medical tourism in india: issues, opportunities and designing

ZENITH

International Journal of Multidisciplinary Research

Vol.1 Issue 3, July 2011, ISSN 2231 5780

ww

w.z

enit

hre

sear

ch.o

rg.in

1

85

MEDICAL TOURISM IN INDIA: ISSUES, OPPORTUNITIES AND DESIGNING

STRATEGIES FOR GROWTH AND DEVELOPMENT

DR. SUMAN KUMAR DAWN *; SWATI PAL **

* Asst. Professor , Centre for Management Studies, JIS College of Engineering (Under West

Bengal University of Technology), Block ―A’, Kalyani , Nadia -741235 , West Bengal.

** Asst. Professor , Centre for Management Studies, JIS College of Engineering (Under West

Bengal University of Technology), Block ―A’, Kalyani , Nadia -741235 , West Bengal.

ABSTRACT

Medical tourism is becoming a popular option for tourists across the globe. It encompasses

primarily and predominantly biomedical procedures, combined with travel and tourism. The term

medical tourism has been coined by travel agencies and the mass media to describe the rapidly

growing practice of travelling across international borders to obtain hi-tech medical care.

Various countries like Thailand, Malaysia, India, etc are promoting medical tourism

aggressively. The key competitive advantages of India in medical tourism stem from the

following: low cost advantage, strong reputation in the advanced healthcare segment

(cardiovascular surgery, organ transplants, eye surgery etc.) and the diversity of tourist

destinations available in the country. The key concerns facing the industry include: absence of

government initiative, lack of a coordinated effort to promote the industry, no accreditation

mechanism for hospitals and the lack of uniform pricing policies and standards across hospitals.

Medical tourism or health care tourism is fast growing multibillion-dollar industry around the

world. It is an economic activity that entails trade in services and represents the mixing of two of

the largest world industries: medicine and tourism. The paper identifies the strengths of India’s

medical tourism service providers and points at a number of problems that may reduce the

growth opportunity of this industry. This paper focuses on the key issues and opportunities

possessed by Indian medical tourism sector that enable it to overcome domestic and international

barriers on upgrading its medical services. Finally, this paper analyses and concludes the main

reasons why the developing country like India attracts foreign tourists for the medical treatment.

KEYWORDS: Medical Tourism, SWOT, Yoga, Unani, Siddha, Ayurvedic, Naturopathy.

______________________________________________________________________________

INTRODUCTION AND SIGNIFICANCE OF MEDICAL TOURISM

Medical tourism is a new form of a niche tourism market which has been rapidly growing in the recent

years. The term medical tourism is the act of traveling to other countries to obtain medical, dental and

surgical care. According to Goodrich & Goodrich (1987), medical tourism is the attempt to attract tourists

by deliberately promoting its health-care services and facilities, in addition to its regular tourist amenities.

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

86

Laws (1996) has defined medical tourism as a travel from home to other destination to improve one’s

health condition as one type of leisure. This includes getting indigenous and alternative medical services,

and any other form of tourism undertaken with the purpose of addressing a health concern. .

Connell (2006) describes medical tourism as a popular mass culture where people travel to overseas

countries to obtain healthcare services and facilities such as medical, dental and surgical care whilst

having the opportunity to visit the tourist spots of that country. Carrera and Bridges (2006) have defined

medical tourism as travel which is systematically planned to maintain one’s physical and mental health

condition.

According to GATS (General Agreement on Trade and Services), medical tourism is the second mode of

trade in health services. In this mode, customers (patients) leave their home country to obtain health care

services with high quality and affordable prices Blouin et al., (2006). Monica (2007) has defined that

medical tourism occurs when international patients travel across boundaries for their healthcare and

medical needs. It can be defined as provision of cost effective private medical care in collaboration with

the tourism industry for patients needing surgical and other forms of specialized treatment.

Bookman & Bookman (2007) have defined medical tourism as travel with the aim of improving one’s

health, and also an economic activity that entails trade in services and represents two sectors: medicine

and tourism. Medical tourism according to Dhaene (2009) is looking for available quality combined with

cost effective and low price health services while offering a similar level of safety to the patient. It has

become 60 billion US dollar a year business with growing rate about 20% by a year which could increase

to 100 billion US dollar by 2012. (Herrick, 2007)

Normally, the majority of medical tourists come from the industrialized countries of the world especially

Europe, the UK, Middle East, Japan, U.S. and Canada where the cost of medical treatment is very

expensive and there are often long waiting times for treatments. Other than India, countries that are

currently promoting medical tourism are Thailand, Malaysia, Singapore, South Korea Bolivia, Brazil,

Belgium, Cuba, Costa Rica, Hungary, and Jordan. Private sector development in emerging economies—

such as India, Thailand, Singapore, and certain Latin American nations—attracts foreign patients for

relatively cheaper care: the uninsured, the underinsured, or those who prefer not to wait for treatment

under a national health insurance system.

