Sorry, I could not read the content fromt this page.Tuesday, October 26, 2010
Unicondylar or Partial Knee Replacement
Unicondylar or Partial Knee Replacement Sorry, I could not read the content fromt this page.Control Your Health Destiny
Related Medical Tourism Articles Sorry, I could not read the content fromt this page.Hip Resurfacing Surgery in India - How to Cut the Costs in One Fourth
Hip Resurfacing Surgery in India - How to Cut the Costs in One Fourth by Alampallam Venkatachalam Hip replacements are in great demand amongst America' s Baby boomers afflicted by Osteoarthrits. A total hip replacement is the ideal operation for these people in their seventies and eighties. In India however the majority of patients afflicted by hip arthritis are young. Ankylosing spondylitis, avascular necrosis, post traumatic arthritis, rheumatoid arthritis are conditions affecting young patients in their thirties. Hip resurfacing or Proxima hip replacements are the ideal operation for these young patients as they preserve bone, last longer and cause less pain.
What are the types of Hip replacement?
The traditional total hip replacement has been around for nearly 40 years and provides great benefits to the elderly afflicted by osteoarthritis of the hip. In this a metal stem is implanted in the upper end of the thigh bone and a socket made of polyethylene is cemented into the acetabulum. Wear particles are liberated and these lead to aseptic loosening in fifteen years. Bone loss occurs and a revision surgery may be needed after the time of the prosthesis runs out.
A Surface hip replacement resurfaces only the top of the hemispherical head of the femur. It is a bone conserving surgery. It has been in the market for nearly 5 years.
A latest type of hip prosthesis has been introduced in India called the Proxima hip. It consists of a large diameter metal head and cup. It resembles a total hip with the distal or long stem like portion cut away and the prosthesis is implanted only in the proximal part of the femur or thigh bone( Hence the name Proxima). It has a ten year follow up in the hands of the designer Orthopaedic surgeon from Italy.
The advantages of the Proxima hip are:
a) Less incidence of dislocation and
b) Low wear rate leading to longevity for hopefully more than 20 years.
A surface hip replacement needs a large incision to implant the prosthesis. However the Proxima hip can be introduced through a small approach. Minimally invasive surgery or MIS. This new hip replacement has been performed recently for the first time in South India.
Hospitals in Chennai.
The hospitals are well equipped and have laminar air flow operating theatre, which reduces the infection rate tremendously. Your stay in hospital would be comfortable in a choice of rooms and special menus can be ordered.
Costs of total hip replacements in the west and India.
A Total hip replacement costs about 30, 000 US dollars and is unaffordable by those without medical insurance. A surface hip replacement is also infrequently available operation in the United States as there are few trained surgeons only. This costs more than 40, 000 US dollars. Hip replacements surgeries done in India are easily affordable and performed to the same standards as in the west. The cost in India is about 6000 - 7000 US dollars. Thus by choosing Chennai for your Hip resurfacing or Proxima hip replacement, you will get the best quotation for your operation in India.
After surgery, you can have a post surgical holiday in a beach near Chennai or head of to the neighboring Kerala or Goa.
Related Medical Tourism ArticlesHealth Tourism, the Next Great Health Care Frontier
Health Tourism, the Next Great Health Care Frontier by PlacidWay Have you ever gone to another country on vacation? Have you ever marveled at their culture and their way of life? There are many countries such as Thailand, India, and even Costa Rica that have hidden treasures you may not be aware of. Treasures that once discovered can change your life and your health forever. There have been medical treatments that have been practiced for centuries in Asia and other parts of the world. The use of these techniques has been proven to work and are continued to be practiced today. The great thing about these ancient remedies is that they usually do not have all of the health side effects that some more modern techniques and medications have today. Just turn on the television. It is full of commercials promising that the new pill that just hit the market is a miracle drug. While you see images of healthy happy people, the announcer tells you how people?s lives have been changed by this new life saving drug. Then toward the end of the commercial, in an almost whisper, the announcer rattles off a whole list of side effects that sound like a horror show. The only thing that is a miracle is that someone would actually take the risk of trying that new drug of the day. Are you, like many others, tired of this roller coaster of being sick and never really getting better? Some people have found the key to getting healthier, health tourism. What is health tourism? People are going to other countries to seek alternative, yet proven treatments of getting healthier and better. Instead of just going to see the sites in other lands, people are going to places such as the Jiva Ayurveda and Indus Valley Ayurveda Center in India to get treatments not available to them where they live. It?s not just alternative treatments people are seeking; there are modern treatments they are seeking in other countries as well. For instance, let us say you are looking for Lasik surgery to improve your eyesight, you might consider going to the Thailand?s TRSC International LASIK Center. What about orthopedic surgery that you have been needing but have not been able to schedule with local doctors because they have waiting lists that are months long or is significantly expensive, you could go to the Knee/Orthopedic Surgery Center in India. It?s not only medical treatments that people are traveling to get help with; there are also dental clinics like the Advanced Dentistry Costa Rica. They handle a variety of different dental procedures to help you get that smile you have always wanted. You might be wondering how you can find these places and set up appointments today. Keep reading because there is a wonderful free site called PlacidWay that can help you. The medical tourism industry is growing by leaps and bounds. People are traveling out of country and even places within their own country to seek both modern and alternative health services. There had been some bad press in prior years about people seeking health treatments abroad, but this is not true anymore. Places like Thailand are famous for Lasik surgery or dental care and India for Orthopedic surgery use modern technologies and procedures, while offering world class treatment to you for less. This is because in places such as the Untied States, doctors have to pay outrageous rent, medical insurance and licensing fees that they have to hike up their prices just to make ends meet. In other countries the cost for these items are much less and therefore they can charge less for their procedures. Treatment centers around the world want to do business from these traveling health tourists so they are getting international accreditations and certifications ensuring that they are using and practicing medical and alterative medicine procedures at the highest standard possible.Places such as India and Thailand are catering more to health tourist. With modern places to stay, traveling to these destinations has become easier and more affordable. These countries are becoming serious health destinations for those people that have discovered the health tourism secret.You may live in a country that has socialized medicine. This means long wait times, procedures not being available and doctors and facilities becoming health factories. They do not give you the time and care they should because they are so overburdened. When you make appointments in places such as Bangkok Hospital Medical Center, they take the time and are ready for your arrival. You can go when it is convenient for you and the wait time is much less then places located in countries with socialized medicine. One of the biggest areas that people are seeking medical treatment for is cosmetic surgeries. These types of procedures are rarely covered by insurance, and are rather costly. People have discovered that they can get the same procedures for less in other countries than they would locally. This includes the cost of travel expenses. Are you interested yet? Do you want more information? I mentioned earlier a site called PlacidWay. This revolutionary site provides for all of your medical tourism needs. Some of the benefits at the site are search engines that not only allow you to look at what various countries around the world have to offer, but you can also search just using the procedure you are looking for. The site provides lists of where the best providers are and links to their sites so that can you can learn more. PlacidWay provides you the ability to book travel and hotels right from their site. What could be easier? There are monthly articles to feature what procedures are available and the best places to seek those procedures. Did I mention this was free? Yes all of the services are available for you to use for free. From finding out where to get your next liposuction treatment to getting heart surgery can all be found at PlacidWay Site. Try it today; see what others have found to be the next great frontier in medicine, Health Tourism.Please click here for more information.Hospitals are a place to get healthy, not sick!
A gentleman from Britain that recently had a leg injury while skiing in France, instead of going to the local hospital, he went on the internet. He found a place in Norway that provided the treatment he needed. He booked his flight and off he went.Why did he choose to travel rather than get treatment locally? He is like many people from Britain, Canada, and the United States that are becoming medical tourists. In the British man?s case, he wanted to go to Norway in order to avoid a growing concern over a very contagious germ called MRSA that plagues many hospitals in Britain and other countries. There are over 5,000 deaths in hospitals a year in Britain caused by infections people contracted while staying in a hospital. Norway has the lowest percentage of MRSA infections in Europe and has become a destination for those looking for quality and safe healthcare practices.Today, over 1.3 million medical tourists are seeking low-cost, high quality healthcare options in top tourist destinations around the world. Europeans are increasingly selecting Scandinavian countries such as Norway which offer serene environment and like culture.One of the other concerns that this British man had was that he was going to have to wait four weeks for a consultation with a specialist in Britain. Upon contacting Scanhealth Scandinavia, he was able to book his trip in a couple of days, see a specialist, and have the surgery that same day.Another woman from Wales needed an MRI and was told she would have to wait 18 months. She contacted Scanhealth Scandinavia and was able to go immediately to Norway to get the same procedure. They promised that they would do the surgery, if needed, the same day. She fortunately did not need surgery for her shoulder. The price tag? It would have cost 325 pounds for the procedure would have had to wait for over a year to receive. Her trip to Norway including the procedure was only 500 pounds. One of the benefits for her was that Norway was so much like Wales that it was like being home. This same testimonial is echoed by a couple that are receiving fertility treatments in Norway for less than they would in Britain. They stated that it was nice to get treatment right away, for less money, and it was comforting that they were being treated by people who spoke English as they did. The testimonials about the wonderful care and comfort people found in Scandinavia are overwhelming. If you are interested in getting medical care, you have been waiting for months to receive and get them for fraction of the cost, then log on to Placidway.com today. PlacidWay presents you global healthcare possibilities that are comprehensive, economical, world-class, and without borders. PlacidWay is your one stop for all of your medical tourism needs.
