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04 NEWS
A round up of regional and international news
and developments
08 PARTNERSHIPOPORTUNITIESPublic Private Partnerships in Health Tourism
12 CHALLENGES Trends and Challenges in Medical Tourism
18 REGULAR COLUMNSlips and Tips, by Dr. Sanjiv Malik
20 HEALTHCARE MARKETINGGlobal Marketing Strategies for emerging trends
24 BIOETHICSMedical Tourism - Proceed with Caution
26 HEALTHCARE INSURANCEOverseas Medical Care Has Become an Option
for Employers
34 MIDDLE EAST FOCUSUAE: Can it share a slice of the pie?
CONTENTS HealtHcare travel MAGAzINE ISSUe 01 2008
08
26
12
34
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24
This publication may not be reproduced or transmitted in any form in whole or in part without the written consent of the publishers. © IIR Middle East 2008
Contents
FOREWORD ISSUE 01 2008
EDITOR Jenna Wilson Tel: +971 4 336 51 61jenna.wilson@iirme.com
ADVERTISING SALES John Suzara Tel: +971 4 336 5161john.suzara@iirme.com
PUBLISHING DIRECTOR Simon Page simon.page@iirme.com
DESIGN & LAyOUT Andreas Schmidt as@stadtrand-design.de
PRINTED By Zabeel Printing Press P.O. Box 5143 Dubai, UAE Tel: +971 4 262 61 71
This publication may not be reproduced or transmit-ted in any form in whole or in part without the writ-ten consent of the publishers.
© Publications International Ltd. 2006Healthcare Travel magazine is published 4 times a year. For subscription information visit www.arab-healthonline.com and follow the link.
HEALTHCARE TRAVEL MAGAzINE IMPRINT
Foreword
HealtHcare has long seemed one of the
most local of all industries. Yet beneath the
bandages and emergency rooms, globalisa-
tion is thriving. The reading of x-rays and the
outsourcing of record keeping is already a
multi-billion dollar business. Hospitals and
clinics in the developed world are making a
habit out of recruiting nurses and physicians
from the developing world. The next growth
area for the industry is the flow of patients in
the other direction – known as “medical tour-
ism” – which is on the threshold of a dramat-
ic boom.
Travelling abroad for medical treatment is
one of the latest and biggest trends. Tens of
millions of middle-class Americans are unin-
sured or underinsured and soaring healthcare
costs are pushing them and cost-conscious
employers and insurers to look abroad for
cheaper healthcare. As such, the Healthcare
Travel industry is growing at 15 to 20 percent
annually and it is estimated that total gross
medical tourism revenues will rise from $56
billion today to $100 billion by 2012.
Under the guiding theme of “the Globalisa-
tion of Healthcare”, the Healthcare Travel
magazine aims to bring together all aspects
of medical travel in one publication keeping
you up-to-date with the development of this
growing sector. Time and money provide the
main incentives for seeking healthcare outside
the patient’s country. I hope you enjoy read-
ing this issue of Healthcare Travel magazine
and I welcome your comments, ideas and sug-
gestions.
Jenna Wilsoneditor
» SingapORE’S CliniCal serviCes are exCellent, with internationally aCCredited FaCilities and renowned physiCians. Beyond merely Being trained in the Best Centers internationally, singapore’s doCtors are well known and respeCted in the mediCal world «
H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8 | 3
news | MIDDLE EAST
President of Private Hospital Association
(PHA) Fawzi Hammouri was quoted as saying
that: “Jordan is the only country in the Middle
East that generates more income than what it
spends on health.” Jordan’s medical tourism
revenues in 2007 exceeded US$1 billion, he
added.
According to a study prepared by the PHA,
over 250,000 patients from around 84 Arab and
foreign countries were treated in Jordanian pri-
vate hospitals, clinics and medical centers last
year.
Iraqi patients treated by Jordan’s private med-
ical sector amounted to 45,000 in 2007, while
Palestinians and Sudanese trailed with around
25,000 patients from each country.
The study also shows that more than 1,800 U.S.
citizens, 1,200 British citizens and 400 Canadi-
an citizens sought medical treatment in the
kingdom last year.
Hammouri noted that treatment expenditures
in Jordan are only 25 percent of the cost in the
U.S., which include airline tickets and the pa-
tient’s stay in addition to site-seeing tours. «
“We Have a department here establishing
this,” he said. “We’ll be ready to start receiv-
ing patients coming here with their families,
whether for plastic surgery, knee replace-
ments or cardiovascular. We have so many
hospitals, with John Hopkins, Harvard, some
of the biggest names in the world are here
doing work,” he added.
Al-Budoor acknowledged that in the past the
Middle East would never have been considered
a destination for medical tourists, but the situa-
tion for the UAE had changed completely.
“People would go to London for shopping
with their families and receive a check up or
undergo a small operation. Now Dubai is
ready for this,” he said. “We have so much to
offer now, with certified hospitals from inter-
national agencies,” he added.
Health tourism is a global phenomenon
that is allegedly worth $50 billion annually
depending on who you talk to. The actual
size of the industry is up for discussion. This
is but one of many issues in an area of medi-
cine that is attracting a huge amount of at-
tention.
These issues are set to be discussed at the
Healthcare Travel Exhibition & Congress 2008
to be held at the Al Bustan Rotana Hotel in
Dubai from November 2-4. Sietske Meerloo,
Marketing Manager at IIR Middle East indicat-
ed that the event is expected to provoke
some heated debate.
“There are so many issues relating to medi-
cal tourism, and because the area is develop-
ing so quickly it’s becoming essential that
hospitals, insurers and policy makers, to name
a few work together closely to streamline
processes to cater to this market,” she said.
“We’re expecting a great deal of debate at
the event, and hopefully we’ll see some prac-
tical solutions adopted for many of these is-
sues,” she added.
Medical tourism is already proving to be
highly competitive with developing nations
offering cheap, quality healthcare. The Minis-
try of Health in the UAE believes it can find a
niche in this market and has endorsed the
Healthcare Travel Exhibition & Congress 2008
in which it’s participating.
“I’m really happy to see IIR [highlighting]
medical tourism for the first time,” Al-Budoor
said. “We have so many hospitals ready to re-
ceive patients from abroad,” he concluded. «
Jordan Tops Region As Medical Tourism Hub
UAE all set to attract medical tourism
The World Bank medical tourism experts ranked Jordan number one in the Arab region and the
fifth in the world as a medical tourism hub, quoted China’s Xinhua news agency.
DUBAI – The Ministry of Health in the UAE is at the forefront of developing the necessary infra-
structure to attract medical tourists. That’s according to Nasser Khalifa Al-Budoor, the Assistant
Undersecretary for International Relations and Health Affairs at the UAE Ministry of Health.
news MIDDLE EAST
» JORDan IS A MODERN COUNTRy, WITH A GOOD INFRASTRUCTURE, A THRIVING BUSINESS «
4 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
in a HealtH Promotion Center at Inha
University Hospital in Incheon recently they
had a comprehensive checkup, including x-
rays and blood tests.
They were among 29 Americans whose
two-week trip to Korea included a medical
program jointly developed by the LA branch
of Korea Tourism Organization (KTO) and an
LA-based travel agency Aju Tours.
Although some individual foreigners have
visited Korea for medical treatment, this was
the first group of tourists to come to Korea
on a ``medical tourism’’ package.
The report stated that the government and
some hospitals are joining hands to promote
medical tourism programs, capitalizing on
reasonable prices and quality medical skills,
especially in cosmetic surgery and other treat-
ments.
The results carried out on the patients take
four days to process. Patients can check on-
line at the hospital’s English language Web
site, or receive them by post.
The group also received skin care treatment
at Anacli Dermatology-Plastic Surgery Clinic in
Gangnam, southern Seoul. Doctors from the
clinic consulted them at their hotel the previ-
ous evening to prepare for treatment. Sixteen
of them received superficial peeling, which
cost $200 each.
Medical tourism in Korea is at an initial
stage. The program for the American tourists
came after KTO and six hospitals offered a
promotional presentation in Los Angeles last
month to medical tourism coordinators and
travel agencies.
In 2007, 16,000 foreigners visited Korea for
medical tourism, and 20,000 are expected this
year, the report said. «
American Tourists Check in for CheckupA group of Americans visited South Korea not only to go shopping
and traveling but to receive high-quality, state-of-the-art medical
treatment at relatively lower costs reports the Korean Times.
news | ASIA
news ASIA
in 2007, the hospital
received over 140,000
patients from around
the world with 19% of
them coming from the
Gulf states, a senior
official was quoted as saying.
So far this year, the hospital has received
18,226 patients from the UAE and 3,152 from
Oman. The number of Qatari patients reached
3,046, a growth of 107% compared to last
year.
Thailand is a popular destination for medi-
cal tourism. “The main benefits of health
tourism include getting the opportunity to
travel to an exotic destination and reaping big
monetary savings,” the official said.
Dr Michael Moreton, deputy director, Bang-
kok Referral Centre, said that Arab patients
sought treatment for cases ranging from
check-up to surgery, heart problems and can-
cer to rehabilitation. According to him, the
hospital has established an Arabic service cen-
tre to cater to Arab patients. «
Thailand lures Arab patients THAILAND - The number of Qatari patients seeking treatment in Thailand rises significantly dur-
ing the summer months of June to August. This year their number has grown by over 100%
compared to last year, Bangkok Hospital Medical Centre officials told Gulf Times.
» in 2007, 16,000 FOREIGNERS VISITED KOREA FOR MEDICAL TOURISM «
6 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
international patient traffic to Mayo Clinic
has rebounded since 2001 to almost pre-9/11
levels, Mayo officials say.
In 2000 and 2001, Rochester saw about
2,100 Middle Eastern patients arrive each year.
By 2006, that number had been cut in half to
about 1,000.
Mayo Clinic currently is attracting almost
1,500 patients a year here from the Middle East,
says Brent Phillips, the international administra-
tor for Rochester.
“My sense is we’re having a strong year and
we’ll be very close to where we before 9/11,”
he says.
And the growth is giving a financial boost to
the Rochester hospitality industry, and to hotels
like the Kahler Grand Hotel and Bridgestreet
Broadway Plaza.
International patients bring $30 million to
$50 million into Rochester each year, according.
And Rochester accounts for 10 percent of all
international visitors coming into Minnesota
each year, he says.
“They (international Mayo Clinic patients) are
very important to us,” says Bruce Fairchild of
Kahler’s parent Sunstone Properties. “The dollar
is down, and it makes buying medical care and
staying here less expensive. That may be help-
ing us.”
Sunstone recently expanded a-hotel-within-
in-a-hotel -- The International -- on two floors
of the Kahler. It is targeted for the high-income
international traveler. The president of Iraq
stayed there during three recent visits, including
last month when he was in town for heart sur-
gery.
The return of the international patients also is
helping keep Broadway Plaza -- Rochester’s tall-
est building -- fully occupied.
“We’ve grown year over year from 5 to 10
percent,” says John Beltz, the plaza’s general
manager. “About a third of our overall business
comes from outside the U.S.”
While Middle Eastern patients are often the
most visible on Rochester streets, Mayo officials
point out that the area with the highest number
of patients coming to Mayo Clinic is Canada.
The Middle East is the second largest source. «
Middle Eastern patient numbers rebound in Rochester
USA | news
USA news
“medical tourism is a small but growing
trend among American patients, and it’s un-
clear at this time whether the risks outweigh
the benefits,” said AMA Board Member J.
James Rohack. “Since this is uncharted wa-
ters, it is our hope that the AMA’s new guid-
ance on medical tourism will benefit patients
considering traveling abroad for health care.”
In 2006, an estimated 150,000 Americans
received health care overseas, and nearly half
of the procedures were for medically neces-
sary surgeries. The emergence of medical
tourism is in part a response to the rising cost
of health care in the U.S., which puts needed
health care out of reach for many, particularly
those without health care coverage.
“We need to address the cost of care in the
U.S. and cover the uninsured so that every
American who needs health care can get it
right here at home,” said Dr. Rohack. “Until
there is significant action at home, patients
with limited resources may turn elsewhere for
care. It is important that U.S. patients have
access to credible information and resources
so that the care they receive abroad is safe
and effective.”
The new AMA principles call for all medical
care outside of the U.S. to be voluntary. They
address financial incentives, insurance cover-
age for care abroad and care coordination.
