Medical Tourism Final

CHAPTER – 1
INTRODUCTION TO TOURISM
World Tourism Industry is an industry which is flourishing all over the world. The
scenario of the World tourism industry is always in a state of flux, ever changing. It is reckoned
that end of 2010 will see the World tourism industry generating as many as 234 million job
opportunities for the people. It is also assumed that the contribution towards the GDP by the
World tourism industry will be approximately 10.3%.
Tourism has been a major social phenomenon of societies all over the world. It is
driven by the natural urge of every human being for new experiences, and the desire to be both
educated and entertained. The motivations for tourism also include religious and business
interests; the spread of education has fostered a desire to know more about different parts of the
globe. The basic human thirst for new experience and knowledge has become stronger, as
communication barriers are getting overcome by technological advances. Progress in air
transport and development of tourist facilities has encouraged people to venture beyond the
boundaries. The importance of Tourism, as an instrument of economic development and
employment generation, particularly in remote and backward areas, has been well recognized the
world over. It is a large service industry globally in terms of gross revenue as well as foreign
exchange earnings. Tourism can play an important and effective role in achieving the growth
with equity – an objective which we have set for ourselves. Tourism has the potential to grow at
a high rate and ensure consequential development of the infrastructure of the destinations. It has
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the capacity to capitalize on the country’s success in the services sector and provide sustainable
models of growth.
Tourism sector stimulates other economic sectors like agriculture, horticulture, poultry,
handicrafts, transport, construction, etc. through its backward and forward linkages and cross-
sectoral synergies. Expenditure on tourism induces a chain of transactions requiring supply of
goods and services from the related sectors. The consumption demand, emanating from tourist
expenditure also induces more employment and generates a multiplier effect on the economy.
TYPES OF TOURISM:
TOURISM
INDICATORS
World tourism industry and the environment: • INBOUND
The impact of the World tourism industry on our environment TOURISM
cannot be overlooked. While global tourism industry is expanding 1. International
manifold, every effort is being made to protect the heritage of Tourist arrivals
historically significant places. With every passing year, world 2. International
tourism industry is experiencing new changes to adapt to the needs Tourism receipts
of time. Increase in the world tourism activities mean more
consumption of energy and the natural resources. Alternative • OUTBOUND
sources of energy are being worked out. Global warming causing TOURISM
rise in sea levels pose to be a great threat to all the nations 1. International
worldwide. Concepts of Eco tourism is fast catching up with the Tourism
common people. Expenditure
WORLD TOURISM INDUSTRY AND ECONOMY 2. Outbound Tourism
In order to find out the contribution of the travel and tourism by region of Origin
industry to a particular country, the Travel and Tourism Account or
the TTSA is an important tool to determine the economics in detail.
The TTSA throws light on matters related to travel, tourism job
opportunities, comparing related tourism industries including hotels,
transport etc, TTSA furnishes information about global travel,
tourism pertaining to growth, demand, export, GDP, employment
opportunities, capital investment etc.
WORLD TOURISM STATISTICS AND RANKINGS
In 2008, there were over 922 million international tourist arrivals, with a growth of 1.9% as
compared to 2007. In 2009, international tourist’s arrivals fell to 880 million, representing a
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worldwide decline of 4% as compared to 2008. The region most affected was Europe with a 6%
decline.
The World Tourism Organization reports the following ten countries as the most visited from
2006 to 2009 by the number of international travelers. When compared to 2006, Ukraine entered
the top ten lists, surpassing Russia, Austria and Mexico, and in 2008, surpassed Germany. In
2008, the U.S. displaced Spain from the second place. Most of the top visited countries continue
to be on the European continent, followed by a growing number of Asian countries.
In 2009, Malaysia made it into the top 10 most visited countries' list. Malaysia secured the ninth
position, just below Turkey and Germany. In 2008, Malaysia was in 11th position.
International Tourist Arrivals to various countries
The slump in the world economy has not deterred the travelers worldwide from going to the
places they want to see. Although there is a little reduction in the tourism industry it has not
drastically fallen. We can see that there was a steady growth from 2006 to 2008 with over 6%
increase every year. Tourism has always been a huge economic growth factor and thus a lot of
countries spend a lot of money to improve their conditions to make sure the tourists have a nice
time.
The following are the top 10 ranked countries in the world highest tourists.
International International International International

UNWTO
tourist tourist tourist tourist
Rank Country Regional
arrivals arrivals arrivals arrivals
Market
(2009) (2008) (2007) (2006)
1 France Europe 74.2 million 79.2 million 80.9 million 77.9 million
United North
2 54.9 million 57.9 million 56.0 million 51.0 million
States America
3 Spain Europe 52.2 million 57.2 million 58.7 million 58.0 million
4 China Asia 50.9 million 53.0 million 54.7 million 49.9 million
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5 Italy Europe 43.2 million 42.7 million 43.7 million 41.1 million
6 United Europe 28.0 million 30.1 million 30.9 million 30.7 million
Kingdom
7 Turkey Europe 25.5 million 25.0 million 22.2 million 18.9 million
8 Germany Europe 24.2 million 24.9 million 24.4 million 23.6 million
9 Malaysia Asia 23.6 million 22.1 million 21.0 million 17.5 million
Latin
10 Mexico 21.5 million 22.6 million 21.4 million 21.4 million
America
International tourism receipts

International tourism receipts grew to US$944 billion (€642 billion) in 2008, corresponding to an
increase in real terms of 1.8% from 2007. When the export value of international passenger
transport receipts is accounted for, total receipts in 2008 reached a record of US$1.1 trillion, or
over US$3 billion a day.
The World Tourism Organization reports the following countries as the top ten tourism earners
for the year 2009. It is noticeable that most of them are on the European continent, but the
United States continues to be the top earner.

UNWTO
Tourism Tourism Tourism Tourism
Receipts Receipts Receipts Receipts
Market
(2009) (2008) (2007) (2006)
United North
1 $94.2 billion $110.1 billion $97.1 billion $85.8 billion
States America
2 Europe $53.2 billion $61.6 billion $57.6 billion $51.1 billion

Spain
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3 France Europe $48.7 billion $55.6 billion $54.3 billion $46.3 billion
4 Italy Europe $40.2 billion $45.7 billion $42.7 billion $38.1 billion
5 China Asia $39.7 billion $40.8 billion $37.2 billion $33.9 billion
6 Germany Europe $34.7 billion $40.0 billion $36.0 billion $32.8 billion
7 United Europe $30.1 billion $36.0 billion $38.6 billion $34.6 billion
Kingdom
8 Australia Oceania $25.6 billion $24.8 billion $22.3 billion $17.8 billion
9 Turkey Europe $21.3 billion $22.0 billion $18.5 billion $16.9 billion
10 Austria Europe --- $21.8 billion $18.9 billion $16.6 billion
International tourism expenditures

The World Tourism Organization reports the following countries as the top ten biggest spenders
on international tourism for the year 2009. For the fifth year in a row, German tourists continue
as the top spenders.

UNWTO
Tourism Tourism Tourism Tourism
Expenditures Expenditures Expenditures Expenditures
Market
(2009) (2008) (2007) (2006)
1 Germany Europe $80.8 billion $91.0 billion $83.1 billion $73.9 billion
North
2 United States America $73.1 billion $79.7 billion $76.4 billion $72.1 billion
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3 United Europe $48.5 billion $68.5 billion $71.4 billion $63.1 billion
Kingdom
4 China Asia $43.7 billion $36.2 billion $29.8 billion $24.3 billion
5 France Europe $38.9 billion $43.1 billion $36.7 billion $31.2 billion
6 Italy Europe $27.8 billion $30.8 billion $27.3 billion $23.1 billion
7 Japan Asia $25.1 billion $27.9 billion $26.5 billion $26.9 billion
North
8 Canada $24.3 billion $26.9 billion $24.7 billion $20.6 billion
America
9 Russia Europe $20.8 billion $23.8 billion $21.2 billion $18.1 billion
10 Netherlands Europe $20.7 billion $21.7 billion $19.1 billion $17.0 billion
Most visited cities
Top 10 most visited cities by estimated number of international visitors by selected year
International
City Country visitors Year/Notes
(millions)
Paris France 14.8 2009
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London United Kingdom 14.1 2009
Bangkok Thailand 10.21 2008
Singapore Singapore 9.7 2009
Kuala Lumpur Malaysia 8.94 2008
Hong Kong China 8.9 2009
New York City United States 8.7 2009
Dubai United Arab Emirates 7.58 2008
Istanbul Turkey 7.51 2009
Shanghai China 6.7 2007
INDIAN TOURISM INDUSTRY
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India’s performance in tourism sector has been quite impressive. During the period 2002 to
2009, India witnessed an increase in the Foreign Tourist Arrivals (FTAs) from 2.38 million to
5.11 million. Due to global slowdown, terrorist activities, H1N1 influenza pandemic, etc.,
growth rate in FTAs during 2009 fell by 3.3 per cent. The year witnessed a contraction in global
tourism by 4.3 per cent; the declaration in India was, therefore, less than that of the scale of
global slowdown. Foreign Exchange Earnings (FEEs) from tourism increased from Rs. 15,064
crore in 2002 to Rs. 54,960 crore in 2009. The growth rate in earnings in 2009 vis-a-vis 2008
was 8.3 per cent. Tourism in India has come into its own as a brand – India Tourism. There have
been several innovative approaches in the Ministry’s policy in 2009-10. The creation of niche
tourism products like heliport tourism, medical tourism, wellness tourism, adventure tourism,
cruise tourism and caravan tourism has served to widen the net of this sector. A major step has
been the issuing of guidelines to State Governments/Union Territory administrations for
development of tourism infrastructure that is world class. The Ministry is contemplating a
workshop to discuss the modalities to evolve Sustainable Tourism Criteria for India. The
Ministry had also commissioned a pilot survey to assess the impact of growth of infrastructure in
and around Corbett National Park. The year has seen some firsts too. The Grand Prix for
publicity related activity of India Tourism world-wide is a vindication of the Ministry’s creative
abilities to project Indian tourism as the world brand as also the stand that publicity is an
important tool for development. The Ministry is also gearing up for the XIX Commonwealth
Games – 2010 scheduled this year. Keeping in view the need for additional accommodation in
New Delhi and the NCR, the Ministry of Tourism has been synergizing with the and owning
agencies for creation of additional hotel rooms.
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An Annual Report 2009-10 five-year tax holiday has been obtained to promote the growth of
new hotels. Hotel projects have been enabled to obtain credit at relaxed norms due to the efforts
put in to have the Reserve Bank of India delink credit for hotel projects from Commercial Real
Estate. External Commercial Borrowings have been relaxed by the Ministry of Finance to solve
the problem of liquidity being faced by the hotel industry due to economic slowdown. Innovative
curriculum was put in place for training of youth to meet the requirements of skilled human
resource in the wake of the Games. The Ministry, in its efforts to deliver responsive governance
has initiated some measures. It is the first Ministry to have a Performance Agreement signed
between the Secretary (Tourism) and the senior officers of the Ministry of the rank of Joint
Secretary and above. This agreement lays down timelines for implementation of specific tasks by
the officers. This has culminated in the Results Framework Document for the Ministry being
hosted in the official Annual Report 2009-10 website highlighting its objectives, actions and
measurable performance indicators. The year 2009-10 witnessed heightened engagements of the
Ministry of Tourism with the States/ UTs to strengthen initiatives to promote tourism to a new
height. This was backed by extensive monitoring of projects in the States/ UTs by the officials of
the Ministry of Tourism. In order to ensure that development takes place in a holistic and
integrated way and inter-state bottlenecks are removed, inter-state regional conferences were
held. At the instance of the Ministry, States/ UTs are setting up State Level Monitoring
Committees (SLMCs) at State/ UT level to hold periodic monitoring meetings to review the
status of implementation of tourism projects. Also, recognizing the need for monitoring of
projects supported by Central Financial Assistance, new Project Monitoring Information System
(PMIS) software has been designed. Since the beginning of time humans have traveled. Food,
water, safety or acquisitions of resources (trade) were the early travel motivations. But the idea
of travel for pleasure or exploration soon emerged. Travel has always depended upon technology
to provide the means or mode of travel. The earliest travelers walked or rode domesticated
animals. The invention of the wheel and the sail provided new modes of transportation. Each
improvement in technology increased individuals' opportunities to travel. As roads were
improved and governments stabilized, interest in travel increased for education, sightseeing, and
religious purposes.
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One of the earliest travel guides was written by Pausanias, a Greek, which was a 10
volume Guide to Greece, for Roman tourists in 170 A.D. Tourism is a collection of activities,
services and industries that delivers a travel experience, including transportation,
accommodations, eating and drinking establishments, retail shops, entertainment businesses,
activity facilities and other hospitality services provided for individuals or groups traveling away
from home. The World Tourism Organization (WTO) claims that tourism is currently the
world’s largest industry with annual revenues of over $3 trillion dollars. Tourism provides over
six million jobs in the United States, making it the country's largest employer.
Tourism is traveling for predominantly recreational or leisure purposes or the provision of

services to support this leisure travel. The World Tourism Organization defines tourists as
people who "travel to and stay in places outside their usual environment for not more than one
consecutive year for leisure, business and other purposes not related to the exercise of an activity
remunerated from within the place visited".
Globally, Tourism has become a popular global leisure activity. In 2006, there were over 842
million international tourist arrivals.
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Performance of Tourism Sector during 2009
Ministry of Tourism compiles monthly estimates of Foreign Tourist Arrivals (FTAs) and Foreign
Exchange Earnings (FEE) from tourism on the basis of data received from major airports.
Because of the availability of final figures of FTAs from Bureau of Immigration (BOI) now for
2008, the provisional figure of 5.37 million FTAs for 2008 released earlier by Ministry of
Tourism, has now been revised at 5.28 million. Following are the important highlights regarding
FTAs and FEE from tourism in India for the year 2009.
Foreign Tourist Arrivals (FTAs)
• FTAs during 2009 were 5.11 million with a growth rate of (-) 3.3% as compared to the FTAs of
5.28 million and growth rate of 4% during 2008.
• Though the growth rate for 2009 is (-)3.3%, it is better than UNWTO’s projected growth rate of
(-)6% to (-)4% for the world.
• FTAs during the Month of December 2009 were 6.46 lakh as compared to FTAs of 5.34 lakh in
December 2008 and 5.97 lakh in December 2007.
• The growth rate in FTAs in December 2009 over December 2008 works out to 21% which is
highest positive growth registered in any month of 2009.
Foreign Exchange Earnings (FEE) from Tourism in Indian Rupee terms and US$ terms
• FEE in Rupee terms during 2009 were Rs. 54960 crore as compared to Rs. 50730 crore in 2008.
• The growth rate in FEE in Rupee terms during 2009 was 8.3% as compared to 2008, and 14.4%
during 2008 as compared to 2007.
• Inspite of the negative growth rate of 3.3% in FTAs, FEE in rupee terms observed a positive
growth of about 8% during 2009.
• FEE during 2009 were US $ 11.39 billion as compared to US$ 11.75 billion during 2008
• The growth rate in FEE in US$ terms during 2009 was (-)3.0% as compared to 2008, and 9.5%
during 2008 as compared to 2007.
• FEE in Rupee terms during the month of December 2009 were Rs.7042 crore as compared to
Rs.5083 crore in December 2008 and Rs.5079 crore in December 2007.
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• FEE in US $ terms during the month of December 2009 were US $ 1510 million as compared to
US $ 1046 million in December 2008 and US $ 1287 million in 2007.
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Performance of Tourism Sector during January 2010
Ministry of Tourism compiles monthly estimates of Foreign Tourist Arrivals (FTAs) and Foreign
Exchange Earnings (FEE) from tourism on the basis of data received from major airports.
Following are the important highlights regarding these two important indicators of tourism
sector.
Foreign Tourist Arrivals (FTAs):
· FTAs during the Month of January 2010 were 4.91 lakh as compared to FTAs of 4.22 lakh
during the month of January 2009 and 5.12 lakh in January 2008.
· There has been a growth of 16.4% in January 2010 over January 2009 as compared to a negative
growth of 17.6% registered in January 2009 over January 2008.
· To a large extent, the trend of substantial growth in FTAs observed during December, 2009
(21%) continued in January, 2010 also with a growth rate of 16.4%.
Foreign Exchange Earnings (FEE) from Tourism in Indian Rupee terms and US$ terms:
· FEE during the month of January 2010 were Rs. 5593 crore as compared to Rs. 4598 crore in
January 2009 and Rs. 5438 crore in January 2008.
· The growth rate in FEE in Rupee terms in January 2010 over January 2009 were 21.6% as
compared to (-) 15.4% in January 2009 over January 2008.
· FEE in US $ terms during the month of January 2010 were US $ 1215 million as compared to
FEE of US $ 941 million during the month of January 2009 and US$ 1382 million in January
2008.
· The growth rate in FEE in US$ terms in January 2010 over January 2009 was 29.1% as
compared to the growth of (-) 31.9% in January 2009 over January 2008.
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From the above statistics we can see that there has been a consistent growth of tourists from
2002 to 2008. Due to the economic slowdown, India has experienced a slight decrease in the
number of tourists. The decrease in tourists did not have any drastic effect on the industry. It was
non- preventable for any country including the likes of USA and European countries.
There has been an improving percentage in the number of tourists. We can see a 10% average
increase in 2010 for the first two quarters. This shows better signs of growth and the initiatives
taken by the government are being useful.
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The above statistics show that there has been a steady increase in the revenue received through
tourism. There was a great increase during the 2002-2003 financial year, a 43% increase. We can
also notice the fact that there was a negative slump during the 2009 period. But India has shown
better growth and development in 2010 as there has been a huge growth of over 36% during the
period of January to June.
This has shown that India is currently a global hotspot for tourists. Only if India can show more
interest in the development of the infrastructure and tourism, it can definitely become one of the
most interesting countries to visit. India can also bank upon the revenues received and improve
to make tourism a important part of the system.
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CHAPTER– 2
RESEARCH METHODOLOGY
In this specific project we have tried to understand the past, present and future of the “MEDICAL
TOURISM “ – SERVICES SECTOR in India based on the data collected and analyzed. In Post-
Liberalization period Indian medical tourism industry emerged as a market leader surpassing the
benchmarks created by the already existing competitors.
The research conducted is Analytical type trying to use facts and information already available
and analyze to make critical evaluation of the edge India has got over others and quantitative to the
extent of cost comparison between different countries and the foreign patient inflows over the years .
Objectives of the research study are:
• Is there room for all of the countries wanting a slice of the medical tourism business?
• How accurate are projections for medical tourism and how realistic are targets set by
countries for numbers of medical travelers?
• Who are the various medical and non-medical accreditors?
• What are the medical tourism promotions India and Andhra Pradesh?
• What purpose do the many international and national trade associations have?
METHODOLOGY:
1. Printed Schedules were circulated through enumerators
2. Additionally questionnaires were emailed to institutions engaged in medical tourism that

have quality certification from the tourism dept.
3. Interviews with Resource Persons actively involved in the promotion of Medical

