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You’ve seen it time and time again. Some publisher has published yet another new report that highlights the market size and potential of the medical tourism / health travel / medical travel market size and opportunity. The cost to access this report is often more than USD $1000. And sometimes, the purchase price of your very own copy will set you back several thousands of dollars – but if you rely upon this information, doing so could “cost” you many multiples of the data and set you up for business failure.
I don’t begrudge these publishers for making claims about the publications they sell, that’s a legitimate business activity in most every country in the world. But as an investor or startup in medical tourism, or a health facility or clinic deciding if you should enter medical tourism and make business decisions on the basis of these numbers, the responsibility for your reliance on and interpretation of the data presented and how you use it rests with you and you alone.
Vet the publisher and the business they are in
Some publishers of these reports are experts at layout and design or they have hired experts whose job it is to use expensive publishing software applications to create attractive layouts and compelling sales messages hidden inside the text. The publisher’s real business may be marketing medical and dental tourism, or marketing certifications, conferences, events, and stand rental opportunities. These reports are merely sales tools for their business. They entice the reader that the market is vast, growing and has a potential for compound annual growth rates (CAGR) of some compelling percentage. This CAGR is defined as a measure of growth over a certain time period (usually 3-5 years). Most people interpret CAGR to mean the growth rate that gets you from the initial investment value to the ending investment value if you assume that the investment has been compounding on the anticipated trajectory over the time period.
Heck! What are you waiting for? An engraved invitation? Sign that advertising sponsorship and stand rental contract and go find some more medical tourism conferences to spend a few thousand dollars on a stand rental and sponsorships and the travel costs to attend! For every thousand dollars you invest in this and your other startup costs, your business will be worth 35X at the end of the time period in question, right? After all, that’s what Deloitte published in 2008. And you trust their brand when they report market projections, right?
Yesterday, a report was released stating that “The point-of-care diagnostics market projected to grow at a CAGR of 10.0%.” It explained that the global point-of-care diagnostics market is projected to reach USD 38.13 billion by 2022 from USD 23.71 billion in 2017 (a five year time period), at a CAGR of 10.0%. High prevalence of infectious diseases in developing countries, increasing incidence of target diseases, and increasing inclination toward home healthcare across the globe are the factors expected to drive the marketduring the study period. But the report says that “the lack of alignment with definitive central lab methods, certain disadvantages of Point-of-Care testing over central lab methods, and the reluctance among physicians to change existing diagnostic practices are the key factors that are limiting the growth of this market. In fact, if one felt that they have the chops to change these constraints, one might be able to realize even more than the 10% projected, right? Sounds plausible at first glance, doesn’t it?
So if you are the person responsible for vetting the publisher and their reason to sell the report to the public:
- What do you know about the publisher?
- What’s their motive for picking this specific report to compile and sell?
- What do they get out of publishing this data for sale?
- What benefit do they get when people purchase the report and attempt to make use of it to support buying decisions for other things?
- Do they have any benefit or involvement in those subsequent purchases?
- Is there any bias on their part for you to buy and believe and invest in something else they might sell downline?
Are you a gullible “mark”?
After all, you were their targeted ideal customer. They have studied you and have determined that their sales message will convince you that if you buy what they are selling, the purchase you’ve made will result in fulfilling your business intention, need, objective or dream to be fulfilled. So if you don’t realize that benefit of purchase, who suffers the consequence of that failure? Caveat Emptor, is a noun that is a phrase that means the buyer alone is responsible for checking the quality and suitability of goods before a purchase is made. Gullible is an adjective used to describe a person or public that is easily persuaded to believe something. It is used to describe someone who is naive, overtrusting, exploitable, inexperienced, or impressionable. A Mark is the term used often to describe a victim or prospective victim of a swindle or abuse. Are you at risk of being a gullible mark you in your present state of medical tourism industry knowledge? Are you vulnerable? If so, keep reading and let’s see if we can improve your odds and reduce the risk of your being taken advantage of going forward.
And what consequence does the seller endure if the data is not accurate or reliable?
