Medical Tourism Climate Survey 2013 Conducted for the International Medical Travel Exhibition and Conference (IMTEC 2013) Monaco 23 March 2013 www.imtj.com © Intuition Communication Ltd 2013
Nov 08, 2014
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Medical Tourism Climate Survey 2013
Conducted for the International Medical Travel Exhibition and Conference
(IMTEC 2013)
Monaco
23 March 2013
www.imtj.com
© Intuition Communication Ltd 2013
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C O N T E N T S
1. Introduction ................................................................................................................................................ 3
The Medical Tourism Climate Survey ............................................................................................................. 3
2. Executive summary .................................................................................................................................... 4
Provider views ................................................................................................................................................ 5
3. Methodology .............................................................................................................................................. 7
The results ...................................................................................................................................................... 7
Sample bias..................................................................................................................................................... 7
4. About the respondents and their organisation .......................................................................................... 9
5. The current international patient market ................................................................................................ 11
6. The international patient market in the future ........................................................................................ 14
7. Impact of political changes ....................................................................................................................... 20
8. International research panel .................................................................................................................... 22
9. Other comments by respondents ............................................................................................................ 23
10. Services offered by providers ................................................................................................................ 24
11. The medical tourism business of the providers .................................................................................... 28
12. Marketing to medical tourists ............................................................................................................... 37
13. Appendix: Results in detail .................................................................................................................... 42
About you and your organisation ................................................................................................................. 42
The international patient market today ....................................................................................................... 47
Factors affecting patient choice ................................................................................................................... 49
The future of the international patient market ........................................................................................... 52
Impact of political changes ........................................................................................................................... 67
Other comments .......................................................................................................................................... 73
About your services for international patients ............................................................................................ 78
Your medical tourism business .................................................................................................................... 85
Marketing to medical tourists ...................................................................................................................... 88
14. Appendix: Email invitation .................................................................................................................... 91
Email invitation ............................................................................................................................................. 91
15. About Intuition Communication ............................................................................................................ 92
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1. Introduction
One of the greatest challenges faced by those who operate in the medical travel sector is the lack of reliable
and accurate information about the market. Much is said and written about the size of the market, about the
exponential growth and how “global healthcare” is going to transform the world. But there is often little hard
fact, and very few statistics to support what is claimed.
Hence, destinations, tourism boards, hospitals, clinics and healthcare providers are unable to benchmark
their performance, track their progress, measure their success, identify market opportunities and measure
their return on investment.
Within Intuition Communication, our aim is to capture and publish independent, standardised, and verifiable
information and data on the medical tourism market and the global healthcare industry
The Medical Tourism Climate Survey
The International Medical Travel Journal (IMTJ), published by Intuition Communication, provides an online
resource and e-newsletter to keep the industry informed about the latest trends and developments in the
sector. Each year, IMTJ “takes the temperature” of this nascent industry through the Medical Tourism
Climate Survey.
This year’s climate survey incorporates the views of over 400 individuals within the industry. The nature of
the respondents does of course influence the findings of this report. There is sample bias towards English
speaking participants (N.B: the survey was not multi-language) and to the US, European and Indian
markets. However, this does not negate the value of the survey in an industry which is bereft of meaningful
information.
The report highlights widespread optimism about the future of medical tourism despite the economic
downturn, with travel for cosmetic surgery expected to be the biggest growth area. The results suggest that
not only is the market currently growing but that it will continue to do so for the next five years or more.
However, it does highlight the fragmented state of the market in terms of the small size and nature of those
providing services and areas of concern such as the lack of marketing expertise and investment, and lack of
government support for medical tourism.
It is encouraging that many of the respondents acknowledge the lack of independent data and market
information, and that they are prepared to share information for the “greater good”.
As a business, Intuition Communication will continue to direct its efforts to plugging the information “black
hole” in medical tourism.
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2. Executive summary
This is the third Medical Tourism Climate Survey run by IMTJ. The survey was conducted in
February 2013, and attracted 404 participants, representing organisations in 77 different countries.
The Medical Tourism Climate Survey 2013 examines current activities, market and business
growth, current challenges and opportunities in the medical tourism sector. The research was
funded by International Medical Travel Journal and was conducted online using the SurveyMonkey
system.
The USA, the UK and Turkey provided the most respondents. A wide variety of organisation types
were represented in the survey. Providers of services to medical tourists (hospitals, clinics, spas
and medical tourism agencies) accounted for 69.3% of all respondents (hospitals and clinics -
42.7%, medical tourism agencies or facilitators - 24.1%, and health or medical spas - 2.5%).
Other organisations participating in the survey included those which do not provide services direct
to patients and medical tourists but which have an interest in this sector e.g. consultancies,
academic institutions, medical assistance companies, government organisations, tourism boards.
According to our respondents, the three main destinations for medical tourists, based on patient
numbers, are India, Thailand and the USA. The USA, Thailand and Singapore are considered to be
the leading destinations in terms of quality and range of services.
The respondents believe that the most important factors for medical tourists in choosing a
healthcare facility in a particular country are the expertise and qualifications of the doctor/dentist,
the cost of treatment, comments and ratings by other patients, and the standard of hospital or
clinic accommodation.
Our respondents expect the market for medical tourism to grow over the next five years. A quarter
of respondents expect the market to grow by between 5-10% pa, 22.1% expect it to grow by
between 10-15% pa, and 16.1% expect it to grow by more than 20% pa.
The sectors expected to grow the fastest over the next five years are cosmetic and plastic surgery,
dental treatment, cancer treatment and infertility treatment.
The respondents believe that the leading destinations for medical tourists in terms of patient
numbers in five years’ time will be India, Thailand and Turkey, followed by the USA, Germany and
Singapore.
The three most significant changes anticipated over the next five years are thought to be the
adoption of e-health and electronic patient records in medical tourism, followed by major tourism
and travel companies entering the market, and a greater emphasis on quality rather than price
among medical tourists.
The most significant issues facing the medical tourism industry are considered to be the lack of
reliable information about quality of services in other countries, the lack of follow-up care in the
patient’s home country, and the lack of insurance for medical tourists.
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Half of the respondents think that Obamacare will make little or no difference to the numbers of
Americans travelling to other countries for treatment. About a third of respondents think that the
effect of Obamacare will be to increase the numbers of American patients travelling abroad, and
one-fifth of respondents think that it will reduce the number of American medical tourists.
Just over a third of respondents think that the European Directive on Cross Border Healthcare will
make little or no difference to numbers of medical tourists, while over half think it will increase
numbers and only 12.6% think it will reduce numbers.
Half of the respondents stated that they would be prepared to participate in an international
research panel to share views and experience of medical tourism.
Provider views
Providers of services to patients and medical tourists (hospitals, clinics, spas and medical tourism agencies)
were asked to complete an additional set of questions, related to specific aspects of their business.
Dental treatment, cosmetic and plastic surgery, general surgery and orthopaedic surgery were the
most common services offered by the provider organisations, participating in the survey.
Extensive support services are provided in the destination country for medical tourists by the
provider organisations. More than four out of five providers arrange accommodation/hotels and
airport pick-up. More than half provide additional services such as 24 hour numbers for
questions/emergencies, interpreter services, arrangement of flights, and online consultations via
video or teleconference. Pre-travel and post-treatment follow up in the country of origin are
provided much less frequently (by just over a third of the providers).
Medical tourists are given a substantial amount of information. Nine out of ten providers state that
they supply information on the risks of treatment always or most of the time. Printed and
personalised treatment plans are provided by 88% of respondents always or most of the time,
while 83% provide detailed profiles of surgeons/doctors always or most of the time. After
treatment has been completed, four out of five respondents ask patients to complete a patient
satisfaction survey always or most of the time.
Interpreter services are provided by the respondents, most commonly for English, then German,
French, Arabic and Russian languages.
There was a very wide range of numbers of international patients treated or handled by the
respondents. The majority of respondents treated less than 100 international patients in the last
12 months.
o 65% of hospitals and clinics treated less than 100 international patients in the last 12
months. 15% of hospitals and clinics treated more than 1,000 international patients in the
last 12 months,
o 56% of medical tourism agencies and facilitators treated less than 100 international patients
in the last 12 months. 11% of medical tourism agencies and facilitators treated more than
1,000 international patients in the last 12 months.
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According to the providers, their international patient business is growing. Six out of ten
respondents said that their numbers had increased in the last 12 months. They expect their
business to grow: four out of five providers expect the numbers of international patients in their
business to increase in the next 12 months.
According to the providers, the UK provides the most patients, followed by the USA, Russia,
Germany, Australia and the United Arab Emirates.
The biggest internal factor considered to restrict growth of their international patient business is
the size of the marketing budget followed by financial constraints. e.g. cost of finance, and
availability of marketing expertise.
The biggest external factor considered to affect growth of their international patient business is a
lack of government support for medical tourism, followed by increased competition and the image
of the country/destination.
Three-quarters of providers are happy to provide basic information about their medical tourism
activities to improve the availability of data about the market.
According to the providers, the largest amount of marketing spend goes on developing web site
content, followed by social media, then exhibitions and events, PR and media relations and on-line
activity such as pay per click, directory listings, banner advertising and lead generation services.
The lowest spend by respondents is on sponsorship and direct mail. The perceived efficacy of
different types of marketing activity broadly reflects current spend on these activities.
More than half of the providers said they spend less than $10,000 a year on marketing; however,
over one in ten spend over $50,000. And marketing spend on medical tourism seems to be on the
increase; more respondents increased their spend last year than reduced it.
The web sites and publications named as the most effective in marketing medical tourism services
were Google and Treatment Abroad, followed by What Clinic, and then their own websites,
Facebook and social media.
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3. Methodology
Two databases were used to attract participants for the 2013 Medical Tourism Climate Survey:
An in-house IMTJ database containing information on hospitals, clinics, agencies and other
organisations involved in the medical travel sector, maintained by Intuition Communication,
publishers of International Medical Travel Journal.
The email distribution list maintained by Informa which is used to promote the International
Medical Travel Exhibition and Conference (IMTEC 2013).
An email (copy provided in the Appendix) was sent to both lists asking individuals to complete an online
medical tourism climate survey to assess their current views on:
Market and business growth
Current challenges
Future opportunities
To encourage participation, respondents were offered a free copy of the survey report.
The survey was conducted online using the SurveyMonkey survey system from 18 February to 8 March
2013. The research was funded by International Medical Travel Journal.
The results
404 individuals completed the survey representing a broad sample of healthcare businesses and
organisations.
The report is based on responses from the whole sample (404 respondents), except for sections 10, 11 and
12 (services offered to international patients, the medical tourism business, marketing to medical tourists)
which were answered only by service providers - those organisations providing services directly to medical
tourists. (i.e. hospitals and clinics, health spas or medical spas, medical tourist agencies or facilitators). The
service providers accounted for 279 respondents.
Sections 3 to 12 contain a summary and analysis of the survey results.
Full details of the results are provided in the Appendix - Section 13.
Sample bias
It is inevitable that in a survey of this type there is built-in sample bias. The number of respondents is higher
than we have achieved in previous climate surveys, but is this sample truly representative of the medical
travel industry? Here are some of the reasons why sample bias will affect the findings:
Some key players have not submitted a response to the survey.
The survey was distributed in English; those who have English as a first or second language
are more likely to respond.
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Some recipients may take the view that sharing their information is not good business
practice.
Equal weight of view is given to someone who runs a major hospital group and someone who
runs a small clinic.
Some respondents may be overly optimistic about the current and future state of their
business and the industry. And vice versa.
The respondent profile is skewed towards the USA, Europe and India.
Nevertheless, in an industry which is hampered by a lack of information and data, we believe that the
sample size is sufficient to provide worthwhile insight.
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4. About the respondents and their organisation
Location of respondents
The 404 respondents represented organisations in 77 different countries: the USA (12.9%), India (11.0%),
the UK (5.1%) and Turkey (4.3%) had the most respondents, followed by Malaysia and Thailand (with 3.8%
each), and Greece, Hungary and Spain (with 3.5% each).
See Section 13: Appendix for the full list of countries represented in the sample.
