Marc LeShay, President of Premiere Medical Travel Consulting, California looks at the main obstacles and challenges facing the medical tourism industry – taxonomy, risk mitigation, brand awareness and industry cannibalism, drawing parallels between the budding medical tourism industry and the early stages of e-business.
Premiere Medical Travel Consulting is a California based business offering international business partners with industry research, analysis, consultation, and insight into the opinions of medical travel consumers.
For the past year, healthcare has been center-stage in the American drama. Lost in all the debate is the growing threat of medical tourism: the exportation of healthcare to global centers of excellence such as Asia, Europe, Central America, and literally around the globe.
Many parallels can be drawn between the budding medical tourism industry and the early stages of e-business. As we anxiously awaited the new millennium, we also watched as a new business model began its steady journey to commerce dominance. While we recognized it was just a matter of time, most of us were initially reticent of conducting business over the internet. The inherent risks of an immature business appeared great: security, fraud, counterfeit, identify theft, etc. These anxieties made it difficult for early e-commerce adopters to fully develop a profitable business. However, over time, one-by-one, these issues were overcome: Credit cards started to offer fraud protection, web sites matured and gained reputability, governance bodies emerged, and so on. Today, e-business dominates commerce.
Medical tourism holds the potential to have an equally steep adoption curve and an equally transformative impact on the global healthcare industry. However, today, the concept is riddled with similar challenges faced by the pre-millennial e-business model. Specifically, the medical tourism industry faces four major obstacles:
1. Taxonomy within the medical tourism market
As I travel the globe, researching medical tourism, the number one issue raised is the concept of global transparency. In other words, how will the industry track and report on volume of patients, outcomes, etc. While nobody will argue that transparency is paramount, the industry is currently paralyzed with how to achieve this critical objective. The reason for this is simple: they’re looking at the symptom not the root cause. The root cause is the fact that global healthcare providers lack consistent quality control metrics. Why do they lack these metrics? Because, there is no consistent taxonomy around which such metrics revolve.
For example, let’s start with the most basic of definitions: What is a medical tourist? This appears simple enough to define, yet healthcare providers subjectively define this most important, foundational term in three distinct ways:
Medical Tourist: A patient who specifically travels to a destination for healthcare.
Medical Tourist: A patient who resides in the country but is not a native (ex-pats).
Medical Tourist: A patient who does not reside in the country, and is not native, but receives healthcare (tourist/business traveler).
Another example that illustrates the need for an industry-adopted taxonomy follows:
Patient Volume: Some facilities list a patient once for their entire treatment cycle (including follow-up visits).
Patient Volume : Some facilities list a patient once for each stage of their treatment cycle (e.g. emergency room, radiology, cardiology, operating room, etc).
There are several examples of this void in taxonomy that make it impossible to develop metrics that can deliver any meaningful analysis of the industry and/or facility comparisons, and as such, any level of effective transparency.
The road to transparency is three fold:
Define the industry.
Develop associative metrics.
Compile and present this information in a consistent and open forum.
2. Risk mitigation in medical tourism
Perhaps, this issue, more than any other listed, closely parallels the challenges faced by e-business. As discussed above, one of the greatest barriers to growth was consumer fear. As credit card companies addressed these fears, consumers flooded to the Internet.
Similarly, there are two significant unaddressed risks plaguing the medical tourism industry. Most notably is dispute resolution: A consumer’s right to pursue medical malpractice. Let’s face it....we live in a society that is consumed with litigation. The perception (and in many cases reality) that patients will have no course for retribution should something go wrong is going to prohibit adoption of medical tourism. It’s that simple an issue to state and equally that complex and issue to solve.
Secondly, the risk that someone will find themselves in the middle of a political and/or natural disaster scares many people away from the concept of medical tourism. Ultimately, procedures will need to be established and globally adopted to ensure patients that, should an event occur, two assurances exist:
If they are already at the destination, their safety will be secured, and
If their healthcare needs are scheduled in a recently unsuitable/unsafe destination, they will be met by another geography (business contingency planning). Unfortunately, this will require far more global communication and cooperation than currently exists, or is close to existing.
3. Brand awareness of medical tourism
Consumers are simple; for the most part, we believe what we see and hear. For many countries, trying to establish themselves as a global center of excellence in healthcare is going to be an uphill battle. Allow me a clarification: Countries trying to establish themselves as a “Premium” healthcare provider will find that it is an uphill battle. Why? The answer is simple; many of these destinations will have to overcome decades of “low-cost” solution branding.
For example, I have visited South Korea several times and cannot put into words how impressed I was by their top-tier hospitals and medical facilities; they are simply amazing. However, South Korea, (with the possible exception of Samsung T.V.s) has spent billions to market low cost automobiles and consumer electronics (KIA, Hyundai, LG, etc.). While recent market messaging is shifting to “quality service” over “low cost,” the brand remains far from one that the majority of consumers will accept as a premium healthcare provider. Many other quality destinations face this very significant obstacle.
4. Industry cannibalism in medical tourism
As an industry, medical tourism is its own worst enemy. At a global, national, and individual facility level, the industry is diluting their message efficacy and literally cannibalizing itself.
At the global level, everybody is fighting to establish themselves as a center of excellence. International cooperation is superficial and lacks the level of commitment required to build a global market. This is one of the leading contributors to the absence of a consistent taxonomy and associative metrics. Countries fight against each other rather than in cooperation to achieve the greater cause: to design, develop, and enable the medical tourism industry. Far greater global cooperation will be required before the industry can even dream of approaching their transformative desires.
At the governmental level, healthcare and tourism bodies fight for position dominance. Consequently, the industry has been bifurcated into destinations who wish to offer global healthcare with the benefits of a beautiful tourism destination and those who are selling beautiful tourism destinations where you can also attend to some healthcare needs. This may appear minor, but in conjunction with the aforementioned absence of a well-defined taxonomy, the industry is becoming fragmented into medical tourism, medical travel, and global healthcare providers. The net effect is industry-wide confusion, message dilution, and in-fighting.
Finally, at the individual facility levels, providers are competing against each other for patient attention and market position. Beyond the obvious financial inefficiencies, for countries with poor brand recognition (as described above), this approach is sadly myopic. There’s an old aphorism, “A rising tide lifts all boats.” The Olympics are representative of the powerful relationship between national branding and that of the individual contributors. Similarly, a focused national strategy would greatly benefit the individual facilities far more than their current “every facility for themselves” approach.
If the medical tourism community can take a page from the e-business industry and work to resolve the above barriers, they can achieve a similar level of industry transformation. It won’t be easy but, over the next 5-7 years, they will. As the world continues to “flatten,” these challenges will be overcome and medical tourism will mature and emerge as a new global reality. History has already written these pages for us. The big questions are:
In what form will their vision finally be realized?
And what impact will it have on healthcare in the USA and other “mature” markets?
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