And if the data is reliable, how much of the total market size number being quoted represents:
- the medical cost of the procedure
- the air travel cost
- the accommodation cost outside the hospital
- the facilitators’ potential earnings
- the tourism incidental expense
- the pre-departure costs at home for preliminary diagnostics and consultations
- the complications insurance premium expense
- the post return home follow on care that is not included in the medical procedure price
- the cost of travel incidentals such as pet sitting or boarding, someone to pick up the mail and keep an eye on the house for as much as six weeks absence, etc.
- and how much of it is other things added into the pot of expenditures being attributed to the medical travel episode of care?
I have an admission to make here. I was one who back in 2005, believed what I read. I was the gullible mark like many others who have since left the medical tourism industry completely. In fact, I quoted those big number statistics from Deloitte (2008) and McKinsey (2008) to my publisher, to clients, and used them to make decisions on strategy for Mercury Healthcare’s own medical tourism verticals. Had I know then what I know now, things would have turned out very differently. I haven’t quoted those numbers from Dr Paul Keckley of Deloitte (who has since left that consulting firm) for almost a decade. But the damages that reliance on his data and interpretation and assumptions cost me more than $1 million in errors. Who is to blame?
ONLY ME! I am the business owner, I was the risk taker, the entrepreneur, and the investor.
I was persuaded by claims of a 35% CAGR dubious number in a report with a Deloitte logo on the cover. He may have been right; he may have been wrong. No matter what, I used the data. I wanted to believe. My reliance led me to sign up for the MTA conference in 2009, pay timely to receive a gala dinner attendance ticket, a new dress and shoes purchased at the Nordstrom in San Francisco, along with a hair salon appointment, and then they prohibited me (and about 40 others) from attending the dinner claiming it was sold out and leaving the sponsor (KHIDI) to pay for empty seats at each table and uneaten meals while many of us had to buy dinner at the hotel. It caused me to believe that people would be at the B2B sessions who never materialized and others who were present but did not keep scheduled meeting appointments. It caused me to visit hospitals and clinics at my expense to build a provider network, and do many other things and make many other flawed business decisions based upon what I read.
I relied upon it and it was my bank accounts that suffered as the result of my decisions to rely upon those data and reports. I was the one who rented exhibit stands at events and commissioned website designs, and hired staff to cope with the growth. I was the one who used the reports to create a go to market strategy, a targeting strategy, a market connection strategy, a destination strategy and priority, and more. I invested time, money, focused my attention on this burgeoning market that was supposed to explode with riches and my business would easily thrive and prosper. So when none of that happened in the time frame in his reports, I was the one to blame. No one else.
There is nothing that anyone can do to redeem those brands of the two consulting firms, the so called industry trade association, and its owners. But I was lucky that I could bounce back. Hundreds of others have not been able to bounce back because they leveraged everything on those data and reports. And lost everything. Caveat Emptor!
I am fortunate in that I had other fallback focus areas within healthcare. But if this could happen to me with my experience, expertise and market understanding, could it happen to you too? When I figured out what was real and what questions to ask and what was meaningful, I was able to recover and got back on track. Bank accounts can always be replenished with hard work, but time and lost opportunity can never be recovered. And with these flawed numbers, not even a forensic economist can determine the extent of the losses if there was a way to recover. But in these data reports, there isn’t. You purchase the data at your own risk and trust it at your peril if you don’t critically assess (or don’t know what you don’t know) the assertions published.
I implore you to study the questions and data points I’ve highlighted below. They came at great professional cost from Hard Knocks University.
Absence of evidence does not equal evidence of absence
For data to be useful and meaningful, it must enable the reader to tell a meaningful story or support a business case argument that makes sense both intellectually and emotionally. That data is not meaningful or informative until it enables managers, statisticians and investors to bring statistics to life. For example, reports often claim these bits of information:
- “The top ten medical tourism destinations” [Who measured, what did they measure and how was it verified?]
- “The leading healthcare facilities” [Who measured, what did they measure and how was it verified?]
- “The must have accreditation scheme for medical tourism” [Which of the more than 20 accreditation schemes was evaluated, by whom, and where was the emphasis on hundreds of criteria assigned and why was that particular criteria selected?]
- “The lowest prices for medical and dental tourism treatments” [Which of the destinations were evaluated, by whom, and how recently? Were firm prices evaluated or were these numbers merely estimates? What was included in the estimates? Just the medical part purchased at the destination or the entire episode of care and the travel?]