Tourism.
4. Data collection from the reports of Indian Medical Travel Association®, International
Medical Travel Journal, Hyderabad Medical Tourism Promotion Society.
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5. The data collected was analyzed by calculating the growth rates of years over year and
also cost comparisons are made taking all the possible costs incurred for a foreign
tourists supported by the “ WORLD BUDGET ESTIMATOR” designed by Patients
Beyond Borders. The calculated growth rates are then represented graphically. SWOT
analysis is carried out; eventually areas of improvement and untapped segments are
identified .The research report also consists of the analyzed data of the Andhra Pradesh
medical tourism sector in brief.
6. A case study is prepared focusing on Medical Tourism in Hyderabad
7. Key questions answered :
• What are the different types of medical tourism?
• Where are governments promoting medical tourism?

• What is happening in the countries that are or want to be medical tourism destinations?
• Where does India stand in this global competition?
• What are the steps to be taken by India to increase its market Share?
1. At the end of the report recommendations are made so as to increase India’s market share
and thereby establish as a Market leader in the coming decades.
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CHAPTER – 3
AN OVERVIEW OF MEDICAL TOURISM
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A GLOBAL PERSPECTIVE
Medical tourism happens when patients go to a different country for either urgent or elective
medical procedures. This phenomenon is fast becoming a worldwide, multibillion-dollar
industry.
The reasons patients travel for treatment vary. Many medical tourists from the United States are
seeking treatment at a quarter or sometimes even a 10th of the cost at home. From Canada, it is
often people who are frustrated by long waiting times. From Great Britain, the patient can't wait
for treatment by the National Health Service but also can't afford to see a physician in private
practice. For others, becoming a medical tourist is a chance to combine a tropical vacation with
elective or plastic surgery.
And moreover patients are coming from poorer countries such as Bangladesh where treatment
may not be available and going for surgery in European or western developed countries is
expensive.
The interesting thing of Medical tourism is that it is a concept which is actually thousands of
years old. In ancient Greece, pilgrims and patients came from all over the Mediterranean to the
sanctuary of the healing god, Aesculapius, at Epidaurus. In Roman Britain, patients took a dip
in the waters at a shrine at Bath, a practice that continued for 2,000 years as it was believed that
the waters had a healing property. From the 18th century wealthy Europeans travelled to spas
from Germany to the Nile. In the 21st century, relatively low-cost jet travel has taken the
industry beyond the wealthy and desperate.
Countries that actively promote medical tourism include Cuba, Costa Rica, Hungary, India,
Israel, Jordan, Lithuania, Malaysia and Thailand. Belgium, Poland and Singapore are now
entering the field. South Africa specializes in medical safaris-visit the country for a safari, with
a stopover for plastic surgery, a nose job and a chance to see lions and elephants.
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Thailand
While, so far, India has attracted patients from Europe, the Middle East and Canada, Thailand
has been the goal for Americans.
India initially attracted people who had left that country for the West; Thailand treated
western expatriates across Southeast Asia. Many of them worked for western companies and
had the advantage of flexible, worldwide medical insurance plans geared specifically at the
expatriate and overseas corporate markets.
With the growth of medical-related travel and aggressive marketing, Bangkok became a
centre for medical tourism. Bangkok's International Medical Centre offers services in 26
languages, recognizes cultural and religious dietary restrictions and has a special wing for
Japanese patients
The medical tour companies that serve Thailand often put emphasis on the vacation aspects,
offering post-recovery resort stays.
South Africa
South Africa also draws many cosmetic surgery patients, especially from Europe, and many
South African clinics offer packages that include personal assistants, visits with trained
therapists, trips to top beauty salons, post-operative care in luxury hotels and safaris or other
vacation incentives. Because the South African rand has such a long-standing low rate on the
foreign-exchange market, medical tourism packages there tend to be perpetual bargains as
well.
Argentina
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Argentina ranks high for plastic surgery, and Hungary draws large numbers of patients from
Western Europe and the U.S. for high-quality cosmetic and dental procedures that cost half of
what they would in Germany and America.
Dubai
Lastly, Dubai--a destination already known as a luxury vacation paradise--is scheduled to
open the Dubai Healthcare City by 2010. Situated on the Red Sea, this clinic will be the
largest international medical center between Europe and Southeast Asia. Slated to include a
new branch of the Harvard Medical School, it also may be the most prestigious foreign clinic
on the horizon.
Other countries
Other countries interested in medical tourism tended to start offering care to specific markets
but have expanded their services as the demand grows around the world. Cuba, for example,
first aimed its services at well-off patients from Central and South America and now attracts
patients from Canada, Germany and Italy. Malaysia attracts patients from surrounding
Southeast Asian countries; Jordan serves patients from the Middle East. Israel caters to both
Jewish patients and people from some nearby countries. One Israeli hospital advertises
worldwide services, specializing in both male and female infertility, in-vitro fertilization and
high-risk pregnancies. South Africa offers package medical holiday deals with stays at either
luxury hotels or safaris.
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ESTIMATED PATIENTS TREATED AND MONEY SPENT IN SELECTED
COUNTRIES
Country Patients Estimated earnings Major services provided

treated (US$)
Cosmetic surgery, organ transplants,
Thailand 900,000 850 million dental
(in 2007) treatment, joint replacements

Cardiac surgery, joint replacements, eye
India 450,000 480 million surgery
(in 2007)
Cardiology, cardio-thoracic surgery,
Malaysia 350,000 43 million cosmetic Surgery
(in 2007)
Singapor Liver transplants, joint replacements,
e 410,000 560 million cardiac
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(in 2007) Surgery
SOURCE : ESCAP 2009
Why the World is moving towards Medical Tourism
Medical tourists have good cause to seek out care beyond the United States for many reasons. In
some regions of the world, state-of-the-art medical facilities are hard to come by, if they exist at
all; in other countries, the public health-care system is so overburdened that it can take years to
get needed care. In Britain and Canada, for instance, the waiting period for a hip replacement can
be a year or more, while in Bangkok or Bangalore, a patient can be in the operating room the
morning after getting off a plane.
For many medical tourists, though, the real attraction is price. The cost of surgery in India,
Thailand or South Africa can be one-tenth of what it is in the United States or Western Europe,
and sometimes even less. A heart-valve replacement that would cost $200,000 or more in the
U.S., for example, goes for $10,000 in India--and that includes round-trip airfare and a brief
vacation package. Similarly, a metal-free dental bridge worth $5,500 in the U.S. costs $500 in
India, a knee replacement in Thailand with six days of physical therapy costs about one-fifth of
what it would in the States, and Lasik eye surgery worth $3,700 in the U.S. is available in many
other countries for only $730. Cosmetic surgery savings are even greater: A full facelift that
would cost $20,000 in the U.S. runs about $1,250 in South Africa.
The savings sound very attractive, but a good new hip and a nice new face don’t seem like the
sort of things anyone would want to bargain with. How does the balance of savings versus risk
pay off in terms of success rates
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Inferior medical care would not be worth having at any price, and some skeptics warn that Third
World surgery cannot possibly be as good as that available in the United States. In fact, there
have been cases of botched plastic surgery, particularly from Mexican clinics in the days before
anyone figured out what a gold mine cheap, high-quality care could be for the developing
countries.
Yet, the hospitals and clinics that cater to the tourist market often are among the best in the world,
and many are staffed by physicians trained at major medical centers in the United States and
Europe.
Bangkok’s Bumrundgrad hospital has more than 200 surgeons who are board-certified in the
United States, and one of Singapore’s major hospitals is a branch of the prestigious Johns
Hopkins University in Baltimore. In a field where experience is as important as technology,
Escorts Heart Institute and Research Center in Delhi and Faridabad, India, performs nearly 15,000
heart operations every year, and the death rate among patients during surgery is only 0.8 percent--
less than half that of most major hospitals in the United States.
In some countries, clinics are backed by sophisticated research infrastructures as well. India is
among the world’s leading countries for biotechnology research, while both India and South
Korea are pushing ahead with stem cell research at a level approached only in Britain. In many
foreign clinics, too, the doctors are supported by more registered nurses per patient than in any
Western facility, and some clinics provide single-patient rooms that resemble guestrooms in four-
star hotels, with a nurse dedicated to each patient 24 hours a day.
Add to this the fact that some clinics assign patients a personal assistant for the post-hospital
recovery period and throw in a vacation incentive as well, and the deal gets even more attractive.
Additionally, many Asian airlines offer frequent-flyer miles to ease the cost of returning for
follow-up visits.
Medical Tourism trend and what Statistics shows:
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Ten years ago, medical tourism was hardly large enough to be noticed. Today, more than 250,000
patients per year visit Singapore alone--nearly half of them from the Middle East. This year,
approximately half a million foreign patients will travel to India for medical care, whereas in
2002, the number was only 150,000.
In monetary terms, experts estimate that medical tourism could bring India as much as $2.2
billion per year by 2012. Argentina, Costa Rica, Cuba, Jamaica, South Africa, Jordan, Malaysia,
Hungary, Latvia and Estonia all have broken into this lucrative market as well, or are trying to do
so, and more countries join the list every year.
Trends in medical tourism in the near future

Some important trends guarantee that the market for medical tourism will continue to expand in
the years ahead. By 2015, the health of the vast Baby Boom generation will have begun its slow,
final decline, and, with more than 220 million Boomers in the United States, Canada, Europe,
Australia and New Zealand, this represents a significant market for inexpensive, high-quality
medical care.
Medical tourism will be particularly attractive in the United States, where an estimated 43 million
people are without health insurance and 120 million without dental coverage--numbers that are
both likely to grow. Patients in Britain, Canada and other countries with long waiting lists for
major surgery will be just as eager to take advantage of foreign health-care options.
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CHAPTER - 4
MEDICAL TOURISM IN INDIA
After the silicon rush India is now considered as the golden spot for treating patients mostly from
the developed countries and Far East for ailments and procedures of relatively high cost and
complexity. India is also aggressively promoting medical tourism in the current years -and slowly
now it is moving into a new area of "medical outsourcing," where subcontractors provide services
to the overburdened medical care systems in western countries.
India's National Health Policy declares that treatment of foreign patients is legally an "export" and
deemed "eligible for all fiscal incentives extended to export earnings." Government and private
sector studies in India estimate that medical tourism could bring between $1 billion and $2 billion
US into the country by 2012.
Going by the Statistics and various studies it can be easily said that india would be the leader in
medical tourism within the next decade if only it could improve the infrastructure and tour
attractions. The question or rather the doubt that is often asked by critics is how can India provide
top line medical care to outsiders while more than 40% of its people languished below poverty
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line and less than 20% of its people can actually afford medical services. Ethically and morally
this problem has to be solved if India has to move into the category of developed country and also
as a place which provides medical care to both its own people and patients from other country
The aim of this project is to put a finger on the highly profitable service of medical care combined
with tourism in which India is currently considered as a market leader. It has been a known fact
for past many decades that Indian doctors are highly skillful in their given field since all around
the globe mot hospitals have doctors of Indian origin. Therefore it became almost natural that this
trend extended to India.
This project also aims to show why India is attracting medical tourists, is it really a secure
destination and how India can promote and develop this particular activity in the coming years so
as face competition given by other Asian and African options.
Medical tourism in India has emerged as the fastest growing segment of tourism industry despite
the global economic downturn. High cost of treatments in the developed countries, particularly
the USA and UK, has been forcing patients from such regions to look for alternative and cost-
effective destinations to get their treatments done. The Indian medical tourism industry is
presently at a nascent stage, but has an enormous potential for future growth and development.
As per the new market research report “Booming Medical Tourism in India”, India’s share in the
global medical tourism industry will climb to around 2.4% by the end of 2012. Moreover, the
medical tourism is expected to generate revenue of US$ 2.4 Billion by 2012, growing at a CAGR
of over 27% during 2009–2012. The number of medical tourists is anticipated to grow at a CAGR
of over 19% in the forecast period to reach 1.1 Million by 2012.
It is also found that India represents the most potential medical tourism market in the world.
Factors such as low cost, scale and range of treatments provided by India differentiate it from
other medical tourism destinations. Moreover, the growth in India’s medical tourism market will
be a boon for several associated industries, including hospital industry, medical equipments
industry and pharmaceutical industry.
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In addition to the existence of modern medicine, indigenous or traditional medical practitioners
are providing their services across the country. There are over 3,000 hospitals and around 726,000
registered practitioners catering to the needs of traditional Indian healthcare. Indian hotels are also
entering the wellness services market by tying up with professional organizations in a range of
wellness fields and offering spas and Ayurvedic massages.
CHANGE OF THE MEDIAN WAIT TIME IN INDIAN HEALTH SYSTEM
What is India Offering?

