China, the Silk Road and Medical Tourism Market Strategy

by Maria K Todd, MHA PhD

Executive Director
Center for Health Tourism Strategy

Recently I was asked to evaluate the Chinese medical tourism market for one of our strategic partners. At first, my response was Hong Kong, Beijing, Shanghai, Shenzhen Guangzhou, and Xiamen. Then I approached the strategic dilemma from a different angle. By adjusting my perspective, I identified a quick start, “low hanging fruit” strategy that is easy to implement.

The strategic approach I explain below can light the way for much higher inbound medical tourism market penetration in additional cities through a low risk, soft landing.

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This strategic approach to develop medical tourism destinations throughout China can be used to build customer lifetime value (CLV) with repeat and follow on business and lower the overall cost of medical tourism customer acquisition.

There are already Mercury Health Travel approved and inspected medical providers in some cities within Mainland China, but there are many other candidates to develop medical tourism, especially at the corporate medical travel level.

One strategic indicator is the tendency for large companies (i.e., shipping companies, cruise ships, and others such as ships purveyors) who have a need for comprehensive, company paid executive checkups to want to accomplish these checkups while docked in a port city where the all-in-a-day checkup may be available. One of our corporate health travel clients gave us a list of port cities where we were assigned to procure Executive Checkup programs for just this purpose.

Another indicator is related to when a passenger on a ship is ill with gastroenteritis for more than 3 days. According to its International Health Regulations of 2005, the World Health Organization (WHO) requires all ships to provide health authorities in every port with a completed Maritime Declaration of Health, reporting any case(s) of persistent fever, acute skin rash, severe vomiting (other than seasickness), severe diarrhea, and recurrent convulsions (Annex 8,

Cruise ships are isolated communities with a high population density, crowded public rooms and living accommodation, shared sanitary facilities, and common water and food supplies. Hence, infectious diseases are easily transmitted aboard, and gastroenteritis has always been a major health concern aboard cruise ships. The doctor must immediately report any unusual number of cases (generally more than 10 per 7 day cruise or 6 cases within 6 hours) of gastroenteritis (diarrhea and or vomiting) to the Master and the relevant Maritime Authorities and keep them updated with regard to further cases.

The ILO, Maritime Labor Convention, 2006 (MLC) (Standard 4-1 4(b)) makes it mandatory to have a physician on board when the total number of persons (crew and passengers) is over 100 and the ship is engaged in international voyages of more than 3 days.  But a communicable disease outbreak aboard ship can easily overwhelm a ship’s clinic and staff.

Compulsory isolation of passengers and crew with gastroenteritis is a necessary measure to prevent and control norovirus outbreaks on ships. So far there is no quick diagnostic test for norovirus that has proven completely reliable. Therefore, to prevent outbreaks, cruise companies cooperating with US authorities demand that all patients with gastroenteritis symptoms are to be isolated for up to 3 days after their last symptom. Many other countries follow this same rule, I’ve been told.


With that, my list expanded to the following additional cities, provided they have an upmarket private healthcare clinic able to delivery a 5-phase circuit program whereby:

  1. the patient arrives fasting at 6am
  2. has blood draws and other biomarker testing
  3. then proceeds to meet the physician for a medical history and physical exam
  4. followed by a battery of imaging and other consulting specialist appointments, and concludes with a final appointment with the doctor to review all findings and discuss next steps
  5. is presented all findings on a USB drive, in the language of the patient, and all medical reports prepared for the employer, upon request of the employer and signed release by the patient.


Therefore, I believe that the following cities could penetrate the medical tourism market in China for foreigner care in the following 26 cities listed below:


The Executive Checkup approach to market penetration for medical tourism is my recommendation because of several compelling factors:

  1. The approach leverages basic services and technologies already in place in most full service medical centers, and are not expensive to set up or operate. Clinics can leverage and fill excess capacity.
  2. If no such upmarket private medical center is present in the market, startup costs to build and commission such a center that can be used as an urgent care center for occupational health and other follow on services and to accommodate cruise ship passengers who might otherwise be put off the ship for symptoms of certain viruses may not be stranded at the port if consultations and diagnostic results can be accomplished in about a 3-hour turnaround. This type of clinic can be co-located at a hotel. We recently consulted to Mandarin Hotels in a US city for this sort of program and it was determined that the entire setup could fit in a space of about 10,000 sq ft. (930m2)
  3. The Chinese local upmarket affluent consumer seeks “Western-medicine checkups” and the more affluent citizens are currently traveling to Singapore, USA, Italy, Spain, Greece, and other destinations, some of which might be recaptured with the right ultra premium branding and marketing. Otherwise, the revenue leakage will continue to fly right over the top of them.
  4. The Comprehensive Executive Checkup is an excellent soft entry because it is low risk, not frightening to a stranger (“It’s just a checkup”), can be done on an outpatient basis, and can be targeted at international employers who pay for these services at a corporate level.
  5. It provides a “foot in the door” for follow on services at a later date if a medical problem is identified. This assumes, however, that the sellers know how to leverage the checkup visit as an entry to the customer lifetime value funnel. If they see it as merely a single episode of care, much of the benefit to the clinic market capture is wasted and the strategy falls flat.


If China cities opt not to follow this easy to implement strategy, I am certain that our Approved Providers in neighbor competitor countries along the Silk Road will step up and snatch it from them in short order.

Speaker, Author, Medical Tourism Marketing and Strategy Expert


Maria Todd is a trusted adviser and expert specialist to hospitals, clinics, governments, healthcare business owners, investors, and independent professionals. Clients call on her to help them do a better job of marketing, branding, or contracting with insurers and employers, and to grow their business.

Maria is the CEO of Mercury Healthcare International, in Denver, Colorado and the founder of Mercury Health Travel, the leader of the Health Tourism Practice Group of Mercury Advisory Group, the Executive Director of the Center for Health Tourism Strategy, its research and education resource center, and a Board Member and Advisor at Higowell, the world’s first health tourism operations platform. She has been recognized as an Academician with the Ukrainian Academy of Rehabilitation and Human Health and is a member of the Scientific Committee of Termatalia in Spain. She is also a Board Member at Global Health Connections, a nonprofit organization associated with the University of Colorado MBA-HA program. She is the author of 15 internationally-published business improvement books in healthcare administration and health tourism.

Invite Dr Todd to speak at your next event.  She presents a compelling workshop of interest to tourism and economic development officials, foreign investors, healthcare strategists, and suppliers on Opportunities for Economic Development through Inbound Medical Tourism Sector Development.



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