Medical Tourism
Kerim has a post about public spending on healthcare in the US, Europe and India. The Hindu has an article on medical tourism in India. It points out the rapid growth of private high end medical care, but is it at the cost of public care? The medical tourism council thinks that it will create “competition” and the good “old trickle down” effect. I don’t see how that is possible unless resources are allocated to public hospitals. A National Human Development Report (2001) points out that private hospitals have a not for profit status, yet:
…the poorest quintile (of the population is) getting only 10 per cent of subsidies, while the richest 20 quintile captures 33 per cent.
I don’t see why a profitable industry would want to give any of that up, even if the public is getting testy:
— in the second half of 2004 there were at least seven reported incidents in Mumbai of patient’s families assaulting hospital staff, both in State and municipal corporation-run hospitals, and private clinics, because of the perception that they were victims of medical negligence.
Who can argue against excellence, yet does it have to be either or? Poorer countries like Bangladesh and Sri Lanka (see previous post) manage to do a better job with basic health care, it might be a better idea to see what they are doing right than imitating an abysmal system like that of the US (refer toKerim’s post).
July 16th, 2005 at 10:00 am
what do you think is an architect’s role in this new wave of medical tourism?
July 18th, 2005 at 10:50 am
Chitra, its an interesting question. Something I am quite unqualified to answer.
December 4th, 2005 at 8:05 am
We are in the eye care business for over twenty five years and are have all three forms of vision correction under one roof at our state of the art facility at Delhi. For the Lasik Laser vision correction we have recently upgraded our facility and have installed the latest Visx. Star S4 system for Customvue procedures. Customvue procedure is the latest FDA approved Lasik technology which gives the patient the potential to see better than spectacles or contact lenses.
April 20th, 2006 at 10:57 pm
While there are some world class physicians in India, the lack of appropriate sanitation and infrastructure is likely to doom India’s medical tourism aspirations for the present. India will continue to attract, as she does now, patients from sub-Saharan Africa, neighboring countries and persons of Indian ancestry. People from more developed countries are likely to shun India’s offering as more people become aware of the serious sanitation issues. Some hospitals in India may offer a safe environment for the patient. But one the patient is discharged into the community for additional treatment and follow up the risk of infection increases dramatically. While some physicians in India believe a patient can be sheltered from contact with the outside community, I suspect this is unlikely. Currently there are reports of medical tourists from developed countries returning immediately to their country of origin after a brief exit from the Delhi airport. This trend will likely grow as more people from developed countries are lured to India by promises of low cost healthcare. As the number of potential medical tourists who witness India’s lack of adequate sanitation grows so will mainstream news reports on the subject.
India is not without competition. Several Southeast Asian countries offer good value for the medical tourist. Singapore has one of the best transplant programs in the world. It is reported in the Indian press that wealthy Indians travel to Singapore for liver transplants rather. That alone should be telling.
Thailand, the current leader in Asian medical tourism currently attracts six times as many patients as India. Many of these patients are from developed countries. Thailand’s medical system was built on the US model. In the 1920s the King’s father made it his life’s work to improve medical care in Thailand. He entered Harvard University and earned an MD degree with honors. He was also inducted into the medical honor society in the US. During his stay at Harvard he convinced the Rockefeller Foundation to fund a US medical education for a group of Thai men and women. These men and women returned to Thailand and were the seed of modern Thai medical system. Today a significant number of Thai physicians are at least partially educated abroad. Many hold US professional certification. You seldom see Thai physicians practicing abroad because most honor their King and return home to practice. Despite claims by the CII, Thailand and Singapore’s physicians have a long track record of successfully performing complex medical procedures. Thailand was almost 10 years ahead of India in performing transplant surgery. Bumrungrad hospital in Bangkok for instance sees a significant number of patients from the US and Canada seeking total disc replacement spinal surgery, hardly a “simple” procedure. Later this year, the Medical Sciences Department, Mahidol University and the Cardiac Institute of Thailand will be conducting additional clinical trials on a cutting edge stem cell procedure that has shown promise in restoring cardiac function in damaged hearts again, hardly a simple procedure.
In summation, India has potential as a medical tourism destination however, if the sanitation and other infrastructure problems are not addressed and soon, that potential will not likely be realized. Other countries in the region may cost more but will likely remain the primary destinations. Patients from developed countries expect a clean safe environment both in the hospital and out.
Neal R. Yerkes, RN
May 3rd, 2006 at 7:27 am
The qustion if Thailand or India has the better cards in medical tourism is a recurring theme at the MediThai media watch website. Check it out and leave us your opinion. See you there.
