Medical Tourism
Content
EMERGING BUSINESS OPPORTUNITIES & CHALLENGES (DD no.002016, date: 12/3/2013)
Special focus on "Healthcare"
22nd and 23rd March 2013
Medical Tourism in Bangalore: Scope and Challenges Author: Dr. Sneha Mankikar Assistant professor – MBA Krupanidhi School of Management, #12/1, Chikkabellandur, Carmelaram Post, Varthur Hobli, Bangalore – 560035 Ph. No.: 9845664105 E-mail: [email protected] Abstract Medical tourism is commonly perceived and popularly depicted as an economic issue, both at the system and individual levels. The decision to engage in medical tourism, however, is more complex, driven by patients‘ unmet need, the nature of services sought and the manner by which treatment is accessed. Leisure has seized to be the sole reason for tourist activity, and the competitive world of business is looking to combine business with pleasure, giving birth to the concept of medical tourism. In order to beneficially employ the opportunities medical tourism offers, and address and contain possible threats and harms, an informed decision is crucial. Accordingly, it comments on the imperative of access to health information and the current regulatory environment which impact on this increasingly popular and complex form of accessing and providing medical care.
Medical tourism, medical travel, health tourism or global health care is rapidly-growing practice of traveling across international borders to obtain health care. Medical tourism can be defined as provision of 'cost effective' personal health care/ private medical care in association with the tourism industry for patients needing surgical healthcare and other forms of dedicated & specialized treatment. This paper aims to enhance the current knowledge on medical tourism by isolating the focal content of the decisions that patients make. Based on the existing literature, it reflects scope and challenges in opting for or against medical care, and engaging in medical tourism, including considerations of the required treatments, location of treatment, and quality and safety issues attendant to seeking care. This paper examines the introduction, origin of medical tourism, some facts about medical tourism in India, core competencies, opportunities, challenges medical packages and future of medical tourism in Bangalore
Keywords: Health tourism, medical tourism, medical packages, tourism industry, Bangalore,
Introduction Medical tourism (also called medical travel, health tourism or global health care) is a term
initially coined by travel agencies and the mass media to describe the rapidly-growing practice of traveling across international borders to obtain health care. Medical tourism can be defined as provision of 'cost effective' personal health care/ private medical care in association with the tourism industry for patients needing surgical healthcare and other forms of dedicated & specialized treatment. Medical tourism is an emerging concept. Governments all over the globe are highly concerned about their ability to meet their social obligations in the health sector. They are highlighting it as ‗International standard healthcare services at affordable prices.‘ Medical or Health treatment package tourism is a recurrent form of vacationing, and covers a broad range of medical services. It mingles free time, leisure, fun relaxation, amusement and recreation together with wellness and healthcare packages. At the same time tourists are able to receive an orientation that will help them to improve their life in terms of their health and general well being. It is like rejuvenation and cleans up process on all levels - physical, mental and emotional. Medical or health tourism is among the fastest growing industries in the world. The major forces driving growth of this emerging industry include the rising cost of healthcare and limiting scope of insurance coverage in developed countries, increasing waiting time for treatments, and low cost of treatments elsewhere.
The concept of medical tourism is not a new one. The first recorded instance of medical tourism dates back thousands of years to when Greek pilgrims traveled from all over the Mediterranean to the small territory in the Saronic Gulf called Epidauria. This territory was the sanctuary of the healing god Asklepios. Epidauria became the original travel destination for medical tourism. Our Indian system of medicine like Ayurveda and Unani system of medicine for the same cause were very famous and peoples from different countries come for their treatment and healings. In Roman Britain, patients took the waters at a shrine at Bath, a practice that continued for 2,000 years. From the 18th century wealthy Europeans traveled to spas from Germany to the Nile. At first, mere traveling was considered to be a good therapy for mental and physical well being. Spa towns and sanitariums may be considered an early form of medical tourism. In eighteenth century England, for example, patients visited spas because they were places with supposedly health-giving mineral waters, treating diseases from gout to liver disorders and bronchitis.
In the 21st century, relatively low-cost jet travel has taken the industry beyond the wealthy and desperate. Later, mostly wealthy people began traveling to tourist destinations like the Swiss lakes, the Alps and special tuberculosis sanatoriums, where professional and often specialized medical care was offered. In this century, however, medical tourism expanded to a much larger scale. Thailand, followed by India, Puerto-Rico, Argentina, Cuba and others quickly became the most popular destinations for medical tourists. Complicated surgeries and dental works, kidney dialysis, organ transplantation and sex changes, topped the list of the most popular procedures. People from many advanced countries, including the United Sates and Europe, see a benefit in traveling to developing third world countries, like India, Thailand, Philippines, South Africa, and etc. while combining medical treatments with inexpensive vacation. This trend is now known as medical tourism.
The three major medical tourism hubs in the world are Singapore, India and Thailand. Indian tourism industry is experiencing a strong period of growth, driven by the burgeoning Indian middle class, growth in high spending foreign tourists, and coordinated government campaigns to promote ‗Incredible India‘. Medical tourism is perceived as one of the finest growing segments in marketing ‗Destination India‘ today. India is on threshold of a healthcare revolution and emerging as the destination for medical tourist. Healthcare industry accounted for 5.1 per cent of the country‘s GDP in 2006. • Private healthcare to form a large share of the healthcare spend, and would increase to US$ 33.6 billion in 2010 from US$ 14.8 billion in 2002. • Expected to generate employment opportunities for nine million people by 2012. • India offers easy access to visa facilities for overseas patients along with best emerging medical infrastructure in large and tertiary towns. This shall generate earnings of about US$ 19.5 billion in foreign exchange by 2012.
