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American Hospitality ~ Inbound Medical Tourism at International Standards

Destination Spotlight

What do Bumrungrad, Cleveland Clinic and Galicia Heart have in common?  Accreditation, high quality standards and medical tourism are in the spotlight.

Bumrungrad International in Bangkok Thailand is one of the largest private hospitals in Southeast Asia with 554 beds and one of the largest international hospitals in the world with up to 400,000 international patients annually. Opened in 1997, Bumrungrad International receives 56 percent of its revenue from international patients and ranks as the top provider of care to Americans who travel outside the U.S. for medical care.

Curtis Schroeder, group CEO of Bumrungrad, said the hospital sees about 190 different nationalities each day.  “We have over 26 overseas patient coordination offices, ranging everywhere from Mongolia and Australia to Ethiopia and Kazakhstan,” Schroeder said.

“We have about nine physicians who are full-time case managers – they speak between them something like 13 or 14 languages – and they take complicated cases from overseas and come up with care plans to help the patient work their way through final diagnoses and treatment,” he added.

Aside from its International Medical Coordination department (IMCO), Bumrungrad relies on an e-mail response and contact center for all patients – international and domestic.

“It’s a round-the-clock manned business; we respond to close to a thousand international e-mails every day, seven days a week,” Schroeder said. “We have people who specialize in international insurance, and we obviously have a very large phalanx of interpreters covering virtually every modern language in the world, both on-site and available by phone.”

Bumrungrad also uses one of the most advanced computer systems in the world, which Schroeder doesn’t know “how we would do what we do without it.” The system, developed over a ten year period in Bangkok, was purchased in 2007 by Microsoft and is now known as Microsoft Amalgam.

Yes, it is safe to say that Bumrungrad International is a successful medical tourism location. In fact, it seems that the trend of outbound medical tourism to hospitals like Bumrungrad International is on the rise. According to the Deloitte Center for Health Solutions’ report “Medical Tourism: Consumers in Search of Value,” an estimated six million Americans will travel out of the U.S. for medical care.

Six million? Well, the Cleveland Clinic and other American medical tourism destinations like it just might have something to say about that number.

Destination ~ Cleveland

Founded in 1921, Cleveland Clinic has 1,800 physicians and scientists on staff and represents 120 specialties and subspecialties. U.S. News & World Report ranks Cleveland Clinic as one of the top hospitals in America and, in 2008, the clinic recorded “3.3 million total visits and more than 50,000 hospital admissions” (

The Cleveland Clinic took notice of medical tourism very early on. The Global Patient Services department was started in 1975 and dealt primarily with patients traveling from within the U.S. but now that global medical travel has grown from a rarity into an industry, Cleveland Clinic is taking on its fair share of inbound tourism.

Nora Bizri, Director of Patient Services at Cleveland Clinic’s Global Patient Services, estimated that the clinic sees about 2,600 international patients each year and works with at least 80 different nations.

“Global Patient Services encompasses both national and international patient services. We provide assistance with hotels, reservations, airport pick-ups, medical planning and general information,” Bizri said.

Bizri said Global Patient Services has 13 different language interpreters on staff who provide interpretation during medical appointments and take on the “role of social work as well – they are the only link some international patients have.”

In conjunction with its Global Patient Services department, the Cleveland Clinic strives to maintain a high level of transparency and understanding with patients.

“We have made accommodations that that we can send patients an estimate before their arrival – we don’t want them to have any surprises when it comes to operations and surgeries,” Bizri said. “We have reached out so that we can adapt and accommodate to our patients for the period of time they are here – each medical institution has its own culture, and every patient has their own culture. [Global Patient Services] acts as a buffer between patients and staff.”

Bizri said that Cleveland Clinic and Global Patient Services have gone to extreme lengths to provide a steady flow of information to patients and their family members, as well as to remain educated on cultural differences. These extreme lengths have led to “superior feedback” from international patients.

Destination ~ Kansas

While the Cleveland Clinic continues to refine and expand its involvement with the medical tourism industry, other American medical facilities are just getting started. Take Galichia Heart, for instance.

An 82-bed general acute care hospital in Wichita, Kansas, Galichia Heart opened in 2001 as a specialty heart hospital and has grown to be more than just a cardiac center. Galichia Heart now offers all services except obstetrics and pediatrics – not to mention that those services are being offered to patients both national and international.

“It’s a growing and developing program at this point – only one or two patients a week – but certainly I think we’ll continue to grow,” Vice President of Business Development Alisa Crawford said. We are working with third-party administrators – we signed a contract with one TPA that has, I think, a million lives on it.”

Galichia Heart may not be pulling in the same numbers of medical tourists as Cleveland Clinic but they are making an effort to get their name out there in the medical tourism world.

“We’re just working to get the word out in any way that we can, working with Google, working with our website – doing the kinds of things that will get us in front of patients that would consider going overseas for a procedure,” Crawford said.

And what does Galichia Heart have to offer international patients? Aside from having high ratings at and being the recipient of the outstanding patient experience award, Galichia Heart features all-private rooms, a Culinary Institute of America trained chef, a nurse-to-patient ratio of 4-to-1 and a heart surgeon who operated on over 200 hearts last year.

