Medical and health tourism is driven to a large degree by the referral of international patients through facilitators, agencies and brokers. And while, throughout recent history, that has not changed, it still warrants exploring whether relying on these parties is a good strategy for healthcare providers and health tourism/medical tourism destinations.
Advantages medical tourism facilitators provide
Before we steer our attention to the risks and downsides, we should look at the benefits medical tourism agencies/facilitators can provide to hospitals and healthcare providers.
Reduced medical tourism marketing expenditures
Medical tourism facilitators do not offer medical services themselves. Thus, they must market providers’ services to build and cater to a patient base. Healthcare providers can benefit from this as they can focus on their domestic marketing activities and leave international marketing to a group of people who better understand foreign patients’ needs and requirements. It offers a way to reduce global activities’ expenditures. It saves other resources, such as time, by removing the need to be present in international fairs and exhibitions.
Guaranteed Return on Investment
Working with medical tourism facilitators further opens the opportunity for guaranteed returns. The return is guaranteed because of the inherent nature of the business, given that hospitals only pay a referral fee or commission once treatment has been concluded. While the practice has been criticised and even outlawed in some jurisdictions, it remains the primary way the medical tourism industry functions. Thus, hospitals are not risking a budget towards marketing and branding that might go unreturned due to unsuccessful campaigns.
Reduced administrative burdens
By including a third party in charge of collecting all relevant patient information and documentation and providing logistical support to patients, hospital staff doesn't have to be involved in these tasks. Caring for international patients is a substantial administrative burden. Relying on a professional and experienced organisation to handle that workload provides operational efficiencies to hospitals and can avoid an increase in head count. Considering that staff needs to be properly trained where intercultural relations are concerned, this can make a considerable impact on a hospital.
Risks of working with medical tourism facilitators
You could stop reading here and be perfectly oblivious to the actual critical part: the downsides of working with medical tourism facilitators. This goes far beyond my personal opinion on the matter. Numerous reported examples in Germany alone highlight the tremendous risk you are putting patients and your organisation at when cooperating with medical tourism agencies.
The following graphic shows some of the issues arising from including intermediaries in treating medical tourists.
In many cases, patients first communicate with a sponsor. This can be a ministry that covers the cost of treatment, a consulate or even an insurance company. They then contact a facilitator who often needs a further facilitator in the target country to organise the treatment and ensure travel arrangements are tailored toward the treatment plan and conditions. It is essential not just to accept this but also to understand the detriment this monstrosity of a communicative failure imposes on patients.
Increased cost for medical tourists
Every additional party involved will at least, in theory, contribute, if not value, then at least administrative effort to the process chain. This administrative effort has to be compensated in one way or another, which regularly increases the price either for patients directly or the sponsor. It is just right that someone who provides value to the process gets compensated, but it remains questionable whether so many intermediaries are truly necessary to fulfil the task. At some point, the cost increase is not any more justified by the added value. Beyond that, patients are often not aware of how the process looks in detail and thus have no control over how many parties are being clued in.
Medical tourism is prone to miscommunication
Involving various intermediaries increases the risk of miscommunications. Whatever the patient wishes to convey gets passed on to the point where a change of intent is nearly unavoidable. While I would like to believe that all parties act in good faith and adhere to best practices, we are still talking about medical tourism, and based on experience, reality just isn't that. Each intermediary has motives and intent that are seldom ignored. Thus, what the patient initially communicated doesn't make it to the concerned party precisely that way. A direct patient account often doesn’t even make it to the healthcare provider in the first place, which can negatively impact the entire patient experience.
Medical tourism facilitators have opaque motivations
In a perfect world, we could safely assume that the only motivation of medical tourism facilitators is to make the patient’s well-being their guiding priority. Unfortunately, though, we do not live in a perfect world. It is a reality of any business that financial incentives drive them. Otherwise, their future existence could be at risk. Thus, their choice of providers is heavily influenced by the economic return they can expect. Hence, a patient-focused decision is not guaranteed and is factually unlikely. Additionally, patients are rarely presented with a choice. Patient autonomy is an essential factor in patient-centric healthcare designs, so this state should not be readily accepted.
Lack of ownership and control
Hospitals leave a huge operational gap in their organisation by relying on facilitators. They do not influence market developments and are not prepared to drive international patients towards their services should the cooperation between them and a medical tourism facilitator go awry. The intermediaries are often left with disproportionate influence and power over the patient flow. They devide where patients go, which information reaches whom, the pricing and even how a hospital is perceived by the patient and outside environment.
The parties involved are responsible for whether the cooperation with medical tourism facilitators will be successful or a disaster of epic proportions. It depends on the choice of facilitating partner and the hospital’s internal policy on what they expect from their partners regarding best practices, transparency, and operational procedure commitments. There are great organisations, both facilitators and hospitals, working effortlessly to provide an excellent patient experience by truly putting the patient first. Still, it is vital to be aware of the potential risks of entering into partnerships blindly.
If you liked this article we invite you to leave a comment. Should you want to learn more about the specific topic or medical tourism in general, feel free to reach out.
Christian El-Khouri is a leading figure in the medical tourism industry, with a proven track record of success in international healthcare. He built and headed the consulting department of MESC International Patient Service, Germany's first and oldest medical tourism company. Christian leverages his extensive experience to advise hospitals, government, destinations, clinics and startups on navigating the complexities of the medical tourism industry. He covers the entire value chain in his work, advising on overall strategy, detailed processes and operations, marketing and ethical considerations of the business. Christian is a frequent speaker at industry conferences and a recognised authority on the ever-evolving medical tourism landscape, for which he has developed and implemented various strategic and operational models.
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