Editor’s Note: Earlier this year Dr. Simon Hudson and his colleague Xiang (Robert) Li published a research report entitled, Domestic Medical Tourism: A Neglected Dimension of Medical Tourism Research. Since then Hudson has presented at several medical travel events where his findings and ideas have been both challenged and lauded. Medical Travel Today caught up with Hudson to learn more about the findings in the report and the cause of the mixed reception. What follows is Part Two of our conversation. Part One can be viewed here. MTT: How has the concept of domestic medical travel been received at the conferences where you presented?

SH: That depends on the audience. At one event where the focus was really on getting Americans to go abroad, I felt like an imposter. There I am touting how American facilities can compete and I got a lot of challenges from the audience. “American hospitals can’t be cost competitive.” “There’s no such thing as personalized care.” “The quality is the same and the experience is worse.” Again, these were folks actively looking to recruit Americans elsewhere. They sort of have an obligation to root for their team, if you will. But I think every time this idea is brought forward, you can see some light bulbs going on. And for a variety of reasons. MTT: It’s interesting. In spite of the challenges of getting to the needed competitive level, American hospitals do have a significant advantage in that they can learn from the successes and failures in the international medical travel business. Granted it’s a slightly different wheel they need to build but in most areas, it operates on many of the same principles. I think that the cost of and timeframe for getting in the game here and now should be significantly less than it was for international players even just a few years ago. SH: The US, with its strong pharmaceutical industry and high-tech hospitals, does have a head start, and cutting-edge research institutions like the Cleveland and Mayo Clinics and Johns Hopkins, have been targeting an international clientele for decades. But recent years have seen a flow in the opposite direction, with American patients traveling abroad in search of less expensive and often more luxurious healthcare. This growth in medical tourism internationally is challenging American hospitals to rethink the way they do business, but I think that if hospital managers can improve the efficiency of their operations in order to reduce costs, offer more personalized care, and work with destination marketers to “package” medical tourism, then they will be able to compete. I would also suggest that US hospitals emphasize that patients treated in many foreign countries have limited legal remedies in the event of an adverse outcome caused by medical malpractice. MTT: Do you think facilitators will play as big a role in domestic medical travel as they have in the international arena? SH: Intermediaries or facilitators are important players in this industry. Since organizing healthcare in other countries requires purchasing air tickets, finding an appropriate medical facility and suitably qualified physicians, reserving hotel accommodations for accompanying travelers, negotiating prices and arranging payment, and transferring medical records, “medical brokerages”, or “medical travel agencies” have emerged to bridge the gap between clients and caregivers. They link international healthcare facilities to prospective clients seeking inexpensive treatments. Medical brokers like Planet Hospital facilitate packages to Belgium, Costa Rica, India, Mexico, Singapore, Thailand, Argentina, Brazil, El Salvador, Panama, Uruguay and the US. Medical brokerages also provide the concierge services customers receive when they obtain healthcare abroad, and often promote exotic side trips such as visits to the vineyards of Stellenbosch in South Africa, or the Taj Mahal in India. Because there is less uncertainty and risk in traveling domestically, intermediaries may not play such an important role as domestic medical tourism grows. In fact a key driver these days in the medical tourism phenomenon is the platform provided by the Internet for gaining access to healthcare information and advertising. However, there will always be a role for facilitators, and already we are seeing the emergence of medical tourism brokers for domestic travelers. Healthplace America, for example, offers a travel-for-care benefit directly to health plans that offer discounts, including travel and lodging on surgeries performed in 35 locations throughout the US. Likewise, Healthbase, a medical tourism company based in Newton, Mass., works with healthcare providers in California, Florida, Kansas and Nevada helping them fill beds for certain discounted surgeries About Simon Hudson The endowed chair for the South Carolina Center of Economic Excellence in Tourism and Economic Development, Dr. Simon Hudson joined the University of South Carolina in January 2010. He has held previous academic positions at universities in Canada and England, and has worked as a visiting professor in Austria, Switzerland, Spain, Fiji, New Zealand, the United States, and Australia. Prior to working in academia, Dr. Hudson spent several years working in the tourism industry in Europe. Dr. Hudson has written five books: Snow Business; Sports and Adventure Tourism; Marketing for Tourism and Hospitality: A Canadian Perspective; Tourism and Hospitality Marketing: A Global Perspective ; and Golf Tourism. His next book on customer service will be published in January 2013. The marketing of tourism is the focus of his research, and, in addition to the books, he has published more than 45 journal articles from his work. Dr. Hudson is frequently invited to international tourism conferences as a keynote speaker. His personal website address is www.tourismgurus.com.