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© 2013 Medical Travel Today

Medical Travel Today is a publication of CPR Strategic Marketing Communications, a public relations firm based near New York City that specializes in healthcare and life sciences, with an international clientele. CPR, its Partners, and clients are at the nexus of where medical travel is today, and where it will be tomorrow.

Laura Carabello

Laura Carabello

Managing Editor
Megan Kennedy

Table of Contents

From the Editor

From the Editor: This week in Medical Travel Today, Laura Carabello

News in Review

UAE's Medical Tourism Business: More Revenue from Hospitals than Hotels

As More Americans Have Surgeries Overseas, US Companies Consider 'Medical Tourism' a Healthcare Option 

Medical Tourism Could be the Overseas Alternative to Obamacare

NIB Considers Overseas Medical Treatment

Singapore Medical Tourism Industry Poised to Grow Magnificently

Canadians: Big Spending on Medical Tourism

Medical Tourism Market is Expected to Reach USD 32.5 Billion Globally in 2019: Transparency Market Research

Medical Tourism: India Doctors are Comforting to Patients, Says India High Commissioner

Why India, Turkey are Cheapest Destinations for Medical Tourism


Richard Krasner, Medical Tourism Blogger


CMI Abasto: A Medical Tourist's FINAL Solution for Addiction, Depression and Eating Disorders

Industry News

Ten Years On: One Person's View of Where the Medical Tourism Industry Will be a Decade from Now

Safeguards Needed to Protect Medical Tourists

DNV has Received Accreditation from the International Society for Quality in Healthcare (ISQua) for its International Hospital Standard

Medical Tourism: Latin America is a Prime Destination

New Study Reveals Wellness Tourism a $439 Billion Market, Representing 1 in 7 Tourism Dollars

Aquarius Announcement - Columbia University & Aquarius Capital Announce Nineteen (19) New Research Projects

Interview: ‘Patient-Centered' Promises Missing In Endocrinology, Fueling Shortages, Wait Times

IHC FORUM WEST Conference Invitation

Upcoming Events

Indian Medical Tourism Conference 2013

Kerala Health Tourism

AnfasHetex Health Tourism Fair

4th International Temos Conference - Healthcare Abroad & Medical Tourism


India Med Expo 2013-Andra Pradesh Medical Tourism & Health Care Conference

Health Tourism Expo 2013

Greek Health Tourism Integration Conference

Kuwait Medical Tourism Conference 2014

Moscow International Medical and Healthcare Tourism Congress

The Health Tourism Show


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Global Health Voyager


Volume 7, Issue 20

Dear Colleagues:

Richard Krasner, medical tourism blogger, suggests that the implementation of medical tourism into workers' compensation cases will lead to the development of international accreditation and quality standards that up until now have hampered medical tourism's expansion and growth.

Please be in touch and let me know how you are surviving and thriving in this emerging marketplace. 

Laura Carabello
Editor and Publisher
Medical Travel Today

2013 IHC Forum West

Global Health Voyager

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SPOTLIGHT: Richard Krasner, Medical Tourism Blogger

Contact Info
Phone: 561-738-0458
Cell: 561-603-1685
Email: richard_krasner@hotmail.com
Skype: richard.krasner
Blog Website: http://wp.me/p2QJfz-gy

Medical Travel Today (MTT): Tell us your position in the medical tourism industry, as well as your thoughts on integrating medical tourism into workers' compensation cases in the U.S.

Richard Krasner (RK): Currently, I am a blogger, blogging about the implementation of medical tourism into workers' compensation.

I first began looking into integrating medical tourism into workers' compensation when I needed a topic for a paper in my Health Law class as part of my M.H.A. degree program in March of 2011. A lawyer who was working for a medical tourism facilitator company at that time, and who had written an article in a law journal about medical tourism, gave me the idea after my first topic did not pan out. She thought that the legal barriers to implementing international medical providers into workers' compensation through medical provider networks was a good idea, and since I had a small interest in the subject of medical tourism, I submitted that as my topic to the instructor.

He gave me his approval and, as I started to do my research, I found many articles on medical tourism and nothing on medical tourism and workers' compensation, so I knew my task was a difficult one. But as the point of the paper was to write about a legal issue and persuade people one way or the other, I felt that I could mention the lack of literature on the subject and perhaps open up dialogue in that area. I then found a roundtable discussion from the January/February 2008 issue of the journal Telemedicine and e-health.

In the discussion, I found something that I had been looking for, but had not expected in a medical journal: a validation from four of the participants for my idea to implement medical tourism into workers' compensation. I made their discussion the centerpiece of my paper, and thus my argument in favor of implementation. They said essentially that they thought that medical tourism could work for non-emergent, i.e., non-emergencies or long-range issues, such as knee or hip replacement, chronic back injury and repetitive action injuries, and that it would not be a leading offering. That is when the light bulb went on, and I realized that it could be accomplished as an option for the injured worker to consider.

Initially, my research consisted of finding articles that discussed medical tourism in destinations, such as India, Singapore and Thailand, and my thought then was that it might be a stretch to send injured workers that far away, but that maybe it could be done. Later on, as I got more involved in medical tourism through my attendance at the 5th World Medical Tourism and Global Healthcare Congress in October 2012, and through conversations online with another lawyer, I realized that the best chance for this to happen was in Latin America and the Caribbean, and that given the rise of the Latino population in the U.S., sending patients home to their home countries for treatment would present no language or cultural barriers, and would allow friends and family in those countries to visit them during recovery, which will improve their self-esteem and improve their recovery time.

I have since come to believe that all injured workers could be offered this as an option, not just those of Latin or Caribbean origin.

MTT: How will the integration benefit individuals, health insurance companies, and the entire medical community, both domestically and internationally?

