Turkish moustaches have become all the rage for medical tourists, particularly, men from the Middle East, Europe and Asia.

Turkey’s economy is getting a facelift, a hair-raising experience of sorts that is not only sprouting the growth of whiskers above the upper lip, but profits in the country’s booming medical tourism sector as well. Long favored as a destination for the follicly challenged, Turkey’s cosmetic surgeons have for years offered hair implants to those balding on top. Now, moustache transplants for the face are growing in popularity, cosmetic surgeons and tourism agencies say, as men from the Middle East, Europe and Asia are coming to Istanbul seeking a virile addition for their upper lips.

The procedure uses a technique called follicle-hair extraction, in which doctors remove clusters of hair from the more hirsute areas of the body and implant them along the lip or cheeks to magnify a mustache or beef-up a beard.

Performed under local anesthetic, the surgery takes around five hours and can cost up to $5,000, cosmetic surgeons say. Medical tourism agencies have begun offering “transplant packages” combining facial-hair operations with a shopping vacation in Istanbul or beachside retreat on the Mediterranean coast.

Most customers are foreigners, according to surgeons, as Turkey’s emergence as a place for facial-hair transplants comes as the number of Turks wearing mustaches has declined sharply.

Selahattin Tulunay is one of the surgeons profiting from this bewhiskered boom. From his surgery clinic in an upscale neighborhood known as Istanbul’s Beverly Hills, Dr. Tulunay started facial follicle transplants two years ago and now says he completes up to 60 such operations a month.

“The mustache is making a comeback,” he told the Wall Street Journal as he leafed through a photo album showcasing his most-prized creations. “If a man’s mustache doesn’t grow, he wants to know he can have one as a mark of masculinity. Our customers know that if they pay, we can deliver the results.”

A 34-year-old businessman from Erbil, in northern Iraq, said he traveled to Dr. Tulunay’s clinic after years of low self-esteem over the patchy hair growth on his upper lip.

“The mustache is very important in our culture and my wife supported me to get the operation,” he said. “Now, I feel much better. I’ve recommended it to my friends.”

Facial-hair transplants are at the fringe of a broader medical tourism boom in Turkey, which last year generated $1 billion in revenues. The number of visitors Turkey welcomed specifically for surgical procedures rose to 270,000 last year from 156,000 in 2011, according to data from a 2012 report by Turkey’s Health Ministry.

The report showed 100,000 people traveled to Turkey specifically for plastic surgery in 2012, although the numbers don’t break out figures for facial-hair transplants.

The mustachioed and bearded stars of Turkish soap operas — wildly popular across the Middle East, North Africa and the Balkans — have helped again make facial hair a popular symbol of virility and machismo. Surgeons say many patients request the full-bodied mustache worn by Turkish singer Ibrahim Tatlises, which has long set the standard for top-drawer whiskers. Another popular style is the stubble beard worn by Turkish TV show heartthrob and model Kivanç Tatlitug, surgeons say.

“My patients often bring pictures of the stars they want to look like, but I never do what they say because it wouldn’t suit their face,” said Canan Melike Koksuz, a surgeon at Isom, an Istanbul cosmetic surgery practice, which says it has welcomed chief executives and celebrities from as far away as China and Australia for hair transplants. “Once there was less demand because facial hair was more political, but now mustaches and beards are more fashionable, and people want to look trendy.”

It isn’t only men who are seeking ways to emulate Turkey’s rising stars. Clinics in the Middle East have reported that Arab women, who previously favored the full lips, small noses and protruding cheekbones of Lebanese singers, are now requesting the more natural looks of Turkish soap stars.

“Turkish TV series have introduced the natural look. Women who had nose remodeling operations in the past are now unhappy with the shape; they want their tip-tilted noses to look more natural,” said Zekeriya Kul, a plastic surgeon who says he recently moved from Dubai to his native Turkey to profit from the surgery boom.

According to surgeons and agencies specializing in medical tourism, the vast majority of clients come from the Middle East, where facial hair still bristles with political meaning. To be clean shaven has for decades been a political statement of solidarity with the secular, Westernizing elites who were pre-eminent across much of the Arab world until the series of uprisings that came to be known as the Arab Spring.

