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.

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Dental tourism...Let's work together

The Irish Dental Association is the most recent medical professionals body to publish a "survey" raising doubts about medical tourism.
In a recent press release from the Irish Dental Association, they state that "3 out of every 4 Irish dentists are treating patients for problems arising from treatment abroad. Let's take a look at the background to the survey, and examine some of the real concerns that are raised.
The Consumers’ Association of Ireland has published research about the high costs of dental treatment in Ireland. The Irish Dental Association accepts that Irish dentists are not immune from the wider economy and the bottom line is that Ireland is a high-cost economy. As a result, significant numbers of Irish dental patients travel for treatment to minimise treatment costs. Some of these are cross border dental tourists. Many services carried out in Northern Ireland are between 25% and 45% cheaper than the same services in the Republic, according to the study published in the Consumers’ Association of Ireland’s magazine Consumer Choice. And of course, many Irish patients take advantage of low cost treatment in countries such as Hungary and Poland. Several Budapest dental treatment providers have offices or representatives in the Republic of Ireland.
According to the Irish Dental Association survey, 76% of Irish dentists in private practice [more than 3 out of 4] have had to treat patients for problems linked to the dental treatment they received abroad.
First, we need to examine the basis of this claim.
There are approximately 1,700 dentists in private practice in Ireland at present.440 Irish dentists responded to the survey.334 said that they are treating problems arising from treatment overseas.So.... in fact 334 out of 1,700 said that they were seeing problems which is 20%. Obviously, this assumes that those who didn't bother are not seeing problems. When reviewing such surveys conducted by on or on behalf of professional associations, we have to bear the following in mind:
Inbuilt sample bias: People who see a problem are more likely to respond to a survey on that issue, than those who don't. We've seen similar bias built into surveys conducted by a PR agency in behalf of the British Association of Plastic Surgeons.Motivation: We always need to remember that professional associations represent the interests of their members. Losing patients to Belfast or Budapest hits the pockets of private dentists.

Nevertheless..... the Irish Dental Association has made some valid points. Are there concerns for dental patients who travel for treatment? Yes. Are the problems as big as the Irish Dental Association suggests. No.

At the end of the day, the Irish Dental Association also has the best interests of Irish dental patients at heart. Dr Donal Blackwell of the Irish Dental Association says that that one of the problems is that when considering travelling abroad for dental treatment, patients tended to focus on short term, aesthetic results rather than the long term quality of the care they receive and suggests that people travelling abroad for dental treatment actually don't know what they need when they enquire about costs. He's certainly right in some cases.

So, what's the solution and what's in the best interests of dentists and patients?

I'd like to see the following:

The Irish Dental Association issuing guidance for dentists and patients when considering dental tourism. See the UK General Dental Council's Dental Tourism Checklist on Treatment Abroad.Irish dentists providing assessment and follow up of patients who travel abroad for treatment.Irish dentists visiting some overseas dentists to get an understanding of how they work and their clinical skills and quality.Irish dentists forming partnerships with overseas dentists, so that patients who need extensive treatment but can't afford Irish treatment have access to the treatment they need under the supervision of their own dentist.Overseas dentists communicating with the patient's Irish dentist when a patient turns up in Budapest or Krakow - informing the patient's Irish dentist what work is to be undertaken, and providing post treatment reports on the work that has been carried out.

Common sense really. So, let's work together!

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