Local studies on Medical Tourism

Philippines The Philippines has been growing as a destination for medical tourism. The US Medical Tourism Association magazine reported that this services sub-sector grew 8.0% in 2007. The number can be expected to grow as American health-care costs rise, or if pending legislation results in an increase in patient wait times for surgical procedures (as has been seen in other countries where care has been nationalized), due to the traditional political, economic and cultural connections between the United States and the Philippines. The Philippines is one of a few countries that sends qualified nurses, physicians and dentists to the US, the thousands serving in American medical facilities being a testament to its quality of medical education. According to year 2000 WHO rankings of the world's health systems, the Philippines takes its position on no.60. http://en.wikipedia.org/wiki/Medical_tourism#Philippines Medical Tourism Philippines (MTP) welcomes tourists from all over the world to visit the Philippines for their medical and leisure needs. The most common procedures are cosmetic and plastic surgery, dermatology, weight loss surgery, ophthalmology, and dentistry. The Philippines has been growing as a tourist destination of choice for health and vacation because of our world class physicians, modern technology, and our uniquely Filipino brand of caring and compassion at great values for money at a fraction of the cost in developed countries. We are home to some of the best hospitals and stand alone Specialty clinics in the world, offering world-class expertise, state-of-the-art facilities, and the distinct warmth of the Filipino hospitality. We also have some of the world's best spa retreat resorts and tour destinations in this part of the earth. http://www.rxpinoy.com/medicaltourismphilippines/index.php

NEWS 2010 News Shinagawa Lasik & Aesthetics is PMTI's newest partner Japan's #1 cosmetic surgery chain and world's largest Intralasik eye surgery provider is here and now an affiliate of PMTI. Two decades of implementing the highest safety standards and providing quality care for more than 2.2 million

PMTI in the Medical Tourism Magazine The Medical Tourism magazine is a monthly journal published in theUnited States serving the global healthcare industry. selffunded companies and Third Party Administrators. This feature supports 51 languages and allows you to instantly translate text and pages for easier access to the information on our site. PMTI Partners with the Department of Health Philippine Medical Tourism. is working hand in hand with the Department of Health (DOH) in the area of medical tourism.com/explorations/none/asias-next-tourist-hotspots423749?hpt=C2 Google Translator Feature Our website now has a Google translator feature found on each web page. Inc. Shinagawa is the only one that offers the IntraLASIK method which is a 100% blade-free technique using high precision laser at a very reasonable price. share knowledge and create new business relationships. PMTI conveys their observations and provides recommendations based on what they see in the country’s health facilities and services performed. In the same manner. 2009. CNN features Marinduque as a future tourist hotspot Visit this page and read about Marinduque being touted as a top future tourist hotspot: http://www. Just scroll down to the bottom of each web page bottom and select your preferred language! 2009 News PMTI attended the 2nd World Medical Tourism & Global Health Congress PMTI once again participated in the Medical Tourism Association's World Medical Tourism and Global Health Congress held in Los Angeles. The event proved to be a great opportunity to network with people from the public and private sectors.cnngo. the annual global conference featured approximately 1. as well as. “In Good Hands” . It has readership from all parts of . Over the course of three days.satisfied clients in Japan and all over the world.500 attendees from 45 countries. California last October 2628. self-funded employers and insurance agents. to showcase what our country and PMTI as medical travel facilitators can offer and do for the medical traveler. the DOH issues guidelines to all involved sectors in the medical tourism industry such that the country’s goal of being THE destination for medical travel is attained. health insurance companies. It was a great occasion to learn. companies.

PMTI spoke on medical tourism in the Philippines and the high quality services it provides the traveling patients. PMTI in the Business Mirror Forum (March 2009) The Business Mirror forum held at the newspaper’s offices last March gathered the country’s leading hospital and government officials involved in the medical tourism industry.and private-sector collaboration. PMTI in the The Business Mirror Special Report “Nurturing Touch. It presented the country’s efforts in positioning itself as a major player in the multibillion-dollar global medical tourism industry. A unified marketing message. Sunshine and Surgery” The Business Mirror came out with a special report in its March 26. These were among the recommendations shared by the select group to be at par with other countries in the region. represented by Eva Trinidad and Joel Garcia. president and director respectively. were there to represent the medical travel facilitators. PMTI. 2009 issue. .the world and features the services of its select members as well as information on the emerging trends and destinations pertaining to medical travel. stronger public. infrastructure spending as well as better data-collection efforts are needed to bring the country’s medical tourism sector to the next level. The 8th issue (February 2009) of the magazine featured an article on PMTI as the country’s pioneer in the area of medical travel facilitation and integration and how it is aiming to be the standard for all emerging medical travel facilitator companies in the Philippines.

