Medical Tourism in India
Medical Tourism in India
Medical Tourism in India
Introduction
After the silicon rush India is now considered as the golden spot for treating
patients mostly from the developed countries and far east for ailments and
procedures of relatively high cost and complexity. India is also aggressively
promoting medical tourism in the current years -and slowly now it is moving
into a new area of "medical outsourcing," where subcontractors provide
services to the overburdened medical care systems in western countries.
Going by the Statistics and various studies it can be easily said that india
would be the leader in medical tourism within the next decade if only it could
improve the infrastructure and tour attractions. The question or rather the
doubt that is often asked by critics is how can India provide top line medical
care to outsiders while more than 40% of its people languished below poverty
line and less than 20% of its people can actually afford medical services.
Ethically and morally this problem has to be solved if India has to move into
the category of developed country and also as a place which provides medical
care to both its own people and patients from other country
The aim of this project is to put a finger on the highly profitable service of
medical care combined with tourism in which india is currently considered as
a market leader. It has been a known fact for past many decades that Indian
doctors are highly skillful in their given field since all around the globe mot
hospitals have doctors of Indian origin. Therefore it became almost natural
that this trend extended to India.
This project also aims to show why India is attracting medical tourists, is it
really a secure destination and how India can promote and develop this
particular activity in the coming years so as face competition given by other
Asian and African options.
The reasons patients travel for treatment vary. Many medical tourists from the
United States are seeking treatment at a quarter or sometimes even a 10th of
the cost at home. From Canada, it is often people who are frustrated by long
waiting times. From Great Britain, the patient can't wait for treatment by the
National Health Service but also can't afford to see a physician in private
practice. For others, becoming a medical tourist is a chance to combine a
tropical vacation with elective or plastic surgery.
And moreover patients are coming from poorer countries such as Bangladesh
where treatment may not be available and going for surgery in European or
western developed countries is expensive.
Countries that actively promote medical tourism include Cuba, Costa Rica,
Hungary, India, Israel, Jordan, Lithuania, Malaysia and Thailand. Belgium,
Poland and Singapore are now entering the field. South Africa specializes in
medical safaris-visit the country for a safari, with a stopover for plastic
surgery, a nose job and a chance to see lions and elephants.
Thailand
While, so far, India has attracted patients from Europe, the Middle East and
Canada, Thailand has been the goal for Americans.
India initially attracted people who had left that country for the West; Thailand
treated western expatriates across Southeast Asia. Many of them worked for
western companies and had the advantage of flexible, worldwide medical
insurance plans geared specifically at the expatriate and overseas corporate
markets.
The medical tour companies that serve Thailand often put emphasis on the
vacation aspects, offering post-recovery resort stays.
South Africa
South Africa also draws many cosmetic surgery patients, especially from
Europe, and many South African clinics offer packages that include personal
assistants, visits with trained therapists, trips to top beauty salons, post-
operative care in luxury hotels and safaris or other vacation incentives.
Because the South African rand has such a long-standing low rate on the
foreign-exchange market, medical tourism packages there tend to be
perpetual bargains as well.
Argentina
Argentina ranks high for plastic surgery, and Hungary draws large numbers
of patients from Western Europe and the U.S. for high-quality cosmetic and
dental procedures that cost half of what they would in Germany and America.
Dubai
Other countries
Tourism will expand greatly in future mainly due to the revolution that is taking
place on both the demand and supply side. The changing population
structure, improvement in living standard, more disposable income, fewer
working hours and long leisure time, better educated people, ageing
population and more curious youth in the developed as well as developing
countries, all will fuel the tourism industry growth.
One of the fascinations of India is the juxtaposition of old and new; centuries
of history – from the pre-historic Indus civilization to the British Raj – rub
shoulders with the computer age; and Bangalore's ‘Silicon Valley’ is as much
a part of the world's largest democracy as the remotest village is.
Weaknesses
Lack of adequate infrastructure is the biggest problem that India faces. The
aviation industry in India, for example, is inefficient and does not provide
even the basic facilities at airports. The visitors are appalled by the poor
sanitation in the public restrooms at the international airports. The road
condition in India is very worse. The population has grown exponentially since
1947 but we still use the same rail system constructed by the British.
Opportunities
More proactive role from the government of India in terms of framing policies.
Allowing entry of more multinational companies into the country giving us a
global perspective.
Growth of domestic tourism. The advantage here is that domestic tourism and
international tourism can be segregated easily owing to the different in the
period of holidays.
Threats
Political turbulence within India in Kashmir and Gujarat has also reduced
tourist traffic. Not only that fear of epidemics such as for malaria, cholera,
dengue, plague etc are foremost in the mind of European and America
patients .Aggressive strategies adopted by other countries like Australia,
Singapore in promoting tourism are also not helping.
AYURVEDA
India has a rich heritage in the areas of traditional and natural medicines. The
earliest mention of Indian medical practices can be found in the Vedas and
Samhitas of Charaka, Bhela and Shusruta. A systematic and scientific
approach was adopted by the sages of the time leading to the development of
a system that is relevant even today. India is the land of Ayurveda. It believes
in removing the cause of illness and not just curing the disease itself. It is
based on herbals and herbal components without having side effects.
Ayurveda considers that the base of life lies in the five primary elements;
ether (space), air, fire, water and earth. And the individual is made up of a
unique proportion of the five elements in unique combinations to form three
doshas (vata, pita and kapha). When any of these doshas become accute, a
person falls ill. Ayurveda recommends a special life style and nutritional
guidelines supplemented with herbal medicines. If toxins are abundant, then a
cleaning process known as Panchkarma is recommended to eliminate those
unwanted toxins and revitalize both mind and body. Ayurveda offers
treatments for ailments such as arthritis, paralysis, obesity, sinusitis, migraine,
premature aging and general health care. Kerala is a world tourist destination
and part of the reasons lies with the well- known stress-releasing therapies of
famed Ayurvedic research centers. The climate along with the blessing of
nature has turned Kerala into the ideal place for ayurvedic, curative and
rejuvenating treatments.