Sick and Tired of being Sick and Tired!
Sick and Tired of being Sick and Tired! by PlacidWay Are you tired of being tired? Are you sick of being sick? Have you had to take a 2nd mortgage on your home just to pay for the 20 or so prescriptions you have to buy every month, and you still are not feeling any better. You may be one of many people that are being treated for symptoms of a problem rather than diagnosing the root of the problem. This is why a lot of people are looking for alternative treatments that can be supplemented and integrated with their modern healthcare options. One of such natural and herbal treatments is Ayurveda. This is not a new age fad, or an untested method of medicine. Ayurvedic treatment has been practiced in India for thousands of years. There are thousands of health tourists, who are traveling to India, seeking to revitalize their life through organic and holistic healing. Ayurvedic medicine is a comprehensive treatment of whole person - physical, mental and even spiritual aspects. The goal is to rebalance you, make you whole and healthy again, and have a renewed sense of life and vitality. Jiva Ayurveda and Indus Valley Ayurvedic Center are two such premier health destinations in India where physicians have developed an intimate understanding of every aspect of your physical, psychological and emotional being. Here you are treated with dignity, as a unique individual who has the ability to recuperate fully with care and support brining you body, mind, and soul back into harmony using herbal and natural treatments.Have you ever noticed the increasing numbers of Indian doctors working in American hospitals? You feel safe and confident on their ability to provide you with best care. You can expect the same or even better from doctors working in Indian hospitals and clinics. They give you an undivided attention with round the clock nursing care and you don?t feel rushed. Several of the Indian hospitals are getting JCI certifications, meaning they are achieving highest international accreditation and provide care equivalent or better than any American JCI certified hospital.India has quickly become the number one destination for people participating in health tourism. Hundreds of thousands of people from countries such as UK, Middle East, US, and Canada are flocking to India to experience not only alternative medicines but also elective procedures as well as surgical expertise and care that the country has to offer. Medical tourism focused companies, such as Sahara Global Medical Tourism, has formed relationships with world class premier medical centers and clinics that offer every thing from heart surgery to cosmetic surgery to rejuvenation tours. The rise of service oriented medical tourism is your passport to good health that can bring you that smile you always wanted and that too at a significantly lower cost.Orthopedics is one of those procedures that India is becoming famous for. Orthopedics and joint surgery experts such as Knee Surgery Center in Chennai, India are truly the world authority in knee, hip, and solder surgeries. They are performing orthopedic surgeries using most advanced procedures and techniques currently known in a modern medical field. The healthcare centers in India are fully staffed with a competent nursing staff to ensure that you are healed and ready for discharge rather than pushing you out the door because they are overbooked and understaffed.Are you interested in traveling to find out what millions of healthy people that practice Ayurveda already know? Why not experience India?s rich culture and visit the Taj Mahal walking for the first time using your new knee! There are many world-class healthcare centers in India and other wonderful locations around the world that offer treatments in dentistry, lasik eye surgery, plastic surgery, and many more. Remember to book your trip to one of these fascinating destinations through www.placidway.com. It is free and meets all your medical tourism needs. PlacidWay Partners with Knee Surgery India to Offer Affordable Orthopedic Options in India
PlacidWay Partners with Knee Surgery India to Offer Affordable Orthopedic Options in India by Barbara Hernandez Denver, October 26, 2007 -- To meet the growing demands of international patients looking for high quality and low cost medical solutions, PlacidWay, a leading health and wellness tourism company, has announced a strategic alliance with India?s Knee Surgery Centre. Knee Surgery Centre, provides patients throughout the world with high-quality, cost-effective orthopedic care including knee, shoulder, and hip surgery.PlacidWay?s partnership with the Knee Surgery Centre, Chennai will benefit thousands of patients suffering with various types of knee and joint disorders. Patients from around the globe with orthopedic problems are coming to this South Indian city to seek treatments such as total knee replacement, hip resurfacing, partial knee replacement, proxima hip and oxford knee implants. The orthopedic surgeries are performed by globally-reputed joint replacement surgeon, Dr. A. K. Venkatachalam, who received his training in the United Kingdom and Belgium. He has pioneered high flexion knee replacement, unicondylar replacements, and proxima hip surgery. Dr. Venkatachalam has already performed over 3,000 knee arthroscopies and more than 1,500 knee replacements surgeries.?The baby boomers in America and other countries with osteoarthrits are increasingly seeking affordable high quality hip replacement solutions. Keeping up with latest advancements in orthopedics, we perform hundreds of such surgeries in India for far less than private treatment in the UK, Canada, USA or Middle East. Our medical standards meet or exceed US and UK guidelines. The cost of a knee replacement is only ?3500 or US $7000 versus 40,000 USD in the US or ?9000 in the UK for a total knee replacement surgery,? says Dr. Venkatachalam.PlacidWay specializes in providing comprehensive global healthcare possibilities, which are both economical and world-class. By utilizing PlacidWay?s extensive network of medical facilities from Norway to India, patients can choose their own treatment in a country of their choice for free. The company provides a vast range of treatment options such as alternative medicines, elective procedures, surgical procedures and wellness programs. According to PlacidWay President and Chief Executive Officer Pramod Goel, ?Patients from around the globe, who are suffering from orthopedic problems, are increasingly traveling to exotic destinations, such as India to regain their musculoskeletal health and vitality at fraction of the cost. The partnership with the Knee Surgery Centre will enable patients who are without effective medical insurance or with long wait times to get orthopedic treatment at a reduced cost while making no compromise, on quality of healthcare.? Please click here to get more information from Dr. Venkatachalam. Related Medical Tourism Articles Millions of People Can Not be Wrong. Find out why they are living Longer and More Healthy
Millions of People Can Not be Wrong. Find out why they are living Longer and More Healthy Related Medical Tourism Articles Medical tourism statistics: Comparing apples with apples ....
At Treatment Abroad, we’ve recently completed some research into the medical tourism market for a third party. It’s been an interesting exercise and has really made us question some of the statistics that are quoted (and that often become accepted truth) about the number of medical tourists and the value of the market. What is a medical tourist?
The first challenge in estimating market size is to be very clear about what a medical tourist actually is. He or she isn’t a tourist. It’s someone whose specific reason for travelling to another country is for medical treatment. It’s not someone who happens to fall ill and requires treatment when they are on holiday/vacation.
Yet many tourism organisations, government bodies, hospitals and clinics classify ailing holidaymakers as medical tourists. They are not.
The data from one destination that we examined claimed vast numbers of medical tourists but in the “small print” acknowledged that the vast majority of these happened to fall ill while visiting the country for other reasons, either business travel or holiday travel.
Another inflationary factor is the expatriate resident. Back in the 1990’s I was involved in the marketing of the Portland Hospital for Women and Children in London. We used to track hospital admissions by nationality of patient. Based on that analysis, the hospital was the biggest medical tourism destination in the world for American medical tourists..... or was it? Of course not. As the only private maternity hospital in London, it attracted a large number of American women whose families were based in or working in London. Did a single American woman fly across the Atlantic specifically to give birth or for gynaecological treatment in London? No, but we could have made it look like plane loads were arriving every month!
Comparing apples with apples
Before the dawn of computing, I studied statistics at college. What I learned about statistics is that you have to compare like with like. You compare apples with apples. But in medical tourism people compare apples with grapes, and oranges with lemons...... Let me explain....
Let’s agree that a medical tourist is someone who travels specifically for treatment in another country, And let’s also agree that medical tourism is a specific segment of the health tourism market which does not include travel to medical spas or wellness resorts or for non-invasive therapy. For the sake of clarity, we’ll exclude dental travel from medical tourism in this instance.
So John Smith jumps on a boat or a plane or a train or into a car and crosses a border into another country and has...an operation or an elective procedure. (Should we include patients who don’t stay overnight? There’s another discussion...).
Are we agreed on what a medical tourist is? Good. John Smith is a medical tourist. He’s one medical tourist, isn’t he?
Well..... that depends where he goes.