RK: I believe first and foremost that medical tourism will have its most important benefit on the individual because of some of the things I mentioned above, namely little or no cultural or language barriers to overcome between Spanish or English in most cases, or between Portuguese or other languages in the region. Also, as I said, their friends and families back home can visit, which would make their recovery more relaxing, more pleasant and would show them that the patient is not sitting at home just collecting a check. It would also give the patient greater self-esteem and speed recovery. Finally, by being treated in the better hospitals in the home country, a patient's friends and family will see that their loved one is being cared for by the best doctors and at the best facility in their country.

I think the benefit for the health insurance company or, in this case, the workers' compensation carrier would be that they will not have to pay for expensive procedures, such as hip or knee repair/replacement, shoulder surgery, spinal fusion surgery or carpal tunnel surgery. This is despite the fact that many states have fee schedules for workers' compensation, which tells providers how much to charge the carrier for each procedure, and which may be less than the normal fees charged. Nonetheless, as the recent New York Times article indicates, the U.S. has the highest cost for healthcare, and it is not slowing down, nor has the average medical cost for lost-time workers' compensation claims, as I have written about in my white paper and my blog.

I think for the entire medical community domestically and internationally, it will have several benefits, the first of which will be the realization that healthcare is globalizing and that it is no longer possible to consider that quality medical care is available only in the developed world. Second, it will lead to the development of international accreditation standards, quality standards and other standards that up to now have hampered medical tourism's expansion and growth.

These standards will take time to be adopted and will be expensive to implement for the medical tourism facilities involved, as it has already been for the implementation of other standards and forms of accreditation, such as from the Joint Commission International.

Thirdly, it will have the benefit of bringing American patients to medical providers in other countries, those who otherwise would never be seen by foreign doctors except for those who have gone to foreign-born doctors practicing here in the U.S., whether in private practice or in a hospital setting. Fourth, and this is more of an issue with workers' compensation cases, doctors abroad will be able to get broad experience treating work-related injuries that they have never seen, thus adding to their medical experience, and providing their fellow citizens with that experience should they ever require it.

Medical tourism will open up global healthcare to all inhabitants of this planet, not just those looking for cosmetic surgery, or procedures that are too expensive or unavailable in their home countries. It will certainly open it up to those who otherwise could not afford to travel out of their country for treatment.

MTT: What would you say are the steps necessary to take in order for medical tourism to be integrated into workers' compensation effectively?

RK: First, there has to be a removal of all or many of the legal barriers that I mentioned in my white paper, as well as many others that I could not or did not mention. Also, there has to be some understanding on how the legal issues surrounding medical tourism can be solved such as malpractice, legal liability, privacy issues, medical records transfers, etc.

There are financial steps that need to be addressed, such as which currency the payments will be made in, any incentives to injured workers, referring physicians, treating physicians, destination hospitals, as well as travel insurance coverage for things not covered under workers' compensation. And lastly there has to be a willingness on the part of employers and insurance companies, third party administrators, and lawyers to accept medical tourism as part of workers' compensation. I have discussed this with several people recently through emails, and in the past six months since beginning my blog, and have written about this as well.

As the Chinese say, a journey of a thousand miles begins with the first step. An industry like the workers' compensation industry in the U.S., which is concerned with issues, such as pain medication abuse, physician dispensing of drugs and dealing with cost-curbing strategies that have failed, must come to the realization that the journey for them must begin now -- before costs skyrocket any further.

MTT: What can you see being potential deterrents in integrating medical travel benefits into workers compensation?

RK: First of all, let me say that I don't have all the answers, and I cannot foresee all contingencies and problems associated with traveling abroad for care. But I do want to make this clear so that your readers will not think that I don't know what I am talking about, or that they will think that integrating medical tourism into workers' compensation will be easy and not fraught with difficulties and complications.

It will not be easy, there are and will be complications from flying after undergoing surgery abroad, just as there are if the patient was treated at the local hospital. I am not a medical person, so my knowledge of how patients will tolerate air travel after surgery or what complications will arise is beyond my experience. But I can say this: I don't see a difference between a patient who traveled abroad for medical care as a private patient for cosmetic, body improvement or other forms of surgery usually associated with medical tourism and a patient who is traveling abroad for surgery as a result of an on-the-job injury. Yes, there are differences in the process of treatment and aftercare and recovery, but if the private patient can develop complications, so too can the workers' compensation patient.

To answer the question then, I think deterrents include a lack of will, fear of lawsuits in countries with laws that do not favor the insurance company or the employer, malpractice insurance and legal liability that does not meet American standards, employee choice to stay at home, and pressure from special interest groups like doctors, hospitals, pain clinics, rehab facilities, trial lawyers, etc.

MTT: During a time of rapid healthcare reform, why do you think medical tourism hasn't been connected to workers compensation already?

RK: Because there is so much uncertainty over the impact the Affordable Care Act will have, not only on healthcare, but also on workers' compensation. In my research on that subject, I found that there will be little immediate impact, but down the line there will be, especially as more people get health insurance, and also because of the doctor and nurse shortage, which will affect both healthcare and workers' compensation.

There are critics of the law who say it will raise costs, and then there are those who say it will lower costs, as some have already pointed out recently. But only time will tell who is right and who is wrong. Finally, I don't think many in the workers' compensation industry have ever considered looking abroad, except to plan their next vacation.

MTT: Is there anything else you would like to add at this point that you think is significant in terms of medical tourism, workers' compensations and/or the integration of the two?

