Medical tourism: Global med
Trading in Specialties
The doctors at UF Health Cancer Center- Orlando Health are among just a few in the U. S. who transplant healthy lymph nodes from one part of the body to another to reduce swelling in arms and legs, for example. Dr. Richard Klein says one in four of his lymphedema patients comes from out of state
IVFMD’s fertility treatment offices in Miami-Dade, Broward, Palm Beach and Collier counties attract couples from as far away as Brazil, the Dominican Republic and El Salvador for fertility preservation, egg freezing or stimulation protocols.
Many international patients are referred from previous customers and from gynecologists in foreign countries, the company says. According to its website, about one third of the practice’s patients are from outside of the United States. IVFMD partners with local hotels and shuttle services to accommodate the international patients.
» Honing a Specialty
Dr. Vipul Patel’s expertise in robotic surgery for prostate cancer has made him so well known in his field that patients come to Orlando from around the nation and the globe for his expertise.
Patel is the medical director of the Global Robotics Institute at Florida Hospital Celebration Health and medical director of the Florida Hospital Cancer Institute Urologic Oncology Program. He has performed thousands of robotic prostate procedures.
In 2015, Patel performed surgeries on 41 patients from the Dominican Republic, Jamaica, Ecuador, Cayman Islands, Uruguay, Brazil, Angola, Colombia, Guatemala, Chile, Italy, Canada, Mexico, Venezuela, Bermuda, Spain, Turkey, Nicaragua, Nigeria, Qatar, India and Australia, among others.
Patients share their experiences in online medical chat rooms, and doctors abroad refer their patients to him. Now, the hospital’s Destination Health team wants to broaden Florida Hospital’s international appeal. The team is reaching out to bring in patients from around the globe to the Orlando hospital for medical services they might not have access to at home by offering care coordination, translation and other services.
» Cosmetic Surgery
Although countries such as Costa Rica have become recognized as medical tourism destinations for plastic surgery, Florida gets its share of visitors who come for lifts, facial restructuring and other enhancements. Dr. Thomas Fiala, an Orlando plastic surgeon and president of the Florida Society of Plastic Surgeons, says many patients from outside of Florida have relatives nearby with whom they can stay as they recover. They come for about two weeks, Fiala says. Procedures in Florida can cost about 20% to 30% less than in New York and California.
“As long as they use a properly credentialed surgeon and the procedure is done in an accredited operating room, there is a wealth of talent in Florida and great reasons to come here,” he says.
» Cancer Care
With 720 hospitals, more than 45,000 health care facilities and four designated Cancer Centers of Excellence, Florida draws visitors for cancer-related surgeries, clinical trials, oncology and cutting-edge medical treatments. In September, the National Cancer Institute designated Moffitt Cancer Center in Tampa as a Comprehensive Cancer Center — NCI’s highest designation and one shared by only 4% of the cancer research institutions in the U.S. Moffitt attracts patients from throughout the U.S. and internationally.
Word of Mouth
Naples Community Hospital finds its reputation is its best marketing tool
About 10 years ago, Naples Community Hospital sent two employees on its marketing team to Dubai to tout the hospital to potential medical tourists. “They had a good time, but it did nothing for us,” says Allen Weiss, president and CEO of NCH Healthcare System in Naples. “It was not the highest and best use of our limited resources.”
So the 716-bed hospital system took a different approach. “We said let’s give good care, build a strong reputation, and the word of mouth will spread,” says Weiss. Today, one out of seven patients at NCH comes from outside the five-county region, many from the upper Midwest and Northeast. “They are coming here for the quality of medical care. It’s all word of mouth.”
Naples’ big seasonal population of wealthy retirees and snowbirds creates a base of potential patients. But while hospital volume doubles during winter months, Weiss says certain specialties lure year-round visitors. For example, more than 1,800 patients a year have total joint replacement surgery at the hospital. For more than 10 years, NCH Healthcare System has been among the busiest for total joint replacements among Medicare patients in the nation.
This happened by design: NCH’s orthopedic team has developed a pre-operative joint replacement educational program and a postoperative pain management program. Rehabilitation starts the day of surgery. Most patients walk within a few hours of surgery. “We have a lower than the national average complication rate, and people talk about that,” Weiss says. The hospital also has become known for its open-heart surgery and its “Code Save-a-Heart” program.
Weiss, past chair of Florida Hospital Association, is convinced that building a reputation in specialized areas that trigger online endorsements from patients is more effective than a medical tourism campaign. “In Florida, we need to focus on the quality and cost. That’s what people are shopping for.”
» Concierge Services
Many hospitals and medical facilities in Florida have international services departments that market services to foreigners and then coordinate their care. At Miami’s Nicklaus Children’s Hospital, a family from Brazil whose young son needs heart surgery works closely with the hospital’s global health specialist, who coordinates the visa and immigration requirements, provides cost-of-care estimates and helps with travel arrangements. The Miami hospital attracts patients from more than 80 countries, many who come to the U.S. for second opinions or to see specialists.
In north Florida, Jacksonville’s Mayo Clinic Florida draws between 1,400 and 1,500 international patients a year and has a group of doctors who specialize in serving the needs of international patients. Mayo has offices in five other countries: Canada, Guatemala, Ecuador, Mexico and Colombia.
» Money Matters
A big reason for hospitals to market to foreign patients is financial. Foreign patients often self-pay, meaning hospitals get their money upfront. In addition, more now have international insurance, which allows them to come to the United States for treatments or consultations.
