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Who should be handling Destination Marketing for Health Tourism?

Marketing of medical tourism destinations

Constantine Constantinides from healthCare cybernetics questions the role of international associations and non-profits in destination marketing for health tourism, highlights the conflict of interest that they face and comes up with his recommendations on the best solution for country destinations that wish to promote themselves in health tourism.

I have in the past expressed my concern and dismay over the practice of “international” industry representative bodies (usually in the form of an “Association”), one week promoting and extolling the virtues of one Health / Medical Tourism Destination,  and the next week saying exactly the same about another (and competing) destination.  The story usually goes something like this: “Country X offers some of the best healthcare available”, “many Country X doctors and specialists were trained in US/UK/Germany”, “the hospitals in Country X have the latest medical technology”, Country X has the highest commitment to quality and excellence in healthcare”, “Country X attracts hundreds of thousands of patients from around the world”, “there’s massive potential for medical tourism in Country X”.

A while later, the story changes to “Country Y offers some of the best healthcare available” etc etc. How does Country X feel now that Country Y appears to be the preferred/recommended destination? How does Country Z feel who hasn’t got a mention at all? How does the representative body respond (or provide an unbiased response) when it is asked “which is the best destination for xxx surgery?”

The role of such international bodies in destination marketing has to be questioned, given the role that they you would expect them to play in the industry. No doubt, someone (the association, its Board Members or a spin off operation) is getting paid to do this and in an uninformed marketplace that’s attracting plenty of attention it can be a lucrative source of income. Nevertheless, the purpose and mission of such international bodies which also operate as “not for profit organizations” should surely be to represent, promote, protect, and lobby for the best interests of their Members (and the Industry as a whole) in an equitable manner. How can one destination be given preferential “promotion” over another competing destination?

When it comes to “national” representative bodies within the medical tourism sector, it is another matter. Thus, we have seen the development of such national initiatives as the Association for Medical Tourism Development in Croatia, the Cyprus Health Service Promotion Board, and the Medical Tourism Association of South Africa. It is an essential part of the mandate and agenda of these national medical tourism bodies to promote their country as a destination (but also to treat their members in an equitable and non-preferential way, so that the benefits of national promotion - or destination marketing - are shared).

The role of “Not-for-Profit” organizations in destination marketing

Should “not for profit” organisations be competing against private “for profit” businesses in the medical tourism sector?

A news item in 2009 reported that the “Country X” Government signed an agreement with “the Y Association”, a not-for-profit legal-entity, to promote Country X as a destination for medical tourism. And we subsequently read other news items proudly reporting similar deals for Country Y and Country Z.

Should legal entities registered as Non-Profit Organizations conduct business as consultancies and compete against the “for profit” private sector?

It may be legal – but is it ethical – and in the spirit of fair play?

So, who should handle … the marketing of destinations?

So, who should handle the marketing of Health (or even just Medical) Tourism Destinations? The obvious answer would be Destination Marketing Professionals and Organizations. They even have their own international industry representative body - the Destination Marketing Association International. This 90 year old body has a code of ethics, an accreditation programme, and embraces 2,800 destination marketing professionals from nearly 650 destination marketing organizations in over 30 countries. 

Doesn’t it make sense for the professionals to handle such things as the promotion of national health tourism destinations (even if they are hired to do so by a national industry representative body or even a government, city or municipality)?

Of course, these assigned organizations should not have a monopoly on the promotion and marketing of a destination. Many individual service providers do their bit; although it may be “self serving”, in the end, it benefits all. Providers in some medical tourism destinations find themselves doing this out of desperation, because there is no “central” and coordinated / concerted promotion and marketing scheme in place for their country.

Destination Promotion (and Marketing) should be part and parcel of a “concerted action project” which includes domain segmentation, integration, development and promotion. These individual “actions” need not be undertaken in sequence; they can be done in parallel. But certainly not in isolation or selectively. Would you spend money promoting and marketing a destination when the industry (the network of providers) is fragmented and disconnected? The task of Destination Promotion and Marketing should ideally be undertaken by the same “legal entity” tasked with segmentation, integration and development of the industry. (Note that “segmentation” by no means contradicts the purpose and aim of “integration”. Segmentation precedes and prepares for integration (see Health Tourism Integration and the ht8 approach).

The Legal Entity ..... “tasked” with Destination Marketing

When it comes to “national, provincial or even local” level concerted actions involving infrastructure development and support, I (now) strongly believe that the state / government (national or local) which is de facto, a stakeholder should be involved. I say “now” or “in this instance”, because I have a well-known mistrust and lack of faith in governments and politicians until (through actions) they prove to be trustworthy and faithful.