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AYURVEDA
India has a rich heritage in the areas of traditional and natural medicines. The earliest mention
of Indian medical practices can be found in the Vedas and Samhitas of Charaka, Bhela and
Shusruta. A systematic and scientific approach was adopted by the sages of the time leading to
the development of a system that is relevant even today. India is the land of Ayurveda. It
believes in removing the cause of illness and not just curing the disease itself. It is based on
herbals and herbal components without having side effects.
Ayurveda considers that the base of life lies in the five primary elements; ether (space), air,
fire, water and earth. And the individual is made up of a unique proportion of the five elements
in unique combinations to form three doshas (vata, pita and kapha). When any of these doshas
become accute, a person falls ill. Ayurveda recommends a special life style and nutritional
guidelines supplemented with herbal medicines. If toxins are abundant, then a cleaning process
known as Panchkarma is recommended to eliminate those unwanted toxins and revitalize both
mind and body. Ayurveda offers treatments for ailments such as arthritis, paralysis, obesity,
sinusitis, migraine, premature aging and general health care. Kerala is a world tourist
destination and part of the reasons lies with the well- known stress-releasing therapies of
famed Ayurvedic research centers. The climate along with the blessing of nature has turned
Kerala into the ideal place for ayurvedic, curative and rejuvenating treatments.
YOGA
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If Ayurveda is the science of body, yoga is the science of the mind. Practiced together they can
go a long way in making an individual fit. The word yoga means to join together. The ultimate
aim of yoga is to unite the human soul with the universal spirit. Yoga was developed 5000
years ago and the base of yoga is described in the Yoga Sutra of Patanjali.
This describes eight stages of yoga. These are Yam (universal moral commands), Niyam (self
purification), Asana (posture), Pranayama (breathing control), Prathyahara (withdrawal of
mind from external objects), Dharana (concentration), Dhyana (meditation), and Samadhi
(state of superconsciousness). To get the benefits of yoga, one has to practice Asana,
Pranayama and Yoganidra. With the regular practice of asanas one can 327 control cholesterol
level, reduce weight, normalize blood pressure and improve cardiac performance. Pranayama
helps to release tensions, develop relaxed state of mind and Yoganidra is a form of meditation
that relaxes both physiological and psychological systems. Today, yoga has become popular in
India and abroad and in a number of places including urban and rural areas yoga is taught and
practiced.
SPA TREATMENT
Most of the other parts of the world have their own therapies and treatment that are no doubt
effective in restoring wellness and beauty. New kinds of health tours that are gaining
popularity in India are spa tours. Spas offer the unique advantages of taking the best from the
west and the east combining them with the indigenous system and offering best of the two
worlds. In hydropathy, Swedish massages work with the Javanese Mandy, lulur, aromatherapy,
reflexology and traditional ayurveda procedures to help keep the tourist healthy and enhance
beauty. Combining these therapies with meditation, yoga and pranayama make the spa
experience in India a new destination for medical tourism. The spas are very useful for
controlling blood pressure, insomnia, cure tension, depression, paralysis and number of other
deadly diseases. Ananda
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Resort in Rishikesh, Angsana Resort, Golden Palm Spa and Ayurgram in Bangalore offer
ayurveda, naturopathy, yoga and meditation packages. (Gaur Kanchilal) Allopathy
India has made rapid strides in advanced health care systems, which provides world-class
allopathic treatment. This has become possible because of the emergence of the private sector
in a big way in this field. More and more foreign tourists are realizing that India is an ideal
place for stopover treatment. Indian Multi-specialty hospitals are providing worldclass
treatment at an amazingly economical cost as compared to the west. Quality services and low
price factor primarily go in favour of India. The cardio care, bone marrow transplantation,
dialysis, kidney transplant, neuron–surgery, joint replacement surgery, urology, osteoporosis
and numerous diseases are treated at Indian hospitals with full professional expertise. Apollo
hospital group, Escorts in Delhi, Jason Hospital, Global Hospital, and Max Health Care are
catering to medical care for international patients in the areas of diagnostic, disease
management, preventive health care and incisive surgeries.
The tourism department has devised websites in order to provide information. Many Ayurveda
health resorts that are owned and rum by traditional Ayurveda Institutes have come up.
Ayurgram is a novel concept that not only offers heritage accommodation but also offers a
whole range of Ayurvedic treatments and rejuvenating packages. Similarly hotels have also
included these types of packages in their holidays. Some of the tour operators have worked out
all-inclusive medical treatment package that include treatment, accommodation, food, airport
transfers, post operation recuperative holidays, along with a host of other facilities. 328 This in
fact shows our product offers true value for money for service. Many world-class state-of-the-
art furnishing and equipment are being added to our Ayurveda Resorts to welcome
international guests. Along with these hospitals there are many centers which offer not just
physical but emotional and spiritual healing to patients. With all these India is going to be one
of the leading medical health care destinations in the near future.
SPIRITUAL TOURISM
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Globally people are increasingly mentally disturbed and looking for solace in spiritual reading,
meditation and moments of divine ecstasy. Our country has been known as the seat of
spiritualism and India’s cosmopolitan nature is best reflected in its pilgrim centres. Religion is
the life-blood for followers of major religion and sects. Hinduism, Islam, Buddhism, Jainism,
Zoroastrianism and Christianity have lived here for centuries. The visible outpouring of
religious fervor is witnessed in the architecturally lavish temples, mosques, monasteries and
Churches spreads across the length and breadth of the country. India is not only known as a
place rich in its culture with varied attractions but also for many places of worship, present
itself as embodiments of compassion where one get peace of mind. Thus India has been
respected as a destination for spiritual tourism for domestic and international tourists. Spiritual
tourism is also termed as religious heritage tourism. It includes all the religions mentioned
above; religious places associated with, emotional attachment to these centers and
infrastructure facilities for the tourists. This can also be referred to as pilgrimage tourism, as
clients are not looking for luxury but arduous journeys to meet the divine goal or simple life.
The essence of spiritual tourism is inner feeling through love. Love should not be rationed on
the basis of caste, creed and economic status or intellectual attainment of the recipient.
Religions come into existence for the purpose of regulating human life; what are common to
all of them are the principles of love. Thus through religious tourism there is a sincere effort to
bring better understanding among various communities, nations and thus foster global unity.
Hinduism is one of the oldest religions of India. Over 5000 years of religious history created
wonderful temples and survived through ages all over India. The most popular spiritual tours
are those that are centered on holy Ganges River. Badrinath, Kedarnath, Haridwar, Gangotri,
Yamunotri, Allahabad, Varanasi. Jaganath temple at Puri, Bhubaneshwar, Konark in Orissa,
Mata Vaishnodevi of Jammu and Kashmir, are some of the important pilgrim centers in north
India. There are many spiritual sites in South India as well which dates back beyond the 10th
centaury. Rameshwaram, Mahabalipuram, Madurai Meenakshi temple in Tamilnadu and
Tirupati in Andhra Pradesh are some pilgrim centers. Every year millions of tourists, both
domestic and international, visit these places. India is special to Buddhists all over the world
and India is the destination for pilgrimage because Buddhism emerged in India. The country is
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dotted with places that are associated with the life and times of Gutham Buddha; Lumbini-the
birthplace of Buddha, Saranath where Buddha delivered his first sermon, Buddha Gaya where
lord Buddha attained enlightenment and Vaishali where he delivered his last sermon and
announced his nirvana. Sikhism also emerged in India. The Golden Temple in Amritsar, the
Hemkund Sahib, and Gurunanak Devji Gurudwara at Manikaran, which is also known for its
hot water springs with healing properties, the holy city of Patna Sahib and Anandpur Sahib are
important for Sikhs.
The Jain temples of Dilwara and Mount Abu in Rajasthan, the Gomateswara temple at
Karnataka, draw thousands of Jain followers. Even small communities like the Bahais have
their own Lotus Temple at Delhi. The Sultanate and Moghul empires built many historical
monuments and mosques during their reign, all over the country. Red Fort, Fatehapur Sikri,
Jama Masjid, TajMahal, Charminar etc., bear testimony to the blend of the Indian and Islam
traditions of architecture. The followers of Islam have many mosques and shrines of Sufi
Saints, like Moin-Uddin Chisti and Nizamuddin Aulia. For Christians, spiritual tours to Goa
among other place like Mumbai and Kolkata are must. Among the most popular sites in Goa is
the church of Our Lady of Rosary, the Rachel Seminary, and Church of Bom Jesus. In addition
to pilgrim centers there are personalities like the Satya Sai Baba, Osho, Shirdhi and others.
This shows that spirituality and religion in India is a serious pursuit. The State Governments
concerned, charitable trusts, temple trusts have made elaborate arrangements for
accommodation, transport and ritual ceremonies. These organizations are also running
hospitals, educational institutes, ashrams, meditation centers which benefit local community.
More than 500 religious places have been identified and efforts are being made to develop
these centers by Central and State Governments with private participation.
ADVENTURE TOURISM
Youth tourism has been identified as one of the largest segments of global and domestic
tourism. The young travelers are primarily experience seekers, collecting, enquiring unique
experiences. Adventure and risk have a special role to play in the behavior and attitudes of
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young travelers. The growing number of young travelers is being fuelled by a number of
factors such as increased participation in higher education, falling level of youth
unemployment, increased travel budget through parental contribution, search for an even more
exciting and unique experience and cheaper long distance travel.
Youth and adventure tourism appears to have considerable growth potential. The rising income
in some major potential source markets such as the Central and Eastern Europe, Asia and Latin
America, combined with the lower travel cost, growing student populations around the world
particularly in developing countries, has fuelled the demand. India: a heaven for adventure
tourism India has been an attraction for travelers from all over the world. Though in the field
of international tourism, the segment of adventure tourism in India is getting only a fraction of
such traffic. The trend has been showing an increased movement year after year with the
development of facilities and greater awareness about adventure tourism options.
Indian tourism offers both international and domestic adventurers a wide choice of adventures.
Water sports, elephant safari, skiing, yachting, hail-skiing, gliding, sailing, tribal tours, orchid
tours, scaling the high peaks of Himalayas, trekking to the valley of flowers, riding the waves
in rapids, and camel safari in the deserts are breath taking opportunities for nature enthusias.
Ladakh, the Garwal hills, the Himachal hills, Darjeeling, Goa, Lakshadweep, Andaman and
Nicobar, Jaisalmer and wildlife sanctuaries and reserves are some of the places that offer
adventure tourism.
RURAL TOURISM
Rural tourism has been identified as one of the priority areas for development of Indian
tourism. Rural tourism experience should be attractive to the tourists and sustainable for the
host community. The Ninth Plan identified basic objectives of rural tourism as: -
• Improve the quality of life of rural people
• Provide good experience to the tourist
• Maintain the quality of environment.
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Indian villages have the potential for tourism development. With attractive and unique
traditional way of life, rich culture, nature, crafts, folk-lore and livelihood of Indian villages
are a promising destination for the tourist. It also provides tourism facilities in terms of
accessibility, accommodation, sanitation and security. Rural tourism can be used as a means
to:-
• Improve the well being of the rural poor
• Empower the rural people
• Empower the women
• Enhance the rural infrastructure
• Participate in decision-making and implementing tourism policies
• Interaction with the outside world
• Improve the social condition of lower sections of the society.
• Protection of culture, heritage, and nature.
To tap the immense opportunities, coordinated actives of all agencies involved in the
development are required. A carefully planned and properly implemented development will
definitely benefit the community economically and improve the quality of life in the villages.
The success of such development depends upon the people’s participation at grass root level
for the development of tourist facilities and for creating a tourist friendly atmosphere.
Development of rural tourism is fast and trade in hotels and restaurants is growing rapidly.
Increase in the share of earnings through rural tourism will no doubt; provide an attractive
means of livelihood to the poor rural community. It increases the purchasing power at all
levels of community and strengthens the rural economy. Development of infrastructure
facilities such as rail, electricity, water, health and sanitation will definitely improve the
quality of life.
Consumer Profile
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India as a Global Destination for Medical Tourism
Tourism and healthcare, being an integral part of many economies services industry are both
important sources of foreign exchange. Globalization has promoted a consumerist culture
leading to the mushrooming of corporate healthcare settings seized with the necessity to
maximise profits and expand their coverage. However, the constraint lies in the fact that these
services can be afforded by a relatively small size of population in developing countries.
Low insurance penetration, lack of standardisation of services, poor information base,

ineffective monitoring leading to low quality, high levels of fraud and corruption, misallocation
of investments and low efficiency of existing hospitals have impeded effective performance
leading to a stagnation of the healthcare sector. In this scenario, corporate interests in the
medical care sector are looking for opportunities beyond the national boundaries.
This is the genesis of “Medical Tourism” industry. The term medical tourism refers to the
increasing tendency among people from the UK, the US and many other third world countries,
where medical services are either very expensive or not available, to leave their countries in
search for more affordable health options, often packaged with tourist attractions.
Long waiting lists, decline in public spending and rise in life expectancy and non-
communicable diseases that require specialist services are some of the factors directing a wave
of medical tourists to more affordable healthcare destinations. Most countries are tapping the
health tourism market due to aggressive international marketing in conjunction with their
tourism industry. In this rat race, Thailand, Malaysia, Jordan, Singapore, Hong Kong, Lithuania
and South Africa have emerged as big healthcare destinations.
India is unique as it offers holistic healthcare addressing the mind, body and spirit. With yoga,
meditation, ayurveda, allopathy and other Indian systems of medicine, India offers a vast array
of services combined with the cultural warmth that is difficult to match by other countries.
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Also, clinical outcomes in India are on par with the world’s best centres, besides having
internationally qualified and experienced specialists. CII believes that India should capitalise on
its inherent strengths to become a world player in medical tourism. According to a CII-Mc
Kinsey study, medical tourism in India could become a USD 1 billion business by 2012. Instead
of adopting a segmental approach of targeting a few states such as Maharashtra, Kerala, Andhra
Pradesh, Chennai, efforts are now being made to project “Destination India” as a complete
brand ideal for medical tourists. Countries from where people head for India are the UK,
Bangladesh, Oman, Sri Lanka, Indonesia, Mauritius, Nigeria, Kenya, Pakistan, etc.
Visitors, especially from the West and Middle East find Indian hospitals a very affordable and
viable option to grappling with insurance and national medical systems in their native lands.
There are thousands of expatriates without any social security and health insurance cover who
usually compare the costs before going for treatment and India has a cost advantage for this
segment.
Although, the existing market for medical tourism in India is small, it can grow rapidly if the
industry reorients itself to lure foreign patients from all potential regions such as SAARC,
Central Asia, Middle East, Africa, Europe, OECD besides the UK and the US. The annual
health bill of people from Afro-Asian countries seeking treatment outside their countries is USD
10 billion. If India can even tap a fraction of that market, the potential is enormous. The price
advantage is however offset today for patients from the developed countries by concerns
regarding standards, insurance coverage and other infrastructure.
The question being asked by many is that how can India become an international destination in
healthcare, when the clientele at home is bristling with dissatisfaction. Hence, arises the need to
define minimum standards at national level, compulsory registration and adoption of these
standards by all providers and regular monitoring and enforcing of such standards at the local
level. Quality assessment should combine evaluation of infrastructure as well as outcomes.
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An obvious answer to all this is accreditation. This will ensure transparency in the way a
hospital performs, and everything from the operating to the cleaning procedures will be
monitored, audited and recorded.
With an aim to boost the much talked about medical tourism, many corporate hospitals in India
are looking to international agencies such as JCAHO/JCI for accreditation. Accreditation will
even make tie ups with overseas health insurance agencies such as BUPA and CHUBS easier to
route patients to India.
As the medical tourism industry is growing exponentially, government and the private players
need to join hands in order to act as a catalyst to build infrastructure for hospitals, create
specialty tourist packages to include medical treatment, promote accreditation and
standardisation, enable access and tie-ups with insurance companies, provide state of art
facilities and improve quality of in-patient care and service to meet the requirements of foreign
patients and to attain sustainable competitive advantage.
Many fear about the serious consequences of equity and cost of services and raise a
fundamental question on the very existence of medical tourism- why should developing
countries be subsidising the healthcare of developed nations? For them, medical tourism is
likely to further devalue and divert personnel from the already impoverished public health
system. However, with good planning and implementation, medical tourism besides being an
economy booster can surely help India maintain good cross border and trade relations, exchange
of manpower and technology among countries.
Strategies are thus needed not just to project India as a major healthcare destination, but also to
create a system to conduct proper market research and feasibility studies in order to quantify the
“How many”, “From where”, “To where”, and most importantly the “How” of medical tourism.
Only then can we leverage and channelize all efforts in the right direction. In the absence of
proper planning, formulation, implementation and evaluation of coherent strategies, the much
created hype and all the talk may just go in vain.
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Inflow of foreign patients to India:
2002 1,50,000
2003 1,65,000
2004 1,81,500
2005 2,26,875
2006 3,15,435
2007 4,50,000
2008 5,85,000
2009 7,60,500
Analysis:
The annual growth rate of Medical Tourism in India was 10-15% from 2000 to 2005. India has
witnessed sudden surge in the inflow of foreign patients from 2007 even during the period of recession
because of the cost advantage. Indian Medical tourism has recorded a growth rate of 30% from 2006
-2007 onwards. Various studies like Deloitte , McKinsey estimate that foreign patient inflow would be
10,00,000 / yr by 2012 and Indian medical tourism would be US $ 2 billion market.
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COMPARISION OF MEDICAL TOURISTS FROM DIFFERENT COUNTRIES FOR
ALTERNATE AND MODERN MEDICINE
Alternate Modern
Medicine Medicine
Middle
Germany 22.20% East 26.46%
France 13.14% UK, 18.41%
Switzerland 12.88% Germany 13.41%
USA 12.29% USA 12.44%
UK 7.29% Maldives 11.46%
Italy 7.20% France 7.32%
Russia 6.78% Australia 3.54%
Middle East 6.36% Spain 2.44%

Switzerlan
Denmark 5.08% d 2.44%
East
Japan 4.66% Africa 1.83%
Spain 1.69% Kenya 0.24%
Kenya 0.42%
Analysis: The above table suggests that percentage of patients coming for modern medicine is higher
when compared with alternative medicine in countries like U.K, USA, Germany, France whereas in
countries like Kenya the case is reverse. Kenya, Japan, Spain, Middle East are potential markets which
remain largely unexplored because they have high sensitivity to price and waiting time
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SIZE OF MEDICAL TOURISM MARKET IN INDIA BY 2012
Source: Healthcare in India – The Road Ahead Mckinsey & Company,2008
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Analysis : From the above bar graphs it is clearly seen that market share would increase at 20-
40% with medical tourism when compared to 15-30% without medical tourism. The main
attraction is India offers world class treatment facilities at third world prices. If Medical tourism
were to reach 25% of private up market, Rs. 5000 – Rs.10000 Crore will be added to the
revenues of these players. Medical tourism will then represent 3 to 5% of total delivery market in
2012.
Trade in medical services 1992-2008 (in millions of dollars)

