You're heading to Brazil and wondering whether you need a yellow fever vaccination. Or you're bound for Vietnam and curious about the threat of malaria. Or you'll be boating in Burkina Faso and are worried about the quality of medical care there, should you need it.
A family doctor might be savvy enough to answer these kinds of travel-related health questions, but you still may want more help. You may want a travel medicine specialist.
Less than 20 years ago, the field of travel medicine was virtually nonexistent, says Bradley Connor, a New York gastroenterologist and travel medicine specialist who heads the International Society of Travel Medicine. ISTM had about 200 members when it formed in 1991 but has grown to 2,400 members.
The reason for the growth?
"Now people are going to the Amazon, on eco-trips, on safari," says Mahmood Peshimam, a Fountain Valley family practice doctor and travel medicine practitioner. He says people are using the Internet to find doctors who treat travelers.
But what qualifies someone as a travel medicine specialist? The truth is that any physician can declare himself an expert. Connor says travel medicine is not a "boarded" medical specialty. A dermatologist, for instance, can be certified by the American Board of Dermatology.
Instead, many travel medicine physicians belong to Connor's organization or the American Society of Tropical Medicine and Hygiene, a 3,000-member group formed in 1951. Its focus is narrower, concentrating on tropical medicine and diseases.
The travel medicine society and the tropical medicine organization say they issue certificates to members who pass a rigorous exam. The travel medicine certificate is new. Only 300 have been issued since the first exam was administered in 2003, Connor says. Both organizations' websites (www.istm.org and www.astmh.org) list members and indicate which ones have earned certificates.
Here are tips from Connor and Brian Terry, a Pasadena physician who offers travel medicine services and recently earned the ISTM certificate:
* Decide whether your family doctor will suffice. For most domestic travel, a specialist probably isn't necessary, Connor says. But travelers going to developing countries or dealing with chronic medical conditions such as heart problems may benefit from a specialist, he says.
* Decide whether you need a travel medicine specialist or tropical medicine expert. "Travel medicine specialists [often] deal with travelers before they go," Terry says. The emphasis is on preventing or avoiding diseases. Tropical medicine experts do the same, he says, "but are often more interested in what happens when you come back, crawling with parasites."
* Ask how long the specialist has been offering travel medicine services. Connor suggests a minimum of three to five years.
* Ask what percent of the practice is travel medicine. "If anyone is doing 30% or more of their practice in travel medicine, they are pretty immersed," Terry says.
* Ask whether the doctor is board certified in a primary field, such as emergency medicine, internal medicine or infectious disease, Connor says.
An unscientific survey of Southern California travel medicine specialists showed that they generally charge $40 to $85 for an office visit. Vaccinations cost extra. These fees are sometimes covered by standard health insurance. But spending a couple of hundred dollars before the trip might pay off in good health after your return.
Kathleen Doheny can be reached at kathleendoheny