The principles also call for patients to be
made aware of their legal rights prior to trav-
el and to have access to physician licensing
and facility accreditation information prior to
travel.
“For those patients considering medical
tourism, the new AMA principles are an im-
portant starting point for consideration be-
fore making the decision to go abroad for
health care,” said Dr. Rohack.
To ensure that insurance companies and
others that facilitate medical tourism adhere
to the new principles, the AMA will introduce
model legislation for consideration of state
lawmakers. «
AMA provides first ever guidance on medical tourism UNITED STATES - To ensure the safety of patients considering traveling abroad for medical care,
new guiding priciples on medical tourism were adopted this summer by the American Medical
Association’s (AMA) annual policy-making meeting. The nine principles are the first-of-its-kind,
and outline steps for care abroad for consideration by patients, employers, insurers and third-
parties responsible for coordinating travel outside of the U.S.
H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8 | 7
london is Well establisHed as a centre
that attracts international patients for a range
of healthcare treatments. The value of the over-
seas patient market to London hospitals in 2007
is estimated to exceed £200m, which is divided
between 10 large private and charity owned
hospitals, and the private patient units at a simi-
lar number of leading NHS hospitals including
Great Ormond St, The Brompton, UCLH and
The Marsden. The majority of these patients
come from the GCC region, mainly funded by
overseas patients offices, with some patients
funded by other government agencies such as
the military, large employers, or paying for their
own treatment. This article explores how some
NHS Trusts and some private companies are re-
sponding to changes in the market.
The overseas market is clearly changing.
Countries such as Germany are taking a larger
slice of the overseas patient market, as increas-
ingly privately owned hospitals in Germany are
looking for additional sources of revenue to sat-
isfy their shareholders. Hospitals in India and
Thailand are increasingly attracting health tour-
ists for higher volume surgical procedures. Per-
haps the greatest changes are in the markets
from where overseas patients are traditionally
drawn – developments in these countries such
as Dubai healthcare city, or The Royale Hayat
women’s hospital in Kuwait (managed by Inter-
health Canada) are reducing the need to travel
abroad to receive high quality treatment, and
are in fact aspiring to attract their own inbound
health tourists to the region.
Another significant change has occurred in
the NHS in England (which is governed sepa-
rately from the NHS in other UK countries),
which is having an impact on the market. All
NHS hospitals in England, including leading Lon-
don teaching hospitals, are becoming ‘Founda-
tion Trusts’. On the one hand, this gives these
organisations much greater management au-
tonomy from the department of health, which
has been welcomed by managers and is part of
a larger drive to decentralise and localise NHS
planning and management in the UK. Howev-
er, in agreeing to this decentralisation of power,
politicians wanted measures to ensure that
these NHS hospitals focused on their core busi-
ness – treating NHS patients – and have capped
the amount of private patient revenue that NHS
Foundation Trusts can earn directly to the same
percentage that they earned in 2003, limiting
their potential to grow private patient revenue.
This legislative change is perhaps less of an is-
sue for trusts with very large and well estab-
lished private patient units, although it does
limit their scope for further growth. It is proving
to be more of a problem for trusts with very
limited private revenue historically, who wish to
grow.
Apart from this new regulatory constraint on
NHS trusts, these organisations have historically
faced a squeeze on capital funding, and have
often had to prioritize investments in their NHS
wards ahead of investment in private facilities.
Consequently, some of these private units are
now looking dated.
A new public private partnership model is
emerging, that will allow some of these units to
compete on the international stage. By leasing
Public Private partnerships in Health Tourism
By hugh risebrow, Ceo interhealth Canada Uk
» HOSpiTalS IN INDIA AND THAILAND ARE INCREASINGLy ATTRACTING HEALTH TOURISTS FOR HIGHER VOLUME SURGICAL PROCEDURES «
FeatUre | PRIVATE PARTNERSHIPS
8 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
PRIVATE PARTNERSHIPS | FeatUre
their private patient unit to a private sector hos-
pital operator, the foundation trust does not di-
rectly invoice the patient or payer, and manages
to bypass the regulatory constraint on directly
earned private patient income.
There are a number of other advantag-
es to this model for patients, doctors,
the NHS Foundation Trust, and the pri-
vate hospital operator:
• The private operator will generally invest
their own capital to upgrade facilities to a
standard that is competitive internationally
• The private operator will have marketing
skills as part of their core competency, and
will be more successful at attracting patients
• Business processes, clinical pathways,
and non clinical services can be re-engi-
neered to better meet the higher expecta-
tion of private patients, as well as the dif-
ferent needs of payers and clinicians in
private practice
• The NHS Trust can focus on their core
business of treating NHS patients, and
leave the non-core activities associated
with private patients to their private sector
partner. Financially it is attractive for the
NHS Trust, who receive a guaranteed rental
income, income from use of facilities such
as operating theatres and diagnostics, and
usually some form of profit share.
• The medical consultants whose NHS
practice is at the same hospital site usually
strongly prefer the convenience of treating
their private patients on the same site as
their NHS patients
• Expensive equipment can be used for
both NHS and private patients, making cer-
tain investments possible that wouldn’t
otherwise have been viable
• Private patients often prefer to be treat-
ed at a private unit on an NHS site, such
that they have the full multi-disciplinary
team back-up, and range of NHS facilities
and resources should they need them
To date, HCA are now managing oncology serv-
ices at a private patient unit at UCLH. Inter-
health Canada have been awarded a contract
to manage and expand a private patient unit at
a leading specialist NHS hospital, and expect to
announce this in January 2009. There have been
two further public procurements advertised, and
Interhealth Canada have had informal discus-
sions with a further eight NHS trusts who are
interested in exploring the concept.
Interhealth Canada’s vision is to develop 6-10
such partnerships with NHS Trusts over the next
5 years. The preference is for partnerships with
trusts that have one or more areas of tertiary
expertise w here they have international recog-
nition, and to develop units with 20-40 private
beds, capable of £15m+ revenues pa, with typi-
cally a 60-40 split of UK to International pa-
tients. Interhealth Canada’s view is that patients
from the Middle East and elsewhere will increas-
ingly only travel for complex tertiary procedures,
and will want to travel to internationally recog-
nised clinical centres. Their expectations in terms
of non clinical services will also be very high –
they will want a 5 star hotel environment with a
range of peripheral services including airport
transfers and accommodation for their family
arranged by the hospital operator as part of a
package.
Interhealth Canada’s view is that these types
of partnerships will provide a service that is very
attractive to international patients and paying
organisations. They will combine world leading
medical skills in internationally renowned NHS
teaching hospitals, with high quality services
that patients will expect from a leading private
sector operator.
Interhealth Canada will use their existing of-
fices in the Middle East to support the market-
ing of these services. Much of this will involve
bringing clinicians from the UK hospitals to
meet clinicians from referring facilities and over-
seas patient organisations in the Middle East to
establish relationships and develop clinical con-
fidence. A further development in the longer
term may be to establish satellite clinics within
the GCC region, which will be supervised clini-
cally by the NHS teaching hospital in the UK.
Moorfields Eye Hospital is one NHS trust that
has boldly taken the step of establishing itself in
Dubai Healthcare City, whilst other trusts may
prefer to do this with a joint venture partner. «
For more information about visiting
the Healthcare Travel Congress log
on to www.healthcare-travel.com or
call +971 43364021
H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8 | 9
tHe flagsHiP facility of the group, Pantai
Medical Centre (PMC), Kuala Lumpur, is a 330
bedded facility, with about 150 consultant
specialists covering almost all major special-
ties.
It is strategically located amidst lush green-
ery in the affluent neighbourhood of Bangsar,
home to a sizeable expatriate population and
just a stone’s throw away from nation’s capital,
Kuala Lumpur. It is also located near to KL Sen-
tral, the integrated transportation hub of the
capital and the transfer point for major rail
systems including the KLIA Ekspres which pro-
vides a non-stop journey between the city and
airport in just 28 minutes.
PMC is steadfast in the delivery of afford-
able services that are technologically appropri-
ate, with emphasis on quality, innovation and
health promotion, through its caring staff and
its sophisticated centres of excellence. Wheth-
er one seeks critical or non-urgent medical
treatment, PMC is able to offer value for mon-
ey services with its highly trained and experi-
enced medical personnel. In addition, consul-
tant specialists of the hospital are highly
specialised in the medical disciplines they rep-
resent, majority with recognised post-graduate
qualifications and fellowships from the UK,
USA and Australia.
Furthermore, the facility is also complement-
ed by the latest healthcare amenities and
equipments such as an advanced Linear Accel-
erator – the Elekta Synergy System, which al-
lows IMRT, IGRT, SRT and TBI; the latest model
of angiography machine – Phillips Allura,
which is capable of performing 3D coronary
angiogram, 3D radiological procedures as well
as stent boosts; and the Toshiba 64 Multi-slice
CT Scanner to further support and enhance
cardiac imaging and diagnostic procedures.
Being in a harmonious and multi-ethnic
country, the medical personnel in PMC are
able to converse fluently in English and collec-
tively able to speak various Asian languages.
A wide choice of foods are available including
Asian and international cuisines, with adher-
ence to “halal” standards in food preparation.
As a key provider of healthcare to the expa-
triate community in the capital and to enhance
appeal to international patients, Pantai’s Inter-
national Ward, the first Medical Ward and
Lounge in Malaysia specially dedicated to for-
eign patients and expatriates was officially
launched on the 25th September 2007. It of-
fers a range of in-hospital accommodations
and has an international lounge on the same
floor, providing club floor facilities to patients
and their guests. International patients are also
able to benefit from the personalised services
provided by the Pantai International Call Cen-
tre - a medical referral centre for foreign pa-
tients, which offers support services such as
medical referrals and appointments, travel and
accommodation, currency exchange, transfer
from airport and hotel, visa extensions, inter-
preter services, tour of the facility and other
patient related assistance.
Through many years of experience in provid-
ing quality healthcare to Malaysians, the expa-
triate community and international patients in
the region, PMC has working relationships
with most major insurance companies, both
domestically and internationally – such as Pru-
dential, Great Eastern, AIA, William Russell,
BUPA International, CIGNA and others.
The hospital was awarded the IS0 9001:2000
Quality Certification and Malaysian Society for
Quality in Health (MSQH) accreditation, which
is a member of the International Society for
Quality in Health Care (ISQua) and the Accred-
itation Federation Council. Other achieve-
ments of the hospital include winning the Su-
perbrands Malaysia Award in 2005 and an
Asian Hospital Management Award in 2006. In
pursuit of continuous improvement in quality
and safety of patient care, PMC is currently
working towards obtaining accreditation by
Joint Commission International (JCI). «
pantai Hospitals, one of the premier hospital groups in asia pantai hospitals, one of the premier hospital groups in asia, currently operate 9 hospitals in malaysia and are managed by pantai holdings sdn Bhd. the share-holders are khazanah nasional, the national sovereign Fund of malaysia and parkway holdings of singapore.
advertisement FeatUre | SINGAPORE
» THROUGH MANy yEARS OF ExPERIENCE IN PROVIDING qUALITy HEALTHCARE TO MALAySIANS «
10 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
INTRODUCTIONTraveling to seek medical care is thousands of
years old. People have been traveling across
the globe in search for cures for any imagin-
able illnesses. In ancient Greece, people have
used thermal and mineral waters for bathing
and their health for many thousands of years.
This was well incorporated in the practices at
the “Asclepeia” which were built near mineral
based thermal springs. The Arabs built on the
knowledge of the Greece and established a
phenomenal success of medicine. Baghdad and
other cities had large hospitals that cater to all
type of people seeking care from around the
world.
After the Arabs, the West took the lead and
established modern medicine. Starting from
the 19th century until recently, people from
around the developing world were traveling to
Europe to seek medical care. Post September
11th and due to visa limitations, many Arab
patients seeking care in the US started to shift
their destinations to Europe and the Far East.
For example and according to a Qatari news-
paper, many patients from Qatar are traveling
to Thailand’s Bangkok Hospital for medical
treatment. This regional trend was inline with
a greater global trend that was underway.
People from the West especially US, UK, Cana-
da, and Germany are seeking care in develop-
ing countries such as Brazil, Mexico, Costa
Rica, Turkey, Thailand, and India for procedures
such as dental surgery, plastic surgery, hip re-
placement, and even heart surgery. Many
countries such as India and Thailand saw this
as a real opportunity and an economic driver.
