What are the qualifications of the doctors overseas?

In many case truly the best in the world. In other cases the best the countries have to offer. When we are making a recommendation, we are sure that the facility and its medical staff are appropriately trained and up-to-date. 

That verification can happen by several different methods. But the concern many may harbor of untrained or uncertified doctors is unfounded. State-of-the-art hospitals and facilities simply will not risk their reputation and business by hiring poorly trained or incompetent staff. There is a self-policing effect as they compete for patients. Of course we should, and will check. But it is foolish for them to risk bad public relations.

As a doctor practicing in the US, I have been very impressed by the skill and knowledge-base of foreign trained physicians. Admittedly, there can some initial language challenges with a slight accent etc., but the vast majority are very bright and adept at their specialties.

Travel Safe, Be Well.

Jim McCormick MD

Premiere Medical Travel Company

How long have you been dealing with medical tourism?

I started to perform my initial research into the industry in 2007. As I moved through my MBA program at Pepperdine University the research turned from an academic exercise to a business project that is my absolute passion. This is an industry that will create a genuine solution to some of the largest problems the US is facing in terms of healthcare and the expenses associated with it.

We plan on 'opening our doors' in early 2009. We will be negotiating with insurers and brokers over the next several months in order to begin our business.

Travel Safe, Be Well.

Jim McCormick MD

Premiere Medical Travel

Are there government resources to help decide about medical travel? resources

There are few formal government resources to help decide about medical travel as an option for your health needs. 

A quality medical travel company can provide guidance and background information about the choices. This should occur with the assistance of your doctor as well. We want the care and experience to be as seamless as possible. 

There is also an abundant amount of material available on the Internet. You should always take into account the bias of the source and reporting of the information. Also how current and accurate the information is as you read it.

Travel Safe, Be Well.

Jim McCormick MD

Premiere Medical Travel 

Why should I go outside the US for medical care and wellness?

The best example to help sort this out is the issue of time. How much is your time worth to you? How long of  a period in your life do you want to be less active or more uncomfortable because of scarce medical care resources?

I hope your answer is: as short a period as possible. 

When we are asked about long distance travel as an issue, I tend to turn the question towards this concept of time.  Yes some of these locations are relatively far in distance, but they are relatively close in time. Consider, a three or four month wait for an elective procedure to be performed to allow your to rehab and get back involved in your life. In some cases these waiting times are much longer. If you chose a 6 or 10 hour flight to accomplish the same procedure, you could easily be involved in your life before your turn came up for the open slot in our slow to respond healthcare system. 

There are always more than one way to look at an issue. To me, I would rather choose the option that made me healthier sooner. In many cases medical travel is the solution. Too many people are simply blind to the opportunity. 

We can help.

Travel Safe, Be Well.

Jim McCormick MD

Premiere Medical Travel

How does the facilitator get paid?

Pricing and fees are an area where people frequently have difficulty. You should feel comfortable knowing exactly what you are paying for with the company you choose.

It is important for you to know whether the travel facilitator receives commissions for referrals or has a fee for service structure. Commissions are a legitimate method of compensation in many fields. But there is growing concern that a facility may be steering referrals by the use of commissions. They appear to be the dominant method of revenue currently in place. 

There are also important value added or experience improving benefits that you can discuss with the facilitator. It is important if you are sharing the expenses with your insurer that you understand exactly what they will or will not pay for before you leave.

It is important to at least have a plan to help out should there be a complication in your recovery. Will you have access to additional cash or credit for an infection etc. 

Are you bringing a companion? How will their needs be addressed and paid for when you arrive? Good planning also includes attention to the important financial questions.

Travel Safe, Be Well.

Jim McCormick MD

Premiere Medical Travel

What are my options if I am immobile or paralyzed?

Conventional travel has its challenges for those who are less mobile.

Has anyone discussed the medical issues you need to be aware of and how to prevent complications?
Has the destination hotel been enhanced to ensure that a wheelchair can into rooms? Are there accommodations for the bathroom? There are many other questions that need to be asked and answered before signing and sending money.

For those seeking healthcare abroad, the need to be sure about the process and have services in place to receive you are important. A good facilitator can ensure that the your needs are met and service the best possible.

Travel Safe, Be Well

Jim McCormick MD
Premiere Medical Travel Company
818.917.6189

How has the exchange rate (us dollar) affected medical tourism?

Currencies valuations fluctuate against each other all the time. In fact, it is the largest trading market in the world. Trillions of currencies are exchanged daily.

There may be an advantage comparing countries for the most favorable exchange rate. The likelihood of a sudden shift that will affect your terms are low. Timing your medical needs will not help you in any measurable way.

The dollar seems to be strengthening recently. This may help your purchasing power over the long haul. For that matter, the destination facilities may charge a higher price to offset the difference. The net result may be that you have a better deal, but can you wait 18 months or two to three years for that currency exchange to change significantly.

