Caroline Ratner from IMTJ spoke to Dr. Michael Horowitz, a former cardiothoracic surgeon, who runs Medical Insights International a consulting firm with clients throughout the world advising medical tourism providers and facilitators on business strategies.
Michael explains why a move into medical tourism may actually be the wrong decision for some healthcare businesses, and why it’s important to have a clearly defined strategy for a medical tourism business.
What does Medical Insights International do?
“Medical Insights International provides business to business consulting and we advise clients in the medical tourism industry.
Our particular area of expertise is providing clients with an overall business strategy and structure for entry into the medical tourism business and subsequent success. We have extensive and up-to-date knowledge of the industry and are constantly researching and analysing the market. As a result we have an awareness of marketplace dynamics, macroeconomic forces, quality of care and patient safety. This enables us to give clients valuable advice about the market, helping them plan and strategise for the short and long term development of their businesses.”
Why did you set up Medical Insights set up?
“I practised medicine – cardiothoracic surgery – until 2004. I subsequently enrolled in an MBA program to better understand the business side of health care. While in business school, I had the opportunity to do an extensive research project on international medical tourism. After graduation, I continued my research and produced a number of key papers that were published in medical journals and also in the budding medical tourism literature. As a result, I soon gained a reputation as an expert in the field. And as my knowledge and interest in the area grew, I began spending increasing amounts of time informally advising people on how to manage a medical tourism business. By 2007 I realised that the logical step was to formalise what I was doing and set up my consulting firm – Medical Insights International.“
Who are your clients?
Clients come from all aspects of the medical tourism industry. I am very interested in serving individuals and businesses interested in entering the market. They are healthcare providers, government entities, insurance companies and medical travel facilitators with the greatest number of enquiries comes from providers based in India and Asia, with some coming from Latin America and Europe.
Our clients could be any company that wants to have assistance in enhancing its business position in the industry. More recently there has been an increase in assistance from US based businesses and individuals wanted to establish facilitation businesses”.
How does the consultancy process work?
“One of the first questions I ask clients is why do you want to do this and what their expectations are.
Many people have no clear reason why they are interested in having a medical tourism business. For some, entry into this industry will not likely be right for them or help their overall business position. It is extremely important for those wanting to enter the business to explore the questions of why they really want to do this.
Another critical thing I do is help clients understand the realities of the MT marketplace as it exists today. Further, I help them recognize the potential changes may come in the years ahead. Together we decide what kind of actions is most appropriate, whether for the short term, for a one-off project or for the long term.
I emphasize to clients that it is vital to really understand the business, to explore all of their options, and then work out how their company should be positioned to have the optimal competitive advantage in the marketplace. We work together to incorporate their existing business model alongside their evolving medical tourism endeavour so that they can be merged them into a viable business strategy.”
Is the medical tourism market inappropriate for some businesses?
“Building a medical tourism business model is sometimes unsuitable for some companies, which is why I believe it is so important to really look at a client’s reasons for entering the market.
The goal of my consultancy is to assist the client to have a successful business endeavour – one that will most benefit their patients, their facility and organisation and the community as a whole. I really feel that among the most valuable contributions I’ve made for certain clients is helping them identify and recognise that serving international patients was not what they really should be doing because of the nature of their existing business.
Even though some people are at first absolutely sure that this is what they want to it is essential that they fully explore their options and potential outcomes. This process is a vital step in strategising and planning and saves much misery further down the line.”
Why shouldn’t a businesses or individual enter the market?
“There is no point in me advising a client to enter the market and grow a business when it is clear that the industry is simply not appropriate for them. Some of the reasons for this include an unsuitable location, inadequate capital, poor facilities, insufficient staff, and an inappropriate service line to attract and serve foreign patients.
Interestingly, among the most valuable contributions I’ve made for certain clients is helping them recognise that serving international patients was not what they really should be doing because of the nature of their existing business. I have advised several clients not to pursue their medical tourism aspirations – and they have thanked me profusely for this advice. “
Can you give some examples of the type of advice you have given clients in the past?
“For example, I have advised hospitals that they would enhance their overall success by focusing their service offerings on one or two highly qualified specialities rather than spreading their efforts on across the board treatments which are already readily available elsewhere.
I also advise clients to take into consideration the impact that treating foreign patients will have on their local existing patients and to carefully balance serving foreign and local patients. Medical tourism can be potentially beneficial to the local population but could also be detrimental. It all depends on what healthcare providers offer and how they choose to serve both local and visiting patients.
For healthcare providers in developing countries, treating foreign patients generates much-needed revenue that may lead to improved services through reinvestment in facilities and equipment, and by enabling the recruitment and retention of top quality medical staff. The downside of an influx of foreign patients is that it could potentially crowd out local patients – both paying customers and those dependent on charitable care. The overall success of these complex endeavours depends on how healthcare providers choose to serve their different constituencies.”
What do you think are the biggest opportunities and threats to the medical tourism industry?
“As in any business, potential opportunities and threats frequently present together. A key example of this in the medical tourism is the evolving healthcare reform in the US. I try and help my clients understand that reform in the US will definitely impact on medical tourism in one way or another. For example, reform will likely alter the drivers of international medical travel for American patients. This will necessarily change the patient and case mix seen by facilitators and providers. As a result the reforms might see an increase in business in certain specialities and decrease in others.
At the moment we can’t be certain exactly what plan will get through Congress and work its way through to Obama’s desk. Furthermore, as yet, it is unknown what the actual outcome will be.
There are reasons to believe that there may be some decrease in US citizens travelling for cardiac surgery, orthopaedic operations and similar procedures. At the same time, US healthcare reform will have little, if any, impact on cosmetic surgery or dental care.
Another change that appears to be coming is that some of the smaller providers will likely be squeezed out the market as increasing number of large healthcare companies enter the marketplace.”
Dr. Michael Horowitz runs Medical Insights International, a consulting firm with clients throughout the world advising medical tourism providers and facilitators on business strategies.