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Economics & Investments

Brain Drain ~ Can Medical Tourism Reverse it?

Economics & Investments

Brain drain is a well known term in developing nations, especially in their healthcare industry. It refers to the migration of highly skilled and trained people from one country to another in search of lucrative avenues, both financial and professional.

The country from which the trained professionals migrate is said to experience brain drain, leading to a shortage of trained professionals. This shortage may have adverse effects on the country’s economy. The country where the trained professionals migrate to is said to experience brain gain. This brain gain is considered profitable for the economy as the country does not spend on training the professionals.

Brain drain is a phenomenon prevalent in all industries in every nation, especially IT and healthcare. Migration of trained professionals from these fields has created an acute shortage of professionals in these countries.

Healthcare industry in the developing nation has been experiencing brain drain since the 70’s. Healthcare professionals, especially doctors and nurses, from countries like India, Philippines, Thailand, and China etc migrate to countries like the US and the UK in search of better pay packages, better working environment and better lifestyles. This usually happens when the native country is unable to provide competitive remunerations.

Brain drain creates a shortage of healthcare professionals and may increase the number gap between the patients and the healthcare professionals. As a result, the native countries do not have enough doctors and nurses to provide healthcare to the local people of their country. In the Philippines, for every two doctors who graduate from a medical school, three leave for foreign shores, resulting in a net loss of one doctor every year.

To counteract it, the Government has started promoting medical tourism. In the past few years, the brain drain in Malaysia has intensified, with a dire shortage of specialists in public hospitals.  The country has about 20 percent of the doctors working abroad as nurses.

Industry experts feel that medical tourism may eventually be able to mitigate the phenomenon of brain drain with foreign patients travelling back to their native countries. These healthcare facilities catering to foreign patients have world class facilities and provide the highest standards of care. Treating a foreign patient is more profitable than treating a domestic patient.

Since revenue from the foreign patients are more,  the healthcare agencies are able to provide better salaries and attractive packages, better than those facilities that cater to the domestic population. As more and more people from the developed countries start coming to the developing nations for medical care, the healthcare professionals may be attracted back to the native countries, thus reversing the brain drain. Many governments are working towards promoting medical tourism in their country to reverse the brain drain.

Medical tourism may claim to reverse external brain drain but may replace it with internal brain drain with healthcare professionals moving from the public sectors to the corporate ones.  Those healthcare facilities that cater to the medical tourists not only provide world class facilities to the patients, but also a better working environment to the healthcare professionals.

Healthcare professionals earn much more in these hospitals when compared to the Government-run hospitals. As a result, more and more healthcare professionals choose to work in corporate establishments rather than in public hospitals. This internal brain drain may leave the public hospitals with less doctors and nurses than what are required for a hospital to function.

For example, Thailand experienced the replacement of external brain drain with internal brain drain in 2007 due to the higher pays provided at Bumrungrad. This brain drain was one of the reasons for the Bangkok government being unable to provide one doctor per 1,800 citizens for public health.

In India, 59 per cent of India’s practitioners are located in cities, and especially metropolitan ones. Medical tourism may intensify this gap with more health professionals attracted to large urban centers, and within them, to large corporate-run specialty institutions.

A research done by the World Bank showed that many countries are hit by internal brain drain, and the impact is more in countries who already have a shortage of nurses and doctors. However, the research also suggests that countries with higher number s of healthcare professionals may not be hit hard due to the surplus of resources. Internal brain drain in these countries could be alleviated by reforms in medical education policies.

Medical tourism may be an answer to the brain drain in many developing countries and the governments should take leverage of their potential as medical tourism destinations to bring their trained professionals back into the country. Government policies should be modified to make the maximum use of medical tourism to attract medical tourists and facilitate easy access to medical care for foreigners.

This modification needed includes not only the healthcare industry, but is equally needed for the tourism policies regarding providing medical visas. Profitable associations need to be made between the healthcare and tourism industry to promote medical tourism and provide a memorable experience to the medical tourist.

However, considering the risk of internal brain drain, appropriate policies should also be formed to take maximum advantage of medical tourism without getting the adverse effects of it. Medical education policies should be reviewed in order to ascertain uniformity in the distribution of healthcare professionals and services.

About the Author

Dr Prem Jagyasi is a Chartered Management, Healthcare Marketing and Medical Tourism Consultant. Providing high-profile consultancy services to Government Authorities and Private Healthcare organizations, he is noticeably leading medical tourism consultant. He also serves Medical Tourism Association, as an Honorary Chief Strategy Officer. He can be reached at |

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