The main reasons for the growing popularity in medical tourism in India are: (a.) the long waiting lists in

the developed countries, (b) the low cost of medical treatments in India than the other developed

countries. In India, complicated surgical procedures are being done at one-tenth of the cost as compared

to the procedures in the developed countries, ( c) The affordable international air fares and favorable

exchange rates, (d) the Internet; with the development of communications, new companies have emerged

who acts as middlemen between international patients and hospital networks, giving patients easy access

to information, prices and option, (e) the state-of-art technology, specialist doctors, nurses and para-

medical staffs that has been adopted by the big hospitals and diagnostics centers in India. In India, the

medical education system also caters to the ever increasing demand for the delivery of the quality health

care services all over the country ( Suthin et al., 2007).

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

87

In order to realize the full potential of this industry, it is needed to develop a strategic plan on medical

tourism in India. This paper highlights the strategy that needs to be implemented for shaping India as one

of the key destinations for medical tourism across the globe.

OBJECTIVES OF THE STUDY

This research works explores opportunities, discusses its key challenges and designing the suitable

strategies for developing medical tourism in India.. It is based on a review of the literature, including

published research, web sites, newspapers, and the travel and tourism magazines that carry medical tourism

related information. This helps to design the strategies being used for promoting medical tourism in India.

This research work also strives to understand why some developing countries like India are more successful

in promoting medical tourism than others. In other words, it also emphasizes over the competitive

advantages of India over other countries. Lastly, it gives an approximate comparison of the cost of medical

treatments offered in India, USA, Thailand and Singapore.

MEDICAL TOURISM IN INDIA – THE CURRENT SCENARIO AND ITS DIFFERENT MODES

Medical Tourism is poised to be the next Indian success story after Information Technology. According to a

Mckinsey-CII study the industry’s earning potential estimated at Rs.5000-10000 Crores by 2012 (CII-

Mckinsey, 2002). Medical tourism can contribute Rs 5,000-10,000 crore additional revenue for up-market

tertiary hospitals by 2012 and will account for 3-5% of the total healthcare delivery market, says the

Confederation of Indian Industry (CII)-McKinsey study on healthcare (2002: pp.1-2). Horowitz and

Rosenweig (2007) have identified the following countries as being medical tourism destination: China ,

India, Israel, Singapore, Malaysia, Philippines, United Arab Emirates, Argentina, Bolivia, Brazil, Colombia,

Costa Rica , Cuba , Jamaica, Mexico, United States, Belgium, Germany, Hungary, South Africa and

Australia.

The major service providers in Indian medical tourism are: the Apollo Hospitals, Escorts Hospital, Fortis

Hospitals, Breach Candy, Hinduja, Mumbai’s Asian Heart Institute, Arvind Eye Hospitals, Manipal

Hospitals, Mallya Hospital, Shankara Nethralaya etc. AIIMs, a public -sector hospital is also in the fray. In

terms of locations – Delhi, Chennai, Bangalore and Mumbai cater to the maximum number of health

tourists and are fast emerging as medical tourism hubs. It also visualizes high-end healthcare services

through Indian BPO firms like Hinduja TMT, Apollo Heart Street, Comat Technologies, Datamatics and

Lapiz that work in the areas of claim adjudication, billing and coding, transcriptions and form processing.

One-stop centres in key international markets to facilitate patient flow and stream lining immigration for

healthcare are envisaged. The CII, along with Indian Health Care Federation (IHCF), wants to establish an

Indian healthcare brand synonymous with safety trust and excellence. Therefore, it is clear that the

opportunities and challenges for growth in the health sector are seen primarily within the private/corporate

sector, not in the public sector.

Nowadays medical tourism in India includes advanced and life savings health care services like open

transplants, cardio vascular surgery, eye treatment , knee/hip different cosmetic surgeries and alternate

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

88

systems of medicine. Also leisure aspect medical traveling/wellness tourism may be included on such

medical travel trips. India provides a variety of medical services to overseas patients.

The medical tourism structure in India is depicted in figure 1.