Private medical services :
Analysis: Medical Tourism revenue of India has reached 5000 crores (in Rs) and is going to
reach 10,000 crores (in Rs) by 2014. Presently the private sector is holding 65% share . The
graph clearly shows that the exports of medical services dominates the imports but the ratio
between receipts and payments remained more or less same in 2005-2008 because of the reason
that India has cost advantage (1/10th) when compared to US but the ratio of hospitals, medical
professionals has not increased in the same proportion with the incoming patients .
Initiative by Indian Government to Promote Medical Tourism:
The medical tourism industry in India is presently earning revenues of $333 million. Encouraged by
the incredible pace of growth exhibited by the industry, the Confederation of Indian Industry (CII) and
McKinsey have predicted that the industry will grow to earn additional revenue of $2.2 billion by
2012.
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With a view to facilitating the medical tourism industry to achieve the targets and to give greater
momentum for its growth, the Ministry of Health and Family Welfare together with the Ministry of
Tourism of the Government of India has set up a Task Force. The Task Force will evaluate the
opportunities in the industry and formulate a policy for accrediting healthcare institutions in the
country. The accreditation programme is aimed at classifying health service providers on the basis of
infrastructure and quality of services offered. It is expected to standardise procedures and facilitate
foreign patients in selecting the best hospitals.
Meanwhile, several hospitals in the country are seeking to take advantage of the booming medical
tourism industry. They are investing largely in acquiring equipments, size and skills.
To provide for brighter prospects for the industry, the hospitals can also acquire international
accreditation, integrate traditional and clinical treatments and offer end-to-end value added services by
tying up with tour operators, airline carriers and hotel companies. Hospitals can also allow foreign
patients to pay through credit and ensure proper support services to foreign patients after they return to
their native countries.
Lastly, the Government of India can also reinforce its support through quick visa processing, improved
flight connectivity and infrastructure development.
Current initiatives by various state governments and organisations:
Government Initiatives:
Central Government and State Governments have been encouraging rural handicrafts and fairs and
festivals that have direct impact on preservation of heritage and culture of rural India. It also draws
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tourists from all over the world. Regional fairs, festivals help the growth of tourism, provide a ready
market for the handicrafts, alternative income to the community, and facilitate regional interaction
within the country. Leading states such as Kerala, Goa, Maharashtra etc have taken the initiative to
promote medical tourism as a package in itself rather then just a side issue or an added benefit. The
effect has apparently been a success a medical tourism has picked up in these states. The state
governments have been monitoring closely the ecological relationship, socio cultural impact and
conducting feasibility studies before selecting tourist sites. The state governments also ensure that:
Tourism –
• Does not cause the tension for the host community
• No adverse impact on the resources
• Psychological satisfaction for the tourist.
• The large inflow of tourists would not put a stress on the local system
• Local community should not be deprived of basic facilities for the benefits of tourist
• The rural tourism does not disrupt the rhythm of community life Thus the Central
Government and State Governments have taken various steps for the promotion of tourism and
attainment of the goal of sustainable tourism development.
• TOURISM MINISTRY PROMOTES INDIA AS A 365-DAY DESTINATION: The ministry of

tourism in an effort to promote India as a 365-day destination launched three CDs on MICE, adventure
sports and cruises. The ministry is showcasing India as a world-class MICE destination with many
convention halls coming up in the line of Hyderabad International Conference Centre (HICC). The
CDs also give details about all the adventure sports facilities available in the country and the many
cruising options that are coming up.
• TOURISM MINISTRY ISSUES GUIDELINES FOR ADVENTURE SPORTS: The ministry of

tourism recently issued special guidelines for adventure sports activities in the country. The guidelines
are regarding land activities like mountaineering and trekking; water sports like river running; and air
sports like parasailing, paragliding and bungee jumping. The ministry has laid down the basic
minimum standards for adventure tourism related activities that are undertaken in different parts of the
country.
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• KERALA TOURISM REVIVE THE URU / ARAB DHOW: Kerala Tourism has plans to start
URU cruises to replicate the spice route travel of the 16th century. The uru is a home made colossal
sailing vessel made out of timber which used to ply the Indo Persian routes in times gone by. It is the
Indian equivalent of the Arab Dhow. When launched they will operate on the Bekal - Cochin sector.
This has been quite a crowd puller for medical tourists who flock to Kerala especially for the Aurvedic
and relaxing treatments offered. The curious mix of vegetarian food, exotic back waters, courteous and
pleasant people and not to mention extremely smart doctors had made Kerela a very popular
destination
• HELICOPTER TOURISM SERVICE IN KERALA: God's Own Country Kerala will be luring
tourists by launching a ''Helicopter tourism'' service. Visitors will be taken from one tourist spot to the
other in a seven-seater helicopter to save time and also discomfort on the roads. A number of cost-
effective packages have been designed in the helicopter tourism segment like ''Capital by Air'',
''Backwaters by Air'', ''Fly the Hills'' and ''Shoreline Flights''. The ''Capital by air'' offers sightseeing
trips around Thiruvananthapuram. The backwater trip takes tourists around Kumarakom, while the
''Fly the hill'' provides tourists a taste of the hill stations at Thekkady and Munnar. It will also touch
Kochi and Kumarakom. The ''Shoreline'' flights offer sightseeing to Kanyakumari along the
picturesque coastline. This service is extremely helpful to the patients who are unfit for long journeys
by road or rail. Not only that it is very fast and and the medical tourist also gets to have his own
privacy. In times of emergency the patient can be immediately flown to and from the nearest airport or
heli pad.
• PALACE ON WHEELS ADDS SEVERAL LUXURIES: The second Palace on wheels to be

launched in Rajasthan early next year ie 2007 will have a dance floor, a massage center, a conference
room and bars. It will be the third tourist train to be operated by Rajasthan Tourism after Palace on
Wheels and Heritage on Wheels (on the Shekhwati sector). The second Palace on wheels will also
have special suites. This has been a great success with post operative tour patients ie to travel in a
princely way. It brings in the nostalgia about the past eras when the prince and kings and heads of
states traveled in a grand way.
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• MEDICAL TOURISM BROCHURE RELEASED: The Ministry of Tourism is aggressively
promoting India as a global healthcare destination and has recently released the ‘Incredible India
Brochure on Medical Tourism’. The government has also started issuing M (medical) visas to the
medical patients, and MX visas to the dependent accompanying them, which are valid for a year.
Around 200000 medical tourists visited India last year, and the figure will grow by 50% this year.
• GARIB RATHS (PLUSH TRAIN FOR POOR): The Indian Railways has introduced the ''Garib
Raths'', a maiden scheme to provide plush rail services to the poor at affordable rates in the year 2004 -
2005, and plans to link all state capitals with express trains, with the induction of 24-coach trains. The
success of the Garib Raths, can already be seen in the rail operating between Saharsa (Bihar) and
Amritsar (Punjab) which is a boon to the traveler especially during the festival season. But as of
current reports the country has not taken well to the Garibh Rath and is making losses for
unforeseeable reasons. Medical patients usually skip on rail travel as it takes a longer time and is a bit
more exhausting.
• TRAIN TO KASHMIR HITS THE HIGHWAY: Ever heard of a train running on a road? It does in
Jammu and Kashmir. Set to chug in Kashmir's bewitching landscape in snowy February 2007, the
first-ever trial train to Kashmir took off for the Valley on November 7, not on traditional tracks but on
the 300 km-long Jammu-Srinagar national highway. It has added another chapter to the history of
Indian Railways and Kashmir's national rail project, as the first trial diesel mobile unit coach, a 36 tyre
wheeled train pulled by a 460 HP engine, drove up the Jammu-Srinagar Highway at 0700 hrs and
headed toward Kashmir's Budgam railway station by taking a road route and not a train track. The
world recognizes Kashmir as the paradise on earth or the Swiss alps of the east. It is especially
targeted to overseas visitors.
• JAIPUR TO SELL HERITAGE LIQUOR: Shops all over Rajasthan will sell heritage liquor, made
from age old recipes of Rajasthan Royals. It is made from dry fruits, nuts, herbs and spices with a
touch of saffron sometimes. To begin with, shops in Jaipur, Jodhpur, Kota, Bikaner, Ajmer, Udaipur
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and Bharatpur will sell the special liquor. General as well as medical tourists can now take these away
as souvenirs.
• 8000 DRUMMERS TO DRUM UP A RECORD IN MEGHALAYA: A band of 8000 drummers is

set to break a record for 5 minutes of synchronized drum beats set by Hong Kong. The band will play
a newly composed piece, "Positive Vibration" to enter the Guinness Book of World Records. The
ensemble will play at Meghalaya's autumn festival which expects to have entertainers from Australia
as well. A great way to pull in the tourist in search of the curious and unique experience. Not only that
the eastern states till now have been in the shadows so this is a great way to bring the extremely
beautiful and lush eastern states on to the world map. Also it is a great location for retreat for the
ailing patients who want calm and quite surrounding.
• FAIRY QUEEN BEGINS DELHI-ALWAR-DELHI RUN FROM 11 NOVEMBER: Built in

1855, the Fairy Queen is the oldest steam engine in working condition. Every year it takes visitors on a
Delhi-Alwar-Delhi trip. This year the schedule has been announced. It will ply twice a month
(beginning 11 November) in November, December 2006 January and February 2007. to experience
the past that too in a luxurious way is the cherry on the cake for the tourists who have been operated
upon. They take with them not only a healed body but a beautiful train journey to remember.
India’s Competencies:
Indian corporate hospitals excel in cardiology and cardiothoracic surgery, joint replacement,
orthopedic surgery, gastroenterology, ophthalmology, transplants and urology to name a few. The
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various specialties covered are Neurology, Neurosurgery, Oncology, Ophthalmology, Rheumatology,
Endocrinology, ENT, Pediatrics, Pediatric Surgery, Pediatric Neurology, Urology, Nephrology,
Dermatology, Dentistry, Plastic Surgery, Gynecology, Pulmonology, Psychiatry, General Medicine &
General Surgery
The various facilities in India include full body pathology, comprehensive physical and gynecological
examinations, dental checkup, eye checkup, diet consultation, audiometry, spirometry, stress &
lifestyle management, pap smear, digital Chest X-ray, 12 lead ECG, 2D echo colour doppler, gold
standard DXA bone densitometry, body fat analysis, coronary risk markers, cancer risk markers,
carotid colour doppler, spiral CT scan and high strength MRI. Each test is carried out by professional
M.D. physicians, and is comprehensive yet pain-free.
There is also a gamut of services ranging from General Radiography, Ultra Sonography,
Mammography to high end services like Magnetic Resonance Imaging, Digital Subtraction
Angiography along with intervention procedures, Nuclear Imaging. The diagnostic facilities offered in
India are comprehensive to include Laboratory services, Imaging, Cardiology, Neurology and
Pulmonology. The Laboratory services include biochemistry, hematology, microbiology, serology,
histopathology, transfusion medicine and RIA.
All medical investigations are conducted on the latest, technologically advanced diagnostic equipment.
Stringent quality assurance exercises ensure reliable and high quality test results.
As Indian corporate hospitals are on par, if not better than the best hospitals in Thailand, Singapore,
etc there is scope for improvement, and the country may become a preferred medical destination. In
addition to the increasingly top class medical care, a big draw for foreign patients is also the very
minimal or hardly any waitlist as is common in European or American hospitals. In fact, priority
treatment is provided today in Indian hospitals.
The Apollo Group, Escorts Hospitals in New Delhi and Jaslok Hospitals in Mumbai are to name a few
which are established names even abroad. A list of corporate hospitals such as Global Hospitals,
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CARE and Dr L.V. Prasad Eye Hospitals in Hyderabad, The Hindujas and NM Excellence in Mumbai,
also have built capabilities and are handling a steadily increasing flow of foreign patients. India has
much more expertise than say Thailand or Malaysia. The infrastructure in some of India's hospitals is
also very good. What is more significant is that the costs are much less, almost one-third of those in
other Asian countries.
India will soon become THE global health destination. It is replicating the Thai model, which has been
the first Asian destination for International Patients. India benefits from a large staff of world class
experts and the ultra-competitive cost advantage it offers.
With prices at a fraction (less than 10% for example in the treatment of gall stone $600 US ) of those
in the US or EU, the concept has broad consumer appeal. Indian private facilities offer advanced
technology and high-quality treatment at par with hospitals in western countries.
India is promoting "medical outsourcing" where subcontractors aim to provide services to the
overburdened medical care systems in western countries. Medical tourism to India is growing by 20%
a year. Most non-urgent Western patients usually get a package deal that includes flights, transfers,
hotels, treatment and often a post-operative vacation. There are many brokers specialized on the Indian
market.
India has top-notch centers for open-heart surgery, pediatric heart surgery, hip and knee replacement,
cosmetic surgery, dentistry, bone marrow transplants and cancer therapy, and virtually all of India’s
clinics are equipped with the latest electronic and medical diagnostic equipment.
Unlike many of its competitors in medical tourism, India also has the technological sophistication and
infrastructure to maintain its market niche, and Indian pharmaceuticals meet the stringent requirements
of the U.S. Food and Drug Administration. Additionally, India’s quality of care is up to American
standards, and some Indian medical centers even provide services that are uncommon elsewhere.
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For example, hip surgery patients in India can opt for a hip-resurfacing procedure, in which damaged
bone is scraped away and replaced with chrome alloy--an operation that costs less and causes less
post-operative trauma than the traditional replacement procedure performed in the U.S.
Healthcare procedures across the world show a wide cost difference. It leads to a question of
affordability even to the developed country like the US where significantly huge number of population
is not covered under any insurance scheme. In some developed country, long waiting period for
elective inpatient and outpatient care has created a situation where people do not hesitate to buy
healthcare from other developing countries like India without compromising on quality.
Complimentary tourism packages make the entire offer more attractive to the people who are
interested to travel for their healthcare. Globalisation of healthcare industry has started in many level.
For instance, Indian software companies like TCS and Mastek has signed IT contract recently worth
more than US $ 200 million.
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CHAPTER – 5
ADVANTAGE INDIA
Scope & Opportunities
Though the service sector has considerable contribution in India’s GDP, it is negligible on the export
front with only around 25 per cent of total export. Value added services generally exceed 60 per cent
of total output in the high income industrialised economy. In the global scenario, India’s share of
services export is only 1.3 per cent (2003) i.e USD 20.7 billion which has gone up from 0.57 per cent
(1990). Overall service export growth rate in India is 8 per cent (2002) against a global growth rate of
5 per cent.
It had a tremendous impact on India’s Forex reserve. Forex reserve rise to USD 118.628 on May, 2004
in comparison to USD 79.22 for the same period in 2003. Being a service sector member, medical and
tourism services export can further rise India’s Forex Reserve along with a major contribution from
software exports.
In India, international tourist rose 15.3 per cent between January and December, 2003. Though
tourism and travel industry contribution is 2.5 per cent to our countries GDP (international ranking
124) but recent initiative from the government like liberalised open sky policy to increase flight
capacity, lower and attractive fares, increase in hotel room capacity by nearly 80 per cent (from 2000)
and better connectivity between major tourist destination (Express Highway project) has helped India
to rank among the top five international holiday destination when independent traveler conducted a
poll in 134 countries.
Healthcare industry has shown considerable growth in last few years. Emergence of top notch
corporate hospitals and continuous effort for improvement of quality of care has placed Indian private
healthcare in a respectable position on the global map.
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High ratio of foreign qualified medical practitioners and well-trained nursing and paramedical staff
have developed confidence amongst the people who are seeking medical care from Indian Hospitals. If
everything moves in the right direction, MT alone can contribute an additional revenue of Rs 5000 -
Rs 10,000 crore for up market tertiary centre by 2012 (3-5 per cent of total delivery market).
Need For Medical Tourism
Medical tourism can be broadly defined as provision of 'cost effective' private medical care in
collaboration with the tourism industry for patients needing surgical and other forms of specialized
treatment. This process is being facilitated by the corporate sector involved in medical care as well as
the tourism industry - both private and public.
Medical or Health tourism has become a common form of vacationing, and covers a broad spectrum of
medical services. It mixes leisure, fun and relaxation together with wellness and healthcare.
The idea of the health holiday is to offer you an opportunity to get away from your daily routine and
come into a different relaxing surrounding. Here you can enjoy being close to the beach and the
mountains. At the same time you are able to receive an orientation that will help you improve your life
in terms of your health and general well being. It is like rejuvenation and clean up process on all levels
- physical, mental and emotional.
Many people from the developed world come to India for the rejuvenation promised by yoga and
Ayurvedic massage, but few consider it a destination for hip replacement or brain surgery. However, a
nice blend of top-class medical expertise at attractive prices is helping a growing number of Indian
corporate hospitals lure foreign patients, including from developed nations such as the UK and the US.
As more and more patients from Europe, the US and other affluent nations with high medicare costs
look for effective options, India is pitted against Thailand, Singapore and some other Asian countries,
which have good hospitals, salubrious climate and tourist destinations. While Thailand and Singapore
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with their advanced medical facilities and built-in medical tourism options have been drawing foreign
patients of the order of a couple of lakhs per annum, the rapidly expanding Indian corporate hospital
sector has been able to get a few thousands for treatment.
In India, the Apollo group alone has so far treated 95,000 international patients, many of whom are of
Indian origin. Apollo has been a forerunner in medical tourism in India and attracts patients from
Southeast Asia, Africa, and the Middle East. The group has tied up with hospitals in Mauritius,
Tanzania, Bangladesh and Yemen besides running a hospital in Sri Lanka, and managing a hospital in
Dubai.
Another corporate group running a chain of hospitals, Escorts, claims it has doubled its number of
overseas patients - from 675 in 2000 to nearly 1,200 this year. Recently, the Ruby Hospital in Kolkata
signed a contract with the British insurance company, BUPA. The management hopes to get British
patients from the queue in the National Health Services soon. Some estimates say that foreigners
account for 10 to 12 per cent of all patients in top Mumbai hospitals despite roadblocks like poor
aviation connectivity, poor road infrastructure and absence of uniform quality standards.
Analysts say that as many as 150,000 medical tourists came to India last year. However, the current
market for medical tourism in India is mainly limited to patients from the Middle East and South
Asian economies. Some claim that the industry would flourish even without Western medical tourists.
Afro-Asian people spend as much as $20 billion a year on health care outside their countries -
Nigerians alone spend an estimated $1 billion a year. Most of this money would be spent in Europe
and America, but it is hoped that this would now be increasingly directed to developing countries with
advanced facilities.
India’s Future Prospect
The global healthcare market is USD 3 trillion and size of the Indian healthcare industry is around
1,10,000 crores accounting for nearly 5.2 per cent of GDP. It is likely to reach 6.2- 8.5 per cent of the
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GDP by 2012. It is expected that medical tourism will account about 3-5 per cent of the total delivery
market.
More than 1,50,000 medical tourists came to India in 2003. Around 70,000 people came from the
Middle East for the medical treatment. Traditional system of medicine is able to attract a sizeable
number of people from western countries (Kerala, for instance). Most of the medical tourists are
Indian in origin. We need to attract more number of people of foreign origin.
International experience shows some of the countries like Thailand, Singapore, Jordan and Malaysia
have done extremely well. There is technical committee formed by Jordan Government operating for
the non-Jordanian Arab patients who visit Jordan for healthcare. This office regulates the healthcare
institutions treating those patients and monitor the entire activity.
Making of a Medical Tourism destination
Our healthcare industry has some inherent drawbacks. Lack of standardisation in medical care and
cost, lack of regulatory mechanism, infrastructural bottlenecks and poor medical insurance coverage
are a few to mention here. On the other hand, tourism and hospitality industries are facing some major
challenges to develop the infrastructure and services. Industry and government collaboration in terms
of some incentives and creation of soothing environment can further make this endeavor easy for both
the service sector. The immediate need is the establishment of health and tourism players consortium
to discuss about all these issues and maintain closer interaction and co-ordination to develop medical
tourism - a growth engine for Forex earnings.
Price Comparison Overview
COST COMPARISON – INDIA VS UNITED STATES OF AMERICA (USA)
Significant cost differences exist between U.K. and India when it comes to medical treatment.
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India is not only cheaper but the waiting time is almost nil. This is due to the outburst of the private
sector which comprises of hospitals and clinics with the latest technology and best practitioners.
Cost Comparison
Following table gives the various costs of major procedures in different