Governments in those countries invested and
promote their medical tourism industries.
To provide some numbers of the size of the
industry, it’s estimated that in 2007, 750000
Americans would travel abroad to seek medi-
cal care. On a global level it’s estimated that
health tourism is worth US$513 billion.
So what are the reasons that make people
travel thousands of miles away from their
homes to get medical treatment? Is cost or is it
quality or love of travel? Would this half a tril-
lion-dollar industry continues to grow and
what we can learn from it in the Middle East
and the UAE to build a medical tourism hub in
this region. The next section tries to address
these questions.
Trends and Challenges in Medical Tourism
By dr. ahmad okasha, healthcare Business development manager, oracle, dubai, Uae
FeatUre | CHALLENGES IN MEDICAL TOURISM
12 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
CHALLENGES IN MEDICAL TOURISM | FeatUre
WHy MEDICAL TOURISM NOW?COST SAVING
The cost of medical care has reached outra-
geous levels that are fueled by many factors
such as bureaucracy and cost of medical mal-
practice insurance. For instance, a simple cal-
culation of cost comparisons of unilateral hip
replacement in the United States of America,
Costa Rica, and India reveals a cost advantage
of more than 70%. Dr. Arnold Milstein, med-
ical director of the United States based medi-
cal group Pacific Business Group, told a U.S.
Special Committee on Aging in 2006 that the
typical combined hospital and doctor’s charg-
es for operations in “technologically advanced
hospitals in lower-wage counties such as Thai-
land were 60 to 85% lower than charges in
the US hospitals. Another study in the UK
done by European Research Specialists re-
vealed that UK patients could save up to 80%
by traveling abroad to undergo surgery and
medical treatment. The big advantage in cost
saving between the US, UK, and developing
countries makes it appealing for cash pay-
ment patients as well as insurance companies
to consider the seeking medical care in devel-
oping countries such as Costa Rica and India
even after adding travel related costs.
SPEED AND CONVENIENCE
When patients have to wait long time for cer-
tain procedures such as Canada and the UK,
they will consider medical care in developing
countries even thought if they have to bear
additional costs. For instance, many Canadi-
ans are travelling to Cuba to seek medical
care. Apollo Hospitals in India is attracting pa-
tients from the UK through prior arrange-
ments with the UK PUBA health insurance
company.
In other cases such as plastic surgery or
dental surgery, which is not covered by many
insurance companies, patients from the US
and the West are finding it less expensive and
convenient to travel abroad to seek care to
places such as Brazil.
TOURISM ASPECT
Getting away form the stresses of home and
work can be much better and more relaxing
way to recover from an operation. Many peo-
ple find it more convenient to combine medi-
cal care with travelling to exotic destinations.
According to a survey of European travel mar-
ket, the top five considerations for medical
travel in Europe were: Scenery, the climate,
cost of travel, and cost of accommodation.
This illustrates that the when people consider
medical travel, the tourism aspect plays sig-
nificant role(4). Thailand, which has built its
tourism industry, is leveraging its tourism des-
tination to build a medical tourism industry.
THE NEW GLOBAL CITIzEN
A new global citizen whose life and work
transcends borders is emerging. The transfor-
mation of the global economy towards a
knowledge economy in which experience and
knowledge can cross borders based on the
best opportunities available. Many people no
longer live exclusively in their country of ori-
gin. This trend will likely increase in Europe,
the Middle East, North America, and East
Asia. As people become increasingly mobile
for both temporary and permanent work as-
signments, they require a global healthcare
model that provides care for them wherever
they are. The global citizens can search the
best treatments available and where they will
be provided. Individuals are seeking outside
their present healthcare systems for better an-
swers, and are willing to travel and pay for
them. This trend is creating millions of global
citizens. These global citizens For instance,
they may be working for a year in the US and
then go back home to India for summer vaca-
tion. Along the same line in the Middle East,
some insurance companies are offering
» Many CANADIANS ARE TRAVELLING TO CUBA TO SEEK MEDICAL CARE «
H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8 | 13
people the choice to seek performs surgeries
in their home countries such as Lebanon in-
stead of the United Arab Emirates for instance
to save cost and be close to their extended
families.
TRENDS AND CHALLENGES IN MEDICAL TOURISMGLOBALIzATION OF HEALTHCARE
The globalization of health care is underway.
Globalization is happening in many industries.
The healthcare industry is catching up with
banking, insurance, and other service oriented
industries. Not only those brands that are
major specialized teaching hospitals focused
on education such as John Hopkins, Cleveland
Clinic, and Mayo Clinic jump on the global
expansion wagon, but also other non teach-
ing hospitals. Recently, a Dallas based Chris-
tus Health, a non-for-profit Catholic system
with more than 40 hospitals has recently
opened hospitals in Mexico to serve not only
Mexican residents living on the US borders,
but also US citizens coming from the US.
The biggest driver of the growth of medical
tourism and globalization of the health mar-
ket is what happening in the US market and
how the US insurers and hospitals react to
this trend. The promise of a growing medical
tourism market has prompted Mexican busi-
nessman Carlos Slim, the second richest man
on earth according to Forbs Magazine, to
build hospitals catering to US baby boomer in
partnership with Grupo Star Medica.
Another example was in 1992 when the
Dallas based International Hospital Corp (IHC)
opened the fist of its 10 hospitals throughout
Brazil, Costa Rica, and Mexico. The main fo-
cus of the Dallas-based hospital system was
to offer high quality care that had long
prompted residents of Latin America to travel
to the US. “Over the last couple of years, the
reverse has been happening,” said Joseph
Bracie, president of Centralized services for
IHC. US patients started to come to the hos-
pital locations in Latin America. According to
Barcie, 11% of the IHC patients now fall in
the category of medical tourists. 66% of
those patients are from the US.
Recently, Blue Cross and Blue Shield of
South Carolina indicated that they would cov-
er certain medical travel claims. It has estab-
lished a managed-care network of foreign-
based hospitals called Companion Global
Healthcare in which ParkwayHealth of Singa-
pore is one of the providers participating in
the network and offering surgical procedures
such as joint replacement, cardiac surgery,
and cancer treatment at pre-negotiated rates.
Would this trend continue? It’s difficult to
predict now. The jury is still out. There are
several challenges to the growth of medical
tourism on a global scale. The first is conti-
nuity of care and the second is legal aspect
and where liability fall in cases of medical
malpractice or injury to patients. The third
challenge is brain drainage of nurses and spe-
cialists from rural and less developed areas to
highly specialized medical centers who are at-
tracting international patients. The fourth
challenge is that as countries are focusing on
medical tourism and attracting international
patients, they are diverting resources from
public health and preventive care resources.
HEALTHCARE FINANCING
Healthcare is influenced to a large extent by
the way it’s financed. How insurance compa-
nies would impact medical tourism is still to
be seen. In one hand, many global healthcare
insurance companies are financing selected
medical travel for patients seeking care out-
side their home counties. As indicated earlier,
Blue Cross and Blue Shield of South Carolina
has extended its coverage to include Interna-
tional Hospitals in Singapore. How many in-
surance companies in the US, the biggest
buyer market of healthcare would pursue
suite will impact the rate of change in medi-
cal tourism.
According to British Medical Journal, the
NHS does not fund British patients to go to
India. It has told Indian hospitals that it can-
not refer UK patients because flying time to
India exceeds the three hours limit set for
transferring patients. This is not the case with
Commercial health insurance companies such
as PUBA, the UK medical insurance company,
which approves hospitals in India such as The
Escorts Heart Institute.
A recent study published in the US indicat-
ed that traditional insurance plans discrimi-
nate explicitly or implicitly against treatment
abroad.
qUALITy AND ACCREDITATION
In order to medical tourism to grow and satis-
fy the requirements of patients and insurers,
hospitals have to provide a minimum level of
quality done by third party agencies such as
accrediting agencies. Accreditation agencies
such as Joint Commission International (JCI)
Accreditation Canada, and the Australian
Council on Healthcare Standards are expand-
ing globally and providing this mission.
Recently, more than 140 hospitals have
been accredited by the JCI. Furthermore, the
JCI has updated its international version by is-
suing a new standard that focuses on patient
safety.
The issue for accreditation will be for na-
tions to agree on accreditation standards. Not
all hospitals that are marketing themselves to
international patients will be JCI accredited.
LEGAL ASPECT
As indicated earlier, with the continuous
growth of medical tourism, patients need to
feel secure and protected. Where does the li-
ability fall in case of a medical error? Does it
fall on the hospital, the doctor or the insur-
ance agency that covered patients for their
FeatUre | CHALLENGES IN MEDICAL TOURISM
14 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
CHALLENGES IN MEDICAL TOURISM | FeatUre
medical travel? Would providers who are
treating US patients or UK patients find them-
selves pulled to court cases in the US in cases
where US patients find themselves entitled to
go to a court. Even though previous legal cas-
es against Middle Eastern hospitals were not
successful such as Jeha v. Arabian American
Oil Co., and Gibbon v. American University of
Beirut(6), still many US lawyers would seek
every step and process of the care to find a
way to bring the jurisdiction to a US court.
Hospitals would treat US patients need to be
prepared to defend against clever lawyer and
sometimes sympathetic judges. International
hospitals must work together with the sup-
port of their countries to agree on a legal
framework that address that issue of malprac-
tice and medical mistakes. If this is not re-
solved and if also US patients started to go to
court, many international hospitals will limit
the number of US patients treated at their in-
stitutions. Therefore, a legal framework for
medical travel under the WHO is essential.
CONTINUITy OF CARE
So what happens when a patient travels and
undergoes a surgery? The optimum outcome
is the surgery is successful, and the patient
travels back home. The Patient stills need to
see a physician and care practitioners for fol-
low up. Would the medical history investiga-
tions be with the patients or would it be at
the treating hospital? The international hos-
pital that treated the patient needs to coordi-
nate follow-up and post surgery care with
physicians and hospitals in the patient home
country. Hospitals in the travel destination
and the home country need to share medical
information, treatment protocols, medication
history, lab results, and follow up visits to en-
sure best outcomes. This is also useful for the
international hospital since it provides out-
comes data to provide feedback on the best
treatment protocols and process.
HOW TO POSITION yOUR HOSPITAL FOR THE FUTURE?Countries in the Middle East have a long way
to go to establish themselves as medical tour-
ism hubs. In the Middle East, one can classify
two types of countries that have the potential
to be medical hubs. The first are the Gulf Co-
operating Council countries with long-term
strategy and plenty to spend on building in-
frastructure and promoting medical tourism.
One can cite two countries that are building
their medical tourism capabilities. The first is
the UAE in which, I believe is on its way to
becoming a center for medical tourism. The
second one is Bahrain, which announced its
intention to build a medical tourism city.
The second type of countries are those that
have built excellent medical institutions and
have high caliber physicians and healthcare
professionals, but lack the financial resources
to build their legal, quality, and marketing to
promote medical tourism at the international
level. One can cite Lebanon and Jordan as ex-
amples of these countries.
So what can learn from international initia-
tives in building medical tourism? I believe
any country focusing on medical tourism
should address the following:
ATTRACTING SUPER STAR
SPECIALISTS
The healthcare industry is still led by physi-
cians. A high-caliber specialist is like a super
star. If you give this star a qualified team and
the state-of-the-art technology he/she excels
to a high level of success and becomes a mag-
net for patients from the region and the
globe. Patients are willing to travel thousands
of miles to be treated by a famous surgeon or
specialist. In addition, there are a body of lit-
erature that supports the role of specialists
versus primary care physicians in certain spe-
cialties such as cardiology and its impact on
increasing the volume of patient care.
» PATIENTS are willing to travel thoUsands oF miles to Be treated By a FamoUs sUrgeon or speCialist «
» COunTRiES IN THE MIDDLE EAST HAVE A LONG WAy TO GO TO ESTABLISH THEMSELVES AS MEDICAL TOURISM HUBS «
H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8 | 15
FeatUre | CHALLENGES IN MEDICAL TOURISM
The more a surgeons or a specialist practices
certain procedures the better outcomes he/
she will get. This is the “practice makes per-
fect” rule in healthcare. I believe as the out-
comes of the spcialist improve so the volume
of patients he/she attracts. Thus specialists
with a record of high volume of certain proce-
dures are important pillars to having a medi-
cal tourism program.
CREATING LOCAL BRANDS
Once a famous specialist is in house and has a
high caliber medical team to support him, a
hospital can build a local and then a regional
healthcare brand in order to attract interna-
tional patients and insurance companies.
