Cosmetic Surgery Tourism Arbitration — Detailed Explanation with Case Laws 1. Meaning and scope

Cosmetic surgery tourism arbitration refers to the resolution by arbitration of disputes arising when a patient travels from one country to another for elective aesthetic or cosmetic treatment and the treatment, related services, payment arrangements, or after-care generate a dispute.

Typical procedures include:

liposuction;

rhinoplasty;

breast augmentation or reduction;

abdominoplasty/tummy tuck;

facelift;

blepharoplasty;

hair transplantation;

body contouring;

gluteal augmentation;

cosmetic dental or facial procedures; and

revision surgery.

The legal problem becomes substantially more complicated when the patient, medical facilitator, clinic, surgeon, insurer and post-operative doctor are located in different countries.

Medical-tourism literature specifically identifies plastic and cosmetic surgery as a significant component of cross-border medical travel and highlights jurisdiction, choice of law, enforcement and continuity-of-care problems. (Journal of Ethics)

Importantly, there is not yet a large body of reported decisions specifically titled “cosmetic surgery tourism arbitration.” Consequently, the most useful authorities fall into three categories:

direct cosmetic-surgery arbitration cases;

medical-tourism/cross-border cosmetic-surgery cases; and

general arbitration and medical-malpractice authorities that determine how such disputes are handled.

2. Why cosmetic surgery tourism creates special arbitration problems

A domestic cosmetic-surgery dispute is comparatively straightforward: patient, surgeon, clinic, treatment and evidence may all be in one jurisdiction.

In tourism cases, the structure can look like this:

Patient — India
↓
Medical-tourism facilitator — UAE/Turkey/UK
↓
Cosmetic clinic — Turkey/Thailand/India/etc.
↓
Surgeon — another jurisdiction
↓
Post-operative treatment — patient's home country

This creates several legal questions:

Is there a valid arbitration agreement?

Which contract contains it?

Does the arbitration clause cover medical negligence?

Where is the seat?

Which law governs the arbitration agreement?

Which country's medical standard applies?

Can the patient challenge the clause as unconscionable?

Can the clinic compel arbitration against a patient who signed only a package agreement?

Is the surgeon a party to the arbitration agreement?

Is the tourism facilitator a party?

Can a home-country doctor be joined?

Where should emergency medical evidence be obtained?

How are damages calculated?

Can an arbitral award be enforced against a foreign clinic?

Are consumer or medical-regulatory remedies preserved?

3. Case Law 1 — Magel v. Nuveen

Magel v. Nuveen, 2023 OK CIV APP 13, 529 P.3d 928 (Oklahoma Court of Civil Appeals).

Facts

The patient brought claims concerning alleged medical negligence arising from elective cosmetic surgery and subsequent revision surgeries.

Before surgery, she had signed an arbitration agreement. She argued that the agreement was unconscionable and had been fraudulently induced.

Decision

The Oklahoma Court of Civil Appeals ultimately directed that the dispute be sent to arbitration. The court accepted that the patient's challenges concerning unconscionability and fraudulent inducement did not invalidate the arbitration agreement. (MidPage)

Importance

This is one of the strongest authorities for cosmetic-surgery arbitration.

It demonstrates that:

A patient's allegation of negligent cosmetic surgery does not, by itself, prevent enforcement of a properly formed arbitration agreement.

Relevance to cosmetic tourism

Suppose an Indian patient travels to Turkey and signs an electronically executed treatment agreement containing a broad arbitration clause. If the patient later alleges negligent rhinoplasty, infection or disfigurement, the clinic may rely upon Magel-type reasoning to argue that the dispute belongs in arbitration.

However, in an international case, additional questions concerning capacity, language, applicable law and consumer protection become important.

4. Case Law 2 — Haworth v. Superior Court

Haworth v. Superior Court, 50 Cal. 4th 372, 235 P.3d 152 (Cal. 2010).

Facts

A patient underwent cosmetic lip surgery by a plastic surgeon and later alleged:

medical malpractice;

lack of consent; and

improper performance of the cosmetic procedure.

The parties proceeded to arbitration.

The arbitration panel ruled in favour of the surgeon.

The patient subsequently discovered that the neutral arbitrator had previously received a public judicial censure.