RK: Yes, as I said in my blog post, The Faith of My Conviction, what is needed is the will to do it, the courage to make it happen, the hard work to get it there, and the determination to bring the two industries together. I have had experts tell me that it won't happen, but I pointed out right away in my post the discussion I found between the four medical professionals, and I believe that as medical professionals they have a better understanding of the issues involved than I do as a layman. I trust their judgment of the issue and defer to them for my belief that it can be done.

So who is right and who is wrong? I don't know the answer to that, but I do know this: for 20 years, the average medical cost for lost-time claims has gone from around $8,100 to almost $30,000 with no decrease in cost, but with a slowdown in the rate of increase. Is that progress? Is that a sign that all other avenues tried have not succeeded? Perhaps it will take higher costs to wake people up to the reality that medical care, like all other goods and services, always goes to those places where the goods or services can be produced at cheaper cost with better quality.


CMI Abasto: A Medical Tourist's FINAL Solution for Addiction, Depression and Eating Disorders

CMI Abasto, a medical facility located in Buenos Aires, Argentina, uses both traditional medicine and philosophy to diagnose and treat patients from all over the world who suffer from addiction, depression and eating disorders in an effort to provide a better quality of life.

CMI has made a significant presence in the U.S. over the last three years, with patients coming from all over the country to receive medical and philosophical diagnosis, treatment for addiction and depression, and simply to learn more about themselves. As the Greeks say, "A healthy mind is a healthy body"-and that is exactly what CMI helps patients achieve.
Upon arrival to CMI, patients must receive seven days of medical and philosophical diagnosis in order to understand the individual's well-being from both a physical and emotional standpoint. The medical tests range from brain scans, blood tests, dermatology-literally head to toe testing. Simultaneously, the patient has philosophical coaching, personal training, a nutritionist and massage therapy. Upon completing the seven days of screening, the patient will review all results with one head medical doctor and one head philosophical coach to better understand where their issues stem from. The medical testing at CMI is completed within two to three days and would take an extensive amount of time and money to schedule and complete elsewhere, making CMI a primary choice for patients globally.

CMI understands that when it comes to depression, addiction and eating disorders, there is not a "one size fits all" protocol in treatment-each person is an individual and needs to be treated that way. Philosophy, and understanding how to apply it in daily life, is what allows a patient to see the core emotional reason they suffer. By understanding and applying philosophy in one's daily life, the emotional stress that resulted in depression, addiction or an eating disorder naturally dissolves and the patient naturally abandons the idea to consume or to feel depressed.

If we look at the human being as an iceberg, we only see the tip-the physical body. People are much more vast, or complex, in the unseen world (under the water the iceberg is enormous, yet unseen). To learn more about oneself from all levels allows the patients to find their own truth. CMI coaches are here to offer patients tools to apply in daily life to help reach their full potential, as well as aid patients in achieving their goals and finding personal truth.

It just so happens that during this process, if one is suffering emotionally (addiction, depression, eating disorders), they no longer suffer in such a way. Understanding oneself and learning about oneself creates a level of happiness that emotional suffering begins to diminish-which results in the physical body changing, as well. Often patients will arrive to the facility with physical and emotional issues other than addiction and depression. CMI takes all aspects of the individual into consideration and designs treatment to handle additional issues found (ADD, dyslexia, insomnia).

CMI is unlike any other facility because it looks at each person as an individual and helps them obtain their essence, which is why individuals from all over the world are traveling to Buenos Aires for treatment.

Industry News

Ten Years On: One Person's View of Where the Medical Tourism Industry Will be a Decade from Now
by Richard Krasner

In these uncertain times, it is difficult, if not impossible, to predict from one minute to the next, one day to the next, one month to the next, or one year to the next, how any industry will grow and what its future will look like. So to predict where one sees the medical tourism industry going in the next five to ten years is anyone's guess. But there are a few key indicators of what might happen if certain trends hold true.

In my first six months of blogging about medical tourism and workers' compensation, I have found three key indicators of where the industry might go if the trends they signal continue for the next five to ten years. These indicators are costs, immigration reform, and technology. The cost indicator can be further broken down into its component costs, i.e., in-patient hospital costs, out-patient services costs, consolidation of U.S. hospitals that lead to higher costs, and costs to employees covered under their employer's healthcare plans, as more employers shift the burden to the employee.

There may be other costs that will affect the medical tourism industry's growth in the next decade, but the costs listed above have a more immediate effect because they impact patients more than they impact the healthcare system at large. While it is true that hospital costs will impact everyone, the patients will experience it more because it may limit them to choosing certain hospitals that charge less for the treatments they require, but at lower quality of care. There will always be one hospital that charges the most and one that charges the least, so the patients may be forced to choose between one and the other.

This article will outline some of the things I think will determine the future of the medical tourism industry, and is based on my knowledge of the U.S. healthcare system and my workers' compensation background. It is by no means an exhaustive inquiry into the future of medical tourism, but it is hoped that the reader will get a better idea of the state of the industry in the years ahead.

To continue reading click here.

Industry News

Safeguards Needed to Protect Medical Tourists
by Amy Miler, Penningtons Solicitors LLP

Medical tourism is a growing industry with an estimated 50,000 Britons who went overseas last year for medical treatment. The reason for this seems to be down to the difference in cost, but medical tourism is not without its problems, and people can often end up in very difficult situations when undergoing treatment abroad.

The Treatment Abroad Medical Tourism Survey 2012 states that plastic surgery, dentistry, infertility treatment and obesity treatment are the most popular treatments sought abroad. The British Association of Aesthetic Plastic Surgeons (BAAPS) estimates that every year 20,000 people travel abroad for cosmetic surgery alone. Surgery carried out abroad includes breast augmentation, tummy tucks and facelifts.