YOGA
If Ayurveda is the science of body, yoga is the science of the mind. Practiced
together they can go a long way in making an individual fit. The word yoga
means to join together. The ultimate aim of yoga is to unite the human soul
with the universal spirit. Yoga was developed 5000 years ago and the base of
yoga is described in the Yoga Sutra of Patanjali.
This describes eight stages of yoga. These are Yam (universal moral
commands), Niyam (self purification), Asana (posture), Pranayama (breathing
control), Prathyahara (withdrawal of mind from external objects), Dharana
(concentration), Dhyana (meditation), and Samadhi (state of
superconsciousness). To get the benefits of yoga, one has to practice Asana,
Pranayama and Yoganidra. With the regular practice of asanas one can 327
control cholesterol level, reduce weight, normalize blood pressure and
improve cardiac performance. Pranayama helps to release tensions, develop
relaxed state of mind and Yoganidra is a form of meditation that relaxes both
physiological and psychological systems. Today, yoga has become popular in
India and abroad and in a number of places including urban and rural areas
yoga is taught and practiced.
SPA TREATMENT
Most of the other parts of the world have their own therapies and treatment
that are no doubt effective in restoring wellness and beauty. New kinds of
health tours that are gaining popularity in India are spa tours. Spas offer the
unique advantages of taking the best from the west and the east combining
them with the indigenous system and offering best of the two worlds. In
hydropathy, Swedish massages work with the Javanese Mandy, lulur,
aromatherapy, reflexology and traditional ayurveda procedures to help keep
the tourist healthy and enhance beauty. Combining these therapies with
meditation, yoga and pranayama make the spa experience in India a new
destination for medical tourism. The spas are very useful for controlling blood
pressure, insomnia, cure tension, depression, paralysis and number of other
deadly diseases. Ananda
India has made rapid strides in advanced health care systems, which provides
world-class allopathic treatment. This has become possible because of the
emergence of the private sector in a big way in this field. More and more
foreign tourists are realizing that India is an ideal place for stopover treatment.
Indian Multi-specialty hospitals are providing worldclass treatment at an
amazingly economical cost as compared to the west. Quality services and low
price factor primarily go in favour of India. The cardio care, bone marrow
transplantation, dialysis, kidney transplant, neuron–surgery, joint replacement
surgery, urology, osteoporosis and numerous diseases are treated at Indian
hospitals with full professional expertise. Apollo hospital group, Escorts in
Delhi, Jason Hospital, Global Hospital, and Max Health Care are catering to
medical care for international patients in the areas of diagnostic, disease
management, preventive health care and incisive surgeries.
SPIRITUAL TOURISM
Globally people are increasingly mentally disturbed and looking for solace in
spiritual reading, meditation and moments of divine ecstasy. Our country has
been known as the seat of spiritualism and India’s cosmopolitan nature is best
reflected in its pilgrim centres. Religion is the life-blood for followers of major
religion and sects. Hinduism, Islam, Buddhism, Jainism, Zoroastrianism and
Christianity have lived here for centuries. The visible outpouring of religious
fervor is witnessed in the architecturally lavish temples, mosques,
monasteries and Churches spreads across the length and breadth of the
country. India is not only known as a place rich in its culture with varied
attractions but also for many places of worship, present itself as embodiments
of compassion where one get peace of mind. Thus India has been respected
as a destination for spiritual tourism for domestic and international tourists.
Spiritual tourism is also termed as religious heritage tourism. It includes all the
religions mentioned above; religious places associated with, emotional
attachment to these centers and infrastructure facilities for the tourists. This
can also be referred to as pilgrimage tourism, as clients are not looking for
luxury but arduous journeys to meet the divine goal or simple life. The
essence of spiritual tourism is inner feeling through love. Love should not be
rationed on the basis of caste, creed and economic status or intellectual
attainment of the recipient. Religions come into existence for the purpose of
regulating human life; what are common to all of them are the principles of
love. Thus through religious tourism there is a sincere effort to bring better
understanding among various communities, nations and thus foster global
unity.
Hinduism is one of the oldest religions of India. Over 5000 years of religious
history created wonderful temples and survived through ages all over India.
The most popular spiritual tours are those that are centered on holy Ganges
River. Badrinath, Kedarnath, Haridwar, Gangotri, Yamunotri, Allahabad,
Varanasi. Jaganath temple at Puri, Bhubaneshwar, Konark in Orissa, Mata
Vaishnodevi of Jammu and Kashmir, are some of the important pilgrim
centers in north India. There are many spiritual sites in South India as well
The Jain temples of Dilwara and Mount Abu in Rajasthan, the Gomateswara
temple at Karnataka, draw thousands of Jain followers. Even small
communities like the Bahais have their own Lotus Temple at Delhi. The
Sultanate and Moghul empires built many historical monuments and mosques
during their reign, all over the country. Red Fort, Fatehapur Sikri, Jama
Masjid, TajMahal, Charminar etc., bear testimony to the blend of the Indian
and Islam traditions of architecture. The followers of Islam have many
mosques and shrines of Sufi Saints, like Moin-Uddin Chisti and Nizamuddin
Aulia. For Christians, spiritual tours to Goa among other place like Mumbai
and Kolkata are must. Among the most popular sites in Goa is the church of
Our Lady of Rosary, the Rachel Seminary, and Church of Bom Jesus. In
addition to pilgrim centers there are personalities like the Satya Sai Baba,
Osho, Shirdhi and others. This shows that spirituality and religion in India is a
serious pursuit. The State Governments concerned, charitable trusts, temple
trusts have made elaborate arrangements for accommodation, transport and
ritual ceremonies. These organizations are also running hospitals, educational
institutes, ashrams, meditation centers which benefit local community. More
than 500 religious places have been identified and efforts are being made to
develop these centers by Central and State Governments with private
participation.