Corporate brand development, image build-
ing, and reputation need to be taking into
consideration when building such a brand.
Borrowing from the success of regional brands
such as Emirates Airlines, Aramco, and
EMAAR, the local healthcare market can use
similar marketing strategies to build health-
care brands. King Faisal Specialist Hospital,
Dubai Healthcare City, American University of
Beirut Hospital, and American Hospital of Du-
bai are among potential local healthcare
brands that have a high potential of becom-
ing regional brands then going global.
INTEGRATING MEDIAL AND LEISURE
PACKAGES
The GCC countries as well as Middle Eastern
countries in general are building their tourism
industry. Billions of dollars are being spent to
develop the tourism industry. The UAE is
heavily investing in building hotels, theme
parks and other entertainment facilities. In
addition, the UAE has been successful in of-
fering attractive touristic packages. It’s ex-
pected that in 2008, more than 8 million visi-
tors will make the UAE their tourist
destination. GCC countries can differentiate
themselves and leverage these investments to
offer attractive medical travel packages that
include staying in luxury hotels, visiting the
parks, and enjoying safari rides in addition to
medical care.
SMART HIRING AND DEVELOPING LO-
CAL TALENTS
The healthcare industry is an experienced
based industry, which relies heavily on high
experienced, licensed, and talented profes-
sionals. Special type of skills and attitude in
addition to technical qualifications are impor-
tant to build successful medical tourism capa-
bilities. A cheerful positive nurse who’s cultur-
ally knowledgeable and trained to deal with
patients from diverse cultures is as crucial as a
highly technically trained nurse. This applies
to all other allied healthcare professionals and
front office staff. Careful screening and re-
cruitment of the right skills is essential.
Along the same line, providing training to
local students and incorporate some hospita-
bility aspects such as dealing with diverse cul-
tures is needed. I believe that the GCC coun-
tries such as the UAE, Oman, and Bahrain are
experienced with developing their hospitality
capabilities. For instance, it’s estimated that
there are residents from more than 80 differ-
ent nationalities living in the UAE. This creates
an environment where people have to deal
with different cultures on a daily basis.
DEVELOPING THE LEGAL
ENVIRONMENT
In order to develop medical tourism, Middle
East countries need to build their legal and
malpractice laws in order to protect patients,
build a reputation of having a safe medical
care industry and to protect their hospitals
from being drawn to courts in the US or the
West. As stated earlier and since medical er-
rors may happen. Not all of these medical er-
rors are due to human errors. Lawyers from
the US or the Western countries may use all
possible legal means to move the cases to the
their countries where judges may be more
sympathetic to their claims.
Medical tourism is a journey that is worth
taking. This journey cannot be rushed. There
are many elements that need to be considered
in order to build a successful medical tourism.
Countries that invest and develop their medi-
cal tourism capabilities will reap huge bene-
fits. Countries that either rush into medical
tourism or do not take the necessary steps
will find themselves overtaken by other near-
by medical tourism hubs. «
References available on request (jenna.wilson@iirme.com)
16 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
every culture has its stories of great divides,
and how those distances were crossed using
passion and tenacity, and with the loyalty of
trusted friends.
In today’s world of global healthcare, the di-
vides are different. They are divides of medical
and facility quality, divides between patient
and employee culture, language and expecta-
tions, and of course the great divides of dis-
tance a patient may travel to your facility.
Within your own organizations there are di-
vides between the administration and the doc-
tors. Divides between medical staff and patient
relations staff. Further divides all along the
continuum of care you strive to provide, to-
gether with your external partners such as
travel agents or overseas consulates.
Then, at the end of the fiscal year, there
may be a divide in the bottom line, between
what your accountant says and what owner-
ship or shareholders desire. Operational effi-
ciency must be planned, worked toward con-
sistently, and met, or else the purse strings will
be strained and may not reach across the bud-
get gaps.
Or perhaps you are planning a new facility
or service to serve the growing healthcare
market. What are the divides between what
the market wants and what you plan to pro-
vide?
These are some of the themes we shall be
exploring in future columns. Each of these and
many other scenarios present dangers of slip-
ups. I will offer tips to help you avoid misfor-
tunes.
To really grasp the opportunities presented
by global healthcare, we must go across each
great divide with every bit of courage, strength
and smarts as our storied predecessors. We
must put forth effort to bring the distances to-
gether and meet our goals. We must learn the
tips to avoid the slips.
In my background as a doctor of Ophtha-
mology, I saw divides in the healthcare avail-
able to rural peoples. I initiated programs and
performed more than 1,000 cataract surgeries
free of charge.
In my background as regional director of a
chain of 5 hospitals for Max Healthcare in In-
dia, I saw divides in each facility among staff
and medical professionals and ownership.
In the successful medical travel initiatives
created during my time at Max, I saw foreign
patients travel great distances for care they
could otherwise not afford, or quality of care
they could not receive in their own country.
In my travels to numerous conferences
throughout the world, I have met people who
did not see the divide in front of them, even as
another step would have sent them slipping
into that gulf. I met others who saw the gulf,
but did not have the tips on how to get across
that distance.
That is the purpose of this column. We shall
have a dialogue between myself and you, Dear
Reader, and go across those divides together.
We seek to bridge the gaps in operations, in-
ternal and external branding, marketing, cus-
tomer service and cross-cultural expectations.
The only way to do this is with tenacity, pas-
sion, and appropriate loyalty.
Together, we shall travel those distances and
find the best solutions to close the gaps. I wel-
come your companionship on these journeys
together, as we will ultimately show how bet-
ter patient outcomes are achieved by our com-
mitments to bridge the divides.
This dialogue will work best with your ques-
tions and comments to this magazine, or to
me directly at drmalik@medicalqi.com.
We shall see examples not only from the
world of healthcare, but also from the worlds
of consumer brands. They have been learning
the lessons of global markets far longer than
we health practitioners.
Next month we shall begin by exploring slips
and tips in “customers desire, we misfire” (the
gap between what customers want and what
hospitals deliver). I hope you will join me in
these great adventures, as we cross the many
great divides. «
Dr. Sanjiv Malik, MS, MBA is Chairman of Medical Qi,
Inc., a healthcare consulting and representation firm.
He was formerly Regional Director of Max Healthcare
in India and has acted as consultant to many health-
care initiatives around the globe. Contact Dr. Malik at
drmalik@medicalqi.com
Slips & Tips
across the great Divide
By dr. sanjiv malik, ms, mBa
gaps exist in every part of healthcare, but with passion and tenacity we can bridge those gaps
FeatUre | REGULAR COLUMN
regular Column
18 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
ask anyone in town to name the best hospi-
tal in Dubai, and the answer would be the
American Hospital Dubai. A landmark in the
city, The American Hospital Dubai (AHD), is a
143 bed acute care, general medical / surgical
hospital was established in 1996 and has prov-
en itself to be a leader among private and
medical centers in the Emirate.
The Hospital was planned, designed, built
and equipped to meet American Standards of
Healthcare. The hospital operates to these
standards and all its physicians are North
American Board Certified or of equivalent
Western training programs, such as those in
the United States, the United Kingdom and
Canada. Catering to quality medicine, Ameri-
can Hospital Dubai is the first hospital in the
Middle East to be accredited by the Joint Com-
mission International Accreditation (JCIA); a
subsidiary of the United States based Joint
Commission on Accreditation of Healthcare
organizations (JCAHO).
Despite the expensive mandate, “AMERI-
CAN HOSPITAL DUBAI is committed to provid-
ing the highest quality patient care by meeting
American and International accredited stan-
dards”, says Richard Larison, CEO.
The hospital has been recognized as a lead-
er in primary, secondary and increasingly ter-
tiary care in the UAE for the past eleven years.
It has built this reputation by insuring the fin-
est hospital facilities, the latest technology and
the recruitment of US / Western qualified and
trained physicians.
The hospital has developed several areas of
expertise: Heart, Total Joint Replacement, Dia-
betes, Neurosciences, GI Services, Cancer,
Emergency Medicine, Pediatrics and Obstet-
rics.
Construction is already well under way for
the hospital’s new seven-storey tower. It is
projected to be completed in February 2010
and will include 8 state-of-the-art operating
rooms, 47 ICU beds, 178 patient beds, a new
Radiation Therapy Center, an expanded Re-
gional Center for Diagnostic and Interventional
Radiology, and a Reference Laboratory. All of
this will allow AHD to continue to meet the
healthcare needs of the people of Dubai, UAE
and the region.
“With a dedication to continual quality im-
provement and growth, AHD is committed to
expand its present services and introduce
new centers of excellence”, concluded Rich-
ard Larison. «Tel: +9714 336 7777, www.ahdubai.com
AMERICAN HOSPITAL | advertisement FeatUre
American Hospital Dubai: quality American Standard Healthcare in the Middle Eastthe american hospital dubai provides quality, cost effective, american standard healthcare to meet the
needs of dubai and the surrounding gulf states through comprehensive primary, secondary and tertiary
care services on an inpatient, outpatient and referral basis.
» THE aMERiCan HOSpiTal WAS PLANNED, DESIGNED, BUILT AND EqUIPPED TO MEET AMERICAN STANDARDS OF HEALTHCARE «
H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8 | 19
HoW HealtHcare Providers make use of
this trend, is a question which will top the
popularity charts in the global healthcare in-
dustry. To find the answers, you do not have
to look far. Strategic marketing principles are
as relevant to healthcare as they are to any
other industry.
The product life cycle, if we could have one,
for Medical Value Travel, will show that the
concept is about to hit the growth phase.
Maybe it already has. According to an esti-
mate, over a million people travel to 28 differ-
ent countries for medical treatment. The num-
bers are likely to rise owing to a number of
factors.
At this juncture, examining the various strat-
egies that the industry players can deploy be-
comes critical. The following are the strategic
lines that the players can follow and attain
sustained growth for themselves:
MOVE FIRSTIt is a foregone conclusion that the competi-
tion will intensify as the concept grows fur-
ther. Everyone will want to jump on to the
bandwagon and earn extra dollars. It is already
happening. At this juncture, therefore, the
first movers’ advantage becomes important.
For medical travel business, according to me,
first movers’ advantage cannot be gained un-
less the forces extraneous to your business are
supportive of you. For example, you may be
the best suited hospital for international pa-
tients, but the visa laws in your country ensure
that the potential medical traveller gets a
good run around before he gets the visa. In
another country the visa laws may be simple
but the political instability may raise questions.
All in all, traveller friendly countries with great
hospital facilities and stable economic and po-
litical conditions are more likely to gain the
first mover’s advantage.
SKIMMINGAnother feature of the early growth phase is
that the price elasticity of demand is less. In
other words, the markets are less sensitive to
price. If Thailand is a bit more expensive than
India but is more convenient and offers better
quality, more people will go to Thailand than
India [and they are going too]. In any case, in
a high involvement service as healthcare, peo-
ple will not always decide on price alone.
Skimming can be an option in the early growth
phase. This essentially means that you can
charge a decent premium for your services as
the category grows further.
The profits thus made can be used in creat-
ing a highly differentiated brand. This exercise
will stand you in good stead when the con-
cept enters the maturity stage.
EARLy ADOPTERSAnother driver for growth in emerging trends
is the ability of the players to locate ‘early
adopters.’ Some people will take on to a new
concept more easily than others. An estimate
puts a figure of 17% as the percentage of
people who can be labelled as ‘early adop-
ters.’ Finding them and winning them over will
spell the difference between winners and lag-
gards in the category. For some hospitals, 50
million or so uninsured Americans seem to be
a lucrative market. It may make more sense to
approach the ‘early adopting’ segments out of
these 50 million and win them over.
EDUCATEA lot of information and education needs to
be provided in the early growth stage. People
would want to know a lot more about the
service category. This is where medical travel
planners, web-sites, published articles, videos,
testimonials will play a very vital role. The
whole idea of travelling abroad for treatment,
its benefits, safety issues, legal issues, number
of people already receiving international treat-
ment, cost involved, etc. needs to be told to
Global marketing strategies for emerging trends
By vivek shukla, healthcare marketing Consultant, mail@vivekshukla.com
FeatUre | HEALTHCARE MARKETING
as the world rapidly moves towards becoming a global village, new unforeseen trends are
arising. amongst many firsts, we are seeing, for the first time, a lot of people travelling from their
home countries to other parts of world for medical treatment. this practice is not new, but the
magnitude of the trend and its potential has caught the eye of many industry watchers.
