Medical tourism research_and_survey_report_by_dr_prem_jagyasi

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The medical tourism is going through exciting phase where alongside of international activities, more intra-regional travels are taking places in this sector of the health market. The responses …

The medical tourism is going through exciting phase where alongside of international activities, more intra-regional travels are taking places in this sector of the health market. The responses received clearly revealed that there is an overwhelming perception among the industry leaders that there is so much more that can be achieved within this sector. However, there are challenges, which require immediate attention of industry stakeholders.

An overwhelming majority of the respondents felt that there was great deal of potential for medical tourism that at present remains untapped, with the perceived major concern being one of complications following treatment. Confusion and a lack of information were also cited here as being factors and one particularly significant finding was that only 8% of respondents believed that there was a perception that health tourism offered no benefits at all.

The perceptions from the respondents were that participants who actively engage in medical tourism do so primarily because of an economic standpoint, with additional important factors being that they can access a treatment that may not be available in their home countries, or if available, there is an unacceptable delay involved before being able to receive it.

The most popular destinations were believed to be those in the Far East and Asia, with the U.S. coming in at number four - an unexpected finding that could mean that there are good opportunities for this country to create inbound medical tourism. Malaysia, Germany, Mexico, South Africa, Brazil and Costa Rica also made to list of top ten destinations. The quality of healthcare services at a destination is deemed to be of supreme importance.

It is clear from the replies that the respondents believe that the role of facilitators in medical tourism is significant; with 88% agreeing that they were ‘important/very important.’ It is the compiler’s overall conclusion (based on the survey findings) that the main key to increasing the uptake of primary medical tourist services is to successfully overcome the confusion, lack of accessible information and fear about healthcare services in other countries. Medical tourism facilitators are in a prime position to do this by utilizing their expertise in this area and harnessing their knowledge to media or public information programs to demystify aspects of the sector

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  • 1. Medical Tourism Research & Survey Report A report into a survey aimed at medical tourism professionals regarding status, trends, terms, opportunities and challenges of the medical tourism industry with analysis by renowned medical tourism industry expert. Research, Compilation and Commentary By Dr Prem Jagyasi Chartered Marketing Consultant Medical Tourism Consultant Medical Tourism Research & Survey Report by Dr Prem Jagyasi, ExHealth | www.ExHealth.com | www.DrPrem.com Page 1
  • 2. Content Foreword 3 Executive Summary 4 Background & Methodology Survey Questions Survey Compilation Industry Terms 7 Medical Tourism… old concept, new buzzword 8 Medical Tourism – Past, Present & Future Trends 9 Decision Factors 10 Medical Tourism Destinations 11 Issues Related to Medical Tourism Growth 13 Concerns for Consumers 14 Role of Facilitator 15 Conclusion 16 About the Researcher 17 About ExHealth 18 Disclaimer & Important Note: ©Dr. Prem Jagyasi 2010. All rights reserved. Please do not copy, amend, reproduce or transmit this document in any form without prior permission in writing from Dr Prem Jagyasi. The opinions contained within it are the author’s own and he accepts no liability or responsibility in any way from conclusions drawn. Medical Tourism Research & Survey Report by Dr Prem Jagyasi, ExHealth | www.ExHealth.com | www.DrPrem.com Page 2
  • 3. Foreword Travelling abroad to receive medical care is becoming an increasingly popular trend and is a phenomenon that is rapidly developing into a thriving healthcare industry. Patients are more than ever availing themselves of high quality, affordable and easily accessible health related services found outside of their home country’s borders. Both patients and destinations are benefitting from this, with the patients able to receive timely care at reasonable prices without compromising on the quality of their treatment and the destinations generating revenue from supplying the services that the health tourists utilise. The purpose of this survey is to communicate expert views on aspects of medical tourism, as there are many issues relating to it that are frequently flagged up by industry professionals and require attention. These concern the industry’s status, its terms, trends, opportunities, challenges and potential for improvements. As an example, 94% of those surveyed agreed that the industry has yet to reach its full potential, so it is vital to address the important issues act as barriers to its