Back in the day (early 2000’s), mentioning the words medical travel in any discussion about healthcare usually triggered two types of reactions:
- The forward neck jerk (think of a hen), furrowed brow, slack-jawed…Whaa??? (i.e., I do not have a clue what you’re talking about).
- Slowly nodding ascent with a growing smirk (i.e., I think you’re pulling my leg but I’m not quite sure).
Fast forward to today and the above reactions have almost disappeared. Instead, they are being replaced by C. “Yes, I heard about medical travel on the news the other day” or “A co-worker of mine just came back from Mexico where she had incredibly inexpensive dental treatment.”
Medical travel (more popularly known as medical tourism) has come a long way since the Greeks and Romans sought out healing temples and hot baths to cure their ailments. It is now a growing industry with patients from around the globe traveling across borders or overseas for treatments. A quick search on Google brings up nearly 5 million hits for the term medical tourism including topics such as: ”Medical Tourism Booms in Asia,” “Top 10 Medical Tourism Destinations in the World,” “How AXA Sees the Future of Medical Tourism,” “Uganda Seeks to Deepen Medical Tourism Cooperation,” and “Switzerland Seeks to Tap Medical Tourism.”
However, popularity does not necessarily breed understanding. There is still a lot of misinformation or misconceptions about medical travel. In this article, we will look at some possible misconceptions about medical travel from the perspective of healthcare providers – particularly those who are not actively engaged in treating traveling patients.
- Medical travel is a fad that has come and gone
The dynamics of patient flow differ from region to region and can be influenced at any given time by population demographics, socioeconomic factors, government policies, and political realities, among other factors. However, the reality is medical travel is growing. In a 2016 report issued by VISA (Visa, 2014), the size of global medical tourism industry was estimated at between 45.5 – 72 billion UDS and projected to grow up to 25% year-over-year for the next 10 years as an estimated three to four percent of the world’s population will travel internationally for healthcare and health-related treatment. Healthcare providers may choose not to actively target medical travelers, however, they should not ignore that the globalization of healthcare is providing unprecedented opportunities for hospitals and clinics to expand their service lines and to penetrate new markets.
- Medical tourism is an easy way for our hospital to bring in some quick revenue
If this were true, many more hospitals around the world would be involved in medical travel. The reality is putting a solid medical travel program together takes a lot of work and is not something that happens in three or even six months. Like any important business initiative, it takes planning, focus and long-term commitment to succeed. To achieve success, healthcare provides must understand the needs and expectations of traveling patients, promote or develop a service line that is attractive to the traveling patient populations they are targeting, and implement the protocols, policies and services to address their target markets’ needs. Most importantly, these initiative must be buttressed by clinical excellence and the ability to deliver a high-quality patient experience.
- Medical travel is always international
While medical travel is often discussed in the context of traveling abroad, in many instances patients are traveling for care within their own countries. In the U.S., an increasing number of self-funded employers are contracting directly with Centers of Excellence so as to improve healthcare outcomes and reduce costs. Many of their employees must travel for medical care to hospitals such as the Cleveland Clinic (OH), Mercy Hospital Springfield (MO) and others. Large countries such as China, Russia and India also experience internal medical travel or what is sometimes called domestic medical travel. And while these domestic patients may not experience all the same challenges as international medical travelers with regards to language and cultural barriers (or at least not to the same degree), they still may require assistance with travel, accommodation and orientation while in the hospital or clinic.
- Traveling patients receive preferential care compared to local patients
To the casual observer, it may appear that medical travelers are receiving preferential or special treatment compared to local patients. For instance, medical travelers may get assistance with travel, hotel reservations, airport pickup and transportation, a fast-track admission process, access to a private lounge and sometimes an advocate or healthcare coordinator who helps them navigate the hospital’s facilities and coordinates appointments. While this certainly may seem like special treatment, the reality is that traveling patients share certain unique circumstances and needs that must be addressed in order to ensure a safe and high-quality patient experience. These include but are not limited to:
- They must travel to access medical services.
- Diagnosis or corroboration of the diagnosis is often performed remotely.
- They may be more susceptible to bringing or contracting infectious diseases.
- They may not be familiar with the medical travel destination, its laws, language(s), customs and culture.
