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The top ten medical tourism destinations for 2012

Women celebrating on beach

Ian Youngman from IMTJ tries to pick out his top ten medical tourism destinations for 2012. An easy task? How can he pick the top ten? By visitor numbers? By services on offer? By price? By quality and standards?

As a starting point for writing this feature, it seemed a good idea to find out how many countries there are where the tourism board, governments, healthcare provider groups have declared that they are or want to be a top ten medical tourism destination.

Then I thought of counting the countries where hospitals, medical tourism agencies, consultants and those on the conference circuit had claimed that country X was or would be or wanted to be a top ten destination.

Somewhere around the 200 mark I gave up counting!

Now….. even if Maths was not your best subject at school, it is fairly certain that you have already spotted the flaw. Not all 200 countries can be a top ten medical tourism destination.

The key basis for being classified within the top ten should of course be the number of medical tourists that a country receives. But then we get into the old arguments about who is a medical tourist, do you or do you not count health and wellness tourists, and do you or do you not include domestic medical tourists. For many of the major EU countries that we know are popular destinations, there are no figures; while the figures declared by certain countries are pure speculation.

So what else can we use to identify a “top ten medical tourism destination”? Can we make a judgment based on other factors? Let’s examine a few that might help us:

  • Top doctors?
    As I have yet to see anyone claiming they have rubbish doctors (and bottom doctors is a specialty that just makes the mind boggle), we can’t use doctor quality and expertise to differentiate.
  • The best and latest equipment, technology etc
    In every country hospitals claim to have the latest and greatest equipment. There’s actually little data around to compare the standard and level of equipment and technology in hospitals across the world. So…that’s out.
  • Excellent hotels
    It’s a destination… it has hotels….next!
  • Wonderful beaches/countryside/ tourist attractions
    For some destinations, this may be a factor that makes it more attractive to the potential customer. But if you have cosmetic surgery, many doctors will tell you to stay off the beach and out of the sun for a few weeks at least. If you are having dental treatment, are you in the mood to enjoy the view and in the right frame of mind to enjoy the food and drink and the sightseeing? If you have heart surgery, a new knee or hip, will you be walking around or travelling in buses or taxis. Medical travel is about treatment not a holiday.
  • Language and culture
    Relevant…. but specifically related to the origin country of the patient. And language fluency claimed by providers may be highly variable. Translating ‘I want some food“ may be fine, but ‘I have a pain just down here and it is irregular” may be a bit harder for an interpreter. Many clinics use a translator, but few are specialists in healthcare or receive medical training.
  • Price
    It is cheaper to walk than drive, so sell your car. It is cheaper to turn off the heating in winter and freeze. It is cheaper to eat less food, and starve. None of us choose goods or services on the cheapest possible price; we look at value for money. Also, my basic Maths again shows that if you have 200 countries than only one can be the cheapest. Then there is the tactic of taking the lowest possible price in one country (minus any extras) and comparing it with the highest possible one in the USA or Europe. Yes, some places are less expensive than others, but some destinations still don’t get it; claiming to be the cheapest actually turns off customers who associate low cost with high risk. Significantly several of the best regarded and best performing medical tourism destinations such as the Germany, the UK, and Switzerland do no such thing. Ironically, the country almost every other country compares prices against, the USA, is probably a top three inbound medical tourism destination!
  • The most accredited hospitals
    Driven by JCI’s marketing efforts from the USA, levels of international accreditation are always a claim made by destinations…..” we have ‘n’ JCI accredited hospitals.”  The number of other international and national accreditators has risen in recent years. It is a good thing that international hospital standards are being developed. But when you count up the number of hospitals with JCI or similar international level accreditations, you have to give up counting. Some sectors and market segments within the USA may be fixated on JCI accreditation, but elsewhere it may mean little to consumers and payors.

 

Conclusion….So…. what are the top ten medical tourism destinations for 2012?

Who knows?

  • We can’t compare destinations on numbers… because they not available, not valid or not comparable.
  • We can’t compare destinations on other factors…because they are irrelevant or not comparable.

 

The whole concept of ‘top ten medical tourism destinations’ is not only laughable but the way that many countries are promoted is out of date and assumes that the customer is a fool.

Much of the way the industry has been and is marketed is “advertising puffery” (see definition) and is down to the hyping of the sector by those who are seeking short term profit before moving onto the next ‘big thing’.

If I hear another “best doctors/cheapest prices/nice beaches/latest hospitals”, I promise to, in the words of  one of Richmal Crompton’s characters,  “scream very loudly until I am sick!”.

Comment

Profile of the author

Ian Youngman

Ian Youngman is a writer and researcher specialising in insurance and health. He writes regularly for a variety of magazines, newsletters, and on-line services. He also publishes a range of insurance reports and undertakes research for companies. An ACII, with an honours degree in Economics from the University of Liverpool, Ian was a co-founder of The General Insurance Market Research Association. He also has widespread experience within the insurance industry at management level, working for brokers, a bank and an insurance company. 

