Who should manage the patient experience?

‘On the ground’ medical tourism facilitators are the best qualified group in the medical tourism market to oversee a positive patient experience, but have been increasingly sidelined over the last ten years. Christina de Moraes, Founder and Chief Experience Officer (CXO) of the US-based International Medical Tourism Chamber of Commerce (IMTCC) explains why this needs to be challenged.

Much like the advent of factories during the Industrial Revolution disenfranchising the skilled artisans that made up the ‘cottage industries’ of the day, the McKinsey Report on Medical Tourism, and the organisations that have emerged since then purporting to be promoters of medical tourism have had the same effect on the medical travel facilitators (MTFs) profession.

Without separate certifications and distinct scopes of practice that validate each of the two clearly separate and important patient advocacy roles of ‘top-down’ medical travel facilitators and ‘bottom-up/ground services’ facilitators, our profession has been debased down to sales-driven surgery brokers. The income models which the industry now employs are ethically questionable, promoting competition instead of collaboration and removing the opportunity for MTFs to be valued and compensated as individual professionals with specialised roles.

Medical tourism is not a commodity

Medical tourism may have been growing, but its long-promised growth is underwhelming. In the USA, most people are still not aware of medical tourism and of those who are, the majority have a negative perception of it due to media coverage that highlights the cases where treatment has gone wrong.

Over the last ten years, the focus has been on marketing and promoting the availability of medical tourism and cross-border healthcare treatments as a commodity; a siloed product, ‘manufactured’ by hospitals and doctors. Competing largely on the basis of price, there are no standard metrics to truly define quality and measure value. Complicating these definitions are also the often significant cultural differences between patients and countries.

All the above means that comparing the services of an upfront MTF or ‘portal, where the patient pays 10-20+% commission on a ‘commodity’, to going through an on-the-ground specialist who greets them when they step off the plane, is like comparing apples to oranges.

Patients do not know what they need, what they can get, should get and will really get for their money. So, competing on procedure price, rather than experience, customisation and ancillary support services that optimise recovery, reduce stress and mitigate risk, ignores where the real value creation inherently has always been in medical tourism and to which it needs to return.

Medical tourism needs Chief Experience Officers

Healthcare is not a commodity or a product; it is not a production industry and it is much more than a service industry. It is a complex and multi-faceted value supply chain that becomes even more complex and nuanced when traveling for care.

Today’s leaders in the healthcare industry now fully acknowledge the importance of managing the patient experience (PX). Several top hospitals have already created the role of a CXO (Chief Experience Officer), tasked with humanising and improving the PX within the healthcare environment.

Dr. Bridget Duffy, the first CXO of the Cleveland Clinic has publicly said “[Improving the Patient Experience]…is viewed by the most forward thinking organisations as the only way to drive sustainable growth, move the needle on quality and build lasting loyalty. Experience improvement is one of the hottest priorities in healthcare and it is not going away”

For medical tourism, undergoing a treatment or a surgery is just one part of an extended (and fragmented) experience. I have found that MTFs ‘on the ground’ in the medical tourism market are well ahead of the PX curve. They are more vested in, cognizant of and qualified to provide solutions for the PX through their expertise of hand-holding patients along the entire treatment experience. Arguably these are the CXOs of medical tourism!

So, where should the focus of be, to take control of the industry’s brand reputation, guarantee integrity, assure sustainable growth and transform medical tourism into a respected healthcare delivery system?

Challenging the commissions and contracts

The use of commissions and contracts to unethically disguise facilitation as a ‘free’ service to patients (and even medical providers in some models) has put the focus on the product/procedure cost, and ignored the essential components of an optimal PX that on the ground MTFs provide.

The more personalised support role of the original Medical Concierge professional on the ground has given way to sales agents in portal call centers facilitating sales of the procedure product. The commission and contract model has degraded the industry, debased our important patient advocacy role and suppressed our professional development. Its use has fomented a lack of collaboration, transparency and accountability to each other, collectively and to the patient, individually. This must now be challenged.

I believe that on the ground MTFs can abandon the provider contracts and commissions and be paid for our unique scope of practice and our own performance, representing our patients’ best interests and optimising their recovery process. Indeed, studies have shown (and existing medical tourism pricing models prove) that patients prefer transparent pricing and will spend more if it correlates to better results and helps reduce pain and discomfort.

#BotchedNoMore Campaign

The IMTCC is seeking to lead this challenge and has launched the #BotchedNoMore Campaign. The campaign aims to gather data from paying participants, in order to show that when medical tourism is done right, complications and readmissions are rare, out of pocket costs are reduced and patients talk about the care and attention they received and ‘could never get or afford at home’.