Decision

The California Supreme Court held that the arbitrator's failure to disclose the relevant circumstance created a basis for questioning his impartiality, and the arbitration award was properly vacated. (Justia Law)

Principle

Arbitrator impartiality and disclosure are fundamental to the legitimacy of medical arbitration.

Relevance to cosmetic surgery tourism

This becomes particularly important in a foreign medical-tourism arbitration.

For example:

a Turkish clinic chooses an arbitrator;

the patient's home-country insurer chooses another;

the two choose a chair who has previously acted for the clinic.

That relationship could become a serious ground for challenge.

The international nature of the dispute therefore makes arbitrator disclosure requirements particularly important.

5. Case Law 3 — Dubrow v. Brocq

Dubrow v. Brocq, G060450 (Cal. Ct. App. May 3, 2022).

Facts

A patient travelled from Texas to California for consultation with plastic surgeon Dr. Terry Dubrow.

She signed an arbitration agreement providing that claims arising out of medical treatment would be resolved through confidential binding arbitration.

After surgery, she alleged negligence.

The surgeon initiated arbitration proceedings.

The patient's lawyer subsequently made public statements concerning the surgeon's alleged negligence, leading to a separate defamation dispute.

Decision

The California Court of Appeal dealt with the consequences of the arbitration agreement and the relationship between the underlying medical dispute and subsequent litigation concerning statements about that dispute. (vLex)

Importance

The case demonstrates that cosmetic-surgery arbitration can produce satellite disputes involving:

confidentiality;

public statements;

defamation;

attorney communications;

publication of allegations; and

the scope of the arbitration agreement.

Tourism relevance

A medical-tourism agreement should therefore expressly address:

confidentiality;

publication of photographs;

social-media disclosures;

medical records;

before-and-after images;

expert reports; and

communications concerning the dispute.

6. Case Law 4 — Brown v. NYC Medical Practice LLC

Brown v. NYC Medical Practice LLC, 2026, New York Appellate Division, First Department.

Facts

The dispute involved Goals Aesthetics and Plastic Surgery.

The clinic sought to compel arbitration under a Cosmetic Surgery Agreement.

The agreement had been electronically signed.

The clinic produced:

the electronically signed agreement;

signature certification;

audit logs;

timestamps; and

information concerning access to the electronic document.

Decision

The appellate court upheld the clinic's ability to compel arbitration against the relevant defendant, while modifying the disposition concerning other defendants. (FindLaw)

Principle

Electronic execution of a cosmetic-surgery arbitration agreement can be sufficient evidence of assent.

Relevance to medical tourism

This is extremely important because international cosmetic surgery frequently operates electronically.

Patients may:

communicate through WhatsApp;

complete online forms;

sign digital consent documents;

pay deposits online;

receive treatment packages by email; and

electronically accept arbitration clauses.

Therefore, an international clinic should maintain a complete electronic evidence trail.

7. Case Law 5 — Sanchez v. NYC Medical Practice, P.C.

Sanchez v. NYC Medical Practice, P.C., 2025, New York Appellate Division, First Department.

Facts

The case concerned Goals Aesthetics and Plastic Surgery and a dispute over whether a cosmetic-surgery patient's claims should proceed through arbitration.

The clinic relied upon its arbitration agreement.

Decision

The appellate court reversed the lower court's refusal to compel arbitration and granted the clinic's arbitration motion. (FindLaw)

Importance

The decision reinforces the significance of:

properly authenticated arbitration agreements;

electronic signatures;

broad arbitration language; and

evidence establishing patient assent.

Tourism application

A foreign clinic should not merely state:

“All disputes shall be arbitrated.”

Instead, it should retain evidence showing:

the exact document accepted;

date and time of acceptance;

patient's identity;

IP or electronic authentication data where appropriate;

language displayed;

translations provided;

consent process; and

opportunity to review the arbitration clause.

8. Case Law 6 — P.C. v. Driscoll

P.C. v. Driscoll, Civil Action No. 25-739, U.S. District Court for the District of New Jersey, March 12, 2026.

Facts

The litigation involved Goals Aesthetics & Plastic Surgery and allegations relating to medical malpractice and other claims.

The defendants moved to dismiss or, alternatively, compel arbitration.

Significance

The court addressed the interaction between medical-malpractice allegations and arbitration issues in the context of an aesthetics/plastic-surgery practice. (Justia Dockets & Filings)

Relevance

This illustrates a critical point:

The existence of medical negligence allegations does not automatically prevent arbitration.