• The market is estimated to touch US$ 77 billion by 2013 at a CAGR of 15 %. • Share of private expenditure as a percentage of total expenditure on healthcare has grown from 60 per cent to nearly 80 per cent over the last decade. • With an annual growth rate of 30 per cent, India is already inching closer to Singapore and Thailand, which are established medical care hubs that attract millions of medical tourists a year. • India excels in providing quality and cheap health care services to overseas tourists. The field has such lucrative potential that it can become a $2.3 billion business by 2012, states a study by Confederation of Indian Industry (CII). In 2004, some 150,000 foreigners visited India for treatment, and the numbers have been rising by 15 per cent each year. Bangalore as medical tourism destination Medical tourism is gaining popularity in India & is recognized as a hot medical hub or global health destination at present because foreign tourists travel India in search of low-cost & worldclass medical treatment. India is also capitalising on it low-cost and world class medical expertise to appeal these ‗medical tourists.‘ India is promoting the "high-tech healing" of its private healthcare sector as a tourist attraction. In short, Medical Tourism in India = World Class Treatment + Holiday + Big Savings. India has been the most attractive destination for the visitors around the globe. India is a perfect destination for medical tourism that combines health treatment with visits to some of the most alluring and awe-inspiring places of the world. This is not only due to the heritage attraction of the country but the medical tourism India which has depicted a steady southward movement, of late. People rush India for 5 Reasons– price, service, quality, availability (cutting edge treatments) & tourism. India is in the process of becoming the "Global Health Destination" owing to the following advantages: • Reduced costs/Economical and affordable pricing - The key ‗selling point‘ of Indian healthcare
tourism is its ―cost effectiveness.‖ Price advantage is a major selling point. The slogan, thus is, "first world treatment at third world prices". The cost differential across the board is huge- only a tenth and sometimes even a sixteenth of the cost in the west. Most estimates claim treatment costs in India start at around a tenth of the price of comparable treatment in America or Britain. The cost of medical services in India is almost 30% lower to that in Western countries and the cheapest in South-east Asia. • Availability of latest medical technologies -The most popular treatments sought in India by medical tourists are alternative medicine, bone-marrow transplant, cardiac bypass surgery, eye surgery and orthopedic surgery. India is known in particular for heart surgery, hip resurfacing and other areas of advanced medicine. All these medical treatments and investigations are done by using the latest, technologically advanced diagnostic equipments. India has a provision and practice of alternative traditional medicine like ayurveda, pranic healing, aromatherapy, music therapy, meditation and yoga. Many people from the advanced countries come to India for the upgrading promised by yoga and Ayurvedic massage. A nice blend of top-class medical expertise at attractive prices is helping a rising number of Indian corporate hospitals attract foreign patients, including from developed nations as they have accepted ayurveda as a medical system and have expressed interest in the ayurveda curriculum and research. India is fast emerging as a global medical health care destination because of its world class medical facilities which are manned by highly qualified doctors and paramedics. Almost all Indian Hospitals servicing Medical Tourists are accredited either by Joint Commission International (JCI) or National Board for Accreditation of Hospitals and Heath Care and follow International safety standards. India remains a safe and preferred medical tourism destination. • Growing compliance on international quality standards/High quality world class medical care / Use of world class implants and consumables-India‘s private hospitals have gained international recognition for their state-of-art facilities and diagnostic centers. India is competing with Thailand, Singapore and some other Asian countries, which have good hospitals, salubrious climate and tourist destinations. • Zero waits times for surgeries - is a big draw for foreign patients also the very minimal or hardly any waitlist as is common in European or American hospitals. In fact,
priority treatment is provided today in Indian hospitals. High eminence expertise of medical professionals, backed by the fast improving tools/ equipments and nursing amenities-India has got the specialist in around the world and also has the world eminent doctors & hospitals where all the services are provided to the patients. Indian hospitals excel in cardiology and cardiothoracic surgery, joint replacements, transplants, cosmetic treatments, dental care, orthopedic surgery and more. • Fluent English speaking hospital staff /foreigners are not likely to face a language barrier in India-Language is a major comfort factor that invites so many foreign tourists to visit India for medical and health tourism. India has a large populace of good English speaking doctors, guides and medical staff. This makes it easier for foreigners to relate well to Indian doctors, • Foreign patients can get package deals including flights, transfers, hotels, treatment & postoperative vacation for their visits. • Customised medical packages-Medical tourism can easily be combined with a holiday/business trip, & • The Indian government is taking steps to address infrastructure issues that hinder the country's growth in medical tourism. The GoI has declared that treating foreign patients is legal. It is encouraging medical tourism by offering tax breaks and export incentives to practicing hospitals. • The Ministry of Tourism (MOT), Government of India has further enhanced the Mvisa and MXvisa (Medical Visa) by extending it from six months to three years. • Holistic medicinal services – addressing mind, body and soul.
Medical tourism in Bangalore "Flying in from 30 different countries, 'medical tourists' account for 10 per cent of patients in the top hospitals, but the majority are seen from UAE and Saudi Arabia," Narayana Hrudayalaya Institute of Cardiac Sciences chairman Dr Devi Shetty says. To cater to the inflow of patients from West Asia, Narayana Hrudayalaya is planning to construct a five-star hotel near its premises to accommodate overseas clientele — a more feasible option than upgrading hospital rooms to suite class.
"This way patients could come to hospital for treatment and post, as well as recuperate in the hotel rooms," explains Shetty, whose 'Narayana Health City' a 5,000-bed, super-speciality hospital on a 30-acre land is also under way. Manipal Hospital registers 3,000 patients from overseas, particularly the Gulf. No wonder Manipal Health Systems MD-CEO R Basil is excited about the new 650-bed hospital at Hebbal — an add-on to their existing 200-bed infrastructure on Airport Road. St John's One World Hospital's USP of providing both allopathic and traditional mode of treatments adds to the buzz. "A single room for a patient who has undergone a complex heart operation bills him Rs 2.5 lakh — at least three times cheaper than in most other countries," Wockhardt Hospital CEO Vishal Bali says. Connectivity is another factor — there are two direct flights plying from West Asia to Bangalore every day involving only three hours travel time. Cashing in further on the buzzing industry, Emirates Airlines plans to fly down tour operators from across the Gulf — Kuwait, Saudi Arabia and UAE — to Bangalore for a 'familiarisation' tour. "Plans to bring in a team of doctors from Bangalore to show them around Dubai in the near future is also on the cards," Emirates commercial operations senior vicepresident (West Asia and Indian Ocean) Nabil Sultan reveals. Apart from introducing eight flights a week to Bangalore in late 2006, Emirates also added 20 more flights to India. Move over Mumbai. As medical tourism is slated to become a 2.3-billion dollar industry by 2012 — next only to IT and BPO — hospitals in Bangalore are gearing up to manage the swelling overseas market. Be it introducing healing coaches for patients, incorporating aerobics centres, health spas or swimming pools or even building a separate 500-bed hospital exclusively for foreign patients, hospitals are leaving no stone unturned to offer worldclass facilities to foreign clientele, particularly from the Gulf.