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Main business activity
A wide variety of organisation types were represented in the survey. Providers of services to medical
tourists accounted for 69.3% of all respondents (hospitals and clinics 42.7%, medical tourism agencies or
facilitators 24.1%, and health or medical spas 2.5%). Other organisations participating in the survey
included those which don’t necessarily provide direct services to medical tourists but which have an interest
in this sector e.g. consultancies, academic institutions, medical assistance, government organisations being
the main ones.
See Section 13: Appendix for the full list of business activities.
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5. The current international patient market
Leading destination countries by patient numbers
According to the respondents, the three main destinations for medical tourists in terms of patient numbers
are India, Thailand and the USA, followed by Germany, Turkey and the UK. These results do not differ
significantly from the previous survey; however, the USA and Germany have moved up the rankings by a
few places, and Costa Rica and Mexico have moved down the rankings.
(Note: The country scores below have been calculated by weighting the country selections: First choice -
score = 3, Second choice - score = 2, Third choice - score = 1).
A full list of countries is given in Section 13: Appendix.
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Leading destination countries by quality and range of services
The leading destinations for medical tourists in terms of quality and range of services are the USA, Thailand
and Singapore, according to the respondents. These are followed by Germany, India and Turkey. The main
change from the previous survey is that the USA has moved from fourth to top place, and India has moved
from first to fifth position.
(Note: The country scores below have been calculated by weighting the country selections: First choice -
score = 3, Second choice - score = 2, Third choice - score = 1).
A full list of other countries scores and rankings is given in Section 13: Appendix.
Most important factors for medical tourists
According to the respondents, the most important factors for a medical tourist in choosing a healthcare
facility in a particular country are the expertise and qualifications of the doctor/dentist (97.5% of
respondents think this is very important or important), followed by comments and ratings by other patients
(93% of respondents think this is very important or important), then the cost of treatment (92.4% of
respondents think this is very important or important), and the standard of hospital or clinic accommodation
(92% of respondents think this is very important or important).
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Cost of treatment ranks higher as a factor among respondents who are providers compared to non-
providers, as do comments and ratings of other patients, and distance to travel destination. Non-providers
rank standard of hospital or clinic accommodation, post-operative infection rates, and post treatment in the
patient’s country higher than the providers.
In the additional comments given by respondents to this question, some stressed the importance of the
softer human side of looking after patients when they are abroad; even though they may be going to an
excellent facility for treatment, it is the additional services or being looked after and not left on their own
that can make a real difference to their overall experience.
The chart below shows the rating averages for the various factors; a weighting has been applied to the five
ratings that the respondents could choose from: Not at all important (weighting of 1), not important
(weighting of 2), neutral (weighting of 3), important (weighting of 4),very important (weighting of 5). A
rating average was calculated from all responses to the question.
See Section 13: Appendix for additional comments given by respondents and a split of results between
providers and non-providers.
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6. The international patient market in the future
Growth rate forecast
The respondents expect the market for medical tourism to grow in the next five years at quite a healthy
rate. 24% of them expect the market to grow by between 5-10% pa; 22.1% expect it to grow by between
10-15% pa; 16.2% expect it to grow by more than 20%pa. If anything, non-provider respondents are a
little more confident in the scale of market growth than respondents who are providers.
See Section 13: Appendix for the split of opinions between providers and non-providers.
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The sectors expected to grow the fastest
The respondents were asked to choose three sectors that they expect to grow the fastest in the next five
years. Top came cosmetic and plastic surgery (56.2% of responses) followed by dental treatment and
cancer treatment (43.4% of responses each) and infertility treatment (40.4% of responses). Also high up
the list were (in order of numbers of responses), cardiac surgery and cardiology, orthopaedic surgery, stem
cell treatment, obesity surgery, and transplants.
There were some differences in opinion between providers and non-providers on which sectors will grow
fastest. Non-provider responders chose cancer treatment more often than respondents who are providers
(52.7% vs 38.5%), whereas providers though dental care would grow more than non-providers (51.7% vs
28.0%). Infertility treatment was mentioned more frequently by providers (46.6%) than non-providers
(29.0%).
See Section 13: Appendix for the split of opinions between providers and non-providers.
Forecast of leading destinations
The respondents believe that the leading destinations for medical tourists in terms of patient numbers in five
years’ time will be India, Thailand and Turkey, followed by the USA, Germany and Singapore. India and
Thailand currently feature as the top two destinations according to the respondents, and are forecast to hold
these first two positions over the next five years. The respondents rank Turkey in fifth position for patient
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numbers today, but forecast that it will rise to third position in five years’ time.
(Note: The country scores below have been calculated by weighting the country selections: First choice -
score = 3, Second choice - score = 2, Third choice - score = 1).
A full list of other countries is given in Section 13: Appendix.
Future trends and changes
The most significant change anticipated over the next five years is the adoption of e-health and electronic
patient records in medical tourism. (87.8% of respondents think this is likely or very likely to happen),
followed by major tourism and travel companies entering the market. (80.0% think this is likely or very likely
to happen). The fact that medical tourists will make choices based on quality rather than price is thought
likely or very likely to happen by 77.7% of respondents, 68.7% of respondents believe it is likely or very
likely that national governments will introduce legislation and licensing of medical travel agencies and
facilitators. A significant increase in the number of patients suing healthcare facilities in other countries is
thought likely or very likely to happen by 61.3% of respondents. However, prices are not expected to fall
(57.6% of respondents thought it unlikely or very unlikely that prices would fall).
Another aspect that was mentioned in additional comments related to the need for a portal similar to
TripAdvisor for medical tourists. Also mentioned was the need to address the problem of getting visas and
visa extensions for medical tourists.
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The chart below shows the rating averages for the various trends and changes. To calculate the rating
average a weighting has been applied to the four ratings that the respondents could choose from: very
unlikely (weighting of 1), unlikely (weighting of 2), likely (weighting of 3), very likely (weighting of 4) and
the rating average calculated from all responses to that question.
A split of opinions between providers and non-providers and additional comments can be found in Section
13: Appendix
The chart overleaf shows the percentage breakdown of responses for each factor.
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Issues facing the medical tourism industry
The most significant issues facing the medical tourism industry are lack of reliable information about quality
of services in other countries (90.7% of respondents think this is significant or very significant), lack of
follow-up care in the patient’s home country (83.6% think this is significant or very significant), lack of
insurance for medical tourists (83.5% think this is significant or very significant), followed by lack of
awareness of medical tourism (80.0% think this is significant or very significant) and lack of international
standards for measuring outcomes (76.0% think this is significant or very significant) and lack of
international standards for patient records (77.5% think this is significant or very significant). Lack of
regulation of facilitators and agents is the next most important issue (74.9% think this is significant or very
significant).
The chart below shows the rating averages for the various issues; a weighting has been applied to the four
ratings that the respondents could choose from: not at all significant (weighting of 1), not significant
(weighting of 2), significant (weighting of 3), very significant (weighting of 4) and the rating average
calculated from all responses to that question.
Full results and a split of opinions between providers and non-providers and additional comments can be
found in Section 13: Appendix
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7. Impact of political changes
The respondents were asked their views on how recent political and structural initiatives in the USA
(Obamacare) and Europe (EU Directive) will affect the medical tourism market.
Obamacare
Participants were asked how they felt Obamacare would affect the numbers of Americans travelling to other
countries for treatment. Half of the respondents (49.4%) thought that it would make little or no difference
to the numbers. More respondents thought that the effect of Obamacare would be to increase the numbers
of American patients travelling abroad (31.8%) than reduce the number (18.9%). The non-provider
respondents were slightly less pessimistic on this issue of the effects of Obamacare on medical tourist
numbers than respondents who are providers.
See Section 13: Appendix for a split of responses between providers and non-providers and additional
comments.
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European Directive on Cross Border Healthcare
Just over a third of respondents (36.0%) believe that the European Directive on Cross Border Healthcare will
make little or no difference to the numbers of medical tourists, while over half (51.4%) think it will increase
numbers and only 12.6% think it will reduce numbers. As with Obamacare, the non-provider respondents
are less pessimistic about the effect of European Directive on Cross Border Healthcare than respondents who
are providers.
See Section 13: Appendix for a split of responses between providers and non-providers and additional
comments.
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8. International research panel
Half the respondents stated that they would be prepared to participate in an international research panel to
share views and experience of medical tourism, and another 41.5% said they might participate in such a
panel.
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9. Other comments by respondents
The verbatims provided by respondents are listed in Section 13: Appendix.
Providers’ comments related to issues such as the importance of the quality of medical and nursing staff, the
need for independent sources of advice for patients, the need for government involvement in marketing of
individual countries, and also accreditation, regulations, standards and ethics to ensure the highest levels of
professionalism, and exclude those organisations who can’t provide them.
Non-providers mentioned issues such as development of sets of standards for the medical tourism industry,
and organisation and management of the medical tourism industry, including co-ordinated management of
detailed information about the industry across the world to help patients make better choices.
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PROVIDER ONLY QUESTIONS
The following sections are based on responses given only by those organisations providing services direct to
patents and medical tourists i.e. hospitals and clinics, health spas or medical spas, medical tourist agencies
or facilitators (279 respondents).
10. Services offered by providers
Treatment types offered by the organisation
Dental treatment, cosmetic and plastic surgery, general and orthopaedic surgery, are the services most
commonly offered by the provider organisations participating in the survey.
See Section 13: Appendix for other services mentioned.
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Provision of support services to patients
Extensive support services are provided in the destination country. More than four out of five providers
arrange accommodation/hotels (86.8%) and airport pick-up (81.0%). More than half provide additional
services such as 24 hour numbers for questions/emergencies (68.6%), interpreter services (63.6%),
arrangement of flights (52.9%), and online consultations via video or teleconference (52.9%).
Pre-travel and post-treatment follow up in the country of origin are provided less frequently (by just over a
third of these respondents) e.g. follow-up in country of origin (39.3%), consultation in the country of origin
(37.6%).
See Section 13: Appendix for other support services mentioned.
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Provision of information to patients
Medical tourists are provided with a substantial amount of information. Nine out of ten providers supply
information on the risks of treatment always or most of the time (90.4%). Printed and personalised
treatment plans are provided by 88% of providers always or most of the time, while 83.1% provide detailed
profiles of surgeons/doctors always or most of the time. After treatment has been completed, 79.2% of
providers ask patients to complete a patient satisfaction survey always or most of the time.
See Section 13: Appendix for other information mentioned.
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Interpreter services
Interpreter services are extensively available, most commonly for English, then German, French, Arabic and
Russian languages.
A full list of other languages mentioned can be found in Section 13: Appendix.
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11. The medical tourism business of the providers
Numbers of international patients
There was a very wide range of numbers of international patients treated or handled by the respondents in
the last 12 months. The charts below show how many of the respondents were reported by the different
types of patients i.e. outpatients, daycase patients and inpatients. Some respondents provided data on all
three types of patients, while others reported on (or only handle) one or two of the three patient types.
Two respondents inputted some extremely large numbers which we believe to have been incorrectly entered
or are spurious. These have been removed from the analysis to prevent skewing of the data.
The majority of respondents treated or handled less than 100 international patients in the last 12 months.
65% of hospitals and clinics treated less than 100 international patients in the last 12 months. 15% of
hospitals and clinics treated more than 1,000 international patients in the last 12 months.
56% of medical tourism agencies and facilitators treated less than 100 international patients in the last 12
months. 11% of medical tourism agencies and facilitators treated more than 1,000 international patients in
the last 12 months.
N.B. Although a definition of “international patient” was provided, there may still be a differing interpretation
of this by individual providers, and hence inconsistency in the numbers provided.
International patient numbers for hospitals and clinics
The average number of international patients p.a. per facility reported by hospitals and clinics was:
299 Inpatients;
195 Day Case Patients
2,258 Outpatients.
The median number of international patients p.a. per facility reported by hospitals and clinics was:
55 Inpatients;
50 Day Case Patients
110 Outpatients.
The chart overleaf shows the responses grouped by numbers of international patients treated pa.
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International patient numbers for medical tourism agencies and facilitators
The average number of international patients p.a. per business reported by agencies and facilitators was:
116 Inpatients;
45 Day Case Patients
55 Outpatients.
The median number of international patients p.a. per business reported by agencies and facilitators was:
94 Inpatients;
44 Day Case Patients
60.5 Outpatients.
The chart overleaf shows the responses grouped by numbers of international patients handled per annum.
