The concept of health tourism is not new. The first recorded instance of health tourism dates back thousands of years to when Greek pilgrims travelled from all over the Mediterranean to a small territory in the Saronic Gulf called Epidauria. “The Asclepieion at Epidaurus was the most celebrated healing center of the classical world, the place where ill people went in the hope of being cured.
To find the right cure for their ailments, they spent a night in the enkoimitiria, a big sleeping hall. In their dreams, the god himself would advise them on what they had to do to regain their health. In the sanctuary, there was a guest house with 160 guestrooms. There were also mineral springs in the vicinity which may have been used for healing.”
For decades, perhaps even centuries, Europe has been known as a distinguished medical tourism hub. European hospitals have led the world in medical research for hundreds of years and still continue to lead in the realm of medicine today. Eastern and Western Europe provide premium healthcare and cater to both European and foreign patients.
Germany, France, Austria, Spain, Switzerland, Belgium, Italy and Greece and take the lead in Western Europe, offering convenient access to high-end medicine and state of the art facilities at relatively low prices. The attraction of Eastern Europe is its lower costs for standard medical, surgical and dental procedures, with Hungary, the Czech Republic and Poland in the lead. All of these countries boast outstanding facilities in health tourism, as well as magnificent landscapes and natural resources (e.g. mineral springs) which positively influence the patient’s healing process.
High quality, low-cost medical care in Europe is often available at rates between 40 percent and 80 percent below the cost of the same procedures in the USA. University clinics in Europe have a long and flourishing history; these strongholds of medical science contribute to a high standard of medical treatment, research and medical education.
Medical Technology and pharmaceutical companies in Europe are among the top institutions in the world and enable a cutting edge research environment for continuous innovations in the field of medicine.
Cross-Border Healthcare and Medical Tourism
The EU gross domestic product amounts to EUR 12 trillion, of which public health spending accounts for 7.6 percent. The publicly financed EU health market has a volume of EUR 1 trillion, with cross-border medical services already contributing at least 1 percent (EUR 10 billion).
The potential of the EU health market is substantially greater than the actual current demand for EU health services. Although over 90 percent of EU citizens currently undergo medical treatment in their own country, 53 percent would be willing to utilize medical services provided in other EU countries. The EU Commission estimates that in the future, at least 780,000 people more than before (intrabound medical tourism) will receive medical treatment in other EU countries every year.
Europe has several major medical clusters that have specialized in taking care of medical tourists from all over the world:
1 http://en.wikipedia.org/wiki/Epidaurus
2 TK Analysis of EU Cross-Border Healthcare in 2007
Bavaria ~ A Better State of Health
Foreign patients are choosing the Free State of Bavaria as their destination of choice because state-of-the-art medical care, in combination with the region’s world famous sights and excellent tourism infrastructure, offer patients something for the body and soul. About 400 Bavarian hospitals provide top tier healthcare service in cardiology, cardiac surgery and orthopaedics, just to name a few.
About 300 prevention and rehab institutions, with over 30,000 beds, interlink in a dense healthcare network. The well-structured range of rehabilitation options are diverse, highly specialized, of outstanding quality and are rarely found anywhere else in the world.
The “gentle medicine” facilities are also unique: Body and soul can be cared for and pampered in about 50 outstanding health spa and rehabilitation centers throughout the region. http://www.state-of-health.eu
University Medical Center UKE ~ The Gateway to Global Healthcare
The University Medical Center UKE is the largest hospital in Northern Germany. Nearly all types of illness are treated in the center’s 80 clinics and institutes. The UKE belongs to the leading university clinics in Germany and delivers high performance medicine for complex diseases. It is also home to many world renowned specialists who have access to the most up-to-date medical technology in Europe’s most modern hospital infrastructure.
