It’s All About Jane ~ Dissecting the Patient Experience

At times it is all too easy to be engulfed by all the commotion surrounding medical tourism. Headlines that blare extraordinary claims such as -“Medical tourism expected to become a 40 billion dollar industry by 2010”; and “Insurance companies surveying medical tourism with interest”; “Asia prepares for medical tourism boom!”; and “750,000 people traveled abroad for medical care last year!”- are certainly attention getters. However, in all the excitement it is easy to forget what medical tourism is actually about.

What is medical tourism about? The answer to this question varies in accordance to one’s association with the field. If it is a hospital in Costa Rica or the Indian government then it is about potential new revenue. If it is a medical tourism facilitator then it is about the future of the business. If it is a hospital or healthcare provider in the US then it may mean fewer customers (or at least the perception that it is so) and if it is a company struggling to provide healthcare coverage to their employees then it may be perceived as a lifesaver. Lastly, if it is the United States government there may not be inkling as to what medical tourism is about. However, in the midst of all these associations and interested parties – countries, hospitals, companies- there is one often overlooked component: the patient!

Jane Smith

What does medical tourism mean to Jane Smith? She is fifty years old and has no health insurance. She is 130 pounds overweight, has difficulty ambulating, suffers from diabetes and high blood pressure and has tried numerous diets without success. She cannot afford the $80,000 required to undergo a gastric bypass procedure in her home town of Albany, New York.

If the industry is to focus on attracting international patients, then it must examine medical tourism from Jane’s point of view, or more specifically the steps or stages that comprise the ‘patient experience’ or the medical tourism process. Understanding what Jane experiences as she is engaged in the medical tourism process can provide insight into ways to improve the international patient process.

The goal of every international hospital or facilitator should be to eliminate or minimize the stress and confusion inherent in the process of traveling abroad for medical care. In order to accomplish this goal every stage of the patient experience must be controlled. The first step in ordering this process is to define what constitutes the ‘patient experience’ or medical tourism process. Where does this process begin and end- is it when Jane arrives at the hospital and then leaves out the door? Or does it begin at the airport when she arrives and departs from the hosting country? The reality is…it isn’t that simple.

In truth, Jane’s impression of your hospital or clinic begins taking shape the moment she visits your website or reads the hospital’s information on a medical tourism facilitator website, when she sees a presentation of your providers on the net, when she speaks to a friend who was treated at your facility and the moment she calls your clinic and receives a greeting in Spanish or poor English. The patient’s experience is being influenced at all these junctures.

An equally important question is, where does the ‘patient experience’ end? One can submit that is should never end. Although many may think it is a lot of work to control each stage of the ‘patient experience’, ultimately it is the key to a successful medical tourism program. Now that we have this information it is time to don our collective gloves on, grab our scalpels and step up to the table (no pushing please). We are going to slit, snip and slash down through every stage of Jane’s medical tourism experience. Are we ready?

Research ~ The search for information about medical tourism and available options.  Picture Jane sitting in front of her computer visiting the websites of facilitators, hospitals and clinics; looking at social networks, watching videos, reading testimonials or blogs, and perhaps even contacting patients who have already engaged in medical tourism. Jane may have even attended a seminar, read an article, or talked to a friend or family member. Along the way the knowledge gained here will most likely lead her to pick up the phone or send an email.

What you need to do:

• You should have a well-positioned website in English.
• Information should be clear, concise, and targeted to your demographic (large type and minimal razzle-dazzle if geared for age 50 plus).
• Stress benefits over features, for example: instead of just rambling on and on about your state-of-the-art technology, let Jane know precisely how this technology will lower her risk for complications.
• Include patient testimonials (video and written), doctor videos, and media coverage, anything that will enhance your expertise and credibility.
• If you’re a government or tourism board, show what regulatory measures are in place to assure visitors that healthcare providers offer quality services.

First Contact ~ Contact with medical provider, usually by email or phone.