In Country A (or in Hospital A), he counts as one medical tourist.
But in Country B (or Hospital B), he counts as 20 medical tourists.
20...am I mad? No.
This is how it works in Country B.
John Smith arrives in Country B. He visits the specialist, and the hospital raises an item of service bill for the visit. The hospital records him as one medical tourist treated.The specialist sends him for an X Ray. The hospital raises an item of service bill for the visit. The hospital records him as another medical tourist treated.The specialist sends him for some pre op blood tests. The hospital raises an item of service bill for the visit. The hospital records him as another medical tourist treated.He has the operation. Bingo! Another medical tourist.He collects some medication from the hospital pharmacy. Another medical tourist.He has post op physiotherapy for ten days.... ten medical tourists.And so it goes on.....John Smith is one medical tourist but according to the hospital records he’s twenty or thirty or maybe even more. And this is good news for the marketing guys in the hospital and at the tourism board. They have some pretty impressive medical tourism statistics.
So, we can see that the medical tourism statistics quoted by some destinations are subject to “statistical error” but not the kind of statistical error I learnt about at college. In some cases this is error on a magnitude of ten fold or twenty fold or even more.
Take medical tourism statistics with a pinch (or sack) of salt
When you hear the latest claim of medical tourism numbers from a hospital or a medical tourism destination, take them with a pinch of salt (or perhaps a sack of salt). And do some basic “hospital” mathematics. If they’re claiming let’s say 200,000 medical tourists a year, ask them where they are putting all the patients.
Let’s put this number into perspective. The Royal National Orthopaedic Hospital in London is the largest specialist orthopaedic hospital in the UK. It’s a very busy and successful hospital. Last year, it admitted around 10,000 patients to its 220 beds. That’s around 45 patients per bed per year. So, 200,000 “real” medical tourists might need....4,400 beds....and hospital beds are hard to find in many countries.
So how do we fix the problem?
When the UK NHS publishes statistics on hospital performance (See Hospital Episode Statistics Online), every set of statistics it publishes has a “responsible statistician”. He’s the one who ensures that they’re comparing apples with apples.
Let’s appoint a “responsible statistician” for medical tourism. Any volunteers out there?
Change in UK regulations may reduce infertility tourism
One factor that can affect any aspect of medical travel and medical tourism is that the market sector can be a victim of its own success. Constantine Constantinides has highlighted this previously in his IMTJ article “Medical Tourism and the West's Revenge”, arguing that in effect the success of medical travel is self limiting. How can this success be self limiting?
Where overseas treatment becomes an attractive option for patients, domestic providers and governments may react to this trend by becoming more competitive (e.g. by reducing prices for local treatment) or by removing the causes and drivers for medical travel (e.g. by changing local regualtion of a treatment). Thus, the more patients travel abroad for treatment, the greater will be the reaction within the domestic market and a “balance of trade” will be reached.
An excellent example of this phenomenon is this week’s announcement by the Human Fertilisation and Embryology Authority (HFEA) that it intends to conduct a consultation over changes to the rules governing egg and sperm donation in the UK. There has been a significant shortage of egg and sperm donors in the UK due to the restrictions on the payments that can be made to donors. The £250 maximum "compensation" payment for both men and women donors has meant that demand for donor eggs and sperm has far exceeded supply. Waiting lists can be as long as two to three years for those patients eligible for NHS treatment.
The removal of donor anonymity has also been a contributing factor to the reluctance of donors to come forward. According to the most recent HFEA statistics (2008), only 1,184 women donated eggs and there were only 396 new sperm donors in 2008. Around 2,000 babies a year are born in the UK using donated eggs, sperm or embryos. As a result, we have seen an increasing number of UK couples seeking infertility treatment abroad; it has been one of the fastest growing areas of medical tourism. (For the background see “New research paper provides insight into infertility tourism”). The response from the HFEA to the increasing number of infertile couples going abroad is therefore to consider how to reduce this ...... by increasing the payments and incentives to egg and sperm donors, AND thus increasing the supply of eggs and sperm. Payments may increase to £1,000 plus.
It’s unlikely that the changes will have any immediate effect on the market sector. No decisions will be made until the end of the HFEA public consultation next year. The three-month public consultation will not start until January 2011 and the HFEA is expected to be subsumed into the UK’s Care Quality Commission as a result of the UK public expenditure cuts. But there’s a clear warning here for those involved in medical tourism businesses and the medical travel sector. Don’t put all of your eggs in one basket..... Or more seriously, be aware that any segment of the medical tourism market may be limited by its own success when domestic providers and governments seek to reverse the trend.
The challenge facing the medical tourism industry
The recent European Congress on Health Tourism in Budapest reflected some of the current issues and challenges facing the medical tourism industry, particularly those presented by a world recession. Budapest is Europe's dental tourism hub, attracting patients from countries such as the UK, Ireland, Germany, Austria, Switzerland and Scandinavia. If the recession is hitting medical tourism, then Budapest is going to feel it more than most.There were workshops and presentations from various providers and industry players at the Budapest Congress. One of the more down to earth of these presentations was made by Dr Bela Batorfi of The Batorfi Dental Implant Clinic in Budapest. This impressive clinic usually carries out around 1,800 dental implants per year. But with the onset of the global financial crisis they have seen some worrying trends:The number of patients from abroad has fallen by around 30%. Medical tourists are harder to find!The average spend per patient has decreased from around £5,000 to £2,600. Medical tourists are spending less per visit.The average age of patients has increased. Medical tourists are delaying treatment.
The experience of the The Batorfi Dental Implant Clinic is reflected among many of the other dental treatment providers in Budapest. It's not the case that Budapest is losing patients and market share to other destinations. Understandably, many clinics are concerned about the fall off in business and how long it will continue.
Against the backdrop of the financial crisis, Hungary is one of the many countries planning a "medical city" aiming to attract patients from across the world to a centre of medical excellence. According to Balázs Stumpf-Biró, Executive Director of the European Medical Tourism Alliance (EuMTA), Hungary is planning to establish 100 hectares of land near Budapest’s international airport as a health complex, similar to Dubai Healthcare City.
Whether this development suffers the same fate as Dubai Healthcare City remains to be seen. The initial building boom in Dubai has come to a grinding halt. Building anything in the current financial environment is a risky business, and with the medical travel market to Hungary down around 20% to 30%, it's going to be a brave investor who lays the first brick.
Various estimates of medical travel numbers for Hungary put the number of incoming medical tourists at around 300,000 to 350,000 per annum. The vast majority of these are for dental treatment, and many may be "short trip/low cost" cross border visitors from Germany and Austria. But that's still a valuable market.
So what's the long term outlook for medical tourism destinations such as Hungary? Better than most, I would suggest. The medical travel market is here to stay and is here for the long term. Hungary has been at the forefront of medical travel in Europe for the last decade and it can retain that position.
But like most countries being encouraged down the medical tourism route it needs to tread carefully. We hear the usual overblown claims by industry proponents such as the Medical Tourism Association that "the biggest potential market for Hungary is the USA". I can just see hundreds of thousands of Americans getting out their maps of Europe, locating Budapest and booking their long distance flight via New York/London/Amsterdam for their dental implants. It isn't going to happen.
So where should Hungary be focusing its efforts?
Well... :
There's a population of 550 million in the "United States of Europe" who may begin to exploit the opportunities within the EU Directive on patient mobility.Not so far away from Hungary, there are 140 million Russians who are beginning to spend their money on holidays all over Europe. Medical travel will follow this trend.And the UK dental problem is here to stay. See this recent article in the Independent: This may hurt a little: Rise in hospital admissions for last-ditch tooth extractionsMy advice to Hungary... The same as you would get from business guru, Tom Peters (In Search of Excellence).
Stick to the knitting - stay with the business that you know!
The war of words....Is it medical tourism or medical travel?
I just read Constantine Constantinides informative and latest missive on medical tourism. Constantine runs Healthcare Cybernetics and is one of the "wise heads" of medical tourism.
Constantine says:
"I am getting fed up with industry newcomers (the “Johnny-come-latelys”), industry outsiders and the self-important upstarts who take issue with the word Tourism – claiming it is not “grand” enough for them to be associated with.They propose replacing it with the word “Travel”. Some even suggest we dump everything and start talking of Global Health (as if healthcare has not been global for ages).......I do not like the “tourism” word – but neither do I like the several suggested alternatives"
He makes some interesting points:
"The word Tourism is derived from Tour - from Anglo-French tur, tourn turning, circuit – a there and back journey.Travel may not include a “back”.
So, here's my two pennyworth (English idiom!).
Let's start with Google's view. Why? Because Google reflects the way that people use words.
I did a search on Google UK for various terms:
A search for medical tourism generated 19,700,000 results. (Our Treatment Abroad and related web sites secure three of the top ten positions. A pat on the back for our search engine optimisation team!)