ADVENTURE TOURISM
Youth tourism has been identified as one of the largest segments of global
and domestic tourism. The young travellers are primarily experience seekers,
collecting, enquiring unique experiences. Adventure and risk have a special
role to play in the behaviour and attitudes of young travellers. The growing
number of young travellers is being fuelled by a number of factors such as
increased participation in higher education, falling level of youth
unemployment, increased travel budget through parental contribution, search
for an even more exciting and unique experience and cheaper long distance
travel.
RURAL TOURISM
Rural tourism has been identified as one of the priority areas for development
of Indian tourism. Rural tourism experience should be attractive to the tourists
and sustainable for the host community. The Ninth Plan identified basic
objectives of rural tourism as: -
This is the genesis of “Medical Tourism” industry. The term medical tourism
refers to the increasing tendency among people from the UK, the US and
many other third world countries, where medical services are either very
expensive or not available, to leave their countries in search for more
affordable health options, often packaged with tourist attractions.
Long waiting lists, decline in public spending and rise in life expectancy and
non-communicable diseases that require specialist services are some of the
factors directing a wave of medical tourists to more affordable healthcare
destinations. Most countries are tapping the health tourism market due to
aggressive international marketing in conjunction with their tourism industry.
In this rat race, Thailand, Malaysia, Jordan, Singapore, Hong Kong, Lithuania
and South Africa have emerged as big healthcare destinations.
India is unique as it offers holistic healthcare addressing the mind, body and
spirit. With yoga, meditation, ayurveda, allopathy and other Indian systems of
medicine, India offers a vast array of services combined with the cultural
warmth that is difficult to match by other countries. Also, clinical outcomes in
India are on par with the world’s best centres, besides having internationally
qualified and experienced specialists. CII believes that India should capitalise
on its inherent strengths to become a world player in medical tourism.
According to a CII-Mc Kinsey study, medical tourism in India could become a
USD 1 billion business by 2012. Instead of adopting a segmental approach of
targeting a few states such as Maharashtra, Kerala, Andhra Pradesh,
Chennai, efforts are now being made to project “Destination India” as a
complete brand ideal for medical tourists. Countries from where people head
for India are the UK, Bangladesh, Oman, Sri Lanka, Indonesia, Mauritius,
Nigeria, Kenya, Pakistan, etc.
Visitors, especially from the West and Middle East find Indian hospitals a very
affordable and viable option to grappling with insurance and national medical
systems in their native lands. There are thousands of expatriates without any
social security and health insurance cover who usually compare the costs
before going for treatment and India has a cost advantage for this segment.
Although, the existing market for medical tourism in India is small, it can grow
rapidly if the industry reorients itself to lure foreign patients from all potential
regions such as SAARC, Central Asia, Middle East, Africa, Europe, OECD
besides the UK and the US. The annual health bill of people from Afro-Asian
countries seeking treatment outside their countries is USD 10 billion. If India
can even tap a fraction of that market, the potential is enormous. The price
advantage is however offset today for patients from the developed countries
by concerns regarding standards, insurance coverage and other
infrastructure.
The question being asked by many is that how can India become an
international destination in healthcare, when the clientele at home is bristling
with dissatisfaction. Hence, arises the need to define minimum standards at
national level, compulsory registration and adoption of these standards by all
providers and regular monitoring and enforcing of such standards at the local
level. Quality assessment should combine evaluation of infrastructure as well
as outcomes.
Many fear about the serious consequences of equity and cost of services and
raise a fundamental question on the very existence of medical tourism- why
should developing countries be subsidising the healthcare of developed
nations? For them, medical tourism is likely to further devalue and divert
personnel from the already impoverished public health system. However, with
good planning and implementation, medical tourism besides being an
economy booster can surely help India maintain good cross border and trade
relations, exchange of manpower and technology among countries.
Strategies are thus needed not just to project India as a major healthcare
destination, but also to create a system to conduct proper market research
and feasibility studies in order to quantify the “How many”, “From where”, “To
where”, and most importantly the “How” of medical tourism. Only then can we
leverage and channelise all efforts in the right direction. In the absence of
proper planning, formulation, implementation and evaluation of coherent
strategies, the much created hype and all the talk may just go in vain.
Medical tourists have good cause to seek out care beyond the United States
for many reasons. In some regions of the world, state-of-the-art medical
facilities are hard to come by, if they exist at all; in other countries, the public
health-care system is so overburdened that it can take years to get needed
care. In Britain and Canada, for instance, the waiting period for a hip
replacement can be a year or more, while in Bangkok or Bangalore, a patient
can be in the operating room the morning after getting off a plane.
For many medical tourists, though, the real attraction is price. The cost of
surgery in India, Thailand or South Africa can be one-tenth of what it is in the
United States or Western Europe, and sometimes even less. A heart-valve
replacement that would cost $200,000 or more in the U.S., for example, goes
for $10,000 in India--and that includes round-trip airfare and a brief vacation
package. Similarly, a metal-free dental bridge worth $5,500 in the U.S. costs
$500 in India, a knee replacement in Thailand with six days of physical
therapy costs about one-fifth of what it would in the States, and Lasik eye
surgery worth $3,700 in the U.S. is available in many other countries for only
$730. Cosmetic surgery savings are even greater: A full facelift that would
cost $20,000 in the U.S. runs about $1,250 in South Africa.
