Indian Medical Tourism

Janakiraman Sivakumaran is a seasoned and a matured health care professional with 30 years of experience in the industry with a thorough understanding of the dynamics of hospitals and the day to-day operational, financial and liquidity challenges faced by hospitals. He has expertise in Optimizing and streamlining stock and consumables in hospitals. Having strong passion on inventory control, he has successfully implemented control systems in corporate hospitals.

Medical tourism could be defined as ‘activities related to travel and hosting a foreign tourist who stays at least one night at the destination region for the purpose of maintaining, improving or restoring health through medical intervention’. The tourists could be broadly classified into 3 categories. Patients visiting for curative purposes like cardiac surgery, transplant, gastro procedures etc. Another group of patients visiting for rejuvenation or life style modification, stress relief etc seeking proactively to maintain and improve their health and wellbeing. Third group of patients visiting for traditional systems of medicines or technically termed as alternative medicine like AYUSH. Medical tourism is renamed as Medical Value Travel (MVT) as it captures patients’ healthcare seeking behaviour as well as the wider economic impact of such travel on nations hosting them.

There are many strengths due to which patients prefer India as their medical destination. State of the art medical facilities, globally trained medical professionals, cost of treatment and savings when compared to home country, less waiting time for procedures, availability of national and international accredited hospitals (India boasts 39 Joint Commission International (JCI) accredited and 657 National Accreditation Board for Hospitals & Healthcare Providers (NABH) accredited hospitals), availability of alternative medicines, combined with tourist destination after treatment etc. While these are the strengths, there are few weaknesses also. Lack of government regulations, lack of recognition of NABH in other countries, lack of uniform pricing policy with hospitals, unorganised facilitators, lack of portability of insurance policy etc.

Medical tourism insurance is a specialized type of insurance that provides coverage for patients who travel to another country for medical treatment. It covers various aspects of the medical journey, including pre-travel medical consultations, medical procedures, and post-treatment follow-up care depending upon the type of insurance the patient chooses. Some of the governments and MNCs offer cross-border coverage to support their expatriate. This has made life much easier for people travelling, working, studying, and residing abroad and provided options for patients facing long waiting times at home or suffering from rare diseases.

The cost benefit for treatment in India is the most powerful driving force for the insurance companies to promote medical tourism. Few insurance companies are in the forefront and aggressive in promoting medical tourism such as International SOS, Asia Rescue, Indus Health Plus etc. Apart from this, many governments have tied up with specific insurance companies to take care of their patients. For example, Government of Maldives offers a health plan through Aasandha Insurance while Government of Kenya offers a health plan through National Health Insurance Fund-NHIF.

Indian government has eased out the visa facilities to many countries to promote medical value travel in India.

Indian government has eased out the visa facilities to many countries to promote medical value travel in India. As per the government guidelines, healthcare providers cannot perform a surgical procedure, if the patient has obtained tourist visa. With this, only medical management can be carried out. Only after converting to medical visa, the required surgical procedure could be done. The medical visa issued by the Indian government can be extended over a period of one year. This enables the patients to visit 3 times in a year and one attender is also allowed to accompany the patient. Before doing a procedure, all legal formalities need to be completed by the hospital management.

It should be in a written form and should have been explained by the licensed professional, the actual risks and benefits of the procedure in the language of the patient’s primary language. India has a robust legal framework governing organ transplantation to ensure ethical practices and prevent organ trafficking. Hospitals need to adhere to the Transplantation of Human Organs and Tissues Act, 1994. Before traveling overseas for medical treatment, it’s essential to familiarize with any legalities of the country to be travelled. If, for example, anybody is seeking out an abortion in the Middle East, it would be out of the question as abortion is illegal there. It is important to respect other countries' cultures, laws, and traditions.

"A person’s cultural affiliations can impact everything from where and how they seek care to how they describe symptoms and whether they follow care recommendations."

Cultural competence plays a critical role in practising medicine as it is creating a feeling of safe and sheltered. This will have a free flow of communication enabling healthcare providers to collect accurate medical information. This also develops a two-way trust between the patient and the service providers. This gives a sense of security and safety which reduces patients’ stress and make feel at ease. A person’s cultural affiliations can impact everything from where and how they seek care to how they describe symptoms and whether they follow care recommendations.

A matured or culturally competent system will provide care to patients with diverse values, beliefs, behavior and make the service providers to deliver quality care, irrespective of a patient’s cultural history. The policies, procedures and system need to be built in to support cross cultural interactions. Failure to address cultural, language, or health literacy discrepancies, can result in things like diagnostic errors, missed screenings, unexpected negative reactions to medication, and inadequate follow-up care. In case of language barrier, it is better to have an interpreter to be with them exclusively.

Medical tourism is also having few obstacles and risks. It is always advisable to do some initial search about the surgeon/physician, nursing service and quality certification of hospital, irrespective of the procedure planned to do. The post operative care and ICU care is very vital and hence research should include this also. Can get firsthand experience from patients already got treated at home town.

In spite of having insurance coverage, without having sufficient liquid financial arrangement for any unexpected incidents, it is not advisable to choose medical tourism. Mentally prepared for unplanned illness due to change of climate, water, food etc. Before planning for a medical trip, it is better to consult doctor at home country and get his advice. In case of a need, the treating doctor can talk to the doctor at home country for history and post operative care instructions.

Around 2 million patients visit India each year from 78 countries for many low ends to highly specialised treatments. This generates $6 million for the healthcare industry, which may likely to touch $13 billion by 2026. As per the Medical Tourism Association, India is in the 10th rank in Medical Tourism Index (MTI) for 2020-21 out of 46 destinations of the world. 80% of the Asia’s medical tourism market is captured by Thailand, Singapore and India followed by South Korea and Malaysia. Many of the Indian hospitals have created infrastructure to handle medical tourism patients seamlessly.

They have created MVT blocks to have everything under one, so that these patients need not have to shuttle here and there for their needs. The way investments made for technology, hiring of specialized talents, quality improved care, improved infrastructure with cheaper cost of treatment by the Indian healthcare providers, will bring more and more business to India and very soon India will improve its ranking in the global scenario.