The tribunal/court must instead examine:

the arbitration agreement;

scope;

parties;

formation;

applicable law; and

any statutory limitation on arbitration.

9. Case Law 7 — Feinberg v. Straith Clinic

Feinberg v. Straith Clinic, 151 Mich. App. 204, 390 N.W.2d 697 (1986).

Facts

The plaintiff underwent elective cosmetic surgery and subsequently sued the clinic and surgeon for alleged medical malpractice.

The defendants relied upon arbitration agreements signed before surgery.

The patient argued that she had signed the documents without reading them and challenged their validity.

Decision

The court upheld the arbitration arrangement and rejected the patient's challenge to the arbitration agreement. (vLex)

Principle

A patient's failure to read a properly presented arbitration agreement does not automatically invalidate it.

Tourism relevance

This becomes more complicated where:

the agreement is in a foreign language;

the patient does not understand the jurisdiction's law;

the arbitration clause is buried in a package agreement;

the patient is pressured to sign immediately before surgery.

Therefore, language and informed contractual assent are much more important in international cosmetic surgery.

10. Case Law 8 — Shaffy v. Motykie

Shaffy v. Motykie, California Court of Appeal, 2025.

Facts

The patient commenced arbitration alleging:

medical negligence; and

medical battery

against a plastic surgeon and his practice.

The dispute involved an allegedly inappropriate nasal procedure and the resulting empty nose syndrome.

Decision

The patient challenged the arbitration award, but the appellate court affirmed the award. (MidPage)

Importance

This illustrates the difference between:

medical negligence
and
medical battery/lack of consent.

Both can potentially fall within a sufficiently broad arbitration clause.

Tourism relevance

Cosmetic surgery disputes frequently contain allegations such as:

“I did not consent to this procedure.”

“The surgeon performed a different technique.”

“The surgeon exceeded the agreed scope.”

“The surgeon failed to disclose the risk.”

An arbitration clause should therefore expressly cover consent, battery, negligence and contract claims, subject to applicable mandatory law.

11. Case Law 9 — MR v Dr Valerio Badiali / Elyzea Cosmetic Surgery Group

This is particularly important because it is a genuine cross-border cosmetic-surgery tourism dispute, although it was litigation rather than arbitration.

Facts

A British patient travelled to Belgium for:

bilateral facelift;

upper eyelid surgery; and

lower eyelid surgery.

The surgeon was Italian and the clinic operated in Brussels.

The relationship nevertheless had substantial UK connections:

initial consultation in London;

UK advertising;

English-language contractual documentation;

payment in sterling; and

UK-facing business operations.

The patient suffered significant nerve damage, scarring and facial complications.

The clinic argued that responsibility lay with the foreign surgeon.

Legal significance

The case demonstrated that an overseas cosmetic clinic can potentially become subject to proceedings outside the country where surgery physically occurred when its contractual and commercial activities have sufficient connections with another jurisdiction. (NCBI)

Arbitration relevance

This is extremely useful when determining seat, jurisdiction and parties.

A medical-tourism provider cannot safely assume:

“The surgery occurred abroad, therefore only the foreign country has jurisdiction.”

The contractual structure may create connections elsewhere.

12. Case Law 10 — Johnson v. Le Roux Fourie

Johnson v Le Roux Fourie [2011] EWHC 1062 (QB).

This was a cross-border cosmetic-surgery negligence dispute involving substantial cosmetic procedures, including facial and breast surgery.

The case concerned complications arising from the treatment and subsequent corrective procedures. (CaseNode)

Relevance

The case illustrates the importance of:

expert medical evidence;

causation;

corrective surgery;

long-term cosmetic injury; and

assessment of damages.

These issues become even more important in arbitration because cosmetic injury may involve both physical and aesthetic loss.

13. Most important legal issues in cosmetic surgery tourism arbitration

A. Validity of the arbitration agreement

The first question is:

Did the patient actually agree to arbitration?

The agreement should ideally be:

separately identifiable;

clearly drafted;

electronically or physically signed;

available in the patient's language;

provided before surgery;

not hidden inside a general admission document.

Cases such as Magel, Feinberg, Brown and Sanchez demonstrate the importance of formation and authentication.

