چکیده (انگلیسی):

Background:Recent trends document growth in medical tourism, the private pursuit of medical interventions abroad.
Medical tourism introduces challenges to decision-making that impact and are impacted by the physician-patient trust
relationship—a relationship on which the foundation of beneficent health care lies. The objective of the study is to
examine the views of Canadian family physicians about the roles that trust plays in decision-making about medical
tourism, and the impact of medical tourism on the therapeutic relationship.
Methods:We conducted six focus groups with 22 family physicians in the Canadian province of British Columbia.
Data were analyzed thematically using deductive and inductive codes that captured key concepts across the
narratives of participants.
Results:Family physicians indicated that they trust their patients to act as the lead decision-makers about medical
tourism, but are conflicted when the information they are managing contradicts the best interests of the patients. They
reported that patients distrust local health care systems when they experience insufficiencies in access to care and that
this can prompt patients to consider going abroad for care. Trust fractures in the physician-patient relationship can arise
from shame, fear and secrecy about medical tourism.
Conclusions:Family physicians face diverse tensions about medical tourism as they must balance their roles in:
(1) providing information about medical tourism within a context of information deficits; (2) supporting decision-making
while distancing themselves from patients’ decisions to engage in medical tourism; and (3) acting both as agents of the
patient and of the domestic health care system. These tensions highlight the ongoing need for reliable third-party
informational resources about medical tourism and the development of responsive policy.