Patients from virtually all over the world are guided and advised by the employees of the International Office, which specializes in making sure foreign patients have a successful and comfortable stay during their time at the University Hospital. Apart from medical care, the University Medical Center Hamburg-Eppendorf also carries out significant medical scientific research and is a teaching hospital where physicians and other health care professionals are trained. Many doctors, scientists and students visit and work in the clinics and laboratories as guests. http://www.uke-io.de
Network for Better Medical Care in Berlin ~ Germany’s Nobel Prize Capital of Medicine
More than half of German Nobel Prize winners in medicine and physiology come from the Charité, one of Europe’s biggest University Clinics. Among these Nobel prize winners are Emil von Behring, Robert Koch and Paul Ehrlich. The member hospitals of NBMC are some of the most reputable in Berlin and are known far beyond the city on account of their medical performance. The main goal of NBMC is the satisfaction of the patient through medical treatment, care and support services, information and a high level of comfort.
The members of NBMC offer the patient the highest level of medical service, the most modern medical and technical equipment and excellent support services. Treatment by fully qualified doctor and a multi-lingual staff, plus attention to individual needs illustrate the University Clinic’s commitment to top notch service and treatment. Quality standards are regularly subjected to external controls, which are a requirement for new members of NBMC. http://www.nbmc-berlin.de
Bonn Medical Partners ~ Ambassadors of German Medicine
With its outstanding medical facilities and its central location in Europe, the former German capital, Bonn, attracts patients from primarily Arab countries who fly in for treatment and high-end medical care. Bonn Medical Partners for medical services was founded in order to promote Bonn abroad as a distinguished destination for treatment that allows foreign patients to benefit from the outstanding treatment options offered at the clinic.
Bonn Hospitals enjoy an excellent reputation in Germany. In a countrywide comparison, Bonn had an above-average number of medical and health-oriented establishments and research institutes. Due to its excellent health care system, Bonn is one of the health economy’s key destinations. Bonn Medical Partners offer a very wide spectrum of medical establishments for treatment. http://www.bonnmedicalpartners.de
United Kingdom ~ Europe’s Leading Medical Tourism “Hub”
The value of inbound medical tourism to the UK significantly exceeds outbound medical tourism. Many people in the medical tourism sector focus on the outbound sector where UK patients are seeking low cost treatment abroad, and ignore completely the long established inbound business.
London attracts high value, expertise based medical tourism with large numbers of patients coming from countries across the Middle East, and from India, Pakistan, Greece, Turkey and Cyprus. London has around 20 private hospitals and NHS hospitals with private patient units.
Over 30% of the revenues for London’s private hospitals comes from. overseas patients. In some units focusing on specific areas of high end medicine and expertise, the percentage is as high as 70% It’s Europe’s leading medical tourism “hub”. For example, the square mile of London around Harley Street is the base for over 1,000 leading specialists in all areas of medicine.
Swiss Leading Hospitals ~ Precision Like a Heartbeat
After ten years in the market, Swiss Leading Hospitals are now a firmly established brand and a potent pillar of the Swiss healthcare system. State-of-the-art medicine and a first class hotel environment is the secret of success that has shaped the Swiss Leading Hospitals, or SLH, group of clinics.
First class medical and nursing care, as well as high-end accommodation services, are a few unique qualities of the SLH. The quality management is pioneering, and in consequence, standards of quality are unique.
The SLH member clinics provide leading medical specialists as well as individual quality care at all times, ensuring that services offered can be customised to meet the exact personal needs of every individual patient. http://www.slh.ch
Spain ~ Zest for Life in Barcelona
Barcelona is not only renowned for its monuments, architectural styles and unique cultural heritage, but also for its high quality of life and long-standing healthcare tradition. The Mediterranean climate and passion for life that characterizes Barcelona ensures that your stay in Spain’s most European city will be a more than rewarding experience.
Due to Spain’s high quality of life and income level, Barcelona can offer quality healthcare comparable to that of the wealthiest countries in the world, but at a far more competitive price. Part of a unique European initiative, Barcelona Centre Medic (Barcelona Medical Center) is a high quality service in integrated medical care, provided by 20 of the most reputable and prestigious health centers in Barcelona: Eight general clinics, Eight specialised centers and four diagnostic centres. http://www.bcm.es/
Belgium ~ Healthcare in the heart of Europe
Belgium’s healthcare service is known for its easy accessibility and high-quality treatments. With four doctors per 1,000 inhabitants, Belgium is well beyond the OECD 2.9 average. Belgian hospitals are outfitted with advanced medical technology and run by highly qualified personnel.