In addition to above average patient amenities and highly qualified medical personnel, Galichia Heart also maintains a competitive business model.

“We’re very competitive with our pricing,” Crawford said. “We compete on fixed rates with the prices that are being charged in India, Singapore and other countries.”

A competitive business model seems to be quite the focus among U.S. medical facilities that are trying to break into the medical tourism industry. Dr. Kenneth Martin, an orthopedic surgeon at Martin Bowen Hefley Orthopedics in Little Rock, Arkansas, has developed what he feels will be a successful business plan for attracting inbound medical tourism.

“We’re privately owned and we’re very efficient,” Dr. Martin said. “We can control our costs unlike some of the larger hospitals. With our efficiencies in the operating room and hospital, we can control our costs directly without having a lot of high overhead.”

This control of costs allows Martin Bowen Hefley to maintain low prices which is what medical tourism is all about, said Dr. Martin.

The 41-bed, nine-operating room facility specializes in orthopedic, spine and plastic surgery. Each room is a completely private suite, and Martin Bowen Hefley is five-star rated in both orthopedic and spine surgery.

“We provide a quality at our hospital that’s document,” Dr. Martin said. “There’s nothing else like it in Arkansas.” While Dr. Martin is yet to receive his first medical tourist, he’s searching for the best route into the industry.

“We’re going to start advertising in the near future. [Medical tourism] looks like a good market and we’d like to do it,” Dr. Martin said. “We like to reach out to other countries and have people come to Little Rock for their joint replacements and spine surgeries.”

Some Words of Wisdom

Global Surgery Network, Inc. is a medical tourism facilitator based in Alpharetta, Georgia, and is one of only seven medical tourism facilitators being certified by the Medical Tourism Association.

Founder and CEO Jack Schafer, who worked in the tourism industry for two decades before breaking into medical tourism, holds his company to very high standards.

“Without thought or concern, our client can expect all of the details of their experience to be taken care of: before, during and especially after the procedure,” he said. “To us, being able to provide “the best” is a standard that we will not sell out. Everyone wins when it’s done right.”

As expected, hospitals and medical facilities are held to equally strict standards. Global Surgery Network, Inc. currently has a network of eight medical providers whom Schafer describes as being “among the best in the world. Period.”

“All of our providers have been visited and inspected. They are all accredited and meet very demanding criteria,” Schafer said.

And the criteria?

“We certainly look to International Accreditation, such as JCI,” he said. “Beyond that, we require the review of a physician’s or surgeon’s resume – any good surgeon will be proud to show it off. Experience, more than anything else, is what we use to bring providers and surgeons into our network.”

Schafer also emphasized a need for clear dialogue on both sides of the process – international departments must be able to communicate in whatever languages they will be dealing with, in addition to their own.

Most importantly, Schafer said, hospitals and medical facilities need to focus on being just that – providers of first class medical procedures. “Stop trying to do it all. The ‘experience’ is a lot harder to manage than the procedures for those not familiar in dealing with travelers,” he said. “Facilitators do play a very important role in making the overall experience work. Either you compete with them or use them as partners.”

Bumrungrad’s Curtis Schroeder pointed out the importance of self-assessment as well. “The one thing I would say to any people interested in embracing international medical tourism is that it’s probably more complex than they’re anticipating,” Schroeder said.

One of the most common mistakes hospitals going into medical tourism make is that they assume they always have the fundamental draws for medical travel, Schroeder explained. Rather than sandy beaches and temperate weather, medical tourists are seeking quality medical procedures, easy access to them and affordable prices.

“You have to first look at your own infrastructure in your home country and make an honest self-assessment of whether people from another country would want to come, would be happy with the environment and services, and you could provide them in a cost-effective way,” Schroeder said.

Marking America as a Medical Tourism Hub

The world of medical tourism is growing quickly and while the emphasis may seem to be on Americans leaving the U.S. for cheaper medical care, it’s important to remember that medical tourism is a two-sided coin. High quality and modern technology attracts international patients to some of America’s top hospitals and medical facilities. American medical providers are placing their own stake in inbound medical tourism and are reaping the benefits – some are operating on large levels like Cleveland Clinic, while others are just hoping to see what kind of international patients they can help like Martin Bowen Hefley. Medical tourism is an encouraging market for U.S. medicine but all the same, it’s not an industry to be taken lightly.

“The message is that it is quite a complex project,” said Schroeder. “It should not be taken on by the faint of heart – it involves a significant investment in time and effort and understanding, but it can prove quite a good business model if you’re willing to put the time and effort into it.”

Those interested in getting involved in medical tourism are encouraged to make a thorough self-assessment and work to develop a competitive business plan and comprehensive international program, as found at Cleveland Clinic. Many medical facilities and entrepreneurs have recognized the business potential that inbound medical tourism represents, and are taking measures to adjust their procedures and protocols to better accommodate and attract inbound medical tourism.

In the world of medical tourism, the United States is certainly a prominent figure.

Cayla Lambier is a senior undergraduate at Washington State University, where she studies journalism and English. Her involvement with the communication industry is steadily growing and has expanded into print, radio, internet broadcast and public speaking. She is a contributing Editor to the Medical Tourism Magazine.  She may be reached at

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