Tuesday, April 21, 2009

A word of warning for medical tourism companies

A woman from Wales who underwent cosmetic surgery in Belgium is bringing a test case against the Belgian clinic in the UK courts.The patient is suing the clinic after undergoing a face-lift and upper and lower eye surgery in 2005. She claims that she has been left with scarring around the eyes and the ears and has experienced numbness of the face.

It is a significant case because it could set a precedent for other patients who wish to sue a clinic or medical tourism company after going abroad for treatment. Rather than sue in Belgium, the legal firm involved have decided to sue the clinic in the UK courts where they might expect higher payouts if they win the case. Laurence Vick, the solicitor who is representing the patient, is a medico-legal expert and specialises in clinical negligence claims. (Coincidentally, he and I were undergraduate students at the same college, many years ago!)

The question of who to sue in medical tourism cases is one that faces any patient where surgery abroad doesn't work out as it should. Is surgery abroad any riskier than surgery in the UK? No one knows.... because there is no comparative data. But the answer is probably not. Nevertheless, any surgery carries a risk. Cosmetic surgery is not risk free, so there are going to be cases of alleged clinical negligence where the patient will pursue a legal action. Medical tourism companies need to be aware of this test case, particularly those that have a UK presence. Rather than sue the surgeon or the hospital in the destination country, the patient may opt to sue the medical tourism company in the UK.

Wednesday, April 15, 2009

The war of words....Is it medical tourism or medical travel?


I just read Constantine Constantinides informative and latest missive on medical tourism. Constantine runs Healthcare Cybernetics and is one of the "wise heads" of medical tourism.
Constantine says:

"I am getting fed up with industry newcomers (the “Johnny-come-latelys”), industry outsiders and the self-important upstarts who take issue with the word Tourism – claiming it is not “grand” enough for them to be associated with.They propose replacing it with the word “Travel”. Some even suggest we dump everything and start talking of Global Health (as if healthcare has not been global for ages).......I do not like the “tourism” word – but neither do I like the several suggested alternatives"

He makes some interesting points:

"The word Tourism is derived from Tour - from Anglo-French tur, tourn turning, circuit – a there and back journey.Travel may not include a “back”.

So, here's my two pennyworth (English idiom!).

Let's start with Google's view. Why? Because Google reflects the way that people use words.

I did a search on Google UK for various terms:
  • A search for medical tourism generated 19,700,000 results. (Our Treatment Abroad and related web sites secure three of the top ten positions. A pat on the back for our search engine optimisation team!)

  • A search for medical travel generated 73,300,000 results.

  • A search for health tourism generated 36,600,000 results.(Treatment Abroad is no 2 for this search. Another pat on the back for SEO.)

  • A search for health travel generated 250,000,000 results. A search for global health generated 133,000,000 results.
But we probably need to be a bit more specific. By putting the phrase in quotes e.g. "medical tourism", Google only returns results for the exact phrase:


  • "medical tourism" generated 5,290,000 results.

  • "medical travel" generated 443,000 results.

  • "health tourism" generated 798,000 results.

  • "health travel" generated 505,000 results.

  • "global health" generated 3,220,000 results

The previous analysis tells you what words and phrases are most frequently used on web sites indexed by Google. But what terms do people use when searching? Here's another analysis. This time we look at the average monthly search volumes on Google worldwide:

  • medical tourism - 90,500 searches per month
  • health tourism - 14,800 searches per month
  • health travel - 165,000 searches per month
  • global health - 135,000 searches per month

And the winner is?

It's probably medical tourism....

Why? Because it's the phrase that's in common usage, whether we like it or not. It's what the media use when they write about the industry. It's what the man on the Clapham omnibus would probably say. Is it the best phrase to use? Probably not.


I prefer medical travel!

Tuesday, April 14, 2009

The challenge facing the medical tourism industry

The recent European Congress on Health Tourism in Budapest reflected some of the current issues and challenges facing the medical tourism industry, particularly those presented by a world recession. Budapest is Europe's dental tourism hub, attracting patients from countries such as the UK, Ireland, Germany, Austria, Switzerland and Scandinavia. If the recession is hitting medical tourism, then Budapest is going to feel it more than most.

There were workshops and presentations from various providers and industry players at the Budapest Congress. One of the more down to earth of these presentations was made by Dr Bela Batorfi of The Batorfi Dental Implant Clinic in Budapest. This impressive clinic usually carries out around 1,800 dental implants per year. But with the onset of the global financial crisis they have seen some worrying trends:
  • The number of patients from abroad has fallen by around 30%. Medical tourists are harder to find!
  • The average spend per patient has decreased from around £5,000 to £2,600. Medical tourists are spending less per visit.
  • The average age of patients has increased. Medical tourists are delaying treatment.

The experience of the The Batorfi Dental Implant Clinic is reflected among many of the other dental treatment providers in Budapest. It's not the case that Budapest is losing patients and market share to other destinations. Understandably, many clinics are concerned about the fall off in business and how long it will continue.

Against the backdrop of the financial crisis, Hungary is one of the many countries planning a "medical city" aiming to attract patients from across the world to a centre of medical excellence. According to Balázs Stumpf-Biró, Executive Director of the European Medical Tourism Alliance (EuMTA), Hungary is planning to establish 100 hectares of land near Budapest’s international airport as a health complex, similar to Dubai Healthcare City.

Whether this development suffers the same fate as Dubai Healthcare City remains to be seen. The initial building boom in Dubai has come to a grinding halt. Building anything in the current financial environment is a risky business, and with the medical travel market to Hungary down around 20% to 30%, it's going to be a brave investor who lays the first brick.

Various estimates of medical travel numbers for Hungary put the number of incoming medical tourists at around 300,000 to 350,000 per annum. The vast majority of these are for dental treatment, and many may be "short trip/low cost" cross border visitors from Germany and Austria. But that's still a valuable market.

So what's the long term outlook for medical tourism destinations such as Hungary? Better than most, I would suggest. The medical travel market is here to stay and is here for the long term. Hungary has been at the forefront of medical travel in Europe for the last decade and it can retain that position.

But like most countries being encouraged down the medical tourism route it needs to tread carefully. We hear the usual overblown claims by industry proponents such as the Medical Tourism Association that "the biggest potential market for Hungary is the USA". I can just see hundreds of thousands of Americans getting out their maps of Europe, locating Budapest and booking their long distance flight via New York/London/Amsterdam for their dental implants. It isn't going to happen.

So where should Hungary be focusing its efforts?

Well... :

  • There's a population of 550 million in the "United States of Europe" who may begin to exploit the opportunities within the EU Directive on patient mobility.
  • Not so far away from Hungary, there are 140 million Russians who are beginning to spend their money on holidays all over Europe. Medical travel will follow this trend.
  • And the UK dental problem is here to stay. See this recent article in the Independent: This may hurt a little: Rise in hospital admissions for last-ditch tooth extractions

My advice to Hungary... The same as you would get from business guru, Tom Peters (In Search of Excellence).

Stick to the knitting - stay with the business that you know!