- “Prices up to 90% less than X” [Where is the proof and what is included in the calculation? Medical treatment, health facility cost, airfare, insurance, accommodation, preparation, hometown expense costs before and after?]
Breaking down big numbers
If you search Google for “medical tourism market size” the first search engine return of 4,280,000 results is attributed to reuters.com. It states that “The Global Medical Tourism Market was worth USD 19.7 billion in 2016 and estimated to be growing at a CAGR of 18.8%, to reach USD 46.6 billion by 2021.”
So here’s my personal preliminary checklist of 6 key concerns when considering such a big ticket purchase. As a consultant, I know what it would cost me to prepare such a report for a client — a lot more than $4200. So, if I were to buy and rely, what must I first understand about the offer for sale?
- The big numbers: This assertion of market size over the next 4 years and one year already past does not mirror any of the other similarly priced reports offered by other publishers. I wonder why there’s such a difference in data and interpretation. Which is closest to accurate? Why the different in projections?
- Time span of the CAGR projection: 5 year time span. A lot can change in our current political arena and the pace of technology release and implementation. Did their analysts have the competency to make such predictions? Who did the research and what is known about their competency to make these projections?
- Publisher? Orbis Research. Seller of a report priced at USD $4255. That’s more money than most medical tourism facilitator startups have to spend for their entire first year in business! So obviously, facilitators are not their ideal consumers? So who are they expecting will buy this product? And how do they expect the buyer to benefit from the purchase? Or do they? I will read their about us page to see if there is objective information there or more hyperbolic claims about what they do.
- Definition of the scope of their report: “Medical tourism is defined as to travel across countries with the reason for benefiting medical treatment of some form, which might not be accessible in the travelers’ nation of origin. ” So immediately, I note that this report is unlikely to take into consideration the millions of dollars in domestic medical tourism within India, within the USA, within China, within Mexico, within Argentina, and within other countries where urban centers of excellence serve rural dwellers who travel in country to receive care from a medical or dental provider inside their own country but far enough away to remain overnight before returning home. So already, I must question the accuracy and the interpretations contained within the report. How will they compare with other publishers’ reports available at similar prices. And how old is the data and how was the research conducted and statistics verified externally and without bias? These are all valid critical thinking questions in order to gauge the value of the data contained within them for purpose of sizing the market for medical and dental tourism.
- Table of Contents: It is interesting to examine the titles used in the report for each section. They have tables on geographic regional predictions about Cardiovascular, Fertility, Orthopedic, Cancer, and Neurological specialties, but don’t mention cosmetic surgeries, weight loss surgeries, and other specialties. They assert that the market leaders are in India, Bangkok, Malaysia, and Singapore and China with their “Market Leaders’ Analysis” section. They offer a PESTLE analysis and a Porter’s 5 Forces Analysis, but the Table of Contents hints at nothing about comparing which market with another market, so I cannot be sure what I am going to get in analysis and value or if it is the “right” analysis that might serve my business meaningfully if I were a competitor or a marketer or facilitator or referral broker. They include what they call a Market Share Analysis. There are 195 countries in the world today. This total comprises 193 countries that are member states of the United Nations and 2 countries that are non-member observer states: the Holy See and the State of Palestine. More than 116 countries have announced entry into the arena of medical tourism and they list, by name, only 13 countries, individually and then re-incorporate, in regional groupings continental groups by geographical area and by type. Where are the rest of the competitors?
- Primary source data: How did they verify the statistics they analyzed? These data are extremely proprietary and subjectively categorized, starting with the definition of the term “Medical Tourism” and which cases are categorized as medical tourism cases?
Now, I am not singling out Orbis Research by any stretch of the imagination. I have the same 6 questions above, for each report being sold. One could easily spend USD $30,000 to purchase what’s on offer from about 5 sources just today. If I were the average medical tourism startup, investors, health facility, clinician, facilitator, or journalist, Which should I blindly trust with investment risk decisions and why? And how would I fact check their facts?
Getting down to relevance for purchasers need to understand
The big numbers problem present other problems because most are just that: “big numbers”. How can I get the data I would need as a medical tourism startup, investor, health facility, clinician, facilitator, or journalist? I need granularity in order to “know the customer demographics, psychographics and purchasing trends: not big numbers. Big numbers smear data and led to inaccurate assumptions. If I were any of the above end users of such a report, I would need to know:
- Who bought which procedures?