Time your healthcare to your medical needs and compare two or three countries simultaneously.  Premiere Medical can help with these issues. That is what a quality outfit can accomplish.

Travel Safe, Be Well.

Jim McCormick, MD
Premiere Medical Travel Company
818.917.6189

How much does medical tourism typically cost?

This question which is frequently asked and is difficult to answer. Another approach is to know what you have, know what you need and then you can begin to search for a solution.

Premiere can create a package for a procedure in different locations throughout the world. The price will change dependent upon the destination, procedure, number of travelers, the duration of recovery care and several factors.

This is where a good facilitator can help by creating a needs list and define a price structure that is within your budget.

Travel Safe. Be Well,
Jim McCormick MD
Premiere Medical Travel Company
818.917.6189

Do I need a visa to go to these countries?

Most of the countries we will be helping you with do not require a formal pre-approved Visa to enter. A simple card is filled out on the flight describing why you are entering the country. There are some governments who are developing online registration options. In either case these are country by country specific issues.

We at Premiere can help you to be sure that you entry, stay and exit are as seamless as possible.


Be Well, Travel Safe

Jim McCormick MD
Premiere Medical Travel Company
818.917.6189

Do they understand who I am and what my culture is?

The facilities that I have visited make great efforts to blend US culture AND the cultures of many of their visiting patients. It was not unusual to find special areas with special scents to remind people of their home. They catered to cultural and religious dietary needs.

If your religion prohibits a male doctor examining a female patient that would be respected and addressed.

Time was also permitted for prayer services with directions to point towards Mecca.

In the lobby of the Bumrungrad Hospital I sat and simply observed the cultural flow in and out of the lobby for a few hours. It was clear that the people entering and exiting, at least outwardly, were at ease. For my culture specifically: McDonalds had a small location, Starbucks had a small area with Neil Young and similar notable songs were playing.

Cultural awareness is essential to a quality experience. US culture was not the only emphasis The destination facilities are aware that in order to succeed, the culture of the people coming for care is very important. It is my expectation that this practice will grow and become more common in the future.


Be Safe, Travel Well.

Jim McCormick MD
Premiere Medical Travel Company
818.917.6189

What is a Wellness Center?

We at Premiere define medical wellness clinics as a destination for you, a traveling patient, to gain powerful new insight into your particular disease or illness and how to best manage it.

In our view, having a pile of paperwork handed to you in an office after a hasty visit is not an effective way for you to learn about your illnesses and their management. We are developing offerings where in addition to your procedure, you receive an intense several week set of sessions that incorporate daily lessons, time to reflect, time to learn and time to renew who you are and how to best approach your illnesses.

What would daily lessons, nutritional tips, exercise instructions, yoga, meditation give you? In our belief, the best chances at a holistic and healthy life. Will you leave the experience illness free? Not likely, but you will be more empowered, more fulfilled and more likely to make the most effective changes in your life for the better.

In our view, the wellness clinic is an avenue to a new life and a rebirth or redefinition of who you are. Better nutrition, better exercise habits and healthier mindsets can change your physiology and potentially reduce the number of medications you need to take. Reducing medications, can reduce costs and medications related complications. This alone is a leading cause of preventable deaths in hospitals. Pills are easier solutions to write out when time is compressed so much in the office setting. It would seem to us at Premiere Medical that the investment in your health will pay for itself very quickly from a financial, health and well being perspective.


Be Well, Travel Safe


Jim McCormick MD
Premiere Medical Travel Company
818.917.6189

Medical Tourism: The Economist Article 8-16-2008

The Economist a prestigious business and politics magazine has a brief article on Page 12 that discusses the impact of Medical Tourism from several points of view. See Article Here

The dialogue discusses the impact on destination hospital resources and infrastructure. The contention is that the inbound traveler is adversely affecting utilization and redirecting resources from the desperate needs of the local population. There is another impact, the elevation of local economies and the active attempt to retain skilled talents in these countries to serve the growing population.

For instance, the Philippines is considering an offering to retain nurses to work in a hub of medical tourism in Cebu. The country sees the potential for this growth industry and needs to build a workforce to meet the needs of the patients. The influx of outside money is almost always beneficial to a local economy.

The article also cites a number from other recent publications that represents the lost revenue as a result of the siphon effect from domestic US healthcare by medical travel. This is a compelling example of market forces affecting price and demand curves. The price in some minds is excessively high in the US. A new competitor is entering the territory and that beneficial competition will affect pricing. That effect's positive or negative effects are centered upon where you as a business are positioned. As a consumer, you may well see prices begin to move downwards, but not enough to offset the margins that medical travel have to offer.