The savings sound very attractive, but a good new hip and a nice new face
don’t seem like the sort of things anyone would want to bargain with. How
does the balance of savings versus risk pay off in terms of success rates
Inferior medical care would not be worth having at any price, and some
skeptics warn that Third World surgery cannot possibly be as good as that
available in the United States. In fact, there have been cases of botched
plastic surgery, particularly from Mexican clinics in the days before anyone
figured out what a gold mine cheap, high-quality care could be for the
developing countries.
Yet, the hospitals and clinics that cater to the tourist market often are among
the best in the world, and many are staffed by physicians trained at major
medical centers in the United States and Europe.
Bangkok’s Bumrundgrad hospital has more than 200 surgeons who are
board-certified in the United States, and one of Singapore’s major hospitals is
a branch of the prestigious Johns Hopkins University in Baltimore. In a field
where experience is as important as technology, Escorts Heart Institute and
Research Center in Delhi and Faridabad, India, performs nearly 15,000 heart
operations every year, and the death rate among patients during surgery is
only 0.8 percent--less than half that of most major hospitals in the United
States.
Add to this the fact that some clinics assign patients a personal assistant for
the post-hospital recovery period and throw in a vacation incentive as well,
and the deal gets even more attractive. Additionally, many Asian airlines offer
frequent-flyer miles to ease the cost of returning for follow-up visits.
In monetary terms, experts estimate that medical tourism could bring India as
much as $2.2 billion per year by 2012. Argentina, Costa Rica, Cuba, Jamaica,
South Africa, Jordan, Malaysia, Hungary, Latvia and Estonia all have broken
into this lucrative market as well, or are trying to do so, and more countries
join the list every year.
Some important trends guarantee that the market for medical tourism will
continue to expand in the years ahead. By 2015, the health of the vast Baby
Boom generation will have begun its slow, final decline, and, with more than
220 million Boomers in the United States, Canada, Europe, Australia and New
Zealand, this represents a significant market for inexpensive, high-quality
medical care.
Advantage India
As Indian corporate hospitals are on par, if not better than the best hospitals
in Thailand, Singapore, etc there is scope for improvement, and the country
may become a preferred medical destination. In addition to the increasingly
top class medical care, a big draw for foreign patients is 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.
The Apollo Group, Escorts Hospitals in New Delhi and Jaslok Hospitals in
Mumbai are to name a few which are established names even abroad. A list
of corporate hospitals such as Global Hospitals, CARE and Dr L.V. Prasad
Eye Hospitals in Hyderabad, The Hindujas and NM Excellence in Mumbai,
also have built capabilities and are handling a steadily increasing flow of
foreign patients. India has much more expertise than say Thailand or
Malaysia. The infrastructure in some of India's hospitals is also very good.
What is more significant is that the costs are much less, almost one-third of
those in other Asian countries.
India will soon become THE global health destination. It is replicating the Thai
model, which has been the first Asian destination for International Patients.
India benefits from a large staff of world class experts and the ultra-
competitive cost advantage it offers.
With prices at a fraction (less than 10% for example in the treatment of gall
stone $600 US ) of those in the US or EU, the concept has broad consumer
appeal. Indian private facilities offer advanced technology and high-quality
treatment at par with hospitals in western countries.
India has top-notch centers for open-heart surgery, pediatric heart surgery,
hip and knee replacement, cosmetic surgery, dentistry, bone marrow
transplants and cancer therapy, and virtually all of India’s clinics are equipped
with the latest electronic and medical diagnostic equipment.
Unlike many of its competitors in medical tourism, India also has the
technological sophistication and infrastructure to maintain its market niche,
and Indian pharmaceuticals meet the stringent requirements of the U.S. Food
and Drug Administration. Additionally, India’s quality of care is up to American
standards, and some Indian medical centers even provide services that are
uncommon elsewhere. For example, hip surgery patients in India can opt for a
hip-resurfacing procedure, in which damaged bone is scraped away and
replaced with chrome alloy--an operation that costs less and causes less
post-operative trauma than the traditional replacement procedure performed
in the U.S.
Healthcare procedures across the world show a wide cost difference. It leads
to a question of affordability even to the developed country like the US where
significantly huge number of population is not covered under any insurance
scheme. In some developed country, long waiting period for elective inpatient
and outpatient care has created a situation where people do not hesitate to
buy healthcare from other developing countries like India without
compromising on quality.
Complimentary tourism packages make the entire offer more attractive to the
people who are interested to travel for their healthcare. Globalisation of
healthcare industry has started in many level. For instance, Indian software
companies like TCS and Mastek has signed IT contract recently worth more
than US $ 200 million.
In India, international tourist rose 15.3 per cent between January and
December, 2003. Though tourism and travel industry contribution is 2.5 per
cent to our countries GDP (international ranking 124) but recent initiative from
the government like liberalised open sky policy to increase flight capacity,
lower and attractive fares, increase in hotel room capacity by nearly 80 per
cent (from 2000) and better connectivity between major tourist destination
(Express Highway project) has helped India to rank among the top five
international holiday destination when independent traveler conducted a poll
in 134 countries.
The idea of the health holiday is to offer you an opportunity to get away from
your daily routine and come into a different relaxing surrounding. Here you
can enjoy being close to the beach and the mountains. At the same time you
are able to receive an orientation that will help you improve your life in terms
of your health and general well being. It is like rejuvenation and clean up
process on all levels - physical, mental and emotional.