Figure 1: The Medical Tourism structure in India

The table 1 gives a classification of the services spectrum of medical tourism in India vis-à-vis its

competitive countries

Table 1: Classification of the services spectrum of medical tourism across globe

Wellness

tourism

Alternative

systems of

medicine

Cosmetic

surgery

Advanced and

life savings

healthcare

Services offered Spas, Stress

relief,

rejuvenation

centres

Ayurvedics,

Siddha treatment

for diseases e.g.

Arthritis,

Rheumatism

Dental Care,

Plastic Surgery ,

Breast

enhancement,

Tummy

reduction , Skin

Treatment

Open transplants,

cardio vascular

surgery, Eye

treatment , Hip

Replacement , In

vitrio

fertilization

Profit Margin Low Low Medium High

Key

Competitors

Thailand , South

Africa

-- South Africa ,

Cuba , Thailand

Singapore ,

Jordan, Thailand

Medical

Tourism

Wellness

tourism

Alternative

systems of

medicine

Cosmetic

surgery

Advanced and

life savings

healthcare

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

89

and Malaysia

India’s Strength Low –Thailand

has captured a

significant share

of the market

High-Kerala is

popular for this

service

Low –South

Africa and

Thailand leads in

plastic surgery

High-India has

strong image on

medical tourism

India has a very old civilization of more than 5000 years and is known for her cultural and

religious diversities with diverse geographical landmarks. The traditional arts and crafts add to

her appeal to attract tourists. In India, according to the famous words “Atithi Devo Bhava” refers

tourists are treated as God. In India, in addition to existence of modern medicine, indigenous or

traditional medical practitioners continue to practice throughout the country. Popular indigenous

healthcare traditions include Ayurveda, Siddha, Unani, Naturopathy, and Yoga. Ayurveda

provides a complete system of preventive medicine and healthcare, which has been proven as its

effectiveness over a long period in India. The science of Ayurveda is based on the knowledge of

the human constitution. If every individual knows his or her own constitution, they can

understand what constitutes a good diet and lifestyle for themselves. The five great elements,

viz., ether, air, fire, water and earth are manifested into the three Dashas or biological

organizations known as Vata, Pitta and Kapha. These biological organizations are used by an

individual to gain a full understanding of all aspects of bodily functions, in order to establish the

harmonious balance required for a healthy existence. Ayurveda is based on natural herbs, which

gives distinct advantage.

The Siddha system defines disease as the condition in which the normal equilibrium of the five

elements in human beings is lost resulting in different forms of discomfort. The diagnostic

methods in Siddha medical system are based more on the clinical acumen of the physician after

observation of the patient, pulse and diagnosis and clinical history.

Unani system of medicine believes that the body is made up of four basic elements viz., earth,

air, water and fire, which have different temperaments i.e. cold, hot, wet and dry. After mixing

and interaction of four elements a new compound having new temperament comes into existence

i.e. hot-wet, hot-dry, cold-wet and cold-dry. Unani system of medicine believes in promotion of

health, prevention of diseases and cure.

Naturopathy has several references in the Vedas and other ancient texts, which indicate that these

methods were widely practised in ancient India. Naturopathy believes that the human body

possesses inherent self-constructing and self-healing powers. Naturopathy differs slightly with

other systems of medicine, as it does not believe in the specific cause of disease and its specific

treatment but takes into account the totality of factors responsible for diseases such as one’s

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

90

unnatural habits in living, thinking, working, sleeping, or relaxation, and the environmental

factors that disturb the normal functioning of the body.

Yoga is a science as well an art of healthy living physically, mentally, morally and spiritually.

Yoga is believed to be founded by saints and sages of India several thousand years ago. Yoga has

its origin in the Vedas, and its philosophy is an art and science of living in tune with the

universe. Yoga, the art and science of maintaining physical and mental well-being, has its origin

in India. It is an instrument to self evolvement and enlightenment, through physical and mental

well-being. Various Yogic postures gently massage internal vital organs, keeping them in perfect

condition. Cholesterol levels are kept in check and the blood pressure is normalized. This

internal harmony cleanses and detoxifies the body and boosts the immune system.

All these traditional healthcare systems are attracting national and international patients, and

generate tourism flows

GROWTH, OPPORTUNITIES AND PROCESS OF MEDICAL TOURISM IN INDIA

The commitment to provide comprehensive healthcare to all citizens, irrespective of their paying

capacity, was given up by the Indian government after 30 years of Indian independence. After

the globalization and liberalization of Indian economy on 1991, the government of India has

opened up medical service to the voluntary and private sectors for foreign tourists and other

citizens who can pay to get the high-tech medical services. The rapid growth of the private sector

over the 1980s and the emergence of a corporate health sector in the 1990s was a part of the

comprehensive policy that chooses to promote these segments. This was done through shifting

subsidies in terms of cheap land, concessions from equipment and drug import, placing these

institutions on government panels and making them a part of government insurance schemes in

addition to providing trained personnel and expert physicians through state –supported medical

education.