- What was their age and gender?
- What was their education level, socioeconomic status, originating city, local health supplier situation?
- How much did they pay and for what?
- How did they pay for their procedure? Cash, credit card, medical expense loans, wire transfer? Some other way?
- Did they pay for their airfare with money or frequent flyer mile credits?
- Did they pay for their hotel accommodation with money or frequent traveler points, or both?
- How much of the package price was medical cost?
- How much was air or rail travel cost? What class of service did they purchase for airfare?
- How much was accommodation cost? What type of accommodation did they purchase?
- How much was ground transfer cost? Did they use taxi, Uber (et al) private transfers supplied by the hospital or clinic? A destination management company? Did they rent a car? Did they pay for parking? If so, how much?
- Was there value added tax (VAT) or GST charged? Was it refundable on departure?
- Where there any extenuating circumstances in their medical history or request that may have caused an aberrance from published prices?
- Were there any surprise upcharges on arrival or just prior to departure? Did the surprise upcharge turn into bait and switch pricing and low ball quotations that were misleading advertising and truth in advertising problems?
- How long did they stay at the destination for each kind of procedure?
- What was the suggested time that they were advised by their doctor to remain at the treatment destination before being deemed “fit to fly” home?
- Did they stay longer to do some sightseeing? Did they go home sooner against medical advice? How did they spend their recuperation time while at the destination?
- Why did they decide to leave their home city?
- What drove their decision to buy where they did?
- Which other destinations, facilities, healthcare providers, hotels, clinics, airlines, facilitators or referral brokers were considered? Why were the other contenders eliminated?
- Who paid for the logistics coordination and marketing?
- Was a facilitator a referral brokerage or a patient advocate involved? What part of that cost was considered in the market size? I’ve been working in medical tourism facilitation for more than 35 years and have never been paid a commission for a referral by any healthcare facility or provider. Nor have I ever been asked by a researcher who publishes these data for how much revenue has been earned and who paid it. Not once! Nor have any of my client health tourism facilitators some who are new and some well established. Is that data missing from the market sizes being reported?
- How much did their pre-departure diagnostic testing cost and where was it purchased?
- How much did their post-operative follow up cost upon their return back home?
A bonus: Another 12 data points we need to know about each country in the big number breakdown
- Which target source markets is the country keen to attract? Which target source markets are unwelcome, if any?
- What medical tourism promotion strategy is each country pursuing? Is it working? How can we know?
- Does % of market share correlate to % of revenues for medical tourism?
- Is the country offering any medical tourism investment incentives and grants? To whom? For what?
- Are there any prominent medical tourism airports and airline partners ready to help get visitors in and out with better planning and lower risks? Are there discounts? How much? What are the conditions to get a discount, if any?
- Which destinations have pursued Center of Excellence designation for certain specialties? Which specialties have they designated for development and why?
- Who has independently and externally verified claims of medical tourism volumes and revenues? What are the numbers and how are they broken down by the 24 questions I listed immediately above this section?
- What are the medical and dental tourism treatment or procedure targets and who has officially declared or decided them? Why?
- What are the revenue targets and how will they be attempted? and by whom? How will anyone know if the targets have been met or exceeded and by how much?
- Do they have people who leave their country to go someplace else at the same time they are claiming to be a medical tourism destination center? Why are they leaving and what are they buying? Where did they go? Who paid the money for the care, the travel and incidentals? How much was paid?
- Is there any government price regulation for medical tourism procedures? How is it determined? Why is it necessary? If the regulations are violated, who pays the penalties, if any?
- Is medical tourism business regulated by any authority?
These are all data that we read almost daily in some medical tourism blog or journalism piece full of unverified propaganda, but are they reliable? How do you know? When you go on a site inspection or fam tour, you need this data to be able to decide if the trip is worth the time, effort, expense and absence from your business. Without it, perhaps you short list a country where the target goals you have for attracting referrals or clients as a medical tourism facilitator are totally off base and impossible to achieve.
Do you agree?
Don’t you agree that these data are far more relevant and meaningful than the big numbers smeared across an unknown mix of data, estimates and unverified claims? If you have questions about the various reports that are available for purchase before you invest, I’d be happy to discuss your concerns. Just call me and set an appointment for us to chat.