This Low-Key Travel Medical Assistance Company Could Save Your Life When You’re On Vacation
If you get sick on your next trip — really sick — you’ll probably never see Eugene Delaune. But chances are, he and his partner, Jim Evans, will be behind the scenes, advising your travel insurance company on how to treat you. Their travel medical assistance company could even save your life.
Delaune and Evans are ER physicians who run a low-key consulting business called SentinelMED that advises insurance companies on critical medical decisions. They’re the guys on call when something goes seriously wrong on vacation, from a car accident to a heart attack.
These doctors have seen it all. Travelers with gunshot wounds. Diabetics trapped at an airport during a riot. Patients with acid burns from a volcano eruption. Terminally ill travelers dying overseas. All told, they handle an average of 600 cases a month for their biggest client, Allianz Travel Insurance.
But nothing could have prepared them for the pandemic, an event that stretched them to the limit of their abilities. Even as the number of monthly cases dropped to just 150, SentinelMED’s team of doctors and nurses had to become experts on the rules and regulations of pandemic travel — a constantly moving target that doubled the difficulty of every medical problem.
“COVID made us more adaptable,” says Delaune.
As the pandemic begins to fade, travel medical assistance experts like Delaune and Evans are playing a key role in restoring confidence in travel. Their recent experiences are both a cautionary tale and a roadmap for anyone who plans a vacation this year.
Travel medical assistance: a rare specialty
The doctors and a small support team working out of an office in Alexandria, Va., have a rare expertise: They specialize in treating people with serious health problems while they’re traveling. Only a handful of other consulting companies — including AP Companies, International SOS, and Redbridge Assist — do this type of work.
Delaune, a former Air Force flight surgeon, honed his skills with tours of duty in Germany and Iraq. He had to make decisions about how to treat wounded soldiers. But he also learned how to transport critically ill patients.
There are factors that wouldn’t occur to even some experienced medical professionals. For example, can you fly a patient with a heart condition internationally? Aircraft cabins are pressurized to 8,000 feet above sea level, which lowers the amount of oxygen in the blood by about 8 to 10 percentage points.
“You’re only getting 92 percent oxygen saturation,” explains Delaune. “If you have a cardiac condition, that’s not enough to keep your heart beating.”
Delaune taught Evans at George Washington University’s emergency medicine residency program. Evans was fascinated by the medical transportation subspecialty. Like Delaune, he saw an opportunity to help travelers get home safely. They decided to start SentinelMED together.
Helping on “M3” cases
Although both doctors continue to practice as ER physicians as part of a travel team of emergency doctors with American Physician Partners, their main focus is on helping with the most complex travel medicine problems, referred to internally as “M3” cases.
Every morning, Allianz sends them their most difficult files. These are medical issues that require someone with travel medicine experience to weigh in. “Should someone get treatment in a local hospital or be moved?” says Delaune. “How should they be moved? And to where?”
Allianz keeps the patients anonymous, showing only their age, gender and medical condition. Typical cases during an average day might include travelers with fractures, cardiac arrests, animal bites — and some unexpected injuries.
Delaune recalls a patient in Belize who suffered an eye injury and then went missing. His team tracked her down and got her medical attention.
“We were surprised to discover that her eye injury was, in fact, a gunshot wound,” recalls Evans.
Another memorable travel medical assistance case involved an overweight traveler who was too large to be airlifted to a hospital from the Bahamas. SentinelMED helped charter a barge that could transport him back to Miami.
The last hurrah and acid burns
There’s a genre of cases that the doctors refer to as “the last hurrah.” It’s someone who is elderly or has a terminal illness, going on one final vacation. Delaune remembers one cancer patient who fell into a coma while in Italy. It was clear he would never wake up and had hours to live. His wife had to decide whether to resume her cruise or stay with her husband. Remarkably, she decided to continue her vacation, leaving instructions to have her spouse cremated.
Some cases involve mental illness. There was the couple who couldn’t leave Brazil because of a riot at the airport. One of the travelers began to experience complications from his diabetes and had to be treated at a hospital. In the meantime, his wife suffered a mental breakdown and was sent to a different hospital. The two had to be evacuated separately.
One of the most horrifying medical issues involved a 2019 volcanic eruption at White Island in New Zealand. The hydrofluoric acid gas emitted from a volcano attached itself to ash particles, which fell on a group of tourists. Hydrofluoric acid is powerful enough to eat through glass. It chewed through skin, flesh and bone.
There’s no antidote for hydrofluoric acid toxicity. Instead, doctors try to mitigate the damage by administering massive doses of intravenous and local calcium. The patients survived.
The SentinelMED doctors are there mainly in an advisory capacity, so they recommend patient dispositions and then work with the travel insurance company and physicians on the ground to help the patients get home. But sometimes, the SentinelMED physicians get directly involved in a resolution, using a team of trained nurses to help with medical evacuations.
How the pandemic changed travel medical assistance
Hard as it may be to believe, these cases were relatively straightforward compared to the challenges Delaune and Evans encountered during the pandemic. Each country had a list of strict and ever-changing requirements for entry, exit and quarantine. What should have been simple medical evacuations suddenly became time-consuming cases. Some patients couldn’t just leave the country. SentinelMD had to make arrangements for quarantine and COVID-19 tests. They had to seek special permission from governments or airlines to transport patients.
“We had to make sure every I was dotted, every T crossed,” says Delaune.
The pandemic has also underscored the value of travel insurance, he adds. In some countries, hospitals won’t even admit you unless you fork over a credit card. Travel insurance can help by dealing directly with the facility and guaranteeing payment. Insurance is also far less costly than having to hire a company like SentinelMED directly. Even something as simple as a broken arm or appendicitis can set you back $50,000.
For major surgery and ICU care, costs can be in the hundreds of thousands of dollars. SentinelMED’s services can range from $6,000 up to over $100,000 when an air ambulance is needed.
The latest Allianz Vacation Confidence Index suggests travelers remain nervous even as they begin planning more trips. Spending for summer vacations this year will reach $153 billion, which is a 160% increase over last year and a 50% increase over 2019. But 44% of those who prefer not to travel say it’s because they’re still concerned about health and safety.
Travel medical assistance companies like SentinelMED can address, but not eliminate, some of those concerns.