May 5th, 2006 at 4:37 am
I beg to differ from what Neal has written. Though I agree to the sanitation problems in India but all is not that bad. I am in this trade for a little over 5 years now and though initially we had problems wooing patients from Western world to come over to India but things have changed drastically over the last two years. The problem of infection is more in Western countries with MRSA creating havoc for Western patients wanting treatment in other neighbouring European countries. We in India have no such issues and the kind of hospitality we shower to the incoming patients is something most courteous. I also would like to ask my worthy friend as to which are those instances wherein a patient has arrived in Delhi and have returned almost immediately. I am open to any such debate on my personal id sourav@longfieldmanagement.com just because I am too old in this field not to know anything concerning Indian or overseas Medical Tourism. Today if Thailand is doing well, everyone knows why it is doing well.Its more of a pleasure destination rather than anything else.In India you could probably have the best transplant surgery but since the legislation are strict for donors it is done at very selective instances. On the other hand there is absolutely no embargo in countries like Phillipines where any donor could come forward to donate in return for commercial consideration. These are hard realities but no one touches these subjects which forms basis of opinions. I have deepest regards for all healthcare professionals and do not want to reserve any comments for any one particular country but the claim of Mckinsey report that India is going to be one of the major healthcare destination by 2012 cannot be ignored. I shall definitely be there to see the claim matures into a reality and am pretty confident that it would.
Sourav Mukerjee,Delhi, India
May 17th, 2006 at 10:00 pm
In response to:
“The problem of infection is more in Western countries with MRSA creating havoc for Western patients wanting treatment in other neighbouring European countries. We in India have no such issues and the kind of hospitality we shower to the incoming patients is something most courteous.”
First, India does have an infection control problem. In fact there are no mandatory nosocomial (hospital origin) infection reporting requirements in India at this time. MRSA does exist in Indian facilities. Among the material I am familar with on ts topic s a 2004 doctoral thesis by a candidate at an Australian University. It cites multiple studies by Indian medical researchers on the nosocomil infection problem. According to the article, the nosocomial infection problem is always mentoned in Inda’s five year plans but the recomendations are never implemented. No one really knows the true statistics on nosocomoial infections in India but it is estimated to be as high as 30% vs 5% in the US. Without mandetory reporting requirements no one really knows and the numbers given by hospitals may not be accurate.
As to Indian hospitality, yes some Indians are are very welcoming. However the problem of inhospitable Indians is significant enough for the US Consular Information Sheet on India to warn potential tourists,
“U.S. citizens, particularly women, are cautioned not to travel alone in India. So-called “Eve Teasing” or verbal and sometimes physical harassment of Indian women is not unusual. There have been more reports in the past year of foreign women being harassed in this manner”.
The consular information sheet also warns travellers about the high risk of malaria and the poor food and water sanitation.
As to transplants, an Express Healthcare Management article on medical tourism in Singapore suggests India’s liver transplant have a high failure rate. Some wealthy indians are traveling to Singapore for liver transplant surgery rather than remaining home.
As to McKinsey, their projections may or may not be accurate. McKinsey’ credibility was damaged in the late 1990s and early 2000s. Google McKinsey Enron and read the articles.
Again, India has potential as a medical tourism destination but unless the problems are seriously addressed, and soon, that promise will likely not be realized.
Neal R. Yerkes, RN
May 17th, 2006 at 10:28 pm
In response to:
“Today if Thailand is doing well, everyone knows why it is doing well.Its more of a pleasure destination rather than anything else.”
I am very familar with the healthcare systems in Thailand and other Asian countries. Thailand has excellent facilites and physicians. It is not merely the pleasure aspect of medical tourism that draw people to the hospitals. Bumrungrad Hospital for example saw over twice as many medical tourism arrivals as did the entire country of India and that is only one hospital in Thailand. Bumrungrad boasts over 200 US Board certified physicians and surgeons. Many other hospitals in Thailand have US Board Certified physicians on their staff as well. India is not the only country in Asia with physicians educated in the United States or the UK.
As to transplants, Thailand began performing heart and liver transplants in the 1980s. The first transplants of this type were not performed in India until the mid 1990s and India was slow to adopt move advanced liver transplant surgery after that date.
The US Consular Information sheet on Thailand gives hospitals in Bangkok a good report. It states, “In Bangkok, excellent facilities exist for routine, long-term and emergency health care.” It states that, “Medical treatment is generally adequate throughout Thailand.”
On the same topic for India, the US Consular services states, “Adequate to excellent medical care is available in the major population centers, but is usually very limited or unavailable in rural areas. Visitors to India should pay special attention to safe food and water precautions, and steps the traveler can take to avoid contracting malaria.” The US Centers for Disease Control further recomends that travelers to most parts of India including New Delhi and Mumbai take malaria medication before arrival and during their stay to prevent disease.
Thailand is doing well in medical tourism as are Malaysia and Singapore because of the quality of the facilities and the environment outside the hospital.
Neal R. Yerkes, RN
February 15th, 2007 at 5:34 am
Though all of us are often concerned about the quality of medical treatment in India and complain about the level of sanitation and hygene, figures show India is doing extremely well in the medical tourism industry and is already a favorite among many patients who wish to tarvel abroad for treatment. This has even lead rise to organisations that are purely dedicated to the business of medical tourism. Now when we can provide such high quality treatment for foreign patients why cant we do it for our countrymen ?