countries.You can easily make out that India is the best place to do surgery as
far as cost is consider. It shows that India is the best place for Medical
Tourism.
Cosmetic Surgery (Costs in US$)

Procedure United States Thailand ($) Singapore ($) India ($)
($)
Face-lift 20000 4800 6250 3100
Breast 10000 3150 8000 2200
Augmentatio
n
Breast 10000 3900 8000 3000
Reduction
Eyelid 7000 1400 3750 2200
Surgery
Liposuction 10000 2100 5000 2500
Nose Surgery 7300 3850 4400 1800
Tummy Tuck 8500 4050 6250 3400
ANALYSIS Dental procedures(Costs in US$)

Procedure USA ($) India ($)
Smile designing 8,000 1000
Metal Free Bridge 5,500 500
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Dental Implants 3500 800
Porcelain Mental Bridge 3000 300
Porcelain Mental Crown 1000 80
Tooth impaction 2000 100
Root canal Treatment 1000 100
Tooth whitening 800 110
Tooth colored composite 500 25
filling
ANALYSIS: The price difference between the Developed world and India
has 65 – 85% variation but the quality of treatment is more or less same.
“World class treatment at third world prices”. So, the inflow of foreign
patients is increasing as the technology advances improving the quality so as
to meet the standards accepted worldwide.
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Prices are as of 2010
Cost
Medical Procedure USA Mexico India Thailand Korea
Rica
Up to
Angioplasty $17,100 $14,000 $10,000 $9,000 $21,600
$57,000
Up to
Heart Bypass $21,100 $26,000 $10,000 $26,000 $26,000
$144,000
Heart Valve Up to
$31,000 $31,000 $3,000 $24,000 $38,000
Replacement $170,000
Up to
Knee Replacement $11,500 $12,000 $9,000 $14,000 $19,800
$50,000
Up to
Hip Resurfacing $13,400 $13,000 $10,000 $18,000 $22,900
$30,000+
Up to
Hip Replacement $13,800 $13,000 $10,000 $16,000 $18,450
$43,000
Up to
Special Fusion $8,000 $16,000 $14,000 $13,000 $19,350
$100,000
Up to
Face Lift $8,000 $6,500 $9,000 $8,600 $5,000
$15,000
Up to
Breast Implants $9,000 $4,000 $6,500 $5,700 $13,600
$10,000
Up to
Rhino Plasty $5,000 $6,000 $5,500 $5,400 $6,000
$8,000
Up to
Lap Band/Bariatric $9,200 $9,000 $9,500 $14,000 $11,500
$30,000
Hysterectomy Up to $7,500 $6,000 $7,500 $7,000 $11,000
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$15,000
Prices are approximate and not actual prices and include estimated airfare for
patient and companion. Prices will vary based upon many factors including hospital,
doctor’s experience, accreditation, currency exchange rates and more. Not included
are costs for meals, miscellaneous expenses and any hotel costs or tourism cost.
World Budget Estimator

Compare the cost of surgery in your respective country hospitals and at hospitals abroad by completing this
worksheet. (The lefthand column shows sample entries). The estimator was taken from Patients Beyond Borders, a
bestselling series of consumer guides to international medical travel that have helped thousands of patients plan for
successful procedures abroad.
Expenses at Hospitals Abroad
Top of Form
Travel Example Hospital 1 Hospital 2
Passport and visa $200

$ $
Fee for expediting passport $ -

$ $
Fee for expediting visa $ -

$ $
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Airfare (patient) $1,100
$ $
Airfare (companion) $1,100

$ $
Airfare (other travelers) $ -

$ $
Aiport entry or exit fee $ -

$ $
Hotel (companion) $800

$ $
Hotel (other travelers) $ -

$ $
Companion's meals and incidental expenses $700

$ $
Other travelers' meals and incidental expenses $ -

$ $
Transportation (taxi, bus, limo) $100

$ $
Rental car $ -
$ $
Other $ -
$ $
Subtotal for Travel: $4,000

$ $
Treatment Example Hospital 1 Hospital 2
Procedure $11,000
$ $
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Hospital room (if extra) $ -
$ $
Physician's fees (if extra) $ -

$ $
Anesthesia (if extra) $ -

$ $
Lab tests $-
$ $
Imaging (CT and MRI scans, X-rays, etc.) $ -

$ $
Additional consultations $ -
$ $
Tips or gifts for staff $ -

$ $
Other $ -
$ $
Subtotal for Treatment: $11,000

$ $
Post-discharge care Example Hospital 1 Hospital 2
Recuperation lodging $1,400

$ $
Physical therapy $ -
$ $
In-room care $ -
$ $
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Prescriptions $65
$ $
Concierge services $350

$ $
Other $ -
$ $
Subtotal for Post-discharge care: $1,815

$ $
Leisure travel Example Hospital 1 Hospital 2
Hotel $ -
$ $
Meals and incidental expenses $ -

$ $
Entertainment and sightseeing $ -

$ $
Transportation $ -
$ $
Other $ -
$ $
Subtotal for Leisure travel: $ -

$ $
"While you're away" costs Example Hospital 1 Hospital 2
Pet sitter, house sitter $400

$ $
Other $ -
$ $
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Subtotal for "While you're away" costs: $400
$ $
Total: $17,215
$ $
Bottom of Form
Expenses at U.S. Hospital

Top of Form
Treatment Example Hospital 1 Hospital 2
Procedure $55,000
$ $
Hospital room charges $4,400

$ $
Physician charges $ -
$ $
Anesthesiologist charges $ -
$ $
Other physician charges $ -

$ $
Other physician charges $ -

$ $
Additional consultations $ -
$ $
Lab tests $375

$ $
Imaging (CT and MRI scans, X-rays, etc.) $ -

$ $
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Other $ -
$ $
Subtotal for Treatment: $59,775

$ $
Post-discharge care Example Hospital 1 Hospital 2
Physical therapy $400

$ $
Medications $500
$ $
In-home care $ -
$ $
Other $ -
$ $
Subtotal for Post-discharge care: $900

$ $
Total: $43,435
$ $
Potential savings from going abroad $ $

Bottom of Form
Major players offering Medical Tourism packages
Indian corporate hospitals excel in cardiology and cardiothoracic surgery, joint replacement,
orthopedic surgery, gastroenterology, ophthalmology, transplants and urology to name a few. The
various specialties covered are Neurology, Neurosurgery, Oncology, Ophthalmology, Rheumatology,
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Endocrinology, ENT, Pediatrics, Pediatric Surgery, Pediatric Neurology, Urology, Nephrology,
Dermatology, Dentistry, Plastic Surgery, Gynecology, Pulmonology, Psychiatry, General Medicine &
General Surgery
The various facilities in India include full body pathology, comprehensive physical and gynecological
examinations, dental checkup, eye checkup, diet consultation, audiometry, spirometry, stress &
lifestyle management, pap smear, digital Chest X-ray, 12 lead ECG, 2D echo colour doppler, gold
standard DXA bone densitometry, body fat analysis, coronary risk markers, cancer risk markers,
carotid colour doppler, spiral CT scan and high strength MRI. Each test is carried out by professional
M.D. physicians, and is comprehensive yet pain-free.
There is also a gamut of services ranging from General Radiography, Ultra Sonography,
Mammography to high end services like Magnetic Resonance Imaging, Digital Subtraction
Angiography along with intervention procedures, Nuclear Imaging.
The diagnostic facilities offered in India are comprehensive to include Laboratory services, Imaging,
Cardiology, Neurology and Pulmonology. The Laboratory services include biochemistry, hematology,
microbiology, serology, histopathology, transfusion Medicine and RIA
All medical investigations are conducted on the latest, technologically advanced diagnostic equipment.
Stringent quality assurance exercises ensure reliable and high quality test results
The chief cities attracting foreign patients to India are Mumbai, Bangalore, Hyderabad, Kolkata and
Chennai. Similarly, the speciality hospitals excelling in the medical tourism industry in the country
are:
* Escorts Heart Institute and Research Centre Limited, New Delhi

* All India Institute of Medical Sciences, Delhi
* Manipal Heart Foundation, Bangalore
* B. M. Birla Heart Research Centre, Kolkata
* Breach Candy Hospital, Mumbai
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* Wockhardt Hospitals
* Christian Medical College, Vellore
* Asian Heart Institute, Mumbai
* PD Hinduja National Hospital and Medical Research Centre, Mumbai
* Jaslok Hospital, Mumbai
* Apollo Hospital, Delhi
* Apollo Cancer Hospital, Chennai
Medical Packages
The health care sector in India has witnessed an enormous growth in infrastructure in the private and
voluntary sector. The private sector which was very modest in the early stages, has now become a
flourishing industry equipped with the most modern state-of-the-art technology at its disposal. It is
estimated that 75-80% of health care services and investments in India are now provided by the private
sector. An added plus had been that India has one of the largest pharmaceutical industries in the world.
It is self sufficient in drug production and exports drugs to more than 180 countries.
* Bone Marrow Transplant

* Brain Surgery
* Cancer Procedures (Oncology)
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* Cardiac Care
* Cosmetic Surgery
* Dialysis and Kidney Transplant
* Drug Rehabilitation
* Gynaecology & Obstetrics
* Health Checkups
* Internal/Digestive Procedures
* Joint Replacement Surgery
* Nuclear Medicine
* Neurosurgery & Trauma Surgery
* Preventive Health Care
* Refractive Surgery
* Osteoporosis
* Spine Related
* Urology
* Vascular Surgery
* Gall Bladder stones surgery ( Laparoscopic Cholecystectomy )

* Hernia surgery ( Laparoscopic mesh repair )
* Piles ( Stapled Hemorrhoidectomy )
* Varicose Veins surgery
* Endoscopic Thoracic Sympathectomy for Hyperhidrosis
* Laparoscopic Appendicectomy
* Laparoscopic Adrenalectomy
* Laparoscopic Fundoplication for Hiatus Hernia
* Laparoscopic Banding of stomach for Morbid Obesity
* Laparoscopic splenectomy
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Other packages include:
• Hip-Knee replacement surgeries and other orthopedic surgeries.
• Bone marrow transplantation surgery.
• Heart surgery packages like Cardiac Surgery And Cardiology, Open Heart Surgery, Angiographies
and Angioplasties.
• Treatments of different skin problems including skin grafting.
The services provided by the host country’s hospital/ organisation are:
• Put in touch with a world class Private hospital or Nursing home and the doctor & fix up an
appointment with the doctor at the hospital.
• Receive you at the airport and provide transportation to the hotel and for the rest of the days during
your stay here.
• Provide accommodation in a hotel as per your choice and budget near the Nursing Home or the Private
hospital.
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• We can arrange for another place to stay or a rejuvenating sight-seeing tour while your mother
recovers after the treatment.
• In addition to the increasingly top class medical care, a big draw for foreign patients is also the very
minimal or hardly any waitlist as is common in European or American hospitals. In fact, priority
treatment is provided today in Indian hospitals.
STEPS OF SEEKING TREATMENT WITH MEDICAL TOURISM
1. Is the medical ailment suitable for treatment in a country different from yours the patients own
country. The answer to this question will be based on combined information from your own doctor
and the overseas doctor.
2. Ailments that require a one shot treatment like surgery for gall stones, hernia, piles, varicose veins,
hysterectomy, adrenalectomy, nephrectomy, thyroidectomy, joint replacement etc are more suitable
for medical tourism.
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3. The ailment should be such that a follow up should not be necessary and you should not need to visit
the country again to ‘ tie up loose ends.
4. The patient/ tourist should be otherwise well enough to be able to utilize the tourism part of it. Other
wise you could just go to the hospital directly for treatment.
5. Mostly planned elective surgery for which there may be a long waiting list in your country is best
suited for medical tourism.
6. Decide on the country, hospital and doctor who would be treating . This information would be
available through the net or from recommendation by another patient. Visit the website of the hospital
and doctor is the next step. Writing and asking about their training and experience in the procedure
along with the cost implications is vital.
7. Next is sending a detailed note of the medical condition. Prior and complete information will insure
that the treatment will get started immediately and without much delay. since the tourist comes from
another country he cannot come again and again therefore he needs to include all reports of
investigations and recommendations of any doctor who has seen him.
8. Based on this, the patient receives full information from specialist doctors / medical consultants advice
on prevailing medical treatment, approximate cost for planning purposes and total duration of stay
required at the hospital with pre -operative and post operative extra stay requirement etc.
9. The patient must also check full details about cost of stay at respective treatment city using a hotel or
service apartment or guest house.
10. Check with the doctor what all sight seeing / shopping / tourism is possible with the treatment patient
is having and if this would be before or after the treatment. Best time for this is after getting the
preliminary check and tests done. Following the sight seeing etc, patient gets admitted for the surgery.
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11. Acquire consent of local physician to fly down to India/ or selected destination.
12. Acquire visa for travel to the host country.
13. Check immunization requirements for going there.
14. Carry a travel insurance .
15. Fix up date of arrival, pick up from airport. It is extremely re- assuring if a person from the hospital
receives visitor at the airport and takes him to the hospital / hotel.
16. Meet the doctor and re-discuss the details of treatment, cost, stay etc as soon as possible to chart out
the plan.
17. Re-confirm return ticket as per his/ her advice.
18. Treatment
19. Discharge from hospital, with follow up advice and medications provided by the hospital.
20. Stay in the city / sight seeing as discussed earlier for the required time.
21. Review with the doctor for clearance
22. Return Home.
Procedure followed by the hospital/ clinic:
Various steps to be followed are as follows
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STEP 1 : Visitor needs to send queries pertaining to their problems.
STEP 2 : The hospital will identify a suitable doctor and hospitals based on
the query.
STEP 3 : Doctors get back to patient with their suggestions and how to
proceed ahead.
STEP 4 : Finalize on which treatment to follow and how to go about it.
STEP 5: Hospital will give the options such as where to stay pre- hospitalization & post
hospitalization .
STEP 6 : Patient/ visitor needs to finalize details and make advance payment.
STEP 7 : Arrival in India/ host country.
STEP 8 : The hospital arranges Airport pick-up and hotel check-in. they also
arrange translator if required.
STEP 9 : Hospital arranges meetings with the requisite doctors.
STEP 10 : Proceed further with the treatment as discussed in Step 4.
Step 11 : Patient/ visitor proceeds for short holiday break if required.
Step 12 : Hotel Check-out, & return to visitor’s own country
Leveraging Competencies For Medical Tourism
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• India has a huge potential of attracting medical tourist and medical tourism will contribute around
USD 2 million by year 2012, as per CII-Mckinsey report . With a good amount of investment in the
private sector, the growth of Indian healthcare is inevitable. India has the competitive advantage of
price, outstanding human resource, state-of-the-art hospitals equipped with latest equipment,
alternative medicine like Kerala’s health retreat, naturopathy and yoga, 5000-year-old civilization,
traditional art and crafts and geographical landmarks and coastlines.
• In healthcare industry, it is said that a satisfied patient is the best source of referral to the hospital. In
case if our hospitals wish to become leaders in medical tourism and achieve competitive advantage, it
is very important that quality service is provided on clinical dimensions as well as hospitality
component. Weakness of our hospitals lies in poor service culture quotient in employees.
• To achieve service excellence, it is important that delivery of service is on the lips of everyone in the
workforce. The importance of the contribution of each individual, the glory of the individual or a
department should never be an issue nor be overshadowed by other focus. Patient’s wants are related
to behavioral aspects of service like: spontaneity, warmth, concern and friendliness attention to
individual needs.
• The total hospital is more successful, if a service is only as good as the people who deliver it and
provide it. When everyone works smart, the collaboration needed to drive organisational performance
increases. Also, the patient appreciates the way he/she is treated.
• From showing empathy and optimism to extreme self-awareness to knowing what’s going on around
them, people competencies are an integral part of a progressive hospital. The use of these skills is what
elevates one’s organisation above the competition. In today’s working environment, where medical
tourist are demanding more, instilling the use of people competencies in one’s team members is
something one simply can’t survive without.
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• Indian hospitals do not face problem with the technical skills as they are acquired through education
and training but the difficulty lies in leveraging the soft skills of the employees. Soft skills are the
underlying principles that trademark a hospital for professionalism and excellent customer service.
• In today’s scenario, where it is predicted that medical tourism industry will grow by 15 per cent
annually, the real challenge lies in acquiring and developing a depository of people skill in the
organisation.
Hospitals should focus on developing workforce with:
1. Positive attitude: “I can do it” is the first thought that an employee should get when he
encounters a problem. He/she can think positively if he/she is happy, cheerful with good sense of
humor.
2. Ingenuity: Employees should possess natural incentive and creative abilities to solve
unforeseen problems. They should be capable of coming up with satisfactory solutions
instantaneously.
3. Initiative: If a hospital has employees who are self-starters, then it is like a dream come true.
If you empower people, then they show exceptional resourcefulness in handling unforeseen events or
situations effectively.
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4. Loyalty: Organisation should value an employee who maintains service interest uppermost
in his mind. Employees who display a high degree of sincerity and honesty of
purpose and are upright in dealings with patients. Superiors, equals and
Hospitals should focus subordinates are asset to any organisation.

