New estimates for Medical Travel traffic?

So who is right? Two powerful consulting groups came up with very different endpoint assessments for the industry analysis.

There are two widely disparate assessments on the size and activity of the medical tourism markets.
The links to the original articles are:

http://www.mckinseyquarterly.com/Mapping_the_market_for_travel_2134_abstract
http://www.deloitte.com/dtt/article/0%2C1002%2Ccid%25253D217866%2C00.html

It is critical to read and understand how each organization defines the traveler for medical care. There appears to be too much investment and construction in the areas of infrastructure and capacity for medical tourism to be justified by the lower boundary defined by The McKinsey Group(TMG) assessment. The Deloitte article may overshoot the actual number. One reasonable conclusion is that the truth is somewhere in the middle of the two.

Going forward, this will continue to be a new growth arena for leaders to enter. Challenges exist in changing mindsets and biases, to which incentives and marketing will be critical. Already large industry forces are moving to create incentives to ease the transition to get elective and semi-elective healthcare outside the US. This is beginning to look similar to several recent 'disruptive technological shifts'.

This means the paradigm, our current structure of thinking, will be changed dramatically. Acute care medicine will still be practiced locally. But opportunities to move many aspects of care abroad exist. Radiology is moving in that direction, pathology, lab specimen processing, procedures, annual visits and much, much more.

What would make you, a US healthcare consumer, interested in seeking care outside the US?
What would prevent you, a US healthcare consumer, interested in seeking care outside the US?

We would enjoy to have a dialogue. Feel free to submit your comments and suggestions.


Jim McCormick MD
Premiere Medical Travel
Be Well, Travel Safe

Who is Your Client?

Before we get to the answer to that question, the situation in Thailand has settled for the time being. Remember situational awareness is an important component of advising potential travelers.

So who is your client?
Is it the destination facility?
Is it the potential patient?
Is it the affiliate for whom you generate fees?

A critical and analytic eye can help to identify who your potential client(s) are in a given business arrangement. The better you identify the client or customer the more you are able to provide valuable products and services to them. Being stuck in the middle and providing all things to all clients is a difficult position. It is a shotgun approach that can deplete capital rapidly. Focus allows precision, which preserves capital and creates a more effective use of content and cash.

While static sites allow anyone to find you, are you finding your customers?

The decision to be focussed is difficult. It mandates that you, as a business, potentially lose customers. There are benefits to shedding some customers and developing a more focussed approach.

We at Premiere Medical Travel can help you define an approach that best suits your business needs. Feel free to contact us and discuss the options that will help to grow your business.

Travel Safe, Be Well,

Jim McCormick, MD
Premiere Medical Travel
818 917-6189

Thailand: Update on Conflict in Area

This is where a quality and value added service oriented medical travel company can assist in decision making. While the likelihood of violence spreading into the Bangkok area is minimal, there are reports in The Economist that Cambodia and Thailand are saber rattling over the disputed Angor Wat temple region.

There is a long history here and significant religious concerns for the peoples on both sides of the border. So if you were deciding to go abroad, would you want to know that there is conflict in an area where you are considering? If you were to engage in a simple transactional website that does not keep abreast of the current state of affairs, you may make a mistake. Thailand is a very very safe country and its people wonderful, it just makes the decision more sophisticated for you the party investing in your health if you have all the facts.

The issue has been handed over to the Security Council of the UN to settle the disputed area. Meanwhile local tensions are reportedly running high. Would I travel to Thailand today? Yes. But I would have contingency plans, contacts and knowledge of the embassy and consulate locations as a safe precautions.

Information, both current and accurate will always help make decisions that are in your best interest. That is why Premiere Medical Travel is a value added company. We look to provide you with the right tools and information to make the right assessments and make the best out of your medical travel experience.

We also can help with the medical components of the trip. We will be offering services for you right up to departure and throughout your stay. We will stay in touch with you and your facility, if you desire, to make sure your experience is the best it can be. We do not simply book you and send you packing.

Ever wonder about a volcano, typhoon, hurricane, economic instability and other issues when you are beginning to decide on a location? Nearly every area involved in medical travel has some element of one, or more, of these risks. We stay current so we are sure you are current.

Travel Safe, Be Well,
Jim McCormick, MD

Does a Complication Always Have to be a Disaster?

Truthfully no.

Medicine is a scientific art practiced by human beings. These three components fail. Even machines and computers running perfectly and incessantly fail at times.

Perhaps the better questions are:
1) Was the mistake or complications foreseeable and preventable?
2) Did the provider(s) make the best of the situation to correct the complication for the patient?
3) Do the people and the organization learn from the error and work to prevent it from happening again?

These are essential process components to any quality system. JCI mandates their existence at a surveyed institution.
Recently, I interviewed a patient who underwent abdominal surgery. She felt quite abandoned by her country and insurance company. The insurer contradicted itself in her mind. It would not perform the corrective surgery until she lost weight. They would not perform weight loss surgery until she corrected her first condition.