Despite Turkey’s emergence as a hub for facial hair transplants, the number of Turkish men wearing mustaches has declined rapidly, according to pollsters. A study by Istanbul’s TNS Market Research Company found that while 77 percent of Turkish men had mustaches in 1993, the figure fell to 34 percent in 2011 and is still sliding.

Puerto Rico Tourism Company will be a gold sponsor at the 5th World Medical Tourism Congress which will take place on the beach in Ft. Lauderdale/Miami October 24-26th. The event in the largest educational and networking platform in the medical tourism industry featuring expert speakers and covering the most exciting topics in the industry.

Puerto Rico provides the ideal getaway seeking “beaches plus”. On the island, visitors will find diverse geography and wealth of activities. Luxurious lodging, rich history and multiple shopping options are available to all tourists. Besides this amazing array of options, Puerto Rico has an excellent healthcare system. With a network of thirteen hospitals, Metro Pavia Health System (MPHS) is the largest hospital and clinic network provider in Puerto Rico and the Caribbean and the center for healthcare necessities. The hospital is also accredited by the Joint Commision.

There are several advantages that Puerto Rico offers to medical tourists. Its population is bilingual – English and Spanish – and its healthcare system provides high quality standards at more affordable prices than other destinations.

For more information visit: http://www.seepuertorico.com/

The Medical Congress Team encourages all participants to network and schedule one-on-one networking meetings with Puerto Rico Tourism Company’s team members through the congress networking platform . Visit them at their booth in the exhibit hall!

5th World Medical Tourism Congress is proud to announce the Preliminary List of Participants for the largest educational and networking international event in the medical tourism industry taking place on the beach in Ft. Lauderdale/Miami Ocotber 24-26th

With an almost sold out exhibit hall and a list of amazing expert speakers, this year’s event promises an amazing experience for all participants.The 5th World Medical Tourism Congress is providing all attendees and sponsors the most well thought-out educational content and pool of expert speakers in the industry.

Westin Diplomat Resort & Spa at night

The event to network and collaborate strategically

The Congress offers all attendees the oppportunity to join their networking platform which includes the attendees to the 4th Employer Healthcare & Benefits Congress and the 3rd Global Benefits Congress.  Participants will be able to network and pre-schedule one-on-one networking meetings at the event in advance since the platform is open and will remain open until after the congress. 

The Congress offers a predetermined number of discount registrations, free registrations, hotel room nights, and flights to buyers of healthcare such as governments, employers and insurance agents who send patients overseas or are interested in doing so,through its VIP Buyer Program.

The event to learn and be inspired

Experts speakers in the industry will cover various topics of interest such as academic research, the perspective of the buyers of

Westin Diplomat Pool View

healthcare, global benefits , marketing best practices as well as the changes in the US healthcare system which have a positive impact on medical tourism. The event welcomes a diverse group of speakers  who will present valuable case studies, practical skills, and tackle the most important issues in the medical tourism industry.  Attendees will be led by former CNN Headline News Anchor, correspondent, author, and two-times cancer survivor, Bob Losure.  To view the full agenda with session descriptions, please visit: http://www.medicaltourismcongress.com/agenda/

 The event to meet the industry decision makers

Some of the highlights of the congress will be the 3rd Global Ministerial Summit and the 1st Medical Director Summit. The first will welcome Ministers of Health, Tourism, Economic Development, Trade Commissioners and Health Attaches to discuss common challenges and best industry practices.

“ As a first time attendee, I am interested in existing programs in other destinations and how I can best market the services we have available in the U.S. Virgin Islands. As the person in charge of all tourism marketing done on behalf of the Government of the Virgin Islands, I am truly coming to learn as much as possible about this segment, best practices and how I can work with providers in the USVI to increase our share of this revenue generating niche market. In discussion with local providers, your organization and this event came highly recommended. ” said Deputy Commissioner of Tourism. U.S. Virgin Islands Department of Tourism and special invitee to the Ministerial Summit.

The Medical Director Summit will welcome medical directors from international hospitals and insurance companies to collaborate and network regarding the challenges in providing quality healthcare and insurance to local and international patients.

“My goal at the congress is to learn more about what services are available, how to fulfill the needs of our clients by getting them quality health care  while maintaining some handle on the costs. I hope to network with other medical directors and get more understanding of this aspect of medicine.  I also hope to network with some of the underwriters and insurance companies that are looking for case management.” Ferial Ladak M.D. Medical Director Global Excel Management

Westin Diplomat Beachfront View

 This is the one event per year where employers, self funded health plans, insurance companies, government officials and medical tourism facilitators that are looking to outsource healthcare overseas have the opportunity to meet with top international hospitals and medical tourism companies, network,  and build strong relationships with key industry partners.

