Ilan Geva talks about what branding means in medical tourism


How did you get in involved in medical tourism?

Throughout my career in advertising, I have worked with multinational companies in both the healthcare and travel industries and have worked within many different cultures.  I’ve been involved with some of the largest, healthcare, hospitality and travel companies promoting to the US market and promoting destinations in the US. Medical tourism obviously combines these disciplines and about four years ago I was asked to do a viability test and research in the US for the Mexican medical tourism market.  As a result of doing this work I started to network within the industry, going to conferences and events and then started to speak at conferences.  Since then I have created a speciality in the branding side of medical tourism, promoting and building brands in the US market, I am primarily involved in branding destinations and services, to include places, cities, hospitals, and countries.

How important is branding in the Medical Tourism market?

Branding is very important in medical tourism but everyone has a different definition of the term branding. I see what they do right and what they do wrong. When you are branding and marketing there are many strands of the marketing mix that need to be considered when trying to penetrate the American market.

What do people need to consider when reaching out to the US market and what are they doing wrong?

Many think branding is just putting together a nice brochure and going to a conference and having a booth, but that is not enough. When I talk about branding I talk about the whole brand touch points of medical tourism. These touch points have many important elements including, online presence, advertising, marketing, PR, reputation and more which all combine to effectively and successfully reach the target market.

I’ve noticed that many of the people who come here to sell their services to the US do not have a clue about what the brand touch points are.  For example, they are spending a lot of money on building hospitals and buying expensive equipment for the hospitals and they market these as big selling points but those are not necessarily the factors that will make people go to that destination. They are also very proud when they talk about having JCI accreditation and use this as big selling point but they don’t understand what JCI accreditation means to the patient and how relevant it is to them when making up their minds in the pre-purchase process. Medical tourism companies need to do more research into what is important and relevant to patients when they are choosing a destination.

What should companies consider when branding their medical tourism product?

It is important to remember that every purchase in the world has three steps and this applies as much to Medical Tourism as anything else. These three stages are the pre-purchase, the purchase and the post purchase.

The pre-purchase includes everything from how your website looks, how easy it is to find information, how much information is available, how relevant that information is to the potential patient and how transparent it is.  Then another extremely important element of the pre-purchase process is word of mouth, what are friends and family saying about a destination and their experiences as patient and as a regular tourist.

The problem is that currently there are far too many countries, doctors, hospitals and clinics that don’t incorporate these essential elements in their pre-purchase branding. Oftentimes the business model is far too simplistic and reliant on basic websites and facilitators to get patients. The US market is very sophisticated and patients have certain expectations about the availability of information and the extent of the information they need before making a decision.  As a result there are many vital marketing tools that are not being utilised properly, or at all, in trying to attract patients at the pre-purchase stage.

It’s the same again with the purchasing process, this process can be a very long one because the minute you sign the patient agreement with the facilitator or directly with the vendor you are in the purchasing process. Again, doctors, hospitals, facilitators etc are not giving enough attention to the detail in how they brand this part of the process or what is important to the patient at this stage.  There are so many factors involved at this stage that are not being properly communicated to the patient and often these vital touch points are overlooked yet they are often significant factors in helping potential patients make purchasing decisions.  These include; the type of treatment, how long the patient needs to stay in the hospital and then how much recuperation time they need before they return home, where are they going to stay when they’ve been discharged, what kind of accommodation is available to their travelling companions, do they speak English, what’s the food like? etc.

What is the most problematic part of the whole purchasing process?

The most problematic area is the post purchase practice because this is really the Wild West of the medical tourism world, and is open to a variety of different interpretations which mean different things to different cultures and companies. As long as the post-purchase process is not regulated it will hurt the perception Americans have of a country and its brands because they don’t understand culturally what the American patient needs and expects post-purchase.

