Medical Tourism -  Interview
Connecting the medical & travel industries

Medical tourism is growing rapidly as more people around world travel abroad for medical treatment and more medical facilities and travel operators jump on the bandwagon to grab a piece of this potentially lucrative pie. This was in evidence at the second annual World Health Tourism Congress in Limassol, Cyprus in March, which was attended by many key players in the industry from across the globe. Callan Emery went along and spoke to Dr Steve Tucker, the first elected president of the newly established International Medical Travel Association, which was officially launched at the Congress.

Middle East Health: Why was the International Medical Travel Association (IMTA) set up?
Steve Tucker: At the PATA Annual Conference 2006, several speakers expressed concern that, with the enthusiastic boom of medical travellers across the world, there was a disturbing trend of viewing such travel as part of the tourism industry, that people were choosing their doctors and hospitals from websites and without the advice of their own doctors, and that some are already paying the price of botched surgeries and other mishaps. Dr Jason Yap, Director (Healthcare Services) of the Singapore Tourism Board (STB), suggested then that an international association for medical travel would assist players to network, form new business relationships, share best practices, set standards and eventually accredit and self-regulate. He offered, on behalf of the STB, to support the formation of such an organisation. In the succeeding months, many players in the medical travel industry from Singapore, Malaysia, Thailand, India and other countries asked about and encouraged its formation. With such encouragement, Dr Yap then organised the registration of the International Medical Travel Association and softlaunched it at the International Medical Travel Conference. The members signed up at that time worked together to formulate its mission, vision and other foundations, and now come together to formally launch the Association during the World Health Tourism Congress 2007 (held in Cyprus in March 2007). The Committee of the Association was also elected during a general meeting held in Cyprus during the same period.

MEH: I understand there are 24 members? Who has expressed interest in joining?
ST: There are 24 signed-up members thus far. Those who’ve expressed interest in joining include healthcare providers and tour operators – those that attend conferences such as this – the World Health Tourism Congress.

MEH: Who are these members – where are they located? Are they from around the world or concentrated, say in Asia?
ST: They are from around the world. They come from an array of countries such as the United States of America, Australia, the UK, Turkey, India, Nigeria, Dubai, Lebanon, Malaysia, Thailand and Singapore, representing various medical travel-related sectors like healthcare providers, travel agents, medical concierges, medical travel publications, national tourism offices, insurance companies and media companies.

There is a lot of work ahead. We need to look at establishing a permanent staff structure and perhaps a non-elected executive director who can begin to co-ordinate the various functions of the association.

MEH: Do you have a website? ST: We have secured the domain name The website is in the process of being set up.

MEH: Can you tell me more about members that have expressed interest in the association?
ST: The other stakeholders that have expressed interest include the hotel industry, the airline industry and the medical industry. At the Congress we’ve also had a legal representative approach us and volunteer his services.

MEH: The legal aspect is an important facet. ST: Yes it is. It is important because of the liability issues which can arise. Though I don’t want to get into this now.

MEH: Can you tell me something about the vision of the association?
ST: It’s important the core vision be described by people with deep knowledge of medicine, so medicine cuts through the entire issue of medical travel. All medical procedures, elective, non-elective, urgent, non-urgent – they make the traveller a patient. So the idea of the tour – really will disappear or will be redefined in the specific medical procedures, because all patients convert from being a tourist to a patient in medical travel. So medicine must form the background of a framework that includes all medical procedures regardless of rationale and all participants in the medical travel industry.

MEH: What are the ideals or goals of the association?
ST: The ideals are different to the goals. Let’s be clear. The association exists to expand, enhance and protect the role of medical providers and of the travel industry for the specific common goal of improving global patient care. The ideals here are – giving people the tools to improve healthcare. We are interested to see that people are capable and given the right tools to help patients make a decision, to help patients accomplish their own specific goals, meet their own needs. The association is not here to tell patients what to do or not to do. It is an association for the industry, to equip the industry with the tools to do an even better job of patient care.

MEH: Just to clarify – the association is not there to protect the patient, is this correct?
ST: Well, it is ultimately for the protection of patients. The association does not have an interaction with patients. The association interacts with the industry.

So the people that we are going to be working with are people in the industry that are deeply involved with patient care. And what’s interesting is that the medical side has always been involved in patient care. Now the travel side needs to realise that they are involved with patient care and therefore there is going to be a need to evaluate how we work with the patient, how the patients are advised, how the patients are handled, how medical records are handled, how safety is addressed at all points during the care process, because typically in an elective situation an individual travels from point A to point B and has some form of medical procedure.