PMTI believes that with the support of the Department of Tourism and their programs. PMTI was tapped to assist the writer by providing much of the information for the feature being the country’s pioneer and consistently credible facilitator companies in the field of health travel planning. It enumerated some of the most popular procedures (for medical. features PMTI and medical tourism in an article entitled “Happy New You” for its June issue. cosmetic and wellness treatments) that balikbayans and foreigners alike choose to take advantage of here in thePhilippines because of the cost savings they realize. we are on the right track in putting the Philippines on the world map for its Wellness Programs. We would like to make special mention of the Office of Sports and Wellness Tourism who has been very supportive of our objectives of making the Philippines the hub for wellness tourism. 2008 News PMTI Works Closely With The Department of Tourism PMTI keeps in close touch with the Department of Tourism on their Medical and Wellness Travel programs. .Cebu Pacific’s Inflight Magazine features PMTI in its June issue Smile. not only for Asia but also the United States and Europe. Cebu Pacific’s Inflight magazine.

October 22-25. such as insurance companies. This is a much needed service for the members and very welcomed by the Insurance companies who do not have satellite offices to handle their members' numerous claims. transparency on quality of care and outcome issues. Their monthly magazine. follow-ups with their insurance providers and communicating with the necessary offices when availing of their benefits. The Association creates a forum for the industry and guides the players in the right direction. benefits and requirements. is a source of information on the worldwide medical tourism happenings and trends. 2008 The 4-day Health and Wellness Tourism Summit hosted by the Department of Tourism presented insights into the state of globalized health care and wellness in the 21st century. PMTI attended "Embracing Health and Wellness in the Heart of Asia" . Foreign-based patients whose coverage permits them to seek medical care and treatment abroad will not have to worry about paperwork. PMTI partners with two of the Country's Foremost Names in Healthcare Providers PMTI has recently signed an agreement with Makati Medical Center and The Medical City that would welcome its medical travelers and provide them with first-rate healthcare. PMTI attended the World Medical Tourism & Global Health Congress PMTI was a participant in the Medical Tourism Association's annual conference in San Francisco. The country's finest doctors practice in their very modern hospital facilities with state of the art equipment ensuring that the medical traveler will get the best quality care possible in the Philippines. and promotes the highest level of quality care.Sofitel Philippine Plaza Hotel. California where over 800 attendees from 45 countries attended. and the benefits it brings. PMTI teams up with a Third Party Administrator to service patients availing of Health Plan benefits PMTI has secured the services of a Third Party Administrator to ably provide Insurance Companies this much needed check and balance system when sending their members here for medical treatment. self-funded companies and Third Party Administrators.PMTI is the VERY FIRST Philippine Member of the Medical Tourism Association in the United States PMTI applied and was readily accepted as a member of the Medical Tourism Association (MTA) which is an organization that delivers information on Global Healthcare. The event provided a great opportunity to network with people who represented organizations of key interest that could further medical tourism in the country. Medical Tourism magazine. It was a great occasion to showcase what we as a company and what the Philippines can offer and do for the medical traveler. It was an opportunity that gathered together experts and policymakers from the government and health and wellness .

