Challenges to PH medical tourism

Dr. Emmanuel Tiongson

Dr. Emmanuel Tiongson

To become one of the Top 3 most desired Asian destinations for global health and wellness seekers, the Philippines has to attract one million clients for medical tourism, two million for the wellness sector, and 200,000 retirees for long-term healthcare, according to the National Competitiveness Council (NCC).

However, the Asian Institute of Management (AIM) said there are several challenges to achieve this goal.

“Medical tourism can only become a viable growth strategy in the Philippines if a progressive health system, developed physical infrastructure and stable political environment are present,” according to Dr. Armando Crisostomo, chief of the Medical Education Unit of the College of Medicine, University of the Philippines-Philippine General Hospital.

For years, the government has been promoting the country as a medical tourism destination in an effort to tap its healthcare system and improve the Philippine economy. But Crisostomo noted that medical travelers have come to the Philippines even before the promotion of medical tourism.

Foreigners earlier sought Filipino traditional healers and hilots for alternative medicine. In addition, local hospitals have already been treating foreign patients and balikbayans from the USA, Middle East, and the Micronesian States of Palau, Guam and Saipan.

In fact, three hospitals – St. Luke’s Medical Center, The Medical City and Chong Hua Hospital – have received accreditation from the Joint Commission International (JCI), the most prestigious health-care accrediting body in the United States.

Specialty clinics
Specialty clinics in the Philippines have also been serving patients from the USA, Japan, South Korea, Taiwan, Indonesia and Australia, who come for dental care, eye care, plastic surgery and bariatric procedures, the Department of Tourism (DOT) said.

Dr. Emmanuel Tiongson, the Department of Health’s (DOH) medical tourism program director, defines medical tourists “as those who come to the Philippines as tourists first and decided to go to a hospital to avail of medical services. Medical travelers are those who come here primarily to get a medical procedure done. Hence, they have already made arrangements with hospitals of their choice on the details of the procedures that need to be done.”

“If you are an American with an eye disease and want to seek treatment in RP, the best thing to do first is to decide which hospital to go. JCI-accredited hospitals have arrangements with medical insurance so patients can use their coverage here. Check hospital websites and contact international patient centers to ask for details that will be needed for treatment. JCI hospitals have hospital call centers that can answer specific inquiries regarding costs, packages and details of diagnostic tests,” he added.

Competitive enough
How competitive is the Philippines as a medical tourism destination? Tiongson said “the Philippines has a pool of competent physicians in top JCI accredited hospitals coupled with a support staff of English-speaking, culturally sensitive nurses, and caring (with malasakit or concern) health and human resources, making it globally competitive compared to its Asian neighbors Thailand, Malaysia and Singapore. Although admittedly some of the best doctors and nurses go abroad, top hospitals in the country maintain international accreditation so we have top caliber health professionals that provide quality health care delivery 24-7.”

In 2004, former President Gloria Macapagal-Arroyo issued Executive Order (EO) 372 that created a public-private partnership (PPP) task force to develop globally competitive service industries. The PPP Task Force created and implemented policies and strategies in three key sectors, including the health and wellness sector.

In 2005, the DOH held a stakeholders’ meeting together with the private sector in Makati organized by the Monitor Group, a private organization. Present were former Health Secretaries Dr. Francisco Duque 3rd and Manuel Dayrit, and former Undersecretary Jade Del Mundo. The DOH was asked to lead in all health-related concerns for “medical tourism” since it has the “greatest scope in the regulation and coordination of health facilities.”

Tourism program
After this, the Philippine Medical Tourism Program was conceptualized and finalized. Dr. Paul Reganit became the program’s first manager. A soft media launch was done in January 2006 at the Manila Diamond Hotel participated in by people involved in the Phase I-A Program Implementation. A grand launch was later done during the First Philippine Medical Tourism Congress and Exhibit on November 2006 at the Philippine International Convention Center in Pasay City.

Arroyo was the keynote speaker with the presence of then Trade Secretary Peter Favila, Duque, Del Mundo and former Sports and Wellness Tourism Assistant Secretary Cynthia Carrion. Joyce Alumno of HIM Communications and Edy Uy of Rx Pinoy were among the few private sector delegates that enabled the Congress to take place at no cost to the DOH.

The Philippine Institute of Traditional and Alternative Health Care and the Department of Trade and Industry-Board of Investments (DTI-BOI)-Philippine Retirement Authority were also present as part of the pool of speakers. Regular cluster meetings were called by the DOH in collaboration with other government agencies and the PPP Task Force.

Focus on health
EO 571, issued in October 2006, formed the NCC. The PPP Task Force was subsumed under the NCC, making tourism focused on health, wellness and recreation (HW&R), one of the eight industries to be developed and promoted as globally competitive industries. These initiatives paved the way for the Philippines to be a medical tourism destination.

The health and wellness sector consists of three clusters: 1) the medical tourism cluster, which was divided into the hospital group and the specialty clinics group; 2) the wellness cluster (i.e. spas, complementary and alternative medicine); and 3) the retirement cluster (i.e. retirement communities for foreign nationals). The HW&R as a whole relies on healthcare as its main backbone and all three may be viewed as different aspects of a bigger entity—the medical tourism industry.

For the country to become a top Asian healthcare destination, the NCC said the Philippines must meet the clusters under the HW&R sector that target one million clients for medical tourism, two million for wellness, and 200,000 retirees or “long-term care seekers.”

“An informal technical working group being headed by the DOT, the DTI–BOI and the DOH are currently working hard to push the medical tourism industry forward. We are currently engaging top hospitals for possible international promotion through quad-media approach,” Tiongson said.

Challenges ahead
But a 2011 AIM study listed several challenges to achieve this goal. The first is the high cost of travel to the Philippines because of the lack of direct flights to and from target markets in North America, Europe and Northeast Asia. High airfares and numerous airport fees not implemented elsewhere also increase the cost of travel to the country, according to a 2008 study by Michael Porter. The AIM said an open skies policy would improve this area but there is much to be done in terms of travel and medicine integration.

The second challenge is the lack of transport infrastructure. Porter said this deters medical travelers used to trains, buses and other organized systems of transportation. Medical City Medical Director Dr. Eugene Ramos said “they are already concerned with their health, yet they have to worry about how to navigate our crazy streets.” Further investments in airports, highways and organized transportation systems are needed to solve this problem.

The third challenge involves security and safety concerns. Worries about peace and order force prospective medical tourists to choose other destinations.

Sick people from other countries also have misgivings about our healthcare system given the gap between the quality of public and private health services.

“Poor health outcomes, combined with poor regulatory mechanisms, and uncoordinated government effort, contribute to the country’s low competitiveness against its competitors,” the AIM said. Also, with the brain drain of doctors and nurses migrating to greener pastures, those who are left are new graduates working here to gain experience.

Thus, the fourth challenge is the development of a market niche and a unique value proposition that will raise Philippine services above what is offered by other countries.


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