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Changes in international patient numbers
Provider throughput of international patients is reported to be increasing. Over half of the providers and
agencies (60.3%) thought that the numbers had increased in the last 12 months, while only 17% thought
that numbers had decreased. Less than a quarter (22.6%) said that the number of international patients
using their services had remained the same.
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Forecast in changes in international patient numbers in their business
The providers and agencies expect their international patient numbers to grow considerably in the next 12
months. Four out of five respondents who are providers or agencies (79.9%) expect their numbers of
international patients to increase in the next 12 months, whilst a quarter of them (26.3%) expect their
numbers to increase by between 10% and 20%. Only 10.3% expect their numbers to remain the same, and
8.7% expect their numbers to decline.
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Where do the patients come from?
Providers and agencies were asked which three countries provide the biggest source of patients for their
businesses. According to respondents, the UK provides the most patients, followed by the USA, and then
Russia, Germany, Australia and the United Arab Emirates.
(Note: The country scores below have been calculated by weighting the country selections: First choice -
score = 3, Second choice - score = 2, Third choice - score = 1).
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Internal factors restricting growth of their medical tourism business
The biggest internal factor considered by providers and agencies to affect growth of their international
patient numbers is the size of the marketing budget (36.5% major impact and 33.9% some impact),
followed by financial constraints e.g. cost of finance (24.0% major impact and 38.0% some impact).
Availability of marketing expertise was also an important factor (22.6% major impact and 31.1% some
impact). Availability of clinical staff and capacity to provide services are not considered to have as
significant an impact on growth.
Other internal factors can be found in Section 13: Appendix.
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External factors restricting growth of their medical tourism business
The biggest external factor considered by providers and agencies to affect the growth of their international
patient numbers is lack of government support for medical tourism (34.6% major impact and 33.0% some
impact) followed by increased competition (24.3% major impact and 45.5% some impact). Over half the
providers and agencies thought that the image of the country/destination had a major or some impact on
restricting growth (27.1% major impact and 29.3% some impact).
See Section 13: Appendix for other external factors mentioned.
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Willingness to provide further information on own activities
It is encouraging to see that three-quarters of respondents are happy to provide basic information about
their medical tourism activities to improve the availability of data about the market.
Additional comments are given in Section 13: Appendix.
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12. Marketing to medical tourists
Current marketing activities
According to the providers, the largest amount of their marketing spend goes on developing web site
content (40.9% of respondents said they spend significantly in this area, and another 40.9% invest some
spend in this area). Next biggest spend is on social media (14.3% spend significantly and 32.4% invest
some spend) followed by exhibitions and events (12.4% spend significantly and 25.4% invest some spend)
and PR and media relations (10.5% spend significantly and 28.2% invest some spend). The results of the
survey suggest that spend on on-line promotional activity is lower down the list, with pay per click being the
most popular form, followed by directory listings, banner advertising and lead generation services. The
lowest spend by respondents is on sponsorship and direct mail.
The chart below shows the rating averages for the various activities. To calculate the rating average a
weighting has been applied to the four ratings that the respondents could choose from: zero spend
(weighting of 1), little spend (weighting of 2), some spend (weighting of 3), significant spend (weighting of
4) and the rating average calculated from all responses to that question.
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The chart below provides a breakdown of responses for each marketing area.
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Perceived efficacy of marketing activities
The perceived efficacy of different types of marketing activity broadly reflects current spend on these
activities, with web site content in first place (56.6% of providers think it is very effective and 33.0% think it
is quite effective) followed by social content (29.4% think it is very effective and 40.7% think it is quite
effective), PR and media relations, and market research. Direct mail and sponsorship are considered to be
not effective or not very effective by over 60% of providers.
The chart below shows the rating averages for the various activities. To get the rating average a weighting
has been applied to the four ratings that the respondents could choose from: not effective at all (weighting
of 1), not very effective (weighting of 2), quite effective (weighting of 3), very effective (weighting of 4) and
the rating average calculated from all responses to that question.
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Marketing spend
More than half of those responding to the question about annual marketing spend said they spent less than
$10,000; one in ten spend over $50,000.
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Changes in marketing spend
Marketing spend on medical tourism seems to be on the increase, with almost half of providers (46.5%)
saying they spent more in the last year and only 11.2% spent less than last year.
Publications and web sites
There were many different answers to the open-ended question ‘which publications and web sites are the
most effective in marketing your medical tourism services?’; top of the list came Google and the Treatment
Abroad web site with eight mentions each, followed by the What Clinic web site, and then the provider’s own
websites, Facebook and social media. See Section 13 for additional mentions.
Answer Options
Response count
Google 8
treatmentabroad.com 8
whatclinic.com 7
Own website 7
Facebook 4
Google Adwords 3
Social media 3
novasans.com 2
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13. Appendix: Results in detail
This Appendix contains more detail on the responses given in answer to some of the questions in the survey.
All verbatim responses are given as provided by the respondent. No corrections have been made for
spelling.
About you and your organisation
Q3 - Company / organisation name
Names of organisations given: 21 Century Hospital Julia Travel & Tourism Co
7 TRAVEL LTD Jyoti Hospital & Minimum Invasive Surgery Center
A2Z Medical Torism in India Kameda Medical Center
AB Consultancy Kamineni Hospitals
academic dental clinic Klinika La Perla
ACCESS Global Healthcare LaDiva Center of Excellence for
Laser,HairTransplant,Aesthetic&PlasticSurgery Acibadem Healthcare Group Laser Clinics (France) Ltd.
Adapta Life Care Marketing Sdn Bhd
Adventist HealthCare LMC
aesthetic dentistry LMT Company
Aevitas fertility clinic, VIncent Pallotti LOHGUANLYE SPECIALISTS CENTRE
AG MEDICAL TRAVEL Longevita
Aga Khan University Longfield Management (P) Limited
Aggarwal Dental Clinic Lotus Medical International
AIHO M
AL ABEER MEDICAL GROUP M&A Innovation
Al Hashar Tourism & Travels LLC M.O.H
Al Iman Medical Clinic Madicare4U LTD
Al Zahra Private hospital,Dubai, UAE Malaysia Healthcare Travel Council
Alhtaia Malaysia Healthcare Travel Council
Alpha Specialist Centre Malaysian Society for Quality in Health (MSQH)
American Hospital Tirana MALO CLINIC
AMTRAC Asia Marketinghouse
Anya Skin Clinic Marlin Safe Med Journey\
Apollo Health City- Hyderabad MCI Management Center Innsbruck
Apollo Hospitals International Ltd MDental
Apollonion Private Hospital Medasia
Apollonion Private Hospital Medaway Health Inc.
artDENTAL - center of dental medicine for aesthetic
dentistry and implantology
Medeguide
Asian Institute of Gastroenterology MEDIC LINK CONSULTANTS LTD
Asian Publication Company ltd., Medica Avenue
ASO Savings and Loans Plc. MEDICA SUPERSPECIALTY HOSPITAL
Astro Air International Inc. Medica Travel
Athens Assistance Medical Care Spain
ATUL NURSING HOME Medical tourism Portugal
az-osp. "cardinale G. PANICO" Medical Tourism Training, Inc
B B CLINIC Medical Tourism Training, Inc.
Bahia Aesthetic Surgery Center Medical Tours Company
BALI ROYAL HOSPITAL Medical Travel Commission
Bangkok Hospital Phuket Medical Travel Europe
Bangkok international dental center (BIDC) Medical Travel Today
Bangladesh Tourism Foundation Medicana Ivf Centre
Baptist Health South floorida Medicatur Medical Travel Agency
Baskent University Hospitals Turkiye Meditour
BCM MediTravel Solutions
Beautiful Escapes MediTrip Advisor
Beautiful Holidays mediwin india tours
Belladent Aesthetic Dentistry&Implantology Clinic MEDSPA BG
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BESTRA Medical Guide ltd Mercury Health Travel
Beverly Wilshire Medical Centre MEXICAN ASSOCIATION OF MEDICAL TOURISM
BOC Sleep Centre Miguelangelo Clinic
BON VOYAGE TRAVEL SERVICE ministry of health
BRACES ministry of health - kingdom of Bahrain
Bumrungrad International Hospital MINISTRY OF HEALTH AND QUALITY OF LIFE
Bupa International Miró Center for Oculoplastic surgery
Camino Recovery Mission Hospital
CAP MITERA MATERNITY HOSPITAL- IVF UNIT
CarpatiaGroup MOHFW
CBHCC MONDIAL ASSISTANCE TURKEY
Center for dental implantology and cosmetic dentistry Moreno Travel
CFA Mount Alvernia Hospital
Cincinnati Children's Hospital Medical Center MTC
Cira Garcia Central Clinic My Smile Dent
Clinica dental costa blanca National Daily Newspaper
Clinica Génese do Tempo National Healthcare Group
Clinical Research Centre National Heart Institute
CLINIQUE INTERNATIONALE DU PARC MONCEAU
(PARIS)
National Hospital for Neurology & Neurosurgery
Cluster Medicine Estonia New Hospitals
CN medical tourism Newfoundland and Labrador Medical Association
Companion Global Healthcare Nicolaus Copernicus University
Companion Global Healthcare, Inc. NMC Healthcare
Consultant Nordmed Tour
Consulting in Healthcare and Finance Novasans
Cosmetic Dental Clinic Nucci Medical Clinic, LLC
Cosmeticdirect NURSE SUCCESS GROUP
CosmeticVacations Obstetric & Gynaecology Clinic
Costa Rica Health Travel Ocean Dental Cancun
Cryos International Oftalmolgy Advance Instituto
CT Group of Institution Olive Branch health Mgt
CWH ORALKLASS
Cyprus sun med connections ORBICARE
Danubius medical Spa Holtels Orbicare, LLC
Dental Clinique Osteitis Centre Vienna
Dental Holiday Oxygen Medical
Dental World Manila Panacea Publishing Asia Ltd
dentalia Panorama-Medica Group Co. Ltd.
Dentalp dental clinic Paracelsus travel
DentalSea clinic Parker Hannifin
Dentaturism Center Parsmedix Ltd.
