The industry discusses the best way to describe itself



Lively exchanges in and out of the symposium venue marked the International Medical Travel Forum (IMTF) 2007, organised by Marcus Evans Conferences at the sprawling Taj Exotica resort in Goa from October 20 to 24.

Following on the heels of a similar event in Bangkok earlier in March 2007, this gathering saw the participation of top-level management, representing a number of sectors such as private and public hospitals, medical organisations, health and tourism ministries, resorts, hotels and airlines. A Marcus-Evans spokesman described the event as “targeting a global audience with delegates coming from the Americas, India and Southeast Asia like Malaysia, the Philippines and Singapore”. The attendance sheet registered a total of 120 participants representing some 26 countries, including Tunisia and South Africa.

Various presentations were made in the hotel’s grand ballroom mainly between October 22 and 23, and on the final day, October 24, the group was bused into downtown Goa to visit Manipal Hospital and Apollo Victory Hospital.

While the scheduled subjects all aimed to bring the assembled up to speed on developments in international healthcare, they also stimulated engaging and thought-provoking discussions, specifically, the issue of “medical tourism versus medical travel”.

While acknowledging that “medical tourism” was more familiar to the general public, delegates agreed it was now time the media – which they believed was responsible for promoting the term in the first place – helped in the move to popularise “medical travel”.

Gary Miller, UK operations director for Sahara Medical, which facilitates medical, cosmetic and dental procedures for British patients to foreign destinations, admitted it was difficult to change current thinking. “We can’t really get away from the word ‘tourism’, and judging by the numbers of people (in the UK) who are travelling overseas to get care, it doesn’t seem to bother them. There is nothing wrong with enjoying the destination you choose to have your surgery, but I always make it perfectly clear that a patient’s health is of paramount importance, thus, I never encourage regular sightseeing post-op. Surgery and sightseeing don’t mix. In some cases, however, for minor surgery, a patient may be able to enjoy some of the local sights, but I feel one has to remain open minded and display a level of common sense.”

Miller instead preferred combining “health” and “tourism”, and added that the title of Sahara Medical’s innovative project reflected this – Health Tourism TV (see box), which airs in a few months.

Daljit Singh, president, strategy and organisational development, of Fortis Healthcare and Escorts Heart Institute and Research Centre in New Delhi, shared a similar view. “Lately, we’ve had to switch focus.

‘Tourism’ connotes having fun like I’m going to visit Singapore and since I’m there, I’ll get some medical procedure done. We have to start changing this mindset, especially if you’re going for some high-end, serious stuff like cardiac surgery.”

His industry colleague, Grant Muddle, senior vice-president for operations at Apollo Hospitals in Bangalore, added his bit: “There’s been so much misuse of the term ‘medical tourism’ for what is really happening, and I don’t think that will ever change. Those who come in for procedures, whether it’s cardiac surgery or hip replacement, don’t have recreational or leisure activities on their mind. They don’t want to hang around; they want to go home immediately after it’s done. It’s a serious thing to travel elsewhere (to get help) for serious ailments.”

Another industry stakeholder Vishal Bali, managing director of Wockhardt Hospitals, headquartered in Mumbai, observed that it was time to reassess the situation. “What started out as medical tourism has led to a global phenomenon where an increasing number of patients are seeking opportunities for affordable healthcare. Against this more serious perspective, it’s time to bring together these two sectors – tourism and the medical field – and graduate into a much broader arena. Some patients may turn out to be tourists. Some may never become tourists at all, but what characterises them is their quest for affordable treatment.”

Bali and Muddle felt that “medical value travel” best summed up the aim of these niche visitors and their own organisations.

Dr Talavane Krishna, president of the Indus Valley Ayurvedic Centre, weighed in with his own label, “medical wellness travel”, which he said could also encompass the purpose of those intent on undergoing ayurvedic or preventive therapy programmes. “Medical tourism gives confusing information as it is associated with sightseeing and insurance companies may have difficulty rationalising that. Also, not everyone who comes in can actually engage in tourism since they’re here for serious procedures.”

Maggi Anne Grace, author of State of the Heart, a recount of her experience accompanying a heart patient to India, however, cautioned the industry against also trying to rush changes in terminology.

“Although I don’t like the word ‘tourism’, it doesn’t help to change the term, if it prevents people from finding us, and medical tourism is what many type in Google when they do their research.”

Day one kicked off with Ravi Raghavan, vice-president, public relations, Healthcare Tourism International and Jonathan Edelheit, vice-president and president of United Group Programs and Medical Tourism Association (MTA), both US based, who outlined medical travel’s current state-of-play as well as the need to uphold the reputation and improve the safety of the industry, starting with creating a culture of transparency. This meant sharing data on quality of care and procedure outcomes.

Healthcare Tourism’s portal (, said Raghavan, was set up to provide patients with free services and unbiased information, while MTA, Edelheit stressed, was committed “to assist international providers in furthering their goal of providing a viable alternative for American patients and serving as a liaison with employers and insurance carriers”.