growth. It is intended that the knowledge gleaned from the survey will be utilised to inform interested parties about the latest trends and developments in the field. The survey was also formulated with the aim of understanding of current topics, which will provide important content for a forthcoming guidebook on medical tourism. This consumer-dedicated publication will provide valuable information for those wanting to know more about medical tourism and will hopefully give the medical tourism industry a significant boost that will help it to realise its full capabilities. We are grateful to all of the experts, industry professionals and other valued responders who took time to complete the survey questionnaire. In doing so, they provided significant insights into current issues associated with medical tourism. We are hopeful their contribution will play an important role towards the growth of the industry. Special thanks go to Steve Bannister for his valuable support. Dr Prem Jagyasi Chartered Marketing Consultant | Medical Tourism Consultant MD & CEO – ExHealth, Dubai Healthcare City, UAE Honorary Chief Strategy Officer – Medical Tourism Association, USA Medical Tourism Research & Survey Report by Dr Prem Jagyasi, ExHealth | www.ExHealth.com | www.DrPrem.com Page 3
  • 4. Executive Summary One definition of medical tourism could be; “the set of activities in which a person travels often long distance or across the border to avail medical services with direct or indirect engagement in leisure, business or other purposes.” There are several synonyms accepted across the globe for medical tourism, with the most prominent being ‘health tourism,’ medical travel,’ healthcare travel,’ global healthcare’ and ‘value medical travel.’ In this document, we have used the term ‘medical tourism’ throughout to refer to the industry. Medical tourism services can be described as being ‘inbound.’ i.e. they refer to the services provided by the recipient country, or they can be termed as ‘outbound,’ meaning that they relate to activities that take place in the patient’s country of origin. Background and Methodology This document is combination of survey report and intense research done by ExHealth Team over six month period. The survey results are presented as summary and research results are presented in analysis and/or commentary. The Survey The survey is responded by 95% professionals closely involved with the medical tourism industry, the purpose of this survey is to gain insights into aspects of experts, with the knowledge gleaned being utilised to inform interested parties about the latest trends and developments in this specialised field. The survey was conducted on-line during July 2010. The survey was designed to have an international reach and was sent to parties in North America, South America, Africa, Europe, the Middle East and Gulf regions, Asia and the Far East. Medical Tourism Research & Survey Report by Dr Prem Jagyasi, ExHealth | www.ExHealth.com | www.DrPrem.com Page 4
  • 5. The Research The research was conducted by ExHealth, an independent healthcare media and marketing organisation based in Dubai Healthcare City, Dubai, UAE and was completed under the supervision of Dr. Prem Jagyasi, a renowned medical tourism consultant, who has visited more than 20 countries and spoken at 30 international congresses throughout the course of his involvement in this sector of the healthcare industry. Dr. Jagyasi has published numerous articles on medical tourism in international publications. Survey Participants The survey format was a qualitative one and in total, 159 valid responses were received. The survey was sent to medical tourism professionals and 95% of the respondents evaluated themselves as being closely involved with the medical tourism industry directly or indirectly, such as having a background/experience in either healthcare, insurance, tourism, facilitation or media services in relation to the industry. Respondents were asked to class themselves into one of three categories, with 84 identifying themselves at the ‘Senior/Top/Consultant/Expert Level’. This number equates to 63% of the respondents. Forty-two (42) of the respondents categorised themselves as being at the ‘Manager/Middle Level,’ a number equating to 31%. Seven (7) of those who replied placed themselves in the ‘Junior Level’ category, a figure which corresponds to 5%. Not every respondent gave replies to all of the questions/statements. 95% surveyed were involved in the Medical Tourism Industry • 63% - Senior/Top/Consultant/Expert Level. • 31% - Manager/Middle Level • 5% - Junior Level Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 5
