FEATURE ARTICLE 1
Medical Tourism And VolunTourism: Similarities & Synergies
With Western healthcare fast becoming an unaffordable luxury for an ever-growing segment of the U.S. population, medical tourism is on the rise. Like VolunTourism, however, Medical Tourism “suffers” from similar challenges. The numbers look promising for both, but how does one quantify them? The impacts appear to cross sectors and influence multiple stakeholders, but how does one measure them? And, in terms of synergies, is there a chance for savvy VolunTourism operators to craft relationships with Medical Tourism practitioners? Certainly, there are more questions than answers; we’ll take this opportunity to begin the discussion.
An Introduction To Medical Tourism
The Healthcare Travel Exhibition & Congress (HTEC), which held its annual conference from 28 – 30 June 2009, offers this factoid on its website:
This sounds like an incredible business to be in. On the other hand, in a recent article written by Sven Berg for the Idaho Statesman.com entitled “High Health Care Costs Lead To ‘Medical Tourism,’” Mr. Berg cites a 2008 report from the Deloitte Center for Health Solutions. “Its report anticipated the United States would lose $15.9 billion in domestic consumer spending to medical tourism in 2008,” he writes, “and nearly $68 billion by 2010.”
“Yet it’s difficult to pin down just how reliable Deloitte’s estimates are,” Berg continues. “Howard Berliner, a professor of health policy and management at SUNY Downstate Medical Center in Brooklyn, N.Y., said he believes Deloitte’s numbers aren’t realistic. For one thing, Berliner said, Deloitte’s estimates don’t take into account how many medical tourists were just regular tourists in other countries when their health took a turn for the worse. Another number that’s not tracked is how many natives of foreign countries who reside in the United States returned home for medical procedures. So just how common is medical tourism? The bottom line at this point, Berliner said, is that ‘no one knows.’”
This sounds strikingly similar to the situation with measuring the number of U.S. volunteers, for example, heading abroad each year. In a recent-released paper co-authored by David Caprara, Kevin F.F. Quigley, and Lex Rieffel entitled “International Volunteer Service: A Smart Way To Build Bridges,” the authors mention that of some 100 entities polled in 2005, the combined number of volunteers being sent abroad was 40,000 and that by 2010 a newly formed group, comprised of some 210 entities, estimated they would be sending approximately 100,000 volunteers abroad.
Yet in a 2008 report released by the Corporation for National & Community Service, interestingly, the same entity at which Mr. Caprara formerly served in the capacity of Director of Faith-Based and Community Initiatives and VISTA, estimated that the number of U.S. citizens volunteering internationally in 2007 was more than 1 million. Which estimate is more in alignment with the reality of the situation? To quote Dr. Berliner, "No one knows."
Growth, Governance, And Quantification
Turning back to medical tourism, in a 9 June 2009 Op-Ed piece on NYTimes.com entitled “Overseas, Under the Knife,” Arnold Milstein, Mark D. Smith, and Jerome P. Kassirer touched on several key points regarding the growth of medical tourism:
- “Average total fees at well-regarded hospitals like Apollo and Wockhardt in India are 60 percent to 90 percent lower than those of the average American hospital…”
- “Most medical travelers seek cosmetic procedures like facelifts and liposuction, but an increasing number have high-risk surgery and joint replacement in places like India, Singapore, and Thailand.”
- “A few pioneering American insurers like Blue Cross Blue Shield of South Carolina and self-insured employers like the Hannaford Brothers supermarket chain sent American doctors to evaluate foreign hospitals. Favorably impressed, they now offer payment for travel expenses and cash incentives as high as $10,000 for choosing offshore hospitals.”
- “More than 200 offshore hospitals have been accredited by the Joint Commission International, an arm of the organization that accredits American hospitals.”
