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Medical Tourism: Taking off in a big way in India
Prof. Vijay Bhangale*
In a country as diverse as India, the health care industry has capitalized on its rich cultural resource and
glorious past. India has the most competent doctors, world class medical facilities and with most
competitive charges for treatment, it’s a very lucrative destination for people wanting to undergo treatment
of certain medical problems. A study by McKinsey and Confederation of Indian Industry says that at its
current pace of growth, healthcare tourism alone can rake over 8,000 crore additional revenue by 2012.
Medical Tourism
Patients going to a different country for either urgent or elective medical procedures is fast becoming a
worldwide, multibillion-dollar industry. The reasons patients travel for treatment vary. Many medical
tourists from the United States are seeking treatment at a quarter or sometimes even a 10th of the cost at
home. From Canada, it is often people who are frustrated by long waiting times. From Great Britain, the
patient can't wait for treatment by the National Health Service but also can't afford to see a physician in
private practice. For others, becoming a medical tourist is a chance to combine a tropical vacation with
elective or plastic surgery.
And more patients are coming from poorer countries such as Bangladesh where treatment may not be
available.
Countries that actively promote medical tourism include Cuba, Costa Rica, Hungary, India, Israel, Jordan,
Lithuania, Malaysia and Thailand. Belgium, Poland and Singapore are now entering the field. South Africa
specializes in medical safaris-visit the country for a safari, with a stopover for plastic surgery, a nose job
and a chance to see lions and elephants.
The Increasing Popularity of Medical Tourism
Although there are no verifiable statistics regarding the magnitude of medical tourism, the available
information suggests that a substantial number of patients travel to developing nations for healthcare. In
2004, 1.2 million patients traveled to India for healthcare and 1.1 million medical tourists traveled to
Thailand.[10,11] One source projects that 750,000 Americans will go offshore for medical services in 2007,
with this number increasing to 6 million in 2010.[12] It is estimated that medical tourism to Asia could
generate as much as $4.4 billion by 2012, with approximately half of this revenue going to India.[1,3] It has
been estimated that the global medical tourism industry currently generates annual revenues up to $60
billion, with 20% annual growth.[4,13,14] However, another valuation suggests that the industry is somewhat
smaller, with growth to $40 billion projected by 2010.[5]
Medical Tourism Destinations
The medical tourism marketplace consists of a growing number of countries competing for patients by
offering a wide variety of medical, surgical, and dental services (Table 1).Many of these destinations boast
modern facilities with advanced technology and appealing accommodations. A substantial number of the
physicians in medical tourism destinations received postgraduate training in industrialized nations, have
board certification (or equivalent), and may have practiced in the country where they completed their
training. Medical tourists are presently traveling to faraway countries for cosmetic surgery, dental
procedures, bariatric surgery, assisted reproductive technology, ophthalmologic care, orthopaedic surgery,
cardiac surgery, organ and cellular transplantation, gender reassignment procedures, and even executive
health evaluations (Table 2). A number of countries in Central and South America have developed strong
reputations for cosmetic and plastic surgery, bariatric procedures, and dental care.[6-8] India, Malaysia,
Singapore, and Thailand are well-established medical tourism destinations that have become popular for
patients seeking cardiac surgery and orthopaedic surgery.[1-3, 9,14] Medical services in India are particularly
affordable, with prices as low as 10% of those in the United States.[2] Several highly developed nations
including Belgium, Canada, Germany, Israel, and Italy are attracting foreign patients under the banner of
medical tourism, offering sophisticated modern care with careful attention to patient preference, service,
and satisfaction.
*Professor, Marketing & Chairman – Healthcare Mgt Course, IES Management College, Bandra. bhangale.vijay@gmail.com
IIMK Part IX – Medical Tourism IIML
Table 1. Medical Tourism Destinations*
Asia/Middle East The Americas Europe Africa Other
China Argentina Belgium South Africa Australia
India Brazil Czech Republic Tunisia Barbados
Israel Canada Germany Cuba
Jordan Colombia Hungary Jamaica
Malaysia Costa Rica Italy
Singapore Ecuador Latvia
South Korea Mexico Lithuania
Philippines United States[18] Poland
Taiwan† Portugal
Turkey Romania
United Arab Emirates Russia
Spain
* Most frequently identified countries in literature and Internet search.
