Medical travel doesn't have to be overseas

Hospitals and physician practices work to make medical tourism a domestic endeavor by offering patients a good location, cost savings and a nationwide reputation for excellence.

By — Posted Nov. 3, 2008

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As medical tourism promoters come to terms with the fact that few people are willing to go to foreign countries for medical procedures, they are starting to shift their focus a little closer to home.

So-called domestic medical tourism appears to be on the rise as medical travel facilitators continue to hunt for the best deals for patients willing to look beyond their hometowns for care they think is better and less expensive.

Meanwhile, hospitals are looking for ways to attract not only new patients from the U.S. but also international patients seeking care they can't find at home.

"As sexy as medical tourism sounds ... people don't travel. Are you really going to get on an airplane to get a knee replacement in India?" said Darren Tomey, spokesman for Healthplace America.

That was the conclusion Global Choice Health Care reached in January when it changed its name to Healthplace America to focus on domestic, rather than international, medical tourism. The Lisle, Ill.-based company had gotten few bites from American patients and employers willing to cross oceans for surgical and other procedures.

Tomey said that when he asked one employer who had a medical tourism plan in place for more than a year how many employees had traveled for care, the employer replied, "Not one." Yet several of the company's employees had procedures that year that would have fit within the medical tourism program.

Jon Edelheit, president of the Medical Tourism Assn., a trade group for those involved in medical tourism, said he has seen the increased interest in domestic medical tourism, but it's not being driven by a lack of interest in patient's going abroad.

"What's basically happening is, medical tourism overseas is in a stage where it is skyrocketing in growth. Insurance groups are now carrying it, and large employers are doing it," he said.

But there are still people who don't want to go abroad, Edelheit said, and hospitals are now telling them they don't have to.

Hospitals are offering big discounts to patients willing to pay cash -- upfront discounts that are growing more competitive with the often lower cost of overseas care.

"I think it's very exciting because it makes [hospitals] more competitive," he said.

Offering more than medical care

One facility in the early stages of becoming a medical destination is the Orthopedic Surgery Center of Orange County in Newport Beach, Calif.

Practice administrator Gabrielle White said she has heard plenty in recent months about the effort to send patients abroad to save them money.

"The biggest reason [we want to do this] is for patients so they have other options rather than go overseas. They can get safe, quality care in their own country," White said.

The practice also figures it can offer the tourism aspect that might also attract patients from abroad, she said. Often, international medical travel is packaged as a combined hospital and vacation stay.

"Newport Beach is one of the most beautiful places in the world. We have the best weather year-round," she said.

Another benefit of keeping the patient in the United States is the ease of coordinating care between the patient's local physician and the surgeon, she said.

Insurers want to send patients abroad to save money, but they can still save by sending them here, White said. The center plans to offer the same discount it would to any cash-paying patient, which is typically 20%.

Orlando, Fla., already well-established as a vacation destination, is launching a citywide effort to promote itself as a medical tourism center. The move is tied to the creation of a 7,000-acre complex called Medical City, which will be anchored by the new University of Central Florida Medical School set to open next year.

Deborah German, MD, dean of the UCF Medical School, said the medical school will help legitimize the city's efforts to become a medical destination. "Name any of the centers across the country where people get on airplanes to go get their care, they all have an academic center," she said.

Dr. German said she doesn't think the medical school needs to become the sole draw for tourists to Orlando, but rather enhance what is already there. Some of Orlando's health, tourist and convention industry leaders met in September to brainstorm how to market the area to domestic and international patients.

"Orlando is already a destination," Dr. German said. "This will just be another attraction."

Experts say that although a good location and cost savings are important, a destination's success will depend on establishing a nationwide reputation for excellence.

Reputation as a draw

Michael Fisch, MD, MPH, director of the oncology program and medical director of the community clinical oncology program research base at M.D. Anderson Cancer Center in Houston, said he believes the center's reputation has led to thousands of patients traveling there for care.

Of the more than 79,000 patients who will be treated at M.D. Anderson this year, more than 9,000 will come from outside the Houston area.

Dr. Fisch's focus is care of international patients. While marketing plays a role in selling the Anderson name, Dr. Fisch said many of his patients come because of referrals from their primary care physicians.

Many foreign doctors attend cancer conventions and seminars in the U.S. or collaborate on research projects and meet M.D. Anderson doctors through those channels.

Dr. Fisch said patients are not the only ones who benefit from seeking care abroad. "It's a real privilege to take care of patients from other countries. ... There are many more similarities than differences, and it's an uplifting experience."

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Medical destinations need careful planning

Practices and hospitals can't just declare themselves a medical destination. A little prep work is involved as well as readiness to accommodate the guests.

Jon Edelheit, president of the Medical Tourism Assn., a trade group for those in the medical tourism field, said he advises those looking to become a destination point to decide what one or two aspects of their care they want to promote.

"You can say, 'We are a medical tourism destination.' But why are you medical tourism destination?" he said.

"They either specialize in certain procedures or they have affordable prices, but you need some kind of niche," Edelheit said.

Experts say you also need to find ways to market your practice.

Without the ability to pay for a marketing team, a practice could use its existing professional networking channels to attract referrals, focusing both on selling quality of care and a willingness to offer discounts to cash-paying patients.

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