14. Scope of the arbitration clause

A narrow clause such as:

“Disputes regarding payment shall be arbitrated.”

may not cover medical negligence.

A broader clause could state:

“Any dispute, claim or controversy arising out of or relating to the treatment, consultation, surgery, consent, after-care, payment, package services, medical records, complications, revision surgery or termination of this Agreement shall be resolved by arbitration.”

However, mandatory laws of the relevant jurisdiction may restrict enforceability.

15. Medical negligence and arbitrability

Claims can potentially involve:

Negligence

Failure to meet the professional standard of care.

Lack of informed consent

Failure to explain material risks.

Battery

Performance of a substantially different procedure without consent.

Breach of contract

Failure to provide contracted services.

Misrepresentation

For example:

false qualifications;

misleading success rates;

fabricated testimonials;

unrealistic guarantees.

Consumer claims

Claims involving:

deceptive advertising;

hidden charges;

package promises;

misleading pricing.

Post-operative care

Failure to provide promised follow-up treatment.

16. The special problem of “guaranteed results”

Cosmetic surgery creates an unusual contractual problem.

Suppose a clinic advertises:

“Guaranteed perfect body contouring.”

If the result is unsatisfactory, the patient may allege breach of contract.

But a medical professional may argue that surgery involves biological uncertainty and that no particular result can reasonably be guaranteed.

An arbitration tribunal therefore has to distinguish between:

medical result
and
contractually promised service.

For example:

17. Informed consent

In cosmetic surgery, informed consent is especially important because the procedure may be elective rather than medically necessary.

The arbitration may examine whether the patient was informed about:

infection;

bleeding;

scarring;

asymmetry;

nerve damage;

anesthesia risks;

thromboembolism;

fat embolism;

revision surgery;

mortality;

possibility of poor aesthetic outcome.

The problem becomes more complicated when the patient receives the consent form immediately before surgery.

International cosmetic-tourism literature specifically identifies language barriers, inadequate pre-operative assessment and difficulties obtaining meaningful consent as major risks. (GOV.UK)

18. Language of the arbitration agreement

This is a major issue.

Imagine:

patient from India;

clinic in Turkey;

contract in Turkish;

arbitration seated in Paris;

proceedings in English.

The patient might argue:

“I signed the document but did not understand the arbitration clause.”

A well-designed contract should therefore provide:

patient's preferred language;

English version;

certified translation where appropriate;

clear arbitration heading;

separate acknowledgement;

adequate time for review.

19. Seat of arbitration

The contract should distinguish between:

seat and venue.

Example:

“The seat of arbitration shall be Singapore.”

This determines the procedural law and supervisory court.

The hearing could nevertheless occur:

online;

in Turkey;

in India;

in Singapore; or

elsewhere.

For medical-tourism contracts, a neutral seat can sometimes reduce jurisdictional controversy.

20. Applicable substantive law

The parties should carefully determine what law governs:

the treatment contract;

arbitration agreement;

medical negligence;

consumer claims;

damages; and

confidentiality.

These may not necessarily be governed by identical legal systems.

Medical-tourism disputes commonly involve difficult choice-of-law questions, particularly where treatment occurs abroad but the patient resides elsewhere. (Journal of Ethics)

21. Forum non conveniens and arbitration

A foreign clinic may attempt to argue:

“The dispute belongs in the country where surgery occurred.”

That argument is relevant primarily where the patient is attempting litigation rather than arbitration.

If there is a valid arbitration agreement, the central question becomes whether the arbitration agreement is enforceable and what disputes fall within it.

Nevertheless, courts may still become involved concerning:

appointment of arbitrators;

interim relief;

jurisdiction;

evidence;

emergency medical preservation;

enforcement; and

setting aside.

22. Medical tourism facilitator liability

A particularly difficult issue is the role of the intermediary.

Suppose:

Indian patient → medical tourism company → Turkish clinic → Turkish surgeon

The facilitator might argue:

“We only arranged the appointment.”

The patient may argue:

“You sold me a complete cosmetic-surgery package.”

The tribunal may therefore need to determine whether the facilitator was:

merely an agent;

contractual service provider;

healthcare intermediary;

joint venture partner;

apparent agent; or

separate entity.

The contract should therefore identify every entity providing a material part of the service.

23. Post-operative treatment in the patient's home country

This is one of the most important issues.

