In my ER I am running into more and more of these people who have gone to Mexico for elective surgeries. The latest seems to be this Swedish band adjustable gastric banding procedure to lose weight. In the past it's been all sorts of other cosmetic stuff. My understanding is that the surgeons are usually Americans or Europeans who are doing this in Mexico to avoid the FDA, malpractice and they do it on a cash fee basis. My issue with it is that when these people come back and have complications they come to the ER. It's almost impossible to get a surgeon to come and see them. They are told by their docs (in Mex) to just "Go to the ER." which is a growingly popular phrase in general. I think it's unethical to do surgeries like this and not provide any follow up other than "Go to the ER." I'm guessing lots of us in the southwest see this. Thoughts?