US-based artist and author Maggi Ann Grace stirred her listeners’ emotions by her simple but evocative retelling of her journey to India with partner Howard Staab for his heart surgery. Noted specialist Dr Naresh Trehan, who is behind the ground-breaking MediCity complex in New Delhi, opening later this year, successfully operated on Staab. (See News, page 11.) Grace, who strongly felt patients as well their companions, need to become active participants in the medical travel dynamics, told IMTJ: “Especially when someone is sedated, they need someone to speak on their behalf or help them navigate the (hospital) system.”

She urged medical professionals to realise the importance of the companion’s role, citing instances when she felt excluded from conversations between Staab and his doctors. “But he was very good about it,” she recalled. “He would look at me and ask: ‘Well, what does Maggi think or what does Maggi say?’” This attitude can only change over time was her belief.

She also advised health facilities to come back quickly to patients seeking information, having experienced uncomfortable delays from her chosen hospital. “We could have come a month earlier if we had gotten the information we needed.”

Faced with choices of Texas, Argentina, Mexico and India for surgery, Grace and partner Staab went with their gut feel about India and Dr Treyhan, who they discovered on Google, and was included in several lists of influential personalities. “My son, a doctor, had worked in India a month before we got word about Howard’s condition so he recommended it, and just looking at the hospitals, we felt good about it,” Grace said.

Due to her book, Grace has received numerous invitations to speak, not only at medical travel conferences around the world and in the US, but also before audiences in libraries and community gatherings. “I feel I’m part of a huge wave of change that’s taking place. I don’t know where it’s going, but at least I am doing my part in building awareness for people, who need help in their healthcare.”

Vishal Bali of the Wockhardt Hospitals network, who delivered the presentation, “The rise of high-quality, lower-cost provider options for patients and payers” rebutted arguments that the medical travel industry would displace domestic clients, in India at least. “Even with the high numbers coming in, these will not go beyond more than 8 percent of our total patient volume. Anyhow, these foreign patients usually take up services, which cost more and just occupy bed space or rooms being utilised by only 10 to 15 percent of the local population.”

Bali did not subscribe to the policy of a dual pricing scheme, saying: “The moment you do this, you create a dual culture, then your manpower gets accustomed to treating patients differently because of pricing.”

Daljit Singh of Fortis Healthcare and Escorts Heart Institute, who spoke on “A Tertiary Care Hospital’s Perspective”, likewise added to Bali’s insights, saying: “Don’t get the impression all hospitals in India are looking for this type of business. For our own hospitals, it’s not our primary business; it’s not the reason why they exist. We take in only about 5 percent of foreign patients, which doesn’t really make a difference to capacity or compromise how we treat local patients. And in our hospitals, there is no dichotomy between local and foreign patients.”

Dr Jason Yap, director (Healthcare Services), Singapore Tourism Board, was scheduled to walk delegates through the island-state’s all-out efforts to capture the market but was unable to attend. So Edward Oh, group business director of SingHealth, the country’s largest network of healthcare institutions, stepped in. According to Oh, the medical travel initiative is being driven by Singapore’s need to maintain a critical mass of patients to support the many subspecialties, high-end services and cutting-edge technology offered in its medical facilities. And since the city’s 4.5 million population cannot support this investment in the long-term, it has had to expand to an overseas clientele.

While the morning sessions were conducted plenary-style, the afternoon sessions consisted of three topic discussions taking place simultaneously.

On Day One, the subjects included “Investment for medical tourism”, “Technological advancements in medical tourism” and “Innovative planning and funding options”.

On Day Two, the subjects were “Best practices in reducing healthcare costs and improving patient health”, “Quality cost and transparency” and “Complementary and alternative medicine”.

Case studies included “Working with media to get medical travel’s message across (Sparrow Mahoney, CEO of, “Managing budgets while maintaining better outcomes (Dr Kongkiat Kespechara, hospital director, Bangkok Hospital Phuket), “Transforming a government hospital into a healthcare leader (Ruzana Abdul Samad, marketing manager, Institut Jantung Negara), “Strengthening the broker-hospital relationship and creating customer expectations that surpass industry standards (Grant Muddle of Apollo Hospitals) and “Medical tourism and the law (Renee-Marie Stephano, general counsel, Medical Tourism Association. All attracted good attendance.

Details of the next International Medical Travel Forum 2008, set for later in the year, have yet to be finalised, a Marcus Evans Conference spokesperson told IMTJ. But what is certain is that it will be held in Istanbul.

Events such as IMTF are expected to proliferate as interest in medical travel heightens, given the deepening healthcare problems in the West. Said participant Dr Krishna of the Indus Valley Ayurvedic Centre: “Meeting others in the field was invaluable. As more people jump onto the bandwagon, conferences like these will become more useful to help them understand and deal with growth issues.”


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