» Second Opinions
Baptist Health South Florida, with seven hospitals, has marketed itself internationally since 1998. The bulk of the 9,000 foreign patients who travel to Miami each year come to see specialists in areas including cardiac, orthopedic, neurology or cancer treatment. Others come for Baptist’s robotic surgeries. Hospital executives have said the system’s international division is one of its most profitable.
George Foyo, chief administrative officer for Baptist Health South Florida, says the hospital system also is expanding care delivery abroad by developing more second-opinion programs where the organization remotely can interact with international patients and their physicians and make treatment recommendations. “Medical tourism is going to be growing significantly over the coming years with the advent of technology,” Foyo says
» Web Marketing
In Tampa Bay, Dr. Adel Eldin, a cardiologist, has set up a website to market his services abroad, Floridamedicaltourism.com. Eldin advertises a wellness tourism package for tourists from outside the state that includes a physical, a one-day pass to Busch Gardens and a fulltime driver during their visit. “We have the weather. We have the attractions. We have good doctors. There are a lot of reasons for them to come to Florida,” Eldin says. “Slowly, I’m starting to get more hits on my website. There is a huge opportunity out there for providers who can offer culturally sensitive care.”
Training and Tourism
Nicholson Center targets professionals from the U.S. and abroad.
While Florida’s hospitals and doctors court patients, Florida Hospital’s Nicholson Center attracts medical professionals to Orlando for medical meetings, conferences and hands-on training in state-of-the-art laboratories.
Nicholson’s 54,000-sq.-ft. facility is south of downtown Orlando on the Celebration Health campus. Along with a 500-seat auditorium with a built-in customizable video wall, Nicholson offers training in 50 surgical skills stations and two operating rooms that closely emulate real world experiences.
For the last year, with a $50,000 grant from Visit Florida, Nicholson has beefed up its marketing efforts, enhancing its website, placing banner advertisements and crafting e-mail blasts to meeting planners. The center takes a two-pronged approach: It markets its hands-on wet and dry labs to Orlando-hosted conferences as an add-on feature to their agendas and then markets its meeting and training space to medical associations and device manufacturers for events and workshops.
“We focused on who is our end client and how are we going after them,” says Carl Pfeiffer, marketing manager for Nicholson Center. Last year, Nicholson hosted more than 15,000 health care professionals from 52 countries, along with another nearly 40,000 from the United States. With the additional Health Care marketing efforts, Pfeiffer says, Nicholson saw a 38% increase in visitors from Latin America.
One of its competitive advantages, says Pfeiffer, is that device manufacturers can roll out new equipment at Nicholson free of charge, equipping its simulated operating rooms with 3-D cameras and other high-tech equipment that gives medical professionals a chance to train on the newest equipment.
Nicholson also is partnering with Experience Kissimmee, a travel and tourism organization, and holding networking events with local hotels and meeting planners to market the entire Orlando area as a medical tourism destination.
» Growth Area
“Robotics training is starting to grow in China, and they want to come here to get skills,” says Carl Pfeiffer, Nicholson’s marketing manager.
» Economic Impact: In August, Nicholson hosted 1,000 surgeons from Latin America for a week long conference. In addition to the $775,000 they spent at Nicholson, the surgeons also boosted the local economy by spending on hotels, restaurants, transportation and printing.
A Uniform Message
An effort to promote the state runs up against regional dynamics
After spending more than a year studying the potential for medical tourism, the Florida Chamber Foundation recommends a primarily regional approach.
In a report titled “A Strategic Look at Florida’s Medical Tourism Opportunities,” the Chamber Foundation says the best opportunities lie in tapping local marketing professionals to highlight the assets and opportunities each area offers. “Different regions have different capabilities, so let them market those capabilities,” says Tony Carvajal, the Florida Chamber Foundation’s executive vice president.
Orlando, for example, is seen as a destination for health care and medical-focused conferences, conventions and meetings.
Meanwhile, Jacksonville’s health industry, with the prominent Mayo Clinic and the UF Health Proton Therapy Center, has become a center for cardiac health and for cancer research and treatment.
The Chamber Foundation’s report suggests that the state should try to create a uniform message that Florida is a destination for health and wellness. Most important, it says the real opportunity to distinguish Florida lies “outside the hospital doors” — with communities focusing on making patients and traveling companions welcome before, during and after their medical procedure by leveraging their hospitality assets.
The chamber’s $250,000 report is part of a $5-million effort by the Legislature in 2014 to promote medical tourism. So far, the Legislature, through Visit Florida has put most of its medical tourism funding toward promotion. It awarded $3.1 million to health care providers, medical facilities and local tourism agencies for promotion of medical meetings and general medical tourism, which each of the recipients matched.
The Legislature’s appropriation also funded the creation of Discover Florida Health, a website dedicated to medical tourism, with the consideration that any international program must present comprehensive information online to capture a greater share of the global market. Some of the $5 million remains unspent.
The chamber’s report comes on the heels of a 2014 study by Florida Tax Watch that urged a statewide marketing effort, saying “When regional areas in Florida have attempted to build up medical tourism, efforts have been largely ineffective, due to internal competition among providers.”
Some suggest that boosting the quality of care and creating a uniform cost structure will do more to draw medical tourists to Florida. Dr. Allen Weiss, past chair of the Florida Hospital Association, says: “If you improve the quality of the care, people will get to know you for it, and that is more effective than any marketing or advertising you can buy.
“It takes longer and it’s harder, but that’s what Florida should be doing.”