Many people from the developed world come to India for the rejuvenation
promised by yoga and Ayurvedic massage, but few consider it a destination
for hip replacement or brain surgery. However, a nice blend of top-class
medical expertise at attractive prices is helping a growing number of Indian
corporate hospitals lure foreign patients, including from developed nations
such as the UK and the US.
As more and more patients from Europe, the US and other affluent nations
with high medicare costs look for effective options, India is pitted against
Thailand, Singapore and some other Asian countries, which have good
hospitals, salubrious climate and tourist destinations. While Thailand and
Singapore with their advanced medical facilities and built-in medical tourism
options have been drawing foreign patients of the order of a couple of lakhs
per annum, the rapidly expanding Indian corporate hospital sector has been
able to get a few thousands for treatment.
In India, the Apollo group alone has so far treated 95,000 international
patients, many of whom are of Indian origin. Apollo has been a forerunner in
medical tourism in India and attracts patients from Southeast Asia, Africa, and
the Middle East. The group has tied up with hospitals in Mauritius, Tanzania,
Bangladesh and Yemen besides running a hospital in Sri Lanka, and
managing a hospital in Dubai.
Analysts say that as many as 150,000 medical tourists came to India last
year. However, the current market for medical tourism in India is mainly
limited to patients from the Middle East and South Asian economies. Some
claim that the industry would flourish even without Western medical tourists.
Afro-Asian people spend as much as $20 billion a year on health care outside
their countries - Nigerians alone spend an estimated $1 billion a year. Most of
this money would be spent in Europe and America, but it is hoped that this
would now be increasingly directed to developing countries with advanced
facilities.
The global healthcare market is USD 3 trillion and size of the Indian
healthcare industry is around 1,10,000 crores accounting for nearly 5.2 per
cent of GDP. It is likely to reach 6.2- 8.5 per cent of the GDP by 2012. It is
expected that medical tourism will account about 3-5 per cent of the total
delivery market.
More than 1,50,000 medical tourists came to India in 2003. Around 70,000
people came from the Middle East for the medical treatment. Traditional
system of medicine is able to attract a sizeable number of people from
western countries (Kerala, for instance). Most of the medical tourists are
Indian in origin. We need to attract more number of people of foreign origin.
Significant cost differences exist between U.K. and India when it comes to
medical treatment.
India is not only cheaper but the waiting time is almost nil. This is due to the
outburst of the private sector which comprises of hospitals and clinics with the
latest technology and best practitioners.
Significant cost differences exist between U.K. and India when it comes to
medical treatment. Accompanied with the cost are waiting times which exist in
U.K. for patients which range from 3 months to over months.
India is not only cheaper but the waiting time is almost nil. This is due to the
outburst of the private sector which comprises of hospitals and clinics with the
latest technology and best practitioners.
Procedure
Heart Valve
Replacement $160,000 $9,000 $10,000 $12,500
*approximate retail costs, US figures based on HCUP data, intl. figures based
on hospital quotes in named countries
Crown
Tooth impactions 500 2,000 100
Root canal 600 1,000 100
Treatment
Tooth whitening 350 800 110
Tooth colored 200 500 25
composite fillings
Tooth cleaning 100 300 75
The chief cities attracting foreign patients to India are Mumbai, Bangalore,
Hyderabad, Kolkata and Chennai. Similarly, the speciality hospitals excelling
in the medical tourism industry in the country are:
Medical Packages
• Heart surgery packages like Cardiac Surgery And Cardiology, Open Heart
Surgery, Angiographies and Angioplasties.
• Put in touch with a world class Private hospital or Nursing home and the
doctor & fix up an appointment with the doctor at the hospital.
• Receive you at the airport and provide transportation to the hotel and for
the rest of the days during your stay here.
• Provide accommodation in a hotel as per your choice and budget near the
Nursing Home or the Private hospital.
• In addition to the increasingly top class medical care, a big draw for foreign
patients is 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.
2. Ailments that require a one shot treatment like surgery for gall stones,
hernia, piles, varicose veins, hysterectomy, adrenalectomy, nephrectomy,
thyroidectomy, joint replacement etc are more suitable for medical tourism.
3. The ailment should be such that a follow up should not be necessary and
you should not need to visit the country again to ‘ tie up loose ends.
5. Mostly planned elective surgery for which there may be a long waiting list
in your country is best suited for medical tourism.
6. Decide on the country, hospital and doctor who would be treating . This
information would be available through the net or from recommendation by
another patient. Visit the website of the hospital and doctor is the next
step. Writing and asking about their training and experience in the
procedure along with the cost implications is vital.
8. Based on this, the patient receives full information from specialist doctors /
medical consultants advice on prevailing medical treatment, approximate
cost for planning purposes and total duration of stay required at the
hospital with pre -operative and post operative extra stay requirement etc.
9. The patient must also check full details about cost of stay at respective
treatment city using a hotel or service apartment or guest house.
10. Check with the doctor what all sight seeing / shopping / tourism is
possible with the treatment patient is having and if this would be before or
after the treatment. Best time for this is after getting the preliminary check
and tests done. Following the sight seeing etc, patient gets admitted for
the surgery.
15. Fix up date of arrival, pick up from airport. It is extremely re- assuring if
a person from the hospital receives visitor at the airport and takes him to
the hospital / hotel.
16. Meet the doctor and re-discuss the details of treatment, cost, stay etc
as soon as possible to chart out the plan.
18. Treatment
19. Discharge from hospital, with follow up advice and medications provided
by the hospital.
20. Stay in the city / sight seeing as discussed earlier for the required time.
STEP 2 : The hospital will identify a suitable doctor and hospitals based on
the query.
STEP 3 : Doctors get back to patient with their suggestions and how to
proceed ahead.
