Discussion about global number of medical tourists

How many medical tourist do we speak about globally? Is it really a huge number. Very good summary of “number of MTs”.

I quoted from Keith Pollard www.imtj.com From that LINK


McKinsey and the medical tourism numbers game…

According to a new report on medical tourism from McKinsey (login required):

  • “Between      60,000 and 85,000 people annually travel abroad for inpatient hospital      care, a number…..far lower than commonly assumed”.

According to the Wall Street Journal:

  • … the      McKinsey report “contrasts sharply” with common assumptions and      with figures often used by those who market medical tourism. “There’s      been an enormous amount of hype” regarding people traveling abroad to      receive necessary procedures at a lower cost, Mango (from McKinsey) said.

So what are we to make of this “authoritative” report…..?

One industry insider who has compiled a comprehensive review of medical tourism suggests:

  • “The      McKinsey figures are nonsensical……looking just at figures from Asia      for travellers from Asia and the Gulf, they are way way out.”

One problem with the McKinsey data is that it relies heavily on government statistics, and few governments record medical travel. Even where figures are collected then they do not include home nationals who work overseas going back for treatment, or US and other residents returning to a country of origin for treatment.

It’s also a strange method of counting medical tourists, if you decide to leave out:

  • people      travelling across borders for treatment, which would include UK to France      or Belgium, Canada to the US, the US to Mexico, Mexico to the US , China      to Taiwan or Hong Kong, central Africa to South Africa , Ireland to the      UK, etc etc.
  • people      travelling back to their homeland for treatment.
  • people      travelling to the homeland of their parents/grandparents
  • expatriates      working overseas
  • people who      decide to mix travel and treatment eg UK travellers to Spain, South Africa
  • people who      mix business travel and treatment
  • people who      live in two countries eg UK and Spain
  • And..all      outpatients

Other oddities…

If they reckon the number of medical tourists are 60,000 to 85,000 worldwide, how does this stack up against other reported data:

  • 70,000 –      100,000 UK medical tourists (from our own Treatment      Abroad medical tourism research and the UK International      Passenger Survey data)
  • Last year,      92,000 patients from the UAE visited the Philippines.
  • One dental      clinic alone in Budapest that is treating over 4,000 patients from abroad      each year.
  • 10,000      visitors to Korea last year for medical treatment, according to the Korean      Tourism Organisation.
  • Singapore      Tourism Board says 555,000 tourists received medical treatment in 2006.

And overall… it is a little strange to say that someone travelling overseas for a hip operation is a medical tourist, but someone travelling for a dental extraction or cosmetic surgery is not.

Whatever the real numbers are, McKinsey did conclude:

  • “Medical      travel is a highly relevant market …….. The acceleration of      unsustainable health care costs in many developed economies, the advent of      advanced technologies in just a few locations, and the increasing      concentration of wealth in developing economies are only a few of the      factors fueling it. Over the next couple of decades, these trends may      largely dispel the idea that health care is a purely local service”

So… good news for the medical travel industry!



The medical tourism numbers game… Part 2

Back in May 2008, I blogged on “McKinsey and the medical tourism numbers game…” and commented on their strange way of counting (or not counting) medical tourism numbers.  Given the latest study on medical tourism numbers, “New study numbers US medical tourists in thousands not millions”,  reported in IMTJ, I thought it was time once again to address the thorny issue of….how many medical tourists are there?

Defining the medical tourist

Before you can begin to count medical tourists, you have to be very clear about what it is you are counting. This is one of the greatest areas of confusion in the business sector.

So, what is a medical tourist?

In my view, a medical tourist is someone who travels outside of their own country for surgery or elective treatment of a medical condition. If we apply this narrow definition, we DO NOT include:

  • dental      tourists
  • cosmetic      surgery tourists
  • spa and      wellness travellers
  • “accidental”      medical tourists (business travellers and holiday makers who fall ill      while abroad and are admitted to hospital)
  • expatriates      who access healthcare in a foreign country.

One of the best attempts that I have seen at defining and categorising “health tourism” (as opposed to medical tourism) and its various segments is by Dr Constantine Constantinides – see www.healthtourism8.com.

I will take the liberty of refining and adapting Dr Constantinides approach to develop my own definition and categorisation of health tourism or …let’s call it “Health and Medical Travel”.