Nigel Mercer, a plastic surgeon and past president of the British Association of Aesthetic Plastic Surgeons, says, "Booking surgery overseas can be as much a minefield as it is in the U.K. - if not more so."

The Mail on Sunday has recently launched its 'Stop the Cosmetic Surgery Cowboys' campaign to highlight the need for regulation of the cosmetic surgery industry.

There have been a number of examples highlighting the need for suitable safeguards for those traveling abroad for treatment that have been recently cited in the news.

June Jonigk, whose bad experience was recently reported by the Daily Mail, traveled to Poland to have a tummy tuck and a breast lift, and was promised that she would receive luxury treatment. Unfortunately, she suffered from post-operative complications, including a gaping hole in her stomach and a breast reduction as opposed to a breast uplift. Although June tried to complain about her treatment, she was abandoned by the very company that had promised her luxury.

In February 2012, 20-year-old Claudia Aderotimi traveled to the U.S. to have a buttock enhancement procedure in the hope that it would improve her career chances as a dancer. The procedure was carried out in a hotel room by an unlicensed practitioner and, sadly, 24 hours later she passed away. The silicone filler used in the operation had leaked into her bloodstream causing heart failure.

There is also an inquiry led by Sir Bruce Keogh to implement legislative safeguards to protect those undergoing cosmetic procedures. The minimum safeguards to be implemented are:

  • Minimum standard of training and experience for cosmetic surgeons
  • Regulatory body of registered, properly insured members
  • An end to hard-sell tactics
  • A 30-minute consultation with the surgeon at least two weeks before any procedure is consented to

Amy Milner, associate in the clinical negligence team at Penningtons, said: "We hope that Sir Bruce's inquiry will lead to suitable safeguards to protect those undergoing cosmetic procedures, but more still needs to be done to ensure that anyone traveling abroad for treatment or surgery has the same safeguards."

Contact: Amy Milner, Clinical Negligence Department
Penningtons Solicitors LLP

Industry News

DNV has Received Accreditation from the International Society for Quality in Healthcare (ISQua) for its International Hospital Standard

"Receiving the highly esteemed honor of ISQua accreditation demonstrates to ministries of health, hospitals, funders and key stakeholder groups that organizations receiving DNV's international accreditation meet the highest international benchmarks for standards and are focused on continuous improvement," says Karen Timmons, Global Business director for Healthcare in DNV.

DNV's International Hospital standard integrates a quality management system based on ISO 9001 principles, along with proven proactive risk management principles and specific clinical and physical environment requirements to enhance safety and quality. Upon accreditation to the standard, the hospitals have a solid framework for identifying goals and implementing improvements at every level of their organization. The accreditation provides assurance to patients, the public and stakeholders of the high standard of safety and quality of service provided by the hospitals.

The requirements of DNV International Healthcare Accreditation are based upon those in DNV's U.S. standards that have been approved by the U.S. government's Centers for Medicare and Medicaid (CMS). The international requirements have been adapted so as to have applicability internationally, with sensitivity to local laws, practices and regulations.

"ISQua's rigorous accreditation process, including self-evaluation and assessment by expert surveyors, enables DNV to walk in the steps of our hospital clients as they prepare for and undergo DNV accreditation," says Stephen McAdam, Global Healthcare Technical director in DNV.

About ISQua
ISQua, the International Society for Quality in Health Care, is a non-profit, independent organization with members in over 70 countries. Its mission is to drive continual improvement in the quality and safety of healthcare worldwide through education, research, collaboration, and the dissemination of evidence-based knowledge.

About DNV GL
As of Sept. 12, 2013, DNV and GL have merged to form DNV GL. Driven by its purpose of safeguarding life, property and the environment, DNV GL enables organizations to advance the safety and sustainability of their business. DNV GL is a leading provider of classification, certification, verification and training services. Its origins go back to 1864, and today DNV GL operates globally in more than 100 countries with its 16,000 professionals dedicated to helping their customers make the world safer, smarter and greener.

In business assurance, DNV GL is one of the world's leading certification bodies. We help businesses assure the performance of their organizations, products, people, facilities and supply chains through certification, verification, assessment, and training services. Partnering with our customers, we build sustainable business performance and create stakeholder trust.

For more information, please contact:
Joacim Vestvik-Lunde
Global PR Manager
DNV Business Assurance

Industry News

Medical Tourism: Latin America is a Prime Destination
by John Benson

The high cost of healthcare has created the lucrative phenomenon of medical tourism.

An IPK International survey revealed roughly 3 percent of the world's population travels to foreign countries for medical treatment, while Patients Beyond Borders, which publishes international medical travel guidebooks, reported the medical tourism industry is a $40 billion a year business.

In the United States, the impetus behind medical traveling goes beyond saving a penny. For the Latino community especially, the attraction of traveling to Latin America is to not only spend less but also peace of mind dealing with Spanish-speaking doctors and quality facilities.

As for why people are seeking out Latin America, the answer is basically, why not? Procedures are much more affordable and with proper research, many quality facilities and accredited doctors can be found.

There is tubal ligation reversal surgery in Mexico, buttock implants in Costa Rica, chin and breast implants in Colombia, assisted fertility and gastric bypass in Argentina, and dental work in El Salvador. More so, people are also visiting Latin America for cancer treatments, cheap pharmaceuticals, diabetic care and rehab.

In fact, Patients Beyond Borders reports Mexico now attracts more than a million patients a year, many of whom are Hispanics from California, Arizona and Texas. It's this proximity to North America that makes Latin America's medical tourism so attractive. Other factors include favorable exchange rates, bilingual healthcare officials, friendly cultures, tropical climates and exotic locations allowing for relaxing and scenic recovery time.

