Urban Planning and Medical Tourism Destination Development

Clusters and Public, Private Partnerships for Health and Wellness Tourism

There are a handful of consultants in the USA who would have you believe that a medical tourism cluster is the answer to everything, as long as the cluster pools money for group marketing and paying congress organizers to bring MICE events to their fair city. They wouldn’t know a properly developed destination if it had a placard on it that said “We’re ready!”  A cluster is not, by any stretch of the imagination, a handful of hospitals, clinics and hotels for premature medical tourism advertising. That blows opportunities for appropriate and valuable first impressions and tends to empty coffers of startup capital.

 For government authorities to agree to participate, fund, and co-manage a public-private partnership (PPP) cluster management services organization, the economic benefit to the community at large must be quantifiable. The benefit must be embedded into the planning, strategy, tactics, branding, product development and marketing of the destination as a health or wellness tourism center of commerce and excellence.  Without that involvement and quantification from the start, the public sector would be castigated – and rightfully so, for using public resources for private commercial benefit of one single supplier. That’s not sustainable over the long term and is generally a non-starter.  Those who have recklessly done so in health tourism destination development have failed and regretted it. 

Their first regret? Paying the inexperienced and unprepared (or nefarious) consultants who led them down that path.  What’s that old Santayana saying? “Those who cannot remember the past are condemned to repeat it.” Some are simply too green. Others have nefarious and self-serving intentions and view government coffers as their target, not results to drive medical tourism business to a destination. Prudence is required to see the difference. 

It helps to have been in health tourism business development for nearly four decades. I can point to many of the failures and explain why  they failed. Those who have yet to grow project portfolio experience and lessons learned that you are listening to in their infomercials are probably not even aware of the trial and error strategies and kickstarts in medical tourism that have failed horribly and still have no real consistent and sustainable traction. This is also what contributes to the ousting of publicly appointed authorities working in tourism, economic development, and the other “pillars” of medical tourism destination development and elected officials, as seen below in my diagram from a client report in 2005:

Questions for discovery and analysis prior to setting strategy

In my consultations with destination stakeholders from the public and private sector, some of the questions I ask and seek inputs into instead of projecting what “I think” they should “do” are as follows:

1. How will anticipated health tourism visitor growth impact planning for land use, urban design, natural resources, transportation, and infrastructure?
2. What have you done already to: predict local and regional population growth that will have to co-exist with the tourists?
3. How do zoning and geographic mapping and analysis of green spaces, water supply, identified transportation patterns for the mobility challenged visitor, CPTED crime prevention, walkability, food supply and commercial catering demands, allocation of existing public and private healthcare and social services, and the impact of land use figure in?
4. Who will balance and advocate for local public interest as it relates to private sector (or public sector or both) health access, health delivery, pricing, and affording technologies, international accreditations and the incremental direct costs of marketing, branding, and advertising as a medical or wellness tourism destination?
5. How and when and by what documented means will urban planning and the other eight pillars timely communicate concerns, observations and guidance to developers and stakeholders?

Why I respect urban and regional planners when it comes to destination development

Consulting style: Transactive planning

Davidoff, in his influential 1965 paper, “Advocacy and Pluralism in Planning” acknowledged the political nature of planning and argued that actions to develop public projects such as a medical tourism destination are not value-neutral and encouraged minority and underrepresented voices to be part of planning decisions.²  

This political obstacle has killed more medical tourism destination development projects for me than any other reason in Thailand, Greece, Nigeria, Colombia, Spain, Puerto Rico, Mexico, and other projects. Understanding how to work with vertical developers is another lesson that comes from experience. It is interesting to study the variety of health and wellness tourism development projects that have been the results of large and small-scale developers who purchased land, designed the health services district and constructed the development from scratch all in the time of one political administration. Crossing over an election is actually one of my red flags when conducting due diligence on a project I might accept. 

I hope that this article provokes you to learn more, ask more, and study more before simply contracting with a panelist you met at a medical tourism event who has mentioned destination development and clustering as a strategy and tactic. If you’ve seen one cluster, you’ve seen one cluster. Study the strengths and weaknesses and ask yourself first if it sounds feasible versus is the cluster itself and the destination ready for development as a health and wellness tourism cluster. And if you can’t determine this on your own, hire the consultant with expertise and a busy client load for a very small, preliminary assessment project to give you an unbiased opinion and read on your situation. Promise NOTHING in the form of future continued engagement. This will protect you and your stakeholders from plunking down hard to rebuild startup capital in too large a commitment up front. Small incremental steps allow you to conclude with the deliverable and pivot to a better suited expert when necessary as a natural evolutionary process of your project. 

Footnotes

1. Whittmore, Andrew (2 February 2015). “How Planners Use Planning Theory”. Planetizen. Retrieved 06 January 2020. citing Whittemore, Andrew H. (2014). “Practitioners Theorize, Too Reaffirming Planning Theory in a Survey of Practitioners’ Theories”. Journal of Planning Education and Research. 35 (1): 76–85. doi:10.1177/0739456X14563144.

2.  “Advocacy and Community Planning: Past, Present, and Future”. Planners Network. Retrieved 12 May, 2014.