The Belgian healthcare system is well developed with a large number of specialized centers and internationally renowned doctors. Besides the health services themselves, various Belgian companies are recognized as international players in the medical equipment and software arenas.
A high level of expertise, world class treatments and technology, coupled with virtually non-existent waiting lists, encourages more and more patients worldwide to come to Belgium, the heart of Europe, for their healthcare needs. In the neighbouring Netherlands they are also very conscious of the relation between the public good of health and economic drivers into health care.
An excellent example of this thought is the existence of a governmental watchdog who guides the economic trade value and ethics of health care in the Netherlands, the Dutch Health Care Authority. http://www.healthcarebelgium.com / http://www.nza.nl
Austria ~ Premium Health Solutions
Austria takes a leadership position in European healthcare due to the excellent performance of Austrian doctors, hospitals and clinics. It is the combination of internationally renowned doctors and high quality basic treatment that pushes Austria into its leadership position.
Along with internationally renowned University Hospitals, there are excellent private clinics and rehabilitation centers where leading technology and state of the art treatments are employed. As a result, patients from Austria and from abroad benefit from outstanding medical treatments and enjoy the highest possible level of comfort. http://www.phs-austria.com/
Greece ~ A Future Olymp of Health and Medical tourism
Greek providers and the Government, through the Ministers of Health and Tourism Development, have declared their commitment and determination to make Greece a health tourism destination with unique attributes. Before that several medical services providers had already taken the initiative of developing and actively promoting their medical tourism services.
Greece will be targeting a consumer demographic which is not primarily “price sensitive”, takes top quality and standards for granted and is looking for such attributes as ambience, sophistication, elegance and flair. Greece is currently integrating and developing its industry along the lines of 8 different health tourism segments.
Towards achieving this objective, in 2007 healthCare cybernetics (hCc) in collaboration with major health tourism stakeholders took the initiative of initiating a national-level domain integration and development project.
High-Tech Medicine & Savoir Vivre in France
An outstanding healthcare system and some of the best surgeons in the world, specializing in obesity, orthopaedic, cardiology and general surgery, places France among the favorite destinations for medical tourism in Europe. To top it all, there are no long waiting lists for elective procedures and patients do not need to seek pre-authorizations.
Medical treatment in France is exceptional, thanks to the abundant number of established hospitals, such as the American Hospital of Paris, the Foch Hospital, the Henri Mondor, and Broussais University Hospital just to name a few. Undergoing medical treatment in France is comparatively far less expensive than in the USA and can be combined with an enjoyable vacation Rejuvenation Through “Liquid Therapy” in Hungary
Hungary is well known in the field of health tourism. For centuries, travellers have been visiting its restorative mineral springs, lakes, baths and spas. Hungary offers a range of excellent dental treatments, cosmetic surgery and elective surgery, which visitors can take advantage of at very economical prices.
Hungary boasts more dentists per capita than any other country in the world and is renowned for its high standards of care and advanced medical procedures, with many of their medical professionals teaching and practicing internationally. The capital, Budapest, is a very relaxing place to recover from medical treatment, and boasts many thermal spas, making the experience of having surgery abroad a real “healthcare holiday”.
Poland ~ Get a New Smile and Forget your Wrinkles
Poland has a long history of health tourism spas dating back to the 13th century. Since joining the EU in 2004, Poland has capitalized on its ability to offer cheap medical treatment to patients from abroad, with large numbers of private health clinics working with national health services of other EU member states as well as with travel companies, resorts, hotels and golf courses from around the world.
Recently, competitively priced elective and cosmetic surgery has complemented spa tourism. Poland is seeking to exploit its ability to offer visitors a combination of healthcare and leisure holidays, and to date it has managed to do it quite successfully.
Charles University in Prague – The Cradle of Cosmetic Surgery
The Czech Republic, and in particular its beautiful and historic capital, Prague, is a major tourist attraction and also one of the newly emerging medical tourism destinations of Europe. High standards of treatment combined with low prices make the Czech Republic an attractive destination for medical tourism.
