94 | Global Health and Travel | March - April 2013

ReevaluatingMedical

FacilitatorsDo medical facilitators add any value to the healthcare

travel industry in an age of easy access to information and

when hospitals are making international outreach efforts?

THE SEASONED TRAVELLER

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95March - April 2013 | Global Health and Travel |

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Travel

IIt might be a tiny shop where you

can buy air tickets, sign up for

sightseeing tours and arrange for a

limo to collect you from the airport,

but it’s more than a travel agency. It’s

a specialised type of business that seems

to have emerged from the global medical

tourism sector: the medical facilitator, who

can also book a health check-up or a spa

session for you at a well-known hospital

or wellness centre.

As the name suggests, a medical

facilitator promises to help make your

medical tourism journey as seamless

as possible. It offers to do most of the

legwork involved in finding relevant

medical services on your behalf.

However, the countless facilitator

companies that fill up the expo halls

at medical trade or tourism events,

exhibitions, and conferences are not

an entirely new phenomenon. They

may perhaps be regarded as simply an

extension of the general class of service

providers that has always relied on

carving out a niche somewhere along the

chain of communication between multiple

suppliers and targeted consumers. Retail

stores, brokers, property agents, travel

agents, medical tourism facilitators,

matchmakers – all these can be seen as

varieties of middlemen, some of which

are more relevant than others in an age

of easy access to information.

If lumping them together in one

category seems offensively reductive, it

is worth examining the value of medical

tourism facilitators. This will – at the very

least – make it possible to differentiate

them from their closest cousins in the

business of being a middle man – travel

agents. Apart from attempting to call

a spade a spade, it will highlight the

potential for medical facilitators to follow

in the footsteps of endangerment that

most travel agencies have trodden. Once

a dime a dozen everywhere, travel agents

are increasingly being edged out of the

landscape of customised and informed

choices that the age of the Internet has

democratically granted everyone with

access to it.  

Pramod Goel, CEO and Founder of

PlacidWay might be described as the

patron saint of the gateway to medical

travel information services. PlacidWay

is one of the biggest central mines of

online data, answering consumers’

questions about medical travel and its

cost in various markets and institutions.

Rather than predicting its demise, like

the “dinosaur industry” of travel agents,

Goel prefers to make a geographical

assessment of the medical facilitation

business.

“I look at it in terms of market

segments, to see where the facilitator has

a greater presence. There’s a segment of

the population the Internet’s proliferation

has not reached. For example, someone

needs to be on the spot in a town in

Ethiopia, where we get a lot of patients

from, to make them understand that there

is good healthcare and surgery for critical

illnesses around the world. Facilitators

can help them to understand that in

simple terms – not technicalities – and

in the local language. These consumers

cannot do the research on their own. In

that scenario, from the perspective of the

local population, facilitators have a huge

role in education,” explains Goel.

If medical facilitators rely largely

on the ignorance of consumers to

make a profit, it would seem the

business of PlacidWay is directly

competing with them. Yet, Goel sees

some supplementary value in medical

facilitators who reach out to populations

that his site might not connect with

directly, thus forming another channel for

PlacidWay to disseminate information as

far and wide as possible.

“The market segment our website

serves extends beyond those with

access to the Internet. Our business

model has another segment. We are

also expanding our role by connecting

and partnering with local facilitators

and providing them with information

online, so they can further distribute it

locally, especially in places where the

Internet and the information are not

readily available, such as Africa and the

Middle East, as well as Bangladesh and

Afghanistan. For example, we deal with

some doctors in local communities, and

we say to them, ‘Okay, you can offer your

patients these things which are available

in other countries,” Goel points out.

From a general and less geographical

perspective, he also sees a certain

criticality in the services a medical

facilitator can provide, beyond being a

convenient catalogue of information,

as some believe themselves to be. “A

facilitator can address more complex

issues, such as when a person needs

critical surgery. For instance, if we need

cosmetic surgery or dental surgery, we

don’t really need a facilitator. We can

investigate it on our own and work with

a hospital directly. But when it comes

to cancer treatment, we need an expert

opinion about how and where to get

this dealt with and the other processes

involved. As the complexity of the issue

increases, so the need for specialised

services comes in,” says Goel.

But how many of these expert

opinions are exercises in the day-to-

day operations of medical facilitators,

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96 | Global Health and Travel | March - April 2013

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and how many of them are unmet

expectations? Just because someone

decides to become a medical facilitator

it does not mean he or she possesses

the expertise to satisfy our justifiable

expectations about his or her medical

knowledge and proficiency.

“Most facilitators don’t add a great

deal at the moment,” declares Keith

Pollard, Managing Director of Intuition

Communication, which publishes the

International Medical Travel Journal

site and the Treatment Abroad medical

tourism portal. “In many cases, their

knowledge and understanding of medical

tourism and healthcare are poor. Very

few doctors or healthcare professionals

are involved in these businesses, yet they

are providing healthcare services. Their

lack of knowledge may lead to patients

getting poor advice,” Pollard warns.

If a patient needs one central location

where complex and technical information

and options can be accurately and

effectively explained to him or her, it

might be better (and also safer) to turn

to the international patient centre of

a hospital for help. The centre has a

relationship with the hospital and is

usually physically on the same site as

the hospital. That makes it much easier

for it to process medical records and

understand a patient’s medical condition

better, as well as the post-operative

care he or she will need. In addition, the

centre can make arrangements for those

accompanying the patient.

