New standards for cosmetic surgery in Europe

The Health Tourism Blog has moved to the IMTJ web site. You can now find the Health Tourism Blog here in future.I will continue to post the first few paragraphs of the blog posts here. You can find the full version of this blog post on IMTJ:

Here's an extract of the latest blog post: New standards for cosmetic surgery in Europe


The recent PIP implants controversy has raised more concerns about regulation, operation and standards within the cosmetic surgery industry. In the UK, the Guardian newspaper has recently highlighted private cosmetic clinics that employ surgeons to carry out breast enlargements, nose jobs and tummy tucks who do not hold qualifications as plastic surgeons within the NHS (Private cosmetic clinics employing 'unqualified' surgeons).  There are also concerns about the quality standards and practices of cosmetic surgery clinics both within the UK and across Europe. A new European Standard on Aesthetic Surgery Services represents a significant move to address these shortcomings.

Regulating the cosmetic surgeons

In general, cosmetic and plastic surgeons who carry out cosmetic surgery at one of the private hospitals owned by UK groups such as Nuffield, BMI and Spire hospitals will hold an NHS consultant position, usually in Plastic Surgery or ENT Surgery - NHS consultants who do some private cosmetic surgery work. In contrast, many of the surgeons working for the cosmetic surgery chains such as Transform, Harley Medical Group and the Hospital Group are not NHS consultants.
The British Association of Aesthetic and Plastic Surgeons (BAAPS) has raised concerns about the influx of cosmetic surgeons into the UK from Europe. The BAAPS President told the Guardian, "We very often get applicants from Europe. Although they automatically get on the specialist register, the quality of training they have had is in no way equivalent to a trainee in the UK and they are often not deemed suitable for an NHS post".

According to Transform, "Qualifications obtained in other parts of Europe are at least the equal to those obtained in the UK" and said it was "completely untrue and highly misinformed" to suggest otherwise.
In June 2011, the European Commission published a Green Paper, “Modernising the Professional Qualifications Directive”. This Directive, adopted in 2005, sets the rules for mutual recognition of professional qualifications between Member States.  Consultation on this paper has now closed.

Read more about this in the full version of this blog post on IMTJ: New standards for cosmetic surgery in Europe

Cosmetic surgery tourism and the PIP implant controversy

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post entitled:  Cosmetic surgery tourism and the PIP implant controversy

The PIP breast implant controversy continues to grab the headlines across Europe. Concerns have been raised by women who have had their breast implants as “cosmetic surgery tourists”. What do they do if they have received a PIP (or a Rofil M) implant in a cosmetic surgery clinic in another country? Research by Treatment Abroad shows that UK patients may be less at risk than if they had gone for breast augmentation in the UK.

It is estimated that 40,000 women in the UK have received implants manufactured by the French company Poly Implant Prostheses (PIP). PIP implants contain low grade silicone; there are concerns about the risk of rupture of PIP implants and the effect that this silicone will have on the patient.

Reaction has varied across Europe. The French government has offered to pay for implants to be removed. The Czech, Dutch and German health authorities say that the implants should be removed. The UK government has said that there is no evidence that routine removal of PIP implants is necessary. However the NHS has agreed to remove PIP implants for free if the original operation was undertaken by the NHS (usually as part of a breast reconstruction after surgery for breast cancer). It has also said that women who are concerned about their breast implants should be able to have them removed for free by their private cosmetic surgery clinic.

The reaction from the private cosmetic surgery clinics in the UK has been mixed. Many providers such as BMI Healthcare have agreed that women who wish to have their PIP implants removed and replaced will be able to do so, at no cost.

However, the company that has done the largest number of PIP implants in the UK has said that it will not replace them free of charge. The Harley Medical Group has 13,900 clients who received PIP implants between 2001 and 2010 at their 31 clinics in the UK and Ireland. At the weekend, patients marched on the offices of cosmetic surgery clinics in Harley Street demanding that private clinics replace PIP breast implants.

.....Continue reading this health tourism blog post on the IMTJ web site.

Why the medical tourism industry must do better...much better

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post entitled: Why the medical tourism industry must do better...much better

Whilst the medical tourism industry continues to sing its own praises and tell itself how great it is.... consumers are telling a different story. The 2011 Medical Tourism Survey being conducted by European Research Specialists on behalf of Treatment Abroad raises some concerns about the quality of treatment and customer service that the industry delivers to patients.