  • 6. Survey Questions The survey asked for responses to questions/statements and was designed to elicit levels of comprehension and opinions from industry professionals on various aspects of medical tourism. The topics that were covered included perceptions over preferred countries, reasons for travel, challenges to the industry and what are the essential components of a good medical tourism destination. The contacts were also asked if they were interested in contributing to the aforementioned medical tourism guide, which is currently being compiled. The questions contained within the survey were developed over a six-month period and based on intensive research. The survey’s remit was primarily to gauge attitudes and opinions and was not designed to comprehensively cover all aspects of medical tourism. The questions were formulated to elicit answers that would reveal the respondents’ perceptions and opinions about the medical tourism industry’s terms, trends, status, opportunities, challenges and values, amongst others. They were also structured to provide valuable information that could be used to benefit the individual consumer as well as the industry as a whole. The survey questions were limited to garnering responses that would provide an understanding of medical tourism terms, trends, opportunities and challenges. The survey didn’t tackle issues relating to the industry’s size, the number of patients that travel to other countries for healthcare and other facts and figures, as these have already been tackled extensively by other research organisations. A number of the questions had limited answer options that were based on an already established observation. For instance, only seven options were included when asking which was the preferred term for the industry, as this figure resulted from research that revealed that there were no other terms in use. Contributors to the survey had the opportunity to include personal comments at the end and these were also taken into account when the results of the survey were compiled. Survey Compilation The survey findings to each of the posed questions are presented in both graphic and textual form, with the text comprising two sections, ‘Result Summary’ and ‘Analysis.’ ‘Result Summary’ gives the statistical percentage breakdown of the answers and ‘Analysis’ provides a subjective view of these results. This latter commentary is the sole interpretation of Dr Prem Jagyasi and it is not necessarily representative of the views of the survey participants. Further Use The knowledge gleaned will as well as provide important information for a soon-to-be published guidebook for consumers who are considering undertaking treatment abroad. Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 6
  • 7. Industry Terms Result Summary 35% Medical Tourism The preferred term from 85% respondents for this particular sector of the healthcare industry 22% Global Healthcare is ‘Medical Tourism,’ with 35% selecting this option. ‘Global Healthcare’ was the next most popular term at 22%, with ‘Health Tourism’ 21% Health Tourism running a close third at 21%. ‘Medical Travel’ was identified by 10% of respondents as their 10% Medical Travel preferred description, with ‘Healthcare Travel’ and ‘Value Medical Travel’ both at 6%. 6% Healthcare Travel 6% Value Medical Travel Analysis There are several terms used for medical tourism across the world to refer to this industry, but this particular one is used most commonly because many people are confused with other expressions. For example, ‘Global Healthcare’ is used widely, even outside of the specialist medical/healthcare tourism/travel field. The term Value Medical Travel is mainly used in India and most of the respondents who stated a preference for this term were either Indian nationals or who were closely associated with the India region. Medical Tourism is a term interchangeable with “Medical Travel”, ‘Health Travel” and “Health Tourism”. Each can be broken down into its constituent parts but basically it describes individuals travelling abroad for any type of medical, quasi-medical or health treatment. It also describes the growing global industry of healthcare providers, doctors, clinics and hospitals who are marketing themselves to overseas patients. Another interesting finding came from a separate research that the term ‘Medical Tourism’ takes a 65% share in online presence*; a figure which is almost five time higher than the second term ‘Global Healthcare’ at 13%. ‘Health Tourism’ at 11% and ‘Medical Travel’ at 8%. ‘Healthcare Travel’ and ‘Value Medical Travel’ both had a mere 1% share. * This evaluation was based on a combined search engine result share utilizing Google and Yahoo. All terms were searched at both search engine and results were evaluated based on individual term results against total results. Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 7
  • 8. “Medical Tourism…” old concept, new buzz phrase Result Summary The survey takers were asked why they thought ‘medical tourism’ was a new buzzword (or more accurately a ‘buzz phrase’). Fifty-six per cent (56%) agreed that it was ‘Because increasing numbers are travelling for healthcare,’ with almost the same percentage (55%) also agreeing that it was ‘Because medical tourism benefits a cross section, including governments, insurance companies, travel/tourism, healthcare and facilitators’. Fifty-t per cent (53%) agreed that it was ‘Because it offers value for money’ and 46% said that it was ‘Because big hospitals are promoting it.’ Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 8
