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‘Health is wealth’ medical tourism industry in india the new revenue generat

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  • 1. International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 4, Issue 4, July-August (2013) 141 ‘HEALTH IS WEALTH’: MEDICAL TOURISM INDUSTRY IN INDIA - THE NEW REVENUE GENERATOR Prof. SHRADDHA CHOWDHARY Professor, Department of Business Management, Kasturba Gandhi College, Secunderabad, INDIA, ABSTRACT We have all grown up hearing “Health is Wealth” but today the same preaching holds good as the Health Industry in India witnesses enormous growth and has become a big revenue generator thus attempting to create wealth for the nation especially during the times when the dollar is overpowering the rupee. The cost effectiveness of medical treatments in India without a compromise on the quality & standards has led to the growth of Medical or Health Tourism industry in the Country. India has long been known all over the world for the best medical and healing solutions, this has contributed to large inflow of foreign medical tourists to India to explore the fast and convenient Health Tourism services. It has been a tradition in India to consider guests as incarnations of God (atithi devo bhava) and are given prime importance, so the treatment offered to such tourists is definitely par excellence. Indian Medical Tourism aims to help tourists who visit India for any kind of medical treatment, be it organ transplant, dental treatment, implants, joint replacements or surgeries by organizing hassle free health travel and health treatment for them. India has always had well qualified, competent doctors in each and every specialization, and this fact has now been realized world over. India’s world class Medical Facilities with most competitive charges for treatments, has made India a very lucrative destination for people wanting to undergo treatment for any ailment. This Paper attempts to study the factors that have initiated the growth of Medical Tourism in India and what needs to be done to over come the obstacles faced by this Industry in order to keep this industry growing in the years to come so as to make Health a contributor to Wealth in India. Medical Treatment in USA / Europe = A Leisure holiday to India + Advanced Medical Treatment + Huge Savings INTERNATIONAL JOURNAL OF MANAGEMENT (IJM) ISSN 0976-6502 (Print) ISSN 0976-6510 (Online) Volume 4, Issue 4, July-August (2013), pp. 141-148 © IAEME: www.iaeme.com/ijm.asp Journal Impact Factor (2013): 6.9071 (Calculated by GISI) www.jifactor.com IJM © I A E M E
  • 2. International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 4, Issue 4, July-August (2013) 142 Key Words: Health/Medical Tourism, Wellness tourism, Tourism, Alternate Medicine I. INTRODUCTION The number of Foreign Tourists Arrivals (FTA’s) to India has been on the rise over the years. It was 2.37 million in 1997, whereas in 2012 this figure of FTA’s rose to 6.58 million. The Foreign Exchange Earnings (In US $ million) from Tourism in India increased from 2889 in 1997 to 17737 in 2012. Tourism in India has been a very good revenue generator over the years. The Foreign Exchange Earnings (FEE) increased from 10511 Crores in 1997 to 94487 Crores in 2012. The number of Foreign Tourist Visits to Indian States and UT’s increased from 5.50 Mn in 1997 to 20.73 Mn in 2012. With the current appreciation of US Dollar, the inflow of Dollars into our economy in the form of Tourism will result in being very beneficial for the growth of our Economy. Tourism Industry as a whole and Medical Tourism in particular will prove to be a good revenue generator in times to come. II. MEDICAL TOURISM Medical Tourism can be broadly defined as provision of cost effective private medical care in collaboration with the tourism industry or patients needing surgical or other forms of treatment which requires specialized means. Now-a-days medical treatment with vacation is on the rise, tourists prefer to combine leisure with medical treatments. Stages in Medical Tourism: The flow of activities in Medical Tourism is in a regular pattern which can be categorized as Pre, Actual and Post Procedure stage. The factors considered in each of these stages are as follows: Pre Procedure Stage: In this first stage the tourist is typically engaged in navigating the process and arriving at a decision to buy the procedure. However, given the complexity many customers prefer to use services of a medical intermediary, which could be an individual or company who is supposed to seamlessly coordinate the outbound medical tourism programme. Medical facilitators are intermediaries that guide the use of medical tourism for patients and makes the services more convenient and much quicker than the tourist organising these on his/her own. They offer single window solutions to the customers. Long before the actual medical procedure/ treatment, a customer must decide about a number of important factors, like the choice of medical intermediary, which hospital to be treated in, the doctors, which country to go to for obtaining
