What is Medical Tourism?
Medical Tourism can be defined as when clients go for medical treatment and choose to travel across international countries for medical services such as dental problems, beauty surgery, and different type of surgery and fertility treatment.
Medical tourism in India is a fast-growing sector. It has been estimated that the current size of the Indian medical tourism industry is a little over $ 3 billion and forecasted that the medical tourism industry will reach India by $ 6billion by 2018.
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It is one of the major drivers of the Indian economy along with biotechnology, software technology, and technology facilitates consumer services.
India has been the most attractive destination for visitors around the globe. But the recent trend in the tourism sector shows a propelling growth in this industry. This is not only because of the heritage attraction of the country but due to growing medical care facilities in India.
Medical tourism is a developing concept and this sector is growing at a very fast rate. India ranks second for medical tourism in the world. In India, people from the world over visiting for their medical and relaxation needs.
It is also offering other medical services like yoga, meditation, and Ayurveda, which is increasingly becoming popular as a non-surgical treatment for various ailments among foreign patients.
The major service providers in Indian medical tourism are the Apollo Hospitals, Escorts Hospital, Fortis Hospitals, Breach Candy, Hinduja, Mumbai’s Asian Heart Institute, Arvind Eye Hospitals, Manipal Hospitals, Mallya Hospital, Shankara Nethralaya, etc.
Challenges of Medical Tourism in India
Medical tourism is not a new field in today’s era but today also it has the potential to nurture. With growing ability, it also tackles many challenges that need to be undertaken.
The challenges faced by medical tourism in India are as follows:
Competition
Medical tourism is not only seeing immense growth in India rather it is seeing extensive growth one has to wait for long times for treatment in these above-said countries. And expectations of foreign customers are also increasing as they want personalized services at an affordable cost.
Follow-Up Problems
As the customer is coming from another country for treatment and if they want to follow up, it becomes very difficult for the patient especially in case of surgery, if any complexities occur after operation and the patient has departed to his own place/country.
In that case, it’s very difficult to follow up with the patient, which is also expensive in nature.
Cultural Proximity
One of the biggest barriers in medical tourism is from the cultural and language front. Many patients, doctors, and nurses are not able to understand the language, apart from the specialized doctors and extremely refined medical systems, many doctors and their staff are not able to communicate in their language which makes the system weak and difficulties arise on both the side; patient as well as on staff side.
Brain Drain
As our country is full of expert professionals but the main problem is to retain them, which is one of the biggest challenges in front of our country, because of not offering good salaries to them. In other countries, the professionalized and skilled professionals are very less so they hire people from India by offering higher salaries to them.
Quality
Quality is the main problem for patients while considering the medical tourism industry as a substitute treatment. Patients need a protected and elevated eminence in medical care. While selecting the other countries for medical treatment their focus is not only on the price but on the quality and safety also.
While choosing the hospitals and countries they also consider the nationalized and worldwide accreditation by quality monitoring bodies like the National Accreditation Board for Hospitals & Healthcare Providers (Indian Accreditation Body) and international boards such as Joint Commission International (JCI)/ Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
But it’s very sad to say that still, many Indian hospitals don’t have this accreditation.
Infrastructure
Before selecting the country, the customer also focuses on the Infrastructure, which is the main concern affecting India as a destination. Bad roads, improper flight connectivity all over the country, lighting problem, water availability are some of the drawbacks which lacking behind India in the race of medical tourism.
Growth of Medical Tourism in India
There are many reasons for the growth of medical tourism in India. The primary reasons cited for this are the cost advantage that the Indian health care sector enjoys in comparison to other countries. Along with cost advantage, the services are offered by internationally experienced specialists.
This mixture of world-class facilities at an affordable cost makes India one of the top five most favored medical tourist destinations in the world. India is also endowed with world-acclaimed tourist destinations.
India provides a wide range of tourist destinations with natural beauties (Jammu, Srinagar, Shimla, Dehradun, Kerala backwaters, beaches of Chennai, Mumbai, Goa, Kolkata, etc.) heritage sites (Western ghats, Sunderbans, Nilgiris, Ajanta, Ellora, and Elephanta caves) spiritual destinations (Varanasi, Haridwar, Bodh Gaya, Ajmer Sharif, Churches of Goa ) and Metropolitan cities (Delhi, Mumbai, Bangalore, Hyderabad).
This gives the tourists visiting India a variety of options to include along with the treatment of their ailments. Another reason for the growth of medical tourism in India is the comparative cost advantages of India vis-Ã vis other countries.
This difference in cost is depicted in the table below: The table below depicts the cost difference between India and other countries. When one compares cost between India and the United States of America (USA) it can be seen that there is a huge difference between the two.
