Medical Tourism in Maharashtra

Organisation & Management of Medical Tourism in Maharashtra

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Author 

 Anil P. Bankar

Ph.D Research Scholar, Dr. Babasaheb Ambedkar Marathawada University, Aurangabad
Abstract
This paper explores medical tourism industry and driving factors and organisation & management of medical tourism in the state of Maharashtra. The discussion is framed about cost effectives in medical tourism comparison with abroad and other states in India with Maharashtra.  Maharashtra is known as the only tourist state in India having four world heritage monuments i.e. Ajanta caves, Ellora, Elephanta caves, and Chhatrapati Shivaji Terminus. Now the period of globalisation Maharashtra is also ahead in health care, Maharashtra has one of the best qualified professionals in each field and this fact has now been realized the world over regarding medical facilities. Maharashtra has the most competent doctors and world class medical facilities with most competitive charges for treatment of certain medical problems.  After carving niche for itself on the global tourism map , Maharashtra is now looking for creating a new identity by offering best health services to tourist. Undoubtedly a lot in the recent days and experts are comparing it as one of the best emerging medical tourism destination. After Bangalore, Delhi, Kolkata, Kerala in India, Maharashtra has better scope in medical tourism in the coming decade, be it a Ayurvedic, Homeopathy, Allopathic medicines local doctors are second to none.
INTRODUCTION
The concept of Medical Tourism is not new one, in ancient Greece, pilgrims and patients came from all over the Mediterranean to the sanctuary of the healing God Asclepius at Epidaurus. In Roman Britain patients travelled to the Hot Waters Springs to cure their diseases, a practice that continued for 2,000 years. 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. Later, mostly wealthy people began travelling to tourist destinations like the Swiss lakes, the Alps and   special tuberculosis sanatoriums, where professional and often specialized medical care was offered. In this century, however, Medical Tourism expanded to a much larger scale.
 Thailand, followed by India, Puerto-Rico, Argentina, Cuba and others quickly became the most popular destinations for Medical Tourists, complicated surgeries and dental works, kidney dialysis, organ transplantation and sex changes topped the list of the most popular procedures. From Neolithic and Bronze age where in people used to visit  neighbouring countries for Minerals and Hot Springs , today we have reached the era where Hospitals are more like Spas and Spas more like hospitals.
DEFINING MEDICAL TOURISM
There are many ways to define Medical Tourism which is also known as Medical Travel, Surgical Tourism, Health Tourism, Medical Value Travel, Health Care Abroad, Medical Overseas, Overseas Medical, and even Medical Outsourcing and Offshore Medical. Medical Tourism can be broadly defined as “ providing cost effective private Medical care collaboration with Tourism Industry for patients needing surgical and other forms of specialized  treatment ’’
In simple words Medical Tourism is the process of travelling abroad to receive superior medical, dental cosmetic care by highly skilled surgeons at some of the most modern and state of the art medical facilities in the world where the cost of treatment is comparatively very low then their home country.
MEDICAL TOURISM IN INDIA
Medical Treatment is the latest reason to visit India because of the low cost with world class services and quality treatment.India is promoting the   ‘high-tech-healing’ of its private health care sector as a tourist attraction. The Ministry of Tourism is encouraging Medical Tourism, Operators to sell the idea of travelling to India for low cost but world class treatment.
 Medical Tourism in India is a combination of several factors which makes India a unique healthcare destination. Over 60,000 cardiac surgeries are done every year with outcomes at par with international standards. Multi-organ transplants are successfully performed at 1/10th the costs in comparison to the West, patients from over 55 countries are treated at Indian hospitals.
The Indian healthcare industry is undergoing a phenomenal expansion and India in now looked upon as the leading country in the promotion of medical tourism, with an annual growth rate estimate at 30% while India top-rated education system provides an estimated 30,000 doctors and nurses each year to meet this demand the Indian governments spend on the health care sector is expected to around 8% of its GDP by 2012. Statistics suggest that the medical tourism industry in India is worth $333 million (Rs. 1,450 crore) while a study by CII-MacKinsey estimates that the country could earn Rs.5, 000-10,000 crore by 2012.
The study predicts that “ by 2012, if medical tourism were to reach 25 per cent of revenues of private up-market players, up to Rs.10,000 crore will be added to the revenues of these players”. According to Government of India, 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 watchers say is growing at 30 per cent annually. Probably realizing the potential, major corporate such as the Tatas, Fortis, Max, Wockhardt, Piramal, and the Escorts group have made significant investments in setting  up modern hospitals in major cities. Many have also designed special packages for patients, including airport pickups, visa assistance and board and lodging.
MEDICAL TOURISM IN MAHARASHTRA
Maharashtra is the third largest State of India, both in area and population. It is located on the West Coast of India with a 720 km long coastline along the lush green Konkan region. Nestled in the Western Ghats and the Sahyadri mountain range are several hill stations and water reservoirs with semi-evergreen and deciduous forests. The Vidarbha region of Maharashtra, with its dense forests, is home to several wild life sanctuaries and nature parks. Thus all the three regions of Maharashtra offer considerable tourism potential. Maharashtra abounds in numerous tourist attractions ranging from ancient cave temples, unspoiled beaches, ancient forts and monuments, forests and wildlife, unique hill stations, pilgrimage centres, and a rich tradition of festivals, art and culture.
Now in the period of globalization Maharashtra is also ahead in health care. Maharashtra has the best qualified professionals in each & every field and this fact has now been realized all the over the world especially regarding medical facilities. Maharashtra has the most competent doctors and world class medical facilities with most competitive charges for treatment of certain medical problems. After carving a niche for itself on the global tourism map, Maharashtra is now looking for creating a new identity by offering best health services to tourist.
Undoubtedly a lot in the recent days and experts are comparing it as one of the best emerging medical tourism destination. After Delhi, Bangalore, Chennai and Kerala, Maharashtra has better scope in medical tourism in the coming decade. Be it a Ayurved, Homeopathy, Allopathic medicines, local doctors are second to none, medical experts claim. On the cost front too, Maharashtra offers affordable treatment compared to other part of India and foreign countries. Mumbai, Pune, Aurangabad, Nasik & Nagpur are an emerging medical tourism destination in Maharashtra.
The Global trend also witnesses tourism as one of the fastest growing industries and every state in India is putting in extra efforts to increase its visibility in the global market. This is the only state to offer all tourist products that is unique and unparalleled.
RESEARCH METHEDOLOGY
For this research paper primary data was collected from the office of the ministry of tourism Government of India for examining the potential of medical tourism in Maharashtra. 25 Doctors from the major private hospitals, corporate hospitals, insurance company officials, were interviewed and their opinions were recorded. The Tourism Professionals, Travel Agents, Hotels, Airline, Govt Tourism office & Academician were also interviewed further data regarding the operative cost of treatment of various surgeries was collected form the major hospitals. A  questionnaire was   prepared for medical tourism companies in Maharashtra and hospitals and some data through an extensive literature review and online search.
  
FINDINGS
Maharashtra is one of the progressive states & second largest state in the country. Important demographic indicators of the state are as below:
Demographic indicators of Maharashtra
Particular
Maharashtra
India
Area (Sq.Km.)
314
3287
Proportion of State Area to Total Area
9.5
100
Population (Million)
96.87
1028
Percentage of state Population to total Population
9.42
100
Population Density per Sq.Km.
314
324
Urban Population
42.43
27.82
Sex Ratio
922
933
Literacy Percentage
77.27
65.8
Female Literacy Percentage
67.51
54.16
Healthcare services in Maharashtra
Maharashtra has been in the forefront of healthcare development in the country. It was among the first states to decentralize primary healthcare administration through Zilla Parishads as early as1961. Further, under the Minimum Needs Program Maharashtra was again one of the first states to achieve the norms mandated for primary health centres, subcentres and Rural Hospitals. The state also has the largest private health sector in India whose reach is quite extensive.
Primary Healthcare service
Secondary Healthcare service
Tertiary Healthcare service
No. of Primary Health Care Services is 1816 including Tribal and Non Tribal
No. of Sub Centre is 10579 including Tribal and Non Tribal
 
Tertiary Healthcare services 
The Tertiary healthcare service in Maharashtra 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 most modern state-of-art technology at its disposal. It is estimated that 75-80% of healthcare services and investment in Mahrathatra are now provided by the private sector such as the Tatas, Fortis, Max, Wockhardt, Piramal, Apollo and the Escorts group. some of the hospital in Maharashtra accredited  by the national and international accreditation body like , NABH, QCI, ISO, JCI
Maharashtra has to-notch centre for knee replacement surgery, hip replacement surgery open-heart surgery, cosmetic surgery and cancer therapy, and virtually all of clinics are equipped with the latest electronic and medical diagnostic equipment. The various facilities in Maharashtra include full body pathology, comprehensive physical and Gynaecological examinations, dental check-up, eye check-up, diet consultation, audiometric, spiroety, stress & lifestyle management, digital X-Ray, 2D echo, colour Doppler, CT scan high strength MRI.
Local medicos have treated number of international patients the clinical outcome was at par with world’s best centres, for Maharashtra has internationally qualified and experienced specialists, super specialists. Surgeons had also presented research paper at several international seminars and undergone fellowship at foreign universities. Moreover there is an assurance that patients will get personalized care and hospitality. Doctors in Maharashtra are proficient in English most even provide interpreters to cut across language barriers while the patient stays at hospitals, they take care to see that the visit becomes a pleasant experience.
 FACTS & FIGURE
Cost effectiveness is one of the most important driving factors for medical tourist in the state of Maharashtra cities like Mumbai, Pune, Aurangabad, Nasik, & Nagpur the cost of treatment is very low compare to US, UK and any other city in India.
COMPRARISION OF CHARGES
Procedure
Abroad
India
Maharashtra
Total Hip Replacement
6.50 Lakh
2.60 Lakh
1.50 Lakh
Total Knee Replacement
7.50 Lakh
3.50 Lakh
2.30 Lakh
Simple Spine Surgery
3.20 Lakh
2.10 Lakh
1.00 Lakh
Spine Surgery with Implant
9.60 Lakh
2.40 Lakh
1.30 Lakh
Ilizorov Surgery
2.50 Lakh
1.00 Lakh
90,000
Deformity Correction
1.50 Lakh
60,000
30,000
Simple Brain Tumour
1.92 Lakh
50,000
30,000
Open Heart Surgery
8.40
2.50 Lakh
1.50 Lakh
 (Source: Private Hospitals from Mumbai, Pune, Aurangabad, Nasik, Nagpur. This is only approx operative charges final cost depend on patient case)
Medical Tourism Facilitator
 
At present in Maharashtra there are some specialist Medical Tourism Facilitator like Medico Travel Club MTC. Aaarex India, Amazon Health & Medical Tourism Pvt. Ltd., Make well these proving service and contribute to development and growth of medical tourism. They deal with all kind of services related to healthcare and tourism. Medical Tourism Facilitator offers world class medical and health treatment combined with leisure holiday packages, they have involved networking with airline, hotel, spa, embassy, forex, insurance companies in abroad and hospitals.  How important a role does the facilitator play in the industry?
Through the online survey by medical tourist and hospitals medical Tourism facilitator play a vital role in the industry.
61% people replied role of medical tourism facilitator is very important
27% people replied role of medical tourism facilitator is important
10 % people replied role of medical tourism facilitator is optional
02% people replied role of medical tourism facilitator is not important.
 
SUGGESTIONS
Medical Tourism is undoubtedly, a trend than is still in its process but it has enormous potential for growth and development in India. Maharashtra too can benefit form this trend of Medical Tourism for which the following recommendations have been suggested.
–          At present there are only 17 hospitals in India and out of 03 hospitals in Maharashtra accredited by JCI i.e. Joint Commission International which is the global are of US based joint commission on the accreditation of healthcare organisations. Which have accredited hospitals in Europe, America, Asia, and Middle East the JCI accreditation to hospitals in India would help an symbol of trust & benchmark for medical tourist worldwide.
–          At National level CII has just enlisted hospitals offering medical tourism facilities in India which is not enough there should be a accreditation body at the national level concisely the Ministry of Tourism, Medical Council of India, National Accreditation Board for Hospitals.
–          The government, the healthcare and the travel industry has to work together to change the predominant image in the minds of the average public in the medical tourist. An special cell for promoting medical tourism should be established in the ministry of tourism Govt. of India. There is no approval procedure for medical tourism facilitator tourism ministry and regional tourism govt office set parameters and standard for Medical Tourism Facilitator.
–            There has been a lot hue and cry from the activist groups against opening up hospitals for medical tourism for the reason that the available facilities are not even sufficient for the domestic patient. It is real menace to see the poor Indian citizen dying on streets while the wealthy foreigners getting five-star hospitality in addition to medical treatment.
–          One major obstacle that is impeding the uninhibited growth of the global medical tourism sector is a lack of PPP Public Private Partnership and of a one brand initiative. Singapore, Malaysia, Korea and several other countries have established boards formed by tourism authorities, chambers of commerce, ministries of health and private organisations with one shared objective. In India, there is lack of a single, unified body that works towards a common goal.
–          Another major hurdle is poor marketing strategies. Many small-scale India healthcare organisations emphasise India as cheaper destination, but there is a significant distinction in what is cheap and what value is for money. India has a long way to go to establish itself as a leading medical tourism brand that can offer high quality healthcare at affordable prices, with an additional pull factor being its attractive tourism activities.
–          The Indian legal infrastructure is not at all geared up to handle healthcare specific litigations in a speedy manner. Internationally, legal redressal is a routine affair, which in India, is considered as against ethics. Though there exists a mechanism to deal with medical insurance related cases, there redressal is so much consuming. There should be one special regulatory body to monitoring and controlling medical tourism operation in India.
References:
  1. Medical Tourism in India by Raj Pruthi, Arise publisher & Distributors
  2. Medical Tourism Guide Book by Dr. Prem
  3. Medical Tourism: Global Outlook and Indian Scenario by Percy. K. Singh Kanishka Publishers.
  4. Medical Tourism in India by Dr. R. Kumar
  5. Principals of Hospital Administrator and Planning by B.M. Sakharkar
  6. Incredible India Broachers, published by Ministry of Tourism Govt. of India
  7. Literature of review from article published  by Dr. Prem Jagyasi , Alexandru Nedelea, Babu P. George, Richard M. Lagiewski.
  8. Joint Commission International ( JCI ) accredited organisation manual
  9. Website of Ministry of health, Govt. of Maharashtra , Ministry of Tourism,
  10. Website of Dr. Prem www.drprem.com & www.globalhealthcarenetwork.com
  11. TRAM Report on Global Medical Tourism,
  12. Healthcare tourism in South East Asia. Tourism Review International by Henderson J.C.