Bangalore is one of the top medical tourism destinations in India, with professional experts, technological sophistication and health care services that easily match the best in the world. Its reputation as the global technology hub and cosmopolitan city has made it a prominent health care destination for foreigners from developed as well as developing countries. Bangalore has a pleasant weather all through the year. Some of the lead institutes and private hospitals in Bangalore with regular patients from abroad include: Hosmat, Recoup, Soukya, Manipal, Narayana Hrudalaya, NIMHANS, Wockhardt, Advanced fertility centre, Sagar Apollo, Kidwai Memorial Institute of Oncology, Sri Jayadeva Institute of Cardiology, St. John‘s Hospital, St. Martha‘s, Victoria Hospital and Sri Sathya Sai Institute of Higher Medical Sciences, Mallya Hospital, Manipal Hospital and The Bangalore Hospital. Bangalore has few of the world‘s best doctors and medical practitioners, who have been trained by the rigorous Indian medical education system as well as in countries like UK and USA. The practitioners are registered with the Indian Medical Association and other Indian and international professional bodies. Many hospitals now have international accreditation to dispel any concerns of patients coming for treatment. Most big hospitals have eminent doctors from abroad as consultants. Also, most hospitals that have foreign patients have facilities and services customized for the comfort and convenience of the patients. Popular specializations for medical consultation, treatments and surgeries in Bangalore include Cardiology, Orthopedics, Nephrology, Neurology, Neurosurgery, Dentistry, Oncology, Infertility, Gynecology, Homeopathy, Ayurveda, Naturopathy etc. Top 5 hospitals as preferred destination in Bangalore Bangalore promises to be the perfect destination for any medical tourist. The government, the medical fraternity and the tour operators are all preparing for this new revolution. Here‘s a list of top 5 hospitals in Bangalore. Bangalore is one of the top medical tourism destinations in India, with professional experts, technological sophistication and health care services that easily match the best in the world. Its reputation as the global technology hub and cosmopolitan city has made it a prominent health care destination for foreigners from developed as well as developing
countries.
Bangalore
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pleasant
weather
all
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Bangalore has few of the world‘s best doctors and medical practitioners, who have been trained by the rigorous Indian medical education system as well as in countries like UK and USA. The practitioners are registered with the Indian Medical Association and other Indian and international professional bodies. Many hospitals now have international accreditation to dispel any concerns of patients coming for treatment. Most big hospitals have eminent doctors from abroad as consultants. Also, most hospitals that have foreign patients have facilities and services customized for the comfort and convenience of the patients. Popular specializations for medical consultation, treatments and surgeries in Bangalore include Cardiology, Orthopedics, Nephrology, Neurology, Neurosurgery, Dentistry, Oncology, Infertility, Gynecology,
Homeopathy, Ayurveda, Naturopathy etc. Narayana Hrudayalaya
The poor come here for the world's kindest care, for no one here is turned away for lack of funds. This was the vision of Dr. Devi Shetty, who believed that no child should be deprived of the best healthcare, because the parents cannot afford it. Caring with Compassion, this world's largest heart hospital for children, is set to be transformed into the world's biggest health city, with all super-specialities that the medical world offers. "
Narayana Hrudayalaya is founded by one of the India‘s oldest construction company ―Shankar Narayana Construction Company‖. Narayana Hrudayalaya group currently has 5000 beds in India and aims to have 30,000 beds in the next 5 years in India to become the one of the largest healthcare player in the country. The Group performs largest number of heart surgeries on children in the World providing cardiac care to children from 73 countries. The postoperative pediatric cardiac surgical unit has 80 critical care beds which is World‘s largest Pediatric cardiac surgical Intensive Therapy Unit (ITU) to look after children who have undergone heart operations. Fortis Hospital
Fortis Hospital (formerly Wockhardt Hospitals) Bangalore is a part of the 40 hospitals chain of Fortis Healthcare. The Fortis Hospitals network consists of 11 hospitals focusing on the high end tertiary care around the specialties of cardiac care – adult and pediatric cardiology and cardiac
surgery, complex brain & spine surgeries, orthopedics and joint replacement surgery and minimal access surgery.
The entity consists of 2 JCI accredited hospitals located in Bangalore and Mulund. Fortis Healthcare is engaged in providing the latest in internationally recognized medical care to patients with a variety of ailments and medical conditions. Their network consists of Super Speciality Hospital Hubs that concentrate on one or more specialities. These hospitals are interconnected to a larger network of multi-speciality hospitals that ensures patient access to expert care for any speciality. This unique network architecture provides expert care to patients and a level of confidence Road, in receiving Tank the latest medicine Tel: has +080 to offer.
Address:
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Millers
Bund
Road,
22260882
Mallya
Hospital
Mallya Hospital is located in the heart of the Bangalore city. Mallya Hospital has grown over the years with substantial increase in bed strength, infrastructure and an assurance of quality patient care with human touch using state-of-the art technology with quality health care under one roof. Mallya hospital has to its credit as the first Multispecialty hospital in the country to received the coveted ISO-9002 certification award which has been recently upgraded to ISO 9001:2000. In Mallya Hospital ―Individual care to deliver the best results – that is what hospital focus at every step‖. With the 360-degree care, patients experience the concept of Total Quality Management. The consultants and Nursing staff are not only just experts in their specialty, they are also driven by the vision of quality and commitment in giving individual attention for maximum treatment outcome. Mallya hospital is well known for its clinical skills, friendly ambience and motivated staff; patients who admit here leave with delight and fondle the memorable Address: moments of their stay.
#2, Vittal Mallya Road. Tel: +91-80-22277979
+91-80-22277979 FREE
Apollo
Hospital
Apollo Hospitals offer the best of medical facilities coupled with warm hospitality. It is among the latest additions to the Apollo Group of Hospitals known for excellent healthcare standards.