For the heart bypass procedure, the difference amounts to $ 1,20,000. Between India and Thailand, the cost difference is not much but India scores well in the state-of-art technology and has world-class hospitals and doctors.
Some other reasons which are cited for the growth of medical tourism in India are:
- In some countries there are long lists for getting treated.
- Favorable exchange rates of developed countries in comparison to India. This makes the travelling and lodging cheap for people from these countries.
- India provides state-of- art facilities because of the specialized doctors, nurses and paramedical staffs.
Treatment Cost Comparison
| Procedures | US ($) | Costa Rica ($) | India ($) | Korea ($) | Mexico ($) | Thailand ($) | Malaysia ($) |
|---|---|---|---|---|---|---|---|
| Heart Bypass | 144,000 | 25,000 | 5,200 | 28,900 | 27,000 | 15,121 | 11,430 |
| Angioplasty | 57,000 | 13,000 | 3,300 | 15,200 | 12,500 | 3,788 | 5,430 |
| Heart Valve Replacement | 170,000 | 30,000 | 5,500 | 43,500 | 18,000 | 21,212 | 10,580 |
| Hip Replacement | 50,000 | 12,500 | 7,000 | 15,600 | 15000 | 15,152 | 12,350 |
| Knee Replacement | 50,000 | 11,500 | 6,200 | 19,800 | 12,000 | 12,297 | 7,000 |
| Spinal Fusion | 100,000 | 11,500 | 6,500 | 15,400 | 12,000 | 9,091 | 6,000 |
| Dental Implant | 2,800 | 900 | 1,000 | 4,200 | 1,800 | 3,636 | 345 |
| Lap Band | 30,000 | 8,500 | 3,000 | N/A | 6,500 | 11,515 | N/A |
| Breast Implants | 10,000 | 3,800 | 3,500 | 12,500 | 3,500 | 2,727 | N/A |
| Rhinoplasty | 8,000 | 4,500 | 4,000 | 5,000 | 3,500 | 3,901 | 1,293 |
| Face Lift | 15,000 | 6,000 | 4,000 | 15,300 | 4,900 | 3,697 | 3,440 |
| Hysterectomy | 15,000 | 5,700 | 2,500 | 11,000 | 5,800 | 2,727 | 5,250 |
| Gastric Sleeve | 28,700 | 10,500 | 5,000 | N/A | 9,995 | 13,636 | N/A |
| Gastric Bypass | 32,972 | 12,500 | 5,000 | N/A | 10,950 | 16,667 | 9,450 |
| Liposuction | 9,000 | 3,900 | 2,800 | N/A | 2,800 | 2,303 | 2,299 |
| Tummy Tuck | 9,750 | 5,300 | 3,000 | N/A | 4,025 | 5,000 | N/A |
| Lasik (both eyes) | 4,400 | 1,800 | 500 | 6,000 | 1,995 | 1,818 | 477 |
| Cornea (both eyes) | N/A | 4,200 | N/A | 7,000 | N/A | 1,800 | N/A |
| Retina | N/A | 4,500 | 850 | 10,200 | 3,500 | 4,242 | 3,000 |
| IVF Treatment | 2,800 | 3,250 | 2,180 | 3,950 | 9,091 | 3,819 |
Issues to Medical Tourism Industry in India
As various countries are at loggerheads to get a greater share in the medical tourism industry, India needs to carve out a distant place for itself, by leveraging its existing strengths and thereby offering a unique value proposition.
Generally, there are three types of medical tourists:
- Foreigners coming for medical treatment.
- Foreigners seeking treatment and leisure.
- Expatriates.
A country like India is facing the following issues/challenges to become a tourist destination with a competent medical tourism industry. They are:
- Lack of infrastructural facilities like lack of connectivity, lack of coordinating system, poor power supply and poor water supply.
- Most Indian hospitals are also facing the lack of trust from the foreign patients. The hospitals have observed poor hygiene awareness in medical attendants, unhygienic food handling, and lack of proper hospitality services, heterogeneous pricing of services and no industry standards.
- The government can play a vital part to upgrade the medical tourism sector. But the industry is facing the following problems which are caused by the governments. They are:
- no regulations,
- taxation anomalies,
- bureaucratic roadblocks,
- no works on land reforms,
- lack of long term investor friendly policies and
- instability with respect to terrorism and communal tensions.
- On the part of insurance and allied services, the medical tourism industry in India is also facing some key bottlenecks. They are:
- inadequate insurance cover,
- underdeveloped insurance market in India,
- insurance frauds and
- overseas companies refusing reimbursement.
