The Dominican Republic has been a medical tourism destination for years without much of a rulebook. That’s starting to change.
On September 3, the country’s Senate approved legislation that would formally recognize health tourism as a national priority and build a regulatory structure around it. The bill still has to clear the rest of the legislative process before it becomes law, but its passage through the Senate is the clearest sign yet that officials want real control over an industry that’s mostly grown on its own so far.
And it has grown. In 2023, roughly 338,000 people traveled to the Dominican Republic for medical or dental care, generating more than $1.4 billion for the economy. A 2020–2021 Medical Tourism Index ranked the country No. 1 in the Caribbean and 19th out of 46 destinations worldwide. Those aren’t small numbers for a country of about 11 million people.
What the bill actually creates
The legislation builds on a national strategy President Luis Abinader laid out in a 2021 decree. It sets up two new bodies: a Health Tourism Advisory Council, housed inside the Ministry of Public Health, and a National Health Tourism Development Fund, run by the Ministry of Tourism. One is meant to set standards. The other is meant to pay for meeting them — new equipment, staff training, marketing campaigns — the kind of spending aimed at keeping patients from booking a flight to Mexico or Costa Rica instead.
Three industry groups helped shape the bill: the Dominican Republic Hotel and Tourism Association, the National Association of Private Clinics and Hospitals, and the Dominican Health Tourism Association. Their fingerprints are visible in the bill’s stated priorities — quality, international accreditation, investment, technology, and public-private coordination. Patient safety is on that list too, and it’s not there for decoration.
The safety record behind the urgency
Here’s the part of the story that explains why “patient safety” made it into a tourism bill at all.
In a report published through its Morbidity and Mortality Weekly series, the U.S. Centers for Disease Control and Prevention tracked 93 American deaths linked to cosmetic surgery in the Dominican Republic between 2009 and 2022. Most of the procedures involved liposuction combined with fat transfer to the buttocks, a combination commonly known as a Brazilian butt lift. Of the cases where autopsies were available, fat embolism showed up in 11 and blood clots that traveled to the lungs showed up in seven. Every autopsied case showed a surgical complication of some kind.
The CDC’s advice was blunt: “U.S. citizens interested in receiving elective cosmetic surgery outside the United States should consult with their health care professionals regarding their risk for adverse outcomes.”
That report didn’t stop Americans from booking these procedures. It’s a big part of why regulators are acting now instead of waiting for the next one. A council with the power to set accreditation standards, and a fund to help clinics actually meet them, is a direct response to years of headlines the country would rather not keep generating.
Why patients keep coming anyway
Cost is the simple answer. A 2022 industry estimate put average patient spending — surgery, hotel, meals, transportation — at around $7,500, roughly 60% less than comparable care in the U.S. or U.K. Dental work makes up more than half of all visits; cosmetic surgery accounted for around 40,000 patients that year alone.
The targets show how far officials want to take this. Official goals call for 500,000 medical tourists annually by 2028 and more than a million by 2043 — a scale that would put the Dominican Republic in direct competition with far larger markets like Thailand and Turkey. One Dominican facility has already earned accreditation from Global Healthcare Accreditation — a credential aimed at patients looking for more assurance than a low price tag alone.
The regional race is already on
The Dominican Republic isn’t the only Caribbean or Latin American country chasing this money. Costa Rica has spent over a decade building a reputation for dental and orthopedic care. Mexico’s border cities have long drawn Americans for cheaper prescriptions and cosmetic work. Colombia markets itself hard on plastic surgery. Accreditation, increasingly, is how these countries try to separate themselves from each other — a certificate that tells a nervous patient in Ohio that the clinic they found through Instagram has actually been checked out by somebody.
Whether this bill changes outcomes for patients, or mainly changes how the industry is marketed, will depend on how COTSA and FONDETUSA are funded and staffed once the law clears its remaining steps. For now, the Dominican Republic has a Senate vote, two new institutions on paper, and a safety record it’s under real pressure to fix before the next CDC report comes out.