As a part of medical tourism, India is recognized as the cradle for test tube babies and is popular

for surrogacy services (Qaders and John, 2009). Over than these, India offers high-tech cardiac,

paediatric, dental, cosmetic and orthopaedic surgical services as well as the traditional healing

systems. The medical tourism definitely does not cater to emergency services. The services

provided are largely knee joint replacement, hip replacement (mostly orthopaedic), bone marrow

transplant, bypass surgery and cosmetic surgery etc. Hospitals also advertise for preventive

health check ups for family members accompanying the patients in addition to alternative

medicine services ( Peacock, 2009).

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

91

Table 2: Cost comparison between India, USA, Thailand and Singapore

(Approximated figures in US$)

Procedure US India Thailand Singapore

Heart bypass 1,30,000 10,000 11,000 18,500

Heart valve

replacement

1,60,000 9,000 10,000 12,500

Angioplasty 57,000 11,000 13,000 13,000

Hip

replacement

43,000 9,000 12,000 12,000

Hysterectomy 20,000 3,000 4,000 6,000

Knee

replacement

40,000 8,500 10,000 13,000

Spinal fusion 62,000 5,500 7,000 9,000

International figures based on hospital quotes in named countries

Source: http://www.docstoc.com/docs/12163631/MEDICAL-TOURISM/P/36

Quality care, relatively cheaper services compared to the west, package deals and cheap services

from the tourism and hospitality sectors are the biggest attraction of medical tourism in India.

The price differentials of various procedures for Singapore, Thailand and India with the USA

reveal the economic advantage offered to interested patients by India.

The health care sector in India has witnessed an enormous growth in infrastructure in the private

and voluntary sector. The Indian government predicts that India's health-care industry of $17

billion-a-year, could grow 13 per cent in each of the next six years, can be boosted up to 30 per

cent annually if bundled with tourism sector (International Marketing Conference on Marketing

& Society, 8-10 April, 2007, IIMK)

A detailed flow chart of the Indian medical tourism process is presented in figure 2.

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

92

Figure 2: Flow chart for Indian medical tourism process

KEY ISSUES TO THE MEDICAL TOURISM INDUSTRY IN INDIA

As various countries are at loggerheads to get a greater share in the medical tourism industry, India

needs to carve out a distant niche for itself, by leveraging its existing strengths and thereby offering a

unique value proposition. Generally, there are three types of medical tourists.

Prospective tourist to get medical

service in India

Planned

Medical

Treatment

Obtain invitation

from hospital & get

medical visa

Visit India on other visa,

identify suitable

hospital/treatment

centre

Get medical services from requisite diagnostics and

hospital, receive post treatment instructions and get

discharged

Spend time through sightseeing of holidaying, if desired

and if medically permitted

Apply for and obtain visa extension, if required

Depart from India-Surrender registration certificate before

departure in the case of medical visa and where stay in

India is for more than 180 days

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

93

Foreigners coming for medical treatment

Foreigners seeking treatment and leisure

Expatriates

The country like India is facing the following issues/challenges to become a tourist destination with

competent medical tourism industry. They are:

1. Lack of infrastructural facilities like lack of connectivity, lack of coordinating system,

poor power supply and poor water supply.

2. Most Indian hospitals are also facing the lack of trust from the foreign patients. The

hospitals have observed poor hygiene awareness in medical attendants, unhygienic food

handling, and lack of proper hospitality services, heterogeneous pricing of services and

no industry standards.

3. The government can play a vital part to upgrade the medical tourism sector. But the

industry is facing the following problems which are caused by the governments. They

are: (a) no regulations, (ii) taxation anomalies, (c ) bureaucratic roadblocks, (d) no works

on land reforms, (e) lack of long-term investor friendly policies and (f) instability with

respect to terrorism and communal tensions.

4. On the part of insurance and allied services, the medical tourism industry in India is also

facing some key bottlenecks. They are: (a) inadequate insurance cover, (b)

underdeveloped insurance market in India, (c) insurance frauds and (d) overseas

companies refusing reimbursement.

