news about medical tourism and patients travelling to foreign countries for medical treatment

Medical Tourism

news about medical tourism and patients travelling to foreign countries for medical treatment

Thursday, May 18, 2006

New English patients fly abroad to go under the knife


New English patients fly abroad to go under the knifeSick of sky-high prices and lengthy waits for operations, growing numbers of Britons are going under the surgeon's knife overseas, in destinations like South Africa, India and Eastern Europe.

Cheaper operations are enticing more than 10 000 Britons per year abroad, some travelling huge distances to factor in some fun in the sun -- and still saving on the price of British private sector surgery.

They range from hip replacements to heart operations to aesthetic surgery, such as breast enlargements and facelifts. The British government says waiting times for operations on the free National Health Service (NHS) are coming down.

But many patients still face delays of several months to have their operations -- some even years.

Fears about hospital hygiene, including the risk of contracting antibiotic-resistant "superbugs" like Methicillan-Resistant Staphylococcus (MRSA), are also making patients consider treatment overseas.

"I was in excruciating pain and all I wanted to do was get rid of it," said Angela Goldsborough, who flew to Poland for a hip replacement and four weeks' physiotherapy.

Wary of the NHS, she found her treatment was available in Krakow for £6 000 -- less than a third of the private cost in Britain.

"I was out in Poland within two weeks," the 74-year-old from west London told Agence France-Presse (AFP). "The treatment was fantastic and you could have eaten your food off the hospital floor."

Barbara Thurgood and Company has been arranging private orthopaedic treatment in Poland for over a decade. Thurgood said it was a logical move to create fixed-price packages offering patients speedy diagnoses and treatment at a cheaper cost than in Britain.

She told AFP that many clients were wealthy professionals capitalising on the option to go abroad -- including doctors. Some head further afield for the anonymity of cosmetic surgery and recuperation abroad.

Lorraine Melvill runs Surgeon and Safari in South Africa, which describes itself as a world leader in the medical-tourism industry.

"At the time when I started the business I was very aware that this was a whole new concept," she told AFP. "Consumers now have choice. There's globalisation in all sorts of markets, so why not in medicine?"

Reflective of a booming market, Surgeon and Safari has grown 100% each year since launching in 1999.

Patients can meet their surgeons in Britain beforehand, and even add on a safari trip afterwards, with the stress on private patient care rather than a cheap alternative.

Sonja Evans (40) took the plunge and flew to South Africa four years ago, having a tummy tuck on her post-pregnancy saggy belly. She faced at least a four-year wait on the NHS or a £6 000 bill to go private in Britain.

Instead she paid £3 700, including flights.

"I felt terrified before going out there, purely on the grounds of vanity, but it was the best thing I ever did," the personal assistant told AFP. "It transformed me. I went from being really shy to brimming with self-confidence.

"I would have otherwise waited on the NHS and got more depressed about how I looked," she said.

Because of the lack of a language barrier, English-speaking countries like South Africa and India are popular.

Med de Tour flew 70 patients to India last year for surgery and holidays and 55 have gone so far this year. Their marketing director, Sahar Ali, said their big advantage was that British patients trust Indian doctors because so many work in the NHS.

They quoted open-heart surgery from $5 000, compared with $25 000 in Britain.

Ali said some family doctors were encouraging people to head abroad while others were set against the idea. "We feel the NHS should be encouraging us rather than putting up obstacles: we're easing the burden on them," she told AFP.

Some detractors warn of botched overseas operations, with British surgeons having to fix the problems.

But there are just as many "horror stories" in Britain as abroad, Ali said, adding that some of her clients were people whose surgery in Britain had gone wrong.

The British Association of Plastic Surgeons (Baps) cautions against "cut-price" cosmetic surgery anywhere.

"If it's a good quality service it doesn't matter where you get it. But if costs are cut, then quite often, corners are too," spokesperson Lisa Mangan said.

Former Baps president Chris Khoo said the association was concerned about developments "which reduce surgery to a mere commodity" and warned against a "consumerist approach".

"Surgery can go wrong: cheapest is seldom best. Having an operation to alter the way you look is not the same as buying a cheap sofa, which you can return," he warned.

However, as more world-class options come within reach, the exodus of aching pensioners and people worried about their looks seems set to grow.

Medical Tourism: Positive Publicity Is The Need Of The Hour - Views - Express Healthcare Management


Medical Tourism: Positive Publicity Is The Need Of The Hour - Views - Express Healthcare Management

Dr Saji Salam

What prompted me to write this piece is a news item in a financial daily which quoted ‘experts’ stating the medical tourism industry in India would bring in revenues worth USD 25 billion by 2020.

A Look At The Numbers

Let’s look at some numbers to put this in perspective. The idea here is to not be precise but to give a sense of what numbers we are talking here and what it takes to the numbers projected. One of the best-managed healthcare groups in India with about 6,000 beds, has revenue of about USD 125 million. I do not have the break-up of what percentage of these beds is owned vs managed. However, going with these numbers, my assumption based on crude mathematical projection is that, it would require about 60,000 beds, to reach USD 1.25 billion revenue and 12,00,000 beds to obtain a revenue of USD 25 billion exclusively from healthcare services.

