By, Advitheya N 091202045

€ Global

competition is emerging in the health care industry patients from developing countries have long traveled to developed countries for high quality medical care numbers of patients from developed countries are traveling for medical reasons to regions once characterized as ´third world.µ

€ Wealthy

€ Growing

€ These ´medical

touristsµ are not wealthy, but are seeking high quality medical care at affordable prices

(also called as medical travel or health tourism) is a term initially coined by travel agencies and the mass media to describe the rapidly growing practice of travelling to another country to obtain health care € The provider viz the hospital and the customer use informal channels of communicationconnection-contract with less regulatory or legal oversight to assure quality and less formal recourse to reimbursement or redress.
€ Medical Tourism

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In addition, to the hospital procedures, leisure activities are also typically associated with this treatment, thus travel and tourism aspects are also included in this medical travel trips.

€ Medical Tourism may be defined as the ´provision of cost-effective medical care with due consideration to quality in collaboration with tourism industry for foreign patients who need specialized treatment and surgeryµ. .

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8 trillion € 500.€ Worlds largest after retailing € Global healthcare revenue US$ 2. to grow by 13% per annum € McKinsey & Company estimates that Indian medical tourism alone will grow to $2.3 billion by 2012 .000 traveled to India for medical care in 2005 € India·s healthcare industry worth US$ 17 billion.

€ For Almost no one would travel a great distance to save $200 or less.  Fewer than 10 percent would travel to save $500 to $1.  .000.most medical tourists the reason for travel is financial but still getting good quality treatment € Willingness to travel for medical care is shown by a recent nationwide survey.

000 about 38 percent of the uninsured and one-quarter of those with insurance would travel abroad for care. but only 10 percent of those with health insurance.000 to $2. would travel abroad for care if the savings amounted to $1.400. About one-quarter of uninsured people. For savings exceeding $10.  .

which can be much higher than government or private insurers have to pay .€ American medical tourists are seeking lower prices for treatments not covered by insurance (such as cosmetic surgery and weight loss surgery). € Uninsured patients paying the cost out of their own pocket travel because American hospitals often charge cash-paying. uninsured individuals inflated ´listµ prices.

000 less in another country. a patient required to pay 20 percent of the cost (through a copayment) would save $800 out of pocket € For . if a procedure cost $4.€ Small but growing number of insurers are creating health plans that encourage enrollees to shop for better prices among approved vendors in other countries and allow them to share in the savings example.

Argentina .Belgium. South Africa etc € Other . Brazil .€ India is rated amongst the world·s ´must see top ten destinationµ by Conde Naste (international magazine) countries include Thailand. Singapore.

AFRICAS.SAARC . Nepal and Bangladesh etc € Limited specialized care WEST € Long waiting ± UK (as long as 1yr sometimes) € Insurance unaffordable leading to semi insured and uninsured population . MIDDLE EAST € No advance care available e.g Afghanistan .US € Private hospitals very expensive .

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arguably has the lowest cost € highest quality of all medical tourism destinations € English is widely spoken € Several hospitals are accredited by the Joint Commission International (JCI) and staffed by highly trained physicians € many hospitals bundle services into a package deal that includes the medical procedure and the cost of treating any complications € hospitals often have hotel rooms or can offer discounts for hotels nearby € It .

€ Cardiology € Joint replacement € Orthopaedic surgery € Gastroenterology € Ophthalmology € Transplants (liver. Bone marrow) € Urology. .

rates). ´Outsourcing Your Heart. May 21.Sources: Subimo (U.µ Time. PlanetHospital (international rates).S. cited in Unmesh Kher. 2006 .

and .000 doctors.Highly skilled experts.Quality Large pool of doctors.Possess English speaking skills Comfort Level NRI doctors recognized as amongst best in adopted countries (First World) Usage of English Indian Nurses increasingly getting international exposure . . nurses & paramedics Strength: .Over 650.

empowered women population . vast coastline  Traditional arts and crafts  Vibrant democracy: Freedom for citizens. Cultural and Religious diversity  Diverse geographical landmarks.Lower Medication cost: Strong Pharma Sector and gaining world recognition  Fast emerging as major Drug R&D Center  Strong Generic drugs business Low cost of drug development in India No waiting Tourist Interest:  5000 year old civilization  Renowned for Historical.

Alternative Medicine Proposition: Ancient Ayurvedic stream of medicines Rejuvenation alternatives: Kerala·s health retreats  Naturopathy and Yoga .

doctors and surgeons who post their skills & specialties. pricing etc on websites has made available a wide choice of treatment to the overseas patients €Media is showcasing India·s ability to treat overseas patients in a comparable environment .Consumer awareness/Marketing €Increased visibility & ease of access to leading hospitals.

