New Study Sparks Debate on Medical Travel

Published July 1, 2008

While some estimates of medical tourism have been quite high, suggesting in some cases that millions of people travel for medical purposes, a study released by consulting firm McKinsey & Company finds the number to be much lower, just 60,000 to 85,000 people worldwide each year.

Health policy analysts have questioned the study’s assumptions, however, and even the lower numbers show the search for quality health care has become an international quest.

Tighter Definition

“These smaller numbers hinge in part on our strict definition of medical travelers,” explained Ceani Guevera, a consultant for McKinsey & Co. “We counted people whose primary and explicit purpose in traveling is medical treatment in a foreign country.

“We excluded from our study patients who receive care on an emergency basis, such as ordinary tourists who become sick; wellness tourists, meaning people who travel for massages or acupuncture; and expatriates seeking care in their country of residence,” Guevara continued. “We also excluded patients who travel in largely contiguous geographies to the closest available care, because they don’t consider other medical-travel destinations and the financial burden is minimal.”

McKinsey used data from nearly 50,000 patients who frequented more than 20 medical travel destinations in 20 countries. The study looked only at procedures done in hospitals; travel to private practices or dental offices was not included.

Many industry observers find McKinsey’s definition of medical tourism and resulting estimates to be faulty because they exclude the procedures most medical travelers actually seek to have performed. Some industry officials choose not to make any estimates precisely because of the lack of an agreed-upon definition for medical travel and medical tourism.

‘Lack of Knowledge’

“I don’t find the numbers to be that much based in reality because there is no standardization to work with,” said Renee-Marie Stephano, chief operations officer for the Miami-based Medical Tourism Association. “For an outside third party to come in and take samplings here and there and define it in the way that they did doesn’t really cover the bulk of what we are doing in the industry. Just the fact that they say that dental and cosmetic surgery is not a large portion of medical travel or tourism shows their lack of knowledge of the industry. Those numbers are more significant than they are reporting.

“Outpatient surgeries and one-day procedures should also be counted because that is the bulk of what people are doing, while sometimes incorporating a bit of a trip out of it,” Stephano continued. “We count wellness exams and Eastern medicine, like acupuncture, and that is what people who build offshore facilities build their business plans on. McKinsey’s definitions are a little skewed and are not consistent with what many of us use in the industry.”

According to Stephano, the Medical Tourism Association defines medical travel simply as leaving one’s home country to go to another to receive medical treatment. Medical tourism is defined as medical travel plus the element of tourism either before or after said treatment.

Multiple Factors

McKinsey also investigated consumers’ motives for medical tourism, finding five main reasons for the practice: more technologically advanced care, better quality of care than is available at home, better overall quality of care, quicker access to medically necessary procedures, and lower costs.

Seeking lower costs represented only 13 percent of the motivating factors for medical tourism. Seeking the most technologically advanced care and better quality were the two most popular reasons.

McKinsey found only 5,000 to 10,000 Americans take part in medical tourism. In time, however, the firm predicts the numbers could reach as high as 710,000.

Stephano agreed the numbers of Americans taking part in medical tourism could rise, citing increased competitive costs and transparency in pricing as prime factors in the trend.

Study Called Harmful

Stephano says McKinsey’s report probably did the industry more harm than good.

“I walked away feeling a bit starved from what it was hyped to be,” said Stephano. “For the professionals who are looking at medical travel as a business opportunity, like Johns Hopkins and the Mayo Clinic who already have facilities overseas, this report is disappointing.

“The foreign governments that are changing the entire branding of their country to include health care as a marketing component are disappointed in this report,” Stephano said. “If there was nothing to medical travel and tourism, these institutions wouldn’t to be making changes to accommodate it.

“I don’t think the report showed what is really going on in the global market of health care,” Stephano continued. “I think we still have a lot to wait for in terms of the economic aspects of this movement. I just don’t think they covered enough providers, nor did they provide a list of the providers and geographies they covered, so how can we use this information constructively or see it as truly valid?”

Aricka Flowers ([email protected]) writes from Illinois.

For more information …

“Mapping the Market for Medical Travel,” The McKinsey Quarterly, McKinsey & Company: