Ramifications of Canadian having surgery in U.S.

April 18, 2021 12:00 PM

Asking for a friend. He is 72, lives in Toronto, needs a hip replacement badly, is in great pain. Covid has made the possibility of hip replacement surgery an intolerable wait in Ontario. He wants to go to Buffalo, for example, to have it done. He understands it to be about $50,000.00 but he is well-off, able to afford it without impacting anyone else.

He's had only the first shot of Pfizer, but is prepared to quarantine on both sides of the border.

Are you a Canadian who has opted for surgery in the United States, or do you have any personal or professional experience of it? Please tell me the downsides, what he isn't considering. Thank you.

posted by uans to Health & Fitness (9 answers total)

He should consider post-op life. Who will pick him up after the surgery, where will he stay? Will he need physical therapy soon afterwards? Where will he do that—here or Canada? Can he do it in Canada in a timely manner? Where/how will he do follow-up in general with the surgeon?

Also, who will complete pre-op clearance for surgery? And if the surgeon wants imaging, where will he get that done?

Also, if he’s paying cash he should consider many places will do a cash-pay discount—just something to consider as he’s looking at centers and physicians.
posted by namemeansgazelle at 12:23 PM on April 18, 2021 [1 favorite]

Best answer: If you haven’t already, doing a search for “medical tourism” or “medical travel” might turn up some resources.
posted by amanda at 12:25 PM on April 18, 2021

Response by poster: Would a doctor here be willing to look after another doctor's surgery? That's what I wonder.
posted by uans at 12:40 PM on April 18, 2021

Best answer: Would a doctor here be willing to look after another doctor's surgery?

Does your friend have a GP? If so, this is a question that your friend should ask their GP. If not, I'm kind of thinking that your friend should plan to stay in the U.S. for the duration of his recovery.

The reason that hip replacement surgery is currently an intolerable wait in Ontario is that hospitals are literally out of space (and more importantly, doctors and nurses) due to the catastrophic third wave of COVID. If "looking after" happens to require hospital care within the next couple of months, your friend could very well be denied it simply due to (catastrophic, unprecedented) lack of capacity.
posted by heatherlogan at 1:11 PM on April 18, 2021 [4 favorites]

My Canadian friend gets care for her complex eye condition, which has included multiple corneal transplants, in the U.S. The biggest issue she's had is that many Canadian eye doctors get super snitty about seeing anyone who's also getting care in the U.S.--less of a problem normally, but now when she'd prefer to avoid crossing the border for routine care (and presumably the government would share that preference!), it's been a bit of a pain.

Given the hospital situation as I understand it in Ontario, if I were doing this, I'd definitely plan to do any post-operative care or rehab in the U.S. I would think doing pre-operative testing in the U.S. wouldn't be a huge barrier. Arranging for a skilled nursing facility or private rehab + appropriate place to stay afterwards might be more involved.
posted by praemunire at 7:02 PM on April 18, 2021

Best answer: In terms of cost, he should have a back-up plan in the event that he experiences a major surgical complication i.e., VTE (DVT or PE), surgical site infection, cardiac complications, intra-operative fracture. All will typically result in a longer inpatient stay, and of course that involves extra diagnostic testing and treatment, care, sometimes additional surgery.

No personal experience but I work in orthopedic research and do lots of work on hip/knee replacement and outcomes.
posted by lulu68 at 7:37 PM on April 18, 2021 [2 favorites]

Best answer: Please read (and/or encourage your friend to read) the following article detailing the triage protocol that Ontario hospitals are "a few bad days away" from having to implement.
posted by heatherlogan at 8:25 AM on April 19, 2021

We had a friend who had a degenerating disk in his neck (!yikes!) and went to Stuttgart, Germany because some super specialist there was... fixing that. It cost him a fraction of what it would have cost in the US - like a tenth or less. And the surgery was a big success and he had no problems afterwards.

I'm not sure what the status is with Corona travel to Germany from Canada right now - but it will likely open up this summer (as it did last summer) and - that's my suggestion.
posted by From Bklyn at 11:51 AM on April 19, 2021

I have a friend who did something similar (both knees), going from Canada across the border to get her surgery in Ann Arbor, Michigan.

She had imagined the experience was going to be a little like a spa vacation, but with her two-week stay at a rehab center post-op, where she did physical and occupational therapy, she said she might as well have been in any industrial building in any city in North America. I think she felt a bit cheated out of a few nice weeks in Ann Arbor.

All of that is to say that, if I had to pick a US city where I would not feel cheated by having to stay indoors or on my back, it's Buffalo.
posted by yellowcandy at 12:18 PM on April 19, 2021 [1 favorite]