A search for medical travel generated 73,300,000 results.
A search for health tourism generated 36,600,000 results.(Treatment Abroad is no 2 for this search. Another pat on the back for SEO.)
A search for health travel generated 250,000,000 results. A search for global health generated 133,000,000 results.But we probably need to be a bit more specific. By putting the phrase in quotes e.g. "medical tourism", Google only returns results for the exact phrase: "medical tourism" generated 5,290,000 results.
"medical travel" generated 443,000 results.
"health tourism" generated 798,000 results.
"health travel" generated 505,000 results.
"global health" generated 3,220,000 results
The previous analysis tells you what words and phrases are most frequently used on web sites indexed by Google. But what terms do people use when searching? Here's another analysis. This time we look at the average monthly search volumes on Google worldwide:
medical tourism - 90,500 searches per month health tourism - 14,800 searches per monthhealth travel - 165,000 searches per monthglobal health - 135,000 searches per monthAnd the winner is?
It's probably medical tourism....Why? Because it's the phrase that's in common usage, whether we like it or not. It's what the media use when they write about the industry. It's what the man on the Clapham omnibus would probably say. Is it the best phrase to use? Probably not.
I prefer medical travel!
Wales....... the latest medical tourism destination for US patients?
A recent news story on CNN attracted my interest when it featured a US patient who travelled to Wales (in the United Kingdom) for sinus surgery to save money. It was headlined “'I can't afford surgery in the U.S.,' says bargain shopper”. It’s an interesting story which shows how the media can sometimes put a slant on a story to create news, but it does highlight some real opportunities for medical tourism providers. The story (view the CNN video) tells us about Godfrey Davies, an American, who needed sinus surgery. It tells how he “set out on a mission to find an affordable surgeon”, and was appalled at the costs that he was going to incur in the USA. The story was picked up by a multitude of other web sites who took it at face value.If you view the video, you get one impression. If you dig a little deeper, you actually get to understand the full story and where this patient fits within the medical tourism marketplace.
As a Brit, I found it a bit odd when I viewed the video. My first impression? Here’s a story about an American guy travelling all the way to Wales for surgery....... Why would he do this? And why Wales? But then I dug deeper. It was in fact a story about someone who started life as a “Welsh bloke”, became an “American guy” and went home for an operation. There’s a clue in his name (Davies...it’s a Welsh surname) and in his slightly odd accent (It’s a Welsh accent). Godfrey comes from Wales. It is where his family lives. He’s a UK and a US passport holder. He married an American and became a US citizen in 2002. He doesn't have health insurance in the US because he believes that the quoted premium of $1,000 per month is too much. He says that "with the deductible and co-pay, I would have had to pay more in over three and a half months than coming home to Wales."
So, what can medical tourism businesses learn from this story?
Firstly, don’t take news stories at face value. There’s sometimes an underlying logic to a news story which the media doesn’t always fully expose. It may make the news less newsworthy. In this case, it’s understandable why a Welshman (as opposed to an American) might choose Wales as a medical tourism destination.
Secondly, it highlights one of the key factors in why people select medical tourism destinations. Godfrey Davies chose Wales because it is an excellent cultural match, there is no language problem for him, and he feels 100% safe there. And it’s cheap!
Godfrey went to the BMI Werndale Hospital in Bancyfelin, Carmarthenshire. It is part of BMI Healthcare, Britain's leading provider of independent healthcare with nearly seventy hospitals and clinics nationwide. To give you another example, I myself had a total knee replacement at one of BMI Healthcare’s hospitals near London, The BMI Clementine Churchill Hospital. How much would it cost for a knee replacement in an American hospital? $50,000. How much did it cost me in the UK? £10,000 all in ($15,000). The UK price is cheaper than Korea ($17,800), and not far off the prices that Americans pay in countries such as Thailand ($12,000) and Singapore ($10,800). Given the cultural and language match, and the lower travel cost, if you were an American which destination would you choose?
Thirdly, it’s a great example of the kind of American medical tourists that some medical tourism businesses should be targeting..... people from their own country. Thus, the biggest and most realistic opportunity in the USA for Korea based medical tourism providers is most likely to be Korean Americans. Target the easy win, if you want to succeed.
Fourthly, it supports the argument that the UK might actually be an attractive medical tourism destination for US patients. Despite the different accent, there’s no language barrier! There’s a public healthcare system that delivers excellent outcomes. And there’s a private hospital system that already provides treatment for patients from all over the world who travel to the UK to access healthcare quality and expertise. And...... as Godfrey Davies has demonstrated, you can save an awful lot of money over UK prices.
How much does private treatment cost in the UK?In addition to Treatment Abroad, we also run various UK health information sites. One of these is Private Healthcare UK. It will tell you all you need to know about private treatment in the UK.
The outlook for medical tourism in 2010
Before looking forward to 2010, let's look back and assess where medical tourism is now. So, was 2009 a good year for medical tourism? In 2009, we heard medical tourism “experts” across the world continue to talk up the potential for medical tourism without any sound basis in reality. It’s in the interests of some within the industry to boost the profile of medical tourism and frankly to exaggerate its potential. But whereas some industry pundits talk in tens or hundreds of thousands of patients, others talk in millions. These over optimistic forecasts have in themselves created a burgeoning medical tourism industry and a flurry of market entrants who may find that the going gets tough in 2010. Much of the current medical tourism sector has been built on hype rather than solid foundations. “In the land of the blind, the one eyed man is King” said Erasmus, and this has certainly been true in medical tourism.
Reality bites.... in the UK
The medical tourism sector is (a) not immune to recession and (b) is not going to thrive in a recession. The argument that people are more likely to look for low cost treatment overseas if money is tight just doesn’t stack up. How has the recession affected self paid treatment in a mixed healthcare economy such as the UK? The number of patients paying cash for elective surgery such as hip and knee replacements and the discretionary spend on cosmetic surgery is down 20% over the last 12 months. And the missing 20% are not going abroad because it’s cheaper. They are hanging on to their money, delaying treatment or deciding to spend their money on more essential outgoings.
Reality bites.... in the USA
For many new entrants to the market, the USA is seen as the “golden goose” of medical tourism. It depends what you read and who you believe. Compare these predictions and numbers:
For 2008
For the future
“23 million Americans could be traveling for medical tourism in 2017.” (Medical Tourism Association – Sep 2009).Recession adjusted forecast: 1.62 million medical tourists in 2012. (Deloitte Medical Tourism Update – Oct 2009)Is either of these future predictions anywhere near the mark? What might be the factors influencing an upward or downward trend:
Obama... the President who may change the way that the USA funds healthcare. And he’s making progress. Universal healthcare coverage in whatever final form it takes pushes medical tourism to the margins.... which is where it is in most developed countries. People do and will travel for treatment but it will always be a small minority wherever they are.Insurers, employers, HMOS’s..... We’re still a very long way from seeing funders of healthcare make a significant move towards using medical travel as a way of reducing healthcare costs. Will it happen? Yes... but slowly and at the margins.The recession isn’t over.... and it isn’t going away anytime soon. In both the US and Europe, unemployment levels hit 10% in December 2009. American workers have been unemployed an average of 29 weeks, the highest ever recorded since the data was tracked from 1948 onwards. Americans are visiting their physicians less, reducing the number of drugs they pay for. They are reducing their level of care. But as with the UK, large numbers are not offsetting this by pursuing lower cost options overseas.According to a report in USA Today this month, medical tourism is number nine in the top ten travel trends for 2010 in the USA. According to USA Today, the three drivers are:
More coverage of overseas medical care by major U.S. insurers.An increase in individual insurance policies that typically carry a high deductible.A marketing push by companies that combine travel and medical services.But will these drivers drive significant growth in the USA or elsewhere in the world?
Some, but only a few, insurers will provide coverage....but will patients actually want to travel?There may well be an increase in deductibles....but will patients be able to afford to “top up” their healthcare anywhere....in their home country or overseas.Companies may well increase their marketing spend and may increase public awareness a little....but what we don’t have in medical tourism is a “big player”, a company that’s prepared to risk hundreds of thousands of dollars/pounds/euros in bring medical tourism to the masses.So... is it medical tourism boom or bust in 2010?
Neither. Medical tourism is not the Holy Grail that will save holiday destinations around the world who are already suffering from the “let’s stay at home” effect of the credit crunch? It’s not the easy win for hospitals and clinics who have been adopting the “if we build it, they will come” approach. The reality is that we will see growth in the long term.....growth where medical tourism makes sense and not at the exponential rates that some have predicted.