For more information visit:http://www.medicaltourismcongress.com/

The Medical Tourism Association™ and Richard Krasner, professional in workers compensation; released this white paper which presents evidence indicating that employers and insurance companies may not have a choice in implementing medical tourism.

Throughout the debate leading to the enactment of the 2010 Affordable Care Act (ACA), one area of healthcare has been relegated to the sidelines; the rising cost of workers’ compensation claims. One major factor for the increase of workers’ compensation claims costs is the rise of medical costs associated with those claims. The average medical cost per loss time claim in workers’ compensation in 2008 was $260,000, and medical losses in that year represented 58 percent of all total losses.

The white paper concludes on the note that the globalization of healthcare will necessitate the removal of all barriers to providing the best care possible at the lowest cost. The cost savings that are being realized by medical tourism as a part of the healthcare industry can be just as beneficial in workers’ compensation. Therefore, medical tourism should be implemented into workers’ compensation and the legal barriers should be modified.

As part of the mission to provide education to those seeking information about the industry, the Medical Tourism Association™ has published the white paper, you can view it here: http://www.medicaltourismassociation.com/en/workers-compensation-white-paper.html

Please send an email with any questions or comments.

Olivia@MedicalTourismAssociation.com

What makes a great International Patient Services Department (IPS)? How do you measure up to other hospitals in your country, region or even globally? How do you know what your competition is doing and what makes your IPS department better? What do you use to measure your success or lack of success?

As medical tourism grows, an IPS Department must make sure they are doing all they can to compete in the growing medical tourism market while increasing international patient flow and guarantying patients have a outstanding experience with positive outcomes. Implementing best practices are great, but how are your practices better?

Many great international patient service departments have lost this battle, because they never changed, and rested on their laurels. Have you gone over your procedures and made sure you are providing your patients the best experience in all the phases and nuances of treating international patients? When did you last ask, how can we improve?

A great way of measuring your success is providing every international patient with a survey regarding their stay. Making sure they all complete the survey may be a difficult task, so maybe you can provide a small gift for their time and thoughts. How much is a nice cup of coffee? Not much, but it let’s your patient know you value their opinion. Do you know how many of your patients come back for additional treatment? Maybe this year they did the right knee, but will they come back for the left knee when it requires surgery? Have you sent your past international patients a birthday or a thank you card from all the staff, with real signatures? It’s these little things that patients appreciate and keep them engaged.

As the cost and availability for healthcare becomes more difficult to obtain, insurance companies will look for Certified IPS departments in providing better healthcare to their clients in addition to reasonable and transparent rates. They will need to know that your International Patient Services Department has gone the extra mile in raising your standards and services.

Certification of International Patient Services Departments has become a valuable commodity. More hospitals are beginning to understand the need to stand above their competition and have the ability to not only to shout it to the world! But prove it to their patients by providing a great experience. Just as JCI has become a standard in hospital quality and standards, so has International Patient Services Certification or IPSC™.

IPSC™ provides a great deal of value not only to the hospitals IPS Departments, but to their patients, by working with procedures and processes that have been proven, tested and developed by the Medical Tourism Industry, not just made up in some boardroom.

When was the last time you made a call to your competitor’s hospital to see how quick they are to respond to your call or e-mail? How does their website look? Is it in multiple languages? Are there hundreds of testimonials? And when was the last time you called your own hospitals IPS department to see how they respond to your inquire?

Sometimes taking a good hard look at ourselves and our competition, helps us to better improve ourselves while helping our patients.

As part of the Medical Tourism Association’s™  commitment to education and transparency we will be providing updated information on basic standard requirements and elements for contracts and agreements between hospitals, facilitators, employers and insurance companies. The MTA receives several calls from medical tourism facilitators and those that want to become a facilitator; all asking legal questions about liability and contracts. The MTA worked with the law frim Squire Sanders (US) LLP in order to provide a valuable resource to the MTA members and future facilitators.