5. The following challenges, due to the infrastructural parts in medical tourism sector in

India, are: (a) poor accessibility, (b) lack of capital, (c) lack of Community participation

and awareness, (d) lack of involvement from rural sector, (e) lack of concern for

sustainability, (f) complex visa procedures, (g) lack of good language translators, and (h)

poor airport facilities.

6. Apart from these, there are some specific issues to promote medical tourism in India.

They are: (a) quality accreditations to the Indian hospitals and service providers, (b)

training and Development to the Doctors, Nurses and Para medical staffs, (c) lack of

customer oriented approach

MEDICAL TOURISM IN INDIA – SWOT ANALYSIS

The figure 3 depicts the SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis on the

Indian medical tourism Industry in its current state:

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

94

Figure 3: SWOT analysis on Indian medical tourism

Strengths Weakness

Quality Service at Affordable Cost

Vast supply of qualified doctors

Strong presence in advanced healthcare e.g. cardiovascular, organ transplants – high success rate in operations

International Reputation of hospitals and Doctors

Diversity of tourism destinations and experiences

No strong government support / initiative to promote medical tourism

Low Coordination between the various players in the industry– airline operators, hotels and hospitals

Customer Perception as an unhygienic country

No proper accreditation and regulation system for hospitals

Lack of uniform pricing policies across hospitals

Opportunities Weaknesses

Increased demand for healthcare services from countries with aging

population (U.S, U.K)

Fast-paced lifestyle increases demand for wellness tourism and alternative

cures

Shortage of supply in National Health Systems in countries like U.K, Canada

Demand from countries with underdeveloped healthcare facilities

Demand for retirement homes for elderly people especially Japanese

Strong competition from countries like Thailand, Malaysia, Singapore

Lack of international accreditation

Overseas medical care not covered by insurance providers

Under-investment in health infrastructure

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

95

DEVELOPING STRATEGIES ON INDIAN MEDICAL TOURISM

After the SWOT analysis on Indian medical tourism and also interviewing the healthcare service

providers in India as well as observing the different websites related to medical tourism’s growth and

opportunities, the following marketing strategies may be used by India’s healthcare service providers.

They may be based on the 7 Ps of marketing mix: Product, Price, Place, Promotion, People, Process, and

Physical Evidence (Kotler, 2008; Chartered Marketing Institute, 2005).

1. Product: India has a number of hospitals offering world class treatments in nearly every medical

sector such as cardiology and cardiothoracic surgery, joint replacement, orthopaedic surgery,

gastroenterology, ophthalmology, transplants and urology to name a few. The various specialties

covered are Neurology, Neurosurgery, Oncology, Ophthalmology, Rheumatology, Endocrinology, ENT,

Paediatrics, Paediatric Surgery, Paediatric Neurology, Urology, Nephrology, Dermatology, Dentistry,

Plastic Surgery, Gynaecology, Pulmonology, Psychiatry, General Medicine & General Surgery. Well-

trained medical staff with international board certification (US, UK, Australia, Germany, Japan) are

considered as a valuable asset of the companies and used as an important tool to promote healthcare

services. Moreover, the cutting-edge technology and equipment available made by each hospital is also

used as one of the major products in this industry. Another marketing strategy used by service providers

is to create more value through services. Superior value-added services have been created to

differentiate themselves from their increasing competitors, increasing its efficiency, creating

convenience for the patients, and developing and strengthening the customer relationships. These non-

medical care services are services such as, on-line service for medical arrangement, travel arrangement,

interpreter services in many languages , luxury service apartments for patients’ relatives adjacent to the

hospital, hotel selection and reservation, sightseeing tour services, medical transportation both on land

and air, one-to-one nursing care service, and etc. Major healthcare service providers in India have

started expanding their business to other countries by investing in and/or operating hospitals or medical

center overseas. These hospitals function as a diagnostic center for screening cases and also for follow-

ups in medical treatments.

2. Price: India’s healthcare service providers have a competitive advantage among their competitor due

to its high standard of medical treatments and services offered to the patients at a very competitive

price. In India, complicated medical procedures are being done only at one tenth of the cost in

industrialized countries but in terms of infrastructure facilities such as roads, sanitation, power backups,

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

96

accommodations, and public utility services much more is needed for the country to become a medical

tourism destination (Kaur et al., 2007).