The good news (for medical tourism) from the economic downturn is that every Western government is going to be under pressure to cut public expenditure and that usually means cuts in healthcare provision. Let’s take the UK as an example. The UK government knows that it cannot afford to fund the healthcare system as it has in the past. The UK national debt in 2010 is 72% of Gross Domestic Product; ten years ago, it was 33% of GDP. In Ireland, the Irish government unveiled one of the most severe budgets in the Republic's history embracing cuts in public expenditure across the board.
In many countries, the pressure on public funding of healthcare will be greater than ever before. In the long term, an ageing population demanding more healthcare and pressure on healthcare budgets will mean more patients funding their own care and looking at overseas treatment as a serious option. And that means there’s an opportunity for medical tourism.
Regional healthcare not global healthcare
In truth, there has never been a global healthcare market, and it’s unlikely that there will be one in the near future....unless, of course we:
Where does medical travel really work...and happen? Across borders....from one neighbouring country to enough....within rather than between continents. However in need of treatment they are, and however desperate they are to save money, the number of patients who are prepared to board a plane and fly for eight hours plus to a different country with a different language and culture is minimal. It’s medical tourism at the margins. And it’s medical tourism that puts patients at risk through combining surgical procedures with long flights.
Patient flows in medical tourism follow low cost airline routes with short flight times or cross border land routes. Americans flying or driving South for surgery, Brits traveling to Budapest for dental treatment, the Japanese heading West to Korea for cosmetic surgery, the Indonesians travelling to Malaysia and Singapore, Central Africans heading for South Africa and so on.
The competition is going to get hotter
With medical tourism numbers failing to live up to the inflated predictions, we may now be faced with too few patients for too many providers. Those who have come to the market in the last twelve months are going to wonder where all the promised patients are. The simple laws of supply and demand mean increased competition. But that doesn’t necessarily mean that prices will plummet. Only the foolish will drop prices to attract patients. Consumers don’t opt for the cheapest when it comes to making healthcare decisions. Yes, they want to save money, but cheapest implies low, quality, risk...all those things that medical tourists are trying to avoid. Added value, customer service, creating new business from existing or past customers will all become important in differentiating your business, and attracting new patients.
New models for medical tourism?
The credit crunch, increasing competition, the slow growth in patient numbers (if we see any growth at all in the near future) will encourage new approaches to medical tourism. We’ve seen the Hungarian “dental tent” come to the UK, and we hear that cruise ship medical tourism is on the agenda of the European Medical Travel Conference. And perhaps in 2010, we may see the serious adoption and exploitation of telehealth and e-medicine in the medical tourism sector.
In a recession....find a niche
So, what can those pursuing the Holy Grail of medical tourism learn from all this?
One key to success in a recession is to find a niche and ideally one that is a recession proof niche - one that people spend their hard earned cash on when money is tight. Whereas many healthcare providers try to be all things to all patients, those that succeed will select their niche and focus their efforts.
There are some niche areas of healthcare that are relatively recession proof and may prove attractive. Infertility treatment is a good example:
Public funding of infertility treatment is under pressure in many countries.The need is high and people aren’t prepared to delay treatment too long.Money may be tight, but having children is the one thing that they may spend money on rather than anything else.It’s high value.There are others...get your thinking cap on and go out and find them.
In summary
2010 may be the year in which we see some rational thinking and some rationalisation in the medical tourism world. Perhaps the recession will bring some of the “blue sky” thinkers down to earth. New market entrants are going to feel the pinch; the long established players will maintain their reputation, improve their services and continue to thrive.
Long term, the medical tourism sector is here to stay.
Stay with it.... businesses that ride out the recession will come out of it in better shape. It’s still an attractive market sector and the business is there for those who take the long term view.
Comparing the costs of (accidental) medical tourism
Whereas much of the attention in the medical travel sector is focused on medical tourism (i.e. where the primary reason for travel is some form of surgery or treatment), a more established and mature market sector is the provision of healthcare services for the tourist or business traveller who falls ill when abroad. The structure and maturity of this sector means that it is far easier to gather comparative data such as the cost of healthcare and actual treatment in different countries. Cost management is in the hands of the international insurers, the travel insurance companies and the assistance companies who negotiate prices with hospital providers worldwide.A recent analysis of travel insurance claims, published by the UK based travel insurer, Sainsbury’s Travel Insurance, provides an insight into the variation in hospital costs across the world and the rising trend in hospital costs.
According to their analysis:
In 2009, a record number of people needed medical treatment whilst abroad.The most expensive country for inpatient hospital treatment was the United States, with the average hospital visit costing £6,000.The average cost of hospital treatment in a foreign country has climbed to £2,040 over the last 12 months, an increase of 6.25% year-on-year.The most significant increase in treatment costs were seen in Turkey (+10%), the USA (+10%) and Spain (+7.5%).Over the summer months (May to September), the most common reason for hospitalisation was gastroenteritis with the average bill for inpatient treatment amounting to £1,200. The most expensive hospital bills were for those who suffered a heart attack abroad, resulting in medical expenses that averaged £12,500.
It’s interesting that the international assistance companies who deal with these "accidental" medical tourists have shown little or no interest in entering the medical tourism business. They have everything in place to become the world’s number one facilitator and blow everyone else out of the market:
They have a network of “approved” hospitals around the world.They facilitate treatment for thousands of international patients in foreign countries every day.They have call centres to deal with patient enquiries.They have extensive technology and systems to manage the patient process.They have people on the ground in major destinations who can provide local support.They have comparative data on treatment outcomes and comparative costs in hospitals around the world.So, why haven’t companies like Europ Assistance, Mondial Assistance and AXA Assistance entered the medical tourism market and used their expertise to attain a dominant market position?
The answer is probably quite simple. The medical tourism market is just not big enough to be attractive to them, nor worth the hassle. Which is good news for the existing operators...but puts the medical tourism market opportunity in perspective compared to the long established international assistance market.
Transparency and fraud in health tourism
One of the criticisms of buying services via the web is that you cannot always be sure with whom you are actually dealing. This is especially true in the field of health and medical tourism. When you visit a site about medical tourism:How do you know who is behind the site?
How can you tell what they actually know about health tourism and healthcare in general?
How do you know if you can trust them?
How do you know where the patient's money is going?
The European Healthcare Fraud & Corruption Network (EHFCN) is the only European organisation dedicated to combating fraud and corruption in the healthcare sector across Europe. The network represents 23 member associations in 10 countries, which provide healthcare services to millions of people in Europe.According to EHFCN, "the healthcare sector appears to be particularly vulnerable to corruption. The large amounts of money involved and the complexities of many healthcare systems play a role as well as the fact that there are many processes with high risks of bribery"
And now it is turning its attention to health tourism.As a web publishing company in the healthcare sector, it's important that Treatment Abroad is transparent, and that when we're publishing health advice on our various web sites, we ensure that the information is written by qualified medical professionals. We make sure that all of our sites go through the Health On the Net Foundation's certification process. (I recommend that all healthcare sites go through this process.) And our company has a Medical Director to oversee what we do - Dr Nick Plowman from St Bartholomew's Hospital in London.But in the world of medical tourism, is there a problem with lack of transparency and is there significant potential for fraud?In researching my presentation for the EHFCN conference, I've taken a look at transparency in medical tourism. I did the usual Google searches and I came across Health-tourism.com for the first time: It states that is "a guide for medical tourism, bringing you reliable, objective and useful information that will help you plan your medical travel".
While I was browsing the site, I came across this:Medical Tourism Transparency Award - "we have created the Medical Tourism Transparency Award. This is a badge awarded to websites of medical tourism providers whose website information meet the criteria below."
Now, let's be clear, the guys at Health-tourism.com may be decent and honest people, with the best interests of medical travelers at heart. But it was their "Medical Tourism Transparency Award" that caught my attention. Health-tourism.com says that "The purpose of this award is to encourage providers to supply necessary information on their web sites - making it easier for you to make an informed decision.
So, I put Health-tourism.com through a "Transparency Test".
I looked all over the site....
It says that it's run by Find Global Care.I can't tell who they are or what their qualifications are.In the lengthy disclaimer it says "the content on this website has not been reviewed or prepared by medical professionals.
And it says that the "relationship between the visitor/user and FGC shall be governed by the laws of Cyprus". Why Cyprus?
I can't find any names at all.
I can't find out who owns the site or the company.
I can find an address - 1B, Pinetree Boulevard, Old Bridge, New Jersey.
I'm an inquisitive person.....
I did some digging for information on Find Global Care. But all I could find... was another web site - half built at www.findglobalcare.com and an entry on WikiCompany with no information on the company ownership.
So I thought I'd pay a visit to 1 Pine Tree Blvd, Old Bridge, NJ 08857, USA using Google Maps Streetview. (Isn't the web a wonderful thing?). I'm not an expert on US arrchitecture but judging by the Real Estate sigh outside and the building, this looks like an apartment building. But who lives there? And who's behind the business? And what does he or she know about health tourism?
