The article outlines the rise of medical tourism among Gulf Cooperation Council (GCC) countries, highlighting patients' motivations such as seeking cheaper and specialized treatment abroad. It discusses challenges faced by GCC governments in managing patient migration for healthcare and proposes outsourcing overseas healthcare administration to third-party administrators for efficiency. The author emphasizes the need for improved local healthcare infrastructure to reduce reliance on foreign treatment, projecting a significant decrease in spending on overseas healthcare by 2020.

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The Nomadic Patient
 The following article contains a brief description and outline of the history of
current trend towards medical tourism from the GCC to countries with
higher perceived levels of healthcare in the Western world.
 The article then goes on to describe how the concept of medical tourism is
evolving, with GCC medical tourists now seeking cheaper healthcare
(Healthcare Along the Silk Route: Middle East to Asia Medical Tourism) as
well as specialized healthcare services in a different GCC country.
 Finally, the article goes on to outline key challenges and opportunities for
GCC governments and private institutions with respect to patient migration.
Much has been written recently in the popular press on medical tourism, medical travel, health
tourism, or global healthcare, which all basically pertain to the fact that many people are
traveling outside of their country to receive medical treatment for one of three reasons:
1. The treatment is not available in their home country
2. The treatment in the destination country is (perceived to be) superior

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3. The treatment in the destination country is cheaper
My own personal experience with medical tourism occurred back when I was still a clinician. I
was on an extramural maxillofacial surgery rotation at Mass General Hospital of Harvard
University a few years ago, when a Kuwaiti patient and his brother were brought into one of the
patient rooms.
“Nothing is too expensive, please do everything you can for my brother,” was a phrased
constantly echoed. My patient had been in a motor vehicle accident resulting in a compound
fracture of his mandible (lower jaw) that had subsequently cartilaginized since it had been
almost three months since his traumatic accident.
Here I was, an aspiring Kuwaiti surgeon treating a Kuwaiti patient 3,000 miles away from Kuwait
in a Harvard hospital as an extern, I was completely shocked and dismayed by the situation
afoot. Was it that my patient could not receive adequate care in Kuwait? At least some form of
treatment that would prevent his wounds from attempting to heal in the wrong position? Or
was it the long and tiresome process of applying for overseas healthcare for three months that
resulted in his complicated medical state?
This is just one example of medical tourism and how it fits neatly with the trends towards
globalization.
More and more Middle Eastern patients are traveling for both acute, chronic and cosmetic
healthcare. According to most calculations, Gulf Cooperation Council (GCC) governments alone
spend well over ten to 20 billion US dollars on sending their citizens abroad for healthcare.
Complicating the matter further, different government agencies typically send their own
employees abroad. The following is a brief outline:

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1. Ministries of Health
2. Local Health Authorities – this is the case in Abu Dhabi and Dubai
3. Military – including the Army, Navy, Police and National Guard
4. Foreign Ministry
5. Oil Sector
6. Amiri Diwan/King’s Decree – official ministry (office) of the ruler of the country
As to which countries patients are sent to. The top countries usually include the US, UK, France
and Germany, with Germany the top country in the case of Saudi Arabia and the UAE, versus
the UK for Kuwait. Surprisingly enough, the Bahraini Ministry of Health sends close to 2/3rds of
its overseas patients to neighboring Saudi Arabia, whereas the Omani Ministry of Health prefers
to send the majority of its patients east to India. The Kuwaiti government for example, used to
rely on the foreign offices of the Kuwait Airways Corporation to manage the international
patient flow and overseas healthcare budgets. Today, the Kuwaiti Ministry of Health has its own
Overseas Health Offices in New York, London, Paris and Frankfurt, which work closely with the
Kuwaiti Ministry of Foreign Affairs to assist patients in their treatment abroad both
administratively and financially.
Even though there will always be a need for GCC government’s to send patients abroad for
specialized care, it is widely accepted that the current model of overseas healthcare is not
sustainable. Local GCC governments are increasingly investing in the local healthcare
infrastructure and encouraging free market dynamics to stimulate private investment in the
healthcare.
Privately, an increasing number of GCC patients are seeking treatment along the (ancient) Silk
Route – traveling to India, Thailand and as far as China for cheaper healthcare that is perceived
to be of better quality.

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I believe that a private sector solution to overseas healthcare may provide an optimal interim
solution – governments in the GCC should outsource the administration of their overseas
healthcare to experience third party administrators (TPA) with an international network and
experience as many global companies already do for their own healthcare needs. However, it is
imperative that the government actively monitor the TPA by setting key performance indicators
and targets to ensure that a quality service is delivered to its citizens. This efficiency will allow
the GCC governments to not only send more patients (in the near future) but to also control
both its cash flow and overall cost of sending patients abroad. Such measures will hopefully
reduce the projected ten to 20 billion dollars of spending by 2020 to a mere fraction.
The article is written by Dr. Mussaad Al Razouki for Arab Business Review
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