Treatments undertaken by United States tourists include dental care, cosmetic, orthopaedic and cardiovascular surgery. The Committee was informed about a comparison of the price of care for selected procedures in the US, India, Thailand and Singapore. The American Medical Association (AMA) guidelines for patients travelling overseas for medical care were as follows: . Medical care outside the US should be voluntary; . Financial incentives to go outside the US for care should not inappropriately limit diagnostic and therapeutic alternatives, or restrict treatment or referral options; . Financial incentives should be used only for care at institutions accredited by recognised international accrediting bodies; . Local follow-up care should be coordinated and financing arranged to ensure continuity of care; . Coverage for travel outside the US for care must include the costs of follow-up care upon return; . Patients should be informed of rights and legal recourse before travelling outside the US for care; . Patients should have access to physician licensing and outcomes data, as well as facility accreditation and outcomes data; . Transfer of patient medical records should be consistent with Health Insurance Portability and Accountability Act (HIPPA) guidelines; and . Patients should be provided with information about the potential risks of combining surgical procedures with long flights and vacation activities.