The Guru of the Dominican Medical Law

Lo siguiente es una reproducción del contenido publicado por Medical Trip Forum: http://medicaltripforum.com/guru-dominican-medical-law/

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As featured in the interview on Planeta Intimo’s radio program, we share some of the important notes highlighted by Dr. Gilberto Objío Subero, the Gurú of the Dominican Medical Law, about facts to consider when seeking medical treatment and in general how the Dominican Republic is facing the nascent industry of medical tourism.

Dr. Gilberto Objío is partner at IurisCorp SRL and manages the medical law division handling cases of demands over healthcare malpractices. The first topic that he addresses during this interview is how can we analyse the cosmetic surgery service in the Dominican Republic?

For patients receiving a cosmetic surgery coming from abroad, they face a Dominican health system lacking of a strong medical law regulations and also on the controls for healthcare centers delivering this service. Patients tend to encounter nocosomial infections in the clinic or hospital where the cosmetic surgery is been performed. Also when patients find themselves in a malpractice situation, doctors in the Dominican health system are not obliged to have a medical insurance with civil responsibility, resulting in unprotected patients needing to hire expensive lawyers when the try to pursue a legal action.

For the responsible of delivering the service, there are clinics that bring doctors and specialists to operate in the Dominican Republic without the Exequatur certification which is the license required to all healthcare professionals both nationals or internationals to work in the country. Without the Exequatur license, the doctor is acting illegally if he’s receiving money in exchange. However if it’s intended to deliver a healthcare service without receiving money as a volunteer or educational purpose, the Ministry of Health in the country can grant a special permission for this matter.

Local patients are also affected when doctors performed all types of cosmetic surgery without being accredited with the Exequatur. Therefore the resolution 00008 of 2015 from the Dominican Ministry of Health is one of the efforts to present a strong medical law regulation establishing that all healthcare professionals without a medical specialization cannot operate in the Dominican territory.

The Dominican Republic is a destination than can well develop the medical tourism industry but it needs an adequate medical law system such as certifying foreign doctors and compelling these healthcare professionals or medical centers to have an insurance of civil responsibility that could cover any physical damages to the patient not included in the informed consent which is a right that the patient has to agree over previous information of the medical procedure. This part is one that commonly is not respected in the Dominican Republic when the doctor does not properly inform the patient about the diagnosis, alternatives treatments, pre and post procedure recommendations, etc.

Other situations also common in the country are medical centers without the certification that permits them to operate as a healthcare facility. A large group of them fail to comply with the prevention protocol for intrahospitalary infections that exist since 2013 for healthcare centers of 50 medical beds and over. This protocol rules that the medical center needs to have an epidemiology surveillance unit. For medical centers with less than 50 medical beds, it must have at least one medical staff assigned for the epidemiology follow-up. Another protocol that is poorly carry out is the one for the asepsis infection although there has been many efforts directed to avoid them. Unfortunately the Dominican healthcare system pays little to professionals that are responsible to design or comply to these protocols. Sometimes healthcare services are offered indiscriminately through non conventional publicity such as Facebook or Instagram.

Dr. Gilberto Objío gives the following recommendations for travelers seeking medical treatment in the Dominican Republic:

1. Verify that the doctor is in fact an specialist of the medical procedure that you’re expecting to get and that is already trained on that field.

2. You can check the above by entering in the Dominican Ministry of Health website, look for the Exequatur option and type the name of the doctor.

3. Choose well the medical center where you’re getting the medical procedure.

4. Do several visits to the doctor.

5. Demand all necessary information about the alternatives and complications associated with the medical treatment.

One common mistake that the medical travelers make is to accept offers to get multiple procedures at once such as liposculpture, liposuction, mamograms implants, among others. There’s the risk to develop a syncope or shock to the patient’s body. Also a bacterial infection could be transferred to the whole patient’s body due to the various incisions and for spending several hours in an infected operating room, leading to an asepsis complication that surely will be more expensive than the medical procedure itself or even resulting in the patient’s death.

Regarding the anesthesia for the cosmetic procedures, at the beginning it was partially applied on the patient’s body. Nowadays and because of the increase of medical law demands, the American Society of Anesthesiologists (ASA) ruled that all procedures must carry out a complete anesthesia on the body and an informed consent needs to be signed confirming specifically that at the moment of receiving the first injection, death could arise.

Finally the medical law demands over healthcare treatments have increased in part because of the level of information that society is handling with the internet and television. Another reason is that since 2004 with the Free Trade Agreement (FTA), the 358 law which serves to protect users and consumers is enacted favoring also medical consumers by strengthen the medical law content in case of demands meaning that with legal texts the patient can required more explicit obligations to the doctors such as appropriate information about damages and the co-responsibility of the medical center with the doctor since is receiving money for allowing the use of his medical facility to perform medical procedures.