Department of Healthcare Administration, I-Shou
University
Patients Beyond Borders
Derm-Al Beauty Perfection Medical Group
Destiny Meditravel persian treatment & travel
DHA PGIMER
Diamond Helix Medical Assistance Ltd Philadelphia International Medicine
Direct Hair Transplantation phm international
Dr Daniel Garcia Paricio Personalized Plastic Surgery
Institut
Phoenix hospital Group
Dr ErfanianIVF Clinic Phyathai 2 International Hospital
dr kulvinder kaur centre for human reproduction Polmed Travel
Dr Pervin Bilginer Dental Practice Pomadent
Dr. Garg's Multispeciality pvt Ltd praxis fuer fertilitaet
Dr. Rothschild's dental clinic Preecha Aesthetic Institute
East and North Herts Trust Premium Care Colombia
EHFCN Priceless Productions
Emergency Assistance Japan Prince Court Medical Centre
erhiere international company limited Prince of Songkla University
EULEX and ORTOMED private praxis
euphoria healthcare Privet practice
Eurodentaire PT. Mediacare International
EUROMEDICA GENERAL HOSPITAL OF RHODES Pzu Mediana Medikal - Mediana Dental
Euromedical Tours Razavi Hospital
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f Reangel SC
Fértilis Clinic Renaissance Healthcare Group, LLC
Fildisi Dental Clinic Reprofit International
Filo diretto Insurance Group Ruby Hall Clinic
Find Medical Tourism Rush University
FirstMed Services GmbH Sacred Heart Dental Clinic
Fondazione Opera San Camillo Sagar Hospitals
Főnix-MED plc Saint James Hospital
Foot and Ankle Clinic sakukidentalhospital
Fortis Healthcare Salvesis GmbH
FREE LANCE ADVISER OWN COMPANY sanjeevani hospital
FrontEnders Healthcare services Pvt Ltd SARONIC NEPHROLOGICAL CENTER Ltd
GE Healthcare Satori World Medical
Gehrig Verlagsgesellschaft mbH Sc Medimar imagistic
General Hospital Jesenice Scanlab
General hospital Pula Sebastian Energy`
Generation Bold secretaria de salud
genese do tempo sehgal dental care centre
Geomedical selfemployed
GEORGALLIDES CLINICAL LABS Seven Corners
Global Benefits Group, Inc. Sevgi Dental Clinic
Global Health Advisors, LLC SGOT-SSOT // SGU-SSU // SGPARC-SSCPRE // SSIPM
Global Health Travel SIA "VASU"
Global Health Travel SIA DentaPlan
Global Health Travel Sime Darby Healthcare
Gooch & Associates SIMED Medical Assistance
Gorgeous Getaways Smart Choice Medical Travel
GPM GOVERNMENT COLLEGE, MANJESWARAM, KERALA,
INDIA
Smile Dental Services
Great Ormond Street Hospital smile partner
Guilmaros S.L. Smilistic®
health and holidays Specialty Hospital
Health Care Strategy Int. SPRING Singapore
HEALTH FIRST Srushti Fertility Research Centre
Health Resources, Ltd. Stem Cell treatment Centers Group
Health Vision Asia STEPS Stravel & Tourism / STEPS Helath & Travel
Healthcare Executive magazine Stomatoloska Poliklinika Jukica
Heart Center Varde SUR India
Heilbronn University Surgical Bliss
Hilton Hotels - West London Symmetria
holhos.com Tajen University
HOLIDAY FOR HEALTH TEMOS AEGEAN
Hospital Britanico de Buenos Aires Temos International GmbH
Hospital Británico de Buenos Aires The Clinic Finder
Hospital de Magalhães Lemos The Health Clinic
Hospital de Olhos Dr. Ricardo Guimarães The Medical Tourist Company
hospital helpline The Medical Travel Commission
Hospital Lam Wah Ee TNHCA
HPP ALGARVE, SA. TRACEY BELL
HR-SCAN LTD. TRAMAZON SAC
Hygeia Holistic Care Travel Cafe
iJET International Travelcity LLC
ilan geva & friends Traveling4Health
Imperial College London @ St Mary's, UCL @ NHNN and
Hospital of St J & E
Treatment in Poland
IMTCC Twin Deer Multi Activities Co ltd
Indexmedica UAB Kardiolita
Indexmedica UKF
Indian Medical Tourism / Travel India Company ULA Technologies/MedTrips
IndiCure Unidolor
inspire peoples consultant univercity
INSTITUT GUTTMANN - Neurorehabilitation Hospital university hospital gent
Instituto Condal de Oftalmología University of Debrecen Medical and Health Science Center
INTEGRATIVE MEDICINE-HOMEOPATHY HEALTH CARE University of Sydney
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intelliex V&V Medical - MedTravelBelarus
Inter-Face International Vejthani Hospital
International Board of Mediciner and Surgery Vijay Dental Clinic
International Med Retreat Well-Being Travel
International Surgery Group WELLCARE MEDICAL TOURISM
Intuition Communications Ltd Wijnland Fertiliteit/Fertility
ioc clinica dental William E. Braun, LLC
ISMETT World Med Net India
Istishari Hospital World Wide Health Italy
IVF Europe WorldCare
izmir aktip celebi university, faculty of tourism WTW
Jet Rescue Air Ambulance Xellum Ltd/The Tourism Observatory for Health, Wellness
and Spa Jinepol Women's Health and IVF Clinic xgfhk
Yemen Tourism Promotion Board
Q5 - In which country is your organisation located?
Answer Response
Percent
Answer Response
Albania 0.3% Lithuania 1.3%
Algeria 0.5% Macedonia 0.3%
Argentina 0.8% Malaysia 3.8%
Australia 2.4% Malta 0.3%
Austria 1.1% Mauritius 0.3%
Bahrain 0.3% Mexico 2.1%
Bangladesh 0.5% Netherlands 0.3%
Belarus 0.3% New Zealand 0.3%
Belgium 1.3% Nigeria 1.3%
Brazil 1.1% Oman 0.8%
Bulgaria 1.1% Pakistan 0.3%
Cambodia 0.3% Peru 0.3%
Canada 0.8% Philippines 0.5%
Cayman Islands 0.3% Poland 2.4%
Chile 0.3% Portugal 1.9%
China 0.3% Romania 2.4%
Colombia 0.5% Russian Federation 0.3%
Costa Rica 0.3% Saudi Arabia 0.8%
Croatia 0.8% Singapore 1.1%
Cyprus 1.3% Slovakia 0.3%
Czech Republic 0.5% Slovenia 0.3%
Denmark 0.5% South Africa 0.8%
Estonia 0.5% South Korea 0.3%
France 0.5% Spain 3.5%
Georgia 0.3% Sri Lanka 0.3%
Germany 2.4% Sudan 0.5%
Greece 3.5% Switzerland 0.3%
Hong Kong 0.5% Taiwan 0.8%
Hungary 3.5% Thailand 3.8%
India 11.0% Trinidad and Tobago 0.3%
Indonesia 0.8% Turkey 4.3%
Iran 0.5% Ukraine 0.5%
Ireland 0.3% United Arab
Emirates
1.3%
Italy 1.6% United Kingdom 5.1%
Japan 0.5% United States 12.9%
Jordan 0.5% Uzbekistan 0.3%
Kosovo 0.3% Yemen 0.3%
Kuwait 0.3% Yugoslavia 0.3%
Latvia 0.8%
Lithuania 1.3%
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Q6 - What is your organisation’s main business activity?
Answer Options Response
Percent Hospital or clinic 42.7%
Medical tourism agency or facilitator 24.1%
Consultancy (e.g. business or marketing consultancy) 5.0%
Academic institution 3.7%
Medical assistance 3.7%
Government organisation 3.2%
Health spa or medical spa 2.5%
Publisher 2.2%
Education and training provider 2.0%
Industry association 1.7%
Quality and accreditation services 1.7%
Travel agency 1.5%
Hospital development 1.2%
Insurance provider 1.2%
TPA, claims management 0.7%
Airline 0.5%
Conferences and event organiser 0.5%
Hospitality and concierge services 0.5%
Software and technology 0.5%
Tourism board 0.5%
Hotels and accommodation 0.2%
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The international patient market today
Q1 - Which three countries do you think are the leading medical tourism destinations TODAY, in
terms of PATIENT NUMBERS?
This question was weighted: a country ranked as first preference, scored 3 points, a country ranked as
second preference scored 2 points and a country ranked third scored 1 point.
Answer Options Response
Algeria 6
Australia 6
Azerbaijan 6
Bahrain 6
Belgium 17
Brazil 27
Bulgaria 6
China 6
Costa Rica 38
Cyprus 6
Dominican Republic 6
Egypt 15
Germany 78
Hungary 47
India 345
Indonesia 12
Iraq 12
Israel 6
Italy 6
Malaysia 23
Mexico 32
Nigeria 12
Panama 6
Philippines 6
Poland 21
Russian Federation 12
Singapore 44
South Africa 6
South Korea 12
Spain 11
Sweden 6
Switzerland 9
Taiwan 6
Thailand 260
Turkey 62
Ukraine 5
United Arab Emirates 3
United Kingdom 51
United States 135
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Q2 - Which three countries do you think are the leading medical tourism destinations TODAY, in
terms of THE QUALITY AND RANGE OF SERVICES PROVIDED TO INTERNATIONAL PATIENTS?
This question was weighted: a country ranked as first preference, scored 3 points, a country ranked as
second preference scored 2 points and a country ranked third scored 1 point.
Answer Options Response Austria 12
Belgium 18
Belize 6
Brazil 6
China 6
Colombia 18
Costa Rica 30
Croatia 6
Cyprus 12
Denmark 6
Egypt 12
France 6
Germany 152
Greece 6
Hungary 35
India 109
Indonesia 6
Israel 12
Italy 6
Jordan 11
Lithuania 6
Macedonia 6
Malaysia 33
Mexico 29
Panama 6
Philippines 9
Poland 17
Portugal 6
Qatar 6
Romania 6
Singapore 179
Slovakia 6
South Korea 6
Spain 21
Sweden 6
Switzerland 39
Taiwan 5
Thailand 199
Turkey 47
Ukraine 3
United Arab Emirates 15
United Kingdom 26
United States 226
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Factors affecting patient choice
Q3 - What factors do you think are most important to medical tourists when they choose a healthcare
facility in a foreign country?
The charts below shows the rating averages for the various factors for providers and non-providers; a
weighting has been applied to the five ratings that the respondents could choose from: not at all important
(weighting of 1), not important (weighting of 2), neutral (weighting of 3), important (weighting of 4),very
important (weighting of 5) and rating average was calculated from all the responses to that question.
Providers (hospitals, clinics, spas and medical tourism agencies)
Non providers (all other respondents)
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Verbatim responses
Q3 - What factors do you think are most important to medical tourists when they choose a healthcare
facility in a foreign country?
As a quality consultant I am afraid I am cynical about the clinical sophistication of the typical
health traveller. While clinical outcomes data and infection rates SHOULD be very important, the
lack of data and indicator definition consistency and transparency make it very difficult for even
the sophisticated individual to make informed comparisons and decisions.
Granted, what I perceive them sensing or demonstrating as "important" or not is not necessarily
what they actually should be considering important. With that said, I filled this out by what I see
patients actually doing... not what they SHOULD consider important.
#1 and #2. In order for the figures to reflect what's really going on, you must ask the questions
based on where the patients are coming from -- not just on where they are going, Patients on the
European continent make different choices than those on the North American continent.
Visit hospitals to check their performance their services accreditation at the hospital
The patient wants a good and qualitative service, but if the patient can not afford the treatment
then the objective is not being met. So the cost of treatment is the key thing that makes the
patient go for it or not.
To have hospitals and doctors after return to their country would boost the MT industry. Insurance
company participation is very important for the growth.
Over all, its very important to have a confidence and trust and a strong belief when a patient is
traveling to Asian countries for their medical treatments. A good case study and referrals plays an
important role also in popularising the medical tourism destination.
List of genuine medical tourism agents required
Patients are dependent on agencies who arrange destination hospital or clinic and do not have
much involvement in finding about the facts. So whosoever pays the agencies get the business.
Ensure a pleasant experience
Written believe it is necessary to build brand with e-medicine technology and loyalty
Time factor is important
Quantifiable scientific standards for patients to understand are very important because marketing
can be overwhelming and recourse outside of a home nation may be implausible. Having a
"medical liaison" that can help understand a patient's needs, interpret what they will receive, how
they will receive it, and what they can expect as well as assist them once there is necessary to a
good outcome which contributes to overall value.
The "neutral" rated points would be of importance if the patients knew about them or if they could
assess them. But patients a lay persons and cannot evaluate and assess clinical outcome, doctors'
qualification or what is behind an accreditation or certification.
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A patient's decision to travel to another country for medical treatment is often made on multiple
factors. Information obtained through internet often proves crucial
Patients don't know what they don't know... that is why many don't know what to expect and they
go for primarily price and quality
Tourist offer, tourist attractions
With my client's value (i.e. pricing) is high with quality a close second.
Questions 1 & 2 depend greatly on variables such as originating country/language of international
patient, travel/budge profile, et al. Very difficult to assess one country over another in general,
without focusing on the needs of a specific patient, region or demographic.
Cost, quality of treatment, basic amenities, language interpreter services are very important. There
should be a proper legislation for medical tourism and provision of aftercare most probably in the
origin country for the convenience.
A contact or representative in patient's country is most important
Why people seek medical treatment out of their own country? It is very simple answer, because
they want to have better service and quality of treatment to save our loved ones.
Patients always need quick service from authenticated hospital with good assurance
Very different answers for cosmetic surgery and for necessary medical procedures - experience
and cost is most important for the former, expertise for the later
Recent personal experiences has shown me that having an international coordinator who is
available from the moment the patient shows up for treatment to the time they leave by cab or
public transportation - who speaks their language - fluently...not someone who claims to know the
language and assumes a translation that sort of sounds like the word but is not fully understood
by the patient, as might happen in Thailand, but not in Malaysia, where the average local has a
good grip on the English language. I'd say I find communication is the #1 concern. Now that
might not be so for Europeans or Asians who have the capacity to "think" in another language,
which makes one braver...
Treatment not available in home country
Although hospitals often ignore the importance of language access and cultural appropriateness of
treatment, a guarantee language access will be of primary importance in choice of country and
cultural appropriateness will greatly influence patient satisfaction with treatment.
