Last year, I blogged about “Medical tourism...lessons from the California gold rush”. It’s taken me a while to
write the postscript to this, but I finally got around to it last week when I
spoke at the European Medical Travel
Conference in Barcelona. (You can download my presentation “Medical Tourism: After the Goldrush” as a pdf file on the
IMTJ web site).
In my gold rush analogy, I describe how in 2005/6, medical
tourism became the next big thing.
In Google News for 2006, you’ll see headlines appearing like
- “One million medical tourists flocking to India”
- “Bumrungrad attracts more than 400,000 foreign
patients each year”
- “Philippines is set to cash in on the
$3-trillion global medical tourism market”
- “Half a million Britons travel for treatment....”
News stories appeared around the world about a surge in
medical tourism. The first prospectors for “medical tourism gold” appeared -
medical tourism agents and facilitators, overseas hospitals and clinics were seeking
their fortune in the world of medical tourism. The tales of medical tourism
gold began to multiply. Estimates of the number of medical tourists were in the
hundreds of thousands, the millions, and then the tens of millions. Few medical
tourism prospectors questioned the validity of these claims of the discovery of
a rich vein of income or whether it was sustainable.
Those involved in the early gold rush exaggerated their
successes, claiming massive finds (e.g. “one million medical tourists to....). New
entrants pursued the dream without really thinking through their strategy and
approach to the market. A community of medical tourism prospectors developed.
As the number of medical tourism prospectors grew, the
“saloon keepers” arrived to profit from this growing community, and “store
owners” and “tool suppliers” appeared to guide the prospectors in their pursuit
of gold. The saloon keepers arrived in the form of the associations and medical
tourism conferences that made their money from membership fees and delegate
fees. They provided a place where the prospectors could get together, but they
also built on the hype, retelling stories of the latest discoveries and
attracting more people to the medical tourism gold rush. Entrepreneurs,
suppliers and consultants arrived on the scene to provide the tools and advice that
the prospectors needed to mine medical tourism gold.
In the California gold rush, it didn’t take long before the
local prospectors and land owners became fearful of the influx of overseas
prospectors (Asian, South American, European) and introduced rules and codes to
cut them out of the prospecting business.
In the medical tourism gold rush, we’ve seen the same... the “West’s
revenge” where local associations and governments act to protect their business
or economy from the threat of overseas healthcare providers. In the UK, we have the British Association of
Aesthetic Plastic Surgeons raising concerns about cosmetic surgery tourism (Cosmetic
surgery tourists in breast implant risk) ; in Ireland, we have the Irish
Dental Association complaining about overseas dental treatment (Dentists
warn over foreign treatment), and in the USA
President Obama raises concerns about Americans travelling to Mexico and India
for treatment (Youtube - Obama
targets India again).
Codes of practice, hospital accreditation and medical
tourism certification schemes appear to “protect” the patient (or perhaps to
make the healthcare provider more attractive?)
So who made money in the medical tourism gold rush?
Well... it’s probably fair to
say that quite a few people actually lost money! Entrepreneurs and investors
attracted by the hype and the exaggerated claims of market growth found out
that the reality was somewhat different. They failed to research and really understand
the market. They failed to question the so called “experts”. However.....the best
equipped, the best informed and the best organised medical tourism prospectors
did well and have survived the gold rush.
The “saloon keepers”
(associations, conference organisers and the like) did well while the hype
lasted but have found it harder to attract members and delegates in recent
times. Several medical tourism conferences have been planned and announced only
to be cancelled when it is apparent that delegate numbers won’t hit break even.
Other conferences have lost their focus moving away from the emphasis on medical tourism into areas
such as spa and wellness, extending their remit into self insurance and healthcare reform to attract a broader (and
So what happens now...after the gold rush?
The worldwide economic downturn has meant a reduction in
discretionary consumer spend – houses, cars, luxury goods – all these markets
have suffered. And healthcare has been no different. In the UK, the number of
people covered by private medical insurance, declined in 2010 for the first
time ever. The number of people opting to pay for cosmetic surgery, or for
dental treatment or for elective surgery has fallen. But there are signs of
recovery (particularly in the UK market).
Too many prospectors chasing too little medical tourism gold
has been made worse by the knock on effect of the economic downturn. But
there’s an upside to the downturn for medical tourism. A surge in national debt
means that there is now massive pressure on governments and payors to reduce
healthcare costs. In the UK, a year ago, a new government came to power saying
that the National Health Service would be immune from expenditure cuts. A year
later we now see headlines such as “NHS presents spending cuts
Abroad, last week, we received our first ever enquiry from an NHS hospital
trust asking about the options for the provision of spinal surgery both in the
UK AND in Europe. Perhaps, we will see local and national funding bodies
seriously considering the options for treatment of their patients in another
What kind of medical tourism world are we facing?
A different one!
A converging medical
tourism world: For a great demonstration of how the health and wealth of
nations is converging, watch this excellent BBC video “200 countries, 200 years...in
4 minutes” in which Professor Hans Rosling, doctor, academic, and statistician,
shows where we have come from and where we are going.
A regional or
cross-border medical tourism world: The next time you here someone
extolling the virtues of “global healthcare”, ask them to explain exactly what
they mean, and when they think that global healthcare will become a reality. We
haven’t got close to sorting out the realities and the practicalities of cross
border healthcare let alone global healthcare. Read Ian Youngman’s recent
article on why the medical tourism world is shrinking, on why it’s good news for the
A regulated medical
tourism world: The recent adoption of the European Directive on Patient
Mobility will stimulate some thinking (and hopefully some action!) across
Europe in terms of making medical travel happen where safety and quality are a
given, not an issue. It may also start governments thinking about regulation
particularly in the medical travel facilitator/agency sector. Regulation and
bonding of (leisure) travel agents exists in many countries already; some would
argue that existing regulation should be applied to medical travel agents, and
that these should be similarly bonded.
A concentration in
the market: Too many small providers and facilitators serving too few
customers means that a shake up is probably overdue. If the market does develop
significantly, it may become attractive to some of the bigger players in
healthcare and in tourism.... but we will need to see a significant expansion.
Joined up healthcare:
The best informed, the best equipped and the best organised facilitators
and providers will continue to prosper. But the real step forward in medical
travel will be taken by those businesses who deliver joined–up healthcare, from
diagnosis through treatment to
rehabilitation and recovery.....
...which probably gives me the subject of my next blog post.
Date published: 06 May 2011
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