When they travel from point B back to point A they are now a patient. They come in as people, they go out as patients. Realistically they have always been a patient. For example, how miserable would it be if a patient flies to Asia to have a knee replacement only to be told that they have to walk 40 gates in the airport terminal when they arrive before they can meet their host. There are a lot of things to think about.

MEH: How does the association intend to achieve its goals?
ST: The methods of achieving the goals of the vision – well we’re not sure yet, but there’s talk of accreditation – though I’m not sure what that would mean at this stage.

MEH: Well this would provide credibility to the service providers, although the practicalities of this are probably quite difficult.
ST: Exactly. I think we also need to address a Patient Bill of Rights. We need to address medical privacy.

We need to provide simple fact sheets for our members to provide to their patients, to their travellers, to make them aware about asking questions such as ‘have you asked the following of your physician? Have you asked the following of your tour operator? Do you have a doctor on the outbound side who is willing to receive you after your therapy?’ Are you just going to show up back home and say this is what I had done, but without a [medical] record? It would be better if there is someone who says; ‘yes I know you are going abroad, bring back the record that shows who you are going to see. I’ll take care of you when you return.’

MEH: Looking down the road when you have an established membership and some form of accreditation in place, if this is the way it goes, do you think that this accreditation will lead to these players becoming the so-called ‘recognised’ operators in the industry, that patients could look to when they want to use the services of the medical travel industry.
ST: I think the accreditation process becomes a binary – it is a yes or no. It should mean that the operator is adhering to a set of standards – and really it will be a minimum set of standards to act in a manner appropriate for medical care or indirect medical care. And I think you start very softly.

We’re not JCI [Joint Commission International] or JCAHO [Joint Commission on Accreditation of Healthcare Organizations]. But I think there is the possibility to have organisations such as these participate in the IMTA and begin structuring the framework for accreditation. The accreditation should not be about what you can achieve or what’s your score. Rather, it’s simply a stamp that says ‘listen, these people adhere to these standards.’

MEH: Take a patient who wants to have their treatment overseas, for whatever reason. They go to the Internet and start searching for tour operators, healthcare providers and so on. But they don’t know where to begin. Do you think accreditation will, in a sense, act as a guide for these patients and facilitate their decision making process?
ST: I don’t think the association should act as a guide. However, patient education is very important. Patienttravellers need to look for reputable operators, in the same way you would want to get a reputable real estate broker if you were buying a house, you would want a reputable surgeon and travel operator if you wanted to have a knee replacement abroad.

MEH: But it could assist in determining who is reputable and who is not.
ST: Right. But the association cannot act as a clearing house. We’re not acting as a front door for medical travel. We’re acting as a backdoor resource for individuals involved and I think it will become clear over the next months and years that the priority services will always rise to the top. And patient-travellers will begin to notice that this operator has a better business deal, this operator has a seal from the IMTA and so on.

MEH: What kind of services can the IMTA offer its members? Why would potential members want to join the IMTA?
ST: I think that those in the industry will want to join so that they can belong to the larger community of medical travel and global medical care. And they would be proud to state they adhere to certain medical principles in their participation in the medical travel process. Other possibilities include having access to a journal, access to contact information within the industry and so on.

MEH: Members will have competing interests. How will this affect the association?
ST: Yes, in all associations, the members are competitive. But in the association we are co-operative. Outside the association we are competitors. But as an association we can work together co-operatively to better the industry.

MEH: What are the fees to join?
ST: The first year entrance fee is US$1,000, and subsequent annual subscription fee is US$500. Membership is on an annual renewal basis. Currently, there is only one type of membership, an ordinary membership. At this stage, membership is meant for organisations rather than individuals. The executive committee will look into having more categories of membership structure in the near future as membership increases.

MEH: And who can they contact if they want to join?
ST: They can contact Felicia Tan ( / +65 6831 3505) Dr Steve Tucker is a medical oncologist at The West Clinic Excellence Cancer Center in Singapore. He has received numerous honours and awards from prestigious institutions, such as the National Institutes of Health, The American Society of Clinical Oncology, The Pew Foundation and the UCLA School of Medicine, where he was an Assistant Professor of Clinical Medicine. Dr Tucker also serves as chairman of the Prostate and GU committee for the ACORN Research Network.

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