  • 9. Medical Tourism – Past, Present & Future Trends The history of travel for medical purposes is inseparable from that of the history of medicine itself, with evidence showing that for thousands of years man has been prepared to journey far from home to avail himself of treatment. Some early examples would be those of ancient civilizations discovering healing springs far from their city walls, which they would travel to in order to seek relief from their maladies. Throughout the ages and across the globe, medical tourism can be chronicled as different epochs that portray how the phenomenon has progressed over time. Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 9
  • 10. Decision Factors Result Summary • The four most popular reasons given for why patients travel abroad to receive medical treatment were ‘Affordability (costly in home country)’ at 88%, ‘Accessibility (waiting period is high)’ at 66%, ‘Better quality (care and support services are better quality than the home country) at 38% and ‘Availability (not available in home country) at 46%. • The top three reasons identified that are essential components of a good medical tourism destination were ‘Quality standards of healthcare and wellness services’ which was marked by 51% of respondents, followed by ‘Accessibility of the destination’ at 30% and ‘Technology, facilities & specialisations available’ at 27%. Analysis People become medical tourists for a number of reasons. For many cost is the main driver, for others accessibility and availability are the prime motivators. Currently, the most popular reasons for travelling abroad for treatment are for dental and cosmetic surgeries and for procedures which are often considerably cheaper abroad. This is especially true for US and Western European patients. However, the quality of healthcare services also plays an important role in the decision making process; Consumers are drawn to certain destinations because they have some of the most highly respected medical centres and healthcare professionals in their respective fields. For many patients, the availability and ease of access to certain treatments is an extremely important consideration and increasing numbers are prepared to travel for experimental and controversial medical procedures, including organ transplantation, stem cell treatment and other medical procedures that are at the cutting edge of medical science. Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 10
  • 11. Medical Tourism Destinations Result summary • Thirty Five (35) countries in total were identified as being medical tourism destinations, which were (in alphabetical order): Argentina, Australia, Belgium, Brazil, Caribbean, China, Costa Rica, Cuba, France, Germany, Hungary, India, Israel, Japan, Jordan, Malaysia, Mexico, Morocco, New Zealand, Panama, Philippines, Poland, Saudi Arabia, Singapore, South Africa, South Korea, Spain, Switzerland, Taiwan, Thailand, Tunisia, Turkey, UAE, UK and USA. • India, Thailand and Singapore were ranked first, second and third as the most popular medical tourism destinations respectively. The United States was placed at number four. • The top three reasons identified as essential components of a good medical tourism destination were ‘Quality standards of healthcare and wellness services’ which was marked by 51% of respondents, followed by ‘Accessibility of the destination’ at 30% and ‘Technology, facilities & specializations available’ at 27%. Note: The survey was completed by 159 respondents, the vast majority (95%) who were industry experts. Not all answered this particular question, so the analysis here should not be considered comprehensive. However, the survey results give a good indication. Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 11
  • 12. Top 10 India, Thailand, Singapore, USA, Malaysia, Germany, Mexico, South Africa, Brazil, Costa Rica Top 11 -35 Poland, Saudi Arabia, Switzerland, Argentina,UAE, Turkey, China, Spain, UK, Australia, Cuba, France, Panama, Philippines Belgium, Caribbean, Hungary, Israel, Japan, Jordan, Morocco, New Zealand, South Korea, Taiwan, Tunisia 35 Medical Tourism Destinations (Random order in box) Analysis A long standing myth that medical tourism is only about low cost treatment was exposed by the survey findings. Value for money is certainly a consideration, but cost alone is not the sole determinant when selecting a medical tourism destination. The top three destinations of India, Thailand and Singapore have already established reputations as medical destinations for healthcare tourists. The United States’ ranking at number four clearly indicates that citizens in affluent societies would prefer to travel for high quality treatment and advanced care. Latin American and European countries were in the top ten, indicating that medical tourism is not dominated by one continent or geography -it’s a truly global industry. The quality of healthcare services at a destination is deemed to be of utmost importance. Advanced technology combined with modern medical science and the ability to deliver a high success rate and a satisfying overall experience are essential components for the development of a top medical tourism destination. Additional factors for popularity include cultural and social sensitiveness and a secure support system. These contribute to the success of medical tourism destinations. As mentioned elsewhere in this document, patients travel for affordability, accessibility, availability, quality of care, tourism factor, privacy and additional benefits. A good medical tourism destination, therefore, is not only about one factor; it must deliver a combination of various benefits. Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 12