There are more than a hundred consulting doctors round the clock at the service of patients.
Due to the economical treatment combined with world class facilities, hospitals in Bangalore are catching the world‘s vision everyday. There a quite a few consulting comp anies which offer end to end medical services to foreigners who are interested in undergoing treatment in Bangalore. They take care of every step right from tickets, hospital reservations, appropriate doctor selection, city tour post surgery (if the patient is interested and in a situation to have) and then finally sending back to the home country. In any angle, this process is much simpler to the processes followed in western countries for the same surgery or treatment.
Address: 154 /11, Bannerghatta Road Tel:+(91)-(80)- 4030 4050 4050 FREE Manipal
+(91)-(80)- 4030 Hospital
Manipal Hospital in Bangalore is considered to be India‘s first hospital to be ISO 9001:2000 certified for Clinical, Nursing, Diagnostics and Allied Areas. Also, the hospital is the winner of the Golden Peacock National Quality Award 2005 in the service category. Manipal Hospitals is an integrated hospital service system that provides healthcare from the smallest to the most complex medical problems.
Manipal Hospitals is a certified pioneer in the Indian healthcare industry for over 4 decades and has been delivering state-of-the-art healthcare services that are curative and preventive in nature, to both national and international patients‘ world over. Driven by clinical excellence, patient centricity and ethical practices Manipal Hospitals provides path-breaking medical services and technologies in this new age of healthcare. Manipal Hospitals offers quaternary, tertiary, secondary and primary health care delivery services which are covered over, 15 hospitals, 9 primary care clinics and 55 community health programmes. Manipal Hospitals has strength of 3700 Beds and over 1000 Doctors.
Address: Airport Road, Tel:+(91)-(80)- 2502 4444 3344
+(91)-(80)- 2502 4444 FREE , 2502
Scope for medical tourism in Bangalore
Bangalore could provide unprecedented opportunities both as a market & as solutions: • Consumers expectations are increasing as well as costs are also increasing: there is a growing imbalance between the developed and underdeveloped countries. Some countries are vulnerable to bioterrorism and thus it needs to have a restructuring of health delivery systems. • India offers holistic healthcare addressing the mind, body and soul, with yoga, meditation, ayurveda, allopathy and other traditional Indian systems of medicine. Tourists travel India for rejuvenation promised by yoga and ayurveda. • Due to demographic changes & disease patterns, unhealthy work/life environment, pollution, epidemics, natural disasters, and ethical considerations there is growing demand for the healthcare services. • Bangalore holds a strong reputation in advanced healthcare segment, viz., cardio-vascular surgery, and organ transplant and eye surgery countries along with the diversity of tourist destinations. • Bangalore offers a vast array of services & customized medical packages along with the cultural warmth which other countries of world cannot even think of. • Improved services with low cost: In India world class medical services are available at comparatively low cost.
CHALLENGES BEFORE MEDICAL TOURISM in Bangalore • No strong government support or initiative to promote medical tourism. • Poor coordination between the various players in the industry- hospitals, air line operators, and hotels. • Customer perception as an unhygienic country. • Lack of proper regulatory system for hospitals. • Lack of uniform pricing policies across hospitals.
• Strong competition from countries like Thailand, Malaysia, and Singapore. • Lack of international accreditation. • Overseas medical care not covered by many insurance players. • Under-investment in healthcare infrastructure. FUTURE / MEASURES TO ENCOURAGE MEDICAL TOURISM Ministry of Health and Family Welfare with Ministry of Tourism set up a task force to evaluate the opportunities in the industry and formulate a policy to accredit healthcare institutions. Industry experts terms Medical tourism as the next best thing for the India because of its inherent The need of the hour is to club together a couple of pathies as we have a strong base of yoga, naturopathy, and ayurveda, as alternative healing therapies. • Create incentive structures (e.g. tax breaks) which encourage the corporate sector to set-up more infrastructure. • Need to set-up more high-value hospitals/health care facilities – specialty facilities with state of the art equipment and high service levels. • Develop business models to make these facilities have a smaller gestation period. • Private firms in the insurance sector should set-up medical insurance facilities and also tie-up with foreign insurance companies to cover foreigners coming into India for healthcare facilities. • Corporate in the healthcare sector should actively control medical fraud, insuinsurance fraud in order to encourage insurance firms to provide medical insurance products. Conclusion: The medical tourism industry has thus found an effective strategy to boost up its market by offering a wide range of medical tourism packages. Medical tourism services provide detailed information on all different medical tourism packages along with some valuable suggestions as well. With hospitals, hotels, conveyance facilities meeting international standards, medical tourism package (A) JOURNALS, BOOKS & NEWSPAPERS
Ajmeri, S. R. (August 2012,). MEDICAL TOURISM - A HEALTHIER FUTURE FOR INDIA. Arth Journal of Economics and Management. • V Kubendran, ―Medical Tourism: Advantage India‖, Facts For You, January 2006, Issue Vol. 27, No.4, • Rakesh Kumar Goswami, ―Medical Tourism: The Next Best Thing‖, Facts For You, January 2007, Issue Vol. 27, No.4. • Dr. I Satya Sundaram, ―Tourism: India Awakens To ‗Incredible‘ Opportunities‖, Facts For You, Issue Vol. 28, No.3, December 2007. • Sharmila R Umamaheswari, ―Why are Medical Tourists Flying To India?‖, Facts For You, Oct. 2008, Vol.29, No. 1. • Dr. S Mahesh Kumar, ―Tourism and Hospitality: Room for Growth‖, Facts For You, July 2010, Issue Vol. 30 No. 10 • ―Managing New Health Markets‖, Indian Management vol.47 Issue 2, Feb. 2008, • Prosenjit Datta and Gina s. Krishnan ―Global Health Trade‖, Business World, December 22, 2003. • Gina s. Krishnan ―the check-up‖, Business world, July 2005 • ―India Fosters Growing 'Medical Tourism' Sector", The Financial Times, 2 July 2003 (Ajmeri) Prabhand: A
http://www.meditripsindia.com/index_more.html http://articles.timesofindia.indiatimes.com/2007-02-28/bangalore/27874769_1_medicaltourism-foreign-patients-super-speciality-hospital http://www.mybangalore.com/article/1010/top-5-hospitals-for-medical-tourism-inbangalore.html
http://www.chillibreeze.com/whitepapers/medicaltourism1.asp
Special focus on "Healthcare"
22nd and 23rd March 2013
Medical Tourism in Bangalore: Scope and Challenges Author: Dr. Sneha Mankikar Assistant professor – MBA Krupanidhi School of Management, #12/1, Chikkabellandur, Carmelaram Post, Varthur Hobli, Bangalore – 560035 Ph. No.: 9845664105 E-mail: [email protected] Abstract Medical tourism is commonly perceived and popularly depicted as an economic issue, both at the system and individual levels. The decision to engage in medical tourism, however, is more complex, driven by patients‘ unmet need, the nature of services sought and the manner by which treatment is accessed. Leisure has seized to be the sole reason for tourist activity, and the competitive world of business is looking to combine business with pleasure, giving birth to the concept of medical tourism. In order to beneficially employ the opportunities medical tourism offers, and address and contain possible threats and harms, an informed decision is crucial. Accordingly, it comments on the imperative of access to health information and the current regulatory environment which impact on this increasingly popular and complex form of accessing and providing medical care.
