Medical tourism in the Middle East has unique dual position. On one hand, the region’s well-developed, modern and highly qualified expat doctors & hospitals are preparing to capture the International Medical Tourism market for elective procedures while on the other, international healthcare organizations are tapping into GCC’s affluent society in search of highly sophisticated and advanced healthcare services unavailable within the GCC.
The rise of medical tourism provides an opportunity for the Middle East, which so far has made few inroads in the sector. From many years, a top priority for medical providers around the world have attracted medical tourists from the Middle East, now the trend is gradually reversing as the Middle East is seeking to attract medical tourists where the cost of health care and delays in getting treatment have risen sharply.
Healthcare Demand
Healthcare demand in the Arab world is under significant pressure as GCC spent just 2-3% of GDP on healthcare. The healthcare demand in GCC is growing rapidly. McKinsey estimated that GCC healthcare spending would increase five fold in next year from currently $12 billion to $60 billion. This demand will continue growing until new strategies on the part of government and private health-care players come into play.
Although GCC health-care systems are far better than they were 20 years ago, many residents remain unsatisfied with the availability and quality of care at government-run hospitals and clinics. Government agencies mostly lack the managerial skills needed to run health-care facilities, and cash incentives alone have not been enough to attract specialists to treat the rising numbers of people with ailments such as heart disease and cancer, stated in report by McKinsey.
Key drivers for the growth in healthcare demand are population growth, limited investment and increase in affluent health disorders. A recent report suggested that Arabians suffer from more than 900 chronic health disorders. In United Arab Emirates, diabetes prevalence rate is above 20 percent, which means one out of five is diabetic.
Today GCC population is 35 million. By 2015, the size of the population will increase at a compound annual growth rate (CAGR) of around 3.0 percent, one of the highest in the world. As a result, total GCC population in 2025 will be almost twice the size it is today.
In 2008, a report done by ExHealth revealed above 50% people in UAE are overweight mainly because of sedentary lifestyle. Healthcare disorders will increase by 20% in next few years because of poor preventative measures and lack of understanding.
There is lack of super specialty services in GCC especially above tertiary level care. Emergency healthcare services are still challenge for GCC as not many private hospitals are prepared to handle cases.
Middle Eastern Patients If the current trends continue and if GCC countries do not take immediate measure, patients from GCC will continue traveling for medical services, providing opportunity to medical tourism stakeholder of west and Asia.
Arabs from GCC spend billions of dollars on healthcare outsourcing. Saudi Arab alone sent more than 200,000 patients in 2008 abroad for medical treatment. UAE spent over billion dollars on healthcare outsourcing. Together, all Arab patients from Arabian Peninsula have willingness to travel outside of UAE.
A recent survey done by the national newspaper reveal that 70% UAE population would prefer to travel outside if they get serious illness. The GCC market is willing to travel. In fact, they travel abroad just for common health checkups. The market has affordability, and most importantly, the government sponsors the medical cost in most of the cases.
Considering all evaluations, it is believed that GCC is within undersupply today; tomorrow they may have enough supply, but still affordability will be a big question because of inflation and several other factors. There is great need of coordinated efforts from government and private sector to reverse the trend till then international healthcare providers can land a hand to provide healthcare services to struggling GCC Healthcare.
At a recent roundtable held at the World Medical Tourism & Global Healthcare Congress in Los Angeles, health leaders from the UAE noted that inbound healthcare is a large an opportunity in the Middle East as outbound. Undersecretary of Health He Nasser Khalifa Al-Budoor of the United Arab Emirates stated, “A very important topic under scrutiny was the economic and qualitative benefits of medical tourism to a country’s population and the positive impact medical tourism exerts on healthcare quality within a specific country and region”.
“We are looking at a lot of collaboration. Our recent health reform was intended to strengthen the health systems in Dubai which will assist us going forward. We are here to strengthen medical tourism,” added Laila Al Jassmin, CEO of the Clinical Support Services Sector for Dubai Health Authority.
Understanding the Outbound Target Market
When healthcare providers intend to serve GCC market, their prime target could be Arab patients. Providers can build a successful brand if they just provide personalized care to Islamic Patients. Many healthcare providers consider Arab patients demanding, but my last ten years of experience in Middle East helped me to realize that if we understand Islamic patient requirement, we can make Arab patients happy very easily.