As results of the latest Treatment Abroad Medical Tourism Survey 2011 come in, we’re beginning to get an idea of how patients view the medical tourism experience. So far, we’ve managed to generate 860 responses to the survey from patients who went to more than 60 countries.  Each respondent completes a fairly detailed online survey that takes them around 5-10 minutes. The results are being analysed by an external research market researcher. (Find out more about the Treatment Abroad Medical Tourism Survey 2011). The aim is to generate over 1,000 survey completions to provide valuable insight into the medical tourism experience.

We’ll be releasing the full results and report in 2012, but I have taken a look at the “story so far” provided by the research. The bad news is that since the previous survey was conducted two years ago, the industry hasn’t got any better at what it does. Initial analysis, suggests that it has got worse. Patient satisfaction levels are down. When asked:

• “How satisfied are you OVERALL with your experience of going to another country for treatment?”

...only 65% of the patients say that they are “Very Satisfied”, and 20% say they are “Quite Satisfied”.
These results are disappointing; they are well below what you see when you research satisfaction levels for patients visiting private hospitals and clinics in their own countries.

.....Continue reading this medical tourism blog post on the IMTJ web site.

Medical tourism: Trends for 2012 and beyond

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post entitled: "Medical tourism: Trends for 2012 and beyond"

Medical tourism: Trends for 2012 and beyond
Christmas is over, the New Year is upon us, so it’s time to dust off the crystal ball and put forward our take on what’s in store for medical tourism in 2012 and beyond. We’ve looked at the future of medical tourism from three perspectives – the market, the patient and the industry 

The market

The global economic downturn and medical tourism
Forecasts for the global economy are not encouraging....recession in Europe, anaemic growth in the US and slow growth in the emerging market economies is anticipated for 2012 (Morgan Stanley: 2012 Outlook). If you are in the medical tourism sector, you need to understand some of the fundamental trends that affect businesses and markets in a recession.

• In the mature, developed economies (e.g. USA, Europe) continued unemployment and pressure on disposable income will influence demand in 2012. Consumers will minimise or reduce spending on healthcare where they can. This does not mean that hard pressed consumers will be flocking abroad for their operations to save money. Many will delay treatment, or in the case of “optional surgery” such as cosmetic surgery, they may not be able to afford it at all. Domestic prices for surgery will be driven down as hospitals apply marginal costing and prices to fill empty beds. In areas of treatment, where the need for treatment is “income-inelastic”, demand for medical tourism services will remain strong.  Patients will continue to dig deep for services such as infertility treatment, stem cell treatment, and for surgery which is essential, life-saving or life changing.
• In emerging markets (such as Russia, China), the growth in incomes (and freedom to spend) is outstripping the development of domestic healthcare services and this may drive demand for medical tourism and present new opportunities.

The big question is whether corporate or insurer paid medical travel will get off the ground in 2012. Will employers and insurers see medical travel as a realistic and credible option to reduce healthcare costs. And will their client and subscriber base actually “buy in” to the medical travel option if it is offered to them?

Medical tourism..... global healthcare or regional medicine?
In 2012, there’s a risk that we get distracted by the trumpeting of “global healthcare”. It’s a nice turn of phrase, but in the real world, medical tourism is about regional medicine and cross-border healthcare; this is not going to change in 2012. In fact, the boundaries of medical travel may be drawn in, as travel costs increase. As travel costs climb, the concept of long distance medical tourism becomes less attractive. The imposition of hefty departure taxes in countries such as the UK, Germany  and elsewhere will reduce the cost advantages of some destinations.

If you are in the medical tourism business, ALWAYS remember that, for most patients, going abroad for treatment is a decision of last resort. AND that the further a patient has to go... further from their own country....further from their own culture... the greater is the actual and perceived risk. The patient needing major surgery who takes a five hour flight to a country with a different language and a different culture is a comparative rarity.

So is it medical tourism boom.... or bust?
The honest answer to this one.... is probably neither.  In recent years, we’ve listened to the hype........

.........to find out more about "Medical tourism: Trends for 2012 and beyond", read the full medical tourism article at IMTJ.

Protecting your medical tourism brand on the internet...beware the "brandjacker"!

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post entitled: Protecting your brand on the internet...beware the "brandjacker"!"

The internet is a great place to market your medical tourism services but because it is difficult to police, it can be easy for a domain name speculator to hijack your brand. Businesses can find that having spent years developing and investing in a brand, one day along comes a domain name speculator or “brandjacker” who aims to profit from the brand value and customer loyalty that legitimate marketers have built.
“Brandjacking” is difficult to combat; the internet crosses international barriers. When someone hijacks your brand or trademark by registering domain names that are clearly related to your business, it can lead to complex and lengthy legal action to protect your marks. There is a set of guidelines about domain name registrations and dispute resolution published by ICANN (the Internet Corporation for Assigned Names and Numbers) that may be of help. See their Domain-Name Dispute-Resolution Policy .