Medical tourism, medical travel, health tourism or global health care is rapidly-growing practice of traveling across international borders to obtain health care. Medical tourism can be defined as provision of 'cost effective' personal health care/ private medical care in association with the tourism industry for patients needing surgical healthcare and other forms of dedicated & specialized treatment. This paper aims to enhance the current knowledge on medical tourism by isolating the focal content of the decisions that patients make. Based on the existing literature, it reflects scope and challenges in opting for or against medical care, and engaging in medical tourism, including considerations of the required treatments, location of treatment, and quality and safety issues attendant to seeking care. This paper examines the introduction, origin of medical tourism, some facts about medical tourism in India, core competencies, opportunities, challenges medical packages and future of medical tourism in Bangalore
Keywords: Health tourism, medical tourism, medical packages, tourism industry, Bangalore,
Introduction Medical tourism (also called medical travel, health tourism or global health care) is a term
initially coined by travel agencies and the mass media to describe the rapidly-growing practice of traveling across international borders to obtain health care. Medical tourism can be defined as provision of 'cost effective' personal health care/ private medical care in association with the tourism industry for patients needing surgical healthcare and other forms of dedicated & specialized treatment. Medical tourism is an emerging concept. Governments all over the globe are highly concerned about their ability to meet their social obligations in the health sector. They are highlighting it as ‗International standard healthcare services at affordable prices.‘ Medical or Health treatment package tourism is a recurrent form of vacationing, and covers a broad range of medical services. It mingles free time, leisure, fun relaxation, amusement and recreation together with wellness and healthcare packages. At the same time tourists are able to receive an orientation that will help them to improve their life in terms of their health and general well being. It is like rejuvenation and cleans up process on all levels - physical, mental and emotional. Medical or health tourism is among the fastest growing industries in the world. The major forces driving growth of this emerging industry include the rising cost of healthcare and limiting scope of insurance coverage in developed countries, increasing waiting time for treatments, and low cost of treatments elsewhere.
The concept of medical tourism is not a new one. The first recorded instance of medical tourism dates back thousands of years to when Greek pilgrims traveled from all over the Mediterranean to the small territory in the Saronic Gulf called Epidauria. This territory was the sanctuary of the healing god Asklepios. Epidauria became the original travel destination for medical tourism. Our Indian system of medicine like Ayurveda and Unani system of medicine for the same cause were very famous and peoples from different countries come for their treatment and healings. In Roman Britain, patients took the waters at a shrine at Bath, a practice that continued for 2,000 years. From the 18th century wealthy Europeans traveled to spas from Germany to the Nile. At first, mere traveling was considered to be a good therapy for mental and physical well being. Spa towns and sanitariums may be considered an early form of medical tourism. In eighteenth century England, for example, patients visited spas because they were places with supposedly health-giving mineral waters, treating diseases from gout to liver disorders and bronchitis.
In the 21st century, relatively low-cost jet travel has taken the industry beyond the wealthy and desperate. Later, mostly wealthy people began traveling to tourist destinations like the Swiss lakes, the Alps and special tuberculosis sanatoriums, where professional and often specialized medical care was offered. In this century, however, medical tourism expanded to a much larger scale. Thailand, followed by India, Puerto-Rico, Argentina, Cuba and others quickly became the most popular destinations for medical tourists. Complicated surgeries and dental works, kidney dialysis, organ transplantation and sex changes, topped the list of the most popular procedures. People from many advanced countries, including the United Sates and Europe, see a benefit in traveling to developing third world countries, like India, Thailand, Philippines, South Africa, and etc. while combining medical treatments with inexpensive vacation. This trend is now known as medical tourism.
The three major medical tourism hubs in the world are Singapore, India and Thailand. Indian tourism industry is experiencing a strong period of growth, driven by the burgeoning Indian middle class, growth in high spending foreign tourists, and coordinated government campaigns to promote ‗Incredible India‘. Medical tourism is perceived as one of the finest growing segments in marketing ‗Destination India‘ today. India is on threshold of a healthcare revolution and emerging as the destination for medical tourist. Healthcare industry accounted for 5.1 per cent of the country‘s GDP in 2006. • Private healthcare to form a large share of the healthcare spend, and would increase to US$ 33.6 billion in 2010 from US$ 14.8 billion in 2002. • Expected to generate employment opportunities for nine million people by 2012. • India offers easy access to visa facilities for overseas patients along with best emerging medical infrastructure in large and tertiary towns. This shall generate earnings of about US$ 19.5 billion in foreign exchange by 2012.