†
Taiwan seeks to become a destination for Chinese-speaking patients.
Table 2. Procedures for Which Patients Pursue Medical Tourism*
Cosmetic Surgery Breast augmentation/mastopexy/breast reduction
Facelift/blepharoplasty
Liposuction/body contouring
Dentistry Cosmetic dentistry
Dental reconstruction/prosthodontics
Cardiology and Cardiac Surgery Coronary artery bypass
Cardiac valve replacement/reconstruction
Percutaneous coronary angioplasty/stenting
Stem cell therapy for heart failure
Orthopaedic Surgery and Spine Surgery Hip replacement/resurfacing
Knee replacement
Arthroscopy/joint reconstruction
Laminectomy/spinal decompression
Disk space reconstruction/disk replacement
Bariatric Surgery Gastric bypass
Laparoscopic adjustable gastric banding (Lap-Band;
Inamed/Allergan, Inc.; Irvine, California)
Body contouring subsequent to massive weight loss
Reproductive System In vitro fertilization
Hysterectomy
Prostatectomy/transurethral resection
Gender reassignment procedures
Organ and Tissue Transplantation Solid organ transplantation
-Renal
-Hepatic
Bone marrow transplantation
Stem cell therapy
-Heart failure
-Neurologic diseases
Other Services LASIK eye surgery
General medical evaluation/checkup
Wide range of diagnostic studies
* Most frequently identified procedures in literature and Internet search.
Medical Tourism in India
India is considered the leading country promoting medical tourism-and now it is moving into a new area of
"medical outsourcing," where subcontractors provide services to the overburdened medical care systems in
western countries.
“Medical tourism” is an important part of the Indian tourism industry and holds immense growth potential.
The medical tourism sector had experienced a phenomenal growth in the flow of medical tourists - from
10,000 patients in 2000 to stupendous 180,000 by 2005.
(Source: RNCOS report on ‘Indian Tourism Industry Forecast (2007-2011)
Conference on Tourism in India – Challenges Ahead, 15-17 May 2008, IIMK 366
IIMK Part IX – Medical Tourism IIML
A study by McKinsey and Confederation of Indian Industry says that at its current pace of growth,
healthcare tourism alone can rake over 8,000 crore additional revenue by 2012.
India's National Health Policy declares that treatment of foreign patients is legally an "export" and deemed
"eligible for all fiscal incentives extended to export earnings." India's top-rated education system is not only
churning out computer programmers and engineers, but an estimated 20,000 to 30,000 doctors and nurses
each year.
The largest of the estimated half-dozen medical corporations in India serving medical tourists is Apollo
Hospital Enterprises, which treated an estimated 60,000 patients between 2001 and spring 2004. It is
Apollo that is aggressively moving into medical outsourcing. Apollo already provides overnight computer
services for U.S. insurance companies and hospitals as well as working with big pharmaceutical
corporations with drug trials. Apollo's business began to grow in the 1990s, with the deregulation of the
Indian economy, which drastically cut the bureaucratic barriers to expansion and made it easier to import
the most modern medical equipment. The first patients were Indian expatriates who returned home for
treatment; major investment houses followed with money and then patients from Europe, the Middle East
and Canada began to arrive. Western patients usually get a package deal that includes flights, transfers,
hotels, treatment and often a post-operative vacation.
Why India
India is a leading player in the medical tourist/healthcare industry. It is increasingly emerging as the
destination of choice for a wide range of medical procedures.
There are numerous advantages of going to India for treatment. Some of the advantages of going to India
for medical treatment are:
• Internationally accredited medical facilities using the latest technologies.
• Highly qualified Physicians/Surgeons and hospital support staff.
• Significant cost savings compared to domestic private healthcare. Medical treatment costs in India
are lower by at least 60-80% when compared to similar procedures in North America and the UK.
• No Wait Lists
• Fluent English speaking staff
• Options for private room, translator, private chef, dedicated staff during the stay and many other
tailor-made services.