  • 3. International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 4, Issue 4, July-August (2013) 143 treatment, costs to be incurred, risks involved, etc. not in the same order though. Pre procedure stage typically ends with patient reaching the destination. Procedure Stage: This is the key component of the medical tourism value chain. Procedure stage begins with patient reaching the destination and hospitals/ service providers offering pickup facilities followed by pre-counselling for treatment, necessary medical examinations required before the medical procedure. Medical procedure includes preparing for the procedure, organising a doctor and para medical team, planning the time of the procedure, operating theatre, prosthesis, medical supplies needed, and the procedure itself. Post Procedure Stage: Post procedure stage has two important components the post operative care and follow-up care. Follow-up care usually includes visits of Doctors and monitoring for any possible complications, getting back to normal in the Hospital, the various physical therapies involved, medical supplies, meals, post operative recuperation in destination country but outside the hospitals, etc. A medical Tourist is concerned about the follow up care facilities long after they have left the country of treatment. Normally there is a tie-up between the medical service providers and doctors in the patient’s country who are responsible for follow up on behalf of the service provider. After the post operative care when the tourist is fit to move around, he/ she may demand post treatment leisure as a part of the package. III. MEDICAL TOURISM IN INDIA "The one land that all men desire to see and having seen once, by even a glimpse, would not give the glimpse for all the shows of all the rest of the globe combined" - Mark Twain for India Medical/ Health/ Wellness Tourism is a developing concept whereby people from around the world visit India for their medical and recreational needs. Common treatments which people fly to India for are heart surgery, cosmetic procedures, hip and knee replacements, and dental treatments. India is considered as a favourable destination because of its infrastructure and technology which is at par with that of developed countries like America, England and Europe. India has been listed as a favourable destination by leading consultant McKinsey which revealed that medical tourism in India could become a US $2 billion industry by 2012 (from US $350 million in 2006). Similarly, a study by Credit Suisse, FICCI-Ernst and Young, estimated medical tourism to be growing at 25-30% annually primarily due to: the low treatment cost in India (20 % of the average cost incurred in the US, Singapore, Thailand and South Africa); rising consumerism; globalization and changing lifestyles (AHEL, 2009). Factors such as low cost, advanced technology, efficient post operative care provided in the country adds to its attractiveness as a medical tourism destination. A. BENEFITS OF MEDICAL TOURISM IN INDIA Cost –The most important factor which a Person focuses on for medical tourism is “Cost”. By getting treated in India tourists save a considerable amount on medical treatments. Anonymity - Some individuals like the fact that they can go on "vacation," and keep their identity confidential back home if needed based on the kind of surgery or procedure required. Value Added Vacation - Patients can enjoy tourism as a part of medical treatment. No Wait Times - Many patients in developed countries with national healthcare face long wait times for surgeries, where as medical tourism in India, helps patients to bypass long wait times. India has over 1 lakh of skilled physicians and nurses and medical practitioners. The economic boom in India over the last two decades has led to the building of medical facilities & infrastructure comparable and sometimes even better than the western counterparts. A large number of Doctors practicing in these hospitals and clinics have returned to India leaving behind successful practices in U.S.
  • 4. International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 4, Issue 4, July-August (2013) 144 and Europe. With the highest levels of service, facilities, and professional skills India is considered as a mainstream option for surgeries and treatments for any kind of medical complexities, whereas, other countries are considered a good destination only for small, less-complicated surgeries. A complicated transplant or bypass procedure can be achieved for a tiny fraction of the cost as compared to the same procedure in the U.S. YEAR No of FTA's % Change from Previous Year Foreign Exchange Earnings (In US $ Mn) % Change from Previous Year 2008 5.28 4 11832 10.3 2009 5.17 -2.2 11136 -5.9 2010 5.78 11.8 14193 27.5 2011 6.31 9.2 16564 16.7 2012 6.58 4.3 17737 7.1 Source: Ministry of Tourism. B. COMPETITIVE ADVANTAGE: INDIA The source of competitive advantage for India arises from the skillful use of its core competencies that are used to gain a competitive advantage against rivals in the global market. Various factors have added to the competitive advantage and has led to the recent increase in popularity of healthcare tourism in India. Certain factors of the Healthcare Industry in India which helps it to standout in comparison to other Countries are: Affordability: India offers world-class healthcare that costs substantially much less than those in countries which are more developed than India and with the use of similar technology as used by competent medical-care specialists of developed nations. India is now being recognized