There’s nothing wrong with registering domain names that you may want to use in your existing or future business activities. I met a group of UK doctors once who had registered over 5,000 domain names related to various types of medical procedure. This was in the early days when you paid over $100 for a domain name! In our web publishing business, we own around 130 domain names... not that many... most of which are in active use for our sites. The problem arises when people start registering multiple domain names:

• To obstruct the activities of an existing business by incorporating their brand or trademark into a domain name.

• To divert visitors from an established web site (often by registering mis-spellings of domains).

• To sell the name back to the brand owner at a premium. 

.........to find out more about "brandjacking" in medical touris, read the full article at IMTJ: Go to Protecting your brand on the internet...beware the "brandjacker"!

Believe what your customers do...not what they say!

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post entitled: "Believe what your customers do...not what they say!"

A recent article in Harvard Business Review, “Four Simple Low Resolution Innovation Tests” highlights the problem faced by anyone who is considering investment in the medical tourism business. How can you know whether people will actually buy your service i.e. whether patients will actually travel abroad to use your services?

Much of the “research” conducted in the medical tourism sector is about what people say they will do.... not about what they actually do. For example, the 2009 Gallup Survey in the USA is frequently used to support the “booming medical tourism market” hypothesis.

The report on this Gallup poll was headed “Americans Consider Crossing Borders for Medical Care”. It found that “up to 29% of Americans would consider traveling abroad for medical procedures”.

Now the key words here are “will consider”. It does not say “will travel” or “have travelled”. And there lies the problem.......

.........Read the full article at IMTJ: Go to "Believe what your customers do...not what they say!"

Medical tourism: After the gold rush

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post on "Medical tourism: After the gold rush"

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 these:

• “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.......

.........Read the full article at IMTJ: Go to "Medical tourism: After the gold rush"

Comparing quality in medical tourism

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post on Comparing quality in medical tourism.

How does a medical tourist make a valid comparison of a doctor, hospital or clinic in one country with a doctor, hospital or clinic in another? The simple answer is that he or she can’t. And the truth is that it may never be the case (well not in my lifetime).

In the hypothetical world, we talk about patients making informed choices about treatment....about how we can provide them with the information that they need to compare healthcare providers and make valid decisions about which one is the “best”, the “safest”, the “highest quality”. But even if someone is only interested in treatment within one country, this may be impossible. In a country such as the UK where there is a national publicly funded health system it becomes more of a possibility. In the UK, there are quality indicators, performance measures, and outcome data that are collected in the same way and analysed in the same way across all healthcare providers (whether they are public or private hospitals). So, patients can make reasonably valid comparisons of healthcare providers.

However, in many countries which are promoting themselves as medical tourism destinations, there may be no strategy or system for collecting data on quality, performance and outcomes on a national basis. So, making an “informed choice” even within that country becomes a virtual impossibility.

.........Read the full article at IMTJ: Go to Comparing quality in medical tourism.

A new dawn for cross-border healthcare in Europe?

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here in future. Here's an extract of the latest blog post on "A new dawn for cross-border healthcare in Europe?"

A new dawn for cross-border healthcare in Europe?
Will European hospitals see a surge in patient numbers following the approval of the EU Directive on Cross-Border Healthcare by the European Parliament recently?

I would like to say...Yes! But the reality may be a little different. So....let’s take a look at how the EU Directive may (or may not) change the way that healthcare works in Europe and more importantly whether it will give a boost to the medical travel sector.

Consolidation of existing patient rights
The EU Directive does not give patients any rights to cross border healthcare that they don’t have already. It doesn’t introduce any new rights. These rights have already been established by the European Court of Justice. What the Directive aims to do is to establish a framework within which cross border healthcare will operate and to set the rules regarding how patients will access care and what kind of treatment they are entitled to. The new rules should be in place by 2013 (in theory....).

The Directive will end the uncertainty about the kind of treatments that patients are entitled to elsewhere within Europe and it will also allow domestic healthcare systems to maintain control of the patient’s entitlement to cross border healthcare. But the Directive does present opportunities for hospitals and healthcare providers to generate revenue from patients from elsewhere in the EU.

But overall, there will not be an overnight change and we are unlikely to see a surge in the number of cross border patients within the EU.

Within the UK, there are already well established procedures for National Health Service patients who wish to exercise their right to cross border care under existing EU law. Every NHS trust has (in theory) a procedure in place to deal with requests and to manage the process. See “NHS Choices - Planned treatment abroad”. Last year, it is believed that around 500 British patients exercised their right to cross border healthcare and underwent treatment abroad that was funded by the NHS.