The Czech Republic offers affordable plastic & cosmetic surgery in Prague with highly qualified and experienced surgeons. Modern plastic surgery was founded in Prague when the first chair of the discipline was established at Charles University back in 1938.
This central European country can be easily reached via frequent low cost flights from various European airports. Prague is an ideal short holiday city, with a remarkably well preserved old town and many inexpensive cafés, restaurants and places to stay.
Medical Science and Innovation Embedded in Europe’s Cultural Heritage
As has been outlined above, Europe offers an excellent and comprehensive portfolio of medical tourism opportunities at competitive prices. European Hospitals are known for their high standards of medical care and have long attracted international patients. This is due to the fact that scientific medicine had its beginnings in Europe back in the 19th century.
Nowadays, it has developed an exceptional number of medical clusters that contribute to its leading rank in healthcare on a global scale. The application of modern healthcare management principles has further contributed to the fact that patients treated in European hospitals can expect top-level and integrated treatment that satisfies all needs of the care cycle.
Quality in Health & Medical Tourism through Education
Medical Tourism and cross-border healthcare has led to the need for educational programs that educate specific management training professionals for this sector. The MBA program for health & medical tourism that will be founded by several leading Universities in 2009/2010 really fills a gap that provides new leaders in the growing business of medical & health tourism.
The MBA program in Medical Tourism, International & Cross-border Healthcare Management is planned as an international educational joint program to guarantee the highest standard of quality in the emerging business of medical tourism and cross-border healthcare, and places special emphasis on the entrepreneurial and innovation challenges faced by managers in all lines of business associated with this industry.
The Driving Forces of Medical Tourism
Globalization of healthcare, internet technologies and an increasing trend for consumerism will be the main driving forces in the future of medical tourism. The European-wide distribution of e-health technologies will simplify the utilization of cross-border medical services in other EU countries and worldwide. The European Commission is investing EUR 23 million in the European-wide distribution of e-health technologies between now and 2010.
This will simplify the utilization of medical services in other EU countries. Patient data, in compliance with data protection needs, will be available on a cross-border basis. The Europe-wide use of electronic patient files and the Europe-wide recognition of medical prescriptions will soon be possible. Moreover, internet-based patient centered e-health solutions will fill the gap between the institutional health IT systems and patient driven health records in the future.
Dr. med. Robert Gerl (MBA) is the German coordinator and co-founder of the European joint-educational MBA program on health & medical tourism, cross-border healthcare & health destination management at the University of Applied Sciences in Deggendorf/ Bavaria, where he is also assigned as associate professor. He may be reached at robert.gerl@german-healthcare-services.com.
Leonore Boscher worked as the managing director of the surgical center of the University Medical Center Hamburg-Eppendorf for two years. Since 2006 she has been successfully managing the International Office of the University Medical Center Hamburg-Eppendorf. She is also currently writing her PhD thesis on the Principle Agent Theory – the Role of Clinical Directors in the Faculty of Medicine. She may be reached
Prof. Dr. Horst Kunhardt has University degrees in computer science and human biology. He is Professor at the Deggendorf University. His areas of teaching are information application systems and health care management. He is academic programme coordinator for an MBA Health care Management and has 15 years experience as CIO and quality manager at the Mainkofen District Hospital. Dr. Kunhardt has significant expertise as project manager in building healthcare networks and member of the scientific advisory board of several health care companies. He may be contacted through the University of Applied Sciences Deggendorf horst.kunhardt@fh-deggendorf.de and www.fh-deggendorf.de .
Tomas Mainil is currently working at the Centre for Cross-Cultural Understanding@NHTV as coordinator of the Masterclass IHS (www.nhtv.nl/MasterclassIHS/), is responsible for the research line Medical tourism and International Health within the Centre. He has a MA in Sociology and a MsC in applied statistics. He is in the progress of a PhD in Medical Sociology on Medical Tourism, cross-bordering Cultural studies, Medical Sociology, Health Management studies and Tourism studies. He is co-founder of the MBA network initiative.