Regrettably, companies spend most of their money on advertisements and promotion; they do not spend on cultural consultancy services. Understanding culture is one of the key component in serving medical tourism industry.
If a healthcare provider would like to extend personalized service to a Muslim or Islamic patient, the below suggestions could be very helpful. Implementation of below guidelines would make the stay of a Muslim patient in hospital more acceptable and contented. It would also make sure that the care being provided was of the highest quality possible for Muslim patients. The recommendations cover aspects of clinical care, food services, religious observance and visiting arrangements amongst others.
Food Services. All catering staff should be aware that only halal meat (ie. meat slaughtered according to religious requirements) must be given to Muslim patients. They should also be made aware that Muslims do not eat pork or any other pig meat and its products eg. Hand washing before and after meals is particularly important to Muslims. Bathroom facilities are readily available to ambulant patients, however washing facilities should be made available to bedridden patients at meal times.
Clinical or Nursing Care. It is preferable for a female Muslim to be cared for by females and a male Muslim by males. This is most important during confinement when strict privacy is very essential. Only female health workers should be present. Exposure should be kept to a minimum. The position of delivery should be discussed and the woman given the choice.
Present medical examination techniques should be modified where possible so that as little of the patient is exposed as possible, whilst not inhibiting the medical procedures. Facilities should be provided for male circumcision if required.
Alcohol. Alcohol and any other intoxicating substance are prohibited in Islam. Where a choice exists, medicines containing alcohol should not he used. In emergencies, this rule does not apply if an alternate drug is not available, but this should be explained to the patient. If the medication is necessary, then Islam permits its use.
Forms In most circumstances informed consent must not be only in English. It must be verbal as well as written in their own language so that the issue is fully understood. In circumstances where the patient has difficulty communicating in English, a professional interpreter should be arranged.
Maternity Services After delivery, the placenta (which is part of the baby) should be offered to the parents for disposal by burial in accordance with Islamic tradition.
In Case, After Death The face and indeed the whole body of the deceased must be covered by a sheet. The body must be handled as little as possible. Muslims believe that the body ‘feels’ pressure and pain numerous times more than that applied. Muslims also believe that the soul remains close to the body until burial. The body must be handled with utmost respect only by a person of the same sex. Relatives may wish to pray close to the body or in a room close by. Islam prohibits post-mortems. However, the statutory laws of the country must be followed with respect to post-mortems.
Fasting In the month of Ramadan, fasting is compulsory for all healthy, adult Muslims on reaching puberty. Every individual is responsible for his or her own fast. Fasting begins an hour before sunrise and ends at sunset. It is a total fast with abstinence from any food or drink. Smoking is not allowed. Gargling is acceptable as long as no fluid goes down the throat. Besides fasting in Ramadan, some Muslims also keep optional fasts. Fasting is a purification inwardly and outwardly. Exempted from fasting are pregnant, lactating or menstruating women, the ill and travelers.
Visiting The Sick Strong emphasis is placed on the virtues of visiting the sick. The sick Muslim is usually happy to receive many visitors. It is a requirement of the family members of the sick Muslim to notify as many people as possible of the illness. This is usually done by the close relatives.
Above are just few basic tips provided by authorities, as this helps in understanding Islamic patient needs.
Marketing
As marketing guru Kotler writes “What should our aim be with customers? First, follow the Golden Rule of Marketing: Market to your customers as you would want them to market to you. Second, recognize that your success depends on your ability to make your customers successful. Aim to make your customers better off. Know their needs and exceed their expectations. Organizations must view the customer as a financial asset that needs to be managed and maximized like any other asset. Tom Peters sees customers as an “appreciating asset.” They are the company’s most important asset, and yet their value is not even found in the organization’s books.
Dr. Prem Jagyasi is a Chartered Management, Healthcare Marketing and Medical Tourism Consultant. Providing high-profile consultancy services to Government Authorities and Private Healthcare organizations, he is noticeably leading medical tourism consultant. He also serves Medical Tourism Association, as an Honorary Chief Strategy Officer. He can be reached at Prem@Jagyasi.com | www.DrPrem.com