MEDICAL TOURISM ASSOCIATION CONTRACT GUIDELINES FOR MEDICAL TOURISM FACILITATORS

April 2012

The following guidelines for contracts between medical travel facilitators (“MTF“), their clients and providers are provided to make you aware of some of the important provisions that should be included in such contracts.  The lists of contract provisions set forth below are not intended to be exhaustive.  Please consult with an attorney to determine which of these provisions is appropriate for your specific contract and for specific language addressing these and other provisions that may be needed for your contract.

Client Informed Consent and Release.  This agreement informs a client of the risks and benefits associated with receiving medical care abroad, including risks and/or consequences of treatment and traveling before and after treatment.  In addition to standard contract provisions, a Client Informed Consent and Release (“Consent“) should include the following clauses:

1. General Provisions.  The Consent should contain clear statements of what the MTF does and does not provide so there is no misunderstanding of the scope of the coordination services provided by the MTF.  It should also recommend that the client seek independent advice from a qualified heath care provider.
2. Warranty Disclaimer.  This clause provides that the MTF does not guarantee the services performed by others, specifically those who provide travel, accommodations and direct health care services.
3. Limited Liability.  This provision provides that the MTF is not responsible for any losses the client may incur that are caused by anyone outside the control of the MTF.
4. Limited Damages.  This clause provides that the MTF is not responsible for any money claimed by a client for loss or injury, for any reason, beyond the amount actually paid to the MTF for coordination services.
5. Limitation on Actions.  This provision requires a client to assert any claim against the MTF within a specified period of time so that the MTF can manage its risks.
6. Governing Law.  Where parties operate in different states or countries, there may be disagreement about the interpretation of a contract.  This clause is intended to address  under what law the Consent will be interpreted if a dispute arises.
7. Dispute Resolution.  Where parties operate in different states or countries, there may be disagreement about where, and under what process, disputes will be resolved.  This provision is intended to address where and how disputes between the parties will be resolved, such as by the courts or by arbitration.
8. Venue and Jurisdiction.  Where parties operate in different states or countries, there may be disagreement about which courts will hear any claims.  This clause addresses where and in which courts such judicial action would take place.
9. Severability.  This provision prevents the entire agreement from being unenforceable if one provision is determined to be invalid or unenforceable.
10. Attorney’s Fees.  This clause specifies who is responsible for paying attorney’s fees in the event a dispute arises.

Client Agreement.  This agreement governs the commercial terms between the MTF and the client.  Because a client will have signed a Consent, it is not necessary to include in the Client Agreement many of the protections contained in the Consent document, resulting in a simpler form of Client Agreement.  That said, in addition to standard contract provisions, a Client Agreement should include the following clauses:

1. Payment.  This provision addresses the amount and timing of all payments due to the MTF.
2. Informed Consent.  The client should specifically acknowledge entering into the Consent.
3. Assignment.  Most contracts are freely assignable, unless stated otherwise.  This clause provides that the Client Agreement may not be assigned to another party.  For example, the MTF may not want the Client to assign its rights and obligations under the agreement to another party unless the MTF consents to such assignment.
4. Governing Law.  Where parties operate in different states or countries, there may be disagreement about the interpretation of a contract.  This clause addresses under what law the Client Agreement will be interpreted if a dispute arises.

Hospital Agreement.  This agreement governs the commercial terms between the MTF and the hospital.  In addition to standard contract provisions, a Hospital Agreement should include the following clauses:

1. Representations and Warranties.  These provisions should contain statements that establish and guarantee certain contract elements such as accreditation of hospital, licensure of hospital, and that the parties are operating in compliance with all applicable laws and regulations.
2. Indemnification.  An indemnification provision requires the hospital to defend the MTF against any claims, and associated expenses, caused by the hospital. Indemnification provisions can also be mutual, where each party will indemnify the other for any claims and expenses caused by the other party.
3. Dispute Resolution.  Where parties operate in different states or countries, there may be disagreement about where, and under what process, disputes will be resolved.  This provision addresses where and how disputes between the parties will be resolved, such as by the courts or by arbitration.
4. Venue and Jurisdiction.  Where parties operate in different states or countries, there may be disagreement about which courts will hear any claims.  This clause addresses where and in which courts such judicial action would take place.
5. Assignment.  Most contracts are freely assignable, unless stated otherwise.  This clause describes any restrictions on the assignability of the contract. For example, the MTF may not want the Hospital to assign its rights and obligations under the agreement to another party unless the MTF consents to such assignment.
6. Governing Law.  Where parties operate in different states or countries, there may be disagreement about the interpretation of a contract.  This clause addresses under what law the agreement will be interpreted if a dispute arises.
7. Insurance.  A key component of risk management for any party is maintaining adequate insurance coverage.  This clause should specify the required types and amounts of insurance.
8. Severability.  This provision prevents the entire agreement from being unenforceable if one provision is determined to be invalid or unenforceable.

