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Exceeding Expectations ~ Domestic and Inbound Medical Tourism

Destination Spotlight

Traveling abroad for medical treatment has become an established practice, but the United States is experiencing an increasing growth of domestic and inbound medical tourism. In domestic medical tourism, people are crossing state lines in search of better quality health care. This is most common with specialized surgical treatments and procedures in the realm of cardiology, oncology and orthopedics

Deciding where to seek medical treatment may not only be a personal preference. Many employers are providing incentives to their personnel to encourage them to travel for medical treatments. In fact, a number of large businesses have signed contracts with large hospitals and medical practices to ensure the best deal for all parties involved.


Domestic Medical Tourism is when patients travel to a different city, state or region for treatment, rather than utilize their home healthcare facilities and providers. Patients that opt for this seek availability, accessibility and what they perceive to be high quality of care; many times involving innovative research and technology. Benefits of domestic medical tourism also include a decreased travel time, patient access to legal recourse, and an absence of a language or cultural barrier.

It may be much easier to facilitate coordination between the patient’s home physician and the treating  surgeon in the selected destination.

Some employers such as Lowe’s, who has a contract with the Cleveland Clinic in Cleveland, Ohio allows their workers to leave the comforts of the familiar to seek treatment for cardiac care, at what is considered one of the nation’s and perhaps the world’s finest Center of Excellence for Cardiology.

These employers tend to cover travel costs for the patient and their companion(s). Although it may be costly to pay for travel expenses, organizations find such savings in investing in preventative and what they perceive to be the very best healthcare options for their employees and their families that they find themselves utilizing the savings of decreased absences due to medical conditions to pay for the travel costs. Employers can also work with insurance companies to waive deductibles and coinsurance.

Many hospitals also try to entice patients by promoting the tourism aspect of their cities. They seek to provide excellent treatment supplemented by the idea that patients can participate in the city’s life and entertainment before or after their procedures, depending on the level of invasiveness. Las Vegas, Miami, Seattle and Houston are great examples of exciting cities that offer endless activities for patients and their companion(s), with the proper planning.


Orlando may be well known for its amusement parks but thanks to the building of the Lake Nona Medical City, it may now add the title of a medical destination to its credentials. This 7000-acre medical complex is anchored by The University of Central Florida Medical School.

“Name any of the centers across the country where people get on airplanes to go get their care; they all have an academic center,” Deborah German, the medical school’s dean, told American Medical News.

The complex includes Nemours Children’s Hospital, a 95-bed main facility plus a pediatric clinic; the Veterans Affairs Medical Center, a 134-bed, inpatient facility for the U.S. Department of Veteran Affairs; the UCF College of Medicine Burnett School of Biomedical Sciences building used for research and instruction; the M.D.

Anderson Orlando Cancer Research Institute, with 20 employees including 12 researchers; and the Sanford-Burnham Institute for Medical Research, which has one of the country’s few robot high-throughput screening centers, machines that can run a large number of biological tests very quickly.

Orlando has always attracted doctors, ranking as the No. 1 destination for medical meetings averaged over the past 13 years by the Healthcare Convention and Exhibitors Association. German said she thinks the medical complex does not need to become the focal attraction in Orlando, but she believes it will be an added attraction for patients and establish more medical credibility for the city.


Not only American citizens understand the value of the medical treatments available across state borderlines. International patients from all around the world also appreciate America’s reputation of great healthcare, and have for decades. This is known as inbound medical tourism, when foreigners enter the U.S. for medical treatment. According to the Department of Health Systems Management, it is estimated that between 43,000 and 103,000 foreigners came to the U.S. for treatment in 2007.

In general, quality assurance is a draw for international patients. They seek accessibility to the best technology available for their treatments & procedures along with the services of highly developed, concierge-like international patient departments.

The U.S. is home to a number of world-renowned hospitals, physicians and surgeons, and patients with the means to do so will travel to the U.S. seeking a specific name; University of Texas M.D. Anderson Cancer Center, Mayo Clinic, Mount Sinai Medical Center and Johns Hopkins Hospital.