3. Place: Internet is the main means for disseminating information related to medical and non-medical

care services offered by each of healthcare service providers. It is the most effective and inexpensive

way to reach the product to its target customers directly, and at the same time helping patients acquire

correct and valuable information allowing them to make an informed decision. Informative online

marketing of each service provider creates awareness of the medical treatments available and reassures

potential patients. Interactive communication, treatments description, description of services and

facilities, quality assurance other concierge services were also presented on the websites to attract the

patient who are on medical traveling program. All the healthcare service providers generally take the

help of the agents the in promoting their medical tourism. These agents provide information and

recommend the patients regarding their treatments to the hospitals. They work as a center cooperating

between patients and hospitals for screening cases, sending all the necessary medical reports of the

patients to the hospitals. And at the same time agents have the responsibility of advertising and doing

marketing in those countries for healthcare service providers, spreading word of mouth advertising of

service assurance and reliability.

4. Promotion: Most healthcare service providers in India particularly big private hospitals participate in

travel marts, travel fairs, trade fair, exhibitions, seminars, conferences, and advertise in travel magazines

in countries with the supporting from the government. In addition, other informative materials such as

brochures, booklets, video-cds, paper bags and t-shirt with logos were also used to create awareness of

the available healthcare services as well. Moreover, some healthcare service providers in India build up

cooperation with the local institutes, universities, medical schools in other countries to establish

collaboration in education, exchange of knowledge and training as well as to promote their alternative

healthcare services. Advertising about medical and non-medical services in both local and international

media are used by healthcare service providers. Articles, video, news related to their high quality and

standard of medical treatments and services, health issues, latest medical technology equipment,

quality assurance/awards/accreditation available on their own websites and also to the international

media. These help to create awareness of the available alternative medical treatments as well as to

build up a positive image of the high quality and international standard of medical care in India.

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

97

5. People: Another strategy that Indian healthcare service providers may use to attract the international

patients for their low cost treatments in India as well as to get the medical services by its well-trained

medical specialists who have qualified from well-known overseas institutes. It is well acknowledged that

having specialized and qualified doctors and staffs gives a competitive advantage for the hospitals.

However, shortage of doctors and trained medical staff is treated as the major concern in medical

tourism in India. Moreover, due to the misunderstanding of the patients’ culture are still considered as

problems and challenges for medical tourism business in India.

6. Process: International patients who seek medical treatments are mostly concerned with the quality of

treatments and also want that the service providers preferably be accredited by a recognized

international organization that audits medical quality. India has a large pool of doctors (approx

6,00,000), nurses and paramedics with required specialization and expertise and the language

advantage (English speaking skills). The medical education system caters to the ever increasing demand

for the delivery of the quality health care services all over the country. The Joint Commission

International (JCI) recognizes and accredits that the standard of the hospital meets or exceeds the

standard of medical facilities as compared to the west. India is a popular destination for medical

tourists. (Iyer, M., 2004)

7. Physical Evidence: In India, big hospitals like Apollo Hospitals, Escorts Hospital, Wockhardt Hospitals,

Breach Candy Hospitals Lilavati Hospital, Manipal Hospitals, Mallya Hospital, AMRI Hospitals etc. have a

good ambience in their infrastructures with spacious, luxury rooms and excellent amenities same as that

of a five star hotel for patients and relatives, and also are equipped with cutting-edge technology. This is

a competitive advantage of India in order to gain the confidence and build up the trust of international

patients, making a decision to choose India as their preferred choice.

SUGGESTIONS FOR DEVELOPING INDIAN MEDICAL TOURISM

The following suggestions lay down the future path for India to achieve leadership position in medical

tourism. Theses suggestions largely draw from the discussions with various stakeholders as well as

observing the other countries’ medical tourism conditions.

(1) Role of Government

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

98

The government of India must act as a regulator to institute a uniform grading and accreditation system

for hospitals to build consumers’ trust. It also acts as a facilitator to encourage private investment in

medical infrastructure and policy-making for improving medical tourism. The government should

actively promote FDI (Foreign direct investment) in healthcare sector as well as also enacts conducive

fiscal policies - providing low interest rate loans, reducing import/excise duty for medical equipment It

also facilitates clearances and certification like medical registration number, anti-pollution certificate

etc. The government should reduce barriers in getting medical visa and institute visa-on-arrival for

patients and also can create medical attachés to Indian embassies that promote health services to

prospective Indian visitors.

(2) Medical Visas: A simplified systems of getting medical visas should be developed in order to make

travel across borders smoother. Visas can be extended depending on the condition of the patients. The

procedures for obtaining medical visa, the subsequent registration and visa extension procedures are

complicated and time consuming. There is a need to simplify and speed up these procedures to make

India a more attractive medical tourism destination.

