Requirements for Bringing Medical Supplies, Equipment, and Drugs into Mexico

  by 


When flying or driving into Mexico, travelers are allowed to bring in certain medications, but others are prohibited. It is illegal, for example, to bring in certain common over-the-counter medicines, such as inhalers and some some allergy/sinus medications. Products that contain stimulants are prohibited, specifically medicines that contain pseudoephedrine (such as Actifed, Sudafed, and Vicks inhalers) or codeine. This is largely because the ingredients can be used to manufacture street drugs.

All prescription-level medicine (even if approved) must be accompanied by a current signed prescription from a medical professional.

Medical Tourism in Mexico Costing Canada Plenty

  by 


Millions of taxpayer dollars are being spent in Canada repairing botched stomach-shrinking surgeries performed outside the country, suggests new research into the growing phenomenon of bariatric medical tourism. Researchers who surveyed Alberta surgeons estimate that that province alone is spending a minimum of $560,000 annually treating complications in people who have traveled to Mexico and other destinations for cut-rate bariatric surgery.

Doctors say abysmally long wait lists in Canada for virtually the only obesity treatment proven to provide long-term weight loss is driving people out of the country for surgery. Yet most don’t receive coordinated, long-term post-surgery care.

When things go wrong, Canadian doctors and surgeons are left to treat them. And their care is entirely funded by the public purse.

Medical travel companies and websites are luring obese Canadians with offers of discount prices, private drivers for pre-op “shopping and sightseeing,” and post-op recovery in four-star resorts. Clinics in Tijuana are offering surgeries such as Roux-en-Y gastric bypass, where the stomach is stapled down to a small pouch about the size of a golf ball, for as little as US$5,900. In Canada, the same surgery at a private clinic can cost $19,500.

But many medical tourists are returning home with potentially catastrophic complications, including anastomotic leakages, where intestinal contents leak through surgical staples into the abdominal cavity, increasing the risk of life-threatening sepsis.

“It’s almost like your stomach ruptures,” says Dr. Shahzeer Karmali, an associate professor of surgery at the University of Alberta, and one of the authors of the newly published paper.

Complications can be a nightmare to manage and repair “because we don’t really know what they’ve had done,” Karmali says. “There’s no real operative report; we don’t know exactly what happened elsewhere. It’s hard for us to figure out what was done, and how to fix it.”

One woman in her 20s who underwent surgery in Mexico had to have “essentially her entire stomach,” as well as part of her esophagus, removed, he says.

She will need to be fed through a feeding tube for the rest of her life.

Despite increased funding in Ontario and other jurisdictions, wait lists average five years across Canada. Only 1 percent of eligible patients are offered access to surgery. “Consequently, many patients turn to medical tourism despite potentially severe complications,” the Alberta researchers write in the Canadian Journal of Surgery.

Earlier work by the same group estimated a complication rate of 42 to 56 percent for out-of-country weight-loss surgery. In Canada, unplanned re-admission to a hospital within 30 days of bariatric surgery was 6.3 per cent in 2012-2013, according to the Canadian Institute for Health Information.

Karmali says Canadians living with obesity are being shortchanged because of lingering stigma and bias. “The stigma is that these people just eat too much and don’t exercise enough and they can fix themselves,” he said. “The reality is, it’s a significant problem and when people become severely obese it is very hard to ‘fix.’” Surgery not only improves weight and overall life expectancy, it helps reduce the drain on the health-care system and economy.

A Senate committee report released this month pegged the cost of obesity at upwards of $7.1 billion a year in health care and lost productivity. The committee made 21 recommendations to combat obesity, from overhauling Canada’s food guide to banning food advertising to children. But it was silent on reducing wait times for bariatric surgery.

Karmali and colleagues surveyed Alberta general surgeons to estimate the cost of revision surgery, ICU stays, and other interventions to treat complications in “BMTs” — bariatric medical tourists. In all, 25 doctors responded to the survey. Together they treated 59 out-of-country surgery patients in 2012-13.

Complications included slipped bands, leaking, abscesses and blood clots. The estimated average cost per medical tourist was just under $10,000 — an “extremely conservative estimate” that doesn’t include total hospital stay, blood work, nursing care, and other costs.

By comparison, the average cost of bariatric surgery performed in Alberta public hospitals was just under $14,000. “Alberta does not seem to save much money by limiting the annual volume of bariatric surgeries,” the authors write.

Studies suggest bariatric surgery accounts for a growing proportion of Canadian medical tourism, with Mexico one of the most popular destinations.

According to Statistics Canada, one in four adults in Canada — more than six million people — are obese.

Source: National Post

Ignorance Can Be Dangerous To Your Health

  by 


Ignorance is not bliss when it comes to choosing doctors in Mexico. In fact, ignorance can be dangerous to your health. “Common knowledge” among the expat community is that private doctors are the best doctors in Mexico. But, in fact, public hospital doctors are generally the best trained and most likely to be up-to-date on the latest in medical education.

