Medical tourism in India. A critical evaluation

Table of Contents

Section 1- Background Context
1.1. Background Context
1.2. Motivation .
1.3. Aims & Objectives
1.4. Method

Section 2- Literature Review
2.1. What is meant by Medical Tourism?
2.2. Opportunities for Medical Tourism Sector in Developing Economies ..
2.2.1. Improving the Image
2.2.2. Quality Standards
2.2.3. Infrastructure
2.2.4. Simplication of Medical & Travel Services
2.3. Challenges & Threats for Medical Tourism in Developing Countries .
2.3.1. Medical Problems
2.3.2. Legal Problems
2.3.3. Ethical Problems
2.4. Indian Medical Tourism Sector
2.5. Forms of Medical Tourism Services in India ...
2.6. Current Situation of Indian Medical Tourism Sector
2.7. PEST Analysis of Indian Medical Tourism Sector
2.7.1. Political Factor
2.7.2. Economic Factor
2.7.3. Sociological Factor
2.7.4. Technological Factor

Section 3- Case Studies
3.1. Case Study on Apollo Hospitals
3.2. Case Study on Escorts Heart Institute & Research Centre (EHIRC) ...
3.3. Max Healthcare

Section 4- Analysis
4.1. Analysis

Section 5- Conclusion & Recommendations.
5.1. Conclusion
5.2. Recommendations

Section 6- References

Executive Summary

This research project is written on the topic of ‘Critical Evaluation of Indian Medical

Tourism Sector’. The scope of this project is broad as it contain case studies of three major players of Indian medical tourism sector. Core aim of this research project is to evaluate the current market situation and the influence of external environmental factor on the Indian medical tourism sector Movement of developed countries’ patients from their country to another (especially developing) countries for the purpose of undergoing cheap medical care or surgical care services is termed as Medical Tourism. Medical tourism gave an opportunity to medical tourists to avail medical facilities in a rapid manner as they would have to wait for longer period if they would undergo treatment in their native countries. Additionally, certain intiatives (enhanced medical facilities, good communication systems and better transportation facilities) improvised by developing countries’ governments have been resulted in promoting medical tourism by great extent. It has been determined that there are various opportunities (improving image, quality standards, infrastructure developmet and simplification services) that could be resulted in promoting developing economies’ medical torism. While, certain challenges (medical problems, legal problems and ethical problems) have limited the scope of medical tourism field specifically in the developing countries. It has been examined that India has managed to hold dominant position in this sector. India’s current position is an impact of its skilled doctors and surgeons. Country’s world standard medical centres and hospitals are also consider as important contributor of this field. These institutions have been equipped with all sort of facilities that are helpful for catering the needs of medical tourists. India seemed to have exceptional selling proposition of various therapies (such as siddha, ayurveda and yoga) for catering medical tourists’ requirements. It has been analysed from the case study section that there are several aspects (hiring experienced doctors & surgeons, good clinical records, installing & using advance medical instruments, offering holistic service package and employees’ behavioural training) that are considered to be significant for accomplishing success in the Indian medical tourism sector. It has been found out that Medical facilities provided to the medical tourists by Indian hospitals and medical centres have generated huge profits for them. Over past decade, this sector has important contribution in creating economic development opportunities for the country.

Section 1- Background Context

1.1. Background Context

The concept of globalization is inclined as an integration between different nations which thus results in decreasing of overall transaction cost. Relatedly, it also outcome in getting rid of barriers that are linked with the flow of products or services, human resource and capital knowledge across the borders (Stiglitz, 2003). Theoretical frameworks suggested by Giddens (1990), Appadurai (1990) and Woodward et al. (2001) seemed to be used widely for the detail understanding globalisation concept and also for study the relationship between two aspects (globalisation and healthcare). Supporters of globalisation factor have seen to be intended on analysing its influence on the healthcare provision. It has been acknowledged that due to the globalisation aspect, developing countries have not only managed to reduce their poverty rate but also have invested great proportion of that funds for the purpose of improving heathcare services at both levels (national and international). It has been observed that with the advancement of trade liberalisation, the world is becoming flatter as innovative ideas, information techonology and people are crossing national boundaries at regular interval. Alternatively, the opponents of globalisation factor used to raise their concerns over the inadequate evidence of growth aspect. They are also seemed to question that the economic policies formulated in the result of globalisation has either resulted in generation satisfactory outcomes in the developing countries or not? They have also issue over the increase of disparities and the challenges to the developing countries’ health determinants that could be occurred as an impact of increasing economic globalisation.