Next, I checked out the domain name. It's registered to Udi Shomer from Illinois. Perhaps he's behind the business? Who is he? I don't know. But it's not a common name, and the web may have some info on him?
There's only ten results for a search for "Udi Shomer" on Google. (Hey, that's close to being a Googlewhack!). Let's take a look at the Udi Shomers on the web:
There's an Udi Shomer who has an entry in the Lonely Planet guide to Thailand.There's a listing page for Tai Chi in Thailand.
And there's a few references in Israeli job sites (I think).
And that's it.
There's a clear message here for medical tourists who use the web to research healthcare services.
Look (very carefully) before you leap.!And if anyone knows who runs Health-tourism.com, ask them to get in touch, so that I can fill in the gaps.
The slumbering giant of medical travel?
Where do you think the international patients' centre shown above is? Singapore? Thailand? Malaysia? India? Korea? Read on to find out...
This week’s International Medical Travel Journal covers a recent announcement by the UK Department of Health (See: Liberated UK hospitals to attract medical tourists) that it plans to remove the cap on the proportion of income that NHS hospitals can earn from private surgery. NHS hospitals are allowed to treat private patients (both domestic and international patients) in addition to their primary responsibility for serving the needs of the UK public.
Many NHS hospitals have private patient wards or dedicated units which benefit from their location close to the extensive clinical resources and medical technology which are available with an NHS general or teaching hospital. These are well supported by private patients but these NHS units have been restricted in terms of their revenue potential; across the UK, NHS hospitals were not allowed to generate more than 2% of their income from private paying patients. Some individual hospitals were allowed to generate a much greater proportion but were still limited in their revenue earning potential.
At medical tourism conferences around the world, the UK gets barely a mention. Yet it ranks in the top ten destination countries in terms of medical tourist numbers and probably in the top five in terms of revenue generated (Source: Team Tourism Consulting 2010). London continues to attract high value medical travellers seeking expertise and quality rather than the lowest prices. The average treatment cost for these patients is around £20,000, and for individual patients it can be much more. London also benefits significantly from the related expenditure of these medical travellers e.g. accommodation for friends and family during these extended patient stays.
Private patient facilities at leading London teaching hospitals such as Moorfields Eye Hospital, Great Ormond Street Children's Hospital, Royal Brompton & Harefield Hospitals, Kings College Hospital, Royal Marsden Hospital, and Guy’s & St Thomas’ Hospital have always been attractive to international patients and they compete with other international centres of excellence in countries such as the USA and Germany . Indeed, these NHS private patient facilities earn more from international private patients (medical tourists) than they do from UK private patients.
The Harris International Patient Centre at Great Ormond Street (pictured above) is a good example. The Centre has 130 staff, working with over 170 clinicians in Great Ormond Street Children's Hospital. It’s bigger than most international patient departments serving “medical tourists” that you would find anywhere in the world. And it’s very busy. But, until now Great Ormond Street and similar NHS run international patient facilities have been limited by the private patient income cap.
That is about to change... London “the slumbering giant of medical travel” may wake up to some of the newly emerging opportunities presented by the international patient market:
The London hospitals mentioned above have a long and impressive track record in attracting international patients.
They were involved in medical tourism long before the term was invented.
And they are able to provide quality and prices that will be attractive to many emerging source markets for medical travel. For example, if US derived medical tourism does eventually take off, and American patients can make significant savings by travelling to London for major surgery (not far short of those available in Singapore or Thailand), would London be an attractive option? Same language (...almost), same culture (...almost).
This American who travelled to Wales for surgery may be the start of a growing trend....
Patient choice in medical tourism...Let's hear the patient's voice
The recent Medical Tourism Climate Survey conducted by IMTJ for the European Medical Travel Conference 2010 provided an interesting insight into the current state of the industry and how people in the industry are thinking about medical tourism. The survey analysed the views of over 250 people involved in medical tourism from 55 countries. One particular question that drew my attention was one that asked people in the industry about the factors that influence patient choice. The question was this:“What factors do you think are important to medical tourists when they choose a healthcare facility or treatment provider abroad?”
Expertise and qualifications of the doctor/dentist ranked first. Comments and ratings by other patients ranked second.
It’s the high ranking of “patient opinion” that surprised me, given the industry’s apparent reluctance to “buy in” to the concept of patient ratings and reviews. Hospitals worldwide are investing large sums of money in accreditation and quality standards, sometimes as a marketing tool to attract patients and referrers. But very few patients have any idea what JCI accreditation means, or how this can help them to compare quality at different hospitals.
So, how are patients comparing competing destinations and healthcare providers?
As patients evolve into healthcare consumers, they are considering the purchase of healthcare in much the same way that they consider the purchase of any consumer good or service. And medical tourists are no different.
Let’s consider the tourism or travel element of medical tourism and medical travel. When consumers are booking a holiday or a hotel, what do they do and where do they go to gather information that will guide their choice. To determine price and availability they visit travel and holiday portals online. Sites such as Lastminute.com and Expedia attract massive volumes of traffic. And where do these consumers go to gather “opinion” about quality and services at their destination or hotel. Travel consumers want to hear from “people like me” before they buy.... which is why TripAdvisor has become one of the busiest web sites in the travel sector.
So, what are the options for medical tourists who want to hear from “people like me” before they buy? Many patients whether they are travelling patients or “stay at home” patients make extensive use of patient forums before they make a decision on treatment at home or abroad. Infertility treatment abroad is a good example. Take a look at the Fertility Treatment Abroad section of the FertilityZone web site, and some of the discussions that take place around the services provided by various IVF and infertility clinics abroad:
If you were a patient seeking infertility treatment abroad what would influence your decision more....
I’m willing to bet that the views of other patients....“consumer opinion” would be the major influence on your decision. (Obviously, for IVF treatment, patients would also be looking at outcome data/fertilisation rates published by the clinic). This seems to be the conclusion reached by the respondents in the IMTJ Medical Tourism Climate Survey.
So...why hasn’t the medical tourism sector bought into patient ratings and reviews?
At Treatment Abroad, we were the first to enable medical tourists to rate and review overseas hospitals and clinics. At Medical Tourism Ratings and Reviews, patients can score these clinics and post their comments about the service and treatment received. To enable this, we invest heavily in Bazaarvoice, the world leaders in online rating systems to manage our new service. They make sure that only valid reviews make it on to our medical tourism reviews site. The moderators are well educated, trained and tested to ensure only appropriate user-generated content gets posted. Nevertheless, we are disappointed in the adoption of this reviews system by our clients.
When we promote the reviews system direct to patients and people who have enquired about treatment abroad, we get excellent take up. Patients are keen to share their experiences and benefit from other patients’ experiences. Similarly, some of our clients see the benefit of allowing patients to rate and review their services and actively encourage their past patients to visit the site and post a review. The system is free. It doesn’t cost the client a penny extra to participate. But many of our clients are less enthusiastic about patient reviews.
Why is there reluctance to encourage patient reviews for medical tourism?
The most common objection from clients is that they are worried about negative reviews. What happens if a patient actually says something that they don’t like?
Well, as all of the hotels and holiday providers on Trip Adviser know, a negative review may affect their business negatively. Or will it?
On Medical Tourism Ratings and Reviews, we publish negative patient reviews, as long as they are not profane or violate other rules of moderation, such as raising litigation or malpractice issues.
Negative patient reviews are valuable
Negative reviews are of value to the healthcare provider and to healthcare consumers. Negative reviews show credibility – if there are nothing but 5-star reviews for your services, healthcare consumers get suspicious about the authenticity of the content.
Negative reviews also give objective feedback and help healthcare providers uncover blind spots. Perhaps there was a breakdown in a process or poor communication with the patient, or some misinformation in the description of your services on your website. Direct feedback from your patients is the most transparent way to uncover these issues and get them solved quickly.
When we publish a negative review on Medical Tourism Ratings and Reviews, we give the client a chance to respond – to explain what went wrong and to say what they are doing to put things right. Negative reviews which we reject and do not publish (but we do pass to clients) are also incredibly valuable. When patients are upset with your service or their treatment, they sometimes get angry, which can cause them to violate the terms of our review system, use profanity, threaten legal action or go off on a tangent – all things that can lead us to reject a review.
Don't ignore negative patient reviews
It’s important for healthcare providers not to ignore this information, because if you can uncover and solve a legitimate problem, and complete the circle, it makes it less likely that the patient will spread their rancour to blogs, forums, and other places where you are unable to see, control or address their comments.It’s important for healthcare providers to review all negative content, so they can uncover service or system improvements to improve future patient interactions.