STEP 5: Hospital will give the options such as where to stay pre-
hospitalization & post hospitalization .
STEP 8 : The hospital arranges Airport pick-up and hotel check-in. they also
arrange translator if required.
• India has a huge potential of attracting medical tourist and medical tourism
will contribute around USD 2 million by year 2012, as per CII-Mckinsey
report . With a good amount of investment in the private sector, the growth
of Indian healthcare is inevitable. India has the competitive advantage of
price, outstanding human resource, state-of-the-art hospitals equipped
with latest equipment, alternative medicine like Kerala’s health retreat,
naturopathy and yoga, 5000-year-old civilization, traditional art and crafts
and geographical landmarks and coastlines.
environment, where medical tourist are demanding more, instilling the use
of people competencies in one’s team members is something one simply
can’t survive without.
• Indian hospitals do not face problem with the technical skills as they are
acquired through education and training but the difficulty lies in leveraging
the soft skills of the employees. Soft skills are the underlying principles
that trademark a hospital for professionalism and excellent customer
service.
1. Positive attitude: “I can do it” is the first thought that an employee should
get when he encounters a problem. He/she can think positively if he/she is
happy, cheerful with good sense of humor.
sincerity and honesty of purpose and are upright in dealings with patients.
Superiors, equals and subordinates are asset to any organisation.
5. Maturity: Tact and maturity are the keys to handle difficult and demanding
patients. Employees who are considerate and understanding in dealing
with patients can form the backbone of service excellence culture.
8. Appearance and Bearing: Hospitals should see that the appearance and
bearing of employees is synchronised at all levels. It should not happen
that support staff like kitchen and cleaning staff does not follow any
hygiene standard. It is not only the employee who is properly dressed
draws attention but the employee who is not neatly dressed also excites
discussion amongst the patient relatives.
Indian healthcare is amongst the best in the world but to attract medical tourist
it has to not only come up with world class infrastructure but India should
focus on optimum utilisation of the talent pool. If it is done, the projected
medical tourism market of USD 40 million can be easily achieved.
The key "selling points" of the medical tourism industry are its "cost
effectiveness" and its combination with the attractions of tourism. The latter
also uses the ploy of selling the "exotica" of the countries involved as well as
the packaging of health care with traditional therapies and treatment methods.
Price advantage is, of course, 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.
Open-heart surgery could cost up to $70,000 in Britain and up to $150,000 in
the US; in India's best hospitals it could cost between $3,000 and $10,000.
Knee surgery (on both knees) costs 350,000 rupees ($7,700) in India; in
Britain this costs £10,000 ($16,950), more than twice as much. Dental, eye
and cosmetic surgeries in Western countries cost three to four times as much
as in India.
The price advantage is however offset today for patients from the developed
countries by concerns regarding standards, insurance coverage and other
infrastructure. This is where the tourism and medical industries are trying to
pool resources, and also putting pressure on the government. We shall turn to
their implications later.
The entire concept of medical tourism hangs on the efficiency, skill and
competency level of the doctors, specialists and consultants etc. World over
patients and hospitals trust Indian doctors without doubt. This is therefore an
advantage for India. Patients from around the globe expect the best of
services solely based on the reputation of doctors of Indian origin. But so far
the government has failed to realize the advantage of this important factor.
This reputation and goodwill that Indian doctors enjoy could be leveraged to
attract and promote Indian medical tourism.
The other most important reason why India has not been able to attract more
customers is that there is no specific campaign which only promotes medical
promotes medical tourism. The incredible India campaign has catapulted India
in the top 5 must visit unique destination for lonely planet but so far as it goes
Thailand, Bangkok and other east Asian countries are still market leaders.
Therefore there is still scope that with specific marketing, advertising and
promotion campaigns considerable number of tourists can be attracted.
The important question here is for whom the 'cost effective' services is to be
provided. Clearly the services are "cost effective" for those who can pay and
in addition come from countries where medical care costs are exorbitant -
because of the failure of the government to provide affordable medical care. It
thus attracts only a small fraction that can pay for medical care and leaves out
large sections that are denied medical care but cannot afford to pay. The
demand for cost effective specialized care is coming from the developed
countries where there has been a decline in public spending and rise in life
expectancy and non-communicable diseases that requires specialist services.
India could earn more than $1 billion annually and create 40 million new jobs
by sub-contracting work from the British National Health Service, the head of
India's largest chain of private hospitals and other such organisations in the
US and European states.
Apollo Hospitals, which provides medical tourism packages has put forth a
suggestion and currently is awaiting a reply to carry out operations at a
fraction of what they would cost in the United Kingdom. They include surgery
for hip and knee replacements and coronary bypass that would slash waiting
times dramatically, reducing the queues of British patients waiting to see their
doctors. They have well equipped, state-of-the-art hospitals and can offer the
same level of care as anywhere else in the world. There is no reason why
India should not become the healthcare destination of the world.
India's healthcare industry is growing at 30 per cent annually and the Apollo
group alone has so far treated 95,000 international patients, many of whom
are of Indian origin. Reddy cited two recent cases of UK nationals who opted
for private healthcare at the Apollo network.
Medical treatment in the UK is free under the NHS, but because of the long
waiting times some patients opt for expensive private care. The advantage of
Reddy's offer is that is that it would reduce pressure on the NHS and offer
sub-contracted healthcare at vastly cheaper rates.
After this million people, there are thousands of expatriates. Not necessarily
Indian, but expatriates who may be given the opportunity to come and get
themselves operated in India where we are planning to give them what is
called health tourism."
• There is little follow-up care. The patient usually is in hospital for only a
few days, and then goes on the vacation portion of the trip or returns
home. Complications, side-effects and post-operative care are then the
responsibility of the medical care system in the patients' home country.