on
1.
1. Positive Maturity: Tact and maturity are the keys to handle difficult and
attitude demanding patients. Employees who are considerate and understanding
in 2. Ingenuity dealing with patients can form the backbone of service excellence
3. Initiative
culture.
4. Loyalty
5. Maturity
2. 6. Team spirit Team spirit: Healthcare cannot be delivered by a single person; it is
7. Interpersonal
always a team work of people with diversified competencies.
skills
8. Appearance Employees who find ready acceptance by others and make good
and Bearing contribution towards functioning of the group are very good team
players. They provide wholehearted co-operation to colleagues,
superiors and subordinates.
3. Interpersonal skills: Interpersonal skills are of paramount importance. Written and oral
communication, listening skills and body language play a very important role in service delivery. It is
important to be respectful and courteous with co-workers and patients.
4. Appearance and Bearing: Hospitals should see that the appearance and bearing of
employees is synchronised at all levels. It should not happen that support staff like kitchen and
cleaning staff does not follow any hygiene standard. It is not only the employee who is properly
dressed draws attention but the employee who is not neatly dressed also excites discussion amongst
the patient relatives.
The question which takes paramount importance is “How to develop the inventory of these
competencies in the organisation? The answer is very simple. Hire employees with competencies to
meet the requirement of the organisation. HR heads should focus on development of a recruitment tool
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which helps in identification of the requisite competencies and measurement of available degree of
these competencies in the prospective employees.
It should be very clearly understood that people with desired competency come at a cost and therefore
entire manning plan and the compensation budget should be re-used. If required people should be paid
slightly more then the competing organisation as hiring is not the only issue, organisation has to also
retain high performing individuals.
Another solution to the problem is nurturing key competencies in the workforce and align
individual competencies to the requirement of the organisation.
1. Identification of individuals with desired competencies: First and foremost, HR department

along with the line managers should identify people for selective retention so that they can be used as
mentors for coaching and development. An employee with similar job role and working conditions
empathies with another employee better than anybody else. The identified mentor should
communicate effectively, know the job profile thoroughly, demonstrate trust in improvisation, help
individuals as and when needed. He knows the constraints and the requirements of the job. He can also
act as a role model and foster a feeling of constructive competition in other employees.
2. Train the identified individuals: The identified individual has to act as an mentor and train
other employees and therefore he has to lead by example. It is the responsibility of the HR department
to train him in conducting training sessions. HR department should sensitise him with issues like how
to conduct training.
3. Conduct ongoing training programme: Ongoing training programmes are very beneficial as
no hospital is free of attrition rate. Exodus of well trained staff to middle east, the US & the UK cannot
be stopped because of massive requirement in these countries, but whenever an employee joins an
overseas hospital, the identity is always linked with the past employer.
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Continuous training programme on communication, attitude and personality development should be
carried out and mechanism should be set to analyse the impact of these programs. Competencies and
strengths vary from people to people and all the employees are never the same. Leverage their
strengths and differences because these are the facts that will help distinguish you and your
organisation from the competition. Leverage each other’s strengths inside the team to develop a new
identity of the hospital.
Indian healthcare is amongst the best in the world but to attract medical tourist it has to not only come
up with world class infrastructure but India should focus on optimum utilisation of the talent pool. If it
is done, the projected medical tourism market of USD 40 million can be easily achieved.
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CHAPTER – 6
PROMOTION OF MEDICAL TOURISM IN INDIA WITH
SPECIAL FOCUS ON ANDHRA PRADESH
The key "selling points" of the medical tourism industry are its "cost effectiveness" and its
combination with the attractions of tourism. The latter also uses the ploy of selling the "exotica" of the
countries involved as well as the packaging of health care with traditional therapies and treatment
methods.
Price advantage is, of course, a major selling point. The slogan, thus is, "First World treatment at
Third World prices". The cost differential across the board is huge: only a tenth and sometimes even a
sixteenth of the cost in the West. Open-heart surgery could cost up to $70,000 in Britain and up to
$150,000 in the US; in India's best hospitals it could cost between $3,000 and $10,000. Knee surgery
(on both knees) costs 350,000 rupees ($7,700) in India; in Britain this costs £10,000 ($16,950), more
than twice as much. Dental, eye and cosmetic surgeries in Western countries cost three to four times as
much as in India.
The price advantage is however offset today for patients from the developed countries by concerns
regarding standards, insurance coverage and other infrastructure. This is where the tourism and
medical industries are trying to pool resources, and also putting pressure on the government. We shall
turn to their implications later.
The entire concept of medical tourism hangs on the efficiency, skill and competency level of the
doctors, specialists and consultants etc. World over patients and hospitals trust Indian doctors without
doubt. This is therefore an advantage for India. Patients from around the globe expect the best of
services solely based on the reputation of doctors of Indian origin. But so far the government has
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failed to realize the advantage of this important factor. This reputation and goodwill that Indian
doctors enjoy could be leveraged to attract and promote Indian medical tourism.
The other most important reason why India has not been able to attract more customers is that there is
no specific campaign which only promotes medical promotes medical tourism. The incredible India
campaign has catapulted India in the top 5 must visit unique destination for lonely planet but so far as
it goes Thailand, Bangkok and other east Asian countries are still market leaders. Therefore there is
still scope that with specific marketing, advertising and promotion campaigns considerable number of
tourists can be attracted.
In India the strong tradition of traditional systems of health care such as in Kerala, for example, is
utilised. Kerala Ayurveda centres have been established at multiple locations in various metro cities,
thus highlighting the advantages of Ayurveda in health management. The health tourism focus has
seen Kerala participate in various trade shows and expos wherein the advantages of this traditional
form of medicine are showcased.
A generic problem with medical tourism is that it reinforces the medicalised view of health care. By
promoting the notion that medical services can be bought off the shelf from the lowest priced provider
anywhere in the globe, it also takes away the pressure from the government to provide comprehensive
health care to all its citizens. It is a deepening of the whole notion of health care that is being pushed
today which emphasizes on technology and private enterprise.
The important question here is for whom the 'cost effective' services is to be provided. Clearly the
services are "cost effective" for those who can pay and in addition come from countries where medical
care costs are exorbitant - because of the failure of the government to provide affordable medical care.
It thus attracts only a small fraction that can pay for medical care and leaves out large sections that are
denied medical care but cannot afford to pay. The demand for cost effective specialized care is coming
from the developed countries where there has been a decline in public spending and rise in life
expectancy and non-communicable diseases that requires specialist services.
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Urban concentration of health care providers is a well-known fact - 59 per cent of India's practitioners
(73 per cent allopathic) are located in cities, and especially metropolitan ones. Medical tourism
promotes an "internal brain drain" with more health professionals being drawn to large urban centres,
and within them, to large corporate run specialty institutions.
Medical tourism is going to result in a number of demands and changes in the areas of
financing and regulations. There will be a greater push for encouraging private insurance tied to
systems of accreditation of private hospitals. There is a huge concern in the developed countries about
the quality of care and clinical expertise in developing countries and this will push for both insurance
and regulatory regimes. The potential for earning revenues through medical tourism will become an
important argument for private hospitals demanding more subsidies from the government in the long
run. In countries like India, the corporate private sector has already received considerable subsidies in
the form of land, reduced import duties for medical equipment etc. Medical tourism will only further
legitimise their demands and put pressure on the government to subsidise them even more. This is
worrying because the scarce resources available for health will go into subsidising the corporate
sector. It thus has serious consequences for equity and cost of services and raises a very fundamental
question: why should developing countries be subsidising the health care of developed countries?
The Golden Goal - India’s $1 billion dream:
India could earn more than $1 billion annually and create 40 million new jobs by sub-contracting work
from the British National Health Service, the head of India's largest chain of private hospitals and
other such organisations in the US and European states.
Apollo Hospitals, which provides medical tourism packages has put forth a suggestion and currently
is awaiting a reply to carry out operations at a fraction of what they would cost in the United
Kingdom. They include surgery for hip and knee replacements and coronary bypass that would slash
waiting times dramatically, reducing the queues of British patients waiting to see their doctors. They
have well equipped, state-of-the-art hospitals and can offer the same level of care as anywhere else in
the world. There is no reason why India should not become the healthcare destination of the world.
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India's healthcare industry is growing at 30 per cent annually and the Apollo group alone has so far
treated 95,000 international patients, many of whom are of Indian origin. Reddy cited two recent cases
of UK nationals who opted for private healthcare at the Apollo network.
Medical treatment in the UK is free under the NHS, but because of the long waiting times some
patients opt for expensive private care. The advantage of Reddy's offer is that is that it would reduce
pressure on the NHS and offer sub-contracted healthcare at vastly cheaper rates.
After this million people, there are thousands of expatriates. Not necessarily Indian, but expatriates
who may be given the opportunity to come and get themselves operated in India where we are
planning to give them what is called health tourism."
One of the major destinations for Medical Tourism in India is Andhra Pradesh:
Kerala is very well known for ayurvedic medicine and Andhra Pradesh is now being
recognised in the areas of Allopathy, energy therapies, alternative medicine and Mind body
intervention.
TOURISM CIRCUITS:
Government of Andhra Pradesh is presently promoting its tourism activities in 6 major circuits viz.,
Hyderabad Circuit covering Hyderabad City and surrounding destinations like Warangal, Adilabad, etc.;
Visakhapatnam Circuit covering Visakhapatnam city, Araku Valley and surrounding destinations in
Srikakulam and Vizianagaram districts; Tirupati Circuit covering Tirumala Temple, other surrounding
temples, Horsley Hills and other nearby destinations; Krishna-Godavari Circuit covering River Cruises,
backwaters, Konaseema, Kolleru Lake area and other surrounding destinations; Vijayanagar Circuit
covering destinations in Anantapur, Kurnool, and Kadapa; and Buddhist Circuit which has two steams
viz., Lower Krishna Valley Circuit covering Nagarjuna Sagar, Amaravati and other Buddhist locations;
and North Coastal Circuit covering Buddhist locations in and around Visakhapatnam District.
Government will encourage any suitable tourism product in these circuits which serve to augment an
existing destination.
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Andhra Pradesh received 15.75 crores domestic tourists and 79.52 lakh international tourists upto
2009. Tourism provides 10% of the overall employment. Andhra Pradesh has the 1st position in the
domestic tourism. There was good growth of tourism in Tirupati and Vizag and Hyderabad.
Since tourism provides large-scale employment and there is every need to encourage it, Government
of Andhra Pradesh has taken many initiatives to promote tourism sector. Government of Andhra
Pradesh has drafted a new State Tourism Policy with an attractive package of incentives to develop
tourism in our State, on 27th November, 2010 on the occasion of World Tourism Day, as the present
policy under implementation pertains to 1998 and there was a need for revision due to time gap and
prudent fiscal management. They have decided to promote medical tourism, film tourism, convention
tourism and heli tourism in the State by developing all tourist spots and infrastructure facilities. They
are also contemplating to develop a huge garden at Nagarjunasagar replicating the famous Brindavan
Gardens at Mysore. Government of Andhra Pradesh has requested Government of India for
introduction of Southern Splendor Luxury Tourist to cover major destinations of South India and
promote rail based tourism in our State. The Tourism Department will also be given more Police force
to start the 'Tourism Police' in all the important tourism spots to ensure security to the tourists.
An excerpt from the Indian Tourism Policy 2010:

SUPPORT TO MICE TOURISM AND MEDICAL TOURISM: Andhra Pradesh, particularly
Hyderabad, also enjoys competitive advantage over other Indian States in terms of Medical Tourism
and MICE Tourism. The presence of the best Airport in the country, the presence of the best
Convention Centre in the country, the presence of the best Exhibition facility in the country, the
presence of hotels at par with the best, very good urban infrastructure, moderate climate, and attractive
tourist destinations can help position Hyderabad as the most preferred destination for MICE Tourism.
As Hyderabad enjoys the presence of highest caliber medical specializations and expertise, it can also
be promoted as a major center for Medical Tourism.
MICE Tourism and Medical Tourism require the coming together of both the concerned Government
Agencies and the private stakeholders on a common platform. Only in such an eventuality can the
strengths of each player be synergized and maximum advantage for the city can be reaped.
Government will endeavor to create appropriate organizational structures, preferably in the form of
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societies, to establish this common platform. The constituted society can hereafter take up all the
required activities necessary for harmoniously organizing MICE Tourism and Medical Tourism
respectively. The Government will also become the main driver behind these Societies by infusing the
required capital in its corpus and by engaging experienced professionals to manage these Societies.
Andhra Pradesh launched Hyderabad Medical Tourism Promotion Society:
MEDICAL Tourism is the major focus area of the Department of Tourism, Government of
Andhra Pradesh and it is in the process of forming Hyderabad Medical Tourism Promotion
Society (HMTPS). HMTPS was launched in April 2010 for which the state tourism department
has selected stakeholders for the Society. HMTPS will work on the required norms for Medical
Tourism like maintaining standards, procedures and payment issues.
“We are currently consulting Ernst and Young to suggest a feasible model for the Society to
promote Hyderabad as a Medical Tourism destination. We are looking at having a committee of
stakeholders comprising of medical players (hospitals) and travel agents who eventually help in
smooth planning for the visiting patients,” said Jayesh Ranjan, Secretary of Andhra’s Tourism,
Archaeology and Museums departments.
Commenting on this initiative, Pradeep Thakural, Executive Director, Indian Medical Travel
Association said,
“Formation of HMTPS by the state tourism department is a positive move and this will give
much needed boost to the Medical Tourism sector, which is growing at 30-40 per cent each
year,” said Pradeep Thakural, Executive Director, Indian Medical Travel Association in
Hyderabad.
Various other Institutional arrangements are State Tourism Promotion Board (STPB) , State
Tourism Promotion Committee (STPC), District Tourism Promotion Committee (DTPC)
Therefore, Indian government is trying to develop its Medical Tourism by considering
the opportunity costs, sensitivity of patients from different economies towards price,
quality, responsivess. Apart from this Tourism Development conducts various awareness
programmes to highlight the goodwill foreign patients have upon the Indian Doctors, State
support provided to eligible tourism products like wellness centers (Spa/Yoga/.etc)
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CHAPTER - 7
A CASE STUDY ON MEDICAL TOURISM IN HYDERABAD CITY