.........Read the full article at IMTJ: Go to "A new dawn for cross-border healthcare in Europe?"

The medical tourism numbers game... Part 2

To keep things simple, this blog has moved to the IMTJ web site. You can find the Health Tourism Blog here, in future. Here's an extract of the latest blog post on "The medical tourism numbers game... Part 2"

The medical tourism numbers game... Part 2
Back in May 2008, I blogged on “McKinsey and the medical tourism numbers game..." and commented on their strange way of counting (or not counting) medical tourism numbers. Given the latest study on medical tourism numbers, “New study numbers US medical tourists in thousands not millions”, reported in IMTJ, I thought it was time once again to address the thorny issue of....how many medical tourists are there?

Defining the medical tourist
Before you can begin to count medical tourists, you have to be very clear about what it is you are counting. This is one of the greatest areas of confusion in the business sector.

So, what is a medical tourist?

In my view, a medical tourist is someone who travels outside of their own country for surgery or elective treatment of a medical condition. If we apply this narrow definition, we DO NOT include:

• dental tourists
• cosmetic surgery tourists
• spa and wellness travellers
• "accidental" medical tourists (business travellers and holiday makers who fall ill while abroad and are admitted to hospital)
• expatriates who access healthcare in a foreign country.

Read the full article at IMTJ: Go to "The medical tourism numbers game... Part 2".

Is medical tourism safe?

To keep things simple, this blog is moving to the IMTJ web site. You can find the Health Tourism Blog here, in future. Here's an extract of the latest blog post on "Is medical tourism safe?"

A significant proportion of medical tourism and medical travel is driven by people seeking established and proven treatments in countries where the cost of the treatment or operation is much lower than in their home country. Within this segment of the market, the focus of patient safety is upon the hospital, clinic or doctor who is carrying out the treatment. Can the patient be confident that the healthcare provider has the necessary expertise and experience to carry out the procedure? The question... “Does this treatment actually work?” does not arise.

For proven treatments, the hospitals, clinics and doctors (and medical tourism facilitators) can reassure the patient by providing proof of qualifications, accreditations; experience and so on.... and in some cases may be prepared to provide data on clinical outcomes. Unfortunately, this is all too often lacking. Patients are often asked to take on trust the claims of the healthcare provider, particularly in those countries that do not have national standards and systems for the collection of comparative clinical outcome data or independent review and analysis. Even an international accreditation such as JCI is not a guarantee of quality, nor an assessment of how good a hospital actually is at delivering safe and successful treatments.

So, in established areas of medical travel such as cosmetic surgery, dental treatment and elective surgery there is still much work to be done to convince potential medical tourists that treatment abroad is a safe option (or at least as safe as within their home country).

Read the full article at IMTJ: Go to "Is medical tourism safe?"

Predicting future demand for medical tourism: Health tourism blog is moving to IMTJ

To keep things simple, this blog is moving to the IMTJ web site. You can find the Health Tourism Blog here, in future.

Here's an extract of the latest blog post on "Predicting future demand for medical tourism".

The latest data on hospital activity within the UK National Health Service provides a useful indicator of where future demand for medical tourism may lie. One of the advantages of the UK public health system is that with one provider....the NHS, and one payor....the NHS it means that an enormous amount of meaningful data can be captured about the state of the nation’s health, about demand for health services and about how the health profile of the population is changing.

Like many developed countries with established health systems, the UK is facing the challenge of meeting the needs of an ageing population at a time when there is massive pressure to reduce or put a hold on public spending, and in effect reduce expenditure on health services. All UK hospitals collect data in the same way (well almost...) and the data is collected centrally by the NHS.

The following data is taken from the recent report “Hospital Episode Statistics: Admitted Patient Care – England 2009/10”, published by the NHS Information Centre.

Take a look at how demand for NHS hospital services has changed over the last ten years. First let’s examine the age profile of patients admitted to UK hospitals:

In 2009/10 there were:

• 16,806,200 hospital stays, a 38 per cent rise on 1999/2000.
• 1,939,190 stays for patients aged 0 to 14; a 15 per cent rise on 1999/2000.
• 7,333,110 stays for patients aged 15 to 59; a 29 per cent rise on 1999/2000.
• 3,642,940 stays for patients aged 60 to 74; a 48 per cent rise on 1999/2000.
• 3,837,990 stays for patients aged 75 and over, a 66 per cent rise on 1999/2000.

Read the full article at IMTJ: Go to "Predicting future demand for medical tourism".