India has some of the best hospitals and treatment centres in the world with the best facilities. Since it is also one of the most favourable tourist destinations in the world, Medication combines with tourism has come into effect, from which the concept of Medical Tourism is derived. Medical tourism holds immense opportunity for India. This paper examines the various factors that contribute to India’s strength as a preferred destination for medical tourism. It examines the diverse challenges that need to be addressed for the Indian medical tourism industry to realize its potential. It then outlines a range of strategic and tactical initiatives, which would contribute to a faster growth of the industry. Special emphasis is placed on the need for partnership amongst the various stakeholders such as medical and healthcare providers, hospitality and transportation services, tourism departments and the Government. IntroductionWith global health care revenues upward of US$3.3 trillion, health care is world’s second largest business after retailing. The health care industry in India is worth US$ 19 billion and is expected to grow at an annual rate of 13 percent for the next six years. India’s annual spend on health care is 5.2% of GDP and is distributed between the Government and public sector (37 %) and private providers (individual, charitable & for-profit ventures-63%). Medical and Health TourismMedical tourism is the practice of travelling to other countries to receive medical services, which are sometimes packaged with travel and sightseeing excursions. Health tourism or now-a-days it’s called “Business Tourism” refers to tourism that focuses mainly on preventive health programmes. Imperatives for a Successful Medical Tourism IndustryIn order for the medical tourism industry to grow there are certain requirements that must be met. One of the premier requirements is the need for high quality health institutions. Advantage IndiaThere are several factors, which contribute to India’s strength as a destination for medical tourism. Expatriate Indian doctors having excellent reputation and are found in almost every country. Corporate hospitals are coming up in the country with improved facilities, equipment, service standards and better marketing capabilities. India can claim expertise in various medical areas such as cardiac care, joint replacement, dental treatments and cosmetic surgery. The cost of medical services is often as much as ten to fifteen times cheaper than in other countries. For example, phacoemulsification procedure can be performed in India with just Rs. 20,000 as against $ 45,000 in USA refer Table 1). Table 1: Cost Comparison for Select Health Care Services
Challenges to Growth Of Medical TourismSeveral issues pose challenge to the growth of medical tourism and which need to be addressed. Currently India faces strong competition from countries such as Thailand, Singapore and Malaysia. Cultural and language barriersLanguage and cultural barriers can make communication with doctors and other people very frustrating for a person from another country. India has a large number of languages and a high diversity in beliefs, value and culture. The comfort of having a major surgery near home with the family at the bedside is a far cry from the experience in the developing world, where the cultural shock alone can be stressful. Generally there is a fearful state of mind about travelling so far away from home to an unknown place. Communicating with the patients and their families and establishing effective customer relationship is a key challenge. Issues of International AccreditationInternational accreditation would be an important step in making the hospitals eligible for the coverage with foreign insurers. For example, the JCI seal would enable Indian hospitals to be accredited with US insurers. This in turn would attract customers from other parts of the world. JCI is the international arm of the Joint Commission Accreditation for Hospital Organizations. Similarly UK has its own system of accreditation, the Health Quality Service. Concerns regarding the Quality of Service and Competency of Service DeliverersMedical tourists are anxious and concerned about the about quality of health care services and the qualification and ability of the health care providers. And even the main problem is the huge scarcity of well-trained professional “Care Providers”. This issue is further aggravated by the fact that most patients and their families are not qualified to judge technical quality and complexity of the variables involved. Hospitals need to focus on indicators to communicate aspects of treatment and care. Negative perceptions related to hygiene/sanitation, pollution and bureaucracy need to be addressed. Growing Customer ExpectationsPatient expectations are growing as he or she has more options for high quality criteria. There is growing pressure for more personalised services. There is a demand for high responsiveness. It is the business of managing the total customer experience- an experience where price is transparent but value is opaque. Strategies to enhance the Service ExperienceThe initiatives to build on the quality of service delivery for the customer can be on both a strategic and tactical level. At the very top are issues such as defining the mission and scope of business for the service provider. Bases of Segmenting the Health and Tourism Market
Ensuring High Quality TreatmentIt must be ensured that the basic product that is the quality of treatment of an ailment or injury is of high quality. The technical outcome of the service should be excellent. For this it is necessary to have the facilities, equipment and trained and competent staff. Similarly in the case of preventive healthcare, suitable programmes should be developed which are based on the study of physiological condition, lifestyle, work pressures and related environment. Focusing on the Functional Outcome;-The functional outcome of the service experience needs to be given equal attention. This may begin with something like “door-to-door travel” and “stay arrangement” so that patients can arrange travel documents. Putting the patient in touch with doctor before travelling would also help to alleviate some of the anxiety related to medical treatment. A clean and pleasant servicescape, minimum waiting time or delays for tests and treatment, appropriate food and other services would all contribute to the service experience for the patient and his/her attendants. Genuine Patient Centric ApproachIt is necessary to develop a service-oriented team. Personal caring and warmth is an important factor in enhancing the service experience. Going to the extent of caring for attendant is a must for reassurance. This would require a careful selection procedure- one which ensures hiring people not only with the right skills and qualifications but also with the right service attitude and then training them suitably. Doctors and the patients should not be viewed in superior-subordinate roles. There needs to be positive, customer –focused attitude in the hospitals as this is what is going to help to deliver service quality. Focus on Two-Way CommunicationAt the very least, it is necessary to have interpreters and some multi-lingual staff. The service employees must be sensitized to the culture and practices of the patients- at least to some extent. Doctor should explain the treatment protocols to patients and relatives. Comprehensive patient feedback system to guide patients for after care & solve problems, if any, should be set up. A dedicated international patients’ service desk would also help. A comprehensive patient feedback system to guide patients for after care & solve problems, if any, should be instituted. Transparency can be built by direct contact between hospital/doctors and patients. Eliminating middlemen/travel agents can be an effective strategy for reducing miscommunication. Proactive follow up after discharge even when the patient forgets must be implemented. It is also necessary to have effective complaint or grievance handling system so that negative feedback can be used to improve the service and thereby convert a weakness in to strength. Promoting the ServiceThe customer needs to be educated about the value of the offerings in a credible manner. Information could be made available at Indian Embassies abroad. Locating early adopters, opinion leaders and promoting the services with them would help to achieve faster growth. The industry body Confederation of Indian Industries is already working in partnership with 29 Hospitals with national accreditation across 16 states to work out price band for speciality services. Development of Alternative TherapiesThe Indian medical tourism and healthcare industry can develop a significant competitive advantage through promotion and packaging alternate therapies such as ayurveda, naturopathy, homeopathy and yoga. For example Kerala has actively implemented initiatives which promote its ancient indigenous therapies on Ayurveda. Need for a Collaborative ApproachIt is necessary for the various stake holders involved in promoting medical tourism in the country to work together. A panel of efficient doctors and hospitals to provide the core services along with infrastructure and marketing support provided by the hospitality industry, transportation services tourism boards and government. For example, recently the Ministry of External Affairs informed the embassies of 18 countries, the procedure for medical visa procedures would henceforth be completed within 48 hours. Also, permission would be given to outsource the visa procedures to a third party during peak season. ConclusionIndia has several advantages in the field of medical tourism. However, this is still an evolving concept and several challenges need to be addressed. Focused efforts on several fronts would be required for the medical tourism industry in India to realize its promise. The medical and healthcare institutions, the hospitality industry, transportation providers, and the government need to work in concert to promote medical tourism in India.
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