• The market is estimated to touch US$ 77 billion by 2013 at a CAGR of 15 %. • Share of private expenditure as a percentage of total expenditure on healthcare has grown from 60 per cent to nearly 80 per cent over the last decade. • With an annual growth rate of 30 per cent, India is already inching closer to Singapore and Thailand, which are established medical care hubs that attract millions of medical tourists a year. • India excels in providing quality and cheap health care services to overseas tourists. The field has such lucrative potential that it can become a $2.3 billion business by 2012, states a study by Confederation of Indian Industry (CII). In 2004, some 150,000 foreigners visited India for treatment, and the numbers have been rising by 15 per cent each year. Bangalore as medical tourism destination Medical tourism is gaining popularity in India & is recognized as a hot medical hub or global health destination at present because foreign tourists travel India in search of low-cost & worldclass medical treatment. India is also capitalising on it low-cost and world class medical expertise to appeal these ‗medical tourists.‘ India is promoting the "high-tech healing" of its private healthcare sector as a tourist attraction. In short, Medical Tourism in India = World Class Treatment + Holiday + Big Savings. India has been the most attractive destination for the visitors around the globe. India is a perfect destination for medical tourism that combines health treatment with visits to some of the most alluring and awe-inspiring places of the world. This is not only due to the heritage attraction of the country but the medical tourism India which has depicted a steady southward movement, of late. People rush India for 5 Reasons– price, service, quality, availability (cutting edge treatments) & tourism. India is in the process of becoming the "Global Health Destination" owing to the following advantages: • Reduced costs/Economical and affordable pricing - The key ‗selling point‘ of Indian healthcare
tourism is its ―cost effectiveness.‖ Price advantage is a major selling point. The slogan, thus is, "first world treatment at third world prices". The cost differential across the board is huge- only a tenth and sometimes even a sixteenth of the cost in the west. Most estimates claim treatment costs in India start at around a tenth of the price of comparable treatment in America or Britain. The cost of medical services in India is almost 30% lower to that in Western countries and the cheapest in South-east Asia. • Availability of latest medical technologies -The most popular treatments sought in India by medical tourists are alternative medicine, bone-marrow transplant, cardiac bypass surgery, eye surgery and orthopedic surgery. India is known in particular for heart surgery, hip resurfacing and other areas of advanced medicine. All these medical treatments and investigations are done by using the latest, technologically advanced diagnostic equipments. India has a provision and practice of alternative traditional medicine like ayurveda, pranic healing, aromatherapy, music therapy, meditation and yoga. Many people from the advanced countries come to India for the upgrading promised by yoga and Ayurvedic massage. A nice blend of top-class medical expertise at attractive prices is helping a rising number of Indian corporate hospitals attract foreign patients, including from developed nations as they have accepted ayurveda as a medical system and have expressed interest in the ayurveda curriculum and research. India is fast emerging as a global medical health care destination because of its world class medical facilities which are manned by highly qualified doctors and paramedics. Almost all Indian Hospitals servicing Medical Tourists are accredited either by Joint Commission International (JCI) or National Board for Accreditation of Hospitals and Heath Care and follow International safety standards. India remains a safe and preferred medical tourism destination. • Growing compliance on international quality standards/High quality world class medical care / Use of world class implants and consumables-India‘s private hospitals have gained international recognition for their state-of-art facilities and diagnostic centers. India is competing with Thailand, Singapore and some other Asian countries, which have good hospitals, salubrious climate and tourist destinations. • Zero waits times for surgeries - is a big draw for foreign patients also the very minimal or hardly any waitlist as is common in European or American hospitals. In fact,
priority treatment is provided today in Indian hospitals. High eminence expertise of medical professionals, backed by the fast improving tools/ equipments and nursing amenities-India has got the specialist in around the world and also has the world eminent doctors & hospitals where all the services are provided to the patients. Indian hospitals excel in cardiology and cardiothoracic surgery, joint replacements, transplants, cosmetic treatments, dental care, orthopedic surgery and more. • Fluent English speaking hospital staff /foreigners are not likely to face a language barrier in India-Language is a major comfort factor that invites so many foreign tourists to visit India for medical and health tourism. India has a large populace of good English speaking doctors, guides and medical staff. This makes it easier for foreigners to relate well to Indian doctors, • Foreign patients can get package deals including flights, transfers, hotels, treatment & postoperative vacation for their visits. • Customised medical packages-Medical tourism can easily be combined with a holiday/business trip, & • The Indian government is taking steps to address infrastructure issues that hinder the country's growth in medical tourism. The GoI has declared that treating foreign patients is legal. It is encouraging medical tourism by offering tax breaks and export incentives to practicing hospitals. • The Ministry of Tourism (MOT), Government of India has further enhanced the Mvisa and MXvisa (Medical Visa) by extending it from six months to three years. • Holistic medicinal services – addressing mind, body and soul.
Medical tourism in Bangalore "Flying in from 30 different countries, 'medical tourists' account for 10 per cent of patients in the top hospitals, but the majority are seen from UAE and Saudi Arabia," Narayana Hrudayalaya Institute of Cardiac Sciences chairman Dr Devi Shetty says. To cater to the inflow of patients from West Asia, Narayana Hrudayalaya is planning to construct a five-star hotel near its premises to accommodate overseas clientele — a more feasible option than upgrading hospital rooms to suite class.
"This way patients could come to hospital for treatment and post, as well as recuperate in the hotel rooms," explains Shetty, whose 'Narayana Health City' a 5,000-bed, super-speciality hospital on a 30-acre land is also under way. Manipal Hospital registers 3,000 patients from overseas, particularly the Gulf. No wonder Manipal Health Systems MD-CEO R Basil is excited about the new 650-bed hospital at Hebbal — an add-on to their existing 200-bed infrastructure on Airport Road. St John's One World Hospital's USP of providing both allopathic and traditional mode of treatments adds to the buzz. "A single room for a patient who has undergone a complex heart operation bills him Rs 2.5 lakh — at least three times cheaper than in most other countries," Wockhardt Hospital CEO Vishal Bali says. Connectivity is another factor — there are two direct flights plying from West Asia to Bangalore every day involving only three hours travel time. Cashing in further on the buzzing industry, Emirates Airlines plans to fly down tour operators from across the Gulf — Kuwait, Saudi Arabia and UAE — to Bangalore for a 'familiarisation' tour. "Plans to bring in a team of doctors from Bangalore to show them around Dubai in the near future is also on the cards," Emirates commercial operations senior vicepresident (West Asia and Indian Ocean) Nabil Sultan reveals. Apart from introducing eight flights a week to Bangalore in late 2006, Emirates also added 20 more flights to India. Move over Mumbai. As medical tourism is slated to become a 2.3-billion dollar industry by 2012 — next only to IT and BPO — hospitals in Bangalore are gearing up to manage the swelling overseas market. Be it introducing healing coaches for patients, incorporating aerobics centres, health spas or swimming pools or even building a separate 500-bed hospital exclusively for foreign patients, hospitals are leaving no stone unturned to offer worldclass facilities to foreign clientele, particularly from the Gulf.