20 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
HEALTHCARE MARKETING | FeatUre
the segments you are targeting.
India may still be a country of snake charm-
ers for many people in North America. So,
unless people are educated about India, its
medical facilities, its economy, price structures,
expertise, etc. they want not want to board
the plane just as yet.
Unless they are educated about the concept
of medical value travel and how it benefits
them, they are less likely to plunge in.
DEFRAGMENTATIONAny new market will defragment with the
times to come. The entire world your target
market will divide. You may find yourself ca-
tering only to the Middle Eastern market. Fur-
ther, as the market matures further, you may
only find yourself providing orthopaedic solu-
tions to the Saudi and UAE patients. The point
is, growing markets divide as they mature. You
have to take your call sooner or later regard-
ing your manoeuvre. Categories divide. So the
service providers should be clear as to which
way they will go as and when that happens.
BARRIERS TO PURCHASEFor medical travel there are many barriers.
These barriers can be categorized into psycho-
logical [going to a different country], logical
[quality of clinical outcomes], economical [in-
surance not covering treatment abroad or lo-
gistical [visa not easily available]. The idea for
the players is to work incessantly towards low-
ering/eliminating these barriers. How far the
industry grows before it starts to mature and
finally decline will depend upon how well the
barriers to purchase medical treatment abroad
are lowered. A significant barrier at the
present moment is the legal cover that pro-
vides security to mistreatment abroad. A
standard international law for medical treat-
ment will significantly help reduce this barrier.
INNOVATEThe faster the category of medical value travel
grows, the more important it is for the players
to innovate. Ones who will innovate and be-
come different will be the ones who will get
ahead, and stay ahead. Rigid providers who
resist change will become as extinct as dino-
saurs. Getting accredited with an internation-
ally accepted quality organization is one exam-
ple of innovation. Changing your operations
to meet the needs of international patients is
another innovation. Ensuring that the interna-
tional patient gets his home cuisine, watches
his home movies, gets his instructions in his
home language through a translator, etc. are
some basic innovations required.
BUILD LOyALTyAs the initial growth phase starts gaining more
pace, competition will intensify. If you have
built loyalties with the patients who used your
services, you will be bailed out much more
easily and will be able to ward off much of
competition. Medical travel is done for elec-
tive treatment and it is mostly one time treat-
ment that is imparted. How do you build a
loyalty with a onetime customer is a big ques-
tion. Well, he may never come back. But he
can send a few people across. If you ensured
his continuity of care and kept in touch with
him long after he has left your borders, chanc-
es are that he will recommend you to others.
Easier said than done; but worth trying never-
theless.
CREATE BARRIERSWith every other person ready to jump on to
the band wagon, it sometimes becomes nec-
essary to create entry barriers for others. Cre-
ating exclusive partnerships with insurance
companies, medical travel planners and even
international governments can create barriers
for others to enter. A big tertiary care teaching
hospital in India has an exclusive tie up with
the Bhutan government to provide tertiary
care services to its citizens. Even though the
hospital is far from the India - Bhutan border,
the hospital serves scores of patients every
year.
All said and done, we are in exciting times
when it comes medical value travel. This may
be the beginning of an era that may see a
huge transformation in the way healthcare is
being sought and provided.
All you have to do is keep a close watch and
create clear advantage for yourself by stand-
ing apart from the rest of the pack. «
More information on the Global Healthcare
Marketing conference can be found at
www.healthcare-travel.com To register to
attend, please call +971 43364021
H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8 | 21
cmc Has been cHosen by Johns Hopkins
Medicine International to be one of its affiliate
reputable medical institutions around the
world. To achieve the goal of serving as a cent-
er of excellence for Lebanon and the surround-
ing region, CMC in Beirut has achieved a long-
term collaboration with Johns Hopkins
International in the United States.
ONE-STOP CAREVirtually all medical services a patient might
need – doctor visits, testing, surgery, and hos-
pital care- are all available “under one roof” at
CMC. The hospital, provides all the essential
health services required through a person’s life
time: These range from simple diagnostic tests
to the most complex surgeries in Neurosurgery,
cardiothoracic, spine surgery etc...
Oncology, Heart, Eye, ENT, Colorectal and
Digestive diseases are among the centers of
excellence at Clemenceau Medical Center.
CMC also houses specialized departments
for renal diseases, urology, as well as women’s
health clinic, fertility and IVF, children depart-
ment, new born intensive care unit, in addition
to a plastic surgery center.
NEW TREATMENTS AND TECHNOLOGyCMC continuously pushes the boundaries to
offer the most advanced options. Patient Care
and safety are always priorities when selecting
equipment, thus, only the best breed of equip-
ment from reputable manufacturers have been
selected. Amongst other things, CMC offers a
completely film-less digital medical imaging
environment, and has built and equipped the
most modern Operating Theaters in the world,
complemented by advanced laparoscopy and
OR automation systems.
TOP DOCTORSCMC chooses doctors carefully based on their
educational background, their medical skills,
and their ability to work together. Our doctors
are with extensive experience in treating every
kind of illness, many are international experts.
CMC supports doctors by providing the best
personnel, facilities and technology to help
them deliver the best care to every patient eve-
ry day.
PREMIER ExECUTIVE HEALTH CHECKCMC offers the Premier Executive Health Check
program, a thorough determination of your
health status with customized wellness pro-
gram for your continued health and well-be-
ing.
This program is designed to target, reduce,
and eliminate health risks through early detec-
tion and counseling of lifestyle-related prob-
lems.
THE INTERNATIONAL PATIENT SERVICESThis includes a complete scope of services for
patients visiting the hospital from outside Leb-
anon. A multilingual staff is available to coor-
dinate all aspects of a patient’s stay, such as
the management of medical consultation and
hospital admission, travel and hotel arrange-
ments for patients and their families including
an air ambulance depending on the distance
and the condition of the patient, assistance in
choosing the right doctor, processing of sec-
ond medical opinion, and remote consultations
via telemedicine, if needed.
CLEMENCEAU MEDICINE INTERNATIONAL (CMI)CMI is an organization whose main duty is the
advancement and spread of the Clemenceau
Medicine’s mission of patient care both region-
ally and internationally. CMI has dedicated
itself to improving patient safety and quality of
medical care, providing assistance in managing
performance and applying the world’s best
practices in the Middle East.
For these reasons, CMI offers a wide array
of services that range from healthcare consult-
ing to clinical services development. Through
its proficient services, CMI strives to foster
partnerships with international organizations
and help them excel regionally and serve as
examples of excellence internationally. «
Clemenceau Medical Center and its Affiliation
in a constantly evolving world of high-end technology and research, it was a matter of sheer
necessity to establish a regional state-of-the-art medical facility with global reach and support.
Clemenceau medical Center (CmC), in affiliation with the prominent and pioneering Johns hop-
kins medicine international, is an ultra-modern medical institution located in the epicenter of
Beirut. our aim is to provide quality healthcare services within a supportive and compassion-
ate environment in both a timely and cost-effective manner, in a 5 star setting environment for
patients from lebanon and the middle east.
advertisement FeatUre | CLEMENCEAU MEDICAL CENTRE
22 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
FeatUre | BIOETHICS
WHat do a HiP rePlacement, a facelift and
a free vacation for your partner have in com-
mon? A lot, if one is embarking on a medical
tourism jaunt. A combination of market dy-
namics and increased globalization has helped
create this new industry which combines re-
quired and/or elective surgery with vacation-
like amenities. The numbers are compelling.
The actual numbers of those participating in
off-shore operations are noteworthy for their
size as well as the variability of the estimates,
which range from 500,000 to 150,000 U.S.
citizens per year. The lack of verifiable numbers
is the first tip- off that medical tourism may be
infused with a bit of the wild west, or in this
case, East. Drawn by the $11,000 cardiac pro-
cedure versus the heart stopping US rate of
$130,000 or a spinal fusion with a price tag of
$5,500 versus a back breaking US bill of
$62,000, patients and more importantly, insur-
ers, are heading beyond the pale for surgery.
However, the allure of inexpensive medical
care may not be quite enough to get your aver-
age cubicle worker with an unstamped pass-
port on an airplane for a hip replacement. The
tipping point may be the perks, which include
airfare and lodging for patient and partner, a
bump up to first class and some additional va-
cation time. Insurance companies are facilitat-
ing the shift of outsourced medical care. The
biggest names in insurance, Cigna, Aetna and
Blue Cross, are either contemplating or imple-
menting off-shore treatments for required and
elective surgeries as a matter of economics. It’s
Medical Tourismproceed with Caution
By Colleen lyons
» MANy DEvElOping COunTRiES ARE BANKING ON TOURISM TO HELP BUILD A SUSTAINABLE ECONOMy «
24 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
cheap. As the median age of the population
rises upwards, along with the costs to care for
an aging yet unhealthy population, insurers are
looking for ways to elongate the dollar.
In addition many developing countries are
banking on tourism to help build a sustainable
economy and play in the global market. Gov-
ernments, businesses and healthcare providers
in India, Thailand, Mexico, Israel, New Zealand,
Costa Rica and Turkey are collaborating with
the medical tourist providers to attract patients
and their currency. In the West, these countries
have historically evoked exotic imagines of un-
reachable allure. Yet, the appearance of finan-
cial savings and efficiencies has made strange
bedfellows of sutures and seductive travel.
Those who have reservations about making
reservations for going abroad to be sliced, su-
tured and sent home are prudent. Price does
not always equal costs and there are a few
points to be considered before a ‘buy and fly”
operation. One such consideration is informed
consent, the full disclosure of surgical risks,
complications and recovery expectations. In-
formed consent in the West is difficult- parsing
the medical jargon, common language use, and
grade-level appropriateness are familiar chal-
lenges. Non-western cultures may place less
importance on ensuring a fully informed patient
and the language differences lend themselves
to hi-jinks.
Beyond informed consent is the issue of post-
operative complications. What may be a routine
complication can take on a menacing twist
when one is thousands of miles from home
without the assistance of friends and family to
interpret the medical milieu and translate the
language. Hospital-based staph infections, for
example, are pernicious. What if a stay is pro-
longed indefinitely? If one does trot home on
schedule, recovery may not be calibrated for a
long, often truncated, flight home. As a result,
unanticipated complications may arise en route
or at home. Then what? Is the patient going
to be inclined to get back on the plane? Prob-
ably not.
Now we come to another significant issue:
legal remedy. Americans are singular in their
propensity to seek legal remedy when medical
complications arise. Yet off-shore law suits for
medical malpractice will be the rare occurrence
and not de rigueur as it is in the US. With
these considerations as part of the cost/benefit
analysis, the bloom may be a bit off of the
rose.
From a policy perspective, the issues are larg-
er, the first of which is certification. The inter-
national medical tourism guidelines and stan-
dards set by the American Medical Association
and the International Society for Quality in
Health Care which certifies 170 +/- hospitals
around the world offer little comfort. For start-
ers, how are the standards monitored, audited
and updated? Are there corollary environmen-
tal standards for air, water and food safety?
The powerful Food & Drug Administration
(FDA) has difficulty managing safe food and
drugs- tomatoes and Heparin come to mind.
How can an AMA imprimatur, which does not
have legal authority, provide assurance of sus-
tained quality and safety?
McKinsey & Co., estimates that 500,000
-700,000 Americans might go off-shore for
medical care if insurers cover some or all of the
bill and that savings may top $20 billion a year.
The first issue is that if insurers sniff the aroma
of cost savings, a la managed care, the patient’s
option to stay home or jet-set may be off the
table. The venue may be mandated. In addition,
if these cost savings become imbedded in the
balance sheet- and the talk track to Wall Street-
the luxuries and incentives will go the way of
house calls. On a macro level, a significant eco-
nomic and social shift will occur if half-million
procedures shift out of the medical system in
the US. The effects are far reaching and may
further exacerbate the issues associated with
the marginal and uninsured.
While medical tourism does have some fine
attributes- there are many positive anecdotes-
we must proceed with caution and consider the
spectrum of implications affecting patients, so-
ciety and the economy. «
Ms. Lyons is a bioethicist and principal with Ethical
Stability for Sustained Prosperity.
Sources:
By JoNel Aleccia MSNBC
updated 8:41 a.m. ET, Mon., June. 30, 2008
Art Caplan
By Alex Davidson , updated 5:40 p.m. ET, Thurs., Dec.
