Long Waiting Times? Medical Tourism Can Save You

1. Introduction

1.1 What are waiting times?

A waiting time is the length of time between the date a patient agrees to a procedure and is placed on the waiting list, to the date of receiving the service s/he is waiting for.

1.2 Reasons behind waiting times:

Long waiting times can occur due to the following reasons:

1. Poorly organized services
2. Shortages of health care workers
3. Lack of teamwork among physicians

1.3 Why are there variations in waiting times?

The reasons for variations are as follows:

1. Emergency cases: An increase in the number of emergency cases can increase the wait times for non-urgent cases because the sicker patients are cared for first.
    
2. Seasonal variations incapacity: The seasonal reduction in services during peak vacation periods may result in increased wait times.
    
3. Availability of health providers and resources: The availability of health care professionals in the operating room and nursing unit can influence how quickly people receive surgery. Additionally, the unavailability of inpatient hospital beds for surgical patients can be a limiting factor, resulting in postponement or cancellation of elective operations.

1.4 How do long waiting times lead to medical tourism?

It is not uncommon in some countries to have waiting lists for a year or more in length for certain medical procedures. Patients thus rely on medical tourism and travel abroad to countries that offer quicker procedures, to save their time and avoid the aggravation of their medical conditions.

2.  Countries with long waiting times

Among the total number of patients looking for treatment from a specialist, 60% in Britain and 57% in Canada have to wait for at least four weeks before they can even consult with a medical specialist. These countries have the highest percentage of waiting for patients in the world. 

2.1   In some of the highly industrialized countries of the world, patients are prey to the problem of high waiting times in healthcare facilities.

1. Canada has the highest percentage of patients (36%) who have to wait six days or more for an appointment with a doctor.
    
2. Waiting lists for non-essential surgery such as knee reconstructions have been as long as 18 months in the UK, and over 2 years in Australia and Canada.
    
3. 57% of physicians in the U.K. and 51% of Canadian physicians reported that their patients experienced long waits for diagnostic tests.
    
4. The United States had a large percentage of people (61%) who said that getting care on nights, weekends, or holidays, without going to the emergency room, was somewhat difficult. In Canada, it was 54%, in the U.K., 38%, and in Germany, 22%.

All these countries perform poorly, compared to most other industrialized countries, on how long patients have to wait to get a regular appointment with a primary care physician or after-hours care. However, the problem is most acute in the United States.

2.2   Waiting times in the U.S.A:

There is emerging evidence that lengthy waits to get a doctor’s appointment have become the norm in many parts of American healthcare. This includes patients with private insurance as well as those with Medicaid or Medicare.

Waiting times for different medical services here vary greatly by market and specialty. For example, patients have to wait an average of 29 days nationally to see a dermatologist for a skin exam, 66 days to have a physical exam in Boston and 32 days for a heart evaluation by a cardiologist in Washington.

It has also been seen that americans are more likely to wait for office-based medical appointments since they are not good sources of revenue for hospitals and doctors, than any other form of treatment. In other countries, particularly not of the west, people tend to wait longer for expensive elective care.

In the American market-based system, patients can easily undergo lucrative procedures on time, even when there is no urgent medical need, like in the case of a new knee, or an M.R.I., or a Botox injection. However, patients suffering from more acute conditions like asthma, where breathing deteriorates rapidly, or chest pains for an elderly patient who is in need of cardiac consultation, will have to wait weeks for such office appointments.

3.   Procedure-specific leading wait times (OECD Countries)

1. Hip replacement: The Netherlands had the lowest waiting time (42 days) and Portugal had the highest (178 days).
    
2. Knee replacement: The Netherlands had the lowest waiting time (42 days) and Slovenia had the highest (512 days).
    
3. Cataract: The Netherlands had the lowest waiting time (35 days) and Ireland had the highest (144 days).
    
4. Hernia: The Netherlands had the lowest waiting time (36 days) and Portugal had the highest (120 days).
    
5. Coronary Artery Bypass Grafting: Denmark had the lowest waiting time (19 days) and England had the highest (63 days).

       *The data considered is of the year 2012.

4. Dangers of delaying certain medical procedures

Since time is of the essence in most medical treatments, delaying essential medical procedures can lead to aggravation of existing medical problems. Some of the dangers in the context of specific medical treatments have been described below:

1. Dangers of delaying hip-replacement surgery:

The risks associated with delaying this surgery include deterioration of the hip joint, increased pain, and lack of mobility. Also, the possibility of undergoing less invasive methods of surgery, such as hip-resurfacing, is no longer an option for the patient.
 

 Dangers of delaying hip replacement surgery include stiffness of joints, weakness in muscles, and worsening of joint deformity.

2. Dangers of delaying root canal:

Deep inside the tooth of a human being, there is a spongy core called the tooth pulp, that contains nerves and blood vessels. When a human diet gets high in foods that attract and nurture bacteria, the pulp becomes infected. This condition requires a root canal procedure.

Delaying a root canal treatment can lead to the destruction of the pulp inside a tooth, resulting in tooth loss. It can also lead to an abscess near the root or tip of the tooth that can be excruciatingly painful, cause swelling of the face or neck, lead to bone loss in the jaw, or actually create a hole in the gum or cheek area that will leak pus and other fluids.

Postponing a root canal procedure can also lead to a serious condition called septicemia, a localized infection (like an infection inside a tooth) that spreads to other areas of the body like the heart, brain, or lungs. Although rare, septicemia can be life-threatening.

3. Dangers of delaying Hepatitis C treatment:

Hepatitis C causes inflammation in the liver. Without treatment, the inflammation can create permanent scar tissue called cirrhosis, which can ultimately lead to liver failure. According to the American Liver Foundation, people with hepatitis C are also at increased risk of developing liver cancer. 

4. Dangers of delaying hernia surgery:

All hernias get larger over time. This is called progression. A small hernia is easier to fix and the recovery is shorter compared to a large hernia.

Delaying surgery for this reason usually only allows the hernia to grow larger and exposes the patient to the risk of strangulation, wherein an incarcerated hernia may cut off blood flow to part of the patient’s intestine. 

5. Countries with low waiting times

The rapid movement of patients across the globe to avail of medical treatment on time is possible due to the presence of exceedingly low wait times in certain countries.  

1. Thailand and India are two south Asian countries that have almost instantaneous knee reconstruction surgeries.
    
2. France, Germany, and Belgium have short waiting times for hip replacement and cataract surgeries.
    
3. The United Kingdom and Finland have experienced large reductions in waiting times from a relatively high level in the early 2000s.
    
4. Ireland has witnessed considerable reductions in waiting times of patients on the list for orthopedic treatment, prostatectomy, and cholecystectomy.
    
5. In several Asian nations, patients are able to reduce the wait time of elective surgeries like nose jobs and also hip and knee replacements, while also saving considerable costs.