Bangalore is one of the top medical tourism destinations in India, with professional experts, technological sophistication and health care services that easily match the best in the world. Its reputation as the global technology hub and cosmopolitan city has made it a prominent health care destination for foreigners from developed as well as developing countries. Bangalore has a pleasant weather all through the year. Some of the lead institutes and private hospitals in Bangalore with regular patients from abroad include: Hosmat, Recoup, Soukya, Manipal, Narayana Hrudalaya, NIMHANS, Wockhardt, Advanced fertility centre, Sagar Apollo, Kidwai Memorial Institute of Oncology, Sri Jayadeva Institute of Cardiology, St. John‘s Hospital, St. Martha‘s, Victoria Hospital and Sri Sathya Sai Institute of Higher Medical Sciences, Mallya Hospital, Manipal Hospital and The Bangalore Hospital. Bangalore has few of the world‘s best doctors and medical practitioners, who have been trained by the rigorous Indian medical education system as well as in countries like UK and USA. The practitioners are registered with the Indian Medical Association and other Indian and international professional bodies. Many hospitals now have international accreditation to dispel any concerns of patients coming for treatment. Most big hospitals have eminent doctors from abroad as consultants. Also, most hospitals that have foreign patients have facilities and services customized for the comfort and convenience of the patients. Popular specializations for medical consultation, treatments and surgeries in Bangalore include Cardiology, Orthopedics, Nephrology, Neurology, Neurosurgery, Dentistry, Oncology, Infertility, Gynecology, Homeopathy, Ayurveda, Naturopathy etc. Top 5 hospitals as preferred destination in Bangalore Bangalore promises to be the perfect destination for any medical tourist. The government, the medical fraternity and the tour operators are all preparing for this new revolution. Here‘s a list of top 5 hospitals in Bangalore. Bangalore is one of the top medical tourism destinations in India, with professional experts, technological sophistication and health care services that easily match the best in the world. Its reputation as the global technology hub and cosmopolitan city has made it a prominent health care destination for foreigners from developed as well as developing
countries.
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Bangalore has few of the world‘s best doctors and medical practitioners, who have been trained by the rigorous Indian medical education system as well as in countries like UK and USA. The practitioners are registered with the Indian Medical Association and other Indian and international professional bodies. Many hospitals now have international accreditation to dispel any concerns of patients coming for treatment. Most big hospitals have eminent doctors from abroad as consultants. Also, most hospitals that have foreign patients have facilities and services customized for the comfort and convenience of the patients. Popular specializations for medical consultation, treatments and surgeries in Bangalore include Cardiology, Orthopedics, Nephrology, Neurology, Neurosurgery, Dentistry, Oncology, Infertility, Gynecology,
Homeopathy, Ayurveda, Naturopathy etc. Narayana Hrudayalaya
The poor come here for the world's kindest care, for no one here is turned away for lack of funds. This was the vision of Dr. Devi Shetty, who believed that no child should be deprived of the best healthcare, because the parents cannot afford it. Caring with Compassion, this world's largest heart hospital for children, is set to be transformed into the world's biggest health city, with all super-specialities that the medical world offers. "
Narayana Hrudayalaya is founded by one of the India‘s oldest construction company ―Shankar Narayana Construction Company‖. Narayana Hrudayalaya group currently has 5000 beds in India and aims to have 30,000 beds in the next 5 years in India to become the one of the largest healthcare player in the country. The Group performs largest number of heart surgeries on children in the World providing cardiac care to children from 73 countries. The postoperative pediatric cardiac surgical unit has 80 critical care beds which is World‘s largest Pediatric cardiac surgical Intensive Therapy Unit (ITU) to look after children who have undergone heart operations. Fortis Hospital
Fortis Hospital (formerly Wockhardt Hospitals) Bangalore is a part of the 40 hospitals chain of Fortis Healthcare. The Fortis Hospitals network consists of 11 hospitals focusing on the high end tertiary care around the specialties of cardiac care – adult and pediatric cardiology and cardiac
surgery, complex brain & spine surgeries, orthopedics and joint replacement surgery and minimal access surgery.
The entity consists of 2 JCI accredited hospitals located in Bangalore and Mulund. Fortis Healthcare is engaged in providing the latest in internationally recognized medical care to patients with a variety of ailments and medical conditions. Their network consists of Super Speciality Hospital Hubs that concentrate on one or more specialities. These hospitals are interconnected to a larger network of multi-speciality hospitals that ensures patient access to expert care for any speciality. This unique network architecture provides expert care to patients and a level of confidence Road, in receiving Tank the latest medicine Tel: has +080 to offer.
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22260882
Mallya
Hospital
Mallya Hospital is located in the heart of the Bangalore city. Mallya Hospital has grown over the years with substantial increase in bed strength, infrastructure and an assurance of quality patient care with human touch using state-of-the art technology with quality health care under one roof. Mallya hospital has to its credit as the first Multispecialty hospital in the country to received the coveted ISO-9002 certification award which has been recently upgraded to ISO 9001:2000. In Mallya Hospital ―Individual care to deliver the best results – that is what hospital focus at every step‖. With the 360-degree care, patients experience the concept of Total Quality Management. The consultants and Nursing staff are not only just experts in their specialty, they are also driven by the vision of quality and commitment in giving individual attention for maximum treatment outcome. Mallya hospital is well known for its clinical skills, friendly ambience and motivated staff; patients who admit here leave with delight and fondle the memorable Address: moments of their stay.