Still, there are those who are fearful of traveling to a foreign country for a medical procedure. They often have misconceptions about third world standards of living, poverty, disease, violence and more. Something else that may keep them from experiencing medical tourism is the threat of malpractice without the U.S. legal system offering protection.

The truth is many healthcare providers in Latin America are internationally accredited by the Joint Commission International (JCI). The doctors are bilingual, with many of them U.S. board certified or trained in the states. Some healthcare providers also have ties to stateside medical institutions.

Here's a look at popular Latin American destinations for medical tourism, according to Healthbase:

Costa Rica offers services in various departments of medicine including orthopedics, bariatrics, ophthamology, dermatology, plastic surgery and dentistry. Savings can be as much as 70 percent or more.

Panama is Central America's most industrialized country. Its medical tourism sector is growing rapidly with upwards of 50 percent in savings. Also, its use of the U.S. dollar as currency makes its friendly for Americans. Many doctors are bilingual and board certified.

Mexico is popular for dental and medical tourism due to cheap surgeries, which are not covered by American insurance companies. Also growing in Mexico is laser eye surgery, dermatology and cardiology with savings ranging from 30 to 70 percent.

Brazil and Colombia are among the most popular destinations for plastic surgery. With many accredited and awarded doctors, costs are usually cut in half, even adding the travel arrangements. In fact, according to Bloomberg News, Brazil is the sixth most popular destination for medical traveling, with more than 4,500 licensed cosmetic surgeons.

Looking ahead, Latin American countries hoping to expand medical traveling may follow the path of Costa Rica, where earlier this year the International Medical Travel and Business Summit was held.

"Costa Rica has become the premier destination for medical travel and tourism in the Western hemisphere," said PROMED [The Council for the International Promotion of Costa Rica Medicine] Director Massimo Manzi, in a press release. "Our biggest challenge is educating the consumer. The Summit is a marvelous opportunity to highlight our medical providers and to showcase the incredible opportunities that exist by placing buyers and sellers of medical tourism together."

Originally published by Saludify.com, to view the original article click here.

Industry News

New Study Reveals Wellness Tourism a $439 Billion Market, Representing 1 in 7 Tourism Dollars

SRI International Report Released at 2013 Global Wellness Tourism Congress Shows Wellness-Focused Travel Will Reach $678.5 Billion by 2017-Nearly 50 Percent More Growth Than Global Tourism Overall

A new study presented at the inaugural Global Wellness Tourism Congress (GWTC) found wellness tourism is a near half-trillion dollar market, representing 14 percent of total global tourism revenues ($3.2 trillion ) overall. According to The Global Wellness Tourism Economy report, the category is projected to grow on average 9.9 percent annually over the next five years, nearly twice the rate of global tourism overall, reaching $678.5 billion by 2017, or 16 percent of total tourism revenues.

The study also noted over one-half of growth in wellness tourism through 2017 will come from the Asian, Latin American and Middle Eastern/North African markets, and India will be number one globally over the next five years, clocking a 20 percent-plus growth through 2017. And wellness tourists are higher spenders, on average, spending 130 percent more than the average global tourist.

The study was conducted by SRI International, in conjunction with the Global Spa & Wellness Summit (GSWS), the industry's leading education and research organization, which presented the GWTC in New Delhi, India. The study is the first to benchmark and analyze this fast-emerging tourism segment and, according to SRI, is expected to be eye-opening for governments and tourism industry stakeholders worldwide.

Read the Executive Summary HERE.

"For decades, the very concept of a vacation has been associated with excess: too much eating, drinking and too little sleep-leaving too many travelers less healthy when they check out than when they checked in," said Ophelia Yeung, lead author of the study and co-director, Center for Science, Technology & Economic Development at SRI. "This new research clearly reveals that more people are now choosing destinations that help them keep or get healthy while traveling, while a smaller (and also growing) segment are also now taking trips with the specific, sole purpose of improving their personal well-being."

Definition & Methodology: SRI defines wellness tourism as all travel associated with the pursuit of maintaining or enhancing one's personal well-being. The wellness tourism economy includes all expenditures made by tourists on these types of leisure and business trips, including lodging, food and beverage, activities/excursions, shopping and transport.


Percentage of Global Trips: While wellness tourism represents roughly one in seven total domestic and international tourism dollars (14 percent), it represents 6 percent of the number of international and domestic trips-or 524.4 million.

Powerful Impact on Jobs and Economies: Wellness tourism is directly responsible for $11.7 million global jobs, which delivers $1.3 trillion in global economic impact-or 1.8 percent of the world's GDP in 2012.

A Strikingly High-Yield Tourist: Wellness tourists spend, on average, 130 percent more than the average global tourist. An international wellness tourist spends roughly 65 percent more per trip than the average international tourist; the domestic wellness tourist spends about 150 percent more than the average domestic tourist.

"Primary" vs. "Secondary" Wellness Tourist Markets: SRI made a distinction between "primary" and "secondary" wellness tourists: the former defined as those taking a trip entirely for wellness purposes, the latter engaging in wellness-related activities as part of a trip. Not surprisingly, secondary-purpose wellness tourists constitute the significant majority (87 percent) of total wellness tourism trips and expenditures (86 percent). And while wellness tourists spend dramatically more than the average international or domestic tourist across the board, a secondary-purpose wellness traveler spends less than a primary.

Domestic Wellness Tourism Dominates: While tourism authorities tend to place an outsized focus on inbound, international travelers, domestic wellness tourism is actually significantly larger than its international equivalent-representing 84 percent of wellness tourism trips and 68 percent (or $299 billion) of expenditures. International inbound wellness tourism represents a $139 billion market (32 percent of total).