There is far more value available for those seeking medical travel abroad. Stay tuned!
As they say... May you live in interesting times.


Be Well, Travel Safe.

Jim McCormick MD
Premiere Medical Travel Company
818.917.6189

Can my family come with me? Is that part of the cost?

Of course. We at Premiere would encourage you to have at least one significant individual accompany you. The initial excitement about going abroad for healthcare has a double edge to it. Except for the most self-reliant people, we all need our social fabric. When you travel abroad for healthcare, that fabric is disrupted at a time when support is critical.

Premiere will have cutting edge valuable options to bridge that gap and ensure you are still woven into your social network while getting the best healthcare options can offer. None-the-less if your spouse, partner, friend etc. is physically present, the intervening gap is not as wide.

Having them present has its associated costs and affects that individual. But it is well worth the money.

We will be there available to you 24x7 but a family member or friend present at the site is an even more effective solution.

Be Well, Travel Safe


Jim McCormick MD
Premiere Medical Travel Company
818.917.6189

Is the medical care equal to, or better than the US?

As my business professors would answer...that depends.

What metrics and outcomes are you comparing and how are you comparing them? If you are comparing the World Health Organization's statistics on healthcare monitors we, in the US are doing a terrible job. If you are asking for the ability to go to a cutting edge tertiary care hospital and receive the latest greatest and hopefully best options we have more than you can imagine. They are however very expensive and not cost effective solutions to large scale healthcare issues.

Now mentally go to a community hospital or an inner city hospital faced with significant budget issues and concerns. There are less choices and less cutting edge (read more expensive) options available. Some places must transfer out heart attack patients for cardiac catheterizations. Other hospitals must transfer patients out for brain surgery emergencies and others for trauma patients. So if you had one of these conditions and the facility you wound up at does not treat that condition than you are at an potentially inferior hospital for that specific condition.

Some hospitals only specialize in a specific disease class or age groups. Examples would include cancer specialty hospital, eye institutes, orthopedics facilities and geriatric or pediatric hospitals. So arguably if you are in one of these hospitals and develop a condition outside their scope of practice you may receive inferior care or need to be transferred to receive adequate care.

Now move to a nitty gritty facility with many poor people who are very ill consuming many precious resources. They should have access to their needed medical care. But can the facility or the government spend endlessly to provide the latest, greatest and most expensive care?

Given the scenarios, I think we can agree that in the US there are different levels of care available which create a significant impact on the care received by our citizens.

Now let us move outside the US and examine this question again. Is it possible that there are hospitals outside the US who exist in countries that provide the latest, greatest care for those who can afford it? The clear answer is Yes. Then move to areas similar in capability to the US and the same gradients of care options appear.

As a medical traveler, you want to be helped in identifying the best facilities and the best providers for your condition in these locations. Then you can comfortably say that the care is comparable. On a more granular level you can say that the care is better than or equal to the US. But the question at that point is more a matter of all the amenities that you can afford when you select medical travel. These options are not even considerations when in the US seeking medical care.

Be Well, Travel Safe

Jim McCormick MD
Premiere Medical Travel Company
818.917.6189

What about my rights to privacy, can they be enforced?

The US laws overseeing the release of medical record information and patient confidentiality laws is called HIPAA. While in the US as a patient these regulations oversee your privacy. That does not guarantee your privacy. It ensures that every step is taken to protect your concerns and if a breech occurs you are told about it and the individuals who were unauthorized to view your records are held accountable. This can mean criminal prosecution with financial penalties and jail time. You as a patient may have civil recourse as well. For that you would seek legal counsel.

Protecting your privacy overseas has its challenges. Consistently the facilities I have visited express a desire to ensure your privacy was a priority. However the legal remedies and accountability are inconsistent. Having said that, any destination facility that wants to continue working in this space will need to move closer to the customers (your) needs and make these issues more defined and favorable for our clients privacy needs. It is my belief that they are doing that and actively work to ensure your best interests are served.

We need to be careful in assuming that everything needs to be enforced in a legally binding manner as in the US. It may be that culturally violating a confidence is unacceptable and perhaps carries more impact than our system. Issues like privacy can be different and better outside our borders than the methods we choose to address them locally. It is worth asking your medical travel company how the destination(s) you are choosing are working to ensure your privacy.

Be Well, Travel Safe

Jim McCormick MD
Premiere Medical Travel Company
818.917.6189

What is Medical Travel and Tourism?

There are several running definitions.

We, at Premiere, consider the emphasis of the trip to be the important determinant. For those who travel specifically to receive medical care then we feel that medical travel is more appropriate. This does not make other definitions wrong, it is how we choose to characterize the process.

There are those who travel for business reasons and become ill or injured. They are not medical tourists or travelers.
Similarly those who travel for tourism and become ill or injured are not medical tourists or travelers.

