An Overview Of Medical Tourism In India

Introduction

Tourism is the act of travel for predominantly recreational or leisure purposes and also refers to the provision of services in support of this act. It has become an extremely popular global activity. As a service industry, tourism has numerous tangible and intangible elements. Tangible elements of tourism include transportation, accommodation and other components of hospitality industry. Intangible elements of tourism, on the other hand, include many benefits enjoyed by tourists. Medical tourism seems to have originated in England. During the seventeenth century, it became fashionable in England to undertake a grand tour/educational experience. Health tourism existed for many years but its importance began to increase from eighteenth century onwards. In England it was associated with Spas - places with supposedly health-giving mineral waters, treating diseases from gout to liver disorders and bronchitis. Continental Spas like the Karlstad attracted many fashionable travellers by the nineteenth century. King George III made regular visits to Weepnouth when in poor health. At that time a number of doctors argued the benefits of bathing in sea water. 

Medical tourism in India

Medical Tourism is one of the fastest growing healthcare industries. The patients worldwide have begun to travel overseas in search of best quality and the most efficient medical services. Almost 50% of tertiary hospitals are actively focusing on tapping medical tourists as a significant chunk of their patient baseIndia ranks among top three medical tourism destinations in Asia. Medical tourism is a growing sector in India. The 21 st century has made healthcare services and premier technologies much more accessible to many developing countries. India gets an average of two hundred thousand international medical tourists annually. India is a preferred destination for cardiology, orthopaedics, transplants and ophthalmology. India also enjoys high credibility in wellness, preventive and alternative medicines The Niti Ayog has identified Madical Value Travel (MVT)as a major source of foreign exchange earnings. India currently has around 18%of the global medical tourism market. Its MVT was pegged at $3 billion in 2015 and is estimated to grow at 15% according to report of FICCI. It has been estimated that by 2020,India’s medical tourism industry could be worth $9 billion and account for 20%of the global market share. In 2015, it was US $3 Billion and is projected to grow $9 billion by 2020. The National Health Policy, 2002 makes it clear and supports medical tourism ‘To capitalise on the comparative cost advantage enjoyed by domestic health facilities in the secondary and tertiary sector, the policy will encourage the supply of services to patients of foreign origin on payment. The rendering of such services on payment of foreign exchange will be treated as deemed exports and will be made eligible for all fiscal incentives extended to export earnings. ’ Recently launched MTC (Medical Tourism Council) aims at making India a prime destination for medical tourism. Since 2006, the government has also started issuing medical visas to pateints and MX visas to their accompanying spouses In the world. India has 33 JCI (Joint Commission International accredited hospitals. Noida is emerging as a hotspot in medical tourism Private institutions like Max Healthcare have treated up to 50,000 foreign patients in its hospital. Apollo now has 46 hospitals with over 7000 beds and is in partnership with hospitals in Kuwait, Shrilanka and Nigeria Promoted by the government and fuelled by the corporate boom in medical care, India is increasingly seen as the favoured destination of medical tourists who cross the boundaries to seek medical treatment. Medical tourism is a multi-dollar industry promoted by government, medical and tourism industry. 

Medical tourism in India and other countries

Medical tourism is not a new concept. But the factors like high cost of treatment, long waiting period for certain kinds of operations, increasing affordability to get treated abroad, improvement in technology and standards of medical treatments in the developing countries have been responsible for the current popularity of the same. Due to globalisation, medical tourism has got a boost in all countries including Asian countries. Developing countries in Asia are the competitors to India. 

Brazil: Brazil is known for cosmetic surgery. The Strength of medical tourism in Brazil is its Joint Commission International (JCI) accreditation. It is entering into the global market for non-cosmetic procedures as a new player just recently. 

Canada: Canada is about 30 to 60% cheaper in the health costs in comparison with the USA. But at the same time, the WTO has declared that the quality of Canada’s healthcare is equal to that of the USA. 

