Author: Medical Tourism Magazine
Medical tourism has become an attractive option for potential economic growth in many countries. Projections of an exponential increase in demand for such services drew representatives from over 40 countries to the first ever World Congress on Medical Tourism in San Francisco this past September, sponsored by the Medical Tourism Association.
The interest of destination countries in the market is understandable. There is no need to look beyond the United State’s spiraling medical costs and continuing reductions in insurance coverage. The US’s population of aging baby boomers is forming into a “silver tsunami” about to crash on the nation’s troubled health care system. The need for alternative options for care is obvious, and medical tourism is one clear response to this need.
Travelers have visited foreign areas for spa therapies, alternative treatments, health diagnostic services, and cosmetic surgery for years. Now, in addition to seeking these services, saving money for needed surgery has become a leading motivator to travel. There is no indication this will change in the foreseeable future.
But, travel to where? What factors beyond top-flight medical care will give a destination an edge in this increasingly competitive field? For individuals looking to venture beyond national borders for care, what is the mix of facilities, policies and services that will be most important? As more and more areas are offering world-class medical services, what will distinguish one from another?
None of these questions has yet been answered through research, but there are economic, legal, medical, hospitality and general tourism models that may provide some idea of which factors could be important.
A starting point is for a destination to consider the types of medical tourists it seeks to attract and what these tourists desire from their travel. Such travelers may be divided into six sometimes overlapping categories from general wellness enhancement to major surgery (as shown in the pie with each being one of the slices).
These six categories may be further divided into specialty services. For instance, major surgery offered may concentrate on such expertise as heart care, cancer, joint-replacement, etc. Less major surgery may be focused on dental or bariatric treatments. For medi-spas, the focus may be on stress alleviation, learning healthier lifestyles, overcoming addictions, botox injections, etc. Alternative therapies may capitalize on regional expertise, offering acupuncture, Ayurveda, herbal therapy, reputable native treatments, etc.
Each slice of this medical tourism pie has unique components that are influenced not only by the destination’s medical services, but also by its hospitality support, tourism appeal and governmental policies. These considerations are the shades of color shown in each piece of the pie, and they will vary in their importance, depending on the sort of treatment being sought. Estimates of these variations are shown by their relative sizes in each slice of the pie.
For example, it would be expected that all medical tourists will make quality health care central to their destination choice (the innermost part for each slice of the pie). But for major surgery patients, the quality of aftercare facilities during their in-country recovery may be a crucial secondary factor, and tourism opportunities of little importance. Those traveling for elective surgery or lifestyle reasons may give greater weight to resort accommodations and tourism opportunities which could supplement their visit. If the government has made the visa process easy, or unnecessary, those needing immediate attention may favor one destination over another, while those seeking a specific alternative therapy available in only one area may be more patient in seeking a visa. In these ways, the four components affect various medical tourist categories in different ways.
Beyond these few examples, what are the factors in each of these components that can be used to evaluate an area’s ability to meet the expectations of its medical tourists? By using economic, legal, and patient care lenses, an outline for each has been compiled. This is just a starting point, and the model may be modified once studies have been done giving patients a chance to identify what was most important to them during both their site selection and in the course of their trip.
Factors of Each Destination Component
which may strengthen or weaken an area’s appeal toward the medical tourist
Medical Facilities & Services Circle
Hotel & Food/Beverage Circle
Area Tourism Support Facilities & Services Circle
Governmental & National Factors Circle
1. Costs – medical
2. Labor available – medical
3. Training available – medical (medical schools, nursing programs)
4. Financial inducements for labor – medical
5. English commonly spoken among medical staff
c. Licensure of staff
e. Staff : patient ratio
f. Ambulance service
7. Equipment available for rental (oxygen, wheelchair, etc.)
8. Private nurses available for hire
b. Safety of medication quality
c. Parallels to US medication
10. Indigenous disease threats
11. Privately operated facilities
12. Operation of “aftercare” facilities?
13. Ease of medical records transfer back to the home country
1. Costs – lodging
2. Costs food and beverage
3. Number of 3/4/5 diamond- rooms available (Are int’l ratings available?)
4. Hospitality labor availability
5. Hospitality training available
6. Financial inducements for labor – hospitality
7. English commonly spoken among hospitality staff
8. Availability of potable water in facilities
9. Reliability of electricity in facilities
10. Licensure & regulation for:
a. Food & beverage operations
b. Hotel accommodations
c. Spa facilities
11. Dietary accommodations available (gluten free, low sodium, doctor prescribed)
12. Internet availability
13. Hotel accommodations:
a. Disability & special services accommodations
b. Private baths
d. Room service availability (24 hours?)
e. Proximity to hospitals
g. Value for services provided ratio
14. Presence of spa services
a. Medical personnel associated with spa
b. Spa treatments
c. Traditional Treatments (acupuncture, herbal, Ayurveda., etc.)
d. Instruction in relaxation, diet, wellness (tai chi, yoga, nutrition, etc.)
e. Diagnostic services
f. Exercise/workout facilities
1. Costs – general labor
2. Commonality of spoken & written English
3. Availability of educated translators
a. Direct service from major American cities
b. Airlines servicing area
c. Accommodations for disabilities
d. Airfare rates
e. Frequency of flights
5. Local transportation
a. Avail. of taxis, limos
b. Avail. of buses, other public transport in hospital/hotel areas
c. Safety of available transportation options
d. Accommodations for disabled available
6. Reliability of infrastructure
a. Electric service
b. Public services
c. Waste management
7. Safety from crime
8. Local political stability
9. Distribution of service for:
a. Cell phones
10. Ease of limited mobility maneuverability (wheel-chair, pedestrian friendly?)
11. Weather appeal for vacation and for recovery
12. Destination appeal
a. City offerings
f. Traditional medicine as supplement/ alternative
13. Receptivity by locals to Americans
14. Current awareness/image of locale by Americans
When a destination decides what its primary emphases will be, it has an advantage in coordinating medical, hotel, tourism, and governmental policy so all are working together to provide the best service to those particular medical segments. Marketing then becomes communicating those specialties.