In the VolunTourism realm, there is vast discrepancy in terms of accreditation and/or oversight, especially at the destination level. If one reviews the travel & tourism industry sector and its connection to VolunTourism, you will see that quite a number of the entities offering trips that include voluntary service as a part of the itinerary are affiliated with a professional association of some kind. Whereas, in terms of nonprofit organizations, there are very few trade-based protocols by which these entities can be held accountable for their activities abroad. It is, therefore, incredibly difficult to know exactly what organizations can be trusted and what recourse stakeholders may have if something goes awry. (At VolunTourism.org we are beginning to address this with the "Mystery VolunTourist" initiative.)
Clearly, we are beyond the point of refuting whether Medical Tourism and VolunTourism represent burgeoning niches within the tourism sector. The challenge lies with quantifying the number of participants and what the impact is on all stakeholders and connecting sectors.
- Can there be some shared-learning opportunities?
- Is it possible to define areas of collaboration that could facilitate both of them as they pass through their respective growing pains – questions of legitimacy, trust, delivery?
These are questions that must be addressed if these segments are to continue to expand in a manner that is substantive and likely to deliver lasting benefit to all stakeholders. For now, we’ll turn our attention from the parallel tracks these two industries are riding and discuss their potential points of intersection.
Points Of Intersection
NuWire Investor.com ran a piece by Melana Yanos back on 31 March 2008 entitled “Top 5 Medical Tourism Destinations.” Countries such as Thailand, South Africa, and Hungary are mentioned as places people are traveling for medical services. But, topping their list of five was Panama, followed by Brazil, Malaysia, Costa Rica, and India. Outside of Hungary, the destinations mentioned in the article are also ones frequented by VolunTourists. Could medical tourism operators be reaching out to VolunTourists when they come to these destinations? Could VolunTourism operators coordinate with medical tourism operators to conduct site visits at hospitals and medical facilities to further educate VolunTourists on advances in medicine in these destinations? What a fascinating prospect this could be for VolunTourists who come to appreciate the people and places they visit and serve!
The Patient Pre-Visit/Pre-Procedure
Some individuals will want to visit a location prior to having a medical or dental procedure performed. What a better way to interact with a destination than to serve in some capacity during your visit. Not everyone will be physically capable, of course, because their condition may require rest and relaxation. But not all procedures will be directed towards major health challenges. Some, in fact the majority according to Milstein, Smith, and Kassirer (see Overseas, Under the Knife), may be corrective procedures, cosmetic alterations, or other, less invasive procedures. Patients may very well have time to render grateful service while scoping out a destination, perhaps making the experience less stressful via greater familiarity.
Depending on the need for recuperation, there may be time for folks to share intellectual skills and support to local residents without undue physical stress. This could prove to be an effective way to stimulate the healing process - for we know about the many health benefits of volunteering. (See "The Health Benefits of Volunteering: A Review of Recent Research," published in 2007 by the Corporation for National & Community Service.) It is very likely that people will also want to see the destination in greater detail, especially if they are feeling as though the medical/dental procedure has gone well. They may find themselves appreciating the destination and its people much more so because of the positive change in their overall health condition.
Quite often family members will accompany loved ones to a given destination to offer support during a medical/dental procedure. Not every moment they have will be spent in a hospital, however, nor may they feel completely comfortable in galavanting around a destination while a spouse, father, mother, or sibling, is on the mend. Lending a hand may be a great way to relieve stress without accompaniment of any nagging guilt.
In speaking with Arthur Schwartz, Founder & President of Globalmed Travel Partners and producer of Medical Tourism Newswire, he offered these two questions:
1) "How are you, as a patient or accompanying family member, going to support the health and well-being of the destination and its residents now that your/your loved one's health and well-being has directly benefited?" and
2) "How will the corporations involved in the supply chain of Medical Tourism demonstrate their corporate citizenship and contribute to the health and well-being of the destinations in which they service their clients?"
The answers to these questions will in many ways shape to what degree Medical Tourism and VolunTourism sync up over the months and years ahead.
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