Let us look at some of the actual numbers from the tourism industry as well. The numbers may be a little dated but this is what it looks like. In 2003, about 2,726,000 tourists visited India and the revenue from the same was USD 3.5 billion. Well, if that many relatives of patients (about 3 million) travel to India, we could manage another USD 3.5 billion from tourism services. Barring inflated projections like these, it remains a fact that medical tourism in India is a growing trend.

Segmentation Of The Patient Population

Currently, the bulk of the patients come to India from neighbouring countries such as Bangladesh, Pakistan, other Asian countries, Africa and the Middle East. In many cases, the driver for cross border care is a question of quality of care than cost itself. The quality of care that we provide in India is simply not available in some of the neighbouring countries.

The second segment is the segment of patients sponsored by the governments in their respective countries such as Middle East and Africa. For those governments, India is relatively a cost-effective option compared to Europe or the US. Private patients (not sponsored) from these countries look at India as value for money option vis a vis Europe and US. Moreover, post 9/11 there has been a dramatic drop in patients from Middle East to the US.

The market segment that the healthcare industry is targeting is the patient population from Europe and the US. There are several patients of Indian origin residing in UK and US, who are already using the services of hospitals in India, when they are on vacation etc. Apart from this we have the widely-publicised cases of patients from the US and Australia.

True, these countries do have an increasing population and the healthcare systems are on the verge of collapse. Even though it is economically viable for some of these governments to officially bless shipping of patients abroad, it is the political viability of such a decision that may need to be worked on. Would a political party in power in Europe/US would want to face the next election as the pioneer of shipping patients to ‘third world countries’?

We may want to recognise that a strategy which works for attracting patients from Bangladesh may not work for patients from Britain, since the expectations and drivers are different. The industry think tank may want to recognise the diversity in the medical tourism patient population and devise niche strategies to tap into each of the segments.

Competition

What is a good reason for an average senior citizen in the US to fly 18-20 hours to get his hip replaced? Can he even travel with hips in such bad shape? Obviously if he is not covered by insurance and cannot afford the same in US he has to look at options. What if this can be done in Mexico or Costa Rica at comparable rate and a shorter flight?

I am not an expert of the patient flow patterns to competitor locations such as Hong Kong, Singapore, South Africa, Costa Rica, Mexico, the Caribbean and emerging destinations such as Dubai. Per Becca Hutchinson’s article on a University of Delaware publication looks like this is what is going on in competitor markets.

South Africa draws many cosmetic surgery patients, especially from Europe, and many South African clinics offer packages that include personal assistants, visits with trained therapists, trips to top beauty salons, post-operative care in luxury hotels and safaris or other vacation incentives. Because the South African rand has such a long-standing low rate on the foreign exchange market, medical tourism packages there tend to be perpetual bargains as well. Bangkok Phuket Hospital is the premier place to go for sex change surgery. In fact, that is one of the top 10 procedures for which patients visit Thailand.

Argentina ranks high for plastic surgery, and Hungary draws large numbers of patients from Western Europe and the US for high-quality cosmetic and dental procedures that cost half of what they would in Germany and America. Duba is scheduled to open the Dubai Healthcare City by 2010. Situated on the Red Sea, this clinic will be the largest international medical centre between Europe and South East Asia.

The Indian healthcare industry needs to examine the factors that have made these medical tourism destinations popular.

Challenges

There are definitely areas for improvement as the Indian healthcare industry starts marketing services to newer patient segments. A key difference in healthcare services in India, unlike the IT sector is the critical role the government has to play to utilise medical tourism opportunity to its best. Some of the areas for improvement, to make India a global healthcare destination are:

Image Makeover

Despite the success of India in the IT market, perception of India in the eyes of the target audience has to change dramatically. The predominant image of India the average senior citizen in Europe (who is a target customer) has in his mind is picture of pre-independent India. To transform those images and present an image of India where he can trust Indian surgeons with his heart, his face and hips is a challenge (outsourcing your heart surgery is a lot different from outsourcing a software code!). To the average senior citizen in the US, it is more of a challenge, since to many, India is still a land of snake charmers and cows in traffic, a land far far away.

Perception Of Quality Of Care

Though one may argue against this, an average patient half a world away perceives the quality of care based on the perception of the country’s image as a whole. The patients may have a hard time comprehending that the quality of care in India can be comparable to the US. One way to get over this is for hospitals to follow international healthcare accreditation standards. Would a patient be willing to trust his heart, kidneys, hips and face if there is an iota of doubt regarding the quality of care? (This segment of high yielding procedures is where the Indian medical tourism market is looking forward to for better profits). In fact, there have been cases of plastic surgery gone bad, particularly from Mexican clinics in the days before anyone figured out what a gold mine cheap, high-quality care could be for the developing countries.