While we believe that clinical outcome data is very important, we don't believe that the medical
tourists understand it and can apply it, therefore from the perspective of the question asked here,
we had to rate it lower.
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The future of the international patient market
Q1 - Over the next five years, what do you think the annual growth rate will be in the international
patient market?
Providers (hospitals, clinics, spas and medical tourism agencies)
Non-Providers (all other respondents)
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Q2 - OVER THE NEXT FIVE YEARS, which of these areas of healthcare will see the greatest increase
in international patient numbers? Select the THREE areas that you believe will experience the most
growth in patient numbers
All respondents
Providers (hospitals, clinics, spas and medical tourism agencies)
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Non Providers (all other respondents)
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Q3 - Which three countries do you think will be the leading medical tourism destinations IN FIVE
YEARS TIME, in terms of INTERNATIONAL PATIENT NUMBERS?
This question was weighted: a country ranked as first preference, scored 3 points, a country ranked as
second preference scored 2 points and a country ranked third scored 1 point.
Answer options Response Answer options Response
Afghanistan 1 Jordan 10
American Samoa 3 Libyan Arab Jamahiriya 2
Argentina 9 Malaysia 75
Armenia 2 Mexico 44
Australia 10 Netherlands Antilles 1
Austria 3 New Zealand 2
Bahamas 3 Panama 6
Bahrain 3 Peru 1
Belgium 9 Philippines 16
Brazil 35 Poland 21
Bulgaria 1 Portugal 1
Canada 7 Puerto Rico 1
China 28 Qatar 3
Colombia 8 Romania 5
Congo 2 Saint Helena 1
Costa Rica 15 Saint Kitts and Nevis 2
Cuba 3 Singapore 77
Cyprus 6 Slovakia 3
Czech Republic 2 South Africa 6
Denmark 3 South Korea 23
Egypt 7 Spain 36
Estonia 1 Sri Lanka 2
France 4 Switzerland 3
Germany 84 Taiwan 10
Greece 9 Thailand 197
Hungary 21 Tunisia 3
India 260 Turkey 116
Indonesia 7 Ukraine 3
Israel 6 United Arab Emirates 18
Italy 4 United Kingdom 30
Japan 1 United States 102
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Q4 - What is your view on trends and changes in the medical tourism market over the next five
years? How likely are these changes to take place?
Providers (hospitals, clinics, spas and medical tourism agencies)
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Non Providers (all other respondents)
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Q4 - What is your view on trends and changes in the medical tourism market over the next five
years? How likely are these changes to take place?
Verbatims
Transparency in hospital and provider complication rates and other statistics will become a
requirement to attract patients.
For the e-health initiatives will depend on infrastructure and available skilled workforce by region
Price, waiting time and perceived quality will dominate decision-making. Those patients who can
pay 'any price' will make decisions on perceived quality of services. Early adopters of emerging
technology, e.g., robotics, nanotechnology, genetics, will draw patients from countries where
regulation, bureaucracy and (medical or) other barriers limit the implementation of innovation.
Third Party Payers and bilateral trade agreements due to gradual extinction of the EU State
Providence and to the EU in economic crisis.
Granted, it is the goal of my organization, the IMTCC, but I see a trend in MT coming into its own
in terms of self-regulation. Trickle down (expecting big govt to step in) is not going to work and
hasn't worked thus far...it's up to the individual players (various types of medical tourism service
providers, docs, mtfs, hotels, etc etc) to come together and play by certain rules and setting our
own higher standards.
Teleconferencing will bring more trust in choosing the consultant / hospital etc
level playing field
Other countries will start to implore the advantages of medical tourism.
Govt are slow to act. India has done a good job creating medical visa, India needs a lot of training
at every level. There is no cultural sensitiveness at many places and this can only improve with
quality education and training.
More and more foreign insurance companies would imbibe medical tourism in its scheme of things.
Airlines and its facilities in bringing the medical tourists. As they need more attention and care
during air travelling and at transit locations. So medical insurance will also play an important role.
1.Significant increase in hospitals pursuing the hospital accreditation that is internationally
recognised in tandem with medical tourist making treatment choices based on quality rather than
price in #4 2.Insurance agencies increasing participation with increase in medical tourists
Mutual collaboration among healthcare provider, insurance and travel agents. Pre & post op care
with smooth and seamless services. Many the patient look for visa and most Embassies fall to give
them. Cost and quality.
The EU cross border legislation & public hospital waiting lists
Global spread of nosocomial diseases as patients do not subscribe to recommended protocols.
Airlines will need to accommodate recovering medical tourists and regulate "patient travellers" or
dedicate rows and cabin areas levying ticket rates for orthopaedic accommodation, O2 tanks, etc.
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Teleradiology and telemedicine (consultations) will increase exponentially
I think that there will be a bigger role for insurance companies and that much bigger medical
tourism companies with stronger marketing influence will enter the market place.
U.S. insurers including a medical tourism option in their offerings.
Marketing and promotion standards in healthcare marketing, facilitator networks and case
management standards, disappearance of provision based patient referral business models
Five years hence, technology-driven cost and quality transparency (a la TripAdvisor, et al) will
allow patients to search, compare and make healthcare decisions/transactions in a way that's
nearly impossible today for most consumers.
Insurance companies will enter the market
Attrition and consolidation among medical tourism facilitators
National governments will simplify visa process for medical tourists.
hope establish an international ethical healthcare organisation (independent and the real non
profit)
Every country will improve their hospital services to deliver many aspects of patient satisfaction
and competition become higher everyday especially in the neighbouring countries such Singapore
and Malaysia.
More focus on the physician surgeon dentists.....who are they?
Consumer advertising of medical tourism in main stream media. Providing chronic care over long
periods and relocation for better and cheaper medical care by US retirees
Outcome of Obamacare in the U.S. and its support for MT.
Competition will increase due to more experiences, Communication platforms and Social media
The European Union may be an exception in that the legal environment may be more regulated.
Merger and consolidation; emergence of branded global health provider networks
A global set of market entry privileging and facility criteria may arise, a truly representative global
roundtable will emerge and replace the medical tourism association's intimidating grip on the
market.
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Q5 - What are the most significant issues facing the medical tourism industry?
All respondents
Answer Options Not at all significant
Not significant
Significant Very
significant
Lack of reliable information for medical tourists regarding quality of services in other countries
0.4% 8.9% 61.9% 28.8%
Lack of an international standard for patient records
1.2% 21.4% 55.3% 22.2%
Lack of patient /consumer demand 6.6% 36.7% 46.1% 10.5%
Lack of controls on advertising and promotion of medical tourism
4.3% 31.4% 48.8% 15.5%
Lack of insurance products for medical tourists 0.8% 15.7% 52.9% 30.6%
Lack of international standards for measuring outcomes
1.6% 22.4% 51.6% 24.4%
Lack of awareness of medical tourism in the source countries
1.6% 18.4% 57.6% 22.4%
Poor image of medical tourism in the media 1.6% 28.1% 47.8% 22.5%
Lack of follow up care in the patient’s home country
0.4% 16.0% 52.0% 31.6%
Lack of regulation of facilitators and agents 0.4% 24.8% 51.6% 23.3%
Poor advertising and promotional practices 0.8% 26.2% 53.9% 19.1%
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Providers (hospitals, clinics, spas and medical tourism agencies)
Answer Options Not at all significant
Not significant
Significant Very
significant
Lack of reliable information for medical tourists regarding quality of services in other countries
0.6% 10.1% 64.3% 25.0%
Lack of an international standard for patient records
1.8% 22.2% 58.1% 18.0%
Lack of patient /consumer demand 6.0% 34.9% 46.4% 12.7%
Lack of controls on advertising and promotion of medical tourism
4.8% 33.3% 48.2% 13.7%
Lack of insurance products for medical tourists 0.6% 17.5% 50.0% 31.9%
Lack of international standards for measuring outcomes
1.2% 26.2% 51.8% 20.7%
Lack of awareness of medical tourism in the source countries
1.2% 16.3% 59.0% 23.5%
Poor image of medical tourism in the media 1.8% 27.0% 48.5% 22.7%
Lack of follow up care in the patient’s home country
0.6% 21.1% 52.4% 25.9%
Lack of regulation of facilitators and agents 0.6% 29.2% 55.4% 14.9%
Poor advertising and promotional practices 0.6% 26.5% 54.2% 18.7%
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A weighting has been applied to the four ratings that the respondents could choose from: not at all
significant (weighting of 1), not significant (weighting of 2), significant (weighting of 3), very significant
(weighting of 4) and the rating average calculated from all responses to that question.
Non Providers (all other respondents)
Answer Options Not at all significant
Not significant
Significant Very
significant
Lack of reliable information for medical tourists regarding quality of services in other countries
0.0% 6.7% 57.3% 36.0%
Lack of an international standard for patient records
0.0% 20.0% 50.0% 30.0%
Lack of patient /consumer demand 7.8% 40.0% 45.6% 6.7%
Lack of controls on advertising and promotion of medical tourism
3.3% 27.8% 50.0% 18.9%
Lack of insurance products for medical tourists
1.1% 12.4% 58.4% 28.1%
Lack of international standards for measuring outcomes
2.2% 15.6% 51.1% 31.1%
Lack of awareness of medical tourism in the source countries
2.2% 22.5% 55.1% 20.2%
Poor image of medical tourism in the media
1.1% 30.0% 46.7% 22.2%
Lack of follow up care in the patient’s home country
0.0% 6.7% 51.1% 42.2%
Lack of regulation of facilitators and agents
0.0% 16.7% 44.4% 38.9%
Poor advertising and promotional practices
1.1% 25.6% 53.3% 20.0%
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A weighting has been applied to the four ratings that the respondents could choose from: not at all
significant (weighting of 1), not significant (weighting of 2), significant (weighting of 3), very significant
(weighting of 4) and the rating average calculated from all responses to that question.
Q6 - What other issues does the medical tourism industry need to address?
Providers (hospitals, clinics, spas and medical tourism agencies)
Unbiased robust data bank of Medical tourist undergone for treatment, doctors, hospital
Need reliable marketing and the insurance covering problems should be solved
Bridge relationship between consultants, hospitals of different countries with referral or source
countries sending patients for treatment abroad.
Lack of benchmarking
How an outside country doctor/organization reach patient of other country regularly
Visas and international migration issues
Culture assimilation, accreditation, Insurance collaboration. A real working model in the industry
which will ease the anxiety of the patients looking for treatment.
Absurd claims by stem cell treatments in India must be banned. They show us in poor light in
world media.
Streamline the process and provide more information about the treatments, facilities and service
providers to the patients.
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Personalised service, packages and care. Pricing.
Government Apathy in some countries which is quite a retard for the Medical Tourism Industry
especially in countries like India. Registration of Medical tourists coming on Medical Visa to India is
quite a pain especially that the Registration Agencies are not so conducive to overall significance of
such a policy.
No idea
You guys are doing good. This survey is quite sufficient in all aspects.
A meeting of minds
Medical Indemnity arrangements for individual practitioners treating international patients
An international Health Tourism feedback site should be created so pt's can look up reviews of
other clients prior to their making a decision - based on the Trip Advisor concept
Increase of price in their country
More and quick communication with the agencies, as well the patients
Standardization of health care, transparency and developing SOPs for measuring outcome in
surgical cases
Accreditation - only one to be used in each country, minimum requirements to be laid out for
facilitators
Slow patient queries processing and account settling with patients - by hospitals.
Search for the doctors/ hospital who can surely give care at International levels
My answers are only applicable for donor semen: More information/translation, more guidance,
more consultancy, more service/help to create contact between patients and sperm banks and to
help/support all the way till the goal, which is purchase of semen, shipping, insemination (home or
at clinic) or travel to the clinic abroad and all practical issues related.
Regularization of prices and getting all the medical tourism destination and the hospitals unset one
umbrella.
Non Providers (all other respondents)
Lack of a responsive/responsible Association for members of the medical tourism and medical
travel industries.