• Most of the countries that offer medical tourism have weak malpractice
laws, so the patient has little recourse to local courts or medical boards if
something goes wrong.
• Inferior medical care would not be worth having at any price, and some
skeptics warn that Third World surgery cannot possibly be as good as that
available in the United States. In fact, there have been cases of botched
plastic surgery, particularly from Mexican clinics in the days before anyone
figured out what a gold mine cheap, high-quality care could be for the
developing countries.
High Hurdles
Therefore the logical thing for India is to strive for a massive Image
Improvement plan, the medical industry in itself is banding together to improve
its image. The Indian Healthcare Federation, a group of about 60 hospitals, is
developing accreditation standards. In the U.S., organizations such as the
Joint Commission on Accreditation of Healthcare Organizations, based in
Oakbrook Terrace, Illinois, assess infection rates, the width of hospital
corridors and the capacity of elevators. In India, there's no accreditation, and
hospitals aren't required to provide information on the outcomes of
treatments. There is nothing as far as quality standards go. Hospitals keep
data, but they don't need to share it
Sketchy Information
The leading question that any potential medical tourist will ask himself is
-where is the information, how detailed is the information and whether it is
easily available or not; for eg Escorts' Web site lists only the number of
procedures it has performed. Thought they do not mention the obvious and
important fact that Trehan, Escorts' hospital had a mortality rate of 0.8 percent
and an infection rate of 0.3 percent in 2003. That compared with an observed
mortality rate, or the rate of actual deaths, of 4.77 percent for heart valve
surgery or coronary artery bypass surgery that included heart valves at New
York-Presbyterian Hospital from 2000 to 2002, according to a New York State
Department of Health report is much better. Such facts not only need to be
told but they also need to unashamedly promoted if India has to attract more
overseas patients.
Infrastructural mess
India competes for foreign patients with Malaysia, Singapore and Thailand but
it offers less in some areas where it matters such as infrastructure. We can
almost call it as the curse of India since no matter what the problem we try to
resolve on the national scale the first and most formidable issue is the
infrastructure or rather the lack of it. Thus if we are to improve the basic
requirement of having wide roads, electricity, grounded electric wiring,
information system in place etc then most of our problems will be resolved
including that of medial tourists. Thailand's airports and roads are in better
shape than India's because Thailand is a major vacation destination. In 2003,
10 million tourists traveled there, according to the Tourism Authority of
Thailand's Web site. That was more than triple the number for India that year.
Bumrungrad Hospital Pcl, which runs Bumrungrad Hospital in Bangkok,
started courting overseas patients during the Asian economic crisis in 1997 as
the devaluation of the baht drove down costs for visitors.
International Focus
We Care attitude:
Indian hospitals are countering with perks of their own. This is due to the fact
that India believes in “ atithi devo bhava” and using this to best their own
cause. Hospital’s representatives meet the patients at the airport , help them
through immigration and drive them to the hospital in a private vehicle. Their
room was stocked with fruit and drinks. They have on call consultants with
arrangements made for pre and post treatment sight seeing, shopping and
other tourist activites. Hospitals even loan a mobile phone so they can stay in
touch once they left the hospital.
More Foreigners
Foreign patients are still far from the norm. Operations on non-Indians
accounted for 10 percent of the more than 4,000 surgeries at Escorts in 2003.
Foreign surgeries will pick up as rising health costs and long waiting lists
provide incentives to travel to India and its low-priced rivals.
In the U.S., health-related spending climbed 7.6 percent to $1.68 trillion in
2003, consuming almost 15.3 percent of the $11 trillion gross domestic
product. It was the fifth consecutive year that the cost of medical care
expanded faster than the economy.
Accidental Patient
In the U.K., the waiting list for the government-funded National Health Service
prompts some patients to look elsewhere. Last year, the lag averaged less
than nine months for surgery, about half the 18 months in 1997.
Unlike people who chose India after deciding not to pursue an operation
through the National Health Service, there are others who have discovered
India by accident.
Charging foreigners more than Indians is one way hospitals can make money
to treat the poor. An echocardiogram machine, used to picture the heart, costs
about $200,000 anywhere in the world. Doctors can charge $800 per scan in
the U.S; in India, they charge 800 rupees, or $18.
The difference makes it tough to recoup costs. The reason why hospitals are
so excited about overseas patients is that in India there are more than enough
Indians to fill the nation's hospitals. India has enough volumes but what we
don’t get is pricing. India should and is charging for the value rater than the
concentrating on volume based profit alone.
Some Middle Eastern patients began choosing India after the Sept. 11, 2001,
attacks on New York and Washington, Oman hospitals often refer patients to
India for complicated procedures because the country is familiar, closer than
the U.S. or Europe and cheap. Also after 9/11, people are scared to go to the
U.S not only due to fear of terrorist attacks but mainly due to the fact that they
feel threatened because of racial discrimination be it overt or subtle. The fact
that people in US look at a turbaned and bearded man as a potential terrorist
is an unsettling experience. Not only in the US but even in UK and other
European countries people of coloured skin and religion are facing
discrimination.
Indian doctors are returning home again .and offering medical procedure
which they performed abroad in their home country itself. There are many
Indian patients who had to go abroad for medical reasons this is one of the
factors that influenced doctors to return home. The other reason is that the
pay in India is gradually rising and the lure to back in one’s own homeland is
quite strong.
Easy Transition
Indian hospitals are working to make the transition easier. Apollo is setting up
a London clinic to attract people seeking alternatives to the National Health
Service. The idea is that a doctor would look at patients find the problem and
make all arrangements to get them to India.