Insurance € India proactively talking to Foreign Insurance companies to treat their beneficiaries in India benefits € Cashless € Hassle Free .

€ Negative    perceptions Hygiene/Unsanitary Pollution Backward & Bureaucratic insurance € Medical     Inadequate Cover Underdeveloped No Global Players Overseas Companies Refuse Reimbursements .

€ Accreditation No Uniformity : NABH.ISO.JCI  WEST: JCAHO  € Instability Terrorism Prone  Communal Unrest  .

These laws make it difficult for American patients to seek care from doctors abroad via telephone and the Internet . It is illegal in most states for a physician outside the state to consult by phone with patients residing in the state if the physician is not licensed to practice medicine there. It is illegal in most states for a physician outside the state who has examined a patient in person to continue treating the patient via the Internet after the patient returns home.€ Licensing Laws     It is illegal for a physician to consult with a patient online without an initial face-to-face meeting.

€  Lack of Follow-Up Care patients who have traveled abroad for medical procedures have problems finding a local physician willing to provide postoperative followup care Liability for another provider·s work is a perceived risk to doctors providing aftercare reluctance to provide follow-up care is that patients treated abroad often lack insurance Physicians may prefer not to treat uninsured patients (unless payment is made in advance) for fear they will not get paid    .

€ Legal Issue Employers and insurers could lower their health costs by sending employees abroad for treatment an employer that sponsors a health plan offering workers a financial incentive to travel abroad for treatment could have greater liability risks. The concern is that financial incentives might induce enrollees to accept substandard care when they otherwise would select the local hospital of their choice   .

For Doctors : Standardized education in Medical Institutions  Strong regulatory mechanism to curb quacks teaching No communication and inter-personal skills For Paramedics Deficient Language skills  Lack of Standardization  Attrition € Other services Hygiene awareness in medical attendants  Unhygienic Food handling Heterogeneous Pricing of services .

€ Measuring  Quality Apollo Hospital Group and Wockhardt Hospitals (which is affiliated with Harvard Medical School) in India. and Bumrungrad International Hospital in Thailand. India·s Apollo Hospital Group has devised a clinical excellence model to ensure its quality meets international health care standards across all its hospitals  . offer a better level of care than the average community hospital in the United States.

.€ Electronic Medical Records. manage patient caseloads and store radiology and laboratory test results. Modern hospitals abroad also use information technology to identify potential drug interactions. most large health care providers and medical intermediaries for patients use electronic medical records (EMRs) to store and access patient files. potential medical tourists must first be evaluated remotely. Patients can then discuss the procedures with potential physicians via conference call.

. board-certified others have internationally respected credentials.€ Hospital € Hospital Accreditation Affiliation Wockhardt (India) is affiliated with Harvard Medical School Credentials physicians are often U.S. € Physician .

Internet communities facilitate the exchange of information about providers. convenience. satisfaction with medical services and the availability of lodging while recuperating . price. including facility cleanliness.Online Communities Potential patients can get some idea of the safety and quality of medical providers by searching online for testimonies of patients who have had surgery abroad.

Group of Hospitals (India) € Escorts Heart Institute (India) € the Bumrungrad Hospital (Thailand) € Sunway Medical Centre (Malaysia) € Raffles Hospital (Singapore) € Apollo Almost all these hospitals have upgraded their interiors to resemble five star hotels. The hotels have also tied up with travel agents / tourists so as to facilitate a comfortable and hassle free travel for the over seas patients .

. Traffic system is well developed and easy to go from one country to another country. Medicines and lab our cost is low as compared to developed countries.€       Strengths: Quality and Range of Services. Affordable costs Internationally reputed hospitals Personal touch by the doctors in India.

€ Weakness  No strong government support/ initiative to promote medical tourism. . and hospitals.airline operators.  Cheating  Political problems etc.  Lack of uniform pricing policies across hospitals. hotels.  Low coordination between the various players in the industry.

.  Increased demand for healthcare services from countries with aging population (US.Opportunities An opportunity is a favorable condition in the service industry which enables it to consolidate and strengthen its position.  Shortage of supply in National Health Systems in countries like UK. Canada. UK)  Fast-paced life style increases demand for wellness tourism and alternative cures.

 Demand for retirement homes for elderly people especially Japanese.  .Demand from countries with underdeveloped healthcare facilities.

‡ Under ² investment in health infrastructure. ‡ Exploitation of tourists by illegal money changers. . They are ‡ Strong competition from countries like Thailand. Malaysia and Singapore.Threats A threat is an unfavourable condition in the industry·s environment which creates a risk for. ‡ Exorcism is more in India ‡ Identifying a real practitioner is a major problem in India. or causes damage to. the industry. ‡ Overseas medical care not covered by insurance providers. ‡ Lack of international accreditaion ² a major inhibitor.