Those whose emphasis for the trip is to seek medical care as a by-product of a tourism related trip would be characterized as a medical tourist. The medical care is an incidental to a vacation trip.

Jim McCormick MD
President and Founder
Premiere Medical Travel Company
818.917.6189

Why is a pre-trip assessment and prearranged aftercare potentially beneficial?

Comprehensive end to end services. Simple words, complex solutions.

That is the basis for what we believe will be a successful company going forward. Those companies that provide simple elements without having the necessary options available for clients to purchase are making potential mistakes for their company and the industry. Clients who seek medical care abroad may not realize the complexity of the undertaking. We should be there to help them understand what is needed and what is required. Simple price points do not address issues such as who will care for wounds when you return home.

Medical Travel companies should consider these problems solved long before you book your first client. Having solutions already built into your business plan will save time, money and reputation when a problem surfaces. Your company should know who will manage the care and how it will be paid for. This complex issue happens occasionally when clients return with a problem and no one was willing to assist them.

There are expectations for continuity of care from the patient through the insurer/payer to regulatory agencies. As a participant in arranging a trip for the clients, our companies may appear to be their contact for services going forward. Simply letting them dangle to find their own aftercare does not help anyone in the arena.

You will get the commission on the first client, but that will not propagate into recurrent trips or referrals for friends and family. Good service and a comprehensive approach is one of the best methods of advertising. One satisfied customer can generate many new leads, while one unhappy client can lead to dozens of negative reports that amplify themselves and suppress potential leads. Is it worth the short term profit to create a self destructive cycle of negative advertisements?

How about screening people before they leave? Is there a value added service in providing this to your client? At first pass who would want to say no to a client. We all want to say yes to a sale. But look a bit deeper and there is a compelling reason to screen and say: ' No our services are not for you. Thank you for your inquiry.'

If you compete in a market on cost than you will need to accept nearly everyone to make up for small margins. The dilemma begins when a client purchases a package from your website and company and something was not screened well or reported by the client. Perhaps they were inaccurate about a condition or they had inappropriate expectations. They traveled with your company name and spent a good portion of their money on the roundtrip flight and some hotel expenses.

Then they arrive at the hospital. They are not candidates for the procedure. What happens next? Who refunds what to whom? Policies can help, but this will be a mess and quickly mushroom.

The patient almost always has the upper hand initially. It can be a very difficult situation to defuse. It is a battle of words. Regardless of the true findings later on, the initial PR stain can hurt your brand. Document can help but it is a reactive approach to the entire set of events and interactions.

You could develop a process and value added package that allows for both parties to meet, assess decide together whether this is the right person, right facility and right service(s) prior to engaging in a more expensive transaction.

Food for thought. Proactive preemption will nearly always beat reactive post hoc solutions.

Be Well, Travel Safe,

Jim McCormick MD
President and Founder
Premiere Medical Travel Services Company
818.917.6189

Healthcare Travel or Tourism?

Can we be both to you, our customer and patient?

Frankly, I am a bit skeptical. There are conditions that suit themselves to a combination trip. But can that brush be applied so broadly? Can you have heart bypass surgery and spend time traveling around a country with relatively fresh wounds that are still healing? Will your hip or knee replacement allow you to walk with enough ease to cover a significant amount of touring 1 week post operatively?

There are companies in this industry that are marketing themselves to be all things, to all customers, for all occasions and at all times. This is an impossible goal to achieve. It can lure many people in and then disappoint many as well. The providers, the facilitators, the customers need clarity.

Who wants to provide, or receive, what service(s) to, or for which patients?

Clarity:
The first issue and choice is the Quality of the Healthcare.
The second issue and choice is the Quality of the Value proposition.
The third issue and choice is the additional components built around the first two core questions if it is possible.

Does it make sense to you as a customer of healthcare providers to simply book a procedure on-line, book the travel on-line and jet off to a destination around the world and not fundamentally understand the first two core concepts?

Some companies break this down into a simple process map. Components of that process can be mapped and defined. It is a process that can be broken down into enough granular detail so any given set of details appear to make sense. But when you pull back up to the macro level, does it all still fit together in a manner that makes sense?

Yes; you can get a bypass for a great value. Yes; you can travel around an exotic country. Yes; you can fly to and from that location. Is it realistic to expect that the wounds will be healed sufficiently at 1 or 2 weeks post operative to have you truly enjoy the tourism? A critical question for you the consumer and purchaser: Are you expectations for the trip in line with the proposition offered and reality? If not, are you are setting yourself up for disappointment.

The investment, even at a huge discount to domestic care, still requires thought, planning and guidance. That is where a skilled professional services company can provide valuable guidance and assistance. The booking is the easy part.

Jim McCormick, MD
Premiere Medical Travel Company, LLC
818.917.6189

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

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/