Health and Medical Travel embraces and defines the market as a whole. Within Health and Medical Travel, there are some clearly defined market segments:

  • Medical      tourism (or travel) – someone who travels outside of their own country for      surgery or elective treatment of a medical condition. This could be broken      down further into sub-segments such as:
  • Infertility tourism (or travel)
  • Stem cell tourism (or travel)
  • Transplant tourism (or travel)
  • Dental      tourism (or travel)  – someone who travels outside of their own      country for dental treatment be it restorative or cosmetic.
  • Cosmetic      surgery (or aesthetic) tourism – someone who travels outside of their own      country for cosmetic or aesthetic surgery.
  • Spa tourism
  • Wellness      tourism

This definition of Health and Medical Travel obviously excludes the accident medical tourist – the holidaymaker of business traveller falling sick while abroad.

It makes sense to segment markets because different market segments contain different types of consumer with different needs and requiring a different approach in terms of service offering, message and promotional activity. It’s at the core of successful marketing. It’s why many medical tourism businesses fail… because they try to be all things to all patients and fail to understand their markets and consumers.

Counting medical tourists

If you thought defining medical tourists was difficult, try counting them…. Because everyone defines medical tourism differently, none of the numbers make any sense at all and we see massive variation in the numbers quoted.

It doesn’t help that some individuals doing the counting or quoting the numbers may have little experience of healthcare or of running hospitals, so when they come up with a number,  they may not realise how ridiculous the number is.  Here’s a couple of medical tourism numbers that you may have heard quoted at conferences and in press releases in 2010 and why they don’t make any sense at all:

  • The Center      for Medical Tourism Research was established in 2010 to      “increase knowledge in the medical tourism industry”. Last year, it told      us that there were 1,120,446 American medical travelers in 2009. These      included dental travellers, cosmetic surgery patients but excluded spa and      wellness travel.  Let’s assume that just one in five of these 1.1      million American medical travellers actually went for hospital treatment.      And let’s assume a five day length of stay in hospital. That’s 1.1 million      patient days, enough to fill over 3,000 hospital beds every day for a      year, enough to fill more than five Bumrungrad Hospitals to bursting 365      days per year. Does that sound at all likely to you? In terms of      destinations, the CMTR research also told us that 7.6% (82,000) of these      US medical tourists went to the UK and 0.5% (5,546) of these went to      Turkey. 82,000 US medical tourists visited the UK last year…….. I am      sure that my colleagues in the UK hospital sector would be delighted to      welcome this many US patients!
  • In a recent      news release for “Patients Beyond Borders Focus On Bumrungrad      International Hospital”, I read that “during the past decade,      more than 3 million patients from 190 countries have traveled to      Bumrungrad”. Now…. there’s no denying that Bumrungrad has an impressive      share of the international patient market, and they are undoubtedly a      leader and trend setter in the sector… but 300,000 international medical      travellers a year for the last ten years? If the patient as stated has      travelled to Bumrungrad from another country, we can probably assume that      they are not flying in for a chest x ray. So, let’s apply the same average      length of stay – 5 days. That’s 1.5 million patient days, a year. Hang on….      Bumrungrad only has 554 beds, but they are filling over 4,000 beds with      international patients. An amazing achievement.

So, in the two examples above what’s gone wrong? Are the Center for Medical Tourism Research and Patients Beyond Borders trying to mislead us. No. They just haven’t thought through what these numbers mean and haven’t questioned the source data or the basis of their assumptions.

In the first example, it’s a case of very poor sample selection, sample bias, and making projections for the total population based on what people say they may do rather than analysing what they actually do.

In the Bumrungrad example, it’s also a case of “sample error”…..counting the same patient numerous times over. i.e. an international patient  at Bumrungrad can get “counted” every time they raise  a bill. So, one visit to pharmacy = one visit, one x ray = one visit, one physiotherapy session = one visit. You can easily see how the numbers mount up. (And why the marketing department like them!) There is also the inflation caused by “accidental” medical tourists (business travellers and holiday makers who fall ill while in Thailand and are admitted to Bumrungrad) who get counted as international patients.

So….how many medical tourists actually are there?

Probably a great deal less than you think.  But that doesn’t mean that you shouldn’t be in the health and medical travel market. You just need to be very clear about your own definition of your market segment, and never believe what you hear at a conference or read in the press.