13, 2007
» WE MuST pROCEED WITH CAUTION AND CONSIDER
THE SPECTRUM OF IMPLICATIONS AFFECTING PATIENTS,
SOCIETy AND THE ECONOMy «
BIOETHICS | FeatUre
H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8 | 25
FeatUre | HEALTHCARE INSURANCE
tHe number of americans traveling over-
seas for health care is rising steadily, climbing
to between 600,000 and 1 million last year, ac-
cording to some estimates. Although a recent
paper produced by McKinsey Consulting sug-
gested a much lower estimate, most experts
agree that the number certainly will increase in
the future. And human resource executives
who design benefit plans for self-insured em-
ployer groups will have a definite say in deter-
mining the rate of acceleration.
The medical travel industry – I prefer the
terms “medical travel” or “global health care”
over “medical tourism” since most patients
travel abroad for the express purpose of un-
dergoing medical treatment and not sightsee-
ing – began to take off in recent decades as
Americans sought cosmetic procedures over-
seas at a fraction of the U.S. costs. Now, with
47 million Americans lacking health insurance
and millions more underinsured, patients are
exploring overseas options for medically neces-
sary surgeries such as cardiac bypass, heart
valve replacement, hip and knee replacement,
hysterectomy and others.
The initial attraction for these globetrotting
patients is the low cost, and many save 80 to
85 percent off U.S. prices. But the level of ser-
vice and five-star hospitality they receive is
equally impressive in most cases … and con-
verts most medical travelers returning to the
U.S. into flag-waving diplomats of this alterna-
tive.
While the desire for cosmetic work launched
the medical travel industry and a lack of insur-
ance coverage for many Americans fed it, I be-
lieve the next wave in demand will be fueled
by employee benefit plan administrators who
include a global health care option in their
benefit packages.
Companion Global Healthcare Inc., based in
Columbia, S.C., was established last year to
streamline access to overseas care for the
members of a large commercial health plan in
South Carolina who choose to travel abroad
for treatment. This 1.5 million-member health
plan knew South Carolinians were traveling to
Southeast Asia and other destinations for sur-
gery, so we decided to make it easier for their
members and provide assistance on a value-
added basis. While member service was the
initial driver behind Companion Global Health-
care, the company also is available to assist the
uninsured, and to contract with other insur-
ance companies and self-insured groups inter-
ested in offering a global surgery option.
Employers are the ultimate payers for most
health care under the current U.S. system, and
we at Companion Global Healthcare are con-
stantly fielding questions from human resource
brokers and others who shape benefit struc-
ture about how a global health care benefit
works.
For example, we are hearing from employer
groups who say they might consider waiving
the $2,000 deductible in an employee’s medi-
cal plan if the employee chooses to undergo
surgery at one of our network hospitals over-
seas. Other incentives are possible, too, such
as employers covering the cost of travel.
Employers are the key as to whether this
trend continues to gather momentum.
Overseas Medical Care Has Become
an Option for Employers
By david Boucher
president and Chief operating officer
Companion global healthcare inc.
26 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
HEALTHCARE INSURANCE | FeatUre
THE ‘PERFECT STORM’ DRIVING THE TRENDThe factors that have led to the heightened in-
terest in medical travel are many, but the rela-
tively high cost of treatment in developed
countries is by far the most obvious. For many
surgical procedures, the cost is 50-80 percent
less at all of the hospitals in Companion Global
Healthcare’s overseas network than for the
same procedure performed at a U.S. facility.
Lower labor costs overseas and the fact that
medical malpractice suits are a rarity help keep
costs in check.
While the low cost is the attention-grabber
for most patients who travel outside the U.S.
for care, those patients are often just as im-
pressed by the superior hospitality they are af-
forded at facilities in Thailand, Singapore, Tur-
key, Costa Rica and other places. Throw in the
ease and affordability of international travel,
and you begin to see how the pace of global
health care is picking up.
Of course, going hand-in-hand with the af-
fordability factor is the substantial number of
uninsured and underinsured people in this
country, who have utilized overseas facilities in
larger numbers than those with comprehensive
health insurance.
Even those with insurance are considering
the overseas option in increasing numbers, and
that is a surprise to some.
Skeptics often ask me, “Why would a mem-
ber of a commercial payer with a $500 deduct-
ible spend $1,500 for a plane ticket and en-
dure a 25-hour flight to go to Thailand or India
for care?” Well, most probably wouldn’t.
When we launched Companion Global
Healthcare, we simply wanted to offer another
alternative that reflects our ongoing commit-
ment to help members seek the services they
want at competitive prices. We certainly did
not envision long lines of our members at the
airport waiting for flights to far-away locales so
they could have knees and hips replaced.
But what about the person with a high-de-
ductible plan? Or the person who has insur-
ance but is not covered for a procedure due to
a pre-existing condition? Or the patient who
needs a specialized procedure not performed
frequently in the United States, such as hip re-
surfacing? Those are the people going abroad
already, and now we have groups asking about
tapping into the Companion Global Healthcare
network and considering incentives for em-
ployees who choose surgery abroad.
Another factor contributing to the growth in
global health care has to do with the aging of
the U.S. population.
According to USA Today, during each hour
of 2008, 365 Americans will turn 62 years old,
and more than half will accept early retirement
from Social Security. Many, however, will no
longer have health care benefits from their
previous employer and will not be eligible for
Medicare for three more years. Clearly, their
Social Security income will not cover traditional
insurance products, and all of this will come at
a time when many of these new retirees are in-
curring substantial expenses. So while the Sil-
ver Tsunami is helping fuel the demand side of
the medical cost equation in the U.S., the ac-
celerating shortage of health care workers in
the States is pressuring the supply side.
Treatment overseas may not be the total an-
swer for this population, but I do believe it will
be an option for many.
IS OVERSEAS CARE qUALITy CARE?Year-over-year growth in international patient
care is approaching 25 percent in some coun-
tries, including Thailand, Singapore and India.
Colleagues in Mexico and Costa Rica say their
numbers of patients from the U.S. are up well
over 50 percent vs. 2007. This could not hap-
pen unless patients there received high-quality
care.
The number of foreign hospitals that have
earned accreditation from the international
arm of The Joint Commission, the group that
accredits U.S. hospitals, has increased from 87
in mid-2006 to more than 170. What’s more,
many of the physicians who practice at these
international facilities are U.S. board-certified.
As we expand our network of overseas hos-
pitals, Companion Global Healthcare will con-
sider adding only facilities certified by the Joint
Commission International (JCI) that we believe
have comparable technology and subscribe to
the same high standards of care as the best
U.S. facilities.
Although Companion Global Healthcare is
aggressive in seeking new network members –
we hope to expand our overseas network from
the current 10 to perhaps 15 hospitals – we
are also conservative when it comes to risk.
Many critics of medical travel suggest that a
few well-publicized deaths or serious injuries in
this business could arrest the trend. And while
those could happen at any hospital –
H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8 | 27
FeatUre | HEALTHCARE INSURANCE
every patient responds to anesthesia different-
ly, for example – we want to be able to miti-
gate that risk as much as possible.
We have been impressed with the transpar-
ency exhibited by many international hospitals
with regard to quality and patient satisfaction,
as well as price.
Several indices have become the back-
bone of the “quality transparency” drift in
the United States, including:
• Number of cases per procedure
• Average length of stay per procedure
• Mortality and hemorrhage rates
• Post-surgical infection rates
• Patient-satisfaction scores
While Web-enabled data available to the pub-
lic for some of these indicators is sparse, at
best, for U.S. facilities, many foreign hospitals
such as Bumrungrad International in Thailand,
Parkway in Singapore, and CIMA in Costa Rica
readily make this data available.
Price transparency also is more common
among overseas hospitals than with those in
the United States, with many offering prices
for all-inclusive packages prior to service. Un-
der this approach, the consumer is more em-
powered and informed as the health care-buy-
ing experience becomes more like shopping for
other goods and services.
LIMITATIONS OF GLOBAL HEALTH CAREWhile I believe strongly that the care delivered
by JCI-accredited facilities is on par with U.S.
hospitals and that a global care option is at-
tractive to millions of Americans, I am quick to
add that traveling outside this country for sur-
gery is not for everyone.
The trend of Americans utilizing overseas fa-
cilities has formidable limitations.
First, many Americans will not consider trav-
eling abroad for fear of surgical complications,
questions concerning whether their primary
physician will see them for after-care following
their return to the United States, and limits on
medical malpractice claims in some foreign
countries.
Also, not every surgical procedure is appro-
priate for global travel. Certainly, emergency
operations and organ transplants will be ex-
cluded from widespread consideration in the
near term. Basically, for a U.S. resident to con-
sider surgery outside this country, the proce-
dure should be costly, one that can be sched-
uled well in advance, and one with consistent,
complication-free outcomes.
Some of our members have expressed con-
cerns about continuity of care following a pro-
cedure in a foreign hospital. A few wonder
whether their primary care physician might re-
fuse to treat them for any post-surgical com-
plications once they return home. While we
would encourage members to use their prima-
ry care physician if they have one, we have
contracted with a group of health clinics to
provide prepaid, after-care consultations for
patients following surgery overseas.
COMPANION GLOBAL HEALTHCARECompanion Global Healthcare was established
to put together a network of JCI-accredited
hospitals outside the United States, and then
to serve as a one-stop shop for those who
choose treatment at one of the network facili-
ties – helping clients schedule appointments,
make travel arrangements, transfer their medi-
cal records and more.
As stated above, Companion Global’s initial
mission was to assist members of the large
South Carolina insurance plan, but for the past
year, the company has been working with ben-
efits brokers, employer groups and limited ben-
efit insurance administrators who want to add
a global option to their benefit plans in a more
structured way.
Several self-insured employers, for example,
have added Companion Global’s network and
service offerings directly to their benefit plans,
and then listed specific medical procedures
that their employees may elect to have per-
formed at one of the network hospitals. All of
the employers have announced plans to share
any savings with the employee as well. For ex-
ample, the employers might waive any deduct-
ibles or co-payments the employee would nor-
mally pay. Some employers even offer to pay
air fare for the employee and a companion.
In the next year, we fully expect some of
these employees who select the overseas op-
tion to return to work and share their positive
experiences. With that, the trend toward
health care globalization will continue to gain
steam. «
More information on the Global Healthcare
Marketing conference can be found at
www.healthcare-travel.com To register to
attend, please call +971 43364021
» COLLEAGUES IN MExICO AND coSta rIca SAy THEIR NUMBERS OF PATIENTS FROM THE U.S. ARE UP WELL OVER 50 PERCENT VS. 2007 «
28 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
SINGAPORE MEDICINE | advertisement FeatUre
eacH year, more than 400,000 patients trav-
elled to Singapore specifically for healthcare,
and many others sought wellness and health-
care services while on the island for other rea-
sons. They come from all over the world for
clinical services ranging from complex, high-
end cancer treatment down to the simplest of
general practice care.
While other destinations provide good clini-
cal services in a tourist-friendly environment,
Singapore’s healthcare system is ranked by the
World Health Organization as Asia’s very best.
There are as many healthcare facilities in Singa-
pore accredited by the Joint Commission Inter-
national (the most common measure of health-
care service excellence) than all the other major
Asian destinations – India, Thailand, Malaysia,
Philippines – put together. Singapore’s doctors
are not just trained in the best centres world-
wide but are internationally respected for their
research and expertise. Technology is up-to-
date but carefully selected for safe and effec-
tive treatment. Some – like the bodyfat Ultra-
Shape and the complete neurosurgical
BrainSuite – are the first deployments in the
world.
The excellent clinical services are backed up
by leading-edge research in facilities like the
Biopolis, a purpose built biomedical research
hub with researchers from both the public and
private sectors. Through basic, translational and
clinical research, Singapore’s doctors not only
provide good, tested treatments to their pa-
tients but create new ones as well. Many world
and Asian firsts happen in Singapore, from the
beginnings of the test-tube babies to the
“tooth-in-eye” operation that makes the blind
see again - small wonder then that Singapore is
also the regional hub for medical conferences
and professional training.