Currently there seems to be a wide variation and understanding about who is responsible for the patient when they have been discharged both abroad and once they return to the US. As a result there are thus far no standardised procedures, no norms, and it seems that no one in the industry can agree on what the norm should be. A lot of this is down to cultural differences and while some will follow a defined procedure of what happens to patients post-purchase others won’t. Only one third of facilitators have some kind of a warranty in place which means that the legal issue is wide open. This is an area that really needs regulating because post-purchasing issues can be very damaging to a brand even when there may be good pre-purchasing and purchasing tools in place.

So how do you work with clients?

I have a whole process which involves study, research, evaluation, observation and training.

I start by doing a brand audit, and I start by spending 4 – 7 days in the hospital or the clinic so that I can observe everything from the patients’ and the staffs’ perspective.  The most important thing to understand is that I am very adamant that when I am observing a hospital that I start with the CEO and not the head of the marketing department. I need to get to know the hospital from top to bottom.

When I first start working with a hospital I want to be treated not as a visitor but as a patient from the US, I try and sleep in the hospital or if they have a hotel for relatives I want to be stay there too and also I need to get to know how the hospital is run as well as I possibly can. I go through a process and get to know the staff and insist I have the freedom to approach nurses and talk to everyone that works in the hospital and talk to vendors and suppliers too, so that I can get a feeling of what’s working and what’s not working. I then write a report about what I’ve seen and heard and how I feel about everything I’ve experienced. Then I go back and spend time on location, getting involved with patients from the pre-purchase stage through to their post purchase experience, then we make recommendations and the training starts in the hospital.

What are the biggest stumbling blocks and blind spots companies have when branding to the US market?

I think lack of cultural understanding of what is important to the US patient and also what the requirements there are of the different cultural sub-groups within the US population. For example a patient with a Polish background will likely understand what to expect culturally if they go to Poland for treatment, whereas for example an African-American or a patient from an area in the US where there are no visible ethnic communities and who has no experience of Poland or Polish ex-pat community will have completely different expectations of what it will be like to be a patient in Poland, including everything from language, food, hospital procedures etc.  This is a very important factor which needs to be taken into consideration when targeting different markets and communicating this to patients is a vital part of the branding process which is often not considered. How would a guy from Texas feel if you throw him into a hospital in Turkey and he feels isolated culturally and emotionally and there isn’t anyone there who can connect with him and understand him? We’re not talking about just fixing you as if you are a car in a garage, patients have different needs that need to be heard and catered to because there is a lot of emotional attachment to travelling abroad for medical treatment. Countries are going to have work hard to make Americans from non-ethnic backgrounds feel comfortable and welcome.

How’s India’s branding in the US?

India is perceived as a good place to go because of price. I’ve sat in conferences and heard people from India talk with great pride about how they almost have a production line of heart surgery, but what they don’t know or understand is how the average American patient will feel if he knows he’s going to be number 53 to go on the table for surgery that day. This just doesn’t match the American psyche or the personality of the average US patient because Americans want to feel special, that’s how Americans are sold to in America, and they expect to be treated as special individuals - think of the L’Oreal “you’re worth it” strap line. Obviously for Indian-Americans there is no problem because for them it’s like going home and they understand where.

What other issues are there with selling medical travel to Americans?

There is the issue of distance, if you tell someone that the best doctor in the world is in New Zealand but it will take you 20 hours to get there but there’s a less famous but excellent doctor in Portugal and they are only 6 hours from New York the patient is more likely to go to Portugal. That’s why Mexico has great potential because it’s round the corner. Other places that are close are serious contenders even if the medical reputation is not the highest, like other Central and South American countries.

Another point is trust.  Who do you trust most in medical tourism? “60 Minutes” broadcast a programme about a year ago that had a report on some clinics in Mexico that were blatantly fraudulent.  This programme did a lot of damage to the whole medical tourism business and I think it was aired it at least twice.  When potential patients see this they think “I’m not going anywhere, I trust my doctor here”. So there’s a challenge for medical tourism companies because the current medical tourism business model is based on directly recruiting patients through the web and facilitators, but in the US we’ve learned again and again that people trust the opinion of their family doctors more than anything else when it comes to making medical decisions. So, for example, if someone is diagnosed with cancer they will go to their family doctor for a referral and recommendation to a specialist because people trust them.  The issue here then, vis a vis medical tourism is that currently our doctors do not recommend their patients go overseas for treatment but this also means that there is great potential for doctors to develop referral system for sending patients overseas and this would involve a different type of branding strategy from the one being used to attract patients directly.