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Players dominating the medical tourism sector : € Tour Operators. € Hotels. € Hospitals and / or integrated hospitals cum hotels For medical tourism to succeed a consortium of Tour operators. Hospitals and Hotels (if an integrated set up is not available) is a must .

. Tie-ups with the leading medical insurance companies also help in reducing the cost of the tour operators.€ Marketing Communication plays a very major role ² Word of Mouth communication. € Additionally tie ups with foreign universities ² wherein internship is offered in India also helps in securing medical tourists to India.

(For e. so as to ensure a steady stream of patients. the non-availability or inadequate transport system etc.€ The purpose of these tour operators / agents is to liaise with the insurance companies and the private /public medical practitioners in the European and American markets.g. € In addition. the tour operators also help in explaining the problems that the patients may face when they visit India.) . the unhygienic surrounding.

Treatments provided € Ayurveda Abhyangam € € € € € (14 days treatment) Dhanyamla Dhara (14 days treatment) Dhara (14 days treatment) Kativasthi (14 days treatment) Kizhi (14 days treatment) Nasyam (14 days treatment) etc .

€ Alappuzha Beach € Kappad Beach € Kovalan Beach € Marari Beach € Periyar Wildlife Sanctuary € Tekkady € Wild life Resorts etc € Success factor: The ancient art of treatments along with these tourists attractions has made Kerala very successful in medical tourism. .

Tanzania.Apollo Hospitals: € On an average it attracts around 95000 tourists many of whom are of the Indian origin. . € Ruby hospitals : in Kolkata has signed a contract with the British Insurance Company(BUPA). € The group has tied up with hospitals in Mauritius. Yemen and Sri Lanka. Bangladesh.

g. € .PROFITS are to be made in two areas: In the treatment offered to the medical tourist € In the areas outside the treatment e. the room offered. the food offered. the laundry services offered etc.

tourists need to be provided a ´More Than DELUXE Service ² an area where customer centricity is a must. € The cost to the hospital is extremely marginal in upgrading the economy room to More Than DELUXE Room. The cost of converting an economy room to a More than Deluxe Room is an additional 20%. which is offered to the customer. € Medical . Such ´More than Deluxe Serviceµ can be offered at a premium price with marginal costs to the hospital. while the tariff charged is more than 300% to 400%.

a host of areas exists where profits can be generated. food served to the medical tourist is different from that served to the normal domestic patients³an area where again profits can be made. along with quality treatment. The medical tourist is normally accompanied by two or three relatives. € € € . Thus from the hospital perspective. The pre and post operative care is another important area where profits can be made.€ From the hospital·s perspective. who need housing³quite close to the hospital or better still within the hospital premises itself³another area where again profits can be made.

ayurvedic and homeopathic medicine € telemedicine services as well. Naresh Trehan € 900-bed € 17 super specialties € A medical college and paramedical college. including unani. € cost an estimated $493 Million € Integrate allopathic care with alternative treatments . .€ ´Medi Cityµ : Support the initiative by well known heart surgeon Dr.

€ Lower .import duties € higher depreciation rates on medical equipment € expedited visas for overseas patients seeking medical care in India.

Role of Government The role of Indian Government for success in medical tourism is two-fold:  Acting as a Regulator to institute a uniform grading and accreditation system for hospitals to build consumers· trust.  Acting as a Facilitator for encouraging private investment in medical infrastructure and policymaking for improving medical tourism .

Interaction Medical Insurance Reforms Seamless Single-Window Facility to Tourists Govt.€ € € € € € € € € € € € Uniform Medical Education Standards Industry Accreditation Standards Mandatory Accreditation of all Colleges & Hospitals Target-oriented Infrastructure Investment More Medical. sell India as Medical Tourism Destination . Nursing colleges and Hospitals Regulatory Bodies with Teeth Government soft loan to Private Players Tax Holiday & Further Duty Roll Back Greater Industry & Govt.

providing quality services both pre operative. post operative and the other incidental services which are provided along with the treatment. ideas like offering a total package which includes medical services plus tourism packages are the key areas for success € Innovative .€ For Hospitals : The key issues is marketing the concept of medical tourism to the developed countries.

Kalyan Chakravarthy K. Herrick Medical Tourism.€ € € € € € € The key issues and challenges in medical tourism sector in India (A Hospital perspective) . Department of Management. R Gopal Medical Tourism: Global Competition in Health Care . C H. Australia. the Future of Health Services Dr Christine Lee Tourism Research Unit (TRU).Dr. Medical Tourism .Devon M. Cherukara and Dr. James Manalel . Ravi Kumar and Deepthi K Medical Tourism in Kerala³Challenges and Scope Joseph M. Monash University.

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