Cuba: It is a popular medical tourism destination for more than 40 years. This is mainly due to a good reputation of Cuban doctors, low costs and the beautiful beaches nearby. There are special hospitals that focus on foreigners and diplomats. It is convenient for patients from Latin America, Europe Canada as they can travel on tourist visa. However to date no Cuban hospital has achieved JCI accreditation. 

Mexico: It is popular destination for Americans particularly those living near the Mexican border. Its speciality is dentistry and plastic surgery. The cost for dentistry is one fourth of US charges whereas other procedures cost one third of US cost. Mexican hospitals are popular for bariatric surgery for weight loss considered as elective procedure that is not covered by some US insurers. However the US doctors point out that the Mexican Legal system makes it almost impossible to sue Mexican doctors for malpractices. The trend has alarmed American health providers. 

Panama: In Panama, health and medical tourism is growing rapidly. The strengths are Panama’s tourist appeal, position as a hub for international travel, use of American dollar as an official currency. Many of Panama’s doctors are bilingual, board–certified and accustomed to working with the same medical equipment s and technology used in US and Europe. The cost is around 50% low. However, no hospital in Panama has international healthcare accreditation. 

United States: The availability of advanced medical technology and sophisticated training of physicians act as a motivators for growth in foreigners traveling to US for medical care. There are international patient centres that assist in arrangement of medical care, accommodations, finances and transportation. 

Asia pacific countries including China: It is becoming a destination for foreigners who want to take advantage of stem cell treatments that are still considered as experimental or have yet to be approved in their own country for conditions such as paralysis. 

Hong Kong: It provides a wide range of health-care services. The private hospitals are surveyed and accredited by both Trent Accreditation Scheme of UK and JCI. 

Thailand: Treatment for medical tourists in Thailand range from cosmetic organ transplant, orthopaedic to dental and cardiac surgeries. Treatments also include spa, physical and mental therapies. Besides the English speaking staff, they have interpreters for over 22 languages Doctors and staff is trained in the U. K. , Europe and the U. S. A. However political problems during late 2008 have made travel less appealing into Thailand. 

Malaysia: The country has excellent hospitals. English is widely spoken and the staff has been trained at high level in the U. K. or the U. S. A. Few of Malaysian hospitals hold international health accreditation. There is an active association for private hospitals working to develop medical tourism. 

Singapore: It has many hospitals with JCI accreditation. Its health system is sixth best in the world and highest in Asia. Singapore is preferred by countries like Indonesia and Malaysia, South Asia, Middle East counties and Greater China. It also provides affordable medical services to patients from the U. K. and the U. S. A. in a clean cosmopolitan city. 

Taiwan: It is known for liver transplants, bone-marrow transplants, reconstructive and plastic surgery. Costs are comparatively low. 

Reasons for recent increase in medical tourism:

• The high cost of healthcare in industrialized/developed nations. 
• The ease and affordability of international travel. 
• The improvement in technology. All recognised hospitals have invested a lot in supportive technology and operative techniques. Complicated heart surgeries, cancer care and surgeries, neuro and even general surgeries
• Standards of care in many countries of the world. 
• Convenience in comparison to that of other countries. 
• Zero waiting time. Britain and Canada it can take a considerable amount of time to get needed medical care in case of many health services like hip replacement whereas in Bangalore or Bangkok or Singapore such operations are possible the day after the arrival of the patients. 
• Medical expertise and safety. 
• Optimal doctor-hospital combination
• After treatment, recuperating in the hospital or nearby accommodation
• Option of continuing treatment through telemedicine
• Lower healthcare cost- 1/10th of US and Europe. 
• The country has the largest pool of doctors and paramedicos in South Asia including allopathic doctors, dental surgeons and nurses, Ayurveda doctors etc.
• Wide choice – Medical treatment, wellness and Rejuvenation, Ayurvada and alternative medicines
• Prior study of need of the patients and customised treatment,
• The hospitals are attached to JCI or the NABH accreditation, which are stringent and oriented to high est standard of medical delivery
• Warmth and hospitality of Indian hospitals and common English language. 
• Hospitals usually provide designated quite rooms/pray halls which cater to the major religions /faith

Over the years, India is becoming top notch destination for medical value travel because it scores high over the range of factors that determines the overall quality of care, quality of therapy, range of procedural and treatment options,infrastructure and skilled manpower. 