Europe and North America Dominate...For Now: While over 50 percent of the projected growth in wellness tourism through 2017 will come from Asia, Latin America, and the Middle East/North Africa, the SRI study found that today's typical wellness traveler is well-educated, well-off, middle-aged and hails from Western and industrialized nations. Europe and North America drive the outbound international wellness tourism segment, with five countries-the U.S., Germany, Japan, France and Austria-currently representing 63 percent of the global market. Additionally, the U.S., France, Austria, Germany and Switzerland drive the most inbound, international wellness tourism arrivals. Countries that attract the most domestic wellness tourism trips include: the U.S., Germany, Japan, China and France.

Spa Tourism Critical, but Not Majority of Market: Spa tourism is a core component of wellness tourism (41 percent of market), but non spa-related wellness tourism (whether "healthy hotels" and cruises; baths/springs; fitness, yoga or lifestyle retreats; travel to nature parks/preserves; organic/natural restaurant expenditures; and other "healthy" lodging and retail) represent 59 percent of the market.

"Wellness tourism is poised to reshape tourism as we know it. So many 21st century forces are fueling it, including the rise of chronic diseases and the unprecedented stress of modern life," noted Jean-Claude Baumgarten, GSWS keynote speaker and former president and CEO of the World Travel & Tourism Council. "What people want to achieve during their ever diminished time off is undergoing a sea change, with millions more every year demanding destinations that deliver physical, emotional, spiritual and environmental health-along with enjoyment."

SRI's complete The Global Wellness Tourism Economy report, which includes data on regional/national wellness tourism markets and future category growth, will be released at a media event in New York City on November 7, 2013.

About the Summit: The Global Wellness Tourism Congress is presented by the Global Spa & Wellness Summit (GSWS), an international organization representing senior executives and leaders from over 40 countries, joined by a common interest to drive economic development and understanding of the spa and wellness industries. Delegates from diverse sectors, including hospitality, tourism, health and wellness, beauty, finance, medical, real estate, manufacturing and technology, attend the organization's annual Summit, which is held in a different host country each year. After just seven years, the GSWS is now considered the leading global research and educational resource for the $1.9 trillion spa and wellness industry.

Media Contacts

Betsy Isroelit
Global Spa & Wellness Summit

Diana Wright
RBI Creative for Global Spa & Wellness Summit

Industry News

Aquarius Announcement - Columbia University & Aquarius Capital Announce Nineteen (19) New Research Projects

Michael Frank and Donald Rusconi of Aquarius Capital to teach as professors at Columbia University in the Masters in Actuarial Science program. They will teach a course called "A Global Perspective on the Health Insurance Market" beginning in September 2013, similar to the two previous courses taught in 2012 and 2013. The program will be expanded to include focus on different aspects of the healthcare insurance industry including products available, delivery systems (US vs. International), healthcare reform, accountable care organizations, CMS grants, finance, reinsurance, self-funding and capital markets.

The course will be expanded to include research projects around healthcare reform (PPACA) focused on the implementation and impact of health insurance exchanges. The course will include sixty (60) graduate students in actuarial science at Columbia University, and similar to past years, students will be involved in research projects that will benefit the actuarial and insurance industry.

Research Projects

We are pleased to announce nineteen (19) new research projects to be undertaken by Columbia University students. Projects include the following:

  • The review and evaluation of nine (9) health insurance exchanges including federal, state and partnership exchanges.
  • The studying and evaluation of six (6) publicly traded HMOs.
  • Evaluation of four (4) additional international healthcare systems, which will include Italy, Israel, Greece and Thailand. This is in addition to the twenty (20) healthcare systems previously evaluated in the prior classes.

As part of the review of international healthcare systems, students will review provider delivery systems, local healthcare reform, evaluate private vs. social insurance, roles of insurance regulators plus comparisons to the US healthcare system. Students will also study the actuarial resources in the local country plus the reinsurance markets for those countries.

Students in the course will also be involved in the research and evaluation of medical tourism and advancements in healthcare technology as well as review managed care programs that have applied for CMS grants as part of the course.

The program will also include opportunities for insurance and reinsurance professionals and organizations to participate in research as part of the program with the Columbia University students. If an interest in participating in research or alternatively access to graduate student for possible internships, then contact Michael Frank at (914) 933-0063 or michael.frank@aquariuscapital.com. To learn more about the Columbia University, Masters in Actuarial Science, visit http://ce.columbia.edu/actuarial-Science.

About Aquarius Capital
Aquarius Capital is an independently owned company with offices in New York and Connecticut. Formed in 2002, Aquarius Capital provides an array of services to its clients in the life, accident & health insurance industry including actuarial, underwriting, insurance/employee benefits brokering, product development, managed care analysis, and reinsurance risk management services. Actuarial services include managed care pricing, rate filings, reserve valuations/opinions, new product development, capitation reviews, financial forecasts, reinsurance pricing/underwriting, other post-employment benefit valuations (e.g., GASB 45, FAS 106), healthcare reform consulting, CMS grant applications, and life insurance valuations.

Aquarius insurance clients include employers, insurance companies, reinsurers, managed care companies, municipalities, managing general underwriters, school districts, brokerage firms, health care providers, Fortune 500 companies, brokerage firms and other actuarial organizations requiring expertise in the life, accident and healthcare market. Employer clients include both municipal and private sector companies purchasing insurance on a fully insured or self-funded basis.

Aquarius is also active in the capital markets having consulted more than eighty (80) financial institutions including investment bankers, private equity firms, hedge funds, asset managers and research organizations in US and international business ventures.

Contact Michael Frank at 914-933-0063, michael.frank@aquariuscapital.com or visit www.AquariusCapital.com for additional information.

