Recently I received two mails from European Entrepreneurs (one Deutch, one English) that are willing to open a medical tourism agency that were both wildly complaining about the lack of support of Asian Hospitals. What they were pointing out was the fact that hospitals were not willing to invest in their operations while these medical tourism facilitators were “working in the best interest of the hospitals”. To be honest, I find this idea totally exaggerated: a medical tourism agency is always hedging surgeries between a pool of more than 10 hospitals. Given the small volumes yielded, what do these medical tourism agency provide: 30 customers per hospital a year? Seriously, why should an hospital invest in your start up and not in another one with a real value proposition?

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Tan Tok Seng to NUH: Let’s work together baby! You take the arms, I take the legs

Yet, even though these claims are too much, there is one point to put forward: hospitals could act as a regulating power for these medical tourism agencies. In fact, the industry is lacking standardization: hospitals are very different from each other and the incoming process always vary from a medical group to another resulting into an incompatibility of medical records system, filing system, reporting system…  plus, medical tourism agencies are often individuals that advice people to go to a certain hospital and take a commission for all the ground work. Yet, what about insurances? what about medical records transfer?

The critical investments that hospitals need to do is a common R&D program to ease up international patient management. Let s take Asian Hospitals: they will gain momentum (against Eastern Europe or South America) by creating a common process (as medical tourism operators will find it easier to work with them). Intercompatibility between hospitals is even more important in case of complications: for instance, one friend of mine got a motorbike accident while visiting Singapore last week (… poor guy, his knee is in shambles …).

He was transfered to Alexandra Hospital, a good but not world class hospital in Singapore where a first operation was performed. An Arthroscopy showed that the operation will be more complicated hence he was sent to Singapore’s best orthopedic clinic in Singapore @ Mount Elizabeth Hospital (a Parkway group hospital). These two hospitals are not belonging to the same group of hospital… This resulted in a messy outpatient management (my friend was still considered a patient of Alexandra Hospital two days after leaving) and the need to do again some examinations as Alexandra hospital was unable to provide the records in due time. A complication during an orthopedic surgery can always happen requiring the help of the adequate team of specialists but not necessarily belonging to the same hospital. If Alexandra and Mount Elizabeth had a common system for their international patient, my firend would not have gone through painful drills and tests for a second time in a week.

In an ideal world, hospitals in a specific place would create an association whereby each hospital will hold a speciality for international patients (hospital X for plastic surgery, Hospital Y for spinal cord surgery and hand surgery…) so that hospitals can assemble the best team of specialists in the aera and gain sizable know how while reaching important volumes. Let’s take Singapore: Mount Elizabeth could specialize in orthopedic surgery while Raffles Hospital could specialize in Cardiology, leading to only one interface and common marketing effort to attract international patients. The Singaporian Board of Tourism (STB) is already gearing towards this direction by creating its medical travel departement, yet this is a governement initiative more than an industrial association. The Public System is in fact working under two groups, but these groups are put at odds (competition should create better process) and are diconnected with Private Hospitals.

There are evident issues to this system (revenue sharing model? volume per speciality? profitability per operation?) … Readers what are your thoughts?