- Orientation at the destination and inside the hospital may be difficult for them.
- They may arrive overly stressed and fearful simply because this is a strange situation to them.
- They will often undergo a shortened in-country recovery process after surgery or treatment.
- They may spend part of their recovery time in a hotel setting.
- They may have to travel long distances within a relatively short time after surgery.
- They may need additional care or monitoring after they return home.
Without customized services it would be very difficult – and perhaps unsafe, for patients to coordinate care in other countries.
- We don’t need to set up a special program to target medical travelers, international patients can find us just fine
This approach may work if your organization has no interest in targeting foreign patients or if you are content receiving the occasional medical tourist or injured tourist. Some hospitals may have one or more doctors on staff who are attracting medical travelers on their own. However, if your goal is to develop a sustainable medical travel program that is growing and facilitates a high-quality patient experience across the entire medical travel continuum, you will want to develop a formal medical travel program and track key performance indicators relevant to medical travel patients. You cannot improve what you are not measuring. This does not mean that you must immediately hire or assign 10 staff members to an international office, revamp your website and pour fifty thousand dollars into international marketing campaigns. Depending on your particular circumstances, you may decide to start with one person overseeing all medical travelers. What it does require is developing a strategic plan and identifying the steps you need to take to reach your goals.
- The primary reason for medical travel is savings
There are a number of factors that motivate patients to travel for medical care, these include savings, better quality, unavailability of certain treatments due to government restrictions or lack of medical expertise, and quicker access to care. The primary reason for seeking treatment will be dependent on each patient’s particular circumstances, however, certain markets or regions are often identified with certain motivating factors. For example, anecdotal evidence and several reports suggest that:
- Savings is the primary motivating factor for medical travelers from the U.S. 
- Quick access to treatments is a main motivating factor for Canadian medical travelers.
- Better quality and/or unavailability of certain treatments is the main motivating factor for patients from China, Russia, some GCC nations and several African nations.   
So while savings may be the motivating factor that is most highlighted – at least in the West, it is certainly not the primary reason for medical travel in many parts of the world.
- We have a national or international accreditation, therefore there is no need for external oversight in medical travel
It is extremely important to pursue a national and/or recognized international accreditation to ensure organizations have evidenced-based clinical and patient safety protocols in place. However, it is also important to understand the difference between a clinical-focused accreditation such as Joint Commission International or Accreditation Canada, and an accreditation focused on medical travel such as Global Healthcare Accreditation (GHA). The GHA program complements existing national and international clinical accreditation programs. While these programs traditionally focus on the clinical aspects of care for the entire organization, GHA conducts a deep review of the medical travel or International patient services program, focusing on three main competencies: Patient Experience, Sustainable Business Processes and Care Management. Most importantly, GHA provides concrete and measurable value to patients by ensuring that the hospital or clinic has instituted processes customized to the medical travelers’ unique needs and expectations – and are constantly monitoring them for improvement.
For healthcare providers who are unfamiliar with medical travel or who are seeking to learn more about this growing market, we hope the information in this article provides a little more clarity about the realities of the industry, the challenges facing traveling patients, and some of the steps needed to develop a strong medical travel program.
 Visa. (2014). Mapping the Future of Global Travel and Tourism [Visa Projection]. Retrieved from https://usa.visa.com/dam/VCOM/global/partner-with-us/documents/global-travel-and-tourism-insights-by-visa.pdf
 2013 MTA Medical Tourism Survey Report. http://www.medicaltourismassociation.com/en/2013-mta-survey-report.html
 Medical Tourism: Push and Pull Factors (2014). http://www.healthcareresearchcenter.org/medical-tourism-push-and-pull-factors/
 Rich Chinese Seek Healthcare Overseas 2015 http://www.globaltimes.cn/content/932404.shtml
 Germany Has Designs on Arab Medical Tourism Patients. (2015). http://www.medicaltourismmag.com/germany-has-designs-on-arab-medical-tourism-patients/
 Nigeria Spends $1 Billion on Outbound Medical Tourism. (2014). https://www.imtj.com/news/nigeria-spends-1-billion-outbound-medical-tourism/
*Medical travel is also known as medical tourism or health tourism.