A patient may undergo surgery abroad and then return home with:

infection;

wound breakdown;

seroma;

hematoma;

tissue necrosis;

nerve injury;

asymmetry; or

other complications.

Recent clinical literature has documented the substantial burden of complications requiring treatment after patients return home from cosmetic surgery abroad. (PubMed)

The arbitration must determine:

Was the injury caused by the original surgery, by inadequate aftercare abroad, by premature travel, or by subsequent treatment?

24. Causation

Causation may be extraordinarily difficult.

Example:

Patient undergoes abdominoplasty abroad.

After returning home:

wound infection occurs;

patient receives antibiotics;

wound deteriorates;

second surgery is performed;

permanent scarring develops.

The tribunal must determine:

Original negligence → infection → revision surgery → permanent injury

or

Proper surgery → unavoidable complication → inadequate home treatment → aggravated injury.

Expert medical evidence is therefore essential.

25. Damages

Possible damages include:

Medical expenses

emergency treatment;

revision surgery;

hospitalization;

medication;

rehabilitation.

Travel expenses

return flights;

accommodation;

transportation.

Future medical expenses

Particularly important where revision surgery is required.

Loss of income

Where complications prevent employment.

Pain and suffering

Depending on applicable law.

Disfigurement

Extremely important in cosmetic surgery.

Psychological injury

Potential claims may involve:

anxiety;

depression;

body-image problems;

post-traumatic symptoms.

Refund of surgical fees

Potential contractual remedy.

26. Revision surgery

Cosmetic surgery disputes often involve a second or third operation.

The tribunal should determine whether revision surgery is:

medically necessary;

cosmetically desirable;

caused by negligent treatment;

merely an attempt to improve an inherently uncertain result.

This distinction substantially affects damages.

27. Confidentiality

Cosmetic disputes frequently involve highly sensitive information.

An arbitration agreement should address:

medical records;

photographs;

before-and-after images;

videos;

social-media posts;

expert reports;

identity of the patient;

settlement terms.

Dubrow v. Brocq illustrates how disputes surrounding public statements can arise from cosmetic-surgery arbitration. (vLex)

28. Emergency relief

Arbitration can be slow compared with medical emergencies.

Suppose the patient requires urgent treatment and needs access to:

medical records;

implants information;

surgical photographs;

pathology reports;

operative notes.

The contract should permit applications to a competent court or emergency arbitrator for:

preservation of evidence;

disclosure of records;

preservation of biological/material evidence;

urgent medical documentation.

29. Expert evidence

A cosmetic-surgery arbitration will usually require experts in:

plastic surgery;

anesthesia;

infectious disease;

wound management;

dermatology;

radiology;

psychology/psychiatry;

damages assessment.

The tribunal should ideally establish:

expert-report timetable;

joint expert meetings;

simultaneous reports;

cross-examination;

photographs and imaging protocols.

30. Consumer protection concerns

A major policy issue is whether a consumer should be bound by an arbitration clause imposed by a clinic.

The tribunal or enforcing court may examine:

bargaining power;

transparency;

language;

prominence of the clause;

statutory consumer protections;

mandatory medical regulations;

unconscionability;

public policy.

The existence of an arbitration agreement therefore does not necessarily mean that every conceivable claim will automatically be arbitrable.

31. Public policy

Public policy becomes especially important when:

the clinic operated illegally;

the surgeon was unlicensed;

consent was fabricated;

medical records were falsified;

advertising was fraudulent;

serious criminal conduct is alleged.

An arbitrator cannot transform a criminal or regulatory violation into an ordinary private contractual dispute merely because the parties signed an arbitration agreement.

32. Comparison of the principal authorities

33. Key principles emerging from the cases

Principle 1 — Cosmetic-surgery claims can be arbitrated

Magel, Feinberg, Brown, Sanchez and Shaffy demonstrate that medical negligence arising from cosmetic procedures can fall within arbitration where there is an enforceable agreement. (MidPage)

Principle 2 — Arbitration agreements require genuine assent

Electronic signatures can be powerful evidence, as shown by the New York cosmetic-surgery cases.

Principle 3 — Arbitration does not eliminate medical evidence

The tribunal still has to determine:

standard of care;

breach;

causation;

consent; and

damages.