In 2004, a patient named Howard Staab (North Carolina, United States) had been told by doctors that he should undergo a heart surgery as his heard needed the replacement of mital valve. Howard Staab is a carpenter by profession and the worryingful fact he didn’t had health insurance. He told by the doctors that he would had to pay $200,000 which was far from his fiancial position. So rather than consulting financial institutions for the loan purpose, he came to New Delhi (India). In India, he not only undergone a surgery but also stayed for three weeks and he was charged only $10,000 by Indian medical institution. It has been revealed from this example that how much useful is the medical tourism factor for the patients (those are without medical insurance or have bad financial position) located in the developed countries. It has been discovered that now developed countries’ patients used to prefer to come to developing countries even for the several medical surgeries or treatments. India seems to have strong position in this sector. This happens because of the fact that numerous Indian medical hospitals and institutions are focused on providing world class level health services mainly to the developed countries’ patients. Medical tourism is appears as beneficial for both parties (developing countries’ healthcare institutions and developed countries’ patients). In short, one could say that medical tourists from developed countries would undergo world class medical surgeries & treatments at economical rate and all is this is possible through medical tourism (which came into existence due to globalisation).

It has been ascertained that medical tourism has various distinguished features. Firstly, it could not be classified as an impulsive activity. Secondly, medical tourism is not about the factor of willingness to spend. Medical tourists only avail this option because of their health conditions. Thirdly, the field of medical tourism does not categorised as a seasonal as the duration of stay under this provision is significantly longer than the conventional travel visits. Fourthly, medical tourism is not a single-time business as there is high likelihood that successful surgeries and treatments would lead towards frequent visits of medical tourists with the help of positive word of mouth (WOM).

1.2. Motivation

I have selected this topic because of my interest and also I want to join this sector after graduation. Medical tourism is considered as one of the leading sector in our country (India). Various institutions and hospitals has been providing medical tourism services and many new players are seeming to enter this field because of its potential. Our country’s government is also supporting this sector with the formulation of certain policies and regulations. It has been believed that these initiatives taken by the Indian government would not only enhance the growth of this sector but also would assure the providence of world class healthcare services to the medical tourists. I would like to enter this sector within the management sector and I believe that it would enable me to accomplish my career development targets.

1.3. Aims & Objectives

Medical tourism and healthcare tourism are determined to be as interchangeable terms. Term known as medical tourism is actually originated from the practice under which patients mainly from developed countries are visiting developing countries’ medical institutions or hospitals for undergoing advanced or complicated medical treatments or surgeries. Main motive for their travel is the availability of same quality medical services in their native country but at much higher cost. On the other hand, healthcare tourism is inclined as a broader aspect where medical tourists are seem to come to developing countries with the aim of complete wellness incorporated with an urgent or elective medical procedures.

Core aim of this research project will be to evaluate the current market situation and the influence of external environmental factors on the Indian medical tourism sector. Additionally, it is important to discover that what type of marketing strategies should be improvised by the potential healthcare organisations for ensuring success in the long term. Relatedly, this report has following objectives:

- To examine Indian medical tourism sector.
- To analyse certain external environmental factors that have direct impact on the Indian medical tourism sector.
- To discover the potential of Indian medical tourism market from the perspective of potential entrants.
- To propose marketing strategies that would permit potential healthcare institutions to accomplish success in the long term.