The message... it’s time for medical tourism providers to start actively encouraging patients to rate and review their services and to start listening to what patients have to say. Accept that sometimes things do go wrong, that patients will be unhappy and will want to tell the world.
You may learn more from getting something wrong than you do from getting something right.
The US healthcare reforms and medical tourism
Caroline Ratner at IMTJ has just published a summary of US reaction to the Obama healthcare reforms from the medical tourism sector, so I suppose I had better throw my comments into the mix. First, let me stress that I am by no means the world expert on the US healthcare reforms! (Does one exist?) But I have been asked by the UK media recently to comment on the reforms and in particular to comparisons with the UK healthcare system. It’s been interesting to watch from afar how a nation is having to deal with both rising healthcare costs and demands for increased expenditure on healthcare.
It’s acknowledged that the USA is one of the most expensive healthcare systems in the world, spending 15.3% of the nation's GDP on healthcare (WHO statistics). This compares to around 8.2% of GDP for the UK and similar for other European countries. Despite the high expenditure, the USA gets atrocious value for money out of what it spends.
Take a look at these comparisons:
The UK spends less than half the amount per capita compared to the USA, but provides a similar number of doctors, more nurses and more beds per 10,000 citizens. Not bad value for the taxpayer's money.
Despite these facts......in the healthcare reform debate in the US, the UK NHS has been used as an example of “how not to do it” and at one point those campaigning against the reforms launched a series of television adverts using “tragic” stories from Britain's National Health Service to contest Barack Obama's plans. The reality of the UK NHS is rather different... it works pretty well most of the time and it costs the nation half of what the US spends (as a percentage of GDP). If .......you were a US politician and could wave a magic wand which would transform the US healthcare system overnight to an NHS system of universal healthcare, free (in most cases) at the point of delivery, AND it would cost the country half the money....what would you do. It’s a no brainer. But there are no magic wands.
The perception of the NHS overseas is very different to the experience of the NHS within the UK Here’s a couple of recent, typical quotes from US industry commentators on medical tourism and the US healthcare reforms:
“People from UK and Canada is (sic) not looking for treatment outside their countries because of being denied of healthcare insurance or financial constraints, it is because of high cost of care and extensive waiting times for elective surgeries”“ (the reforms) will also potentially create long waiting times for medical procedures which will create situations like in Canada and the UK, where patients travel outside their country because of long queues for important surgeries.Note the references to the long queues and extensive waiting times in the UK. This kind of uninformed and factually incorrect comment does little for the credibility of the medical tourism industry. It’s political dogma.
Here are the hard facts on UK waiting lists:
The average NHS waiting time from referral to treatment is around 8 weeks. It’s often much shorter.Anyone suspected of having cancer has the legal right to wait no more than 2 weeks to see a specialistAnyone referred for elective procedures has the legal right to start treatment within 18 weeksIf there is a significant waiting list in your local area, you have the right to exercise patient choice and go to another hospital anywhere else in the country to avoid the wait. (internal medical tourism). You can also compare outcome data, infection rates and many other data online through NHS ChoicesIf you have a serious and life threatening problem, there’s virtually no waiting list. That’s why I’ve only ever met one British heart surgery patient who has gone abroad for treatment. Despite this, I’m regularly amazed by overseas providers or consultancy companies who call me to discuss their plans for attracting British patients overseas for major surgery such as heart bypass.And here’s some recent “real life” experience.
The Web Communications Manager at my company recently celebrated the birth of his first child. Unfortunately, the birth was at 27 weeks so it has not been easy for him or his wife. The child has been in paediatric intensive care for some weeks in a local hospital, and has recently been transferred to Great Ormond Street Hospital in London for heart surgery. Is he happy with the NHS care?....Yes. Has it cost him a penny?.... No.My wife has a recurrent inflammatory problem at the back of her eye. She has regular assessments at the local NHS eye unit, and recently went for a minor procedure. It was urgent, so she didn’t have to wait. She went to the brand new eye state of the art NHS eye unit at Stoke Mandeville Hospital. How long did she wait?..... a week or so. How much did she pay?..... Nothing?Are British patients flooding overseas for treatment because of “long queues” and “extensive waiting times”? No. The majority of UK medical tourists are not patients requiring elective surgery that they can’t get or will not wait for on the NHS. The reality of healthcare is that patients want affordable (or free) treatment close to home, or within their country. Before they even consider going abroad for treatment, they explore all the avenues for treatment within their own country.The NHS has its faults, of course, but no system is perfect. And would I swap our NHS for the current US model? No, I couldn’t afford it..... either as an individual or as an employer!
So, will the Obama healthcare reforms lead to a massive surge in medical tourism, as some have suggested? No.
Medical tourism will continue to grow as more patients become aware of the possibility of low cost treatment abroad. But we should never forget that what every patient wants is affordable healthcare on their own doorstep.....and travelling for treatment is for many a last resort.
Will Obama end the American medical tourism dream?
As reported in International Medical Travel Journal this week, President Obama has pledged to cure Americans from "the crushing cost of health costs." His proposed reforms include lower prices from hospitals, salary cuts for doctors, and payment to hospitals by government insurance schemes linked to quality of care not quantity of care. He also wants to give Americans the option of a public health insurance plan. His plans follow a social insurance model which is found in some European countries. Simplifying the funding structure within US hospitals could also lead to significant cost savings. At present an individual US healthcare provider may have to administer payments through upwards of 700 different providers.
Past research (1) has shown that while the United States spends significantly more on health care per capita than Europeans nations, Europe actually delivers more real resources per capita. For example, Europe employs a larger health workforce per capita and delivers more physician visits, hospital days, and prescription drugs than the United States. Higher prices and administrative inefficiencies account for most of this differential.
Obama's grand plan could end the American medical tourism dream. Introducing what is in effect a publicly funded healthcare system and forcing down prices could remove a key driver for outbound medical tourism from the USA.
The IMTJ's conclusion:
"If Americans are a target market, you need to keep a very close eye on US healthcare reform as it could quickly impact your business. You may even have to change from marketing on price to marketing on quality alone."
...and I tend to agree.
Recent years have seen a bandwagon effect in the medical tourism sector. And it's been a "get it cheap" bandwagon. But for decades medical tourism has been driven by patients seeking better treatment, specialist expertise, and higher quality. Some new market entrants may need to rethink their strategy.
1 Mark V. Pauly, “US health care costs: The untold true story,” Health Affairs, 1993, pp. 152–9.
NHS Patient Choice - Lessons for medical tourism
In the UK, "patient choice" is one of the driving forces in healthcare. Since April 2008, patient choice has been extended in the UK. Patients can choose which hospital they are treated in....anywhere in the country. Patients can choose the time of their hospital appointment. In some cases, patients can choose the individual consultant they see. The NHS Choices website lists information about all NHS hospitals, such as their MRSA rates, facilities and ratings and reviews by patients which means that patients can make an informed choice.The NHS Choose and Book web site enables people to make their choices.
In reality, the patient choice initiative has been a bit of a disappointment. One problem is that not enough patients are actually aware that they have a choice. The Report of the National Patient Choice Survey, England - December 2008 has analysed uptake of patient choice so far.
The key findings:
The percentage of patients recalling being offered a choice of hospital for their first outpatient appointment was 46% in December 2008, the same as in September but up from 30% in the first survey (May/June 2006)50% of patients were aware before they visited their GP that they had a choice of hospitals for their first appointment, up from 48% in September and 29% in the May/June 2006 survey.
The factors influencing choice
Hospital cleanliness and low infection rates were given most often (by 74% of patients) as an important factor when choosing a hospital.The other five are quality of care (given by 64% of patients), waiting times (63%), the friendliness of staff (57%), the reputation of the hospital (55%) and location or transport considerations (54%).So what can medical tourism businesses learn from this?
If UK patients can compare NHS hospitals on MRSA rates, post operative infection rates and outcomes, why can't they do this for overseas hospitals? Or perhaps, why is it difficult if not impossible to find a hospital treating medical tourists that publishs such data or makes it freely available on their web site?
Many people in the UK have the right under EU law to travel abroad for treatment. The EU Directive sets up a framework around this. but the basic right of free movement already exists. So, why aren't people taking advantage of this?
They don't know they have the right.They don't "trust" overseas hospitals.They would rather wait for treatment on the NHS in their local area.Awareness of overseas treatment options can be generated by the providers themselves. One of the best tools to consider is the use of patient stories to create local press coverage and thus raise awareness. See this story in the Scotsman. Let's see more of them!