world over for possessing skilled medical practitioners in almost every field of medicine. Because of these reasons India is now considered a great option for Medical Tourism for cost effectiveness, a skilled team of Doctors and the availability of advanced medical technology. Medical Cost Comparison between India and United States Procedure United States (USD) Approx India (USD) Approx Bone Marrow Transplant USD 2,50,000 USD 69,200 Liver Transplant USD 3,00,000 USD 69,350 Heart Surgery USD 30,000 USD 8,700 Orthopedic Surgery USD 20,000 USD 6,300 Cataract Surgery USD 2,000 USD 1,350 Smile Designing USD 8,000 USD 1,100 Metal Free Bridge USD 5,500 USD 600 Dental Implants USD 3,500 USD 900 Porcelain Metal Bridge USD 3,000 USD 600 Porcelain Metal Crown USD 1,000 USD 100 Tooth Impactions USD 2,000 USD 125 Root Canal Treatment USD 1,000 USD 110 Tooth Whitening USD 800 USD 125 Tooth Colored Composite USD 500 USD 30 Fillings / Tooth Cleaning USD 300 USD 90 Source: India Travel Destination by Beachcomber Tours & Travel India Pvt Ltd
  • 5. International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 4, Issue 4, July-August (2013) 145 Medical Cost Comparison between India and United Kingdom Procedure United Kingdom (USD) Approx India (USD) Approx Open Heart Surgery USD 18,000 USD 4,800 Cranio-Facial surgery and skull base USD 13,000 USD 4,500 Neuro- surgery with Hypothermia USD 21,000 USD 6,800 Complex spine surgery with implants USD 13,000 USD 4,600 Simple Spine Surgery USD 6,500 USD 2,300 Simple Brain Tumor -Biopsy - Surgery USD 4,300 $ 10,000 USD 1,200 $ 4,600 Hip Replacement USD 13,000 USD 4,500 Source: India Travel Destination by Beachcomber Tours & Travel India Pvt Ltd There is no compromise on quality in the medical services provided in India and also this World class quality can be achieved at a third World price. The costs of medical treatment in India comes at only 1/10th of the total cost of treatment in the developed Countries. The cost of recreational facilities like traveling, sight-seeing, shopping etc are also very low in India and now with devaluation of the rupee its even more affordable. India has also gained popularity in fields like Dentistry, cosmetic surgery, joint care, cardiac care etc. India is known for its Hospitality and the foreign currency exchange procedures are also simplified for the medical tourists. Resource Availability: Indian medical education churns out around 30,000 doctors and nurses every year adding to the existing pool of over 14 lakh medical fraternity. Over a dozen corporate hospitals provide world class treatments across all specialties. There are over 15,000 hospitals and 870,000 hospital beds that gives adequate infrastructure support to the medical tourists visiting India for health services. Reputation: India has a large number of hospitals offering world class treatments in almost every medical sphere ranging from cardiology, cardiothoracic surgery, hip and knee replacement, other orthopedic surgery, ophthalmology, gastroenterology, transplants to urology. It also offers specialized treatments under oncology, neurology, neurosurgery, ophthalmology, endocrinology, ENT, rheumatology, pediatric surgery, pediatric neurology, nephrology, urology, dentistry, dermatology, gynecology, plastic surgery, psychiatry, pulmonology, general medicine & general surgery. The success rate of treatment in each of these areas also has been pretty good, because of this reliability factor the number of foreigners coming to India for medical purposes has increased over the years. Alternative forms of Medicine: Alternative medicine is any practice that is put forward as having the healing effects of medicine but is not based on evidence gathered using the scientific method. Kerala for ayurveda and Kairali massage, Uttarakhand for yoga and meditation, Goa for holistic living, Rajasthan for spas and heritage living, are some of the world-renowned places in India for alternative medicine. The various forms of Alternative therapies followed in India which have gained popularity world over are: Ayurveda Therapy: Ayurveda which is over 5,000 years old is believed to completely cure illness that cause imbalance in the human body. Ayurveda makes use of simple treatment procedures like meditation, nutrition counseling, massage, natural medications made with herbs and similar kinds of methods. Naturopathy: Naturopathy is a mix of various kinds of natural therapies and other such healing methods. These procedures have been carried over generations and are based on the knowledge of the ancient and modern science. It is believed that natural healing comes from