Most new greenfield hospital in ASEAN are investing in JCI accreditation but this alone does not
change the cultural issues on how risk and adverse events are managed and are transparent
Medical mediation services, Consumer protection tools, Transparency in user-generated posted
reviews of providers
Informed choice to the "consumers". Medical tourists need to be advised on the legal
establishment in the country of therapy, (regarding their area of interest)
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Lack of creating accurate awareness to patients before coming for treatment. Lack of detail
information on mode of treatment and cost of treatment beforehand.
Reality and Trusty worthy issues. It can’t be commercial. If it is going too much on commercial
practises then it might affect the quality and right choices.. It need to have ethical principles and
there need to be an international authority or body to control the regularities and issues.. Not a
regulator which certifies the infrastructure, rather a regulator body which looks into the services
part.
1. Participation of insurers that have international coverage and additional items besides medical
costs. These include logistics, accommodation, etc. 2. Uniformity in analysis of outcome data by
the medical tourism association e.g. successful rates by types of hospitals and state/country. This
performance outcome will be the country's benchmark in the future. Insufficient hospitals in the
medical tourism country catering for foreign medical tourist. It is important that the country adopts
a certain acceptable percentage addressing the needs of local patients before deciding to promote
foreign medical patients into the country.
#1 is the inability of patients to get follow up care in the US after returning to the US due to
legitimate liability concerns. US doctors don't like to follow up with other US doctor patients if
there is a perceived or even potential problem. Americans are litigious by nature. Adding a foreign
country to the mix, makes physicians uncomfortable.
If local doctors could communicate better with doctors in other countries (telemedicine consult
would be ideal), perhaps this could improve.
US doctors are suspicious of the quality of care and quality of medical training in our countries.
Sometimes this is founded; most often, it is not. If local, US doctors could develop a relationship
with a particular hospital or set of doctors in a foreign country, even visit the facility, this could
help."
they should try to be getting visa for patients so that inflow will be for them to travel
Entire co-ordination of care and medical-legal aspects of other issues, such as disability issues for a
poor outcome if a patient suffers a catastrophic event during a procedure performed in another
country, repatriation coverage in the event there is some unforeseen event, security issues, How
do you address United States HIPAA constraints on an international level?
The medical tourism "industry" is too small to effectively address the larger issues cited above. It's
up to the market, and the ever-elusive "tipping point" to drive patients to cross borders in pursuit
of quality, affordable care.
The integration between hospital facilities and tourism supports such as easy transportation from
the airport to hospital destination in each country.
Tour operators should not yet accepted medical tourism with top priority. On the other hand,
service providers (like hospital etc.) are not at all serious about promoting and make a tie with
other promoters and operators.
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Incidence of medical complications, emergencies and post operative infections; Focus on regional
niche markets; Negotiated cost benefits/advantages in niche markets
Communication with ease and less expense by phone and Skype to friends and family to stay
connected with people at home; Message points with a clear understanding of benefits; Cross
national or international insurance coverage for a global population of boomers and older adults
that do not see boundaries, as did the past generations, and will travel for medical care, but need
to feel that the medical procedure is fully integrated through records an communication wherever
they live or travel, Failure to promote medical care to ordinary tourists so they are familiar with it
when they actually need care-in other words a disconnection between medical tourism and leisure
tourism. Yet, the veteran leisure tourist is the same market as the medical tourist.
Follow up care in home country is most on patients minds. If you are sick or have medical
condition that needs addressing, why shouldn't any doctor see that patient? I have heard from
doctors in the U.S. or the UK won't see a patient because that patient has seen a doctor in another
country. I hear a big outcry from M.D.'s in both countries saying that they will not see patients
who they know were treated outside of their region. This is ludicrous. What ever happened to the
Hippocratic oath? Whatever happened to the rights of the patient? I see that here in the U.S.,
there is more talk about ""Domestic Tourism"" where the patient makes a deal with a hospital or
doctor in another state - therefore bring his family to Florida, for example for surgery, and be with
his family in America, rather than a foreign country...
As someone who was a pioneer in cultural and linguistic competence in healthcare in the US, I see
the same failure to recognize the importance of clear patient/physician communication and
understanding the patient's culturally bound needs and expectations as there was in the early days
of cultural & linguistic competence in the US & in other diverse countries. Thus far, medical
tourism has concentrated in the marketing and business aspects and ignoring language & services.
Most hospitals in places pursuing medical tourism are similar in their technical and physician
training aspects, what will make the difference in the future of medical tourism will be making the
patient feel confident and comfortable--this requires attention to communication and cultural
issues. While, at the moment they are seen as non-essential "extras" by both facilitators and
hospitals, they ARE BUSINESS ISSUES! Patients will be attracted to countries and hospitals that
market to their values and in language that is culturally appropriate and correct. They will be
satisfied and thus promote hospitals which provide the kind of care that they are culturally
programed to need.
Combining holiday, getting healthy and stay healthy on high standard
Provider and industry collaboration and globally integrated continuity of care, inefficiencies and
leveraging economies of scale through geographically clustered market entrants that still maintain
a competitive and comparative advantage but simultaneously raise the tide for all players.
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Impact of political changes
Q1 - What do you think will be the impact of "ObamaCare" on the number of Americans travelling to
other countries for treatment, EACH YEAR? Obamacare will..
Providers (hospitals, clinics, spas and medical tourism agencies)
Non providers (all other respondents)
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Q1 - What do you think will be the impact of "ObamaCare" on the number of Americans travelling to
other countries for treatment, EACH YEAR? Obamacare will..
Verbatims
I HAVE NO IDEA ABOUT THAT ACTUALLY....
I am not in America so cannot comment
There will be longer waits for procedures and coverage deductibles will increase. Some procedures
may no longer be covered.
No comment
1. ObamaCare has already resulted in the loss of the ""personal doctor"" valued by Americans. For
example, I've lost my primary physician (he quit) due to ObamaCare, and therefore I am now
reduced to being seen by the ""doctor-of-the-day"" for 15 min appointments with a doctor who
knows only my medical chart and has no personal relationship with me. 2. When people start to
experience the ""free tests"" that aren't free with the exchanges, they will more readily shop
across borders for procedures at prices they can budget. For example: 1) Now a colonoscopy is
free only if the test results are not positive. If the test results are positive the patient will incur the
entire cost of the operation. 2) If a patient is seen in a doctor's office for a free exam but is
asked if ""something hurts"", the visit will be recoded and the patient will bear the expense of
what they were told was a free exam.
Especially for those that opt out or want procedures or therapies that are not paid by Obamacare...
alternative treatments included!
Unsure what ObamaCare refers to
In as far as the Insurance policy is not changed, and equal right are giving in terms of treatment
standard. In addition to providing cheap and conducive medical care. People will continue to travel
for medical checkup elsewhere.
I don't know
Depending only on USA patients may not be the best path forward for providers.
Purely depends upon the medical treatments and waiting time at home countries. Health and life is
more important. It may be an important issue for all citizens, but when it comes to life, it is a
decision on individual based and urgency.
If Obama Care aim is to reduce the health care, every citizen should decide where to go to have
medical attention.
No idea
Access will go down (how will the system absorb 40M more patients with same [or fewer] number
of physicians. Costs will continue to go up. Types of treatments patients want are NOT AVAILABLE
in the US, such as stem cell, total body hyperthermia, aphoresis, and a long list of cancer
techniques.
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I have no comments on the American medicare
Don't know what's Obamacare
Increased wait times and hidden costs within health caused by the reduction of services that will
be seen through the Affordable Care Act will make people view "combining reduced fee healthcare
and vacations" as a viable alternative to their high deductible healthcare plans.
I expect we won't see significant effects of ACA on medical tourism until well into 2016 and
beyond. Wheels of change, entrenched attitudes, et al, turn quite slowly in US and int'l
healthcare.
More uninsured Americans will be covered, but already-high costs will continue to rise, and service
levels and waiting times will decline.
Good for American citizen since it will give more protection for their own health insurance in their
own country
Pluralistic approach to attaining health care dependent on financial orientation, ethnicity, need and
timing
Obama care will be a disaster as we will lose the best of the medical profession.
No idea
Overcrowding and long wait. I did do workshop on this issue, if you need a copy email me
Don’t really know about the Obamacare.
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Q2 - What impact do you think the European Directive on Cross Border Healthcare will have on
patient mobility within Europe, EACH YEAR? The EU Directive will...
Providers (hospitals, clinics, spas and medical tourism agencies)
Non providers (all other respondents)
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Q2 - What impact do you think the European Directive on Cross Border Healthcare will have on
patient mobility within Europe, EACH YEAR? The EU Directive will...
Verbatims
For member states that have a social welfare system this will be an issue of cost recovery as most
of the systems do not incorporate robust billing systems
Americans will continue to travel outside the U.S. for services for which their new or existing
insurance will not pay or law/regulation prevents treatment.
I am not familiar with the European Directive on Cross Border Healthcare
Not familiar enough with it to judge
It all boils down to the cost of treatment and quality of service being provided. In as far the two
mentioned are not put in check, patients will continue their basic trips elsewhere to get treated.
The real growth is in south Asian, middle east and African countries. Caribbean countries and USA
will have better and efficient providers with whom Asian providers can not compete.
We think this is on the constant increase as pricing in eastern Europe is less and quality is good. It
provides competition to us here in SA , as we are far away
As stated above
List of genuine and leading medical tourism agents who get dental patients to India required -
please
No idea
I'm not familiar with the specifics of this Directive.
Don't know about this directive
Having the EU Health card enabling them to travel (with permission) to another nation which they
view as higher quality in the service or specialty with which they need to receive care will increase
patient traffic to many areas. There are some countries with a plethora of sub-specialists and a
concerted lack of general practitioners. Although this may facilitate many areas and stimulate
some of the EU economy through "trickle down" in patients stopping to purchase goods or
ancillary services, it may harm overall healthcare in the long run by creating pockets of specialties
and voids or vacuums in areas.
Because insurance companies don´t support this direction. The patients don´t have any
information about
Maximum 2 %
I'm not in a good position to comment intelligently on this query
Depending on implementation and support
Don't know
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I think it’s a positive initiative so that people will have a freedom to find our own better healthcare
When I addressed a delegation at a medical tourism conference the Cross Border was just starting
- makes sense and will work well.
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Other comments
Q1 – Any last comments?
Providers (hospitals, clinics, spas and medical tourism agencies)
Don't reduplicate US model of health care delivery system to other countries specially to
developing one. Don't overestimate importance of international accreditation of hospitals/doctors.
Put emphasis on quality of doctors & other health professionals :- A decent hospital fully equipped
with modern equipments is enough to maximize outcome of procedures/treatments. Strengthen
doctors - patients relationship which will have tremendous +ve impacts on psyche of patients even
for the cases which have gone wrong, thus yielding in higher satisfaction rating from patients. No
more emphasis on comfort, fringe services, pleasure & sight-seeing. Reduce procedures,
formalities & role of middle men to bare minimum. Target , educate regular tourists to specific
country & motivate them to avail the health services
My country and my city must be marketed....this is the biggest problem for our business at the
moment....
No
I hope to attend this events to increase my knowledge
A lot of awareness is needed on what and where patient can avail treatment which is cost effective
best treatment results and patient care.
Kindly guide me how to get international patient in my city agra, india. Lots of foreigners come
here to see taj mahal and other monuments, so how we get patients out of that.please reply.
Please share the results
Thank you for your time and interest
Integrative Medicine involving evidence-based Complementary Medicine ,especially Homeopathic
Medicine is the most promising dynamic for Sponsors.
No
MT focus is needed to improve accreditation and education and training. Develop functional and
efficient models to improve service and efficiency.Bring in the partners (Insurance and hospitals)
to make it a global Industry than a patch work of providers.
Well done for doing this survey. We need some standards and opinions from all in the industry , so
we can all benefit
Thank You
Medical Tourism is an industry per se and not a Fly by Night operation. It involves significant work
and roles and is a work of professionals who understand healthcare markets. Stringent regulations
should be imposed so that entry to this profession is limited and only those who understand
healthcare and patient care would only think of entering.
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Our organization is not big, but we want to grow up and every time we´ll be participating more
and more.
I need the list of genuine medical tourism agents who get dental patients to Bombay (India).
No for now
Good luck
I will play a definite lead role in steering MT in Gujarat
Thank you.
At the moment, my impression that nearly all the international patients we see depend on personal
contacts with embassies and other government agencies. There seems to be little availability of
independent quality-based advice for individual patients.