Industry News

Interview: ‘Patient-Centered' Promises Missing In Endocrinology, Fueling Shortages, Wait Times

The promise of "patient-centered" healthcare, with a focus on rewarding outcomes, would seem to be good news for endocrinologists. But according to a leader in their community, the rhetoric of healthcare reform isn't matching the reality. The results are shortages of endocrinologists and long wait times for patients. To confront epidemics of obesity and diabetes, a prescription of different compensation and management structures is in order.

New compensation models that are "patient-centered" and designed to reward outcomes, not procedures, should be just what's needed to overcome challenges in endocrinology, right?

So far, the rhetoric of healthcare reform isn't matching the reality, according to an interview with George Grunberger, MD, FACP, FACE, the vice president of the American Association of Clinical Endocrinologists. Dr. Grunberger spoke with Evidenced-Based Diabetes Management, a supplement to The American Journal of Managed Care, in its most recent issue.
Dr. Grunberger, a leader with 30 years' experience in the field, recommended the following in an interview: 

  • New compensation structures, such as loan forgiveness, to encourage new doctors to enter endocrinology.
  • Financial incentives to draw endocrinologists in regulatory or research areas back into clinical practice.
  • Revisiting billing codes to recognize the challenges of cognitive specialties, which require patience and knowledge built over time.
  • Changing insurance and reimbursement requirements to allow senior endocrinologists to oversee teams of nurses and physician's assistants, for more efficient delivery of care.

EBDM spoke with Dr. Grunberger in the wake of ongoing shortages of endocrinologists that have extended wait times and left entire states without subspecialists such as pediatric endocrinologists. This is occurring at a time when the alarming levels of obesity and diabetes have made endocrinologists more important than ever. (In June, the American Medical Association declared obesity a disease.)

Dr. Grunberger said the shortage of endocrinologists has long been exacerbated by compensation levels, which do not adequately reward these cognitive specialists for the added training needed to take on complicated cases with patients who may or may not follow instructions. But things got worse in 2010 under new billing codes from the Centers for Medicare and Medicaid Services (CMS). "My reimbursements both by Medicare and private insurers have been cut," he said.

A decade ago, a landmark report by Robert Rizza, MD, and colleagues found there was a 12 percent shortage of endocrinologists in the United States and that the shortage would grow. While the report correctly predicted a rising need, its estimates failed to gauge how rapidly the epidemics of obesity and diabetics would escalate, leaving practicing endocrinologists more overworked than ever.

By January of 2013, the American Diabetes Association (ADA) and the American Academy of Pediatrics (AAP) issued updated guidelines for handling the crisis, including an emphasis on the need for better education on how to diagnose diabetes in children. Among the concerns, "In 2011, three states had no pediatric endocrinologists, and 22 had fewer than 10, and the situation is not likely to improve in the near future." Estimates of 5000 practicing endocrinologists, compared with 26 million Americans with diabetes and 79 million with prediabetes, show the math just doesn't work.

Most reports on the endocrinologist shortage have cited pay as the major factor in the crisis. A 2011 Medscape/WebMD survey found that most fulltime practicing endocrinologists earned between $150,000 and $175,000 in 2010.

So far, Dr. Grunberger told EBDM, compensation structures have been slow to reward those who work to change patient behavior and prevent illness, rather than treat those who have become ill.

"Healthcare, by definition, should be focused on maintaining the health of people. If you focus on screening and prevention so people don't get sick in the first place, it costs less to serve more people. We haven't done that, and we are now stuck in an epidemic of these metabolic diseases," he said. 

For the full interview click here.
For more information on this press release visit here.

Media Contact: Mary Caffrey
Company Name: American Journal of Managed Care
Email: mcaffrey@ajmc.com
Phone: (609) 716-777 x 144
Address: 666 Plainsboro Road Suite 300, Plainsboro, N.J., United States
Website: www.ajmc.com

Industry News


would like to extend a personal invitation for you to attend the IHC FORUM WEST Conference
"Making HealthCare Consumerism Work"

Health and benefit costs are arguably the number one challenge that employers face today. With the uncertainty of exchanges and defined contribution during this fall's open enrollment, along with urgent compliance standards, analysis and discussion with stakeholders from all corners of the industry has become a necessity. Healthcare consumerism has been the clear answer to lowering your healthcare cost and empowering your employees to become better consumers of health and healthcare.

Our conference will give you tools and solutions you can use right now to create a comprehensive, cost-effective healthcare consumerism program that serves your employees' needs and your bottom line. No matter where you are on your journey, the IHC FORUM will equip you with the money-saving strategies you need to successfully navigate the healthcare consumerism landscape and avoid the bumps along the road.

Through five cutting-edge general sessions, 24 interactive workshops, intimate roundtable discussions and unlimited networking opportunities, you'll:

  • LEARN collectively, think innovatively, and drive change cooperatively with actionable solutions. Click here to see agenda
  • CONNECT with forward-thinking experts and industry professionals on leading practices and successful strategies. Click here to view past attendees
  • SHARE valuable insights and ideas, opinions and research, and more on the latest topics and current trends.

"The IHC FORUM is the only conference series 100 percent dedicated to innovative health and benefit management."

WHERE: Red Rock Casino Resort - Las Vegas, NV
WHEN: Dec 5-6, 2013

Register now to LEARN, CONNECT and SHAREhttp://www.theihcc.com/portals/cdhc/eblast/ihc_logo.png

Produced by: The Institute for HealthCare Consumerism
292 South Main Street, Ste 400
Alpharetta, GA 30009


Upcoming Events

Indian Medical Tourism Conference 2013

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October TBD, 2013 - Bangalore/Ahmedabad, India

To learn more or to register click here.

Kerala Health Tourism

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October 31-November 2, 2013 - Le Meridian Hotel, Kochi, Kerala
To learn more or to register click here.

