Health tourism in Iran: from past to present

Why is Iran still relatively unknown as a health tourism destination? Niloufar A’alami, an MBA student in Health Tourism and employee of AriaMedTour, a large medical travel facilitator in Iran reviews a survey of the market and offers some suggestions.

The production and export of goods and services that directly affect the foreign exchange earnings of a country are crucial factors in moving towards a more sustainable economy, especially for countries such as Iran which depend heavily on unsustainable oil revenues. One approach could be the promotion of the health tourism industry, in its new form, in Iran.

Holding tenth place in historical and ancient attractions, and fifth place in natural attractions in the tourism sector in the world [13], on the one hand, and having expert Iranian doctors contributing to the fields of medicine and healthcare on the other, Iran has the potential to be considered as one of the leading destinations of health tourism in the world [2].

Effective factors in health tourism

Health tourism has two parts: treatment, and non-medical services. One cannot improve the industry without the other and paying attention to both categories of the service is the recipe for success. The role of insurance companies and facilitators in expanding the industry should also not be ignored.

Iran was and is a pioneer in the field of medicine. The Canon of Medicine, compiled by Persian physician-philosopher Avicenna has been taught for nearly seven-hundred years at the largest European science centres, not to mention the current day presence of expert leading Iranian doctors across the globe, are both testimony to the strength of Iranian medicine [5].

Arguably the proper cycle of health tourism is defined from the moment the patient makes contact with the treatment centre in the destination country until the patient returns to their country and even after returning home [5]. Therefore, providing a complete package of treatment and logistics services equates to being successful in meeting patient need.

Why is Iran not better known in health tourism?

An answer to this question comes from analysing surveys from three different hospitals, each with between 75-200 beds, carried out over six years, in three different cities of Iran. International Patient Department experts were also contacted in eight hospitals in Tehran, and more than 50 patients were interviewed about their arrival in Iran and the procedures that they took to be able to enter the country, such as visas, permits and hospital reservations. (For legal reasons, there is no permission to name these centres).

A summary of the results is in Table 1 below. The identified problems can be categorised into three fields: medicine, tourism, and country and state laws and regulations.

Table1. Problems for the development of Iran’s health tourism sector

Having identified the weak points, the following suggestions for improvement can be made to support the development of Iran’s health tourism sector.

1. National standardisation in Iran for the treatment of international patients begins with the International Patient Department (IPD)in hospitals (public or private) that have an excellent grading (1 or 2) and provide the minimum standards on the basis of the Ministry of Health checklist. About 700 of the 981 hospitals in Iran have an excellent grading (1 and 2 [8])  but only 166 hospitals have ever had IPD certification [8] . This is due to the mismatching of hospital facilities with the checklist. By allocating funds to rebuild or build hospitals (public and private) with hotel and other facilities, it could be possible to add more medical centres to the medical tourism industry in Iran.
2. Most of Iran’s health tourists in 2018 were from Afghanistan, Iraq, Pakistan, Azerbaijan, and Oman,for treatment including gynaecology, cardiology, cosmetic and eye surgery and other general surgery [11]. According to a survey from Iraqi patients about entry to Iran and selecting a special hospital, the result was that most of them entered using agents, with friends or relatives suggesting a special clinic or doctor.  The above factors, alongside offline advertising, have led doctors and hospitals in Iran to recruit directly or through agents. This has led to problems such as the lack of full services to international patients, including hotel provision, affordable prices, follow up and so on. Facilitator companies, by providing complete services including clear prices, contracts with hospitals that have IPD certification, and logistics services (visa, ticket, hotels) can solve many of the problems in Iran’s health tourism industry. For nearby countries like Iraq, we may not improve the traditional ways of finding a doctor or hospital; but in Iran, doctors referring patients to hospitals with IPD certification (without getting money from the clinic) and hospitals contracting with facilitators can play an important role in improving health tourism in Iran.
3. For the development of health tourism in Iran, we need to improve infrastructures, such as improved airline connectivity and ground transportation systems, build a hotel-hospital, and facilitate visa issuance for medical tourists. Right now, Iran does not have direct flights from many countries and this problem dramatically reduces the rate of arrival of health tourists to Iran. Physical infrastructure, like road signs, for example, are also unclear for international visitors [10].
4. IPD certification is an internal certificate in Iran.Having international accreditation certificates such as ACI or TEMOS (currently, Iranian hospitals are not allowed to receive a JCI certificate) is an important factor in gaining the confidence of international patients in proving health services meet global standards.  The difference in the value of the Rial compared to the world’s currencies, such as the Dollar and Euro, has caused government hospitals not to pay to apply for these certificates because of the opposition to the withdrawal of currency from the country and private hospitals due to lack of funds.  Currently only Qa’im Hospital in Rasht has an ACI certificate [12].
5. The government has an export health service approach.It can play an important role in promoting health tourism to Iran by organising health tourism exhibitions, online and offline promotions, and holding meetings in target countries.
6. One of the important issues in the medical tourism experience of the international patient is thecare and support provided after the treatment and return to their home country. When a patient needs post-surgical care or medical visits, they may leave Iran for a long time and return to their own country to continue treatment.  The existence of a contract between hospitals in the country of origin is essential. Unfortunately, the patient’s follow up does not work in this way in Iran. Hospitals and facilitators should pursue this to enhance and complete the patient’s follow up process.

References:

1. Hashemzadeh.MD, Communication skills for healthcare providers, 2019;20.
2. Hashemzadeh.MD, Facilities for the patients and their competition, 2019;35.
3. Asheneh, S.Emamgholipour, the status of successful Asian countries in health tourism, the first national conference on Geography, Tourism, Natural Resources and Sustainable Development, 2013;12.
4. Mohammadpour.MD, S.Seifollahpour, part 6: International patient expectations, Setting up the International Patient Department, Tabriz, 2015;210:91-117.
5. A’alami, Gandhi Hotel Hospital, an opportunity for health tourism in Iran, 7 am Weekly newspaper, 2017;1000,32.
6. irna.ir
7. internationalhta.com
8. td.lums.ac.ir 
9. Jabbari, B.Delgoshaie, R.Mardani, S.J.Tabibi, Medical tourism in Iran: Issues and challenges, 2012;4.
10. Ranjnoush, part 5: Strengthen medical tourism, Know With medical tourism in Iran and the world, 2019;215,103-147.
11. http://mohht.ir
12. http://www.accreditation.ca
13. https://www.irna.ir/news/82791750