Perhaps in my next blog post, I should tell you how many medical tourists I actually think there are…..



 The medical tourism numbers game: Part 3… “Medical tourism skyrockets”

This week another medical tourism news story hit the headlines. According to the New York Daily News, “Medical tourism skyrockets…Turnover is expected to total $100 billion in 2012, compared with $79 billion in 2010”.

I picked up the“news” story this week from various sources; it’s been re-published multiple times over through re-tweets, LinkedIn discussions and blog postings.

Great news for those who are interested in investing in medical tourism, or in expanding their medical tourism activities!

Or is it…….?

If you read it in the New York Daily News just last week, it must be true…surely?

If it was re-tweeted and re-posted by medical tourism experts/consultants/advisers it must be true…. surely?

Well…not necessarily.

Here’s a great example of medical tourism hype and how if enough people repeat something enough times, a myth becomes accepted truth.


Tracking down the source

Let’s track down how this news story arose and see if we can separate fact from fiction.

I actually get a few mentions in the New York News article (hey…that must add some credibility to the story…), so there’s a clue to how this news story started. My quote “medical tourism is not global, it’s regional”, and the other quotes are sourced from presentations made at the European Medical Travel Conference in Berlin in April this year. The “Turnover is expected to total $100 billion in 2012…” quote is based on a slide from a presentation at EMTC 2012 by Dubai Healthcare City.

The news item doesn’t have an author, so who actually wrote it? And can we believe what they report? The source is stated as AFP RELAXNEWS. This is a French newswire “dedicated to leisure and lifestyle”. A newswire reports news (or creates news items…) that are then supplied to a network of publications who cannot afford to employ sufficient in-house writers to provide all of their content.

If Dubai Healthcare City is quoting the data in a presentation… it must be true?

The speaker (quite rightly) references the source of the data to KPMG.

If it’s KPMG data… it must be true?

Or is it…….?

Where did KPMG get the data?

Take a look at KPMG’s Issues Monitor for May 2011. You’ll see this statement: …”the global medical tourism industry is growing at a rate of 20-30% annually, and by 2012…expected to reach US$100 billion etc etc”.

But… It’s not KPMG data.  KPMG is simply re-stating data that they have got from somewhere else (and they haven’t checked out). The statement is referenced to two sources. Here are the two sources:

  • The first      is to “Business Standard, December 11 2010”. Business      Standard is an Indian newspaper. The article reads “the medical      tourism sector is set to become a $100 billion sector by 2012”. The      article is again supplied by a newswire (Press Trust of India) as opposed      to being written by an accredited journalist. It references a Frost and      Sullivan “report”.
  • The second      reference is to a Frost and Sullivan press release (not a report),      entitled “Malaysia’s      Medical Tourism Industry has healthy vitals” published in April      2010. The press release contains various information about the Malaysia      market… but nothing about the global market.


Now, we’re getting somewhere… if it’s in a Frost and Sullivan press release… it just has to be true, surely?

But…there’s nothing relating to the global medical tourism market in the press release. It doesn’t contain the data that KPMG are referencing.There’s no report.

So, where has the data come from?

I did some digging with Frost and Sullivan to see where the figures originate. There isn’t a published Frost and Sullivan report that states “the medical tourism sector is set to become a $100 billion sector by 2012”. It doesn’t exist.

The figures were produced by a consultant working for Frost & Sullivan who researched medical tourism for a client over two years ago. This is the same consultant who stated in 2010, that Thailand received 1.7 million medical tourists (that equates to one in ten visitors to Thailand being medical tourists). You may be thinking…”that’s probably a bit on the high side”.

According to Frost & Sullivan, “there is no report on this topic per se that would be available for public consumption”. They also acknowledge that “there may have been areas that have inflated the numbers.”

Two year old data becomes today’s news

Bear in mind that the figures whether they are fact or fiction or just wildly inaccurate were compiled over two years ago… but they are news today and have been given credibility through Twitter, Li nked In, blogs and so on. I’ve no doubt they will continue to re-appear.

And bear in mind that there will be some who will use these “facts” to support investment decisions, new initatives and marketing spend.

So there you go… the message, as always, is… never believe what you read on the internet about medical tourism numbers!

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