- The following challenges, due to the infrastructural parts in medical tourism sector in India, are:
- poor accessibility,
- lack of capital,
- lack of Community participation and awareness,
- lack of involvement from rural sector,
- lack of concern for sustainability,
- complex visa procedures,
- lack of good language translators, and
- poor airport facilities.
- Apart from these, there are some specific issues to promote medical tourism in India. They are:
- quality accreditations to the Indian hospitals and service providers,
- training and Development to the Doctors, Nurses and Para medical staffs,
- lack of customer oriented approach.
Scope of Medical Tourism in India
India has many advantages. The first and the foremost is the cost advantage. Then, it has many hospitals equipped with international standards. Most Indian doctors and other medical staff have world-class exposure and are fluent in English which is connecting language globally.
India also has a whole lot of natural solutions to health like Ayurveda, and Sidha. It has many exotic tourist spots. Many medical tourists have already chosen India as their destination for treatments.
In the olden days, people used to travel to the USA to get advanced medical treatment. Now the reverse is happening. IT boom and cheaper flights make people to choose alternate health destinations for treatment.
Fast-paced lifestyle increases demand wellness tourism and alternative cures. Health insurance in countries like the USA covers only critical care and not cosmetic care and beauty treatments. Those who seek cosmetic /beauty treatments choose low-cost destinations like India.
Soaring medical costs, high insurance premiums, long waiting lists, a large number of uninsured/underinsured and insured in many advanced nations force people in those nations to be medical tourists. Insurance companies and employers also prefer to send patients to India in order to reduce health care expenses.
The large Indian community living abroad also makes use of a significant part of medical tourism in India. In Japan, the USA, UK, and many other European nations, the proportion of elder people has increased rapidly. At the same time, life expectancy has also increased steadily.
The combined result is significant demand for the natural healthcare system. The inability of many healthcare systems drives many individuals to seek alternatives to domestic healthcare. Demand from countries with underdeveloped healthcare capacities also increases.
The main opportunity presented by medical tourism is its contribution to the growth of health economies. It is a major source for foreign exchange and stimulates economic growth in other sectors including tourism, transport, pharmaceuticals, hotels, food suppliers to hospitals and restaurants.
The labor-intensive nature of the tourism industry makes it an excellent generator of employment. Medical tourism and the competition on the global health market promote technological advances and improved medical infrastructure.
After the SWOT analysis on Indian medical tourism and also interviewing the healthcare service providers in India as well as observing the different websites related to medical tourism’s growth and opportunities, the following marketing strategies may be used by India’s healthcare service providers.
They may be based on the 7 Ps of marketing mix:
Product
India has a number of hospitals offering world-class treatments in nearly every medical sector such as cardiology and cardiothoracic surgery, joint replacement, orthopedic surgery, gastroenterology, ophthalmology, transplants, and urology to name a few.
The various specialties covered are Neurology, Neurosurgery, Oncology, Ophthalmology, Rheumatology, Endocrinology, ENT, Paediatrics, Paediatric Surgery, Paediatric Neurology, Urology, Nephrology, Dermatology, Dentistry, Plastic Surgery, Gynaecology, Pulmonology, Psychiatry, General Medicine & General Surgery.
Major healthcare service providers in India have started expanding their business to other countries by investing in and/or operating hospitals or medical centers overseas. These hospitals function as a diagnostic center for screening cases and also for follow-ups in medical treatments.
Price
India’s healthcare service providers have a competitive advantage over their competitors due to its high standard of medical treatments and services offered to the patients at a very competitive price. In India, complicated medical procedures are being done only at one-tenth of the cost in industrialized countries.
But in terms of infrastructure facilities such as roads, sanitation, power backups, accommodations, and public utility services much more is needed for the country to become a medical tourism destination.
Place
Internet is the main means for disseminating information related to medical and non-medical care services offered by each healthcare service provider. It is the most effective and inexpensive way to reach the product to its target customers directly, and at the same time helping patients acquire correct and valuable information allowing them to make an informed decision.
Informative online marketing of each service provider creates awareness of the medical treatments available and reassures potential patients. Interactive communication, treatments description, description of services and facilities, quality assurance other concierge services were also presented on the websites to attract the patient who is on a medical traveling program.
Promotion
Most healthcare service providers in India particularly big private hospitals participate in travel marts, travel fairs, trade fairs, exhibitions, seminars, conferences, and advertise in travel magazines in countries with support from the government.
Articles, video, news related to their high quality and standard of medical treatments and services, health issues, latest medical technology equipment, quality assurance/awards/accreditation available on their own websites and also to the international media.
These help to create awareness of the available alternative medical treatments as well as to build up a positive image of the high quality and international standard of medical care in India.
