Destination spotlight: Thailand
Thailand is seeking to market itself as an attractive destination for international patients. Tatum Anderson investigates the potential for medical tourists and talks to the experts to find out more about standards of patient care and the cost of treatment
The country’s medical facilities are less expensive than neighbouring destination Singapore, but more pricey than other destinations in the region, such as Korea or Malaysia. “Thailand is cheap but not the cheapest, Thailand is advanced but not the most advanced in all fields, but Thailand, in my biased opinion, has the best overall package – price, quality, speed of service and hospitality,” said Danny Quaeyhaegens, head of the international insurance department at Bangkok Pattaya Hospital in Thailand.
Thailand attracts a wide range of different patients too, according to Nicolas Leloup, assistant director, international marketing at Samitivej Hospital, based in Bangkok. “Our neighbouring countries do not have quality medical providers and their most affluent system will seek healthcare in Thailand or Singapore,” he said. He also stated that Thailand appeals to many expatriates whose employers have set up their South East Asian offices in Bangkok.
Establishing a global centre
Since 2003, the Thai Government’s strategy has attempted to make Thailand a global centre for medical travel through efforts such as international road shows and tax exemptions for investment in new health facilities that target international patients.
Most recently, it has been pushing wellness businesses. In August its Tourism Authority of Thailand (TAT) launched the ‘Thailand: Paradise for Longevity’ campaign to promote the Kingdom as a destination for products and services for a longer life. It is also attempting to encourage public hospitals to develop international standards of care to service both domestic and foreign customers (there are around 3,000 hospitals, many of varying quality according to the Medical Travel Quality Alliance (MTQUA)). Most of its medical travel business is conducted via private hospitals. University hospitals are understood to have requested additional budgets to invest in infrastructure to cater to this market.
In March, the government also approved 90-day visas for patients and medical visitors from Cambodia, Lao PDR, Myanmar and Vietnam (CLMV), as well as from the People’s Republic of China, in a bid to boost medical travel in Thailand. Interestingly, long-stay 10-year visas are now available for senior nationals of 14 countries including: Japan, Australia, Europe, Canada and the US.
The accreditation game
Thailand now has 58 Joint Commission International (JCI)-accredited hospitals. And perhaps the most high-profile is Bumrungrad International Hospital, which has become synonymous with Thai medical travel. The largest outpatient facility in the world, it boasts 12 stories, 1,200 physicians and dentists, 900 nurses and 580 inpatient beds. It treats over 1.1 million patients each year (outpatient and inpatient). Over 520,000 are international patients from over 190 different countries, it estimates, with a turnover of US$477 million in 2013.
The Bangkok Hospital group also benefits from business from international patients. It is a chain of hospitals owned by Bangkok Dusit Medical Services (BDMS), which originally began life providing medical services to American soldiers during the Vietnam War. It operates throughout the country, from Bangkok to Chang Mai in the North, and coastal areas in the south too.
Samitivej Hospital – another BDMS hospital – has been recorded as one of the best hospitals in the world, according to MTQUA. It was one of the first private hospitals to obtain JCI accreditation – in 2007 – and believes around 44 per cent of its revenue comes from international patients.
The Hospital has created a Japanese service centre, to aid largely Japanese expatriates living in the surrounding area said Leloup. Here it provides Japanese interpretation, processes documents, liaises with hospitals and medical personnel in Japan, and has a Japanese doctor, as well as Thai medical staff who have spent time in Japanese hospitals. This model has been extended to Arabic, Myanmar and Chinese service centres. Samitivej Hospital also has affiliations with hospitals in Japan and the US, including a neonatal unit.
An influx of international patients
Generally, international patients are drawn to Thailand from the Middle East and Asia. The highest numbers of international patients in Thailand in 2010 came from the United Arab Emirates (UAE), followed by Bangladesh, the US, and Myanmar, according to a report from the London School of Tropical Medicine and Hygiene.
it’s difficult to quantify the real number of international patients, experts say
Bangkok receives more international patients than any other part of Thailand. Many expats work in Bangkok; there are many visitors from Oman and Qatar based within Bangkok’s Middle Eastern district of Nana. Coastal resorts such as Samui attract more wealthy holidaymakers and independent travellers from western Europe and Scandinavia. Russians used to come almost exclusively to Pattaya, but now visit many more parts of Thailand. And Pattaya sees more retirees and groups of Asian travellers – especially the Chinese, who have been visiting in record numbers said Quaeyhaegens: “For nearly two years we have been seeing groups of Chinese coming with 60 to 100 or more at time for anti-ageing check-ups,” he said.
However, it’s difficult to quantify the real number of international patients, experts say. The government believes 2.35 million people received treatment in 2014. But some studies have called into question the accuracy of figures.
The discrepancy arises because many hospitals fail to distinguish between international patients, expatriates, immigrants and tourists who have simply fallen ill or been injured while on holiday in Thailand. Thai hospitals also report foreign patients by counting the number of visits – rather than the number of patients said Thinakorn Noree of the Ministry of Public Health’s International Health Policy Program (almost 105,000 international patients visited the five biggest private hospitals in Thailand in 2010 said one study).
The fact is, international patients in Thailand do not form a homogeneous group. They are retirees who wait until they reach Thailand for their six-month stay to have treatments, those who travel with serious health issues and those seeking minor treatments while taking a holiday.
Previously, international patients from North America and Europe were assumed to be seeking complicated procedures when they travelled to Thailand for medical care. The reality is, most come for minor elective procedures, such as cosmetic surgery. UK visitors, for example, prefer relatively cheap procedures at the end of their holiday, rather than dedicated medical travel trips with a few days of leisure tacked on.
Medical procedures vary with nationality too. Americans most frequently purchased cosmetic surgery procedures, followed by orthopaedic operations (musculoskeletal) and eye operations (laser surgery and intraocular lens implants are popular). Australians arrive for plastic surgery too. Patients from the UAE primarily purchase services such as cardiac catheterisation, angio-cardiograms, other cardiovascular procedures and gastric bypasses, however.
The trend we are seeing is a shortage of qualified medical staff. Without good doctors, it is not possible to provide quality healthcare
Despite the size of the industry, medical travel generates the equivalent of just 0.4 per cent of Thailand’s gross domestic product. And, it has exacerbated the shortage of medical staff by luring more workers away from the private and public sectors towards hospitals catering to foreigners, say researchers.
A future challenge will be to ensure there are enough medical staff, in a country with over 22 medical schools and one of the oldest medical schools in the region. Many go abroad or are attracted to the industry said Samitivej’s Leloup, who says his hospital invests in overseas training for doctors. “The trend we are seeing is a shortage of qualified medical staff,” he said. “Without good doctors, it is not possible to provide quality healthcare.”