Thank you for asking and sharing!
Do I get a copy of all the answers I gave?
We are Sri Lankan dental care providers giving high standards dental care help us to promote our
hospital internationally. www.sakukidentalhospital.com
My country Kosovo is making initial steps towards Medical Tourism and I would be glad to give my
contribution towards this goal. By the way, Kosovo is a beautiful country with acceptable level of
security, taking into the consideration that some areas are considered less secure.
Be honest in sharing final outcome our survey at various places. i.e. it should not be commercially
industrial driven for individual benefits but trying to help globally & honestly
I would like to attend and participate in your team if you need someone from Turkey. Thank.
Keith, thank you for this work!
Good luck
Please do send us a copy of the result of the survey. Update us in all possible ways so that we may
partner to make the medical tourism industry well regulated, with ethical guidelines incorporated
and make the Medical tourism industry grow. Try and focus with all the countries across the globe
and not just US centric. Make it a Global forum
Thanks for doing this on behalf of the industry. One suggestion: allow a "don't know" or "not
applicable" response to many of these questions, rather than forcing an answer.
No
Thank you IMTJ for your work and care about med.tourism!
The all facilities or facilitator related in medical tourism should look at the patient from outside
ethically, not just to make money. This is a kind of business but first we couldn't forget to be think
of the people to get healthcare services best in true price tariff.
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Making Medical Tourism Industry up to standardize with measurable result will be most significant
factor.
It is too early for us to answer some of the questions of the survey. We are at the very beginning
and trying to learn with others that have a longer experience. Congratulations for the initiative, it is
very interesting!
Please understand that sperm banking is a little different than other border crossing activities as
the sperm is the "traveller" more than the patients. However, both is a kind of traveller. The
phenomenon is more wide spread in Europe, as there are many different legislations and only very
few sperm banks that can find out to manage more than one country. The EU directive have
"killed" a lot of small sperm banks. The national legislation in different countries have made it
almost everywhere impossible to run a sperm bank.
All the best and hope my feedback is a value addition.
Thanks for your work to get some reliable data for this industry!
Non providers (all other respondents)
I have been involved in this field (international medical care) as a participant and observer since
the late 1990's as a member of the first class of Joint Commission International surveyors and
subsequently establishing my own consultancy comprised of former Joint Commission surveyors.
The same technological forces that allowed me to successfully market to international clients now
allows patients and providers from different parts of the world to successfully reach each other. As
with any emerging market there will be huge success stories and stories of terrible abuses. Over
time the extremes will moderate toward the center. There will always be uncertainty in medical
decision-making irrespective of evidence-based medicine as the human (patient and provider) are
not standard. Both are flawed. Overall, the emergence of "medical tourism" (or health travellers)
is a boon to both the patients in the source countries and the providers (healthcare personal and
facilities) in the destination countries. Both will benefit in the aggregate. I am pleased that my
colleagues and I have played a small part in this process.
Someone should start the discussion of a UNWTO corresponding Organization for MT, with one set
of standards for Medical Tourism and governmental policy coordination between source and
destination countries or at a macro regional level.
Africa is one of the largest sources of medical tourist, and Nigeria being my country has been a
major contributor to this. It is important that medical tourism is giving more consideration in
African nations either by encouraging it or making it a hub by building good medical facilities to
attract outsiders and providing good professionals to handle health sector in the continent. Thank
you. Engr. Bilyaminu Ibrahim Gusau. Facilitator of NOVA Speciality Surgery India.
Please keep me informed about any conferences related to this subject. Thank you.
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Great Job. Keep on bringing the newer innovations on medical tourism through media and
journals. Keep promoting the Medical travel events in the medical booming destinations. This way
it can be pre market survey and preparedness for Medical Travel Customers. Bring more
awareness on medical travel promoters or agencies, Certify these agencies and issue renewing
licensing certification programs by looking at the number of successful patients history.
I totally agree that medical tourists mean where a patient travels specifically for the purpose of
treatment in another country. They are not expatriate resident or business or holiday traveller
who fall ill in a country.
Some healthcare provider or some country quoted a big number of medical tourists that include
accident or non-elective treatment from all holiday traveller, expatriate and resident into their
records."
I work for a Fortune 250 company with 60,000 employees in 40 countries. We are looking for local
care for our employees, particularly integrative/holistic medical care. I am responsible for building
a network of integrative oncology locations worldwide. I would like to be more involved with
Medical Tourism. I spoke at your meeting several years ago and was very warmly accepted.
The fact is that medical tourism is a help worldwide due to specialisation.
Am available for more than once to participate on international platform
As a big player in this industry I sincerely feel there are great growth potentials in the industry.
It is very important to make available adequate information and details about medical tourism
across the world. This helps in the decision making of tourist and in fact a deciding factor on which
country to go.
Medical tourism have a future, and countries having natural resources (climate, thermal water...)
and qualified personnel (physicians etc.) with an efficient organization seem to benefit from this
sector.
Good luck
Although we deal mostly with business travellers, we try to prepare all of our clients in a holistic
sense. Preparing their trips requiring an entire awareness of all risks from culture to security and
health. Concerns over current epidemics, security alerts, worker strikes, or environment need to be
relayed and medical tourists also should be prepared in a similar sense. It concerns me that many
may be swayed by nice photos of clinics unaware that the electric grid in the area may not
function half the time or that the water supply is not filtered to the facility.....The physicians may
have degress, but how about the nurses? Respiratory? Food service HACCP? These issues matter
for complete recovery.
No , thx
No
We know medical tourism is not in organised of so I request to all industry experts they should
think about organisation and management of medical tourism
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I am research scholar in medical tourism on the topic "development of sustainable indicators for
medical tourism development" in Kerala, India with special reference to modern medicine. Please
help me in this work by providing data.
The most important for hospital is to create a loyalty patient and the only one way is - the patient's
personal experience.
Many countries, like Bangladesh can enter into the medical tourism industry with their existing
resources. So, it is very important to develop an equal opportunity pattern to develop the market
more big, participatory and win-win.
I believe that the US baby boomer is a prime market for medical tourism and will also be more so
as we age. My expertise is in marketing to and researching that cohort, and I see it coming as less
high quality medicine will be practiced in the US, and we see that other countries as innovative. I
personally have had several of my doctors build or be part of off shore medical facilities. Medical
tourism will also be fuelled by boomers acceptance of and familiarity with alternative medicine
(Chinese, Aruvedic, etc) that has been practiced in other countries far longer than in the US.
Thanks for asking!
My belief is that medical Tourism Travel does exist due to two matters: 1. Lack of service and
quality in home medical care System. Brings People traveling to Advanced countries because of
Image and experiences of Friends, Families etc. 2. Price: People decide to consume standard
health care services because it is cheaper than in home country (e. g. Dentist).
[email protected]. Tenured Professor of International Health.
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About your services for international patients
Q1 - What healthcare and medical services does your hospital, clinic, agency or organisation provide
for international patients and medical tourists?
Additional answers given by respondents
Oral surgery; implantology
Neurorehabilitation (spinal cord injury, brain injury and other major disabilities of a neurological
origin)
Laboratory, radiology, er, mammography, ward, icu/iccu, maternity unit, operating theatre,
nicu/picu, intermediate room, internist, plastic surgery, minimal invasive surgery
Interventional cardiology and radiology, vascular surgery
Rehabilitation in balneology medical centers
Integrative medicine-homeopathy for chronic diseases
Physio therapy
Bmt, liver transplant, pet ct, spect gamma camera,
Otolaryngology, alergology diagnosis, treatment
Pediatric, internal medicine, psychology, hemodialysis, rehabilitation
Clinical laboratory
Naturopathy & ayurveda
And physical rehabilitation
Rehabilitation inclusive of audiology, dietetic, physiotherapy, speech-language therapy, auditory
verbal therapy, psychology, neurofeedback therapy, occupational therapy
Acupunture
Medical services while in the country
Knee implant
Ayurveda and alternative medicines.
Anti-ageing and hormone-balancing
Anxiety, depression and trauma
Ccsvi liberation for the treatment of ms & hair transplants
Care for people with special mental needs, rehabilitation, long-term nursing, sleep-treatment,
medical on-call service helpline solution
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Psychiatric care. Not in a regular basis
Our center provides services as screening the operation 's level of kidneys; hemodialysis and on-
line hemodiafiltration
Hemodyalisis, thoracic surgery, neurology, stroke unit. Chest pain unit, bone marrow
transplantation, rheumatology, endocrinilogy and diabetes, internal medicine, physical medicine
and rehabilitation, endoscopy suite, icu (adults and pediatric)
All surgeries and medical treatments
Gynaecological laparoscopy & hysteroscopy training
Onco
Information
Plastic surgery, aesthetic medicine, spa
Facilitation
Sex reassignment surgery
Many others, e.g., pediatrics, endocrinology/diabetes, physical therapy, etc.
Interventional radiology
Medical rehabilitation
All medical services suggested by our partner-hospital
Preventive health promotion
Pet ct, gamma knife
Ayurvedic
Oculoplastic surgery and general ophthalmology
Foot and ankle and sports medicine
Rehabilitation, traditional balneo therapies for mobility disorders
Donor semen
Behavioural health
Pulmonology, dialysis, high risk pregnancies, pediatrics
Medical assistance and advise
Stem cells treatment
All of the above and more.
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Q2 - What support services does your hospital, clinic, agency or organisation provide for
international patients and medical tourists?
Additional answers given by respondents
Arrangement for their hotel accommodations and tours
Cost estimates, appointment scheduling, info on local resources
We send them abroad but we do all the arrangements from a-z
Arrangement of accommodation. Parking place
24 hours alarm center services; home visit/home care services; evacuation/repatriation
arrangements; insurance coverage process; medical check up (including travelling package in Bali)
Daily visits by allocated customer service. Nurse visit after discharge, transportation to and from
hospital for pre and post surgery. Massage
Pastoral services
Travel and complication insurance, discount plans for consultation in the United States for US
residents, discount card for medications and diagnostics in the us.
Personal manager. Helping with arrival documents and organizational issues for foreign (non EU)
patients. Meeting and accompanying patients on arrival in Lithuania. Transport services - car and
driver. In special cases, providing air or ground ambulance for pick-up, accompanied by the
resuscitation team. Searching and booking a rehabilitation clinic after treatment. Organising and
booking various tourist tours for our patients
Tourism service packages
Sightseeing and excursions
Skype consultation
Transportation, tourism
Tour guide
Arranging of foreign exchange, visa extension, visa invitation letters,
Support throughout the process ad tailor made package that includes medical treatment, nursing ,
accommodation, hospitality and transfers.
Arrangement of extension visa, email consultation, concierge services
Clinical laboratory testing
Emergency evacuation services
Touristic activities (guided city tours etc.)
Forex assistance,
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Pre-arrival consultation appointments; special arrival services (fast-track); transportation
English speaking only
Golf (playing with pros, green fees, classes and clinics ) European nursing services, most
languages.
Pt visited in her hotel room post discharge by hospital nurse
Due to the language skill of the doctors, interpreter services are usually not necessary
Selection of clinic
UK coordination, medical monitoring and support
Other custom services such as shopping, a night out, dinner at selected restaurants etc
They have an English speaking medical host who meets them for all of their appointments while
they are here and access to a nursing team.
Drop to airport
Publication
Tourism plans - packages
Health guidance, medical consultation
Free welcome pack, free consultation & examination, arranging of sightseeing tours
Patient recovery resort medical travel insurance
Accompanying patient in trip, arrangement of post-care of patient, opd / cme / conferences
conducting, etc.
Emergency health insurance
In house nurse available 24hrs during their stay in apartments. Case manager to answer all
questions before they leave and after they return. Doctor evaluation (based on photos) before
they leave their country. Doctor liaison. Doctor profiles supplied. Detailed hospital information
Contact to embassy. Visa extension for long term treatment. Vegetarian food & hala food church.
Arrange local tours
Skype and viber conferences
Airport transfer
Pre check up in the country of origin
We ship donor semen world wide. We have no clinical treatment.