Introduction
Definition of Medical Tourism
Medical tourism can be broadly defined as provision of ‘cost effective’ private medical care in
collaboration with the tourism industry for patients needing surgical and other forms of
specialized treatment. This process is being facilitated by the corporate sector involved in
medical care as well as the tourism industry – both private and public.
Ancient History-Indian Medical Tourism
Some might have difficulty categorizing yoga retreats, Buddhist pilgrimages, and meditation
centers as medical tourism, but the unbelievable reach of India’s healing arts is not to be ignored.
Ever since yoga’s birth more than 5,000 years ago, India has enjoyed a constant influx of
medical travelers and spiritual students hoping to master and benefit from this most fundamental
and revered branch of alternative medicine. When Buddhism came along roughly 2,500 years
later, this only added fuel to the fire and helped position India as the epicenter of Eastern
cultural, spiritual, and medicinal progress. Not only is India one of the world’s oldest medical
tourism destinations, but it has now also become one of the world’s most popular ones as well.
Medical Tourism Industry Overview
The Indian healthcare market is Rs. 15 billion and growing at over 30% every year. Indian
private hospitals are increasingly finding a mention in the travel itineraries of foreigners, with the
trend of medical tourism catching up in the country. If industry estimates are to be believed, the
size of the medical tourism industry stands at Rs 1,200 – Rs 1,500 crore (Rs. 12-15 billion).A
recent CII-McKinsey study on Indian healthcare says medical tourism alone can contribute Rs
5,000- Rs 10,000 crore (Rs. 50-100 billion) additional revenue for tertiary hospitals by 2012, and
will account for 3-5% of the total healthcare delivery market. This is a huge, untapped market,
not just for therapeutic medical tourism like ayurveda, but also for curative treatment. India can
lead the world in medical and health tourism since we have a tremendous advantage with a large
pool of skilled manpower and technological edge.
Why India?
The countries where medical tourism is being actively promoted include Greece, South Africa,
Jordan, India, Malaysia, Philippines and Singapore. India is a recent entrant into medical
tourism. The Indian government predicts that India’s $17-billion-a-year health-care industry
could grow 13 per cent in each of the next six years, boosted by medical tourism, which industry
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watchers say is growing at 30 per cent annually. Price advantage is a major selling point. The
slogan, thus is, “First World treatment’ at Third World prices”.
The cost differential across the board is huge: only a tenth and sometimes even a sixteenth of the
cost in the West. India has a lot of hospitals offering world class treatments in nearly every
medical sector. For long promoted for its cultural and scenic beauty, India is now being put up
on international map as a heaven for those seeking quality and affordable healthcare. Analysts
say that as many as 150,000 medical tourists came to India in 2004. As Indian corporate
hospitals are on par, if not better than the best hospitals in Thailand, Singapore, etc there is scope
for improvement, and the country is becoming a preferred medical destination. In addition to the
increasingly top class medical care, a big draw for foreign patients is also the very minimal or
hardly any waitlist as is common in European or American hospitals.
About Hyderabad
Hyderabad is the fifth largest city in India with an ancient civilization and culture. Hyderabad
and Secunderbad are twin cities, separated by Hussain sagar which is a man made lake. A natural
and sophisticated blend of old and new, an old ‘Nawabi’ culture with a new pro-active approach
and hospitality. The teeming bazaars of the old city, in the midst of which stands the 400-year-
old Charminar, the modern shopping complexes and ultra-modern malls in the newer areas of the
city add to the charm of Hyderabad. The Golconda Fort, capital of the kingdom by that name, is
today very much part of the city, as is Cyberabad (means Cyber City), a new local area created to
keep pace with the zooming Information Technology and Tourism sector. Pearls, bangles, silks,
computer software, handicrafts and above all a delectable cuisine add to the splendor of this
great city. Hyderabad is one of the most densely populated cities in the country and is home to
about 2.2 million people. Hyderabad has a mix of Hindu-Muslim culture with a number of
monuments of historical importance, including the very famous Charminar. Hyderabad has too
many tourist attractions that would often make it difficult for a tourist to set his priorities. While
art lovers cannot defy the attraction of the huge repository of antiques displayed at the A.P.
Museum, The Nizam Museum and the Salarjung Museum would offer a delightful insight to the
rich imperial history.
Hyderabad is known worldwide for its diamond markets, glass embedded bangles and delectable
Hyderabadi cuisine. Hyderabadi Cuisine can itself be a big reason for visiting Hyderabad. The
delicious Biryanis and myriad of mutton and chicken dishes religiously followed by mouth-
watering sweets will earn the accolades from all gourmets across the world.
Advantages of Coming to Hyderabad for Medical Treatment
• Internationally accredited medical facilities using the latest technologies
• Highly qualified Physicians/Surgeons and hospital support staff
• Significant cost savings compared to domestic private healthcare
• Medical treatment costs in India are lower by at least 60-80% when compared to similar
procedures in North America and the UK
• No Wait Lists
• Fluent English speaking staff
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• Options for private room, translator, private chef, dedicated staff during your stay and
many other tailor-made services
• Can easily be combined with a holiday/business trip
Quality in Health Care
India the glorious country has found yet another way to contribute to the world through quality
health care. Now is the time when it is giving its best through quality health care and medical
tourism facilities. Increasing pressure on the medical facilities and the hike in the purchasing
capacity of the Indians and the foreigners visiting India has led to the recent development in the
quality health care and medical facilities.
The geographic conditions and the increase in the quality health care services are all conducive
to boost the medical tourism facilities in India.
Importance of Accreditation
Obviously, you want to receive the best possible care that you can. When you stick with medical
facilities that have reputable credentials and accreditation, you can be reasonably sure that they
adhere to certain standards, medical codes, and professional ethics. Having accreditation does
not necessarily mean that your doctor or dentist is a miracle worker, but it helps to weed out
undesirable medical practitioners. In addition, many insurance companies will not pay for
medical services performed at non-accredited health care facilities.
Joint Commission International (JCI)
Joint Commission International (JCI) is the global arm of the US-based Joint Commission on the
Accreditation of Healthcare Organizations (JCAHO); the same body that certifies over 18,000
hospitals in the United States. Although JCI approval is not the only accreditation available for
medical tourism facilities, it is a fairly good benchmark to use when researching foreign
hospitals.
If you come across a medical tourism facility that doesn’t have JCI accreditation, there’s no need
to be alarmed. Many countries have their own accrediting bodies that put forth standards and
regulations that closely mirror (and sometimes exceed) the accrediting standards established
by JCI.
International Organization for Standardization (ISO)

While ISO is not necessarily a health care accrediting body, it’s important that you stick with
medical tourism destinations where ISO has representation.ISO and its member organizations
help ensure that hospitals and dental clinics closely adhere to the strict international standards
that they put forth. In this way, you have a much better chance of receiving optimal medical and
dental care when you take your health vacation abroad.
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Access to Hyderabad:
By Air: Indian Airlines has flights connecting Hyderabad with all major cities in India. The
nearest airport is Shamshabad International Airport.
By Rail: The world’s second largest railway under one management the Indian Railways carries
more than ten million people every day. Main railway stations are Begumpet Station, Hyderabad
Station, Kachiguda Station and Secunderabad Station.
By Bus: The AP State Road Transport Corporation (APSRTC) has a busy district service that
connects Hyderabad to every city, town and almost all villages.
Cost Comparison: Preventive Health Checks
Preventive Health Checks Charges in Hyderabad
Master Health Check $45
Executive Health Check $90
Cardiac Checkup $130
Procedure Charges In Hyderabad and USA (US $):

Cost (US$)
Procedure
United States Hyderabad
Bone Marrow Transplant 2,50,000 69,000
Liver Transplant 3,00,000 69,000
Heart Surgery 30,000 8,000
Orthopedic Surgery 20,000 6,000
Cataract Surgery 2,000 1,250
Dental Procedure Charges between USA and Hyderabad

Cost in US ($) Cost in Hyderabad ($)
Dental procedure
General Dentist Top End Dentist Top End Dentist
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Smile designing - 8,000 1,000
Metal Free Bridge - 5,500 500
Dental Implants - 3,500 800
Porcelain Metal Bridge 1,800 3,000 300
Porcelain Metal Crown 600 1,000 80
Tooth impactions 500 2,000 100
Root canal Treatment 600 1,000 100
Tooth whitening 350 800 110
Tooth colored composite fillings 200 500 25
Tooth cleaning 100 300 75
Cost Comparison – Hyderabad Vs United Kingdom (UK)

United Kingdom (USD)
Procedure Hyderabad (USD) Approx
Approx
Open Heart Surgery USD 18,000 USD 4,800
Cranio-Facial surgery and skull base USD 13,000 USD 4,500
Neuro- surgery with Hypothermia USD 21,000 USD 6,800
Complex spine surgery with implants USD 13,000 USD 4,600
Simple Spine Surgery USD 6,500 USD 2,300
Simple Brain Tumor

USD 4,300 USD1,200
-Biopsy
USD 10,000 USD 4,600
-Surgery
Parkinson’s
USD 6,500 USD 2,300
- Lesion
USD 26,000 USD 17,800
- DBS
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Hip Replacement USD 13,000 USD 4,500
‫ ٭‬These costs are an average and may not be the actual cost to be incurred.
RESEARCH METHODOLOGY
Objectives
1. To study the factors which are attracting the International Patients to Hyderabad.
2. To study the satisfaction level of International Patients
3. To compare the cost of the treatment in Hyderabad with foreign Countries.
Data Collection
This study was conducted in a corporate multi-super specialty hospital at Hyderabad.
Primary Data – Primary Data is collected using methods such as interviews, questionnaires and
observations of the admit patients in the study hospital for the year 2007 randomly.
Secondary Data – All methods of data collection can supply quantitative data (numbers, statistics
or financial) or qualitative data (usually words or text). Quantitative data may often be presented
in tabular or graphical form. Secondary data is data that has already been collected by someone
else for a different purpose. For example-Data supplied by a marketing organization, Annual
hospital reports, Government statistics.
Sources of Data Collection – Paper-based sources, Electronic sources, Official or government

sources, Unofficial or general business sources.
Findings and Interpretations – Specialty wise International Patients Received Treatment in Study
Hospital- (2007)
No. of
Sr.No. Specialty
Patients
1 Cardio-Thorasic Surgery 38
2 Plastic Surgery 49
3 Ophthalmology 58
4 Gynecology & Obstetrics 09
5 Orthopedics 68
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6 Surgical Gastroenterology 38
7 Laparoscopic Surgery 49
8 Health check 60
9 Kidney Transplant Surgery 00
10 Oncology 62
11 Dental 32
TOTAL 463
From the above data we can say that the international patients are coming to Hyderabad to get
the world class treatment at negligible cost without any waiting time by the world class western
qualified and trained Doctors for the major health issues and tourism. There is more demand for
Orthopedics, Ophthalmology, Plastic Surgery, Cardio-thoracic and Oncology Surgeries as these
are the most expensive surgeries in their countries with more waiting time.
Nationality wise International Patients Received Treatment in Study Hospital (2007)
Nationality wise International Patients Received Treatment in Study Hospital (2007)
Sr.No. Country Name Number Of Patients
1 NRI-USA 31
2 NRI-UK 32
3 KSA 78
4 UAE 82
5 Tanzania 63
6 Nigeria 38
7 Ethiopia 53
8 Kenya 32
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9 Afghanistan 12
10 Uganda 36
11 China 06
TOTAL 463
From the above data we can say that the Non-Residents-Indians from the developed world and
from the Arab Countries and African Countries Hyderabad is getting good number of patients in
all specialties. Patients are paying from their own pockets to escape from the diseases and the
huge waiting time in their countries.
Satisfaction Level of International Patients Received Treatment in Study Hospital:

Very Below
Sr.No. Services Good% Average%
Good% Average%
1 Medical Treatment 85.52 13.82 0.64 00.00
2 Medical Services 88.12 11.44 0.43 00.00
3 Nursing Services 88.76 10.58 0.64 00.00
4 Patient Service 88.33 11.23 0.43 00.00
5 Administrative Staff 83.80 14.90 1.29 00.00
6 Food And Beverage 77.75 21.16 1.07 00.00
7 House Keeping 85.74 13.17 1.07 00.00
8 Over All Facilities 87.47 11.66 0.86 00.00
Total 85.68 13.49 0.80 00.00
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Interviews were conducted in the study hospital of the international Patients, who are treated and
those under treatment, in the conscious state of mind. This reveals that 85.68% patients rated the
services provided by the study hospital are very good, 13.49% patients rated the services
provided by the study hospital are good, 0.80% patients rated the services provided by the study
hospital are average, 0.00% patients rated the services provided by the study hospital are below
average.
Conclusion
The following factors are attracting the international patients to Hyderabad-India for treatment
and tourism
1) Cost Benefit:
The prime advantage is the cost savings with respect to medical consultancy or surgeries. Many
of the Hyderabadi hospitals, serving international patients, have state-of-the-art infrastructure,
highly educated doctors and top-notch services but the figure on that price tag is a fraction of
what it would be in developed countries. Even if the patient’s insurance does not cover the costs
of treatment in India, the final bill in an Indian hospital would most probably be lower than
patient’s out-of-pocket expenses.
2) Timeliness:
Another advantage is the possibility of getting immediate medical attention. There are no waiting
lists or delays to contend with, due to insurance issues or unavailability of doctors etc.
3) Quality Health Care:
Hyderabadi doctors and paramedics are well trained and are one of the best in the world.
4) Personalized Care:
Here patients are monitored closely with a personal care of all age group.
5) Technological Sophistication:
All the corporate Hospitals in Hyderabad are having State-of-the-art equipment and
infrastructure for the best treatment and diagnosis.
6) Facilitation by Government:
The Government of India has recognized the economic potential of medical tourism. It has
facilitated travel by introducing a special visa category known as ‘medical visa’ for patients as
well as introduced tax incentives for hospitals.
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7) Ease of Travel and Communication:
Travel to Hyderabad (India) has become easier and much faster due to introduction of private
airlines. Access to Internet in Hyderabad is considered to be one of the cheapest in the world and
communication facilities are well established. Travel agencies have a great online presence and
can offer you package deals that include travel costs, boarding as well as treatment costs.
8) Easy Availability of Medicine and Drugs:
Certified drugs and medicines are easily available in Hyderabad, at comparatively lesser prices.
9) Modern &and Traditional:
Modern medical aid as well as traditional therapy, such as Ayurveda, Yoga, Naturopathy etc, is
available at different locations in Hyderabad.
10) Tourism Potential:
People, who come for relatively simple, but important procedures, can consider packing in some
travel too, with their doctor’s permission! This is an added advantage. Every part of the country
is rich in history and diverse in geography.
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CHAPTER – 8
SUMMARY
Where does India need to improve
High Hurdles
Hurdles to India's medical ambitions abound. With 100,000 patients a year traveling to the country --
up from 10,000 five years ago -- hospitals are struggling to remedy first impressions that can turn
people off. European people are aware of the poverty and decrypt state of the infrastructure but this
knowledge is second hand gained through books and other media as such it really as a reality check
when these visitors are faced with streets overflowing with people and bicycles and by neighborhoods
where new offices butt up against tarpaulin-covered slums. It is a make or break situation, on one hand
they are promised with world class health care at nominal cost( as per their standard) but on the other
hand they face reality with in your face human degradation and surreal poverty. Patients can
sometimes decide not to go through with the process just looking at the general state of the local
people of the host country. They wonder whether the price of their operation with an Indian hospital
compared with five times more in their home country is worth the risk.
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Therefore the logical thing for India is to strive for a massive Image Improvement plan, the medical
industry in itself is banding together to improve its image. The Indian Healthcare Federation, a group
of about 60 hospitals, is developing accreditation standards. In the U.S., organizations such as the Joint
Commission on Accreditation of Healthcare Organizations, based in Oakbrook Terrace, Illinois, assess
infection rates, the width of hospital corridors and the capacity of elevators. In India, there's no
accreditation, and hospitals aren't required to provide information on the outcomes of treatments.
There is nothing as far as quality standards go. Hospitals keep data, but they don't need to share it
Sketchy Information
The leading question that any potential medical tourist will ask himself is -where is the information,
how detailed is the information and whether it is easily available or not; for eg Escorts' Web site lists
only the number of procedures it has performed. Thought they do not mention the obvious and
important fact that Trehan, Escorts' hospital had a mortality rate of 0.8 percent and an infection rate of
0.3 percent in 2003. That compared with an observed mortality rate, or the rate of actual deaths, of
4.77 percent for heart valve surgery or coronary artery bypass surgery that included heart valves at
New York-Presbyterian Hospital from 2000 to 2002, according to a New York State Department of
Health report is much better. Such facts not only need to be told but they also need to unashamedly
promoted if India has to attract more overseas patients.
Infrastructural mess
India competes for foreign patients with Malaysia, Singapore and Thailand but it offers less in some
areas where it matters such as infrastructure. We can almost call it as the curse of India since no
matter what the problem we try to resolve on the national scale the first and most formidable issue is
the infrastructure or rather the lack of it. Thus if we are to improve the basic requirement of having
wide roads, electricity, grounded electric wiring, information system in place etc then most of our
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problems will be resolved including that of medial tourists. Thailand's airports and roads are in better
shape than India's because Thailand is a major vacation destination. In 2003, 10 million tourists
traveled there, according to the Tourism Authority of Thailand's Web site. That was more than triple
the number for India that year.
Bumrungrad Hospital Pcl, which runs Bumrungrad Hospital in Bangkok, started courting overseas
patients during the Asian economic crisis in 1997 as the devaluation of the baht drove down costs for
visitors.
That year, Bumrungrad treated 50,000 foreigners. It handled seven times as many in 2004, accounting
for 35 percent of its patients. In 2003, Bumrungrad hosted 150 Indian delegations, including one led
by Wockhardt's Bali, showing them intensive care units, recovery rooms and the Starbucks cafe in the
lobby.
International Focus
The focus on international patients screams at us. Having interpreters and instructions in multiple
languages such as Arabic, English, German, and Spanish etc is a must. The patient must feel that
whatever he is trying to convey goes across and all the communication must be clear. What it shows is
that convenience offsets most other things for an international patient. At the end of the day the patient
must feel sure is that he is treated for the right ailment and his consultant understands him perfectly.
We Care attitude:
Indian hospitals are countering with perks of their own. This is due to the fact that India believes in “
atithi devo bhava” and using this to best their own cause. Hospital’s representatives meet the patients
at the airport , help them through immigration and drive them to the hospital in a private vehicle. Their
room was stocked with fruit and drinks. They have on call consultants with arrangements made for pre
and post treatment sight seeing, shopping and other tourist activites. Hospitals even loan a mobile
phone so they can stay in touch once they left the hospital.
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More Foreigners
Foreign patients are still far from the norm. Operations on non-Indians accounted for 10 percent of the
more than 4,000 surgeries at Escorts in 2003. Foreign surgeries will pick up as rising health costs and
long waiting lists provide incentives to travel to India and its low-priced rivals.
In the U.S., health-related spending climbed 7.6 percent to $1.68 trillion in 2003, consuming almost
15.3 percent of the $11 trillion gross domestic product. It was the fifth consecutive year that the cost of
medical care expanded faster than the economy.
U.S. employer-paid health insurance premiums have soared 59 percent since 2000, according to the
Henry J. Kaiser Family Foundation and the Health Research and Educational Trust, nonprofit groups
that study medical care. In 2004, premiums averaged $9,950 for families and $3,695 for individuals,
the groups found. What all this means is that no matter what happens the number of foreign tourists
will keep on increasing and India should be ready or atleast get ready to attract these patients.
Accidental Patient
In the U.K., the waiting list for the government-funded National Health Service prompts some patients
to look elsewhere. Last year, the lag averaged less than nine months for surgery, about half the 18
months in 1997.
Unlike people who chose India after deciding not to pursue an operation through the National Health
Service, there are others who have discovered India by accident.
Case in point : In July 2004, Ian Brown, a director at Harrogate, England-based electronics company
Surevision Ltd., suffered chest pain and went to his local doctor. The National Health Service told him
he'd have to wait as long as four months for a test and then, if required, two years for an angioplasty to
open blocked arteries.
On vacation in India in September, Brown experienced chest pain again and was rushed to Wockhardt
Hospital in Bangalore. Wockhardt performed an angioplasty the next day, inserting a wire mesh tube
101 | P a g e
called a stent to prop open an artery. Back in England, Brown got a letter from the National Health
Service in November asking him to come in for his initial test -- two months after he'd had the surgery
in India. In this instance an accidental discovery proved to be a life saver.
$800 vs. $18
Charging foreigners more than Indians is one way hospitals can make money to treat the poor. An
echocardiogram machine, used to picture the heart, costs about $200,000 anywhere in the world.
Doctors can charge $800 per scan in the U.S; in India, they charge 800 rupees, or $18.
The difference makes it tough to recoup costs. The reason why hospitals are so excited about overseas
patients is that in India there are more than enough Indians to fill the nation's hospitals. India has
enough volumes but what we don’t get is pricing. India should and is charging for the value rater than
the concentrating on volume based profit alone.
Catering to the middle East tourists
Some Middle Eastern patients began choosing India after the Sept. 11, 2001, attacks on New York and
Washington, Oman hospitals often refer patients to India for complicated procedures because the
country is familiar, closer than the U.S. or Europe and cheap. Also after 9/11, people are scared to go
to the U.S not only due to fear of terrorist attacks but mainly due to the fact that they feel threatened
because of racial discrimination be it overt or subtle. The fact that people in US look at a turbaned and
bearded man as a potential terrorist is an unsettling experience. Not only in the US but even in UK and
other European countries people of coloured skin and religion are facing discrimination.
Brain drain reversal
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Indian doctors are returning home again .and offering medical procedure which they performed abroad
in their home country itself. There are many Indian patients who had to go abroad for medical reasons
this is one of the factors that influenced doctors to return home. The other reason is that the pay in
India is gradually rising and the lure to back in one’s own homeland is quite strong.
Easy Transition
Indian hospitals are working to make the transition easier. Apollo is setting up a London clinic to
attract people seeking alternatives to the National Health Service. The idea is that a doctor would look
at patients find the problem and make all arrangements to get them to India.
Changing the trend
Just as Indian software companies started with small programming jobs and expanded to become a
$16 billion global industry, India's international health care initiative is in its early stages. For patients
and profits to increase, India must remedy negative first impressions and persuade doubters that
millions of the country's poor and ailing won't be left behind.
Lessons from International Success Stories

The success stories from across the world provide significant strategic inputs for the development of
a strategy for India.
The Case of Cuba
Cuba is one of the earliest successes in medical tourism industry. The country successfully tapped the
demand for medical tourism from Latin-American countries. Cuba’s success can be attributed to the
strategic push provided by government through State-Owned Companies. The two main ingredients
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of Cuba’s success were:
Promoting Privatization of HealthCare
The government promoted private investment in healthcare to increase the supply of high quality and
specialized healthcare. Healthcare was accorded infrastructure status and laws enacted to increase
participation of private entrepreneurs. One example is allowing treatment for skin diseases using
human placenta that was banned elsewhere.
Centralized Marketing through SERVIMED
The government centralized promotion of health services abroad by entrusting the responsibility to
SERVIMED a newly formed public company. SERVIMED coordinated with tour operators and
travel agencies to develop health packages.
The package included travel in Cuba’s national airline, 24 hours assistance, and companion
personnel for the patient, repatriation, and post-surgery controls. To support efficient marketing,
SERVIMED also opened offices in Argentina, Brazil, Chile, Mexico, and Venezuela.
The two-pronged strategy successfully resulted in 30,000 patients visiting Cuba in 1997 for
treatment earning US$ 30 million foreign exchange.
Indian Scenario:
Privatization of health services has increased initially only few groups like Apollo existed later on
as the Govt. of India started supporting investment in health care the number of players increased
and thereby the resources also increased which made it possible to respond to the increasing inbound
patients.
Centralized bodies like IMTA , HMTPS etc have emerged to carry out promotional activities for
medical tourism.
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The Case of Thailand
A more recent success story is that of Thailand. Thailand is one of the world's leading healthcare
destinations with a forecast of 1 million overseas patients for the current year. The main reasons for
Thailand’s success are:
Inter-Sectoral Coordination
The Thai government realized early the need for coordination across various sectors to realize the
industry’s potential. Hence it developed a common vision, strategic direction, joint-strategy and
shared objectives for various sectors in order to facilitate better coordination between the concerned
players – the Ministries of health, tourism, foreign affairs and other bodies like Thai Airways
Tourism Authority of Thailand.
Effective Marketing - Tourism Authority of Thailand
The Tourism Authority of Thailand (TAT) has played a stellar role in providing integrated
marketing Thai tourism abroad. TAT has more than 18 offices worldwide and has won several
international credits for developing excellent marketing campaigns targeted at tourists. TAT has
so far been extremely successful in marketing Thai health services also.
Focus on Hospitality
Thailand heavily focuses on hospitality to provide superior consumer experience and building brand
equity. For example the Bumrungrad Hospital in Bangkok provides hospitality services that include:
pick up from Airport, language interpreters for 18 languages and an in-house Starbucks and
McDonalds to cater to tourists from U.S and U.K.
Indian Scenario:
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Currently the Ministries of health, tourism, foreign affairs and other bodies like APSRTC,
IRCTC, Airways, insurance providers are collaborating to take care of the tourists right from the
Foreign Tourist Arrival, stay, domestic travel , treatment requirements.
CHAPTER – 9
CONCLUSION
India is a developing country and a lot needs to be done before we can call ourselves as a developed
country, all we can claim is to be a progressive one. After the dotcom com boom in the nineties we
have gone through a lean patch as such. India as an emerging nation needs to grow both from with in
and outside; in the sense development needs to done both for the Indian Diaspora and at the same time
opportunities need to be grasped and developed so that foreign investment pours in.
After the dotcom rush India has again got the opportunity to earn billions of dollars with
medical tourism . We have all the bases coved in the sense we have the qualified doctors and
consultants, we have already developed the trust of people the world over in the past decades and we
also have the exotic environment meant for tourism. All that we do need is to make the transition from
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being a potential destination to a fully rewarding and sound medical tourism destination which is
equivalent to or better than any service offered world over.
The question that India will have to handle in the coming years is how to justify giving world
class medical care to visitors where as it spends just 1.4 % of its GDP on medical care of its own
people. Health of its own people will reflect on the robustness of the general state of the country. So
unless this is balanced off the issue of biasness will keep on cropping up.
Time and again we see that the root of all our national issues and problems arise from having
an inherently weak infrastructure with poorly executed law and order and political red tape.
Compounded with the problem of over population, dwindling natural resources and reckless disregard
for the environment we stand at a junction where things can go haywire or they might become
extremely successful if we only start resolving them. Currently it is like moving 1 step ahead and then
going 3 steps backwards. Medical tourism is based on having a well oiled network of tour operators,
medical facilities, hotels, conventional tour packages and infrastructure tools such as electronic
connectivity, air network and good sanitation. Only then we can compete with already established
markets such as in Thailand , south American states such as Mexico and Costa Rica etc.
Although the situation appears to be grim there is still hope. One step at a time is all that is
needed. First and foremost is to have the basic infrastructure in place such as having proper road and
rail connectivity, having a good network of airports to all the major states and cities and with the
countries from where the potential tourists will arrive such as the US the middle east and western
Europe and also the major African and Islamic countries in Asia. Secondly but more importantly there
is a need to put forward the information required by the tourists. Aggressive marketing is the only way
to go as seen in the case of Thailand, Singapore , malyasia etc. Not only that there should be
government authorized websites where people can get all the information regarding surgeries, hotels,
cost comparison etc . they have to be developed exclusively for the medical tourism purpose. Twenty
four hours helpline, television advertisements, getting information and advertisements published in
medical journals and popular magazines etc is a worthwhile investment. We have already seen how
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successful the Incredible India campaign is. Based on similar line but exclusively for medical tourism
other such campaigns must be developed.
Since India already has the advantage of having highly qualified, English speaking doctors
and medical staff it seems just a matter of time when medical tourism will take off in a big way. We
have the cost advantage, we have the skills advantage we even have world class facilities and so all we
need is a better image, a functional infrastructure and some clever promotional campaign. This is a
golden opportunity which we cannot pass up. Not only that the foreign currency that we earn is going
to give our own people various benefits. It just seems like a circle in which all the bodies who
participate have a win win situation on hand.
The idea of doing this project was to bring to light how medical tourism is the 21 st century’s
golden goose for India. Bringing out all the true facts, the weak points and in general trying to
understand the phenomenon itself of medical tourism has been insightful. This project has been
laborious since finding out relevant information is difficult and there are very few sources to find it
out from.
It has been worthwhile doing this project on medical tourism since it is an upcoming industry
with lots of potential and also facing various difficulties. The main idea behind doing this project was
to highlight all the important features and data and give atleast a birds eye view over the concept of
tourism for medical purpose. In conclusion I can easily say that medical tourism for India is a once in
a life time opportunity and we certainly need to take up on our strong points in order to become the
leading nation in this area. I hope I have done justice to my project and based on the data collected I
might easily say that India is the place where people come to heal themselves since god’s grace seeps
and flows through all the pores of India. We are a nation of people who feel honor in helping out and
healing the mind and the spirit. I therefore dedicate this project to all the worthy doctors and medical
professionals and to India my mother and may gods will guide us to to a better and prosperous era.
“ATITHI DEVO BHAVA”

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Bibliography
• C.R.Kothari, 2002, Research Methodology, 2nd Edition
• Philip Kotler, John Bown, James Makens, 2003, “Marketing For Hospitality and Tourism” 2nd Edition
• V S Ramaswamy, S Nanakuars, 2002, Marketing Management, Global Prospective,
3rd Edition.
• James A F Slouer, R Edward, Daniel R Gilbert, May (1998), Management, 1 st Edition
• Syed AminTabish, Hospital and Health Services Administration, 2001, Oxford.
• Dr. B. Narayan, 1999, ISO 9000 and Quality Movements
• K Sridhar Bhatt, Aug 2002, Total Quality Management
• Modern Medicare-Vol3, No.12, Nov. 2007
• Indian Journal of Medical Ethics, Vol-IVNo.4, Oct-Nov-2007
• Health Administrator, Vol-XVI, Vol-XVII, No.2, No.1, July 2005
• ExpressHealthcare-Vol.1, No-12, Dec-2007
• International Journal of Management Science-Vol-2, No-2, Dec-2006
• http://www.medicaltourismmag.com/article/medical.html
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• http://www.medicaltourismmag.com/article/understanding-culture.html
• http://www.medicaltourismmag.com/article/healthcare-reform-and.html
• http://www.medicaltourismmag.com/article/developing.html
• http://www.medicaltourismmag.com/detail.php?Req=150&issue=7
• http://healthtourismmagazine.com/blog/
• http://www.bharatbook.com/detail.asp?id=76596&rt=Asian-Medical-Tourism-Analysis-2008-2012.html
• http://www.admedusa.com/info/healthcare/how-many-medical-tourists
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CHAPTER – 1

International Tourist Arrivals to various countries

International International International International

International tourism receipts

International International International International

2 Europe $53.2 billion $61.6 billion $57.6 billion $51.1 billion

10 Austria Europe --- $21.8 billion $18.9 billion $16.6 billion

International tourism expenditures

International International International International

Most visited cities

Paris France 14.8 2009

Bangkok Thailand 10.21 2008

Singapore Singapore 9.7 2009

Kuala Lumpur Malaysia 8.94 2008

Hong Kong China 8.9 2009

New York City United States 8.7 2009

Dubai United Arab Emirates 7.58 2008

Istanbul Turkey 7.51 2009

Shanghai China 6.7 2007

INDIAN TOURISM INDUSTRY

Tourism is traveling for predominantly recreational or leisure purposes or the provision of

Foreign Tourist Arrivals (FTAs)

Foreign Tourist Arrivals (FTAs):

Objectives of the research study are:

1. Printed Schedules were circulated through enumerators

2. Additionally questionnaires were emailed to institutions engaged in medical tourism that

3. Interviews with Resource Persons actively involved in the promotion of Medical

6. A case study is prepared focusing on Medical Tourism in Hyderabad

7. Key questions answered :

• What are the different types of medical tourism?

• Where are governments promoting medical tourism?

Country Patients Estimated earnings Major services provided

(in 2007) treatment, joint replacements

SOURCE : ESCAP 2009

Why the World is moving towards Medical Tourism

Medical Tourism trend and what Statistics shows:

Trends in medical tourism in the near future

CHANGE OF THE MEDIAN WAIT TIME IN INDIAN HEALTH SYSTEM

What is India Offering?

Low insurance penetration, lack of standardisation of services, poor information base,

France 13.14% UK, 18.41%

Switzerland 12.88% Germany 13.41%

USA 12.29% USA 12.44%

UK 7.29% Maldives 11.46%

Italy 7.20% France 7.32%

Russia 6.78% Australia 3.54%

Middle East 6.36% Spain 2.44%

Spain 1.69% Kenya 0.24%

Source: Healthcare in India – The Road Ahead Mckinsey & Company,2008

Trade in medical services 1992-2008 (in millions of dollars)

Initiative by Indian Government to Promote Medical Tourism:

Current initiatives by various state governments and organisations:

• TOURISM MINISTRY PROMOTES INDIA AS A 365-DAY DESTINATION: The ministry of

• TOURISM MINISTRY ISSUES GUIDELINES FOR ADVENTURE SPORTS: The ministry of

• PALACE ON WHEELS ADDS SEVERAL LUXURIES: The second Palace on wheels to be

• 8000 DRUMMERS TO DRUM UP A RECORD IN MEGHALAYA: A band of 8000 drummers is

• FAIRY QUEEN BEGINS DELHI-ALWAR-DELHI RUN FROM 11 NOVEMBER: Built in

Need For Medical Tourism

India’s Future Prospect