  • 13. Issues related to Medical Tourism Growth Result Summary • Ninety-four (94%) of respondents agreed with the statement that medical tourism has yet to reach its full potential. • The top four challenges to the medical tourism industry were identified as being ‘Accessing reliable information’ at 59%, ‘Too many newcomers jumping on the medical tourism bandwagon, not experienced or understanding of the industry’ at 54%, ‘Lack of pre and post operative care arrangements’ at 52% and ‘Complicated intra-country laws and legal procedures’ at 49%. Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 13
  • 14. Concerns for Consumers Result summary One question was concerned with the key reasons why medical tourist are not opting for medical tourism related services. One hundred and nineteen (119) people responded to this, with 50% of survey participants believing that potential patients are often concerned about complications. Confusion and not receiving complete information were other major issues, while 39% believed that patient finds medical tourism to be a complicated procedure. The most important finding based on these results is that 92% think that medical Tourists find such services beneficial as only 8% voted for the statement that they don’t. Analysis The answers from the respondents to this question clearly suggest that the key to facilitating medical tourism for potential patients is to adequately prepare and reassure them, with 50% believing that patients are concerned about complications. The preparation list for a medical tourist is extensive and includes researching the treatment options, identifying good healthcare facilities, understanding international accreditations, ensuring pre and post- operative care programs, facilitating the transfer of medical records, trusting online information, understanding cultural and ethical issues, completing legal documentation and identifying support systems. A thorough patient check-list is vital balance score programs as are easy to understand instructions for medical tourism related services. Such information is not readily available. Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 14
  • 15. Role of Facilitator Result Summary The role of facilitators in the industry was deemed by the respondents to be significant (an explanation of facilitators being that they arrange medical tourism either in part or in whole for health tourists). Sixty-one per cent (61%) said that facilitators were ‘Very important,’ 27% said that they were ‘Important,’ 10% regarded them as ‘Optional’ and 2% said that they were ‘Not important.’ Analysis The process of deciding on medical tourism is no doubt a challenging task for a prospective medical traveller. It requires critical preparations, such as identifying reliable providers, ensuring trouble-free travel arrangements and having a full understanding of any preoperative and postoperative necessities, amongst many others. Because of the complexity of this decision-making process, some medical tourists seek help from travel agents or the international patient departments of hospitals, or concierge service providers. While all these agencies can act as effective intermediaries, none can offer a comprehensive medical tourism support Not Important services in the same manner as a one-stop 2% Optional medical tourism facilitator. This is an agency 10% staffed by a team of professionals who are equipped to offer a seamless combination of what would otherwise be complicated arrangements within medical tourism. However, not all facilitators perform perfectly. There are many inexperienced operators who Important can be seen to have recently ‘jumped on the 27% Very bandwagon’ for medical tourism services and Important these are a major threat to the growth of the 61% industry. In conclusion, a medical tourism facilitator plays a vital dual role - firstly, in attracting medical tourists and secondly, in providing a high quality experience by ensuring the first- class provision of medical, travel, concierge and How important a role does the insurance-facilitation services. The growth of the medical tourism industry will be largely facilitator play in the industry influenced by this key player. Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 15
