Letters to the Editor
Physicians Should Conduct Pretravel Consultations
Am Fam Physician. 2010 Feb 15;81(4):401.
Original Article: The Pretravel Consultation
Issue Date: September 15, 2009
Available at: http://www.aafp.org/afp/2009/0915/p583.html
to the editor: I read with interest the article on pretravel consultation. The authors provide an excellent overview of travel medicine and many of the topics that should be included in a pretravel consultation. I agree that family physicians are ideally suited to perform travel-related medicine and hope that this article will encourage other family physicians to provide this service.
Travel consultations are not billable to insurance. Patients should be informed that they will have to pay out-of-pocket for these services and applicable vaccinations. In our office, we charge $55 for the office time spent in consultation, watching a video on travel safety, and for customization of a handout based on the patient's itinerary. Our office is certified by the state to administer the yellow fever vaccination. Information on how to become a yellow fever immunization provider can be found through your state's department of health and the Centers for Disease Control and Prevention.1
The authors' presentation of topics that should be covered in a travel medicine evaluation was comprehensive. Combined with wearing insect repellent and sleeping under permethrin-impregnated bednets, permethrin treatment of clothing has also been shown to significantly decrease malaria transmission2 and can easily be performed before packing clothes in a suitcase.
For patients who take daily medications, one useful recommendation3 is to pack extra doses of each of their medicines and place them in separate suitcases so that if one bag is lost or stolen they will not be without their medications. Also, patients should create a list of the generic names and doses of their medications and keep a copy in each bag. Many medicines are sold under different trade names in different countries, but generic names are more consistent.
1. Centers for Disease Control and Prevention. Frequently asked questions about the U.S. yellow fever vaccination center registry. http://wwwnc.cdc.gov/travel/content/yellow-fever-registry-faq.aspx#notcert. Accessed September 24, 2009.
2. Kimani EW, Vulule JM, Kuria IW, Mugisha F. Use of insecticide-treated clothes for personal protection against malaria: a community trial. Malar J. 2006;5:63.
3. Beran RG, Docking J. Travelling with medications—some lessons learned. Aust Fam Physician. 2007;36(5):349–351.
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