People
Another strategy that Indian healthcare service providers may use is to attract international patients for their low-cost treatments in India as well as to get the medical services by its well–trained medical specialists who have qualified from well-known overseas institutes.
It is well acknowledged that having specialized and qualified doctors and staff gives a competitive advantage for the hospitals. However, shortage of doctors and trained medical staff is treated as the major concern in Medical Tourism in India.
Moreover, due to the misunderstanding of the patients’ culture is still considered a problem and challenge for the medical tourism business in India.
Process
International patients who seek medical treatments are mostly concerned with the quality of treatments and also want that the service providers preferably be accredited by a recognized international organization that audits medical quality.
India has a large pool of doctors (approx 6,00,000), nurses, and paramedics with required specialization and expertise and the language advantage (English speaking skills). The medical education system caters to the ever-increasing demand for the delivery of quality health care services all over the country.
The Joint Commission International (JCI) recognizes and accredits that the standard of the hospital meets or exceeds the standard of medical facilities as compared to the west. India is a popular destination for medical tourists.
Physical Evidence
In India, big hospitals like Apollo Hospitals, Escorts Hospital, Wockhardt Hospitals, Breach Candy Hospitals Lilavati Hospital, Manipal Hospitals, Mallya Hospital, AMRI Hospitals etc. have a good ambiance in their Infrastructures with spacious, luxury rooms and excellent amenities same as that of a five-star hotel for patients and relatives, and also are equipped with cutting-edge technology.
This is a competitive advantage of India in order to gain the confidence and build up the trust of international patients, making a decision to choose India as their preferred choice.
Suggestions to Develop Medical Tourism
- Role of Government
- Medical Visas
- Holistic Medical and Diagnostic Centers
- Setting Up National Level Bodies
- Integrate Vertically
- Joint Ventures or Alliances
Role of Government
The government of India must act as a regulator to institute a uniform grading and accreditation system for hospitals to build consumers’ trust. It also acts as a facilitator to encourage private investment in medical infrastructure and policy-making for improving medical tourism.
The government should actively promote FDI (Foreign direct investment) in the healthcare sector as well as also enacts conducive fiscal policies providing low-interest rate loans, reducing import/excise duty for medical equipment.
It also facilitates clearances and certification like medical registration numbers, anti-pollution certificates,s, etc. The government should reduce barriers in getting medical visas and institute visa-on-arrival for Patients and also can create medical attachés to Indian embassies that promote health services to prospective Indian visitors.
Medical Visas
A simplified system of getting medical visas should be developed in order to make travel across borders smoother. Visas can be extended depending on the condition of the patients.
The procedures for obtaining a medical visa, the subsequent registration and visa extension procedures are complicated and time-consuming. There is a need to simplify and speed up these procedures to make India a more attractive medical tourism destination.
Holistic Medical and Diagnostic Centers
Holistic medical and diagnostic centers within the corporate hospitals: Most of the big tertiary hospitals are opening up holistic centers within the premises, with yoga and meditation programs long with naturopathy, herbal medicine, acupuncture, and homeopathy departments.
The claim is that these enhance treatment. However, these services are charged for and add to additional revenues. The hospitals have small spaces for the relatives to pray in, thereby wedding science with religion and traditional with modern medical practices.
Setting Up National Level Bodies
To market India’s specialized healthcare products in the world and also address the various issues confronting the corporate healthcare sector, leading private hospitals across the country are planning to set up a national-level body on the lines of the National Association of Software and Service Companies (NASSCOM), the apex body of software companies in the country.
It is therefore essential to form an apex body for health tourism –the National Association of Health Tourism (NHAT).
Integrate Vertically
Various added services may be offered to the patients. For example, hospitals may have kiosks at airports, offer airport pickups, bank transactions, or tie-ups with airlines for tickets, and may help facilitate medical visas by the government.
With more Arab patients coming in, some hospitals may have hired Arabic interpreters, stocked up on prayer rugs, and opened up a kitchen serving the food preparations in corporate hospitals in India.
Joint Ventures or Alliances
To counter increasing competition in the medical tourism sector, Indian hospitals should tie up with foreign institutions for an assured supply of medical tourists. Specifically, they may tie-ups with capacity-constrained hospitals and insurance providers.
The Apollo group has also tied up with hospitals in Mauritius, Tanzania, Bangladesh, and Yemen. In addition, it runs a hospital in Sri Lanka and manages a hospital in Dubai.
As a part of this policy of promoting public and private initiatives, the Indian travel industry and tour operators have also designed packages that include air travel, hotel accommodation, and surgery expenses, claiming savings.