WorldMed Assist specifically does not: we have helped many people obtain organ transplant surgeries.com/default/news-and-press The basic issues of Organ Transplant Tourism 1sep2008Filed under: ArticlesAuthor: Admin Excellent article.com/Liver_Transplant_India_jo_ann. reveal the country's national branding and positioning vis-a-vis the strategic direction of global health and wellness tourism industry. . we couldn’t agree more." PMTI President speaks at the Philippine Chamber of Commerce Business Conference and Expo . molecular biologist and an expert in regenerative medicine and Dr. lawyer.worldmedassist. The summit had an impressive lineup of speakers such as Dr.htm http://www. please see: http://www. Sanjiv Malik. together with the heads of other tourism-related industries. At WorlMed Assist.htm To read more about one of our past patients." Eva A.worldmedassist.sectors to identify areas of greatest concern in establishing world-class health and wellness infrastructure.com/medical_tourism_guidelines. To read more about our ethical guidelines. October 20-22. a doctor. PMTI President. present global opportunities for the industry. Some of these companies engage in the selling of organs. The reference to Medical Tourism and Medical tourism companies is made in this article several times and correctly so.com Organ transplant tourism is not a fad nor a fashion. best-selling author of "Wellness at Warp Speed. Luis Villafuerte of Camarines Sur. such as the Spa and Retirement industries and Gov. 2008 The Philippine Chamber of Commerce and Industry hosted a Business Conference and Expo. Noah McKay. Trinidad. but a serious 21st century problem for health service providers and governments. please see: http://www. Sam Bernal. http://www. In this article I try to identify the basic ethical and political issues.philmedtourism.worldmedassist. Chief Executive of Max Healthcare. was invited to speak on Medical Tourism and was a guest panelist during the tourism segment of the conference. Dr. Since tourism is one of the most viable industries that contribute to the continuous growth of our economy.Manila Hotel. a segment of the conference was dedicated to it with the theme of "Effective Strategies in Managing Tourism Investments. but in all cases the recipient had to provide a family member and the organ donor. and finally.

in the June 2008 edition of the British Medical Journal. There is a difference between organ transplant tourism and health service providers outsourcing medical services abroad.“The core of the debate is how best to put an end to such abuses. the British NHS has a programme to outsource certain medical procedures in the rest of Europe. and transplant centres) devoted to providing transplants to patients from outside a country undermine the country’s ability to provide transplant services for its own population. writing in Nephrology Dialysis Transplantation. such as kidneys. proposed. vulnerable or simply easy to coerce. And in the abstract of a paid for paper. write about the various insurance programmes in the US who encourage policy holders to travel abroad. but also other elements relating to the commercialization of organ transplantation. December 2007. The first is that life saving transplantation of organs is a successful procedure. In the Bulletin of the World Health Organization. In a paid for article by Prof.000 transplants are carried out each year. he objects to the use of the term in both the media and academic circles. in 2007.” The Declaration of Istanbul (2008)(pdf) (via Transplantation Society). Dr Yosuke Shimazono writes that in 2005 around a total of 93.000 kidney. The second factor is that this success has also created a problem with the supply side. the NHS website. is referring to is the commercialising of organs from live donors.” The abuses Dr Gabriel Danovitch. UK Transplant. but because they are poor. Organ transplant tourism is the common term used to describe people who travel abroad. But semantics and style apart. usually to poor countries. illustrates the point with these simple words: “Today more than 9. . Dr K. For example. professionals. to have organ transplant operations. in AprilMay 2008.000 people in the UK need an organ transplant… But less than 3. Shimazono. “Travel for transplantation becomes transplant tourism if it involves organ trafficking and/or transplant commercialism or if the resources (organs. “The shortage of organs is virtually a universal problem. Leigh Turner.” (see the Declaration itself for a fuller description).” The term Organ transplant tourism is itself disputed.” Shimazono confirms the scale of the problem when he writes. A Bramstedt et al (Pubmed). Organ transplant tourism is not a fad nor a fashion but the result of two factors. the following definition. not because they act from altruistic motivation. gives the following definition of the term: ““Transplant tourism” involves not only the purchase and sales of organs. liver and heart transplants were carried our globally. For example. in Ethics Corner American Journal of Transplantation (July 2007). The organs come from live donors who sell their organs.