At this facility she had her weight loss surgery. One of her pre-existing hernias became stuck unrelated to her weight loss surgery. She was rushed back in the OR and had the hernias corrected. All performed quickly and with as much safety as could be achieved. The problem was rapidly identified and corrected. A turn she had not expected, but it was managed masterfully by this institution and its personnel.

To say that she was simply glowing is an understatement. There was not enough time to hear how happy she was that someone, this facility, took the time to give her the needed services that would allow her to get back to a healthy life. It took a complication in a foreign country to give her the keys for her life. The hernias were no longer there to cause her pain and discomfort. It was an inspiring story to hear her tell the events. She clearly felt and had the impression that this facility and its staff were on her side and acting to improve her health. It was clear in her mind which party had served her poorly.

So complications can have good outcomes. Not all, but some do end up with favorable events.

Travel Safe, Be Well
Jim McCormick MD
Premiere Medical Travel Company
www.premieremedicaltravel.net

What is a DVT and what does it mean for me as a medical traveler?

DVT= Deep venous thrombosis = blood clot (Typically in the leg) The real concern is if these clots break off and travel to your lungs. This can cause some significant medical complications.

There are certain important predisposing risks to developing a DVT. 

• Long Flights
• Underlying cancer
• Previous history of DVT
• Birth control pills 
• Obesity
• Recent hospitalizations
• Several other conditions.

So from the list we can see that this is a condition that is not exclusive to the medical traveler.

There are quite a few things that can be done to reduce the chance of this condition. First walking, simply walking is very helpful it pumps the blood out of our legs and back to the heart. Stroll around before the flight, wander up and down the aisles during the flight and walk after the flight. Getting up several time to move around when it is acceptable to the flight crew is important.

Flexing your feet. If you are unable to walk due to flight conditions or other restrictions, simply pumping your calves mimics the walking. It may be as effective, but it is likely better than nothing. You can also do this far more frequently than walking. 

Compressive stockings are available to purchase. These support hose fit more snugly and increase the pressure in the lower legs. This helps to move blood out of the legs and back to the heart.  

Importantly, none of these require a physician to assist you with or guide you. These can be performed easily, by nearly anyone.

The next options require some guidance by a physician. Even aspirin, which is a blood thinner should be taken with a medical travel physician's advice. This may seem a simple medication, but if you thin your blood some surgeries may be delayed. Some blood thinners: wafarin (coumadin), clopidrogel (Plavix), enoxaparin (Lovenox) and others are more aggressive therapies. These require active physician oversight and written orders to administer. While there may be a role for these medications, it is likely small.

The benefit to all these medications is a reduction in the risk of DVT. There is always a downside. By thinning your blood you may find yourself bruising more easily. More significant bleeding can occur internally. They can also interact with other medications you are taking.

Begin with the first three and consult a medical travel physician for advice on the more involved options. 

Travel Safe and Be Well,

Jim McCormick, MD

Premiere Medical Travel Company

How will the challenging economic times in the US affect Medical Travel?

Similar to the economic challenges that are impacting the country faces, these forces will impact medical travel. While no one has a crystal ball, these are some thoughts on how this may play out going forward. 

Clients, both payers and patients, will want a better value for the money. The financial business landscape has changed significantly from less than a year ago. There are two most likely scenarios from my perspective. 

These very tough times will increase costs for the simpler transactional web based models for medical travel. The margins will squeeze tighter and tighter as the cost floor on these web based models making their environment difficult. Higher jet fuel costs, higher inflation, rising unemployment, a weakening dollar, and less available flights etc. will eat into their pricing structures. 

Those companies that have prepared themselves, anticipated these potential conditions and made adjustments to their operating models will fare better. Not without some difficulty. Those who are ready can create a growing client volume by best targeting clients, services and destinations. Markets are made by bringing these components together. 

The winners will need to add value to absorb or offset the rising costs and justify their pricing to begin with. These times make the potential client to expect more for their hard earned money. Our challenge is to deliver. Create value and return value. 

By focusing resources specifically, we can ensure that our strategies are more likely to succeed. It will not be good enough to be all things for all clients. There are some clear gaps in service that, if filled, will more than likely generate traffic. 

Tough times can also compel some interested parties to enter an arena, that they previously felt was not a viable option. Medical travel may become a forced market sooner than I had contemplated previously. Tightening belts can help companies and people to see the opportunities that lie ahead. 

Even in the most difficult of economic adversity, there are those who are willing and able to pay to improve their health. Who are they? Where are they? How do we find them? How do we communicate a value proposition that resonates within the client? That requires the crystal ball and skilled collaborative approaches.

In all challenges lie opportunity. 

This one and these times are no exception.

More to follow from Central America in the next few days!!

Jim McCormick MD

Premiere Medical Travel

818.917.6189

First World Congress on Medical Tourism in the US

In September the Medical Tourism Association, based in Florida, is hosting a tremendous event in San Francisco. Here is the link and the affair's name: http://www.medicaltourismcongress.com The affair will last from September 9th through the 12th. Workshops, lectures, guest speaker and a floor with booths will provide great opportunities to learn about the field, network with the attendees and develop business opportunities.

