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Editorial

Defining Medical Tourism ~ Another Approach

Editorial

Any age-old, saying or popular fable simply appears in front of us without struggle for its meaning.  Every individual has different takes on a particular notion, yet keeping the purpose and initiative intact.

For instance, when we say Humpty-Dumpty, we mean Humpty-Dumpty. We understand and visualize Humpty-Dumpty.  A person thinks different thoughts about Humpty-Dumpty, but the visualization itself has served the purpose.  No one refers to a dictionary to find out what Humpty-Dumpty means, but we know what it is.  Similarly, there would be significant value to the term Medical Tourism Definition, if we define it the same way as a well-known rhyme or a fable? If more information is needed, we can always Google it.

Well, if this can be accepted, then we don’t really need a proper definition for Medical Tourism either.   Should we rely on Internet information? Of course we should.  The Internet has done wonders in providing all sorts of information on just about any topic on Earth and beyond.  But how many of us are alert to the negative aspects of using the Internet?

Let me explain.  Imagine (if is not hard for you to imagine), Albert Einstein existing in the afterworld, searching for some information on his personal computer (which is faster than yours and without anti-virus), he finds a quote which is stated under his name, “If the bee disappeared from the surface of the globe, then human being will only have four years of life left.”  


He would have afterworld-time (obviously, not life time) shock to observe his own quote on the Internet which he never wrote or quoted. Relying on finger-click information can be as dangerous as relying on an ophthalmologist to treat you nasal disorder, which is just a matter of a finger distance organ away.

Medical Tourism is a direct result of Globalization of Healthcare; the industry is coming up in vigorous speed. This emerging industry is set to boom because of several factors which are not defined or observed clearly.  In order to define its right objectives, we need a proper definition for “Medical Tourism.”

It is correctly stated, “A definition is the envelope of ideas caught in the wall of words.”  The definition must serve the general purpose and betterment of the term.  Though the term “Medical Tourism” constitutes two words, the definition requires extensive understanding of these words.

The word “Medical” means treatment of illness, disorder or injuries.  In general, “Tourism” means traveling for pleasure. According to World Tourism Organization (WTO), the word “Tourism” compromises of “the activities of persons traveling to and staying in place outside their usual environment for leisure, business and other purposes.”

Understanding of word medical and tourism individually is not sufficient to define Medical Tourism.  Medical Tourism is combination of various and definite activities and clear understanding of such activities is essential.

Considering the above sets of definitions, the following can be observed:  When a person travels across the border and outside their usual environment, to seek medical service, the travel portion of the trip travel is called “medical travel”, and upon arrival, such person is called “medical tourist”, and such activities which includes utilization of medical services by the medical tourist, be it direct or indirect – hospitality, cultural exposure or site-seeing, is called “Medical Tourism”.

Hence, Medical Tourism could be defined as “The Medical Tourism is the set of activities in which a person travels often long distance or across the border, to avail medical services with direct or indirect engagement in leisure, business or other purposes.”

But generally, the health professionals do not prefer to mix the word “medical” with “tourism.” They have an idea that the word tourism reduces the value of decision which is primarily made for medical services. They also argue that not every patient get involved in tourist activities. An interesting argument would be if patient travels abroad, he/she would be certainly exposed to the culture, environment, food, heritage, leisure or other various aspects of destination’s activities.  Isn’t that tourism?

Obviously, emergency or critical care travels should not be considered as medical tourism. Such travels could be subject to medical travel, say be medical evacuation for instance, but not medical tourism.

Medical Tourism Statistics

There is already a lot of confusion about the statistics of medical tourism, and we don’t want to confuse industry participants more by providing vague figures, but my well researched figures are more authentic, optimistic and dependable than other fellow industry colleagues.

Also, let me ask you, how much value do statistics hold? Particularly when an industry is at emerging stage?  It is said that “Statistics are often used as drunkard uses a lamp-post… not to light his way but to support his instability. Isn’t this true in many cases?

Statistics are no substitute for judgment. Most of us can recall the story about the statistician who, going by the average depth of a river, drowned mid-way. Though we do not have an agreed upon proper definition, statistics or ways to measure performance of this emerging industry, yet it doesn’t hold us back to think about the potentiality of the industry.

Healthcare is in transformation. Medical Tourism is triggering this transformation. NHS has accepted, AMA is keeping an eye.  European Union is gearing up.  Asian Governments have started measuring the size of the pie.  Healthcare providers are improving their appearance to adopt contemporary trends. Travel agents have opportunity to recover from becoming historic icons, and facilitators are emerging. Isn’t this true globalization of healthcare in a real sense?  So what value statistics hold at this moment?

Many economists have expressed their concerns about industry’s long term life-cycle. I must agree with them, but I don’t see a decline in very near future, unless local authorities of developed the world come together to develop healthcare delivery solutions that are cost effective for its users.