Concierge services
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Interpreter services are not needed as we take English speaking patients and have English
speaking staff in attendance
Case Management Services
Other services upon request
Q3 - What information do you provide to international patients and medical tourists:
Answer Options Never Sometimes Most of the
time Always
A printed and personalised treatment plan. 4.1% 7.9% 15.8% 72.2%
A detailed profile of the surgeon or doctor. 3.4% 13.5% 19.8% 63.3%
Information on the risks of the treatment 2.1% 7.5% 15.9% 74.5%
Information on hospital or clinic infection
rates. 16.3% 21.6% 19.4% 42.7%
Information on clinical outcomes for the
hospital or clinic. 10.9% 17.0% 26.2% 45.9%
Information on clinical outcomes for the
specific surgeon or doctor. 16.5% 20.5% 20.1% 42.9%
A patient satisfaction survey at the end of
their treatment. 6.0% 14.9% 14.9% 64.3%
Additional answers given by respondents
Travel arrangements
Daily medical report; temporary billing; insurance progress; estimation costs; hospital facilities;
hospital services
The 'never' questions information is on the website
All the information related to logistics and travelling
All information required is included at the website of my practice
Package with all the details - includes & excludes, care to be taken on reaching their home
country, follow up tests to be done & send the results for review by the specialist,
Approximate stay in and out of the hospital
Personalised service for tour travel, hotel accommodation
Success rates
Electronic personal medical data (e-mail, cd, flash drive)
We offer live video during surgery to patient's relative during gynaecological laparoscopy &
hysteroscopy surgery
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Any information that patient deems important to make an informed decision about his/ her case
Information on the surgery and recovery
Cost estimates before treatment
24 hour nurse post-operative care
We don’t do any official survey on patient satisfaction although see to it that patients are satisfied
with personalized touch and efficient care considering patients leave problems into account etc.
Several options with hospitals in personalized treatment plan
Alternative healthcare facilities reports before treatment
Treatment plan - yes, printed - no (emailed)
Outcomes data on website
If asked for most of the questions
Q4 - For which languages do your provide interpreters?
Additional answers given by respondents
Interpreters are available in all languages
Russian, Moldovan, Romanian, Albanian, Macedonian
Catalan
Our teams speak fluent English. Most location also have staff that speaks other languages.
Interpreters for other languages can be available on request,
Norwegian, Danish
Malaysian
Amharic
Lithuanian
Norwegian. The rest can be organized for extra surcharge.
Consultations are held for English-speaking patients or persons accompanying them
Swahili
Latvian
Bhutanese, Cambodian, Myanmar
Hungarian
All languages on request of patients preferred language
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Indonesian language
Gujrati
Interpreters are available for any language.
We have a comprehensive "all language" interpreting service on telephone but face to face
interpreters must be booked separately
Norwegian
Norwegian
Malay, Indonesian
Albanian, Serbian, Bosnian, Croatian
with an advanced notice we can outsource qualified interpreters
Urdu
Norwegian
Swahali
Norwegian, French
Burmese, Cambodian, Vietnamese, Mongolian, Amharic (Ethiopia)
Romanian, Albanian, Bulgarian, Serbian,
Uzbek, Kazakh, Ukrainian.
Myanmar. Cambodia. Laos
Ukranian, Romanian
As requested
Almost any language
Bulgarian
Hungarian
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Your medical tourism business
Q5 - To what extent do these INTERNAL factors restrict your ability to grow your international patient
business?
Additional answers given by respondents
Political situation of Iran
Government regulations
Obtaining visa
Not yet a well targeted contact with sponsors and decision makers
Government regulations for medical advertising in Malaysia
Hospitals now have their own wings to facilitate international patients has surely affected our
business.
We just began to work steam cells and after tramits and studies.
We are mostly dealing with local patients and sending them abroad.
As little knowledge of Internet marketing and restricted budget
Difficulty in finding good local staff.
Had been running a centre in partnership earlier and have restarted from scratch after over
15years of partnership & ownership without getting any financial return from my original venture.
Internal limitations (mostly ethical) on the number of foreign patients we could possibly admit due
the current situation of the waiting lists for transplantation.
The donor countries are cutting their budgets and going to the third world
High cost of medical care in US
Q6 - To what extent do these EXTERNAL factors restrict your ability to grow your international
patient business?
Additional answers given by respondents
A trusted third party (Press Ganey, JCI, etc) to display international v American hospital quality
statistics side-by-side in the public domain
Visa procedure is not easy for Belgium
I do private patients its increasing everyday
MHTC are over coming this
South Africa is a Long Haul destination. Expensive flight and long flights to get here.
Hungary so far focused only on dentistry and thermal water, very small governmental effort to
promote other fields of medical tourism.
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No support at all from Local or National Government
Lack of a good medical travel insurance cover and protection if complications when patient arrives
home
Recent laws on surrogacy and nationality issues have cropped up for babies born in our country
not getting citizenship in some countries.
Slow query examination in some hospitals, long period for medical visa processing in embassies.
Cost of care, language, distance, drug lag, device lag.
Lack of preparedness for 'outreach' to target markets by the service providers
The government supports only big health factories!!
If tourism is not marketed for our state it will be a major impact as patients will know very less
about our city.
Q7 -Would you be happy to provide basic information about your medical tourism activities (patient
numbers, types of treatment given etc.) to improve the information about medical tourism in your
country and worldwide?
Verbatims
We would want to be able to get comparable benchmarking data, ie related to other pediatric
providers
due to currently unclear country government policy towards medical tourism
Thanks.
Any information that may help all involved in medical tourism I am involved in this business for last
37 years sending patients around the world.
Willing to do and appreciate it if able to provide feedback results in return for contribution
Will consider in exchange for some advertising on IMJT
No yet is the precise answer
We don't have updated information in Brazil...
MT needs to organised and needs to be working with hospitals in US for post op care and partner
with insurance companies for future growth. Regulation, certification and seamless process to
future in MT is a must.
Let us know how we can associate with IMTJ to improve and support this problem.
We dedicate ourselves to promote a professional secure environment, looking forward and
embracing challenges while maintaining sustainable growth according to 'Global Best Practices.
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We are under stringent NDA's with Hospitals and Service providers which restricts divulgence of
any information.
Only General Information, not details on Patients or processes on them.
Unsure
We have had patients from more than 20 countries and all have been 100% satisfied for many
good reasons like latest treatment procedures, no price fluctuation for foreigners and ethical
practice.
They might be willing in the future but at the moment there are many developing factors and
uncertainties
Data is sensitive part, we all know the average flow of international patient to particular country /
city to diagnose or assist to grow further.
Willing to join International Network of Medical Tourism Market
As long as any information given is confidential and will not be passed to third parties.
Since I have just restarted my centre the data is very limited and have faced umpteen problems
living in a country where bribe prospers so just started growing up so data is very inadequate.
Basic information will be provided according decision our Legal Department
We are currently starting the business in Portugal. We do not have information to share yet. We
will be happy to provide it next year!
Having the information is one thing, making it verifiable will make numbers credible
No
There is a cooperative effort in the US undertaken by the US International Cooperative in Chicago.
I am sure they would share their data.
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Marketing to medical tourists
Q5 - Which publications and web sites are the most effective in marketing your medical tourism
services?
Additional answers given by respondents
allexperts.com
Antalya Health
Arab countries newspapers
athens.angloinfo.com
BKPA Review (BKPA)
chat areas about health solutions
clinic finder
Deik
dental departures
dentalworld.com.ph
direct comments from patients
directories
e-newspapers and magazines
euromedicaltours.com
fertility.treatmentabroad.com
flyer and brochure
Forums
globaldialysis.com
google organic
healthinTurkey
hospitalmedicmar.com
imer.at
IMTJ
International publications and web sites
intmedtourism.com
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isaps.org
ivfeurope.eu
just dial services
Kidney Life (NKF)
listing directories
local mostly
magazines
masqsalud.com
med. directories
medbeaver.co.uk
MEDEGUIDE
media such as newspaper and TV news
medical magazines
Medical Tourism Association
medical tourism conferences
Medical Tourism Facilitators Websites
medical tourism magazine
medical tourism websites
medicaltourismdatabase.com
medvoyage.info
mls-dentalcosmetics.com
News paper ads n flyers conference and events
newspapers
online magazines
online marketing and multimedia PR activities
online media
osteomyelitis.at
placidway.com
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plasticsurgeryforum.com.au
plasticsurgeryindia.net
Popular sites in India and some of the travel magazines
private healthcare
rightchoiceuk.com
the dedicated ones
web
web sites of local hospitals
website
yourdentistryguide.com
Any that is authentic and has international reach and is also at the same time very cost effective.
I need information about how to contact the right medical tourism agencies who would get us
international patients for dental treatment
It is country specific. Local publications and websites of the target country are more effective.
Still searching for effective sites
UK doesn’t work like this. Patients are sponsored so push is to Governments not individuals
We operate directly with brokers
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14. Appendix: Email invitation
Email invitation
The following email invitation was sent to the participants:
Subject: The Medical Tourism Climate Survey 2013
Funded and operated by International Medical Travel Journal (www.imtj.com), the annual Medical Tourism
Climate Survey provides insight into the current state of the medical tourism market and the issues and
challenges for the future of the industry.
We want you to provide your input. Whether you run a hospital, a clinic or a medical tourism agency, or
whether you provide services into the medical tourism sector, your views are important. As a reward for
your participation, you will receive a PDF copy of the final report.
The survey must be completed online by Friday 8th March 2013. It will only take 5-10 minutes of your time.
• Complete the medical tourism climate survey:
https://www.surveymonkey.com/s.aspx?sm=lbC6uvqHnbb6GWhdShWhGw_3d_3d
The results of this year’s survey will be published on 22nd March at the International Medical Travel
Exhibition and Congress in Monaco.
FILL THE VOID!
The survey will help to fill the vacuum of information in the marketplace and will provide some real data on
which hospitals, clinics and businesses can make decisions about the future. The more people who
participate, the more valuable will be the results.
• Complete the medical tourism climate survey:
https://www.surveymonkey.com/s.aspx?sm=lbC6uvqHnbb6GWhdShWhGw_3d_3d
CONFIDENTIALITY
Your answers will be kept confidential, and the compiled report will not identify the answers given by
individuals or organisations. The data will be collated by an independent external market researcher on
behalf of International Medical Travel Journal.
• Complete the medical tourism climate survey:
https://www.surveymonkey.com/s.aspx?sm=lbC6uvqHnbb6GWhdShWhGw_3d_3d
If you want to know more about the Medical Tourism Climate Survey 2013, contact IMTJ -
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15. About Intuition Communication
INTUITION COMMUNICATION is a specialist publisher of consumer and business-to-business information
on private healthcare and medical tourism. It has three areas of activity within medical tourism:
INTUITION INTELLIGENCE provides independent research and data on the private healthcare
and medical tourism markets. We publish surveys and reports, and undertake bespoke research
projects. Our services include original research into patient needs and behaviour; benchmarking of
competitors; market forecasting and trends; and best practice guides. Our reports include: The
Medical Tourism Climate Survey, The Treatment Abroad Medical Tourism Survey, The Medical
Tourism Facts and Figures Report.
INTUITION MEDIA operates consumer-facing health and medical tourism online portals
providing information for patients about treatments, destinations and healthcare providers. Around
500,000 patients visit our sites each month seeking information to support their healthcare
choices. Our medical tourism sites include Treatment Abroad, Fertility Treatment Abroad, Medical
Tourism Reviews, and DoctorInternet, an Arabic medical tourism portal. We also operate inbound
medical tourism portals such as: HealthCzech, Treatment in Turkey, Treatment in Spain,
Treatment in Hungary, and Treatment in Cyprus. And in the B2B sector, we publish International
Medical Travel Journal.
INTUITION SOLUTIONS is our customer publishing and content marketing service for
healthcare providers and destinations. We provide tailored content and publishing solutions –
online, in print, and face to face. This ranges from website and mobile app builds and branding, to
destination guides, magazines, video and digital content creation, and live events.
Who to contact
For further information about Intuition Communication, International Medical Travel Journal, and the Medical
Tourism Climate Survey:
Call: Keith Pollard
on +44 (0)1442 817817
or mobile 07710 229102
Web: www.imtj.com
Email [email protected]
Write: Intuition Communication Ltd
3 Churchgates
Wilderness
Berkhamsted
Herts HP4 2UB
Fax: 01442 817818