Although it is a country known and internationally recognized by the vastness of the territory, natural resources and hospitable people, Brazil has a cultural history of following the more developed countries in the activities that are going well. Even in segments where it holds leadership, Brazil has not always acted with an entrepreneurial attitude.
For instance, in the poor utilization of natural resources, the export of raw materials or non industrialized products of low value added, and the resistance to explore the possibilities that relatively new markets such as medical tourism. This is a growing trend worldwide and has been the focus of public policy of various governments.
Despite the timid changes occurring in recent years with Brazilian companies opening subsidiaries or purchasing business units in other countries, the amount of participation in the world still falls short for a country the size of Brazil.
The problem is even greater when the Brazilian bureaucracy and the indifference of the authorities discourage or even prevent the country to act freely in international trade, discouraging the exporting companies and professionals from other countries to work here with unnecessary barriers. It is no wonder that there is a brain drain to countries that offer opportunities and fertile ground for the development of new projects.
In the case of medical tourism or health tourism, so far there are a number of factors that hinders the full participation of Brazil in that segment. Despite having world-renowned professionals, last year the country received less than 50 thousand medical tourists, while other countries with a lower health infrastructure received hundreds of thousands. It is a difficult task to list all the complicating factors and impediments that contribute to this scenario, however, among the principals are:
Definition
There is a lack of a defined strategy of the private sector, which is common to all hospitals, clinics and other providers of medical services. In this framework, each provider serves as they imagined being the best in the market. Having been isolated, they reduce the scope of its dissemination and consequently the prospects for success in other markets that are unaware of their existence or are simply not known. Acting together and with a well-defined strategy reduces the individual costs of the business and increases the chances for return on investment, especially for the so-called clusters of health.
Indifference
There is notorious indifference of the public sector for the medical tourism activities within and outside the country. When such a thing takes place, the public sectors’ actions are ineffective, and often leave much to be desired, as they do not work together with the private sectors to take effect.
Joint Effort
There is an evident need of concatenated and joint efforts between the public and private sectors. Although attempts occur, they are usually in isolated events without continuity or presentation of results for the segment. Despite the low transparency of actions, the results fall short of ideal for this whole industry.
Politics
Despite the good infrastructure of the country, some politicians are in charge of key areas like tourism and healthcare, and do not deal properly with travel in high seasons or other usual problems for big cities. Common situations in the world can turn into discouragement to tourists when they occur almost simultaneously; excessive violence in the main cities, chaotic traffic, poor transportation systems, lack of structure in the cities with which to receive those who speak other languages, among other obvious reasons.
Country Image
A negative image of the country within the international media also presents a problem. Unfortunately, it seems that the world has more negative than positive information of Brazil. Upon their arrival to Brazil, many tourists are surprised and dazzled to find that we are a modern and well-developed country. Very little to nothing is done by the authorities to prevent excessive negative exposure or even try to improve the image of the country within the world.
Focus
Hospitals are not focusing on areas in which they excel nor have a defined and established trademark (brand) used to attract everyone, everywhere. They imagine that selling an image of efficiency across all medical specialties, that they will be more attractive. It is great that a hospital holds excellence in many different specialties; however, there needs to be a clear identification of the areas that stand out and separates them from their competitors, by focusing for example on the rate of success in certain procedures.
Publicity
Accreditation systems, whether national or international are not being publicized properly. Some institutions invest small fortunes in obtaining an international accreditation seal, only to keep it almost hidden. The fact one hospital holds this confirmation of their high standard of quality of its services does not automatically guarantee the attraction of domestic and international customers. It is important that the institution act positively within its advertising, disclosing the seal with its services and showing it with alongside their own image.
International Patient Centers
Not many hospitals are armed with the internal structure necessary to receive patients from other countries. For example, many hospitals lack specialized staff who can speak other languages fluently. Good communication is crucial to business nowadays, and any miscommunication can potentially jeopardize the entire experience. When dealing with medical treatment the situation becomes far more complex because it is a person’s life in the hand of his or her physician and other professionals.
Unfortunately, many hospitals seeking to attract international patients currently lack may of the basic tools to do so, such as signs in other languages, trained staff to mitigate the cultural impact of the patient, and often even health care professionals lack the preparation to meet patients’ needs in an ideal timely manner.
International Participation
The lack of participation in international organizations and associations that operate in this segment or promote medical tourism or health, such as the Medical Tourism Association, where experienced professionals with a broad network of contacts can bring much exposure to our hospitals. Being featured and/or cited in international guides, specialized books, magazines and working with trained facilitators opens the door to the world, assisting in the dissemination and reducing the distance between the future patient and the hospital.