AnfasHetex Health Tourism Fair
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November 14-16, 2013 -Antalya Expo Center, Antalya, Turkey
To learn more or to register click here.

4th International Temos Conference-Healthcare Abroad & Medical Tourism

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December 1-3, 2013 - Bonn, Germany
To learn more or to register click here.



IHC Forum

December 5-6, 2013 - Red Rock Casino Resort Spa, Las Vegas, Nevada
To learn more or to register click here.

India Med Expo 2013-Andra Pradesh Medical Tourism & Health Care Conference
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December 6-8, 2013 - HITEX Exhibition Center, Hyderabad, India
To learn more or to register click here.

Health Tourism Expo 2013


December 19-22, 2013 - Istanbul Expo Center, Istanbul, Turkey

To learn more or to register click here.

Greek Health Tourism Integration Conference

February 22-24, 2014 - Royal Olympic Hotel, Athens, Greece
To learn more or to register click here.

Kuwait Medical Tourism Conference 2014


March 18-20, 2014 - Crowne Plaza Hotel, Al Baraka Ballroom, Kuwait
To learn more or to register click here.

Moscow International Medical and Healthcare Tourism Congress


March 19-22, 2014 - Expocenter, Moscow, Russia
To learn more or to register click here.

The Health Tourism Show


July 10-12, 2014 - The Health Tourism Show
To learn more or to register click here.

Medical Travel Today: Opinions and Perspectives on an Industry in the Making

Medical Travel Today - the authoritative newsletter for the worldwide medical travel industry - is pleased to announce publication of a new book, "Medical Travel Today: Opinions and Perspectives on an Industry in the Making.

Featuring 40 of the newsletter's most compelling interviews from the first five years of publication, the volume chronicles the explosive growth of international medical tourism as witnessed and experienced by some of the key stakeholders and players. A must-read for anyone interested or involved in the industry.

News in Review

UAE's Medical Tourism Business: More Revenue from Hospitals than Hotels

Medcitynews.com - The hospital sector is capable of yielding four times of the revenue generated by the hotel industry for the same amount of investment, a leading hospital management expert told the Hotel Show Dubai 2013 at the Dubai World Trade Centre on Sunday.

As More Americans Have Surgeries Overseas, US Companies Consider 'Medical Tourism' a Healthcare Option

Abcnews.go.com - Joy Guion was boarding a plane for the first time to fly from her native North Carolina to Costa Rica, a sun-soaked tourism hot spot where she would stay in a four-star hotel with a personal concierge and a local driver.

Medical Tourism Could be the Overseas Alternative to Obamacare

Gobankingrates.com - Open enrollment for federal health insurance exchanges for the Affordable Care Act is now in effect, and has already seen enough web traffic from Americans trying to compare plans that servers have experienced glitches in areas like Pennsylvania and Maryland during the first few hours of its launch.

NIB Considers Overseas Medical Treatment

Perthnow.com.au - NIB says growing its Australian residents' health insurance is still the top priority, but the company will explore other ways in which to expand. "We're particularly interested in exploiting some of the big trends within healthcare such as the accelerating growth of cross-international-border medical treatment," NIB chairman Steven Crane said in the company's annual report released on Friday.

Singapore Medical Tourism Industry Poised to Grow Magnificently

Pr-bg.com - Singapore medical tourism industry exhibited stupendous growth over the past few years, owing to world-class healthcare infrastructure, state-of-the-art facilities and low cost treatment.

Canadians: Big Spending on Medical Tourism

Lacombeglobe.com - Canadians seeking stem-cell treatment abroad for various illnesses are among the major groups feeding the growth in unproven and expensive therapies offered at private clinics around the world, a researcher says. The Canadians treated beg to differ.

Medical Tourism Market is Expected to Reach USD 32.5 Billion Globally in 2019: Transparency Market Research

Abc27.com - According to a new market report published by Transparency Market Research "Medical Tourism Market (India, Thailand, Singapore, Malaysia, Mexico, Brazil, Taiwan, Turkey, South Korea, Costa Rica, Poland, Dubai and Philippines) - Global Industry Analysis, Size, Share, Growth, Trends and Forecast, 2013 - 2019," the global medical tourism market was valued at USD 10.5 billion in 2012 and is estimated to reach a market worth USD 32.5 billion in 2019 at a CAGR of 17.9% from 2013 to 2019.

Medical Tourism: India Doctors are Comforting to Patients, Says India High Commissioner

Dailytimes.com.ng - High Commissioner of India to Nigeria, Mr Mahesh Sachdev in this chat with Lara Adejoro says Nigeria's health sector can be improved and attract medical tourism if the government and people team up to set up tertiary healthcare institutions where Nigerians can be treated properly.

Why India, Turkey are Cheapest Destinations for Medical Tourism

Businessdayonline.com - The growing dearth of specialist medical care services in the country and a corresponding growing middle class have resulted to more Nigerians seeking treatment abroad, with India and Turkey being major destinations.


Do you know of any available job openings relative to the medical travel industry? We encourage readers to submit any available, relevant job opportunities along with its descriptions and requirements for fellow readers and industry professionals to consider. All submissions are appreciated.


Editor's Note: The information in Medical Travel Today is believed to be accurate, but in some instances, may represent opinion or judgment. The newsletter's providers do not guarantee the accuracy or completeness of any of the information and shall not be liable for any loss or damage caused - directly or indirectly - by or from the information. All information should be considered a supplement to - and not a substitute for - the care provided by a licensed healthcare provider or other appropriate expert. The appearance of advertising in this newsletter should in no way be interpreted as a product or service endorsement by the newsletter's providers.