As health care costs rise and incomes fall, Americans are heading abroad for affordable surgical procedures or therapies not available in the United States.

Books, websites and organizations tout medical tourism as health care plus a vacation. And insurance companies may one day cover these way-out-of-network procedures. But some doctors advise caution.

“Get all the facts,” says Lalita Kaul, PhD, professor of nutrition at Howard University Medical School in Washington, DC. “Research the doctor as well as the institution offering the procedure—including accreditation and post-surgical care.”

Terrence Fullum, MD, chief of Minimally Invasive and Bariatric Surgery at Howard, advises patients to seek reputable hospitals and doctors with publications and credentials linked to universities or to American institutions. “Find an open-book place that shares experiences and points you to other sources for references,” he says.

Some common-sense starting points:
Don’t expect to go under the knife and fly home the next day. It can be risky to combine surgery with long flights or vacation activities.

Do check with a respected organization to determine whether a foreign medical institution is accredited. Fullum suggests these: the American College of Surgeons (800.621.4111;, the International Society for Quality in Health Care (353.1.871.7049; and the Joint Commission International (630.268.4800;

Don’t make decisions in haste, Kaul adds, or you could end up spending a bundle (not to mention time and discomfort) to correct unnecessary mistakes. Some vacation!