• Can easily be combined with a holiday/business trip
India is renowned for ancient alternative therapies such as Ayurveda, Yoga and Meditation, and
Therapeutic Massage. India is an exotic tourist destination offering everything from beaches, mountains,
cosmopolitan cities, quaint villages and pilgrimages to suit every palate. Rich in history and culture, India
has proved to be an oasis in the modern world, providing complete health and well being, while providing
the latest in technology.
Indian corporate hospitals have a large pool of doctors, nurses, and support staff ensuring individualized
care. The highly skilled personnel, with wide experience and international exposure excel in Cardiology
and Cardiothoracic surgery, Orthopedic surgery, Bariatric or Obesity surgery, Gastroenterology,
Ophthalmology, Dentistry, and Urology, to name a few. Our hospital partners have exclusive
Cosmetic/Plastic surgery departments. Our alliance partners have Centers of Excellence in their specialty
areas.
All medical investigations are conducted using the latest, technologically advanced and cutting edge
diagnostic equipment. Stringent quality assurance exercises consistently ensure reliable and high quality
test results in a timely manner.
Even though India has many different languages, English is widely spoken. All hospitals have excellent
English speaking staff and language or communication is very easy.
India has kept pace with the latest in technology and its application has been widely felt in the health
industry. Moreover, India's strong pharmaceutical sector has gained international recognition and
contributed to the growth of medical tourism.
The downsides of medical tourism
Experts have identified a number of problems with medical tourism
Conference on Tourism in India – Challenges Ahead, 15-17 May 2008, IIMK 367
IIMK Part IX – Medical Tourism IIML
• Government and basic medical insurance, and sometimes extended medical insurance, often does
not pay for the medical procedure, meaning the patient has to pay cash.
• There is little follow-up care. The patient usually is in hospital for only a few days, and then goes
on the vacation portion of the trip or returns home. Complications, side-effects and post-operative
care are then the responsibility of the medical care system in the patients' home country.
• Most of the countries that offer medical tourism have weak malpractice laws, so the patient has
little recourse to local courts or medical boards if something goes wrong.
• There are growing accusations that profitable, private-sector medical tourism is drawing medical
resources and personnel away from the local population, although some medical organizations that
market to outside tourists are taking steps to improve local service.
References
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http://www.usatoday.com/money/industries/health/2006-07-26-travel-surgery-usat_x.htm Accessed June 21,
2007.
Arnold K. Going under the knife abroad: medical tourism industry booms as health costs rise. The Monitor (McAllen,
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Baliga H. Medical tourism is the new wave of outsourcing from India. India Daily. December 23, 2006. Available at
http://www.indiadaily.com/editorial/14858.asp Accessed January 2, 2007.
Great Indian hospitality can be biz too. The Economic Times (India). July 29, 2005.
Hancock D. The Complete Medical Tourist -- Your Guide to Inexpensive Cosmetic, Medical and Dental Surgery
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Jones CA, Keith LG. Medical tourism and reproductive outsourcing: the dawning of a new paradigm for healthcare. Int
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Konrad W. Employers make a push for 'medical tourism'. CNNMoney/Fortune Small Business Web site. May 15, 2007.
Available at
http://money.cnn.com/magazines/fsb/fsb_archive/2007/05/01/100003808/index.htm?postversion=200704301
2 Accessed June 28, 2007.
Lancaster J. Surgeries, side trips for medical tourists. Washington Post. October 21, 2004:A1.
MacReady N. Developing countries court medical tourists. Lancet. 2007;369:1849-1850. Abstract
Schult J. Beauty from Afar -- A Medical Tourist's Guide to Affordable and Quality Cosmetic Care Outside the U.S.
New York, NY: Stewart, Tabori & Chang; 2006.
Sen C. Thai health tourism gives India headache. The Economic Times (India). July 24, 2005.
Vacation, adventure and surgery? [transcript and video]. "60 Minutes." CBS television. September 4, 2004. Available
at http://www.cbsnews.com/stories/2005/04/21/60minutes/main689998.shtml Accessed January 15, 2007.
Woodman J. Patients Beyond Borders -- Everybody's Guide to Affordable, World-Class Medical Tourism. Chapel Hill,
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Conference on Tourism in India – Challenges Ahead, 15-17 May 2008, IIMK 368