There are a number of issues to consider when receiving foreign patients. It is imperative for hospitals to understand and prepare for the cultural and linguistic obstacles they will face. For this reason, most hospitals have an international patient department which works to make foreign patients feel welcome.  

The international patient department provides both onsite and offsite services. First, it creates marketing plans specific to each country from which it hopes to attract patients. It will also offer assistance with visas, travel planning, accommodation reservations, tours and other activities.

The department will also review payment options with the patients and help them finalize their choice. Additionally, the department offers a variety of in-hospital support. One of the main considerations are language barriers, so hospitals will often have specific reception offices staffed with employees who are fluent in the patients’ language along with educational materials and customized welcome packages.

They might also have medical and registration forms translated into the language as well. Some hospitals also have doctors and nurses who speak the language and/or have a highly developed interpretation program.

It is extremely important to make these patients feel comfortable in this new environment. As much as a hospital relies on its reputation to attract patients, it also relies on word-of-mouth marketing, which remains the strongest influencer of the purchasing of all products and services in the world according to a study by Bazaarvoice, a social marketing leader.

If patients have a good experience, they will pass that on to their family and friends back home. The international patient departments will thus often have an orientation session with the patient and physician to ease any concerns of the unfamiliar before any treatment is administered.

The use of a Certified Medical Tourism Facilitator, such as Medvoy, is highly recommended. They are able to connect international patients with top facilities and providers in the U.S. for services and procedures and treatments such as joint replacements, cardiac care and spinal surgeries. They communicate directly with doctors to insure the best quality of care is ensured to the patient and provide clarity to their concerns before and after treatment.


According to an inbound medical tourism survey done by MTA member, Stackpole & Associates, two-thirds of the hospitals it surveyed in 2010 offered these types of services. The survey also found that those hospitals provided services for special dietary needs, pre-arrival medical assessments and coordination of post-treatment care but less than half reported providing assistance with transportation needs and/or tourism-related activities.

The same survey also found that the largest percentage of patients came from Mexico (21.18 percent), the Middle East (14 percent), South America (12.33 percent), Central America-excluding Mexico (11.25 percent) and Europe (11.23 percent). In regards to the treatment sought, the highest percentages were in oncology (31.69 percent), cardiology (14.17 percent) and neurology (11.75 percent). Defined as a wide variety of surgical and medical specialties, “other” was 23.26 percent.

The research indicated that 62 percent of the hospitals surveyed provide specialized training in cultural sensitivities to the staff of the international patient department. It also showed that the price of health care was the greatest obstacle for international patients and obtaining a visa was the second. More detailed results from the survey can be found here: http://

The U.S. is trying to ease that pressure and find ways to increase inbound medical tourism. So in November 2010, the U.S. Department of Commerce awarded the Rush University of Chicago, in partnership with the University HealthSystem Consortium, a three-year $500,000 Market Development Cooperative Grant to help boost medical travel to the country.

The idea is to stimulate growth through better data that tracks international patients and services, networking across institutions and the implementation of the best strategic business development practices.

The grant is intended to support President Obama’s National Export Initiative, which aims to double exports (any form of U.S. medical care purchased by people outside the country) by 2015. The aim is to create millions of U.S. jobs with the influx of thousands of patients with a vast array of needs.

Resources (Department of Health Systems Management)

About the Authors

Daniela Abratt is a Communications Intern with a focus on Journalism for the Medical Tourism Association. She is currently pursuing a Bachelor of Science in Journalism with a minor in International Development and Humanitarian Assistance at the University of Florida, where she is also a member of the Golden Key International Honour Society.

She has worked as a freelance writer for the Independent Florida Alligator and has had pieces published in newspapers such as The Gainesville Sun, The North Florida Herald and other publications associated with The South Florida Sun-Sentinel. Daniela writes for MTA’s Medical Tourism Magazine and Health Tourism Magazine.

Eda Firat is a Global Congress Repre¬sentative with a focus on marketing and communications for the Medical Tourism Association. She graduated Florida State University with a Bachelor of Arts in International Affairs and a Minor in Business.

Due to her Turkish background, Eda provides recruitment, coordination and retention support for members of the MTA in the European region. She contributes articles to the Medical Tourism Magazine and Health Tourism Magazine.

Eda can be reached at

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