  • 6. International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 4, Issue 4, July-August (2013) 146 within the body itself as the main cause of every disease is a violation of the law of nature and hence cure too can be found within nature. Homeopathy: Homeopathy is a medical system which puts into use extremely small doses of natural substances (remedies) in order to bring in stimulation in the immunity system of the patient. There are certain symptoms which are addressed by homeopaths in infants and other kinds of birth or childhood diseases, apart from fatigue, allergies, infections, and chronic illnesses like asthma and arthritis. Unani Therapy: In Unani treatments plants and herbs are used to cure ailments. It offers cure for a number of diseases like jaundice, elephantiasis, sinusitus, leucoderma, rheumatism, etc. Yoga and Meditation Therapy: Yoga has been derived from Sanskrit word 'Yuj' that means 'to unite', it is the unity of the mind, body and the soul. Meditation and Yoga are known as a great way of achieving enlightenment and also one of most well-known widely practiced form of alternative therapies all over the world. All kinds of diseases both physical and mental are cured with Yoga. One can avoid numerous troubles like hypertension, irritable bowel syndrome, diabetes, hyperventilation, heart conditions and many more through the regualr practice of yoga nad pranayam. Diversity of Destinations: Leisure tourism is already very much in demand in India as the country offers diverse cultural and picturesque beauty. India caters to the likes of almost all tourists with its high mountain ranges, beautiful beaches, places of historic importance, religious places etc, and is also recognized world-wide for its hospitality. India being a subcontinent is home to many cultures, languages, delectable cuisines, people, religions etc, which is spread across its length and breadth. A medical tourist can plan a recreational tour of this historic country before or/and after the medical procedure. Promptness: In many countries, such as the UK and US where the flow of patients is very high, patients are made to wait for long in order to obtain medical treatment. In India, as guests are given utmost importance, they can have access to medical treatment with much more ease and in much lesser time. It is the shorter time lags involved with medical treatment in India that acts as a major competitive advantage. C. THREATS TO MEDICAL TOURISM IN INDIA Most of the foreigners who are treated in India hail from countries in Asia, Africa or the Middle East, where there is a scarcity of top-quality hospitals and health professionals. Though patients from the US and Europe still are relatively rare not only because of the distance they must travel but as hospital executives acknowledge, it is also due to India continues to suffer from an image of poverty and poor hygiene that discourages many patients. The following are some of challenges of fast pacing medical industry in India: Lack of initiative: The Government of India has not taken much initiative to promote Indian Medical Tourism globally. The investment made in the Health care segment also has not been adequate. India still has not been able to reach it’s full potential in this Industry in spite of being world renowned for the services it has to offer. Poor Coordination: The various operators in this Industry are Hospitals, Airlines and Hotels do not coordinate their activities according to the needs of Medical tourists. Even if there are many tourists wanting to come to India for purposes of leisure and medical treatment there are either no proper tickets available or not enough hospital beds or lack of proper facilities in Hotels. Perception about our Country: Tourists perceive India as unhygienic with poor sanitation and drainage system. Basic amenities such as drinking water, waiting rooms and toilets, first aid, cafeteria, lounge and parking facilities among others needs to be improved to meet the requirement of the tourists travelling to India.
  • 7. International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 4, Issue 4, July-August (2013) 147 Lack of proper Regulations: The visa procurement procedure is often very cumbersome for India. The pricing policies across hospitals are also not uniform hence, variances in prices and reasons behind it could lead to dissatisfaction. Dominance of Private Hospitals: Most of the Hospitals catering to the Medical Tourism needs belong to the Private sector. There are growing accusations that profit oriented private-sector medical tourism is drawing medical resources and personnel away from the local population. This has been seen as a threat by Government Hospitals and the local Public which feels that medical treatment at private hospitals has become way beyond their reach though Foreigners might find in affordable. Legal Issues: Most of these issues arise because of restrictions in Insurance guidelines. Overseas medical care is not covered by many insurance players that leads to hassles in bill payment and Insurance Claim clearance procedures. Most of the countries that offer medical tourism have weak laws for any kind of malpractice, hence the patient has very little recourse to local courts or medical boards if something goes wrong. Security and Competition: Terrorist attacks or political unrest, lack or safety for women in different parts of the country have adversely affected sentiments of foreign tourists. In addition, insurgency in different parts of the country also mars India’s image as a safe destination. Hence, Foreigners are preferring to visit countries like Thailand, Malaysia and Singapore for Medical treatment which are also medically well advanced and equally affordable. If India as a Brand is not promoted effectively we might lose out due to this competition. IV. FUTURE OF MEDICAL TOURISM IN INDIA The growth of Medical Tourism in India is expected to witness an upward trend in the Future. It has been observed that the number of Tourists visiting India has been on the rise mostly due to the rise of the