(3) Holistic medical and diagnostic centers within the corporate hospitals: Most of the big tertiary

hospitals are opening up holistic centers within the premises, with yoga and meditation programmes

long with naturopathy, herbal medicine, acupuncture and homeopathy departments. The claim is that

these enhance treatment. However, these services are charged for and add to additional revenues. The

hospitals have small spaces for the relatives to pray in, thereby wedding science with religion and

traditional with modern medical practices.

(4) Setting Up National Level Bodies: To market India’s specialized healthcare products in the world and

also address the various issues confronting the corporate healthcare sector, leading private hospitals

across the country are planning to set up a national-level body on the lines of National Association of

Software and Service Companies (NASSCOM), the apex body of software companies in the country. . It is

therefore essential to form an apex body for health tourism – National Association of Health Tourism

(NHAT). The main agenda for NAHT will be:

(a) Building the India Brand Abroad: Classify the target consumer segments based on their

attractiveness and position the India Brand based on the three main value propositions – high quality

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

1

99

service, value for money and destination diversity. An integrated marketing Communications campaign

using print, media and road shows should be developed.

(b) Promoting Inter-Sectoral Coordination: The NAHT should take up the responsibility of aligning the

activities of various players – Tourism Department, Transport Operators, Hotel Associations, Escorts

personnel etc.

(c) Information Dissemination using Technology: NAHT should set up a portal on medical tourism in

India targeted at sharing information and enabling online transactions.

(d) Standardization of Services: NAHT should also focus on establishing price parity for similar kinds of

treatments in various hospitals and ensure the hospitals adhere to high hygiene and quality standards. It

is felt that not only the private hospitals but the country too stands to benefit from this by earning

foreign currency (Roy Choudhury and Dutta 2004).

(5) Integrate vertically: Various added services may be offered to the patients. For example, hospitals

may have kiosks at airports, offer airport pickups, bank transactions, or tie-ups with airlines for tickets

and may help facilitate medical visas by the government. With more Arab patients coming in, some

hospitals may have hired Arabic interpreters, stocked up on prayer rugs and opened up a kitchen serving

the food preparations in corporate hospitals in India.

3. Joint Ventures / Alliances: To counter increasing competition in medical tourism sector, Indian

hospitals should tie-up with foreign institutions for assured supply of medical tourists. Specifically they

may tie-ups with capacity constrained hospitals and insurance providers. For example Mohali’s Fortis

Hospital has entered into a mutual referral arrangement with the Partners Healthcare System, which has

hospitals like Brigham Women’s Hospital and Massachusetts Hospital in Boston under its umbrella, to

bring patients from the US (Kohli 2002). The Apollo group has also tied up with hospitals in Mauritius,

Tanzania, Bangladesh and Yemen. In addition, it runs a hospital in Sri Lanka, and manages a hospital in

Dubai (Dogra 2003).

As a part of this policy of promoting public and private initiatives, the Indian travel industry and tour

operators have also design packages that include air travel, hotel accommodation, and surgery

expenses, claiming savings. They may also operate jointly to facilitate travel for medical services. Other

than the central government’s list of hospitals for medical tourism on the web, the medical tourism may

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

2

00

also get promoted through popular magazines, tourist guide books, business magazines and journals on

tourism. Textual and video testimonies of cured foreign patients and administrators describing the

excellence of the treatment, the low cost, the professional approach, the technical expertise, the

affectionate and caring doctors and staff, and the cutting edge technology are all displayed on hospital

web sites as evidence of efficiency.

CONCLUSION

India is in an advantageous position to tap the global opportunities in the medical tourism sector. The

government’s role is crucial to the development of medical tourism. The government should take steps

in the role of a regulator and also as a facilitator of private investment in healthcare. Mechanisms need

to be evolved to enable quicker visa grants to foreign tourists for medical purposes where patients can

contact the Immigration Department at any point of entry for quick clearance. Tax incentives to the

service providers, import duty reduction on medical equipment, committees to promote and foster

medical tourism are some of the initiatives that can be undertaken. There is also a need to develop

supporting infrastructure such as transport services to facilitate tourism in India. The tourism, health,

information and communication departments need to work in tandem for efficient patient care. This

paper has recommended some of the medical tourism strategies for further promoting medical tourism

in India. These include building and promoting the image of India as high quality medical tourism

destination, creating and promoting new combination of medical tourism products, keeping up the high

standard of quality treatments at a reasonable price, providing informative online and offline materials

and make them available to the potential customers. Also attaining the accreditation/standard to

reassure the quality of treatments as well as emphasizing on the needs and demands of the existing

target markets must be incorporated.