What you need to do:

• You should be easy to contact (web forms, emails and 1-800 number) and have staff on hand who speak English.
• Your first response needs to come in less than 24 hours and clearly state why and how you can help Jane with her problem. Show her that you’re the expert by highlighting your experience, technology and patient testimonials. Fail in this task and Jane will go somewhere else.

Decision: ~ The decision to proceed or not to proceed with the chosen medical treatment at your facility. Remember, Jane may not make a decision at the drop of a pen. It is often a process that must be nurtured with follow-up emails and calls for weeks, months, and perhaps even years.

What you need to do:

• You should offer a product package with a cost-value that is attractive to Jane.
• You need to decide if Jane is fit for surgery, and then clarify the nature and scope of the treatment.
• You need to detail her recovery process and the logistical support you offer (communication, lodging and transportation).
• The information you send to Jane should allow her to picture in vivid detail the entire medical tourism process, answer all her questions, and minimize to near zero the chance for nasty surprises (sorry, the sofa-bed for your companion is $45 extra…).
• Your staff should understand basic sales techniques. For example, asking the right questions and being passionate about what they are selling. However, it’s not about convincing Jane to purchase your procedure package; it’s about understanding what she needs and wants, and helping her make the right decision.

Arrival at destination ~ Airport arrival in the country where the medical provider is located.      Meet and greet and transfer to the hotel or hospital.

What you need to do:

• You should have a welcoming process arranged.
• Your bilingual and uniformed representative should meet and greet Jane at the airport (or inside the airport), and then transfer her in a comfortable bus or van to her hotel or the hospital. Remember, this is your chance to provide a glowing first impression!

Pre-surgery ~ Arrival at the hospital or clinic, and pre-surgery process.

What you need to do:

You should have a process in place that puts Jane at ease, keeps her informed, and allows her to get her pre-op work completed quickly. This means welcoming Jane as she arrives at your hospital, briefing her as to what she can expect during her stay, and having staff accompany her during the prep-work leading up to the actual procedure (pre-operative exams, doctor consultations and form filling). The idea here is to make this stage as stress-free as possible.

Medical Procedure or treatment ~ I won’t go into much detail here except to say that you don’t want your doctor prancing around the surgical theater singing: “Like a Surgeon…Heeeey, cutting for the very first time….,” courtesy of Weird Al Yankovic. If you are a quality facility, you undoubtedly have expert surgeons with great outcomes. I expect Jane will be fine. 

Post-surgery ~ Encompasses the recuperation period after surgery or treatment until the patient returns home.

What you need to do:

• Make sure you have nurses that can communicate with Jane in English.
• Provide Jane with clear discharge instructions, her medical records, and a doctor’s report (at the very least the discharge instructions and doctor’s report should be in English).
• Have a network of hotels and recovery retreats that offer the installations, services and care Jane will require.
• You should also have the ability to coordinate out of hospital nursing care when needed.

Back home ~ Recuperation period after Jane returns home.

What you need to do:

• Contact Jane by phone a few days after her return home to inquire about her trip and her condition.
• Send her a follow-up email a few days later to request a testimonial and to see if she would like to be used as a referral.
• Send her your newsletter; call her on her birthday; at Christmas, Easter, the 4th of July, Memorial Day…don’t stop until she files a restraining order!

Okay, let’s not go quite that far.  The idea is to follow-up with Jane on a regular basis to ensure that her recovery goes as planned, and so she knows, without a doubt, that you truly care about her.
Well, we have come to the end of the process. As we step back, pull off our gloves and wipe the sweat off our brows, the grandiose proclamations about medical tourism, the predictions, its key players, they all fade into the background. What we are left with is the patient. Jane, if you will. When we cut down to the bone, that’s what medical tourism is really all about.

Bill is the operations and marketing manager for Hospital Clinica Biblica’s international patient department. A keen observer of the international patient process, Bill is continually striving to identify and remove roadblocks, pot holes and detours in order to improve the international patient experience. He may be reached at w.cook@clinicabiblica.com.
Bill is also involved with the development of information packages, analyzing trends and overseeing the hospital’s international staff.