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Some sectors and market segments within the USA may be fixated on JCI accreditation, but elsewhere it may mean little to consumers and payors.


I am not sure where. We spent the money and time to do a passerby survey here in downtown Denver's central business district, using college kids as surveyors.

Fewer than one half of one percent knew what medical tourism was, and fewer than half of those ever heard of "JCI" and of those, many thought it was a trucking company.

If one limit's one's panel to "JCI" hospitals, one misses many good hospitals with the sense to not pay the exorbitant fees for a brand that means little outside the medical tourism sub-sub sector of healthcare as a whole.

I have a bit of difficulty with Tom's "medical outcomes" as that too can mean about a "gazillion" metrics all of which need appropriate sample sizes for statistical validation, and those numbers are still living in "anecdote-ville" in my book.

Since the Indian hospitals don't have a central monitoring and validation system through which data is verified, I feel like Duchovny's Fox Mulder character( X-Files) ... "I Want to Believe" " The truth is out there!"

Maria K Todd, MHA PhD (19/11/2011 01:01:56)

What a relieve, finally in a short article myths are busted by an observer, rather than participant. Nevertheless, the first reaction mentions again, price, tourism an quality. And 2 others mention price and quality as well. How typical. In our experience patients hardly ever ask data, actually we find that patients make important decisions lacking (and not asking for) information. Understandable, as we the providers do this work on a daily bases where as a medical health traveler has hardly any experience and thus doesn't know what is important. It is our responsibility to provide them with more relevant information than they ask for. We work on the premises that a patient prefers to be treated by a known , respectable physician, in a hospital around the corner within a reasonable time. That means we are always second choice. Nice beaches, great hotels have less (or no) value,. Indeed who wants to go sight seeing after a hip replacement operation if you cant even put on your socks yourself. After care, specially equipped accommodation, caring (and good) translators, add value to the patient, however. And can make the difference. The problem is most patients don't look beyond the treatment and hospital stay.
One topic I disagree with Ian is price. As patients have no way of assessing the quality of the care and treatment before they undertake going abroad (or choose for local treatment) , price happens to be one of the few hard criteria patients can actually compare. This is not to say that patients will always choose the lowest price, but it is always a factor one way or another (high price is high quality, low price is affordable), sometimes it even is the determining factor to decide to look for treatment oversees.As to the example of the US, again we don't have hard data, but I would argue that the US might also be in the top 3 of outbound destinations. Also, the US offers in many fields the (perceived) top treatments. This attracts an affluent group of patients, many for which the treatment is paid for by their employer or government. We have yet to come across a self paying patient considering the US as a possible destination for treatment.

Johan Smit (16/11/2011 11:10:36)

kerala state , India is reputed as a good tourist destination as well as medical treatment centre . High quality treatment is offered by various multispeciality hospitals here at 30% of cost compared to Europe or USA. The medical professionals are internationally trained and equipments are world class.
Apart from modern medicine and surgery , india has a traditional treatment system called ayurveda and massage therapy.

AFIA INDIA MEDICAL TOUR OPERATORS,
KERALA STATE , INDIA

afiaindia@gmail.com

AFIA INDIZ (16/11/2011 04:44:56)

There are reliable ways to model consumer choice using data analysis and marketing engineering, so let's not count out the possibility.

What we don't have is a trade organization or private advisory services group that has the expertise and spends the money to answer questions like this.

Scott Frankum (15/11/2011 17:10:45)

What about Russia? Is the country on the scene of medical tourism at all? We work with India because it reportedly has amongst the top quality treatments coupled with lowest prices for these treatments. I say "reportedly" because unfortunately we've not had the pleasure of confirming this ourselves yet (due to a low volume of customers).

Andrei P (15/11/2011 16:39:49)

Thanks, Ian.

Despite the best efforts of the medical tourism industry and even entire countries to commoditize and market health care, consumers have remained mostly indifferent to "packaged" choices and to the needs of anyone other than themselves.

Shocking, isn't it?

Jeff Schult (15/11/2011 14:56:33)

Can we camp inHarley Street (considering that is the equivalent of Wall Street) to register our protest and scream very loudly at this unethical practice?

Zahid Hamid (15/11/2011 14:45:44)

If you use medical outcomes, patient satisfaction and price as the primary ranking categories, India continues to maintain its first place position. IndUShealth will soon be releasing a landmark 5 years patient outcomes study, which will provide some interesting new benchmarks for comparison. I agree with the authors laments. Ian accurately lists all the tired superlatives that we have had to endure...until real outcome data is published.

Tom Keesling (14/11/2011 23:02:05)