MedSG is one medical facilitator that

readily acknowledges the gap between

the provision of medical-related services

and the proficiency of those who deliver

them, and it has devised an approach that

does not compromise on the information

the patient receives. Established as a

medical travel consultancy in Singapore in

2011, MedSG now specialises in providing

options for cosmetic surgery procedures

in Korea.

“International patient service

departments sometimes find themselves

with too many duties, and they cannot

provide the same level of service as a

medical travel facilitator. In contrast,

MedSG adopts an unbiased approach

to finding the best-possible medical

treatment. We try our best to maintain

a neutral stance. We do not allow

our partnering medical institutions to

advertise on our site,” says Shafiq Ali,

one of its founders.

“Although our consultants possess

some medical knowledge, it is not

sufficient for them to be able to provide

our clients with medical advice. We

collaborate with our partner medical

institutions to give us that advice and the

best-available choices. In our experience,

clients are very interested in obtaining

this; they always request professional

opinions from a few different specialists,”

explains Shafiq.

The value of medical facilitators is

recognised by the Malaysia Healthcare

Travel Council (MHTC). Set up by the

country’s Ministry of Health in 2009, it

signals the government’s intention to

promote Malaysia as the medical tourism

destination of choice in Asia. MHTC

is making efforts to ensure at least a

modicum of medical proficiency among

the country’s medical facilitators. It

staged its third Introductory Workshop

for Health Facilitators in February 2013.

The event’s aims included imparting

basic understanding about medical

treatments and procedures. The Council

also plans to establish the country’s

first medical tourism health facilitator

certification course.

MHTC advises facilitators to adopt a

sensible approach when matching the

patient to a hospital. “It is best to start

with screening packages,” says Dr. Mary

Wong, CEO of MHTC. “From thereon,

facilitators will learn more about different

medical procedures and treatments

during follow-up visits. Most facilitators

in Malaysia will eventually specialise in a

certain discipline and create a network

with a few doctors or hospitals that can

offer niche services based on location.”

More ambitious plans are also on the

cards for MHTC. According to Dr. Wong,

the establishment of customer service

guidelines for healthcare travel by various

industry stakeholders in the medical tourism

value chain – such as logistics providers,

health facilitators and accommodation

providers – is also in the pipeline.

“It means that, besides the focus

on our certification course, we are also

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98 | Global Health and Travel | March - April 2013

Travel

devising a guideline to check the whole

process by the various industry players.

MHTC will organise business networking

sessions to connect health facilitators

with medical tourism stakeholders to

assist them to start up and do B2B

matching,” explains Dr. Wong.

While businesses might feel

concerned about such top-down efforts

by a government ministry, MHTC’s

well-meaning initiatives to establish

an accreditation system and set of

guidelines could undoubtedly streamline

the medical facilitation industry’s

processes and, most importantly, make

them transparent. After all, the stakes

are high. MHTC is making efforts to

promote Malaysia’s healthcare travel

industry at a time when it is flanked by

strong competitors in this field, such as

Singapore, Thailand and India.

It remains to be seen whether its

recommendations might include pricing

and commission models. This is a tricky

area. Some businesses prefer to collect

advertising fees from hospitals, while

others charge patients a fee.

Few international institutions that

could implement a credible accreditation

system exist, unlike the Joint

Commission International’s accreditation

of hospitals. The scope of the Medical

Tourism Association (MTA) is also

limited. For instance, a look at its online

list of member hospitals reveals only one

in Thailand, Bumrungrad, one in India,

the Moolchand Healthcare Group, and

none in Singapore.

“The MTA’s certification programmes

are not assessed by an external body,

and they are not delivered by people

qualified to provide certification in

healthcare,” says Pollard. “It’s a scheme

to generate income for the Association’s

owners. They ‘certified’ more than 50

exhibitors at their recent conference

by asking them to attend a four-hour

workshop. Even those who didn’t attend

were certified! Asia has seen through

the MTA’s ‘smoke and mirrors’. It doesn’t

represent the industry, and it isn’t the

right body to be certifying or accrediting

medical travel,” he adds.

“There is a role for certification and

accreditation in medical travel, but

these are early days in the sector. At

the moment, too many agencies and

hospitals see certification as a marketing

ploy to make them appear more credible

to the patient.”

Establishing a framework for the

accreditation, certification and even

potential regulation of medical facilitators

and verification of their medical

proficiency and outreach capability –

whether it is done on a governmental,

national, regional, or international

basis, or in the form of an international

accreditation system - can seem like

a formation of a reductive and policing

checklist that will cast doubt on their

value and hinder their growth.

However, the value medical tourism

facilitators can add to the healthcare

industry will be extremely limited in the

absence of such crucial infrastructure,

and the trust that can be created through

a sustainable three-way relationship

between medical facilitators, patients and

other healthcare travel institutions, such

as hospitals. That is very regrettable,

especially in places where medical services

and information are not easily available.

“I’ve been following this very carefully

the last five or six years or so,” says Goel

of PlacidWay. “There’s a huge turnover

in this business because every facilitator

thinks there is a big market in which they

can make millions. I relate that to the

dotcom era, when you had a website and

thought you could become a billionaire

the next day.

“Everyone has the same dream.

As soon as they have that mind-set,

they open a website, get a cell phone,

and they are a medical facilitator who

is ready to make millions. But the

reality is different. They don’t have the

understanding and know-how to conduct

a business in this area. The infrastructure

is huge and it includes things like

transparency. The sustainability of the

model has to be there,” he adds. GHT

: Placidway.com

: Imtj.com

: Treatmentabroad.com

: Medsg.biz

: Mhtc.org.my

: medicaltourismassociation.com

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