Just as Indian software companies started with small programming jobs and
expanded to become a $16 billion global industry, India's international health
care initiative is in its early stages. For patients and profits to increase, India
must remedy negative first impressions and persuade doubters that millions of
the country's poor and ailing won't be left behind.
With a view to facilitating the medical tourism industry to achieve the targets
and to give greater momentum for its growth, the Ministry of Health and
Family Welfare together with the Ministry of Tourism of the Government of
India has set up a Task Force. The Task Force will evaluate the opportunities
in the industry and formulate a policy for accrediting healthcare institutions in
the country. The accreditation programme is aimed at classifying health
service providers on the basis of infrastructure and quality of services offered.
It is expected to standardise procedures and facilitate foreign patients in
selecting the best hospitals.
To provide for brighter prospects for the industry, the hospitals can also
acquire international accreditation, integrate traditional and clinical treatments
and offer end-to-end value added services by tying up with tour operators,
airline carriers and hotel companies. Hospitals can also allow foreign patients
to pay through credit and ensure proper support services to foreign patients
after they return to their native countries.
Lastly, the Government of India can also reinforce its support through quick
visa processing, improved flight connectivity and infrastructure development.
Government Initiatives:
Government and State Governments have taken various steps for the
promotion of tourism and attainment of the goal of sustainable tourism
development.
• KERALA TOURISM REVIVE THE URU / ARAB DHOW: Kerala Tourism has
plans to start URU cruises to replicate the spice route travel of the 16th
century. The uru is a home made colossal sailing vessel made out of
timber which used to ply the Indo Persian routes in times gone by. It is the
Indian equivalent of the Arab Dhow. When launched they will operate on
the Bekal - Cochin sector. This has been quite a crowd puller for medical
tourists who flock to Kerala especially for the Aurvedic and relaxing
treatments offered. The curious mix of vegetarian food, exotic back waters,
courteous and pleasant people and not to mention extremely smart
doctors had made Kerela a very popular destination
• GARIB RATHS (PLUSH TRAIN FOR POOR): The Indian Railways has
introduced the ''Garib Raths'', a maiden scheme to provide plush rail
services to the poor at affordable rates in the year 2004 - 2005, and plans
to link all state capitals with express trains, with the induction of 24-coach
trains. The success of the Garib Raths, can already be seen in the rail
operating between Saharsa (Bihar) and Amritsar (Punjab) which is a boon
to the traveler especially during the festival season. But as of current
reports the country has not taken well to the Garibh Rath and is making
losses for unforeseeable reasons. Medical patients usually skip on rail
travel as it takes a longer time and is a bit more exhausting.
• JAIPUR TO SELL HERITAGE LIQUOR: Shops all over Rajasthan will sell
heritage liquor, made from age old recipes of Rajasthan Royals. It is made
from dry fruits, nuts, herbs and spices with a touch of saffron sometimes.
To begin with, shops in Jaipur, Jodhpur, Kota, Bikaner, Ajmer, Udaipur
and Bharatpur will sell the special liquor. General as well as medical
tourists can now take these away as souvenirs.
Conclusion
India is a developing country and a lot needs to be done before we can call
ourselves as a developed country, all we can claim is to be a progressive one.
After the dotcom com boom in the nineties we have gone through a lean
patch as such. India as an emerging nation needs to grow both from with in
and outside; in the sense development needs to done both for the Indian
Diaspora and at the same time opportunities need to be grasped and
developed so that foreign investment pours in.
After the dotcom rush India has again got the opportunity to earn
billions of dollars with medical tourism . We have all the bases coved in the
sense we have the qualified doctors and consultants, we have already
developed the trust of people the world over in the past decades and we also
have the exotic environment meant for tourism. All that we do need is to make
the transition from being a potential destination to a fully rewarding and sound
medical tourism destination which is equivalent to or better than any service
offered world over.
The question that India will have to handle in the coming years is how
to justify giving world class medical care to visitors where as it spends just
1.4 % of its GDP on medical care of its own people. Health of its own people
will reflect on the robustness of the general state of the country. So unless this
is balanced off the issue of biasness will keep on cropping up.
Time and again we see that the root of all our national issues and
problems arise from having an inherently weak infrastructure with poorly
executed law and order and political red tape. Compounded with the problem
of over population, dwindling natural resources and reckless disregard for the
environment we stand at a junction where things can go haywire or they might
become extremely successful if we only start resolving them. Currently it is
like moving 1 step ahead and then going 3 steps backwards. Medical tourism
is based on having a well oiled network of tour operators, medical facilities,
Although the situation appears to be grim there is still hope. One step
at a time is all that is needed. First and foremost is to have the basic
infrastructure in place such as having proper road and rail connectivity, having
a good network of airports to all the major states and cities and with the
countries from where the potential tourists will arrive such as the US the
middle east and western Europe and also the major African and Islamic
countries in Asia. Secondly but more importantly there is a need to put
forward the information required by the tourists. Aggressive marketing is the
only way to go as seen in the case of Thailand, Singapore , malyasia etc. Not
only that there should be government authorized websites where people can
get all the information regarding surgeries, hotels, cost comparison etc . they
have to be developed exclusively for the medical tourism purpose. Twenty
four hours helpline, television advertisements, getting information and
advertisements published in medical journals and popular magazines etc is a
worthwhile investment. We have already seen how successful the Incredible
India campaign is. Based on similar line but exclusively for medical tourism
other such campaigns must be developed.
The idea of doing this project was to bring to light how medical tourism
is the 21st century’s golden goose for India. Bringing out all the true facts, the
weak points and in general trying to understand the phenomenon itself of
medical tourism has been insightful. This project has been laborious since
finding out relevant information is difficult and there are very few sources to
find it out from.