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Health Tourism

Health Tourism

Medical tourism describes the act of people making health choices and accessing health treatments across borders. Depending on who is asking the question, it can be trade in goods and services, a health choice, or a health service.

The term medical tourism has come to embrace all facets of consumers seeking treatment, improvement or change through medical or wellness practices – provided they cross an international border to do so.

On one hand, medical tourism is a popular, consumer driven internet search term. To find information about medical treatment abroad, consumers and media alike google medical tourism.

For government planners, economists and academics, medical tourism is data: population movements and the value they bring or leave in their wake. This definition of medical tourism serves a need to count and put an economic value on movement of people.

The economic definition is not sufficient or useful for those “on the ground” who provide the goods and services for this population. Medical professionals, health care providers, and medical travel service companies need a useful and practical definition that guides them in caring for traveling international patients. It is a matter of giving value to life, death and quality of life.

 

1. WHY DOES IT MATTER?

Should it matter that there is no agreed upon definition or common understanding of medical tourism?

Without a common understanding of the phrase medical tourism, for example, data is poor and unreliable, and affects the quality of academic research, media reports, government policies and business plans.

 

2. WHAT IS THIS INDUSTRY ABOUT?

Is it medical? Is it health? Is it wellness?

Medical tourism, health tourism, medical travel, and health travel – these phrases are not interchangeable, yet they are being used interchangeably, but with very different meanings, by different interest groups, leading to some of the current confusion.

Is it travel or is it tourism?

The word travel – as in medical travel or business travel – suggests a purposeful, not recreational trip. Highly skilled, professional services accompany purpose-driven travel – educational conferences, continuing education workshops, various business, trade, or professional meetings.

The word tourism – as in medical tourism, adventure tourism, cultural tourism, or culinary tourism – reflects a more leisurely or pleasurable trip.

Associated with all varieties of tourism are non-professional service industries such as transportation services (airlines, cruise ships, tour buses), hospitality services (hotels, resorts) and entertainment venues (amusement parks, casinos, shopping malls, music and sports venues, theaters).

3. HEALTH TOURISM

If we accept the World Health Organization definition of health, that health is a state of complete   physical, mental and social well-being and not merely the absence of disease or infirmity, health tourism is the broadest of all possible categories of health-related activity that involves travel. In other words, medical tourism is a subset of health tourism.

Other subsets of health tourism may include culinary tourism, accessible tourism and sports tourism.

4. MEDICAL TOURISM

What is medical tourism?

The term medical tourism has come to embrace all facets of consumers seeking treatment, improvement or change through medical or wellness practices – provided they cross an international border to do so.

Medical tourism is the go-to keyword phrase for internet searches and advertising campaigns. For search engines like

Google and Bing, medical tourism by far exceeds any other phrase when searching for cross-border health care options.

Medical tourism, the phrase, is here to stay. It’s a popular, consumer-driven search term. When looking for information about medical treatment abroad, media and consumers alike search out medical tourism

If medical professionals, health care providers, and medical travel service companies look for guidance in caring for traveling international patients, will they find it by searching medical tourism? Not easily.

Has medical tourism lost its meaning?

Medical tourism still has meaning for consumers. But medical tourism is not very useful or practical for health care practitioners and service providers.

It has become a universal term that embraces virtually all categories of people who seek or obtain any kind of health-related activity – provided they travel away from “home” to get it. It embraces consumers and stakeholders in medical travel, wellness travel, international patient care, and domestic medical tourism.

By entering new international markets under the rubric of global health care presented as medical tourism, insurance companies have received a warm welcome in countries that are anxious to explore the various opportunities offered by medical tourism.

Global health is the purview of multilateral organizations, government agencies, non-governmental organizations and private foundations that have accepted a mandate to expand and improve the delivery of standard health care around the globe, particularly in impoverished or disease ridden regions.

Global health refers to a wide range of health problems, determinants, and solutions, such as epidemic infectious diseases, chronic illnesses and injuries, development, and foreign aid.

Secondary references to global health include global health care, global health systems, global health issues, and global health policy.

Global health care includes panoply of industries such as health care, pharmaceuticals, biotech, medical devices, health care logistics, consulting and business services.

Domestic medical tourism

Domestic medical tourism is a recently-coined phrase used chiefly to describe local patients traveling across state lines to obtain medical treatment.

In countries where there is one primary national health care funder, domestic medical travel is not currently an issue.

Cross-border health care

Cross-border medical travel, particularly within Europe, has a meaning to economists specific to the ebb and flow of cross-border workers, migrants and retirees within the European Union.

But in popular media, it is starting to characterize regional medical travel, or medical travel to a nearby country. Closer to home, one usually drives rather than flies to the medical destination. It may include both medical travel and wellness tourism and is often referred to as cross-border health care.

Diaspora medical travel

Some medical travel companies have created special medical travel programs for people with cultural and social ties or family roots in a medical destination.

These are often first or second generation immigrants. These companies argue a medical travel program will be more popular and patients easier to manage because the patients are in a familiar environment, maybe speak the local language, and have lower expectations of treatment or care.

5. MEDICAL TRAVEL

Invasive vs. non-invasive procedures

Wellness travelers may seek care characterized as non-invasive: alternative therapies and wellness treatments; most dental treatments; some non-invasive cosmetic surgery procedures like Botox, facial fillers, spot liposuction, and fat injections; acupuncture therapy; ayurveda; mineral spas; colonic cleansing; most executive check-ups.