#2, Vittal Mallya Road. Tel: +91-80-22277979
+91-80-22277979 FREE
Apollo
Hospital
Apollo Hospitals offer the best of medical facilities coupled with warm hospitality. It is among the latest additions to the Apollo Group of Hospitals known for excellent healthcare standards.
There are more than a hundred consulting doctors round the clock at the service of patients.
Due to the economical treatment combined with world class facilities, hospitals in Bangalore are catching the world‘s vision everyday. There a quite a few consulting comp anies which offer end to end medical services to foreigners who are interested in undergoing treatment in Bangalore. They take care of every step right from tickets, hospital reservations, appropriate doctor selection, city tour post surgery (if the patient is interested and in a situation to have) and then finally sending back to the home country. In any angle, this process is much simpler to the processes followed in western countries for the same surgery or treatment.
Address: 154 /11, Bannerghatta Road Tel:+(91)-(80)- 4030 4050 4050 FREE Manipal
+(91)-(80)- 4030 Hospital
Manipal Hospital in Bangalore is considered to be India‘s first hospital to be ISO 9001:2000 certified for Clinical, Nursing, Diagnostics and Allied Areas. Also, the hospital is the winner of the Golden Peacock National Quality Award 2005 in the service category. Manipal Hospitals is an integrated hospital service system that provides healthcare from the smallest to the most complex medical problems.
Manipal Hospitals is a certified pioneer in the Indian healthcare industry for over 4 decades and has been delivering state-of-the-art healthcare services that are curative and preventive in nature, to both national and international patients‘ world over. Driven by clinical excellence, patient centricity and ethical practices Manipal Hospitals provides path-breaking medical services and technologies in this new age of healthcare. Manipal Hospitals offers quaternary, tertiary, secondary and primary health care delivery services which are covered over, 15 hospitals, 9 primary care clinics and 55 community health programmes. Manipal Hospitals has strength of 3700 Beds and over 1000 Doctors.
Address: Airport Road, Tel:+(91)-(80)- 2502 4444 3344
+(91)-(80)- 2502 4444 FREE , 2502
Scope for medical tourism in Bangalore
Bangalore could provide unprecedented opportunities both as a market & as solutions: • Consumers expectations are increasing as well as costs are also increasing: there is a growing imbalance between the developed and underdeveloped countries. Some countries are vulnerable to bioterrorism and thus it needs to have a restructuring of health delivery systems. • India offers holistic healthcare addressing the mind, body and soul, with yoga, meditation, ayurveda, allopathy and other traditional Indian systems of medicine. Tourists travel India for rejuvenation promised by yoga and ayurveda. • Due to demographic changes & disease patterns, unhealthy work/life environment, pollution, epidemics, natural disasters, and ethical considerations there is growing demand for the healthcare services. • Bangalore holds a strong reputation in advanced healthcare segment, viz., cardio-vascular surgery, and organ transplant and eye surgery countries along with the diversity of tourist destinations. • Bangalore offers a vast array of services & customized medical packages along with the cultural warmth which other countries of world cannot even think of. • Improved services with low cost: In India world class medical services are available at comparatively low cost.
CHALLENGES BEFORE MEDICAL TOURISM in Bangalore • No strong government support or initiative to promote medical tourism. • Poor coordination between the various players in the industry- hospitals, air line operators, and hotels. • Customer perception as an unhygienic country. • Lack of proper regulatory system for hospitals. • Lack of uniform pricing policies across hospitals.
• Strong competition from countries like Thailand, Malaysia, and Singapore. • Lack of international accreditation. • Overseas medical care not covered by many insurance players. • Under-investment in healthcare infrastructure. FUTURE / MEASURES TO ENCOURAGE MEDICAL TOURISM Ministry of Health and Family Welfare with Ministry of Tourism set up a task force to evaluate the opportunities in the industry and formulate a policy to accredit healthcare institutions. Industry experts terms Medical tourism as the next best thing for the India because of its inherent The need of the hour is to club together a couple of pathies as we have a strong base of yoga, naturopathy, and ayurveda, as alternative healing therapies. • Create incentive structures (e.g. tax breaks) which encourage the corporate sector to set-up more infrastructure. • Need to set-up more high-value hospitals/health care facilities – specialty facilities with state of the art equipment and high service levels. • Develop business models to make these facilities have a smaller gestation period. • Private firms in the insurance sector should set-up medical insurance facilities and also tie-up with foreign insurance companies to cover foreigners coming into India for healthcare facilities. • Corporate in the healthcare sector should actively control medical fraud, insuinsurance fraud in order to encourage insurance firms to provide medical insurance products. Conclusion: The medical tourism industry has thus found an effective strategy to boost up its market by offering a wide range of medical tourism packages. Medical tourism services provide detailed information on all different medical tourism packages along with some valuable suggestions as well. With hospitals, hotels, conveyance facilities meeting international standards, medical tourism package (A) JOURNALS, BOOKS & NEWSPAPERS
Ajmeri, S. R. (August 2012,). MEDICAL TOURISM - A HEALTHIER FUTURE FOR INDIA. Arth Journal of Economics and Management. • V Kubendran, ―Medical Tourism: Advantage India‖, Facts For You, January 2006, Issue Vol. 27, No.4, • Rakesh Kumar Goswami, ―Medical Tourism: The Next Best Thing‖, Facts For You, January 2007, Issue Vol. 27, No.4. • Dr. I Satya Sundaram, ―Tourism: India Awakens To ‗Incredible‘ Opportunities‖, Facts For You, Issue Vol. 28, No.3, December 2007. • Sharmila R Umamaheswari, ―Why are Medical Tourists Flying To India?‖, Facts For You, Oct. 2008, Vol.29, No. 1. • Dr. S Mahesh Kumar, ―Tourism and Hospitality: Room for Growth‖, Facts For You, July 2010, Issue Vol. 30 No. 10 • ―Managing New Health Markets‖, Indian Management vol.47 Issue 2, Feb. 2008, • Prosenjit Datta and Gina s. Krishnan ―Global Health Trade‖, Business World, December 22, 2003. • Gina s. Krishnan ―the check-up‖, Business world, July 2005 • ―India Fosters Growing 'Medical Tourism' Sector", The Financial Times, 2 July 2003 (Ajmeri) Prabhand: A
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