I am honored to have been asked to speak about aftercare issues within the industry. I am looking forward to the share both my medical knowledge and my understanding of aftercare as a gap in the service provided to patients.

This would prove to be a very exciting event and a great avenue for new entrants to participate. A special thanks to Renee Stephano, C.O.O. of the Medical Tourism Association for her hard work!

Safe Travel and Best Health

Jim McCormick, MD

818.917.6189

How would we promote Medical Travel from non-west coast states?

I was recently asked about how to move patients from a non-West coast location to receive medical travel related healthcare. This was the response. The original posting can be found at: http://fastcompany.com/blog/james-mccormick-md/medical-travel-tourism

There are many global destinations that can provide healthcare, besides asian locations. We can assist your patients in sourcing care that is medically appropriate, culturally relevant, geographically important, or for purely interest in a location for medical care. All that can be done at an attractive value proposition.

A potentially important consideration in the analysis is the delay for a client to return to an active productive life.  A 6 t0 12 hour flight and recovery time next week is potentially more attractive, than a several month wait for a procedure appointment slot in a hospital bed, OR, day surgery or conscious sedation suite etc.

There are some important obstacles for some clients that will prevent their opting for this type of care plan. We can incentivize clients to move past their internal biases and concerns. We need to help them move from a place of hesitancy and uncertainty about medical travel to a zone of comfort and excitement. We must lead that campaign. That is where a physician led organization has a role. I understand patients, their needs and how to communicate to them.

Our perspective looks at the price issue from a different angle. It is and always will be, a avalue proposition. How much does a potential patient value their time hampered by a quality of life condition that can be corrected in an expeditious manner? What value does a patient place on waiting to return to an active, productive and involved life? 

Price cutting implies (in patient's minds) quality shortcuts. While the assumption may not be valid, it is likely at the forefront of any healthcare consumers mindset when we discuss price cuts.

The size of the destination facility can be less important than the capability, skill and expertise of the providers. Many of the existing facilities have designated areas in the hospital for medical travels to cater to their needs. Some are specializing in specific types of care.

We both know that complete solutions are never simple. There are important initiatives that the industry is currently building to implement in order to strengthen confidence for consumers of non-acute healthcare.

This industry can not solve our problems entirely. Rather it will be a important contributor to the solutions of the the US healthcare dilemma we face now and going forward for several years.

We, as an industry, are working to ensure that US standards are incorporated into the processes and practices abroad. JCI, an international arm of JCAHO, inspects facilities abroad. They certify that these standards are in place. I believe this certification is essential to ensure confidence and growth.

In my opinion, facilitators should play a role beyond booking flights etc. They should ensure seamless travel, privacy, and bidirectional transfer of medical information. This promotes the conditions for the best possible outcome for all involved.

There will be an important role for expert physicians and teams that can ensure the care and process are at a level acceptable to US payers, facilities and patient needs.

I would enjoy speaking to you and your group about this subject.

Jim McCormick, III M.D.

General Manager and President 

Premiere Medical Travel

818 / 917- 6189

http://premiere-medical-travel-blogspot.com/

What can Medical Wellness offer our clients?

A growing movement to encourage wellness AND medical travel is important to build client traffic. Medical wellness may mean different things. I was able to recently engage in a conversation with well placed individuals on this subject. 

Here is what we discovered. Clients devote time in a more introspective and exotic location to learn about themselves and their medical conditions. Trained professional dietary consultants, physical trainers, medical specialists, cooking teachers and the host facilities would help the clients learn about the management of the illnesses.

How to manage diet, habits, physical activity and weight all prevent future medical complications. Not just booklets, but committed everyday learning and activity. Teaching these concepts in a more self-intensive location, allows more time to focus and learn. 

This pattern strengthens the teachings by incorporating these new habits into daily routines. Teams can develop to support each other at the destination. There is time to fully embrace and live this new life, free from the distractions of modern life.

In building this state of mind, strength of mind and habit changing activity, clients have a better chance of returning as a stronger person with new habits and learnings to successfully maintain their new found lives.

We want to develop groups of similar people who will travel, live, learn and return together. This team building approach also builds a better support network for when they return and challenges appear.

Best of health!

Jim McCormick MD

Premiere Medical Travel

Is the Philippines moving forward at a faster pace?

Recent conversations with a well placed individual in Manilla's healthcare system would clearly say "YES!"

More and more facilities are coming to understand the importance of JCI certification in order to have US clients feel more comfortable about medical care abroad. The government bodies that oversee this field are encouraging a broader embracing of participation in this important program.

There was a fair degree of certainty that the new air line terminal will open in the very foreseeable future. A welcome addition to the experience. It is an important improvement to the first impression that clients will experience.

As I stated in a previous blog post, there is tremendous investment in infrastructure here that will bear fruit. Perhaps sooner than I had expected. It is a welcome change in the schedule. The quicker the infrastructure and capacity is built the faster the market can mature here.