It is critical to make a distinction between invasive and non-invasive procedures.

Insurance companies that issue medical travel insurance are clear about this. Medical travel insurance – different from travel medical insurance which covers tourists for accidental, unplanned medical treatment while on vacation – insures against complications of invasive procedures. In a definition surgical and other invasive procedures describe as “operative procedures in which skin or mucous membranes and connective tissue are incised, or an instrument is introduced through a natural body orifice.” Invasive procedures encompass a range of services, including:

  • Minimally invasive dermatological procedures (e.g., biopsy, excision, or deep cryotherapy for malignant lesions)
  • Extensive multi-organ transplantation
  • All procedures classified as surgery
  • Procedures such as percutaneous transluminal angioplasty and cardiac catheterization
  • Minimally invasive procedures involving biopsies or placement of probes or catheters requiring entry into a body cavity through a needle or trocar

Some very minor procedures such as drawing blood or using certain instruments for examinations are technically invasive procedures but are not included in the definition.

Non-invasive procedures sought by wellness travelers are dental treatments (excluding implants), dermatology procedures, certain cosmetic procedures, some ophthalmology procedures, genetic testing and so on.

They may be single-purpose travelers, mostly focused on saving money, who travel across a border and return the same day. They may be on vacation and opt to have some non-invasive treatments at the same time as participating in wellness tourism activities. Medi-spas have emerged to serve these vacationers.

Similarly, Europe offers many spas for wellness travelers that traditionally provide healing waters and mineral baths, and are prescribed by medical doctors for rehabilitation.

Medical tourism is not medical travel

Medical travel is a phrase very much preferred over medical tourism by health care leaders, hospital executives, doctors and other medical professionals.

Most have reluctantly accepted the term medical tourism but many continue to dislike it because they feel it trivializes the process of getting and giving treatment and care.

Medical travel is the process by which a consumer (a patient) gets treatment for a medical condition. Treatment is nearly always invasive. It includes dental implants, fertility treatments, alternative or experimental procedures, addiction treatment, Lasik eye surgery, cancer therapies, as well as major surgery procedures.

Many medical travel patients, or medical travelers, require admission to hospital, whether for ambulatory care and a stay of less than 24 hours, or for inpatient care and overnight stay. Most require light or general anesthesia, administered by a licensed medical professional.

Most, if not all, must make their medical travel plans in advance. Seldom does one pop into a hospital or clinic casually for an invasive treatment. Indeed, those who do choose to have an invasive procedure on a whim may be putting themselves in harm’s way and the facility or doctor who takes them may be negligent.

6. MEDICAL TRAVELER

Characteristics of the medical traveler

Medical travelers have 3 common characteristics:

  • They are not resident in the destination country
  • They travel from home to a different country for care
  • The cultural or social environment and/or language of the medical destination may be different or strange
  • They are traveling international patients.
  • A medical travel journey is distinguished by the following:
  • Advance planning
  • Exchange of medical records and medical history
  • Pre-surgery instructions that may need to be followed prior to reaching the medical destination
  • A procedure that is invasive and/or requires general or twilight anesthesia; or is a major non-invasive treatment (chemotherapy, radiation therapy, etc.)
  • Consideration about the kind of accommodations that will be needed post-surgery
  • Recovery care management
  • Care planning and follow-up upon returning home
  • Possible additional, unexpected medical attention

This last item is very important. The medical traveler may acquire an infection, get a complication, or have a bad outcome, likely needing further medical attention.

The medical traveler may be required to return to the original place of treatment, or may be able to receive treatment at home. Treatment at home may depend on how medical travel is perceived by the treating doctor at home.

There are no re-dos for medical travelers

A Singaporean colleague liked to use the example of a tourist who books a vacation stay at a hotel advertising a “seaside” location. Upon arrival, the tourist finds the sea is across a highway and down a cliff from the hotel. Next year, when the tourist repeats his seaside holiday, he will be sure to choose a different hotel.

A medical traveler does not have the opportunity to “try out” a hospital and, if unsatisfied, try a different one. The medical traveler has one shot at getting it right. There are no re-dos.

Are international patients medical tourists?

International patients are not medical travelers or medical tourists. By reason of employment or retirement, they may reside in a foreign country, and they usually will seek medical care there. They are expatriates. Their homes and families are nearby.

Other international patients are people on vacation who are struck by illness, experience health-related symptoms that need attention, or have an accident while on vacation. Most of these international patients make their way to nearby clinics or hospitals for emergency care.

International patients may be considered “incidental” or “accidental” medical tourists – seeking treatment for an unplanned medical condition while on a foreign holiday.

They may purchase travel medical insurance for emergency medical coverage along with trip insurance.

Medical travelers are traveling international patients. International patients overlap with medical travelers in key ways in needing and expecting a supportive clinical and care environment.

A insurance supportive environment may mean hospital staff that provide translation, deal with off-shore approval and payment, and cater to “comfort” requests such as better quality food, room upgrades, international television channels, and internet service.

For international patients, it is a bonus to find hospitals that have doctors and professional staff who are culturally in tune with them. If they have special medical treatment preferences or if they are demanding individuals who insist on full disclosure of care, they may present problems for unprepared hospitals.



“ Health Tourism ”