Danovitch writes. governments. exploitation and physical harm. writes in Medscape Journal of Medicine. socially or economically vulnerable…” And a Lancetcommentary (pdf) (via Transplantation Society) describes live donors as possibly being: illiterate and impoverished individuals. the money they might have made from selling an organ would soon disappear. But what does this really mean?. undocumented immigrants. 2007. 78% of the group spent their money within five months (Shimazono). as Shimazono describes the situation. inability to do labour intensive jobs. while other studies . says that family doctors back home might have to deal with the problems. prisoners. Recipients (organ transplant tourists) of organs from live donors are themselves not immune from consequences of the transplant. As for the success rate of the procedure Shimazono says that some studies show that results are considerably lower than international standards. For donors. organ transplant tourists can be the victims of fraud and more seriously sometimes die from the procedure. the consequences of organ transplant tourism are much worse. Live organ donors are usually people from countries without a regulatory framework to protect donors from. and political or economic refugees. if exploiting live organ donors seems bad. NGOs and professional groups.” After an operation abroad. psychological effects. and lack of follow up health care.The organ transplant tourism that is repugnant and objectionable is the one that exploits living donors directly. discrimination. In a study of Egyptian donors. Shimazono. that transplant tourists may also find it difficult to “identify well trained physicians and modern hospitals. But the more serious consequences for donors. What is more revealing about this study is that from the 305 donors. and in many cases the patients. refers to a study were 71% of the Indian donors were below the poverty line. Dr Michael D. 71% were female and 96% of all the donors sold a kidney to “pay off” debt. coercion. Horowitz et al. who does the recipient consult should a problem develop? In a Canadian study. “Potential living donors who may be educationally. the list of consequences is nearly endless. Like donors. The circumstances of obtaining organs from live donors and the consequences of organ transplant tourism are the main concerns of international health organisations. Ironically. such as the WHO. writing in Canadian Family Physician.Dr Leigh Turner. are deterioration of health.

and not mention money and countries. Given that Organ Transplantation Tourism depends on poor people giving up their organs it is not difficult to imagine the origin and destination of this trade. but other studies dispute this and project a figure of US$40 billion by 2010. “heightened frequency of medical complications.” The Lancet commentary is more forceful. Iraq. the Lancet commentary reports that the representatives of the Declaration of Istanbul have “played major roles in the promulgation” of laws and regulations affecting transplantation tourism in China. Turkey and Eastern Europe as destinations for transplant tourists. David Spurgeon (quoting Professor Daar. is a serious concern for the medical profession. China. even if we have to stretch the meaning of the word here. gives some figures. the money aspect is not that relevant because this changes with time. 000 to US$160. Danovitch describes how the Declaration of Helskinki (1964)(pdf)(Wikipedia) can be applied in the context of the Declaration of Istanbul.” It is not surprising. Shimazono says that there is a. However. South Africa.show results “comparable with local results. India. For practical reasons. including the transmission of HIV and the hepatitis B and C viruses” Organ transplant tourism would not be a global medical issue if it did not involve some serious ethical problems. some studies suggest annual revenues from global medical tourism (Wikipedia) (and not just organ transplantation tourism) to be US$60 billion. . “The success of transplantation as a life-saving treatment does not require-nor justify-victimising the world’s poor people as the source of organs for the rich. responsibility for human subjects should always rest with the medically qualified person even if consent is given by the patient. Maybe the most relevant of these problems is the implication organ transplant tourism has on the medical profession itself.” Giving specific examples. therefore. commercialisation of organs and lack of follow up treatment does not exactly meet the criteria of what an honest medical health carer ought to be associated with. For example. Canada: BMJ) identifies the Philippines. But how does one calculate a market value for an industry that can easily be described as murky? Horowitz. Coercion. It would be rather odd to write an article on the theme of tourism. Pakistan and the Philippines. Shimazono calculates renal “transplant packages” to range between US$70. for example. “consent does not free the physicians from responsibility…. that Organ transplant tourism. That organ transplant tourists can just pay their way to the front of the queue only confounds the ethical issues. 000.