Medical Tourism Drivers & The Five “A” Factors

Why do patient travel for Medical services? What are the key factors driving this industry? Primarily there are five major factors involved in decision making process of medical tourist. I call them the “5 A Factors.”   They are Affordable, Accessible, Available, Acceptable and Additional.

Affordable

An American proverb says “the laughter is the best medicine.” An American person says “it’s medicine cost that brings tears.” If medical disorder brings discomfort then treating such disorder brings problems full of discomfort. The developed world is experiencing serious problems for the cost of medical services. Millions of uninsured patients seek affordable care. This factor is key factor for the emerging industry.

Available

Many patients travel because the medical treatment not available in their local areas. This type of travel is known as “need factor travel” which makes medical tourist to opt for best available option.

Accessible

Many developed countries have care available for patients, but because of high demand the treatment and care are not accessible. In some countries, patients have to wait for six to twelve months for a surgery, hence patient search for easy accessible care.

Acceptable

Few patients travel because “medical services” are acceptable abroad. Services might be affordable, available and accessible but are not acceptable because of religious, political and social reasons. It is hard to define ethical value of such services.

Additional

This is the most important and extensive factor of all. Many patients travel because they receive additional benefits by making use of treatment abroad. It could be better care, modern technology, latest medicine, better hospitality, personalized care or privacy among others. This factor provides some sort of additional benefits to patients which is better comparable to home country.

The five above factors are the major ones which are driving patients to seek treatment abroad.  Similarly, the evolution of medical tourism industry involves five key drivers.


Five Key Drivers of Medical Tourism

Technology

Technological improvements drive medical tourism, like more efficient global transportation and communication systems.  The flattening of the world through the Internet and technology in medical industry are improving the quality of services.

Cost

When patients don’t have health insurance or their health insurance does not pay for all the care they need, the cost of the care is shifted to those patients with health insurance. This is known as Cost Shifting.


The competition in industry is not operating on the proper objectives. The focus should be on providing care to patients, not to gain economy of other countries or build the tourism sector from needy to sick patients.  Moreover, the cost of medical treatment in developed countries is extremely high. Hence, private, social and corporate health schemes are very costly.  The above pay model is shifting to individuals. Therefore, Cost is another driving factor.

Need

The emergence of the new consumer needs, like avoiding waiting queues to get medical treatment or the possibility to have the latest medical treatment, requires new solutions which are not available in consumer’s home country.  So, Need is another driving factor.

Change

Hospitals are adopting the more luxury hotel concept rather than a traditional unexciting general wards. After the surgical procedure, there is the opportunity to engage in attractive tourism, which is certainly a better change for patient. For example, a patient may take a safari trip in South Africa after an orthopedic surgery, a Taj Mahal trip after eye surgery in India, and a Mayan cultural experience after cosmetic surgery in Mexico.  Hence, Change is another key factor.

Demographics

Demographic drivers such as an aging population due to baby boomers causing significant strain on national healthcare system are a driving factor.

Competition on the Wrong Objectives

Governments, healthcare providers and so called travel agents (because of e-ticket, the word travel agent is under a discussion worthy of the history books) are busy in luring patients to hook from the developed world. The competition in the industry is not operating on the proper objectives. The focus should be on providing care to an increased number of patients, not to gain economy of other countries or to build the tourism sector from needy to sick patients.

By all means, the priority should be given to the national patients; the healthcare system should be developed and delivered on national requirements. Several organizations set different price structures for international patients. This needs to streamline.  There is a dire need of strong measures for this industry. The million dollar question is who will bell the cat?

The Industry Needs Direction

This industry needs to focus on proper objectives.  We need proper international accreditation and renewed quality of care indicators.  Health leaders need to come together to develop two-way path so that healthcare resources can be exchanged with harmony and synergy. Otherwise, the end of this story may be the same ending Humpty-Dumpty had.  Medical Tourism may sit on the wall, and after the fall, we won’t be able to put it back together again.

Dr. Prem Jagyasi is a Chartered Marketing, Management & Health Tourism Consultant in
Dubai, United Arab Emirates.

Dr Prem Jagyasi is world renowned Health Tourism / Medical Tourism Consultant. He provides exceptional, extensive & high-end consultancy services to Healthcare Organizations, Medical Travel Facilitators, Governments and Semi-Government Authorities. He is serving Medical Tourism Association (A Non-Profit Organization) as a Chief Strategic Officer, and is responsible to develop, execute and monitor marketing, brand and communication strategies. He is also closely involved with MTA team to create, protect & foster industry standards, quality of care projects & strategic developments. He may be reached by email at drprem@jagyasi.com |web: www.drprem.com .

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