Perhaps no other subject today has been the subject of conversations at cocktail circuits as much as the subject of Medical Tourism. But for the lay person it conjures nothing more than the idyllic comfort of the warm beaches of Florida or Pattaya while getting a face chiseled to the likes of Angelina Jolie or the carving out of a smile of Robert Redford.
But in reality Medical Tourism, a misnomer of present times, is a really serious, over $40 billion business with perhaps not too much thought really given to it. But we will have to accept that every swimmer jumps into a pool without really checking out the temperature of the water.
Its time we made some serious distinctions — lifestyle centric tourism destinations vs. medical care centric destinations. Cosmetology, dental care, day care ophthalmic procedures and other such day care procedure aptly fit under the category of lifestyle centric tourism. They perhaps warrant the picturesque brochures with the warm sandy beaches and the tropical sea backdrops with a Bacardi evenings thrown in.
Centers in Turkey have made a success of a cataract procedure programs well packaged into a weeks holiday and the tales of Thailand is legendary. But we need to get our format right. Advance secondary care or tertiary care treatment needs a careful repositioning. They will need to be centers of clinical excellence with infrastructure and clinical backup to match.Â Their being on a scenic location would, off course, only be a bonus.
In a recent global summit organized by Harvard Medical International in Boston in October 2007, what clearly emerged were the progressive and forward steps already taken by hospital organizations across the world to stake their claims to the fortunes of Medical care programs. Turkey, Greece, Dubai, India, China, Malaysia, and Singapore are a few of the countries that have recognized the potential of this business. But another clear picture is also emerging. For Advance Medical care program business will be soon be time-centric and all these countries have unsolicited business within two flying hours in any direction.
This may soon be the main consideration for mobility between nations. It is also of serious consequence for Americans to deal with the exodus of uninsured patients to some third world countries.Â There you have heard horror stories of unscrupulous agents who lured patients on cost considerations to consequences of gross medical negligence, gross clinical incapabilities and no appropriate medical infrastructure to back their claims to fame.
I am an advocate of globalization. I also feel that nations will become destinations of excellence in chosen fields, so why not for Medical care if they do have the facilities and clinical outcomes of world class. If we do chose to be borderless in this endeavor, we need to put across a globally acceptable format to be followed by those who wish to be a part of this new trend. Nations will need to agree to an accreditation process for hospitals and facilities and clinical capabilities.
Clinical outcomes information will have to be transparent, audited and known. We will have to set up a code of conduct for clinical teams and follow and internationally accepted medical standards, which must be framed. We will also need to have a legal code of conduct, which is universally applicable so that there is deterrence to medical malpractices.
We will also have to address the issues of post medical follow up issues and rehab programs. Advance tertiary care programs need significant post follow up at the patient’s home location. There will need to be a structured acceptable rehab program at the operating hospital to be synchronized and contiguous with the program that is required to be carried out at his hometown. Web based connectivity programs will have to be a part of this exercise so that there is no disruption or discontinuity in the line of treatment of the patient concerned.
Clinical outcomes are also dependent on the conditions on which patients are brought in. There will have to be total transparency of the diagnosis and prognosis of a patient from the referring center and it would have to be equally mandatory for a patient to undergo all the required tests in such referred hospitals if the diagnosis has to be reconfirmed and the most appropriate line of treatment be administered.
Insurance companies are justified in trying to keep costs under control and therefore accredited and empanelled hospitals and clinics is the right approach. But insurance code of conduct has to be again universal and transparent and all empanelled hospitals will need to be well acquainted with their process and the allowables and disallowables so that Medical care centers are not put to a loss.
A clear antibiotic and medication policy also needs to be in place for all kinds of procedure set by clinicians of eminence and not by graduate medical staff of insurance companies who in all fairness cannot hold a brief to deciding the medication policy to be followed by senior surgeons and consultants. Therefore once again a common format and process has to be agreed between all insurance companies so that the system is productive, fast and user friendly.
Medical Care destinations are not the low hanging fruits but matters of life and death if not addressed properly. The process of clearances at immigration points in various countries will need to address this important facet of business and provide for a quick and accelerated process of clearances so that the patient is not inconvenienced.
The paper work needs to be dealt with through a separate high-speed channel. Any negative outcomes also need equally a quick, humane approach at the consulates concerned, the local police and the immigration authorities.
We are still at the threshold of the inflection point of “Medical Tourism”. Is it just a short-term blip or a long-term robust trend transforming itself to a global industry is yet to be seen? An apt comment heard was “Why don’t you get our roads rid of potholes and then lets talk of medical tourism”. Seriously, first the infrastructure, connectivity and convenience need to be in place in aspiring countries to take on this gamble.
Service sector is definitely here to be a dominant part of every nations GDP and Medical Tourism is certainly going to make or break some nations if not handled right. A cross borderless world is inevitable, but success will be for those who have strategically thought through Medical Tourism as a national priority like Malaysia, Singapore and Thailand which now is globally promoting this sector.
One will also be well cautioned to note that the most scarce resource that is clinical and para medical talent will also suffer cross border mobility for which currently there is not a serious answer. There are shortages of beds, doctors, nurses, and paramedics of large magnitudes inadequate to meet the basis healthcare needs of the home countries themselves. It will be an intricate mathematical exercise to see how these equations will fit in when global needs are to be addressed.
Mr. Anil Kamath is the Managing Director of Wockhardt Hospitals, India. The views expressed are strictly the personal views and no part represents the views of the organization he represents. Mr. Anil Kamath is a Chartered Accountant by qualification and is an alumnus of the Michigan Business School, Ann Arbor. He is a Member of the Chartered Management Institute UK, The Institute of Certified Internal Auditors USA, the Royal Society of Health UK, and the All India Management Association.
He started his career with Wockhardt in 1976 when he headed the Finance, legal and Secretarial function till 1984. He thereafter was associated mainly with Unichem labs Ltd and Blue Star Ltd as Vice President and Executive Vice President respectively till his return to Wockhardt in 1998 to handle its Business Development and the Hospitals initiatives. Currently as the Managing Director of Wockhardt Hospitals Ltd he is responsible for all new initiatives in Joint Venture hospitals projects and their operations in addition to his corporate role of Business development, Finance, Supply Chain and Equipment procurement, and Information technology.