Are countries beginning to market directly to US doctors?

Not yet. It’s being discussed among doctors, some discussions on LinkedIn, but I have not yet seen a very determined and committed process, it’s up to those in the business to push this branding angle.

Will US medical insurers start sending people overseas?

Insurance companies are realising medical tourism is cost effective but there are currently the post-purchase problems and potential legal issues that need to be sorted out.  There are some insurance companies specialising in this and I think they realise what the potential is, and their business model is very smart.

Do countries need to do to promote their brand as a country or should they continue to promote themselves as separate entities in the US?

I’m seeing this issue with how Israel, for example, promotes itself in the US. Their problem is that they are divided as a country in terms of marketing themselves to audiences in the US and therefore they are not very well known in the US.  This works very well for them in the former Soviet Union nations where they are very successful and this is where most of their overseas patients come from but doesn’t work in the US marketplace.  Israel as a whole receives about 30,000 international patients a year, Jordan which borders Israel receives 250,000. In the US, Israel has no branding as medical tourism destination whatsoever yet they come to conferences and compete with each other instead of working  together, no one pushes Israel as a destination and this is not working for them in the US.  Similarly with Turkey, which has the largest number of JCI accredited hospitals in the world, yet Turkish influence is minimal and Americans just don’t know about them because they are not being branded properly.  I think we will see more and more investments in infrastructure, hospitals, equipment etc but if they are not being branded and positioned properly then no one will know about them and the businesses will fail.

So, what would you main message be?

Do your homework. When people put business plans together they have everything down to the last detail when it comes to mass forecasts etc but they don’t pay attention to the most important thing and that is  “what is your vision, what is your position in the market, what brand are you building”. Those are the most neglected areas yet without this the business cannot succeed. It’s not a big a deal to build a fantastic building with amazing facilities and get the best doctors in the world to work there, but so what, if you don’t do your homework and if you don’t make the commitment to positioning your business or have a real vision and be different from the others then all you’ve got is a building with no patients.

What countries do you think will succeed in the US market?

Mexico has great potential because of geographic proximity to the US but they have to sort out their issues in terms of reputation and safety, because this is so extremely important to Americans. Other Latin American countries have great potential, also because of proximity and of course because the biggest ethnic group in the US is Hispanic and it’s easy for them to go “home” for treatment. European countries are second because the European standards are considered to be closest to American standards and in some cases they exceed it.  In Eastern Europe some countries are providing good serves but their strengths may emerge in the wellness sector and not necessarily in very advanced medical procedures.


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Resources, 30 April, 2018

Ilan Geva, Managing Director, Ilan Geva & Friends

How the patient experience drives the global brand

Resources, 01 May, 2017

Ilan Geva, Destination Health: The Medical Travel Summit USA

How to build your clinics brand - marketing for medical tourism

Resources, 26 April, 2017

Ilan Geva, Ilan Geva & Friends, IMTJ Medical Travel Summit 2017

Consumer behaviour: The forgotten science of medical travel

Resources, 26 May, 2016

Ilan Geva: IMTJ Summit 2016

What’s in a brand? The art and science of destination branding

Resources, 15 April, 2015

Ilan Geva: IMTJ Summit 2015

The Other Side

Articles, 22 December, 2014

Do governments destroy their own countries' brand?

Controlling destiny

Articles, 03 April, 2014

How are brands shaped by events beyond their control?

"Destination branding"

Articles, 03 December, 2012

What is this latest buzz phrase all about?

Branding & Advertising, Strategic Marketing Thinking

Resources, 01 May, 2012

Ilan Geva: EMTC 2012




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