dollar and devaluation of the rupee that has made medical tourism to India more affordable for foreign tourists. The travel and tourism demand is expected to reach US$ 266.1 bn (14,601.7 bn) by 2019. During 2004–2009 travel and tourism demand in India increased at a compound annual growth rate (CAGR) of 16.4% to US$ 91.7 bn (4,412.7 bn) and foreign exchange earnings from tourism increased ~13% to US$ 11.39 bn. The number of U.S. patients seeking medical care abroad has declined from 750,000 in 2007 to 540,000 in 2008. An increase of airline transportation costs may be another factor contributing to the reduction in U.S. patients traveling for healthcare and the rate at which foreigners are traveling to the U.S for medical care (Deloitte 2009). Measures to Foster the Growth of Medical Tourism in India: The biggest challenge is to position India as a favorable healthcare destination by setting high health standards and to work hand in hand with the government and the medical council to insure that all hospitals keep up the standards. The Indian healthcare federation now is working along with different industry chambers to promote medical tourism in the country. The following steps can be taken to improve the existing medical tourism segment and also to help it grow leaps and bounds in the future: Create Information outlets in all possible markets through road shows, Brochures, Dedicated Exhibitions in International Travel Expos etc. Indian healthcare industry should work more closely with the industry chambers and various government departments to spread the awareness about Wellness Tourism and remove any hurdles. Tourism Ministry should take initiatives to promote health Tourism and also focus on Fiscal incentives to be provided for improving this segment. Efforts should be made towards getting International accreditation and FDI for various hospitals to build up perception of quality among foreign tourists.
  • 8. International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 4, Issue 4, July-August (2013) 148 Focus should be on building “Brand India” through proper Promotion and Marketing Strategies by developing physical infrastructure in India with good roads, hospitals, hotels, good sanitation and drainage system throughout the country. Stringent laws and quick punitive action must be taken against any flaws in Safety and Legal matters so as to provide an easy interface for tourists to resolve their problems. V. CONCLUSION The growth of Medical Tourism in India is expected to witness an upward trend in the Future. It has been observed that the number of Tourists visiting India has been on the rise mainly now due to the rise of the dollar and devaluation of the rupee that has made medical tourism to India more affordable for foreign tourists. World-class treatment & highly advanced healthcare infrastructure already present in India must be wisely used to help revive the falling Rupee by concentrating on one of its high potential Health Tourism Industry. Strong academic & research base & a booming healthcare industry in India contributes towards a world class medical force including Physician’s, Surgeon’s, paramedical staff and nurses. India’s medical fraternity boasts of a highly intellectual resource pool skilled & qualified professionals. (10% Doctors in USA are Indians). Low operating costs, high resources & highly qualified English-speaking manpower have made India the hub for Research & Development as well as clinical trials, thereby contributing primarily to the healthcare infrastructure. In a bid to attract large number of medical tourists the government of India has taken substantial steps to improve the quality standards of the health care services in India, but the GOI must further enhance its health tourism services united with all the agencies involved in order to generate wealth through this booming health Industry. BIBLIOGRAPHY Websites 1. ICRI. Medical Tourism. What is Medical Tourism? 2. Overseas Indian Felicitation Centre (2011), Tourism Industry of India. 3. Neeraj.V.S.Neeni (2010), Health Tourism. A boon or Curse? 4. Indian Institute of Travel and Management,. A study of problems and challenges faced by medical tourists vising india. Journals 1. Shaik Shahzadi Begum, (2012), Medical and Wellness Tourism: Opportunities and Challenges- Marketing “Brand India”. 2. Dr. Shishupal Singh Bhadu, (2011), Opportunities and Challenges of Medical and Health Tourism- Creating a Brand of Alternative Tourism in India. 3. C.B. Venkata Krishna Prasad. Medical Tourism Industry- Advantage India. 4. Ayan Chattopadhyay and Arpita Banerjee Chattopadhyay, “Healthcare Management Status of Indian States – An interstate Comparison of the Public Sector using a Mcdm Approach”, International Journal of Advanced Research in Management (IJARM), Volume 3, Issue 2, 2012, pp. 11 - 20, ISSN Print: 0976 – 6324, ISSN Online: 0976 – 6332. 5. Ramesh U and Kurian Joseph, “The Holistic Approach of Ayurveda Based Wellness Tourism in Kerala”, International Journal of Advanced Research in Management (IJARM), Volume 3, Issue 2, 2012, pp. 29 – 39, ISSN Print: 0976 – 6324, ISSN Online: 0976 – 6332. Books 1. John Connell, (2011),. Medical Tourism, CABI. 2. Dr. R.Kumar (2008). Medical Tourism in India: Management and Promotion. Deep and Deep Publications Pvt. Ltd.

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