Increase in IVF tourism in Europe
At Treatment Abroad, we've seen increasing interest from IVF clinics abroad that are experiencing significant growth in patient numbers from the UK and other European countries. The latest report from the European Society for Human Reproduction and Embryology confirms an increase in IVF treatment abroad, The report surveys infertility clinics in Belgium, the Czech Republic, Denmark, Slovenia, Spain and Switzerland and is based on a sample of 1,230 patients visiting these infertlity clinics. See details of the report in the Guardian.
Lack of access to IVF services in the home country for the over 40's and legal restrictions on infertility treatment are the prime drivers. Italy was the biggest source of IVF "medical tourists" accounting for 32% of the patients in the survey. Next was Germany (14%), followed by the Netherlands (12%), France (9%) and the UK (5%). The average age was over 37 but 63.5% of the British patients were over 40.
According to study coordinator, Dr Francoise Shenfield from University College Hospital in London, "Spain and the Czech Republic are popular destinations for oocyte donation; Swedes travel to Denmark for insemination, and the French to Belgium." She also highlighted the significant numbers of Italians who travel abroad to receive treatment that was rendered illegal in their home country under recent legislation or because they believe they will receive better quality care.Extrapolating the data, EHSRE estimates that 20,000 to 25,000 cross-border fertility treatments are carried out each year.IVF related medical tourism is a relatively new but growing trend in the UK, as couples delay having children into their 40's and then discover that they have a problem.
IVF treatment is available within the National Health Service in the UK, but access to treatment can be a problem.
Age and waiting lists can be a barrier to treatment.Overweight women are excluded from NHS treatment.
Demand for egg donation exceeds supply. ( The right of anononymity for egg donors was removed in 2005)Obviously, private IVF treatment is available in the UK but this may be expensive and the same legal restrictions will apply.
Whereas some areas of medical tourism may be feeling the effects of the recession and the resulting impact on people’s pockets, IVF treatment abroad is an opportunity worth pursuing for those IVF clinics abroad that can demonstrate impressive results and cater for the needs of the “fertility tourist”.
EU votes on medical tourism directive
Members of the European Union's various committees vote this week on whether to make changes to the EU Directive on cross border healthcare. The Directive aims to provide a framework for patient mobility, whereby patients in one member state will have the right to treatment in another state. The UK's General Medical Council (GMC), which regulates the country's 230,000 doctors, is running a lobbying campaign to protect Britons seeking healthcare in Europe from what it describes as "dangerous" doctors. the GMC wants the new EU laws to give patients access to the disciplinary history of incompetent clinicians.
Quoted in the Guardian, Paul Philip, the GMC's deputy chief executive says:"The vast majority of doctors do a very good job under very difficult circumstances. However, when UK patients travel to mainland Europe, there is a risk they could be treated by a doctor who is not fit to practise or not fully qualified to give the required treatment."
UK patients have full access to GMC records and are able to check whether a doctor has been disciplined, or is the subject of a disciplinary hearing. The GMC wants doctor organisations in other countries to provide similar patient access to information about their doctors.
In the first 9 months of 2008, the UK NHS paid for over 500 British patients to have treatment elsewhere in Europe. Some patients were also funded by their primary care trusts. It is estimated that another 80,000 Britons funded their own treatment overseas.
A word of warning for medical tourism companies
A woman from Wales who underwent cosmetic surgery in Belgium is bringing a test case against the Belgian clinic in the UK courts.The patient is suing the clinic after undergoing a face-lift and upper and lower eye surgery in 2005. She claims that she has been left with scarring around the eyes and the ears and has experienced numbness of the face. It is a significant case because it could set a precedent for other patients who wish to sue a clinic or medical tourism company after going abroad for treatment. Rather than sue in Belgium, the legal firm involved have decided to sue the clinic in the UK courts where they might expect higher payouts if they win the case. Laurence Vick, the solicitor who is representing the patient, is a medico-legal expert and specialises in clinical negligence claims. (Coincidentally, he and I were undergraduate students at the same college, many years ago!)
The question of who to sue in medical tourism cases is one that faces any patient where surgery abroad doesn't work out as it should. Is surgery abroad any riskier than surgery in the UK? No one knows.... because there is no comparative data. But the answer is probably not. Nevertheless, any surgery carries a risk. Cosmetic surgery is not risk free, so there are going to be cases of alleged clinical negligence where the patient will pursue a legal action. Medical tourism companies need to be aware of this test case, particularly those that have a UK presence. Rather than sue the surgeon or the hospital in the destination country, the patient may opt to sue the medical tourism company in the UK.
The opportunities for Korea in medical tourism
South Korea is a country that has come late to the medical tourism game, but it may in the long term become one of the winners. Perhaps initially attracted by the inflated forecasts that are touted around the medical tourism industry by “industry experts” and commentators, Korea has however taken a more realistic view of where its success may lie.The recent Busan Medical Tourism Convention provided an insight into how Korea is thinking about the opportunities presented by medical tourism. In 2010, Korea is expecting to attract around 60,000 medical tourists and the target is to attract 140,000 in 2015. This is not an unreasonable target and is far more realistic than some of the numbers that we see appearing from government and tourism organisations in other countries. The “highest quality, lowest cost” strategy is not one that Korea wants to pursue or indeed should be pursuing. Korea’s research into existing medical travellers shows that quality, convenience and trust factors far outweigh cost related drivers. In terms of relative costs of healthcare services, Korea is significantly less expensive than the USA (but then every country is) but is not as price competitive as countries such as India, Singapore or Thailand. Indeed, something like a knee or hip replacement would cost a similar amount in Korea to the cost of private treatment in the UK.
So, Korea is not going to win on cost. Nor is it going to attract vast numbers of medical tourists from Europe. Its prices aren’t competitive enough and long flight times will deter potential European patients. The same may apply to patients from the USA if the much hyped US medical tourism boom begins to happen. For a US patient, the perception of quality of care in medical destinations such as Korea, Singapore and Thailand may be very similar. So, if it comes down to the cost factor, Korea will lose out.
So, from where is Korea looking to attract its patients? The drivers of accessibility and cultural match provide the answer:
Although the USA is a twelve hour flight away, cultural connections mean that the Korean community within the USA has to be a prime target. Around 1.2 million Korean Americans, many of whom are on the West coast should provide a source of patients.
Within a one hour flight from Korea is Japan, already a source of many cosmetic surgery tourists, and where healthcare costs are rising fast.
And not much farther away is China which may provide a plentiful supply of medical tourists in the longer term.
The interesting market that Korea and many countries are turning their attention to is Russia. With the movement towards a market economy in Russia, there’s a wealthy upper class that is investing abroad, taking holidays abroad....and seeking healthcare abroad.
How can Korea create a competitive advantage in the overcrowded world of medical tourism? It may not be in Western medicine; Kang Dong Hospital in Busan is a Korean hospital that combines Western medicine with “traditional” oriental medicine and provides a model of healthcare that is attractive to many in the Far East.
Another opportunity is for Korea to build on its existing strengths and the image it has created in world markets. Through the success of companies such as Samsung and LG, Korea has created a hi-tech modern image for itself. Applying its technological knowhow and skills to the medical tourism sector may prove advantageous in creating an edge over the competition. The only technology company that I have encountered at a medical tourism conference so far is Samsung.
It has been said that Korea’s success in technology and in manufacturings industries such automotive lies in its ability to copy what others are doing, learn from their mistakes, do it better and work harder at it. If Korea applies the same philosophy to medical tourism, then some of the more established destinations will be looking over their shoulders.
NHS staff numbers reach an all-time high
The UK Department of Health today released it's latest update on NHS staff numbers. It reflects the investment that the UK has been putting into the NHS in recent years, and also has an impact on outbound medical tourism from the UK. NHS shortcomings and waiting times are a significant driver of people seeking elective surgery abroad. In the last couple of years NHS waiting times have come down and there is now an 18 week target which most NHS trusts are meeting.
The number of people working for the NHS has reached an all-time high. After a dip in overall numbers in the previous two years, the annual NHS census showed staffing levels recovered to reach a peak of 1,368,200 in September 2008. This is a 2.8 per cent increase on the previous year and a 27.7 per cent increase compared to 1998.
In September 2008, the NHS employed:408,200 qualified nurses – up 2.1 per cent or 8,600 on 2007 and up 26.2 per cent or 84,700 on 1998.25,700 midwives – up 2.3 per cent or 570 on 2007 and up 12.4 per cent or 2,800 on 1998.34,900 consultants – up 3.7 per cent or 1,200 on 2007 and up 56.4 per cent or 12,600 on 1998.49,200 hospital doctors in training – an increase of 5.1 per cent or 2,400 on 2007 and up 59.4 per cent or 18,300 on 1998.
The number of people in employment in the UK was 31.32 million in December 2008 which means that 4.4% of the UK workforce is employed in the NHS.
The UK unemployment rate has now reached 6.5 per cent. So, the NHS is quite a good place to have a job!
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