Much is sometimes made of Singapore’s rela-
tively higher prices. But that’s relative. The dif-
ference is often not large and what prices one’s
health, one’s life anyway? And higher prices do
not always translate to higher total costs for
the traveling patients when better outcomes
lead to a shorter stay and an earlier return
home. In any case, Singapore’s average bill siz-
es are published regularly by the Ministry of
Health, providing feedback to the local and in-
ternational patients on healthcare costs. Clini-
cal outcome indicators, such as survival rates
for childhood leukaemia and cataract surgery,
are similarly published for public scrutiny; such
is the increasing desire of the medical commu-
nity to be open and transparent with the pa-
tient and the community.
All major healthcare facilities have Interna-
tional Patient Liaison Services to look after the
language, travel, accommodation and leisure
needs of patients and their family members,
ensuring a comfortable stay for all.
A city well-known for its international repre-
sentations like the Singapore Girl, Changi Air-
port and the world’s busiest seaport, Singa-
pore’s cosmopolitan community welcomes
travellers from all parts of the world.
English is widespread, crime is low, security
is high, transport is convenient, Singapore is a
tourist’s dream destination. There is little need
to say more about the touristy aspects of medi-
cal travel beyond the destination tagline –
Uniquely Singapore, Beyond Words – since Sin-
gapore welcomed more than 10.3 million
discerning tourists last year. That’s more than
twice the total resident population of the whole
island state!
Ultimately, medical travellers do not want to
go where there are uncertainties about the
quality of care or the safety of blood, rumours
of wars and bombs, social antagonism or dis-
trust, or any concerns for the safety and com-
fort for themselves and their accompanying
persons. Singapore is the one destination
where patients will have no such fears, and
can find peace of mind when their health really
matters. «For more information on medical travel to Singapore visit
www.singaporemedicine.com
Singapore: More Than Just a World Class Healthcare Destination
if any place on earth can be called the ultimate healthcare destination today,
singapore is it, with more than 400,000 people making a trip each year.
» EngliSH IS WIDESPREAD, CRIME IS LOW, SECURITy IS
HIGH, TRANSPORT IS CONVENIENT, SINGAPORE IS A
TOURIST’S DREAM DESTINATION «
H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8 | 29
UK paediatric brain injury specialist extends help to the Middle East
with more than 20 years experience in providing care, therapy and
support to children with acquired brain injury, the Children’s trust
is expanding its help to families from the middle east
advertisement FeatUre | CHILDREN’S TRUST TADWORTH
nearly five years ago The Children’s Trust
began offering brain injury rehabilitation to
children from the Middle East – helping a
young boy from Qatar.
Left minimally conscious and with a serious
brain injury following a road traffic accident,
the boy came to the UK with his family for
treatment. He was admitted to The Children’s
Trust for its specialist therapy, nursing care and
medical input, where he had a programme tai-
lored to his needs. Upon discharge he had re-
gained many of his skills and was able to at-
tend the Trust’s on-site school for 52-week
residential special education.
Since then the Trust has been strengthening
its links with the Middle East and has helped
many other children from the region.
The Children’s Trust started the UK’s first res-
idential rehabilitation service for children with
acquired brain injury in 1985. It is still the UK’s
largest centre and has purpose-built specialist
facilities and an extensive team of profession-
als to help each child.
Children come to the Trust having acquired a
brain injury from causes such as road traffic ac-
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Due to increasing demand, the Trust is open-
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dren.
The Trust’s interdisciplinary team includes
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language therapists and teachers. Its consult-
ant neuro-developmental paediatrician is re-
sponsible for medical care, supported by an as-
sociate specialist in paediatrics and doctors in
training.
On-site clinics and individual assessments are
also available through the Trust’s extensive net-
work of specialists, from neurology to epilepsy
and dentistry.
The Children’s Trust works closely with other
specialist children’s medical providers including
Great Ormond Street Hospital and Adden-
brooks Hospital, and is within easy access of
London.
The Trust is able to help some of the most
profoundly disabled children and those with
complex health needs, and provides opportuni-
ties for therapy, education and leisure not
available in a hospital. It can also provide fol-
low-up advice and treatment strategies for
long-term care.
The Children’s Trust is also there to help the
child’s family. Interpreters are provided for the
duration of the child’s daytime sessions and
can be accessed outside of these times if nec-
essary. Families are helped to find local accom-
modation during their child’s stay and an advo-
cate is available to offer support. The Trust has
good working relationships with embassies to
support a child’s placement.
Salim is one example of the benefits of The
Children’s Trust’s rehabilitation service. He was
admitted to the Trust following three opera-
tions to remove a brain tumour. Totally physi-
cally dependant, he needed help in all aspects
of his daily living.
After a six month placement at the Trust,
Salim was able to sit up, stand and walk short
distances unaided. He also regained much of
his speech and returned with his family to the
UAE. Physiotherapy in particular played an im-
portant role, encouraging his movements and
helping him regain his cognitive skills. Each
member of the interprofessional team played
an important role, helping Salim learn to be in-
volved in his activities of daily living and com-
municate with others.
Salim’s parents believe he benefitted greatly
from his stay at the Trust and are grateful for
the treatment and care he received. He is now
attending the Centre of Human Services in
Sharjah, which provides care for children with
special needs. He recently returned to The Chil-
dren’s Trust for a follow-up reassessment and
continues to do well. «
For more information about The Children’s Trust or how
to refer a child please contact Bob Butler at enquir-
ies@thechildrenstrust.org.uk or telephone +44 1737
365847 and quote reference HCTM1.
www.thechildrenstrust.org.uk
30 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
املركز غادرت وقد بغيبوبة. م�صابة ال�صغرية فاطمة و�صلت
والدها يتذكر وجهها. على االبت�صامة وتبدو اأ�صهر ت�صعة بعد
الطويلة. ال�صهور اإبراهيم خالد
فاطمة كانت عاتقي. على ال�صغرية ابنتي حياة م�صئولية اأحمل كنت �صنغافورة، اإىل الطائرة ا�صتقللنا عندما
غيبوبة، يف دخلت قد حينها فاطمة كانت للغاية. مري�صة وكانت فقط، �صنوات ثالث العمر من تبلغ حينها
معدودة. اأ�صبحت قد العامل هذا يف اأيامها واأن تنجو، لن باأنها الأطباء واأخربين
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دكتور اآجن مع ال�صغرية فاطمة
وعندما ات�صلت ب�صنغافورة و�صاألت عن العالج، وجدت
اأخربوين بلدي يف الأطباء ولكن اأمل. بارقة هناك اأن
واأتذكر كبرًيا. خطًرا متثل �صوف بالطائرة الرحلة باأن
ال�صماح اأ�صتطيع ل »اإنني يل قال حينها الطبيب اأن
بذلك، فهي لن تنجو من هذه الرحلة.
اأن اأفعل؟ وعندما �صاألت »فماذا على
اأنت تتحمل اأن عليك يكون »�صوف الطبيب اأجاب
امل�صئولية.
وكانت عاتقي. على امل�صئولية واأخذت فعلت، وقد
الأطول الطائرة هي ق�صيناها يف التي �صاعات ال�صبع
يعتنون وممر�صة طبيب هناك كان وقد حياتي. يف
اأنا منت وقد الرحلة. طوال هادئة كانت التي بفاطمة
حافلني الرحلة �صبقا اللذان اليومان كان فقد الآخر،
للغاية، حيث كان علي ترتيب العديد من الأمور.
حياتي يف راأيتها التي املناظر اأجمل من كان وقد
يف الهبوط ممر اإىل الطائرة نافذة من نظرت عندما
واأنا�س الإ�صعاف �صيارات راأيت كما �صنغافورة.
امل�صاعدة. لتقدمي م�صتعدين
باأن و�صعرت م�صتعدون«، »اإنهم لنف�صي قلت عندها
العبء الواقع على كاهلي مل يعد بنف�س الثقل. وبعد اأن
لتاأدية الأ�صخا�س اأولئك هرع الطائرة، من نزلنا
عملهم.
اإعطاوؤها قد مت كان الطائرة، من فاطمة اإخراج وقبل
وعند لها. ميكانيكي تنف�س جهاز و�صع ومت مهدئًا
باأخذ العمل فريق قام الطائرة، �صلم اآخر اإىل الو�صول
تكد ومل الإ�صعاف �صيارة اإىل الطائرة من فاطمة
اإىل و�صلوا حتى اأظن ما على دقائق 10 مت�صى
امل�صت�صفى.
يف و�صولنا وكان اأخرى. �صيارة يف تبعناهم وقد
ذلك م�صم�س حار. وكان يوم الظهرية يف بعد ما فرتة
لنا. اأمل جديد بالن�صبة مبثابة
انبثاثي من نوع »ويلم«، كانت فاطمة تعاين من ورم
الأطفال له يتعر�س الكلى �رسطان من نوع وهو
اأحال قد بلدي يف املوجود اجلراح وكان اأحياًنا.
فاطمة اإىل طبيب يف �صنغافورة، وهو الدكتور اأجن بنج
تيام، وذلك لأنها كانت تعاين من ورم كبري للغاية يف
كان اأنه لدرجة للغاية كبرًيا الورم كان وقد ال�صدر.
بنف�س الرئتان تعمل مل ولذا، اليمني. اإىل القلب يدفع
املفرت�صة. الكفاءة
كان ال�رسطان ينمو ب�رسعة كبرية.
لعملية اإخ�صاعها هو الأطباء فعله �صيء اأول وكان
الورم بع�س ل�صتئ�صال حماولة يف جراحية
ال�رسطاين. ولكن عندما حدث ذلك، وقام الأطباء بفتح
ال�صدر، بداأ الورم يف النزف ب�صدة.
اأخذ الأطباء عينة �صغرية من الن�صيج. ويف النهاية،
يعني هذا هل بال�صدمة. وزوجتي اأنا �صعرت وعندها
اأن اجلراحة قد ف�صلت؟
فما الذي يبقى بعد ذلك؟
الثالثة املرة هي هذه كانت نفعل؟ اأن ن�صتطيع ماذا
اإىل �صنغافورة. التي ناأتي فيها
وعندما غادرنا اأخربونا باأن الأمر اأ�صبح على ما يرام
واأنه لي�س هناك ما يدعو للقلق. فقد ذهب ال�رسطان.
وبعد للغاية«. حمدوًدا »ن�صاًطا هناك اأن واأخربونا
اإىل بلدنا. ذلك باأ�صهر قليلة عدنا
مل نكن نعرف ماذا ميكن اأن نتوقع.
بدرجة الأوعية »منت�رس يف الورم اأن الأطباء قال لقد
كبرية«. واأنه ميكن اأن ينزف يف احلال.
قبل بالفعل ينزف كان الورم اأن اأخربونا اإنهم بل
اإجراء اجلراحة.
مل يكن باأيدينا حينها �صوى اأن جنل�س يف احلجرة، ومل
نتكلم فلم يكن هناك ما يقال.
من يقرب ما يوم كل تنزف فاطمة ال�صغرية كانت
300 ملليلرت من الدم؛ قطرات وقطرات من الدم تخرج
اأننا �صوى �صيئًا نفعل ومل ال�صغرية. طفلتي ج�صد من
اإىل بع�صنا. جل�صنا يف احلجرة ن�صلى ونبكي وننظر
الأيام، جل�س اأحد بالياأ�س. ويف ي�صعرون الأطباء كان
معنا الدكتور اأجن وقال:
»اإن اخليار الوحيد هو متابعة العالج الكيميائي.« وقد
اإخ�صاع اأثناء الكيميائي العالج اإجراء اأن لنا اأو�صح
حالة يف كما ال�صناعي، التنف�س جلهاز املري�س
املر�صى فهوؤلء للغاية. النادرة الأمور من فاطمة،
العالج يتحملوا اأن من اأ�صعف الغالب يف يكونون
نظًرا وفاتها يف يت�صبب قد ذلك اأن كما الكيميائي.
كان الكيميائي. العالج عن الناجتة العدوى خلطر
يكن »مل اأجن الدكتور قال كما ولكن كبرًيا اخلطر
اآخر. اأمامنا خيار
املوت بني الختيار اختيار- اأمامي كان بالطبع
ال�صغرية لفتاتي احلياة اخرتت ولكنني واحلياة.
بركوبي قبل من خاطرت كما ذلك اأجل من وخاطرت
الطائرة.
اأطباء ثالثة من املكون الفريق ياأتي كان يوم، وكل
ينظرون اإىل اجلداول وي�صجلون كمية الدم املتدفق من
خالل من الكمية نف�س با�صتبدال يقومون ثم ال�صدر
اإخ�صاع �صغريتي فاطمة لعملية نقل دم.