Country Brand
Although there is a good image of Brazil abroad linked to certain medical procedures or in the areas in which Brazil is renowned for its excellence, there still isn’t a “country brand” strong and well established enough overseas in the health sector. The good references that exist today in the areas of plastic surgery, orthodontic, oncology, orthopedic and artificial insemination were built over time by professionals who developed their own techniques, without government support.
Marketing
The lack of marketing abroad, or the establishment of communication with prospective consumers of medical services in the major cities of the United States and Europe to solidify the image of medical tourism destiny. Ads in magazines, newspapers, TV programs and events in cities like London and New York among others, are essential to become a known destination.
Attitude
An entrepreneurial attitude is essential in order to change the prevailing mentality. Good opportunities rarely come about without great efforts, and much less if there isn’t a change in the mentality of the entrepreneurs and the government as a whole. Innovation must be used to break old paradigms, which may currently prevent an institution or an entire country from becoming competitive in the market today.
Patients seek new standards of hospitality and their attention has turned to the comfort, luxury and access to unconventional resources such as cultural and leisure activities in addition to many packages of medical treatment in other countries.
Infrastructure
Hospital infrastructure and accommodations are approaching the system used in currently by hotels. The hotel structure has become essential and one of the many differentials, as medical treatment has become an international commodity. We must bring the institution to international standards of hospitality by making it more attractive and more competitive in the international market. Unfortunately many hospital administrators in Brazil have resisted to embrace this idea and won’t even dare consider it, unknowingly ignoring the potentially significant gain and highly profitable market shares.
It is imperative to realize that this set of factors which interfere with the participation of Brazil in the international market, does not present an impossible task to solve. Nor is this a widespread reality across the entire country. On the other side, Brazil has many hospitals and clinics that have prepared themselves adequately, and are offering their accredited services internationally. Although they are located mainly in major Brazilian cities, there are important institutions that are investing heavily in:
Hotel structure:
a new concept of hospitals and clinics focusing on natural light, an attractive and modern color scheme, shops, and restaurants. There are companies offering exhibitions, cultural activities and musical concerts that have become part of routine of the hospital. They also offer comfortable accommodations comparable to those of luxury hotels, managed by professionals from hotels and famous restaurants throughout Brazil, creating a climate conducive to hospitality, contributing to the welfare and improvement of the patient health.
Humanization of care:
the change of the environment in the hospital led to a change of its professionals’ mentality; where the product (service) sold by the hospital is the “cure” and the “life”, i.e. the hospital does not exist solely to treat illness and dying patients. The image of the hospital does not need to be tied to a cold and impersonal environment linked to pain and death.
There is a warm environment with attention to individual and human needs with the inclusion of new professionals as the hospital staff. Patients can be accompanied by full time (caregivers), participate in musical and theatrical groups, have contact with (properly sterilized) small animals and the use of play spaces for children has also humanized and mitigated the pain of a hospital internship.
Hospital Accreditation:
many hospitals and clinics have sought these seals of quality that prove the excellence of its services, especially from institutions like the Joint Commission International-JCI, the Canadian Council on Health Services- CCHSA, and other institutions or service providers in each specialty as the Commission on Laboratory Accreditation of the College of American Pathologists (CAP) for laboratories. The search for international certification has become a way to testify for the clients in other countries that they may find here the same standard and quality of services in their own country.
The major problem is still the little involvement, support and encouragement of the government and the resistance of hospital administrators to go abroad and increase their participation in this profitable market. There are, however, some initiatives already underway, for example the participation of the APEX-Brazil (Brazilian Agency of promoting exports and investments) and a group of private hospitals seeking to attract some of the international demand through the dissemination of events in other countries.
The hospitals and clinics that enter this market are well prepared, with a good infrastructure and eager to show what they can do. Moreover, the human warmth and receptiveness of the Brazilian people, high quality of services, low prices and the internationally recognized competence in various areas of medicine, certainly put Brazil as one of the main destinations of medical tourism in the coming years.
As the situation is changing with more facilitators and providers interested in showing what Brazil has to offer in medical tourism, this country looks forward to a “key player” status within the medical tourism industry.
Adalto Felix de Godoi
Holds a degree in Hospitality, a specialization in Strategic Management of People, and an MBA in Strategic Business Management. Is an author of a book and articles in specialized journals and magazines about hospitality in hospitals, education and tourism. At present works as an Administrative Coordinator, responsible for coordinating the administrative and operational activities in one of the best Brazilian hospitals, the Hospital do Coração – HCor. He is also professor of economy and projects in the Anchieta College; works as a consultant in the area of hospitality and health in Brazil, and is also an external consultant to DeMatteo & Monness (USA).