As medical tourism services develop, some of these four components will have considerable overlap. Many medical facilities are showing an interest in learning and imitating hospitality operations for instance, and even incorporating hotel facilities within their complex. Several medical centers are including concierge support, ground transportation arrangements, expedited hotel-like check-in processes, simplified billing, menus for food selection, and personal translators. Such efforts may reduce the use of outside hotel facilities for early stages of recovery, but may also provide hotel corporations and hospitality professionals’ new venues in which to apply their expertise as consultants or facility managers.
Some hospital-run recovery centers even may grow to resemble resorts more closely than hospitals.In fact, at least one facility, the Barbados Fertility Centre, has relocated the entire facility to provide seaside views from its rooms. In other cases, hotels, such as the Bodyline Resorts of Thailand, have been developed solely to serve medical tourists during their recovery time.
What seems apparent is a linkage between medicine and hospitality; however a destination chooses to do that. Other current approaches include:
- Treatment in hospital, then moving to resort for recovery (most common model)
- Treatment at resort with medical facilities (ex: Palace of the Golden Horses, Kula Lumpur)
- Fly-in treatment to medical treatment within the airport (ex: Munich airport)
- Treatment and recovery on cruise ship (ex: Renaissance Cruises)
- Traditional/alternative treatment provided at clinics or in the hotel spa (applicable to any resort with extensive spa facilities and offerings)
- Diagnosis at hospital, lodging provided at resort (a common model)
- Diagnosis done in resort med-spa (common at European spa/hotel facilities)
- Diagnosis begun on airplane while going to destination (ex: Emirates Airlines has installed medical equipment on some of their aircraft to allow basic medical information to be gathered and relayed to a hospital prior to the traveler’s arrival in the country)
- Lifestyle treatments at resort spa ~ relaxation, education, corrective behavior, cleansing, holistic approaches (services found at many spa operations)
- Drive in ~ drive out treatment, not involving traditional tourism/hotel support (particularly common in cross-border services such as dental clinics located in Los Algodones, Mexicali, and Tijuana)
While hospitality facilities are a common part of the tourist’s experience, the way in which they are evaluated by the potential traveler may be greatly influenced by the sort of treatment being sought. These considerations include physical designs of guest rooms and access to facilities, the ability of the hotel to meet dietary restrictions, and the staff understanding of needs. Other factors include the availability of privacy, service levels, and proximity to medical help. For instance, if the guest has noticeable bandaging, secluded areas in the resort may be desired by the medical guest to avoid potential embarrassment, and the availability of nursing support to help change bandages may be a valuable service provision. In the recovery from other treatments, medical gases, such as oxygen, would be an enhancement to the amenities available in the hotel room.
Beyond medical and hotel facilities, destination appeal will also be directly affected by the area’s ability to provide a pleasant, positive experience for the visitor. In fact, hotel hospitality and general area tourism offerings may be the distinguishing factor that allows an area to avoid relying solely on being the low price leader for a particular medical service. With increasing competition in medical tourism, a destination must avoid the perception that its medical services are simply a commodity, or it will be vulnerable to cheaper service offerings elsewhere. The potential medical visitor must also feel good about visiting the area. This good will is generated by an area’s attractions and accessibility.
Attractions include such tourism activities as enjoying the sites, culture, weather, and relaxation options of the region. As already noted, these may be less important for those travelers seeking major surgery, but for all others, these become an important way an area distinguishes itself from others.
Tourism accessibility includes facilities, such as international airport access and ground transportation availability, and access to needed services, such as being able to find others who speak one’s language, the availability of internet services, or cell phone support. Accessibility appeal is also influenced by the proximity of the destination from the traveler’s home.
Finally, all categories of medical tourists are likely to be affected by perceptions of how safe is the area, how developed is the area, and how friendly are locals toward tourists in general. These are factors influenced in large measure by government action and in fact, may be the most significant in the development of the region’s viability as a medical tourist destination. Governmental policy also determines underlying economics, legal systems, civil liberties, sanitation, dependability of utilities, and ease of access to the country.
In short, with increasing competition from more and more destinations entering the pursuit of medical tourists, areas are encouraged to take a holistic approach. Development of world-class medical service is an obvious first step, but unless an area wishes to rush into maintaining itself as simply a low-cost leader for treatment, other factors must be entered into the mix.
A region’s permanent status as a destination must factor in the blend of medicine and hospitality to serve specific types of medical tourists, it must show a finesse by which tourism options are appropriately intertwined, and it must demonstrate governmental support through policies and focus. Otherwise, its role as a medical destination may be short-lived, as newcomers compete to replace it as the cheapest provider of a particular treatment. While cost will remain a driving motivation for many travelers, if cost is allowed to be the sole factor, there is likely to be only a few areas to emerge as winners, and development of full economic benefits for an area will remain restricted.
The models and outlines proposed here are certain to need refinement, but are offered as a first step. By starting to understand the different types of medical tourists, and taking a holistic perspective on what components are important to each of them, perhaps areas may develop sustainable appeals to travelers as demands for such services increase.