النخفا�س. املفقود يف الدم بداأت كمية اأ�صبوع، وبعد
ال�صحية جيدة الثالث، كانت حالتها الأ�صبوع وبحلول
ال�صناعي. التنف�س جهاز عن لف�صلها يكفي مبا
اأن ا�صتطاعت كما ا�صتيقظت. الوقت، ذلك وبحلول
تراين.
بهاتفي لعبت اأنها هو فعلته �صيء اأول كان وقد
فوتوغرافية �صورة راأت عندما وتب�صمت املحمول
اأذين ثقبت قد زوجتي وكانت عليه. ال�صغري لأخيها
فاأعدنا عمرها. من الأول العام بلغت عندما فاطمة
عن ف�صلها مت عندما ال�صغري الذهبي قرطها اإليها
جهاز التنف�س ال�صناعي. ول زلت اأذكر تالألوؤ القرط يف
اإلينا وتبت�صم. تلتفت اأذنها عندما كانت
تتح�صن اأ�صهر، ثمانية مدار وعلى يوم، كل نراها كنا
يت�صاءل ال�رسطان حجم وكان النزيف، فقل حالتها.
امل�صح �صور خالل من ذلك علمنا وقد – با�صتمرار
ال�صوئي الذي كان يجريه الأطباء.
وكل ليلة، كنا نعود اإىل �صقتنا بجوار امل�صت�صفى، ناأخذ
وكانت امل�صت�صفى. اإىل اأخرى مرة ونعود نحتاجه ما
على اإليها الو�صول ميكن بحيث جًدا قريبة ال�صقة
بع�س يف اأجرة �صيارة ن�صتقل كنا كما القدمني
الأحيان.
اأخربونا الأطباء لأن نظًرا قرب عن البقاء نريد وكنا
من« »بالرغم الورم »انفالت احتمالية هناك اأن
ل�صتئ�صال ثانية عملية باإجراء قاموا لذلك، العالج«.
املتقل�س. الورم
انتهى »لقد زوجتي: يل قالت عندما ذلك كان وقد
وا�صرتت خرجت وقد الآن.« جيدة بحالة اإنها الأمر.
التي الأوىل املرة هي هذه كانت للجميع. احللوى
اأراها ت�صحك فيها ب�صوت مرتفع لقرتة طويلة.
وقد ا، اأي�صً الأطباء اأعني يف البهجة راأيت اأنني كما
الأجنحة! الفرحة جميع عمت
»اإن اأجن الدكتور يل قال حينما اأذكر زلت ول
الطفولية الأعمال بتلك وتقوم جتري لها م�صاهدتي
اأن اأخربين كما يومي!«. يف به اأ�صتمتع ما اأكرث هي
%15 من يقرب ما اإىل ت�صل فر�صة لديها فاطمة
التعلق اأحاول مل ولكنني البلوغ. مرحلة اإىل للو�صول
بالأمل كثرًيا.
�صغريتي واأحمل اأ�صتيقظ �صباح، كل ويف والآن،
اأطعمة ماكدونالدز للخارج لتناول الطعام. وهي حتب
يوم كل معها وجبة اأتناول وكنت للت�صوق. والذهاب
بها نخرج الآن ونحن رغبتها. هي تلك كانت اإذا
كاٍف ب�صكل الآن قوية تعد مناعتها لأن نظًرا للت�صوق
ميكنها من اخلروج.
والذهاب اخلروج الآن ن�صتطيع تتخيل؟ اأن ميكن هل
الطبيب اأخربنا حني يف الأطفال لعب حمالت اإىل
10 هذه – انظر! اأمل. هناك لي�س اأنه قباًل املحلي
بها قمنا التي اجلولت اأثناء ا�صرتيناها قد دميات
هناك.
وقد ات�صلت يف بلدي بذلك الطبيب املحلي، ومل ي�صتطع
ت�صيح واأنها احلياة، قيد على تزال ل اأنها الت�صديق
اإليه. وجتري وتتحدث
جيدة �صهيتها اأن كما والتلوين. املل�صقات حتب وهي
للغاية.
و�صوف نعود للوطن. و�صتلتحق فاطمة باملدر�صة. فهي
مل تلتحق باملدر�صة حتى الآن.
ل وهذا طبيبة. ت�صبح اأن تريد اأنها والدتها وتعتقد
يعنيني كثرًيا، فكل ما اأريده هو اأن اأراها ت�صحك.
يف ويعمل عاًما 35 العمر من يبلغ اإبراهيم، خالد
العمر من تبلغ عايدة، زوجته البرتول. �صناعة جمال
من يبلغ ابن فاطمة، جانب اإىل ولديهما عاًما. 29
يف �صنغافورة جميًعا غادروا وقد واحًدا. عاًما العمر
العا�رس من �صهر مايو.
32 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
tHe Pack of Profiteers is led by India,
China and Thailand, all with their individual
assets and short -comings. The numbers talk
for them self: 1.2 million patients travelled to
India for healthcare while another 1.1 million
medical tourists travelled to Thailand in 2007.
India’s biggest asset has been its numerous
Western trained English speaking doctors. It
also has some of the worlds largest corporate
hospital chains. A report from the Confedera-
tion of Indian Industry and McKinsey has pre-
dicted that up market tertiary care hospitals in
India could generate up to $2bn (£1.1bn;
€1.7bn) in revenue through health tourism by
the year 2012.
China with its liberal policy with organ re-
trieval and donation has become the top
choice for liver and kidney transplants, even
though the international community does
chastise it for the lack of transparent medical
practices.
Thailand, the perfect tourist destination has
come up with a rich blend of American trained
accredited establishments and an eclectic mix-
ture of Thai Hospitality. Also with a permissive
culture, it is sought by many for rehabilitation
and respite care.
Unfortunately the Middle East remains a net
exporter of patients rather than a net importer.
This scenario is changing, but the pace is too
slow.
The Middle East in the last few years has be-
come a brand ambassador for opulence and
luxury. Dubai, Abu Dhabi and Doha are taking
the tourism industry by storm. The whole
landscape is changing with the emergence of
these super cities. Museums, retail space,
theme parks, and business parks are coming
up all over. The demographics are changing as
well. Gone are the days when it was the haven
for adventurous Westerners and industrious
Indians. Now it is a playground for the rich and
uaE: Can it share
a slice of the pie? By anshul govila, sheikh khalifa medical City, Uae
FeatUre | MIDDLE EAST FOCUS
40.4 Billion dollars is the projected size of the medical tourism industry in the
year 2012. From Bombay to Bagota people are lining up to take a jab at this fruit.
But will the UAE get a slice of this pie. Maybe, maybe not.
34 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
MIDDLE EAST FOCUS | FeatUre
famous, more so in the years to come. Such
periods in history, when new cities are being
created and previous ones re-defined come far
and few.
Unfortunately, the healthcare picture does
not reflect the same confidence. Though the
hospitality industries standards have been at
par or in some cases better than international
standards, the healthcare industry cannot
boast the same. Few hospitals are true con-
noisseur hubs where health and hospitality are
both at their prime. New hospital chains are
trying to address this issue. These establish-
ments often find themselves lacking in talent
when it comes to bringing the hospitals up to
steam. Accreditation, infrastructure cost, short-
age of paramedics and attrition of staff all get
in the way. Further, the effort required to un-
ravel the logistics of healthcare is humongous.
It requires the steady hand of a seasoned play-
er.
This is where there is a clear and present
need for the Middle East Entrepreneurs to
partner with its not so distant brother in arms,
India.
Several Indian Hospital chains are today JCIA
accredited. The Corporate hospitals in India
have also made a reputation to be lean opera-
tors, keeping operating budgets slim and mar-
gins high. This is a lesson the UAE hospitals
still have to learn.
This need is mutual. Indian hospitals are also
looking out for expansion in to the Middle East
too. The infrastructure cost and licenses are
what keeps them away. This is an obvious area
for synergy between the two regions.
UAE today has the capability to address the
shortcomings of its large Indian neighbor.
The market in India still lacks the panache to
lure the celebrity patient. It lacks the depth of
luxury and the perfection in service, both of
which the Middle East offers. The medical
tourism market in India still caters to those un-
fortunate few who have either found a similar
health care solution too expensive in their
country or have found the waiting period dis-
mally long. Patients tend to come for these
reasons rather than by choice.
Also the Indian story comes unstuck with
the current social turmoil. Bomb scares have
wreaked havoc in the Indian tourism industry.
The already unwell are not wiling to take their
chances.
Then there has been the odd case where a
medical tourist has caught a communicable
disease while on the subcontinent. Though
these cases may be far and few, the fears are
not unfounded.
The NHS in the UK and some other health
care providers have sited the distance involved
in traveling to India as hazardous for their pa-
tients and hence refused to reimburse medical
tourist. Acting as a major hub for several direct
Trans Atlantic and European carriers Dubai and
Abu Dhabi can escape this incrimination too.
From time immemorial the Middle East has
been a market at cultural and economic cross-
roads. The end of the silk route-the sea link to
Africa. It has always profited from its unique
geo presence. This is yet another industry
which is beckoning to be explored by the Mid-
dle East entrepreneur.
Fair winds are blowing for those few who
are ready to lift the anchor. «
» unFORTunaTEly THE MIDDLE EAST REMAINS A NET
ExPORTER OF PATIENTS RATHER THAN A NET IMPORTER «
H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8 | 35
SingHealth – Singapore’s largest healthcare group
singapore health services (singhealth) is singapore’s largest healthcare group with 3 JCi-
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heart, eye, neuroscience and dental; and a network of primary healthcare clinics.
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Another leading edge SingHealth hospital is
the Changi General Hospital, located only 10
minutes from Singapore’s international airport.
Offering a full range of medical services, the
hospital excels in Sports Orthopaedics, General
Surgery, Obstructive Sleep Apnoea and Gastro-
enterology.
PIONEERING TREATMENTSThe 5 national specialty centres of the Sing-
Health group are tertiary referral centres provid-
ing specialised treatment for patients in Singa-
pore and the region. As national referral centres,
they lead the way not only with highest level of
medical care but also with pioneering treat-
ments.
National Cancer Centre Singapore, a national
and regional one-stop specialist centre housing
Singapore’s largest pool of oncologists, offers
the latest therapies including mini transplants
and targeted therapies designed to maximise
outcomes while minimising undesirable side ef-
fects.
Outcomes for many treatments, including
head and neck cancers and liver cancer are
comparable to the best institutions worldwide
National Heart Centre Singapore is Singapore’s
designated national centre for cardiovascular
medicine. It is the first heart centre outside of
the USA and in Asia to receive Joint Commission
International (JCI) accreditation. It is the largest
cardiovascular specialty group in Singapore,
treating complex cases requiring specialised care
from other hospitals in Singapore and region.
Outcomes for treatments, including percuta-
neous transluminal coronary angioplasty and
coronary artery bypass grafting surgery are com-
parable with international benchmarks.
Singapore National Eye Centre, a designated
national centre for ophthalmological services is
one of the leading transplant centres in the
world offering new advanced LK techniques,
stem cell transplants and Osteo-Odonto Kerato-
prosthesis (OOKP) surgery, a radical and complex
eye operation.
It is a world pioneer in conjunctival stem cell
transplant, a technique of growing one’s own
stem cells to treat conditions such as chemical
injuries, severe contact lens overwear and Ste-
ven-Johnson’s Syndrome.
National Neuroscience Institute is the national
specialist centre for treatment of neurological
diseases. The centre is well-equipped to provide
patients with high quality care in the areas of
neurodiagnostics, neurology, neurosurgery and
neuroradiology. National Dental Centre Singa-
pore, Singapore’s referral centre for specialist
oral healthcare offers comprehensive, integrated
care for the full spectrum of, from simple to
complex, dental needs.
INTERNATIONAL PATIENTSSingHealth’s extensive experience and expertise
makes it a logical choice for international pa-
tients seeking high quality multidisciplinary med-
ical care.
Interested parties wishing to collaborate in fa-
cilitating International Patient Care at our insti-
tutions, please contact jaryll.chan@singhealth.
com.sg or ims@singhealth.com.sg «
At the National Cancer Centre Singapore, the latest
image-guided technology in radiation oncology en-
hances cancer treatment.
36 | H e a l t h c a r e T r a v e l M a g a z i n e | I s s u e O n e 2 0 0 8
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