Originally Released: September 25, 1997
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Now that you are on your dream vacation, what happens if you have a heart attack in Rome, slip on the deck of a Caribbean cruise ship or get bitten by a snake while bird-watching in a Peruvian jungle?
Tourists can call a toll-free number listed by their credit card or travel service and get help from a University of Maryland Medical Center doctor, no matter where they are. Through their affiliation with World Access Service Corporation -- a Richmond-based provider of insurance and assistance services -- University of Maryland Emergency Department physicians provide medical expertise for travel programs that cover more than 60 million people worldwide.
Three University of Maryland emergency physicians make "rounds" by telephone every morning with specially-trained World Access nurses -- dealing with 15 to 20 cases. They determine the appropriate referrals and transportation needs of injured and ill Americans traveling abroad, often in countries where they don't speak the language and where medical care may not be up to U.S. standards. Foreign travelers, often Canadians and Japanese visiting the United States, use the service as well.
Besides the travelers insured directly through World Access, members of VISA Gold, American Express and the American Automobile Association can use the referral service, which is staffed around the clock by nurses, who are the first point of contact.
"Our goal is to make sure patients are receiving the proper treatment," says Betty Tso, M.D., an emergency medicine specialist at the University of Maryland Medical Center, who is the medical director for World Access. "If they need to be moved to another city or back home, we coordinate the transportation as well. We are also available to family members to explain the type of care their relative needs and how soon he or she can come home," says Dr. Tso.
The team, which directs patients to the best medical care available, no matter where they are traveling, includes Dr. Tso and University of Maryland emergency physicians Michael Rolnick, M.D., Dean Johnson, M.D., Joseph Crisanti, M.D., and David Jerrard, M.D., along with World Access owner Sol Edelstein, M.D.
"This service is especially important for senior citizens, who seem to be increasing their travel and who are at higher risk of having serious health problems," explains Dr. Tso. "As more people are visiting exotic locations, getting competent care when they experience an unexpected injury or illness can become tricky." Dr. Tso reminds travelers that Medicare provides no coverage outside the United States.
The most common problems the physicians have been seeing have been heart attacks, falls, stroke and traffic injuries.
"What we do is manage medical emergencies overseas, directing travelers to the right hospital or specialist," says Dr. Rolnick. "We help get them home or enable their families to travel to see them. We advise patients on whether to stay in the foreign country or come home right away. Our desire is to see that they get to the closest, most suitable medical facility."
The partnership between the University of Maryland Medical Center and World Access began July 1. Among cases already handled was that of a 75-year-old New York woman who became comatose aboard a cruise ship. Through the World Access Assistance Center, Dr. Rolnick arranged for her transfer to a neurological hospital in Austria and for her daughter to fly from the United States to be with her. In another case, a Canadian man touring in Ohio developed a kidney stone. A local physician wanted to operate, but Dr. Rolnick suggested the use of a less invasive stent, a thin tube that keeps passageways open, allowing the stone to pass and the patient to travel home.
The absence of appropriate local medical services, though, can have disastrous consequences for travelers. Dr. Rolnick tells of a man on a bird-watching expedition in a Peruvian jungle who was bitten by a poisonous snake. Local health officials told him to rest for 24 hours in a small clinic in the nearest village before traveling to a major hospital in Lima. By the time he eventually got there, it was too late to save his leg. But a call to World Access could have resulted in arrangements to fly him expeditiously to Lima for a dose of anti-venom.
World Access selected the University of Maryland emergency physicians because of their world-renowned expertise in referral and transport medicine. Locally, the unique Maryland ExpressCare service developed at the Medical Center allows the referring community physician to consult with a specialist and make arrangements to transfer a patient directly to a unit of the hospital with just one phone call, bypassing the emergency department, if appropriate. Special vehicles, which are sent to pick up patients, are equipped with life-support technology and staffed with critical care nurses. ExpressCare has been operating for three years and served 4,300 patients in 1996.
Along with its partnership in helping travelers worldwide, World Access has selected the University of Maryland Medical Center as a center of excellence for patient referrals in the Mid-Atlantic region.
In addition to providing a needed service through World Access, University of Maryland doctors are planning to conduct research to improve outcomes for travel-related medical problems.
For patient inquiries, call 1-800-492-5538 or click here to make an appointment.