REFERENCES:

1. Baru , R. V. (2000) : “Privatisation and Corporatisation”, Seminar , 489 , pp. 29-22

2. Blouin C. Drager, N. & Smith, R. (2006): “International Trade in Health Services and GATS:

Current Issues and Debates”, World Bank, Washington DC., ISBN-13

3. Bookman, M. & Bookman, K. (2007) : “Medical Tourism in Developing Countries “, New York :

Palgrave Macmillan

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

2

01

4. Carrera , P.M. & Bridges J.F.P (2006) : “ Globalisation and Healthcare : Understanding Health and

Medical tourism”, Expert review of Pharmacoeconomics and Outcomes Research , 6(4), pp.447-

454

5. Chartered Institute of Marketing. (2005). Marketing and the 7Ps A brief summary of marketing

and how it works. Retrieved March 1, 2008 from www.cim.co.uk/MediaStore/FactFiles/Factifi

le7ps.pdf

6. CII-McKinsey (2002): “Health Care in India: The Road Ahead”, CII, McKinsey and Company and

Indian Healthcare Federation, New Delhi

7. Connell, J. (2006): “Medical tourism: Sea, Sun, Sand and … Surgery”, Tourism Management , 27

(6), pp. 1093-1100.

8. Dogra, Sapna (2003): “Can Delhi Be a Successful Model for Medical Tourism?” Express

Healthcare Management, 1-15 September. Also at: http://www.

expresshealthcaremgmt.com/20030915/focus01. Shtml

9. Forbes S. Open-heart surgery—90% off! Forbes. August 13, 2007.

http://members.forbes.com/forbes/2007/0813/021.html. Accessed September 3, 2008.

10. Goodrich , G.& GoodrichJ. (1987): “Healthcare Tourism-An exploration study”, Tourism

Management, September, pp.217-222

11. Harrick , D.M., (2007): “Medical Tourism: Global Competition in Health Care , NCPA, Policy report

No. 304, National Centre for Policy Analysis, Dallas Texas, pp.40

12. Horowitz, M. & Rosenweig, J. (2007): “Medical Tourism-health care in the global Economy”, The

Physician Executive , pp. 24-30

13. Iyer,M.(2004):”India out to heal the world”, Times of India, October 26.

14. Kaur, J., Sundar. G H., Vaidya D., and Bhargava S. (2007). Health Tourism in India Growth and

Opportunities. Proceedings, International Marketing Conference on Marketing & Society, 415-

422. Retrieved September 2, 2007, from http://dspace.iimk.ac.in/bitstream/2259/345/1 /415-

422.pdf

15. Kohli, Shweta Rajpal (2002): “Medical Tourism Growing at 30% a Year: Study”, Rediff.com

Money, 12 November. Accessed 27 November 2009: http://

www.rediff.com/money/2002/nov/12med.htm.

16. Kotler, P., Armstrong, G. (2008): “ Principles of Marketing”, New Jersey: Pearson education, Inc.

http://www.cim.co.uk/MediaStore/FactFiles/Factifi

http://www/

http://dspace.iimk.ac.in/bitstream/2259/345/1

ZENITH



ww

w.z

enit

hre

sear

ch.o

rg.in

2

02

17. Laws, E.(1996) : “Health tourism : A business opportunity approach . In S. Clift and S.J. page

(Eds.) Health and the International Tourist (pp. 199-214), Routledge : London and new York.

18. McKennis, Ann T (1999): “Caring for the Islamic Patient”, AORN Journal, 69(6): 1185-96.

19. Monica, R. (2007) : “ Hospital and Medical Tourism in Singapore, Ezine Articles Retrieved from

http://ezinearticles.com

20. Peacock, L. (2009) : “ Medical Tourism in India”, Smart Travel Asia Accessed from Http://

www.smarttravelasia.com/medical Tourism.htm

21. Qadeer, Imrana and Mary E John (2009): “The Business and Ethics of Surrogacy”, Economic &

Political Weekly, 44 (2): 10-12.

22. Suthin, K., Assenov, I., and Tirasatayapitak, A. (2007). Medical Tourism: Can supply keep up with

the demand. Proceedings, APac-CHRIE & Asia Pacific Tourism Association Joint Conference 2007,

May 23-27 May, 2007, Beijing, China

http://ezinearticles.com/

http://www.smarttravelasia.com/medical%20Tourism.htm

medical tourism in india: issues, opportunities and designing

Documents