NOTICE

This outline was prepared by the law firm of Squire Sanders (US) LLP as a guide for developing agreements between medical travel facilitators, their clients and the providers.  The outline is not intended to serve as legal advice relating to individual situations or as a legal opinion concerning such situations, and does not constitute the rendering of legal advice or a legal opinion by Squire Sanders (US) LLP to any Medical Tourism Association, Inc. (“MTA”) member or other person or entity.  Additionally, the use of the outline does not establish an attorney-client relationship between any person or entity and Squire Sanders (US) LLP.  Further, this outline is made available to MTA members with the understanding that the MTA is not engaged in rendering legal or any other professional advice.

This outline is subject to change without notice to MTA members.  Neither MTA nor Squire Sanders (US) LLP assume any liability for any errors or omissions or for how this outline is used or interpreted or for any consequences resulting directly or indirectly from the use of this outline.  For legal advice or any other professional advice, please consult your personal lawyer or the appropriate professional.

For those of you in the travel industry or those of you that know someone who is, I hope this is helpful in determining the possible role in medical tourism.

The hospitality industry which is made up of hotels and tour operators is a very important part of proving an overall exceptional patient/companion experience. Many hospitals have partnered up with these companies to coordinate transportation and tourism activities. The hospitals are staying focused on providing quality healthcare and are allowing hospitality to handle the rest. For tour operators this could be a new market.  Nowadays, it is simple to book your own trip so the demand for travel agents is not as high. With the growth of medical tourism, a travel agent specializing in medical or wellness travel could attract more business.

Hotels can really go above and beyond by offering certain services that recovering patients would require such as:

• Prescription pick-ups
• Wellness packages
• Custom dietary accommodations
• Special activity accommodations
• Medical personnel on staff

Tour operators could extend their services by:

• Arranging transportation to medical appointments
• Planning tourism activities based on the recovering patients capabilities
• Providing activities or restaurants for the companion that may need to spend time alone while the patient recovers

For tour operators there is an opportunity to get even more involved by taking on the role of a medical tourism facilitator. Facilitators can simplify the daunting process of patients trying to find the best healthcare, where to stay, will someone speak their language and how to get around in a different country. Medical tourism facilitators can assist with the following arrangements:

• Provide a list of recommended hospitals and doctors
• Ensure that a translator is provided at the hospital if needed
• Provide approximate cost for the procedure, and the length of time to stay in the destination
• Arrange conference calls between the patient and doctor as well as between the patients primary care physician and the overseas doctor
• Provide detailed information about the destination the patient would travel to
• Transfer patient medical records to the overseas hospital
• Arrangements for passports, visas, flights, lodging and transportation
• Provide a complete itinerary, recommendations and contact numbers

Facilitators can be based anywhere and assist the patient in finding the best facility for their needs. In some cases facilitators are contracted with hospitals so the patient could approach the hospital themselves and they could then set them up with a facilitator to take care of the details. Some countries have developed healthcare clusters which would include hospitals, facilitators, tourism boards and hotels this is where all entities work together to provide the best patient experience and to brand their destination as leaders in medical tourism.

Getting started

The MTA receives so many phone calls each week from people that want to get into the medical tourism industry and they think they could be a facilitator, but that is the extent of their knowledge. It is difficult to help someone in getting started when they have no idea where their expertise lies within this industry. The MTA has many articles published and even a book called The Medical Tourism Facilitator that will guide you through the process of getting started.  If you are serious about starting a business as a facilitator you must know everything it entails, read this book and all the articles you can find to become an expert on what to do.  Some people even call in asking how can I work for a company that is already established, in this case the MTA could post their job inquiry on the MTA members only page and if someone is interested they could contact you directly, but you still need to read the book first!