But despite the various efforts to deal with this problem the situation is still. Winston moved his research to the USA.co.Although the Australian websiteabc. in 2007 failed to persuade the Department for Environment. published in 2006. Canada. Japan. Saudi Arabia and the USA. but not ethical to provide us with life saving organs. Oman. Prof. Israel.” . Prof Winston was also reported as saying that it was ethical to eat pigs as food.net. This model is supposed to maintain the equitable nature of organ transplantation and still reward the family of the deceased. identifies the following major countries as “organ importing countries” (origin of tourists): Australia. “provisional and tentative. It is also an issue that cannot be solved by a single lobby or group with vested interests. Nor is organ transplant tourism a problem for the medical profession alone to solve or politicians to fudge. however. Ghods et al. Iranian Model of Paid and Regulated Living-Unrelated Kidney Donation. The Committee on Environment. The Iran model is often quoted as an example of a successful organ transplantation programme for a country where the donor is paid from an official fund. the Guardian. No doubt organ transplant tourism is a serious ethical and philosophical issue in bioethics. In the same article. Food and Rural Affairs (UK) to start research on modifying pigs.uk (UK) reported that Prof.au on 12 August 2008. Shimazono quoting an Organs Watch report. What is clear. (March 2008)have urged the Commission to introduce an European donor cards and regulations to fight organ transplant tourism. Public Health and Food Safety of the European Parliament. Imperial College. Donors and recipients are managed by this programme with the result that there were no waiting lists. However. Robert Winston. Another solution aimed at addressing the shortage of organs is to modify genetically animals to provide the necessary organs. is that this is a twenty first century problem. Some advocate going the commercial route and let market forces decide. Of course. had a story with the headlines: Australia urged to ban China’s ’transplant tourism’. in the Clinical Journal American Society of Nephrology. market forces with the right sort of regulations and safeguards. in a paper. to use Shimazono words. Details of the model are described by Ahad J. The Declaration of Istanbul is a major step forward in curbing organ transplant tourism by apply pressure on the relevant authorities and governments.

In this cultural montage. an analysis of transnational medical travel hopes to generate efficient ways to improve their bottom-line during this global financial crisis. . the social.http://medicaltourismblog. and they promote the incorporation of this qualitative research into ongoing business innovation . hospital providers and their staff. the analysis thus far precludes questions that are beneath the surface of numbers and charts. countries. However. Some authors have started to recognize the importance of the engaging.org/2008/09/01/the-basic-issues-of-organ-transplanttourism/ As healthcare globalizes at a rapid scale it introduces local complexities for a variety of players: patients and their families. health insurance firms and hospital agents. humanizing methods that anthropologists use to reframe the issue. medical technology and pharmaceutical corporations. By now many are well aware of the heightened interest in analyzing the medical tourism market. Others seek to inform the economic or political agenda of the countries participating in this process. we are not only seeing the movement of people across national boundaries that should hold significant weight in our analysis. medical technology companies. Specifically. monetary and ideological movements are important factors. this article outlines the issues that dive deeper into understanding the consumer demand for international medical travel and reviews some empirical evidence to inform ways in which stakeholders must welcome the complimentary qualitative research perspectives while playing a hand in this burgeoning market. accreditation agencies and regulatory bodies. Thus. As such. How we evaluate these trends will be critical in predicting future growth. but the accompanying technological. This stems from a shared stakeholder incentive to quantify and measure the growth of this industry. ethical and cultural explanations underlying the expansion of international medical travel require a much deeper empirical study to address the more cogent adjustments for demand-and-supplier-side participants. the statistical trends must share their results and forecasts with qualitative and ethnographic findings that bring us closer to the human nature of the medical tourism process. For some corporations. as anthropologists have noted.

000 in the U.S suggests that international travel extends a critical solution for the 46 million uninsured Americans and out-of-pocket patients faced with attenuating costs for care. providers and other stakeholders to paint new direction for improving and innovating domestic healthcare .g. Who then are the people taking advantage of medical tourism and what are the myriad thoughts that help them decide to go abroad? Are the affluent travelers and able patients in developed countries widening the gap between domestic and now international health access? The critical factor with these types of ‘non-guiding’ questions is the way in which responses are analyzed through qualitative methods instead of blanket categories with an all-encompassing label.Problems With the Surface The now well-attributed Deloitte Consulting survey on medical tourism asked over 3000 people ages 18-75 various questions about consumer healthcare. nationals. survey respondents were allowed a numerical rating on topics ranging from their perspectives and attitudes to their expectations and desires for adequate healthcare. not an expensive trip abroad. At a macro-level.S.000 in India). Treatment abroad in places like India is sometimes 10% of the cost of domestic care (e. with poor advantages for tax-savings and a decreased buying power in which potentially only universal healthcare. this study paints a picture of a segmented patient market with self-sufficient incentives to manage their healthcare process and increase demands for better quality care. providers to hospitals overseas. this requires unraveling the stories behind the patient decision making process. before becoming the authority for directing strategies on global healthcare.S. The following section implicates some of these issues and outlines other consumer related questions that are important for consideration. we must consider and compliment the issues that surveys or non-qualitative research methods potentially fail to uncover. The very premise for this study (and many other case studies on medical tourism) in the U. the personal moral and ethical values. and $12. But the uninsured tend to fall in a lower income bracket. Representing an expansive demography of U. Thus. This picture enables insurance agencies. fifteen million innovationseeking consumers will transfer $400 US billion (base case scenario) of healthcare spending from U. In the context of medical tourism.S. might ail their treatment demands . and the shared experiences of a cultural mixing of local and global care. . The findings suggest that by 2017. aortic valve replacement costs on average of $100.

