blog_img_Maria Todd explains Why Medical Tourism Clusters Fail Repeatedly

As a strategic and tactical adviser, not only have I written the book on medical tourism program development (literally), I've helped several attempt to salvage the clusters that have failed to thrive.

Examining the most critical issues leading to a cluster failure, here’s what I commonly encounter:

  • Poor communication
  • Insufficient leadership and support
  • Organizational politics
  • Lack of understanding of the purpose of the cluster
  • Lack of member buy-in
  • Lack of collaboration as the most critical issues
  • Copy/paste design
  • Lack of infrastructure creation and support


The purpose and function of health tourism clusters changes over time. If your cluster was improperly or inadequately designed and you can't manage the change, technological innovation, evolving customer tastes, market preferences, new business models and member relations and value, your cluster is doomed.

The reason for this is rather simple, actually. Change creates an identity crisis.  When competitors that have been acting and deciding strategy, theme, and destination brand standards for themselves suddenly find themselves in a collaborative setting that also involves governance and operations at a more transparent level, the new way of doing things requires communication, leadership, support, governance, and most of all buy-in. Hospital CEOs, marketing managers, physicians and other suppliers must pivot to be team players and play nice in the competitive field. Their first question is, "What did we sign up for and will we like it?" Their second question is "What if we don't like it or don't agree with the direction chosen by the cluster?"

Now add to this anxiety and difficulty with change that each individual stakeholder may be attempting to execute multiple change initiatives simultaneously. Different business functions – from operations and accreditation, to Health IT to marketing and revenue cycle – create the cacophony every healthcare business attempts to tackle concurrently.


Many clusters established since 2007 were created by consultants who set up a corporation, talked about what the cluster will "do", but never implemented the "how" or the infrastructure to make it work properly.

Then they took all the cash out of it that they could and departed to the next copy/paste cluster project. It was like gathering a group of business owners onto a bus, telling them the destination, arriving at the destination and having them exit the bus, only for the bus to drive away. They were left standing there by the side of the road with no map, no money, no water, no leader and everyone standing there on the dusty dirt road wondering what to do next.

When a cluster is formed without the necessary leadership and leadership training, and the members don't commit to the strategy, emotions prevail over logic. All the above-listed problems are human problems.

A large but ambiguous goal, no metrics to speak of and knowledge gap is the root cause of widespread failure in cluster development initiatives. With poor communication as an obstacle and a lack of understanding about the purpose, direction or collaborative strategy derailing most initiatives, it seems as though cluster organizations either ignore the human factor or take it for granted.

Before one decides to "jump on the bus to Clusterville" they must decide how far they are willing to go and why to go "there" instead of someplace else.  What puzzles me the most in these failures is how most were willing to pay $50,000 on the cluster formation, but less than $100,000 on training, software, implementation and infrastructure. Most jumped straight to renting conference stands in all their glorious naked lack of preparedness and announce to the world that, "They now have a cluster!" when all they had was a logo and a nearly empty bank account.

Then there is the ego factor. No hospital executive wants to hear that they are at the mercy of their subordinates. No cluster leader wants to hear that they are at the mercy of the hospital executives. They don’t understand why hospital executives don’t trust them when they say change needs to be made. And if the cluster is a public-private partnership, the hospitals don't trust the public sector partners and politicians either.  But many clusters also lack budget to hire (and train) employees. Clusters didn't know how to "be" clusters. They didn't know what they should do, and they had no money to pay employees to do anything. So once they ran out of money and they realized that another conference stand wasn't going to improve the situation, most languished.

Most of the failed clusters are still standing by the side of the road. No water to sustain them, no direction, inadequate capital to operate and grow, and no brand value, no strategy and very little hope of salvation.

If this describes your situation and you are interested to know what it will take to fix it and reanimate it, call us and let's discuss what you tried, where you stand, and what you want the cluster to achieve.