Scalability Of Healthcare Infrastructure

The first question that comes to my mind is whether India can scale up to address the increasing patient mass. Do we have enough specialists and super specialists? We may have enough and more of entry-level physicians, but how are we placed with regard to doctors with postgraduate qualifications? What is the reality on the group with regard to paramedical staff? How is the attrition among nurses due to demand abroad?

I am sure these questions are being asked. The other question is the sheer number of beds and physical healthcare infrastructure required. On a different note, from a social perspective, would there be enough doctors and infrastructure left to treat the not so ‘profitable’ Indian patient?

Role Of IT Standards

Finally, adopting and adapting of IT systems and standards that are in vogue in the developed world would be required to ease the administrative processes involved in cross-border care and integration with the medical records in the country of origin.

How Can The Government Facilitate?

The role of the government is critical in various areas if we need to scale the existing model. Some of the areas where government can and should act are:

Medical Education

It is high time that the government really looked hard at the demand supply situation of human resources in the healthcare sector and recalibrated the supply of specialists and paramedicals in the country. This would mean changes to policies on post- graduate medical education, nursing education etc.

Infrastructure

Quality of healthcare service can be limited by traffic and hartals. The last thing the fledgling medical tourism industry in India wants is bad press on a couple of foreign patients in ambulances that were stuck in traffic for several hours due to a political party’s rally. From airports, and high ways, and hassle free environments for patients’ relatives, there is quite a bit where improvements can be made on the infrastructure side.

Law And Order

Law and order and general sense of security are definitely areas for improvement. For all the gold in the world, I might want to get my hip replaced in nearby countries, which are infested with and mines and missiles waiting to take off.

Legal Infrastructure & Ethics

What is the mechanism for international patients who seek legal redressal for service gone bad? How long would it take for resolving the same in India? Is our legal infrastructure geared up to handle healthcare specific issues in a speedy manner?

Privacy Of Patient Information

One area that is understated in discussions around healthcare services in India is confidentiality of patient data and regulations related to privacy and security of patient data in India. A good start would be to adopt HIPAA standards in India.

Monday, May 15, 2006

MY INDIAN TAKEAWAY


MY INDIAN TAKEAWAY
Plastic surgery tourist Catherine loses 6 pints of fat and 20in of skin
By Natasha Weale

CATHERINE KERR paid £1300 to go on a plastic surgery holiday to India - after waiting two years in vain for a NHS tummy tuck.

The 41-year-old went abroad for the life-changing op four weeks ago after NHS bosses scrapped them to save money.

Catherine, a nursery nurse, had managed to slim down from 15 stones to 12 - but she was left with unsightly loose fat around her stomach.

Having a tummy tuck and liposuction done privately would have cost the mum of four a whopping £8000 in the UK.

But a pal suggested she have the procedure abroad, so Catherine travelled to Mumbai with husband Danny, 43.

Surgeons at the Wockhardt Hospital in Mumbai removed 20 inches of skin and six pints of fat. Her weight fell to 11st 2lbs after the operation.

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Last night, thrilled Catherine said: "I don't know how they get away with charging the prices they do in the UK. It's a rip-off. "Anyone thinking about surgery should go abroad.

"Going to a foreign clinic was a leap of faith and there were risks but it would have been the same in this country.

"But I couldn't have been in better hands. I couldn't be more delighted with the results."

Catherine, of Priesthill, Glasgow, was a size 8 before starting her family but put weight on with each pregnancy.

She has been pregnant seven times but suffered a miscarriage and lost two other babies late on in her pregnancy.

She said: "With both those pregnancies I never realised I was expecting until four months.

"There was nothing that could have been done to change the outcome but it was devastating.

"My stomach muscles had stretched so much because of the pregnancies but I didn't help myself by having a rubbish diet.

"My deep-fat fryer was on every day and I would help myself to crisps and chocolate.

"Being a vegetarian you would think I followed a really healthy diet but I'd eat things such as cheese pasties, veggie pizzas and lots of chips."

Catherine was at her heaviest four years ago - 15 stones and wearing size 20 clothes.

She vowed to lose weight after seeing herself in a relative's wedding pictures.

She said: "I couldn't believe it was me. I looked horrendous and had no idea what a frump I had become." Catherine joined Weight watchers and lost three stones in two years.

She said: "I felt worse after I'd lost weight because of the loose flesh around my stomach.

Getting my tummy tuck made me feel like a new woman."

India: Tummy tuck and liposuction, £1300. UK cost, £8000.

Croatia: Nose job, £1600. UK cost, £3500.

Egypt: Facelift, £1900. UK cost, £5500.

Tunisia: Breast lift and enlargement, £2600 (includes food, accommodation). UK cost, £6500.

Spain: Tummy tuck, £3600. UK cost, £4500.

South Africa: Eyelid surgery, £1750. UK cost, £3000.

Prague: Tummy tuck and liposuction, £3150 (includes food, accommodation). UK cost, £8000.

Malaysia: Breast enlargement, £2500. UK cost, £5000.

Belgium: Bottom implant and lift, £3000. UK cost, £5000.