we must question how much is actually known about medical tourists. Access to the Internet and other online channels are not even possible. although U. their understanding of their condition. and learn about the intricacies of their medical condition . medical tourists save costs by receiving treatment in India.S. As result. Patients show vulnerability due to their inability to understand cost and treatment comparisons. including their motivations. Although insights with consumers are heightened through online interactions. With such an advanced and complex channel through which patients can learn and share about the medical experience with others. For some travelers. personal characteristics. medical tourism agencies and the international patient divisions at hospitals promote the fantastic success rates and positive foreign patient testimonials. ways they sought services abroad. let alone frequently utilized. Yemen medical travelers find the same treatment option tied with a hard earned. For example. there is little information about the consumers who seek these services. and discern the medical risks involved. we can no longer assume that the incentives for health care travel can be explained through easily defined categories and trends. investigate their doctors and providers. Further research and questions are required to develop an intimate understanding of the . This is widely accomplished in developed countries through the advent of Internet literacy on various topics of science and medicine. and their experience in a different cultural setting . debt inducing expense involving symbolic capital for a sick family member that has exhausted all options for care domestically . Even more. This could form an enigmatic and ostensive perception of “care abroad”. institutions and corporate stakeholders.Beneath Consumer Demand International health consumers are believed to participate in “biomedical selfshaping” . As one researcher describes. The Yemenis ethnographic study also illuminates the heightened expectations that any medical traveler might have when going overseas. and partially through online or local support groups. The aforementioned anthropological study is just one example revealing the differences in the consumerism process for transnational medical care. the soon-to-be medical traveler demands for high quality life saving treatment places unintended pressure on doctors to provide for expectations that extend beyond medical service . in which patients transform into autonomous investigators of their own health and medical concerns. there is a serious disparity in the influences for medical travel between developed and emerging economies.

consumer process. the studies that will provide the greatest enlightenment are not just the surveys and questionnaires that engage a statistically randomized representation of medical travelers. The quantitative analysis that helps us gauge and forecast the limits of growth must share concomitant objectives with the deeper. Ten years from now. how do hospitals construct “global” spaces. conducting research at the BIOS Center for the study of biomedicine. regulations. with a case study of medical tourism in India.html . it is critical that the promotion of foreign medical care in India through government and private incentives do not subsume the priorities for delivering healthcare to the millions of rural residents with poor access to adequate care. how does the doctor-patient relationship change during this global medical process? Is a knee replacement surgery in India the same as a knee replacement surgery in the UK? Or. like international airports and hotels. For example. ideologies and values across the medical cultures. qualitative research in the field. For example. of greatest value will be those enlightening studies that should compliment stakeholder strategies for action are those that immerse in consumer communities. and follow the patients. doctors. He is now a graduate student at the London School of Economics. national level. Thus. But. Applying Complex Understanding To recapitulate. bioscience and society. technologies. within their local culture in order to standardize healthcare? It is precisely these types of qualitative ethnographic and social science questions that will benefit the more penetrating associations between the medical tourism process and the macro-level comparisons of care. http://www. On-site investigations in participating countries are required to digest the economic and health resource implications at the local. the reflexive outlook upon global medical tourism should not frame a world where the inequalities in proper healthcare have irreversibly widened.medicaltourismmag. we must contextualize ethnographic and qualitative research in the strategy discussions for improving the trade in global medicine. specifically. His current area of research is in the sociological and cultural relationahip of medica care between “Western” and developing countries. Nishant Bagadia is a former consultant in customer relationship management at Deloitte Consulting LLP USA.com/issue-article/investigating-medical.

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