in the news recently for the wrong reasons: Medical tourism . Medical tourism is the practice where patients seek medical care, typically surgery, that they couldn’t afford to have in the United States. Despite the Affordable Care Act, many people are still uninsured or underinsured and unable to cover the out-of-pocket expenses associated with a potentially life-saving procedure such as a cardiac bypass. Another type of medical tourism is when patients go to other countries to have elective, cosmetic procedures that are offered at a discount to the costs locally. As a consumer, I am definitely guilty of shopping around for a better price and am very budget-conscientious. Unfortunately, I have found that there are times when you get what you pay for and a lower initial price ends up costing you more when that product fails and needs to be replaced or the procedure needs to be repeated. There are many first-rate physicians and surgeons who practice outside the United States and many medical tourists have excellent outcomes along with a significant savings. In these cases, medical tourism has a positive outcome. However, this is not always the case. There are occasions where the surgeons have not received the same level of training as their American counterparts and the surgical outcome is inferior. Another potential problem is when patients experience a complication after surgery when they are back in the United States. It can be extremely difficult to determine what procedures have been done and how they were performed in order to decide the best treatment option. I have read of cases where patients have returned from overseas heart valve surgery and encounter a problem and local surgeons are unable to obtain the details of the operation and what valve was used. I have also read of patients having difficulty finding a physician who is willing to treat the complications of a foreign procedure. Personally, I have seen patients who have gone to various places in Mexico for cosmetic procedures, ranging from surgeries to non-invasive treatments like fillers and Botox. A number of these patients have complained that they did not see any results from either the filler or the Botox. Even worse, I have a patient who thought they were receiving stem cell injections and instead were injected with industrial silicone. This created a massive reaction requiring multiple surgeries and courses of antibiotics and she still has problems to this day. The problems with dishonesty in treatment are certainly not limited to foreign countries, and I have encountered similar problems with patients who have been treated locally. The biggest difference, in my opinion, is the difficulty for medical tourism patients to return to their international provider with their concerns. Many just opt to seek treatment locally or to “chalk it up to experience” and not do something like that in the future. When undergoing procedures locally, patients are much more likely to return to their original provider with unsatisfactory results or concerns. I believe that when providers are held accountable for suboptimal results, they become better. When I first finished training, I worked for the now-defunct company, LifestyleLift. This company was not interested in the quality of their results, only the quantity, and limited the length of time patients could be seen after surgery. When you don’t see your bad results, it is easy to fool yourself into thinking that you are the best. Even the most meticulous physicians will have results that they do not like, and by addressing them, will improve for the future. For foreign physicians, there is less of a concern of facing unhappy patients as well as relying on word of mouth for future patients, so the drive for exceptional results is less. I know how long and hard it is to grow a practice with good “word of mouth” and a reputation for honesty. It may be a slower process, but it is much more substantial in the long term. I will end by telling you about a patient I was emergently called to care for last month. She had gone to Mexico for a number of procedures, one of which, included a facelift. She returned a week after surgery to have her stitches removed and the surgeon placed her on a blood thinner. She developed bleeding from the left side of her face and went to the local Emergency Room. I was called because the ER physician was unable to stop the bleeding, despite the use of pressure bandages. When I arrived, she had a stream of blood shooting out the side of her incision. She was taken emergently to the operating room where I opened up the old incision to find a hematoma, or blood clot, the size of a baseball. After removing it, I encountered an artery that was spurting blood. After repairing it, there were no more signs of bleeding, and I was able to sew up the incision. She had lost so much blood and had such a low blood pressure that the anesthesiologist wanted her to stay in the hospital until her blood pressure returned to normal. Fortunately, she did very well after surgery and was able to go home the next day and seems to be well on the path to recovery. I am unsure of the medical rationale behind putting the patient on a non-reversible blood thinner given that she was one week out from surgery and did not have an increased risk for blood clots now compared to right after surgery. To this day, I still have not received a copy of the patient’s operative report from the surgeon. While this is an uncommon event, it definitely highlights the danger of medical tourism. When deciding on a procedure and provider, there are many factors to be considered. While cost is important, the amount and availability of care after the procedure as well as trust in the provider are generally more essential.