Additionally, if you already have a facilitation company and are looking to get patient referrals or to contract with a hospital, becoming a member of the MTA could be the right step for you.  We have several patients calling in looking for the best place to go, we post the inquiries on the members’ only page and this provides the members the opportunity to contact them directly. If you are looking to develop a relationship with a hospital or cluster you can connect with the MTA members on the social network Medical Tourism City, or in some cases the MTA will do personal introductions.  And if membership isn’t for you, attending the MTA’s annual conference will put you face to face with these healthcare providers for the chance to establish a relationship, you can even request one on one networking meetings with them.

Below is a list of articles and books to read that will provide examples and hopefully answer some questions you have about medical tourism and the travel industry.

Understanding Medical Tourism- An Overview

Legal Issues- Medical Tourism Association Contract Guidelines for Medical Tourism Facilitators

Legal Issues in Obtaining and Providing Healthcare Internationally

Due Diligence in Facilitation

Hospitality- Creating Alliances and Developing Services

Las Vegas- Adding Healthcare to the Brand

Food Service Meet Your New Patron- The Medical Traveler

Health and Wellness Destination Guides

Feel free to contact me with any additional questions, Olivia@MedicalTourismAssociation.com

The Accreditation Association for Ambulatory Health Care (AAAHC), founded in 1979, has become the leader in ambulatory health care accreditation with more than 5,000 organizations accredited in the US. The AAAHC accredits a wide variety of health care organizations including ambulatory surgery centers, office-based surgery centers, primary care practices, managed care organizations, student health centers, and large medical and dental group practices.

 The AAAHC serves as an advocate for the provision of high quality health care and patient safety. The comapny offers health care organizations of all types and specialties a unique peer-based review system that adopts a collaborative, consultative and educational approach to help them meet internationally recognized AAAHC Standards. 

 In 2010, AAAHC International was formed to bring the same process of peer review to health care organizations worldwide. Since then, AAAHC International has helped organizations in Costa Rica, Peru, and India to increase their quality of care and level of patient safety.

Attendees to the 5th World Medical Tourism & Gloabl Healthcare Congress which will take place on the beach on Ft. Lauderdale/Miami October 24-26th, will be able to network with the team at AAAHC as they will sponsor the event.
For more information visit: www.aaahc.org/international/

To attend the Congress and save $500 register at: http://www.medicaltourismcongress.com/en/registration.html (only before July 1st)

A new study funded by Cancer Research UK found that breast cells that turned cancerous could be categorized in about 10 different types of diseases.

A team of researchers led by Professor Carlos Caldas analyzed frozen breast samples from 2,000 women, looking at the genetics of the cells and how they morphed to become cancerous.  Depending whether the cells mutated, became inactive or became overactive, a different treatment would be recommended.

The study is still in its early stages so it hospitals will not be applying it in their treatments just yet.  The new process is expected to not be into effect for another three to five years.  Still, this finding could be revolutionary because by grouping different cases of breast cancer, more customized treatment and medication will be prescribed which will increase the probability of survival. This finding could even set a new precedent in categorizing other types of cancers in the future.

This is not a topic discussed as often as it should be. What can people in the medical tourism industry do to solve this crisis? What are people already doing?

Sure, the news sometimes features stories about medical tourism and yes many people have at least heard of it. But in almost every case where I have personally talked to someone I know about this industry they have never heard of it, aside from some of the horror stories blasted in the news. They do not know the legitimacy of this industry and all the things it has to offer.

What is the MTA doing?

Www.MedicalTourism.com is the MTA’s consumer based website, it is designed to assist a potential medical tourist in the research process of planning a trip. The site features:

• Details about certain destinations such as, hotels, airlines, currency, entrance requirements and more
• Price chart comparisons per procedure
• The latest news stories in the industry
• The MTAs  membership directory, so patients can see who we work with and possibly contact them directly
• Full versions of the Health & Wellness Destination Guides

The Destination Guides are designed with the consumer in mind, it features, clinical listings, tourism activities and even gives a guide to how much a patient should budget for a medical trip to that destination.  CVB’s are highly involved in the production of this guide, as they have direct access to the consumers.

There are many more initiatives the MTA is involved in, but there needs to something more!

For the next issue the Medical Tourism Magazine, I am planning to write an article on this topic. I would like to speak with several different people in the industry and find out what they are doing, why they are not doing anything and what do they think would have the greatest impact on increasing consumer awareness and how can it be achieved?

If anyone is interested in contributing some thoughts on this topic, please let me know! Olivia@MedicalTourismAssociation.com