  • 16. Conclusion The medical tourism is going through exciting phase where alongside of international activities, more intra- regional travels are taking places in this sector of the health market. The responses received clearly revealed that there is an overwhelming perception among the industry leaders that there is so much more that can be achieved within this sector. However, there are challenges, which require immediate attention of industry stakeholders. An overwhelming majority of the respondents felt that there was great deal of potential for medical tourism that at present remains untapped, with the perceived major concern being one of complications following treatment. Confusion and a lack of information were also cited here as being factors and one particularly significant finding was that only 8% of respondents believed that there was a perception that health tourism offered no benefits at all. The perceptions from the respondents were that participants who actively engage in medical tourism do so primarily because of an economic standpoint, with additional important factors being that they can access a treatment that may not be available in their home countries, or if available, there is an unacceptable delay involved before being able to receive it. The most popular destinations were believed to be those in the Far East and Asia, with the U.S. coming in at number four - an unexpected finding that could mean that there are good opportunities for this country to create inbound medical tourism. Malaysia, Germany, Mexico, South Africa, Brazil and Costa Rica also made to list of top ten destinations. The quality of healthcare services at a destination is deemed to be of supreme importance. It is clear from the replies that the respondents believe that the role of facilitators in medical tourism is significant; with 88% agreeing that they were ‘important/very important.’ It is the compiler’s overall conclusion (based on the survey findings) that the main key to increasing the uptake of primary medical tourist services is to successfully overcome the confusion, lack of accessible information and fear about healthcare services in other countries. Medical tourism facilitators are in a prime position to do this by utilizing their expertise in this area and harnessing their knowledge to media or public information programs to demystify aspects of the sector. Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 16
  • 17. About the Researcher Dr. Prem Jagyasi Chartered Marketing consultant | Medical Tourism Consultant Dr Prem Jagyasi is a successful entrepreneur and experienced strategic professional. He is a renowned chartered management, healthcare marketing and medical tourism consultant responsible for providing high-profile consultancy services to both government authorities and private healthcare organisations. Dr. Prem Jagyasi’s commitment to developing medical tourism has seen him become a leading figure in the international healthcare tourism world. Currently, Dr Prem Jagyasi is MD & CEO of ExHealth; a Dubai Health Care City-based firm engaged in offering multi-dimensional healthcare solutions across the international domain. He also serves the Medical Tourism Association — a non-profit organization based in USA - as Honorary Chief Strategy Officer. He is also the Chief Editor of UAE’s leading health magazine, HealthFirst, which is published in association with one of the region’s leading English language daily newspapers. In addition to running a successful healthcare solution firm and consultancy business, Dr. Jagyasi has initiated several innovative health awareness projects, such as the Family Health Festival, the No Tobacco Campaign, the Summer Health Festival, Ahlan Ramadan, as well as number of diabetes-related events. His initiatives are endorsed and recognised by the country's Ministry of Health and other governmental authorities. On a global front, Dr. Jagyasi is also developing a medical tourism guide, a global health directory and is actively involved in educational initiatives, health-related workshops and quality practice procedures for international patients. Current profile of Dr Prem Jagyasi: MD & CEO – ExHealth, Dubai HealthCare City Honorary Chief Strategy Officer – Medical Tourism Association, USA Co-Editor – Medical Tourism Magazine, USA Chief Editor – HealthFirst Magazine, UAE Prem@Jagyasi.com | www.DrPrem.com Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 17
  • 18. About the ExHealth Based in Dubai Healthcare City, ExHealth is dedicated to providing integrated marketing, media and management advisory services to clients across the healthcare industry. The firm is a one-stop solution for companies striving to grow or revitalise their business. ExHealth offers an extensive portfolio of services that includes Healthcare Marketing, Management, Public Relations, Events and Publication. Staffed by a seasoned team of healthcare marketing, media and management professionals, our firm is in a unique position to understand the specialised needs of the healthcare sector. Accepting nothing less than complete fulfillment of its clients’ marketing, media and management goals, ExHealth is committed to helping healthcare organisations transform themselves into market leaders. ExHealth offers high-profile medical tourism consultancy services promoting government authorities, healthcare organisations and medical tourism facilitators. Dr Prem Jagyasi and affiliated international experts provide extensive & high-end consultancy services to healthcare organisations, medical travel facilitators, governments and semi-government authorities. The health tourism consultancy services are provided in conjunction with international and regional representatives. Medical Tourism Research & Survey Report by Dr Prem Jagyasi | www.ExHealth.com | www.DrPrem.com Page 18