The national-level medical tourism initiative in Greece was repeatedly “enthusiastically supported” (in terms of “declared intentions”) by successive governments but successively betrayed by these governments (a change of Ministers or a change in government). Nevertheless, the project remains on course.

I would even say “yes” to a Public Private Partnership (PPP) because the money, investment and “assets and liabilities” of all the stakeholder groups are involved. The legal entity tasked with Destination Marketing, ideally through the services of a professional “Destination Marketing Organization”, should be a Council, the same one involved in the segmentation, integration, development and promotion project. I have come to this conclusion because Professional Associations represent or should represent the industry and its interests. And do not and should not include the Government as a member. Associations should not get involved in infrastructure development. They should have enough on their plates looking after and upholding the interests of their members. When “Associations” get involved in infrastructure development, there may be conflicts of interest for individuals or the association as a whole. On the other hand, Councils such as the one suggested should include “government”. Having said this, relevant Associations should be members of such a Council (and prominent ones, at that). Council membership is primarily extended to “legal entities” (or “sole proprietor” providers which in essence, amounts to the same thing.

Comment

Profile of the Dr Constantine Constantinides

Constantine Constantinides

Dr Constantine Constantinides runs healthCare cybernetics, a “think and do tank” with a recognized competency in Health Tourism Integration and Development. His home base is on the island of Samos in Greece.

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This is good topic area and one that needs significant attention devoted to it in order to grow the industry. I would suggest to IMTJ that you establish a section devoted to Ethics in Medical Tourism.

Regarding the article, The "Association" under the scenario that you have outlined is not properly structured and inherently creates an ongoing series of conflicts of interests (i.e. a pattern of such behaviors that are at odds with the best interest of the industry and the patient). By the way, these conflicts of interest are customary considered unethical). Moreover, the root problem with those types of "Associations" is that typically their founders have diverted business coming into the association to their private companies. In some cases, their private company (often tied to the conference side and the revenue it generates) is messed so depth into the inner workings of the Association that the conflicts of interest arise on that basis alone. Typically, if you follow the money trail, you will find this to be the case. It is also quite visible to the public, so it should not be a surprise to anyone. In fact, you have to look the other way not to know this. But, the real big losers in all of this are the members of such Associations. A few may benefit, most do not.

As far as governments participating in this type of practice/scenario, I believe this is because their medical tourism strategy and operational plans are not properly designed in terms of concept and execution. Thus, they are not able to distinguish between the "right" relationships that they should have versus the "wrong" relationships they should not. It can also be detrimental to their overall success in the medical tourism arena because they are presenting themselves (at a global level) as supporting questionable business practices…..something that you don't want to do if you are trying to build a credible medical tourism destination image and attract patients.

So, I am not sure if new mode

Mahatma Davis (03/08/2010 19:08:07)

All should be centered on "what's in the BEST interest of the patient" to include costs--isn't this the main reason why patients go elsewhere?

Lee Unknown (03/08/2010 07:07:02)

What is the role of the physician treating a patient who desires care in another location?

Arlen Meyers,MD (30/07/2010 15:22:09)

If these trade associations were local or national politicians -they would be banned from undertaking many of the activities you mention due to a confict of interests.

Any international association promoting a different country every month - often tied to a lucrative conference- is like going to court and finding your own lawyer also representing your opponent.

People only get away with this as governments new to medical tourism are gullible.

Ideally, promotion should come from within a country, but it needs direction.Some national bodies spend so much time talking, and ego clashing, that nothing gets done.

These bodies often do need outside help just as you or I buy in a plumber or electrician to to things they can do better than us. But the " paid help " must be independent and in an advisory role.

The key is that all parties and all government bodies need to work in the same direction.I have written many stories where a health ministry is promoting medical tourism but immigration, tourism, employment or other ministries are putting road blocks in the way .

For any national promotion to work it has to have a leader who is allowed to get on with it, and not have every advertising or marketing campaign or suggestion watered down. Anyone in marketing willl understand that every person you show a paper or art work to , seems obliged to make a change, to boost their own position.

Another vital thing is for politicians to provide resources and money, not just words of support.


Is an international body that sells its favours to a different country every month being ethical ? - no-there are better words for what they are called , but readers can work that out themselves !


Ian Youngman (29/07/2010 16:48:24)