1.4. Method

This theory into practice report is based on the secondary research. Literature review section will contain thoughts of different authors on the certain aspects of medical tourism aspect. Case Study section will discuss the practices of two renowned Indian healthcare institutions concentrated on providing Medical tourism services. Discussion section will be an important section because all objectives of this report will be accomplished there. It will usually achieved through the creation of relationship between the literature review and case study sections.

Section 2- Literature Review

2.1. What is meant by Medical Tourism?

Movement of developed countries’ patients from their country to another (especially developing) countries for the purpose of undergoing cheap medical care or surgical care services is termed as Medical Tourism (Frechtling, 1997). It has been estimated that in 2011, over 3.5 million citizens obtained the advantages of medical tourism (Ehrbeck et al., 2008). Reason for this fact is the cheap cost of similar treatment available in the developing countries. For example, in US the overall expense for the liver transplant surgery is about $0.3 million while same treatment could be done in developing countries for $70,000. It means that there is a great difference in term of cost and thus medical tourism is a cost saving aspect for patients with limited financial resources. Additionally, it has been expected that travel of medical tourists to developing countries will grow by 10 times in a coming decade.

It has been discovered that medical tourism could be availed by developed countries’ patients for a vast range¹ of medical services. Additionally, patients suffering from rare disorder caused due to genes could also avail medical tourism services as developing countries’ medical institutions have better understanding on this treatment. Relatedly, all of sort of healthcare treatments (such as psychiatry, convalescent care and alternative treatment) would also be undergone by medical tourists. Around 50 countries have signified medical tourism as their industry (Lunt & Carrera, 2010). During 2012 period, India generated $2 billion revenue from medical tourism. According to Indian economists, medical tourism sector has potential to emerge as key success driver for Indian economy.

Various medical agencies are seen to be enthusiastic for helping medical tourists through their medical tourism ventures. These agencies appeared to provide medical and healthcare services to medical tourists at relatively cheap prices. Moreover, they also used to offer an opportunity to medical tourist to visit attractive destinations in their respective countries (Henderson, 2003).

According to Connell (2008), medical tourism also gave an opportunity to medical tourists to avail medical facilities in a rapid manner as they would have to wait for longer period if they would undergo treatment in their native countries. Additionally, certain intiatives (enhanced medical facilities, good communication systems and better transportation facilities) improvised by developing countries’ governments have been resulted in promoting medical tourism by great extent. Furthermore, reducing contraints and regulations in relation to medical tourists’ visit is also determined as influential measure of developing countries’ governments (Cormany & Baloglu, 2011). Some of the characteristics (better medical facilities, efficient technical facilities, extensive knowledge of surgeons & doctors, conveyance facilities, better transportation and small waiting time period) of developing countries’ Private sector have also intented medical tourism towards success. It has been understood that developing countries’ governments and private bodies have been initiated towards making joint Public Private Partnership (PPP) investment for developing the infrastructure for the support of medical tourism.

It has been recommended by Smith & Forgione (2007) that the countries who want to go ahead in medical tourism would have to make sure that superior quality healthcare services and medical treatments are provided to medical tourists at lowest possible price. At the same time, they would also have to make certain that transparency has been maintained. Therefore, it is significant for developing countries’ healthcare and medical sectors to develop ultramodern treatments and facilities for meeting the core needs of medical tourists (Smith & Forgione, 2007).

2.2. Opportunities for Medical Tourism Sector in Developing Economies

It has been determined that there are various opportunities that could be resulted in promoting developing economies’ medical torism sector and thus would make them as global destination for healthcare.

2.2.1. Improving the Image

It has been ascertained that all three major players (healthcare sector, travel industry and government) of developing countries would have work on collective basis. This step is important for ensuring the proper image of specified countries which could be in the minds of medical tourists Relatedly, docotors and surgeons must need to be trained in a proper manner.

[...]

¹ Health screenings, cardiovascular treatment, cosmetic surgery, weight loss, scans, reproductive treatment, cardiac surgery and cancer treatment.