The wonderful private specialist you love is also likely to spend part of his or her time in Seguro Popular, Mexico’s public health insurance plan. To understand why private and public care overlap, it is important to understand how doctors are trained in Mexico.

Unlike the US and Canada, any student with the grades and test scores to become a doctor gets their medical education paid for by the Mexican government. New doctors repay the government for their education by giving at least 2 years back to the system by working in a Seguro Popular hospital or clinic.

Medical education in Mexico also starts actual patient care earlier than US training. “Hands-on” medical training is usually in a Seguro Popular hospital under the supervision of doctors from the medical school—who also practice at the Seguro Popular hospital. This adds several additional years of service by the medical student to the universal health care system.

New medical school graduates performing their 2 years of required Seguro Popular service are also allowed to work a percentage of time in the private sector. One young doctor told me, “We have to eat and take care of our family. Working in private practice part of the time makes it easier to survive.” This combination of public and private practice is a pattern that many doctors in Mexico continue with throughout their medical careers. This means that the private doctor you love is often the same doctor you will see in Seguro Popular hospitals.

This was clearly the case when a good friend of mine was having surgery at one of the most expensive private hospitals in Guadalajara. He was due to be released, and his private doctor suggested that the anesthesiologist remove the saddle block that had been used in his surgery, since the private doctor was not completely comfortable with removing the block. He was surprised when his private doctor informed him that the anesthesiologist was in the middle of a surgery at Hospital Civil Viejo (a Seguro Popular hospital), which now has one of the most modern cardiac operating theaters in Mexico, and that she would be there as soon as that surgery was complete.

In another example, a leading cardiologist at Hospital Civil Nuevo (a Seguro Popular hospital) could not get an emergency heart patient in surgery because the cardiac suites were completely booked. Since he was also on staff at a well-known private hospital, he arranged or Seguro Popular transport to the private hospital, where he did the emergency procedure.

Hospital affiliation, particularly public hospital affiliation, is an important credential when you are looking for a doctor. It means that that doctor is required to meet requirements for continuing medical education. Doctors in strictly private practice have no such requirement, and they may or may not be certified in their specialty, or be up-to-date on medical training. The editor of Lake Chapala Reporter recently did an article here on choosing a doctor, and you should definitely take a closer look at her findings.

This reality was brought home by a pulmonologist with Hospital Civil Nuevo, which is a Seguro Popular hospital affiliated with the University of Guadalajara Medical School. He was very frustrated that he was seeing patients from Lakeside with fungal infections of the lungs that had been previously treated by Lakeside private doctors. He explained that we live in a semi-tropical climate where fungus infections are very common. In fact, he said that as many as half of the pulmonary infections in our area are caused by fungus, and are not bacterial or viral in origin. “Doctors at Lakeside seem to just write a prescription for Cipro when they see a lung infection, and never consider the respiratory infection might be caused by a fungus”, he said. “I never hear that Lakeside private doctors tested to find the cause of the lung infection.”

A physician at a private clinic at Lakeside spent her time in medical school, as most students today do, working at a Seguro Popular hospital. Since she was a recent medical school graduate, she did not have the prejudices of some older physicians and clinic staff who really know very little about Seguro Popular. She commented that all of her professors and supervising doctors divided their time between the medical school, a Seguro Popular hospital, and private practice.

She asked what could be done for her patients who don’t have the resources for a private specialist or surgery or treatment at a private Guadalajara hospital. She did know about the new Seguro Popular (SP) hospital in Jocotepec, but didn’t realize they provided ambulance and helicopter service for patients to the hospital, and to Guadalajara, if needed. I provided her with information on the 066 emergency number, the services provided in Jocotepec, and the newly available free translation services. If this young, well-informed recent graduate knows so little about SP resources at Lakeside, what are the chances a private Lakeside doctor knows much about the available options for universal health care (which was first available on a limited basis as far back as 2003)?

A new insight was provided by the Chairman of the Endocrinology Department at the University of Guadalajara Medical School, who also sees patients in his specialty at a Seguro Popular hospital. He is Mexico’s only representative in his specialty to the United Nations. He is also one of the seven doctors on the United Nations panel that provides treatment recommendations in his specialty, and he is in demand around the world as a speaker. He has recently published papers on his specialty in Singapore, South Africa, and Denmark.

When asked why he continued to see patients in Mexico’s universal health care system, he said “It is certainly not for the money. The public system pays very little, which is why most SP doctors also maintain a private practice.” He then pointed out that in Mexico, doctors in the public sector are the ones who have political clout. “If you are active in the public system you can make a real difference in the decisions about medical training and patient care in Mexico and around the world.”

The next time you hear others bashing universal health care in Mexico and “government doctors,” you will know how ignorant that are about health care in Mexico. Their opinions are based on lack of information and prejudices from other places they have lived. Share what you now know about medical training and universal health care in Mexico. You may save a life!