Principle 4 — Arbitrator neutrality is crucial

Haworth demonstrates that failure to disclose potentially significant circumstances can invalidate an award. (FindLaw)

Principle 5 — International treatment creates jurisdictional complexity

The fact that surgery occurs abroad does not necessarily end the jurisdictional inquiry.

Principle 6 — The medical-tourism package must be analysed as a whole

The tribunal may have to examine:

advertising;

consultation;

contract;

payment;

surgery;

travel;

accommodation;

aftercare;

revision surgery.

34. Model arbitration clause for cosmetic surgery tourism

A carefully drafted clause could provide:

“Any dispute, controversy or claim arising out of or relating to the consultation, medical or cosmetic treatment, surgery, informed consent, after-care, revision treatment, payment, medical records, promotional representations, package services or termination of this Agreement shall, to the extent legally permissible, be finally resolved by arbitration. The seat of arbitration shall be [neutral jurisdiction]. The arbitration shall be conducted in English by a tribunal of three arbitrators, unless the parties agree otherwise. The tribunal shall have authority to determine contractual, tortious, negligence, consent and related claims falling within the scope of this Agreement, subject always to mandatory provisions of applicable law.”

For international patients, the agreement should additionally specify:

language;

governing law;

seat;

institution/rules;

number of arbitrators;

emergency relief;

confidentiality;

electronic evidence;

expert evidence;

medical-record disclosure;

interim measures;

service of notices;

enforcement of awards.

35. Particularly important drafting safeguards

A good cosmetic-tourism contract should contain separate sections for:

A. Medical consent

What procedure is being performed?

B. Commercial terms

What exactly is included in the price?

C. Travel arrangements

Who arranges:

flights;

accommodation;

transfers?

D. Aftercare

Who pays for complications?

E. Revision surgery

When is revision included?

F. Insurance

Who bears the risk of:

complications;

cancellation;

emergency treatment?

G. Arbitration

Where and how will disputes be resolved?

H. Governing law

Which substantive law applies?

I. Language

Which version controls?

J. Electronic records

How will electronic consent and communications be authenticated?

36. Special relevance for India

For an Indian patient travelling abroad, a cosmetic-surgery arbitration may involve at least four legal systems:

India
Patient's residence and post-operative treatment.

Destination country
Surgery, clinic and medical regulation.

Arbitration seat
Procedural law and supervisory court.

Enforcement jurisdiction
Country where the clinic or insurer has assets.

Therefore, a dispute can be legally international even though the underlying medical event appears to be a simple malpractice claim.

37. Overall legal framework

The best way to analyse a cosmetic surgery tourism arbitration is through six layers:

Layer 1 — Contract

Was there a valid agreement to arbitrate?

Layer 2 — Medical law

Was the standard of care breached?

Layer 3 — Consent

Did the patient understand and authorize the procedure?

Layer 4 — Private international law

Which country has jurisdiction and which law applies?

Layer 5 — Arbitration law

What is the seat, tribunal, procedure and scope?

Layer 6 — Enforcement/public policy

Can the eventual award legally be enforced?

Conclusion

Cosmetic surgery tourism arbitration is an emerging form of cross-border healthcare arbitration rather than a completely separate branch of arbitration law. The reported cases presently provide a much stronger body of authority on cosmetic-surgery arbitration itself than on the narrower combination of cosmetic surgery + international medical tourism + arbitration.

The most important authorities are Magel v. Nuveen, Haworth v. Superior Court, Dubrow v. Brocq, Brown v. NYC Medical Practice, Sanchez v. NYC Medical Practice, P.C. v. Driscoll, Feinberg v. Straith Clinic and Shaffy v. Motykie. They collectively establish important principles concerning formation, electronic assent, scope, medical negligence, informed consent, confidentiality, arbitrator impartiality and judicial review of awards. (MidPage)

For the tourism component, the cross-border cosmetic-surgery authorities such as MR v. Badiali/Elyzea demonstrate why jurisdiction, contractual connections, applicable law and continuity of care are critical. The practical difficulty is that the patient's injury may be treated in one country, the surgery performed in another, the contract signed electronically in a third, and the arbitration seated in a fourth. (NCBI)

Accordingly, the best arbitration clause for cosmetic surgery tourism should be drafted before treatment, in a language the patient understands, with an explicit seat, governing law, broad but legally permissible scope, emergency-relief mechanism, confidentiality provisions, medical-record rules and clear treatment of post-operative and revision-surgery claims.