The Business of Health Tourism

There are myriad reports on the "business" and "market size" projections for the Medical Tourism industry. Search the internet for the terms "Medical tourism", also known as "medical travel", "surgical tourism" "dental tourism", "health tourism" "wellness tourism", "thermal tourism", "pharmacy tourism" and you'll be served a dizzying array of expensive reports in the thousands of dollars price ranges from analysts and so-called experts of dubious expertise.

Many simply craft a pretty, official-looking, desktop publishing document with information they obtained from someplace, with loads of seemingly impressive statistics. The statistics are accompanied by interpretive statements so that one doesn't only see charts and graphs.  From these charts and graphs of data, you'll read accompanying statements like, "The medical tourism market is projected to reach USD "x" hundreds of millions of US dollars by [fill in the year] at an impressive [fill in the percentage] CAGR during the forecast period [fill in the range], so sayeth [fill in the name of the publisher].  People seem to go online and then cut and paste these statements into their business plan. Investors read it and some ask deeper questions. Most just toss it in the bin. They weren't born yesterday.

This site helps you with market analysis by sharing a perspective you might not encounter elsewhere.

Medical tourism is an export service/product. While many physicians, dentists and health facilities continue to dabble in the industry as an aside from their every day business to local patients, 82% of countries have published press releases announcing their entry into medical tourism in their country.

Contrary to popular myth that "The medical tourism market is amid the fastest growing and also the most lucrative in the healthcare sector" the numbers being published in these documents are neither verifiable nor blatantly obvious to any trained observer. In fact, it is worse than that. The numbers are poorly defined and essentially meaningless from a strategic standpoint.

Many of the novice publishers latch onto the problem statement that treatments are expensive and delays are long. That's a fallacy. Most focus only on the treatment prices for their comparisons when the real costs are loaded into the travel and hospitality expenses that, when coupled with the treatment cost, make the argument for traveling to receive care weak if not indefensible.  The prices published as examples are also meaningless because without details explaining exactly what is included and excluded in the price, the number is not comparable to numbers published elsewhere for same and similar procedures.

Medical tourism includes a wide array of services in various specialties. For providers with international renown and established brands, there's potential to attract consultations and referrals by medical professionals at a loss to help their patients locally. But the abundance of talking points you'll find from report sellers, conference organizers, and newly-formed accreditation bodies who themselves lack any accreditation or certification have paved the way for corruption, charlatans, and predatory individuals and companies touting "novel opportunities" in health tourism business at hospitals, medical clinics, and by medical tourism facilitators who last an average of about 18-36 months before shutting down their websites or simply abandoning them, promise the more gullible hopefuls a rags to riches success story.

But, in fairness, there is some potential to make money with medical tourism. There just aren't a lot of examples to point to across 160 countries.  The definition of success is largely dependent on one's business and revenue objectives and key results sought.

People participate in medical tourism as consumers or patients for a number of reasons. These include, but are not limited to:

• Finding rapid access to treatment
• Seeking the services of a world renowned specialist for a confirmatory consultation or treatment
• Participation in a clinical trial unavailable locally
• Access to treatment that might be illegal or restricted in one’s home town
• Seeking care under a veil of anonymity (such as addiction rehab or sexual surgery, IVF, cosmetic services, or other delicate matters)
• Accessing care at a reduced cost
• To receive care or consultation about a healthcare or wellness matter in a place where they can combine other leisure and touristic activities
• To receive care in a location where the patient can be close to family, friends or psycho-social support willing to help them during the treatment and recuperative phase

• Insufficient vetting and credentials review - could lead to treatment by an unqualified provider lacking the proper training, experience, and credentials to perform the treatment. The resulting risk - bodily or psychological harm to the patient.
• Logistics coordination failures by an untrained, incompetent referral agency or facilitator or by the providers “International Patient” or “Medical Travel” coordinator.
• Bait and switch - a number of providers quote a lowball price to lure the customer and then intentionally add surcharges and unbundle some services that were vaguely described in the original package quote resulting in thousands of dollars in extra unanticipated fees.
• Surgical and post-operative complications - similar to any surgery, which is why one is asked to give “informed consent.”
• Complications resulting from the act of traveling by car, by air, by train, by boat. These complications could stem from accidents by common carrier, deep venous thrombosis, pulmonary embolus, suture disruption due to clear air turbulance injury, post operative infection, compartment syndrome, etc.
• Lack of continuity of care - many patients find that when they return home, if the medical tourism journey was not properly planned and organized, they could face abandonment on return by their local physician. This is prevented by proper multi-disciplinary care team involvement at the home town and destination throughout the entire episode of care.
• Arriving at the destination hotel to find one has been denied registration because of overbooking.
• Being assigned to a hotel room that is inappropriate or insufficiently set up for the patient’s recuperative needs.
• Ground transfers risks of being transferred in the wrong type of vehicle (too small, too high) or by an unsafe vehicle or unsafe, unvetted and uninsured or underinsured driver. Car jacking, car accidents, sinkholes and other natural unexpected disasters are some of the other risks of ground transfers.

• Bundled services cost more than the price quoted. This happens when providers focus on price and commodity competition without knowing their treatment and supplier and other activity-based costs and price their services inaccurately.
• The risk of non-payment. Many providers who rely on guarantees of payment by insurers and other third parties risk non-payment after the fact. For this reason, many savvy providers now ask for a deposit on account of estimated charges and then refund the unused deposit if any, or require full settlement within 10 days of the receipt of the claim by the payer.
• Risk of brand reputation damage and negative publicity scandal by social media. Patients may be led to expect something different than what they believe they have received - a failure in service, quality, discrimination, access, or bait and switch pricing for bona fide unanticipated complications and plaster the brands of all stakeholders in the episode of care on social media with negative reviews.
• Risk of improper and wrong marketing strategy. Many providers spend thousands of dollars on needless certifications that the consumer market does not recognize, or on failure to know one’s ideal customer. In turn they send out the wrong marketing messages and the business exists but no one identifies the offer as a solution to their need or desire. The business fails to thrive.
• The clinic or hospital or resort is established in a place that is difficult or costly to travel, too remote and a far distance from the airport, or in a place perceived as unsafe or unappealing or otherwise unstable.
• The price is not competitive because the value proposition to the consumer or patient has not been properly marketed. The risk of substitution is high when price is the leading competitive strategy because it turns the provider into a commodity seller.
• The providers’ marketing and advertising message does not build or inspire trust. People will not elect to receive treatment at any price if they don’t trust the provider. They want clinical outcomes data and social proof. That is not an either/or choice. Both must be present to tame the amygdala response and quell the neurotransmitter response for fight or flight so that the logical forebrain can deductively reason that the medical tourism journey will be safe, successful, and enjoyable.

There is no limit to the innovations, creativity and market penetration strategies one can create to develop a unique product and a brand of health and wellness tourism. The late Peter Drucker said in The Practice of Management that "If we want to know what a business is, we have to start with its purpose. And the purpose must lie outside the business itself. In fact, it must lie in society, since a business enterprise is an organ of society. There is only one valid definition of business purpose: to create a customer." In this case, a healthcare or wellness customer who exchanges money in payment for treatment. The money can come from the patient’s own pocket or from a third party source of payment.