Scope of medical tourism in India:

1. Simple comprehensive medical check-up
2. Elective procedures like Rhinoplastry, Liposuction, Breast Augmentation, Orthodontics, Laser surgery
3. Life Saving procedures like Joint replacements, Bone marrow replacement, Transplants and Bye-pass surgery
4. Dental procedures
5. Stem cell transplant in India is a popular medical procedure for which hundreds of medical tourists especially Arabs visit the country every year.

Services offered to the foreign patients

Different special services provided to the foreign patients are not available in all hospitals. 

Special cuisine, house-keeping, accommodation for the relatives, concessions, arranging site- seeing tour/shopping etc. , pick up, drop from airport, local travel arrangements for relatives, finance, communication, money exchange facilities, internet connections, prayer room, interpreter etc. 

Comprehensive rehabilitation services, finest quality implants, prosthesis and consumables imported from overseas international, highest standards of infection control, specialised physiotherapy & rehabilitation services,

English speaking dedicated well trained staff, strong clinical team who are trained at top medical schools & hospitals, experience & excellent track record best in this part of the world. , air conditioned rooms, well- equipped with computers, high speed internet; colour TV and DVD player, attached wash room, and sofa cum bed for the companion room, food service, and laundry services etc. 

Professional set-up/ team of cardiologists and other specialists. . 

Treatment to patient with medical excellence, care and tenderness. support to the foreign patients and their family members, who find new environment to interact with new people, new places, new doctors etc. 

Concluding remarks

A brief review of medical tourism brings about many important observations about this growing industry. It has become an important economic activity for both the developed and developing countries in the recent years. Increasing globalisation has resulted in a speedy and convenient travel possible all around the world and that to at the reasonable cost. This has furthered the development of medical tourism. International standards are being achieved even by the developing countries. They are having the hospitals with the latest technology and best services which are attracting foreigners in increasing numbers. A growing number of tourists are flocking to India for a superlative medical treatment that is being provided by the skilled doctors. This has made India grow as a hub for medical tourists

However, there are certain marketing strategies required to be adopted by Indian healthcare industry. 

To attract foreign patients, there should be more super-speciality hospitals in all metro cities providing quality medical services. The international accreditation is a pre-requisite for getting patients from developed country as it gives assurance of international medical treatment in India. Technology also plays as important role as medical science is getting advanced day by day. There are heart transplants happening in India which seemed to be impossible some years ago. The hospitals should gain specialisation in specific surgeries or treatment. The medical services should be qualitative as well as cost-effective. The promotion for medical tourism is done by hospitals individually through their websites. There are also success stories which can boost medical tourism. Mouth publicity is also the common and popular method of promotion which can increase the flow of foreign patients in India. 

To club medical tourism with sightseeing is also one of the promotion strategy. However it depends on type of treatment. If there is only health check-ups, the patient and his/her relatives can enjoy the stay after successful treatment. But for complicated surgeries, it may not be advised by doctors. There is also a scope for cosmetic surgeries which is in great demand all over the world. Finally, government support to medical tourism industry in terms of financial and non-financial incentives should be taken as an opportunity to expand their business by large hospitals managed by corporate sector. 

References

• Indian Journal of Medical Ethics,online ISSN-9975-56911
• Medical Torists Flocking to India-Apaper by Yuthika Bhargava
• www. Indiahealthcaretourism. com
• www. tourmyindia. com/medical-tourism
• www. thehindu. com
• Anupama Nerurkar, Medical Tourism, Sheth Publications