Medical Tourism Blog

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Question : First up, how did you get interested in medical tourism, and when was this? Your page on St. Joseph's Univ. says that you're on a sabbatical and medical tourism is a 'research in progress' for you. When did this research turn into a book?

Dr. Bookman : As a development economist, I study everything that affects the growth of countries. I have been working on population movements for quite some time, and that includes tourism- the temporary population movement for pleasure. While researching the economic impact of tourism on less developed countries, I realized that travel for medical purposes was one of the fastest growing niches. After that book went to print (Tourists, Migrants and Refugees: Population Movements in Third World Development), I immediately turned my attention to medical tourism.

There is also a personal reason for my interest. Every summer I spend a few weeks in my hometown- Belgrade, Serbia. Over the years, I have needed medical attention for myself and for my children, and have always been impressed with the care we received, coupled with the low prices.

Question : While most of the literature and published books on medical tourism focus on the medical and logistical aspects, yours is focused on the economic impact of medical tourism and its effect on the healthcare infrastructure of developing countries. I take it you believe that medical tourism will have a serious impact, in the coming years? I mean, you just wrote a book on it. Can you give a brief explanation of the impact of medical tourism on healthcare infrastructure in developing countries?

Dr. Bookman : A few excellent how-to books have recently been published (Hancock, Schult, and Woodman). My co-author and I do not deal with the logistics of medical tourism. Instead, we focus on the growth potential of medical tourism. In other words, we look at the effect of medical tourism on the destination country economy. The foreign currency medical tourism brings to developing countries diffuses throughout the economy in the form of employment, income, savings, investment, tax revenue, etc. Under the right conditions, the growth potential could be huge. For example, some expect that in the next decade, medical tourism will do for the Indian economy ten to twenty times what information technology did in the 1990s.

Question : What do you think of the current healthcare debate, with Presidential candidates calling for a universal single payer plan? Is it feasible?

Dr. Bookman : I am not a health economist and therefore prefer not to comment on the state of US health care. Suffice it to say that I do believe medical tourism will continue to grow even if the US adopts a universal health plan for the same reasons it is growing in countries like England and Canada.

Question : In your book The Demographic Struggle for Power you portray ethnic and religious groups pitted against each other, in a struggle for supremacy. Does that tie-in, in any way, with medical tourism?

Dr. Bookman : Not really.

Question : Simple question - For America and Americans, is medical tourism good or bad? Why?

Dr. Bookman : This is not a simple question!
Medical tourism is good because it offers options for health care that some Americans might otherwise not have (because it is too expensive or unavailable). In that sense, medical tourism might turn out to be the great healthcare equalizer.

However, if it continues to grow at its current phenomenal rate, there might be some negative consequences in the future for the American health care system. For example, if patient demand for some medical specialties moves overseas, then American doctors in those fields will need to adjust to that demand change (and its consequent price and supply changes). Also, if medical tourism in other countries takes off, some of the foreign-born doctors and nurses in the US might return home (or not come in the first place), with serious personnel implications for US health care. These possibilities and others are discussed in our book.

Question : You say that medical tourism is not a universally feasible growth strategy and is successful only in countries with economic and political advantages that enable them to navigate around international and domestic obstacles to trade in medical services. Could you explain that? What advantages? What obstacles? Maybe an example?

Dr. Bookman : Why does Malaysia have a medical tourist industry but Mali doesn’t? Why does India attract international patients while Nepal does not? In answer to those questions, we tried to identify economic, social, legal and political features that help medical tourism take off. These include, a stable political system, reliable legal institutions, a market economy, a developed physical infrastructure, abundant human capital, and a domestic emphasis on research and development. Countries that have most of these features are better poised to deal with the international and national obstacles to the development of the MT industry (obstacles such as licensing and accreditation, visa requirements, etc).

Question : Your book on medical tourism was co-authored by Karla R. Bookman. I take it she's related to you? And in some places, I see only your name as the author. How did you two collaborate on the book? She help you, or you help her?

Dr. Bookman : Karla is my daughter. She is a graduate of Columbia Law School and a practicing attorney in New York. When I first started researching medical tourism, I realized that there were legal issues both in source and in destination countries that affect the development of medical tourism. I needed a legal expert to explore these issues so I approached Karla with the idea of collaboration. She researched and wrote some sections of the book, and also conducted the on-site visits and interviews.

Question : Since you are still doing research on medical tourism and its economic impact, is there anything we should know that is not there in the book? What are you working on now?

Dr. Bookman : Since our book went to print (in December 2006), I have been observing and studying new developments in the medical tourism industry. Interest in medical tourism has been rising not only among individual consumers but also among insurance companies and businesses. We are therefore entering a whole new phase of medical tourism, one in which individual western patients will not be the only consumers of medical tourism in developing countries. Their employers, insurance companies and governments will also be part of the equation.

Question : Did you visit any of these hospitals or countries, to collect information and data for the book? If so, do you have anything to say about any specific country, or hospital?

Dr. Bookman : Karla, my co-author, visited hospitals in India and in Dubai where she interviewed a wide range of individuals for our book. Also, I have had personal experience with medical tourism in Belgrade, Serbia (see above).

Question : Forgive me if these questions seemed a bit amateurish, and if there's anything you'd like to add - Something important which I may have missed in these questions regarding medical tourism?

Dr. Bookman : Medical tourism is a growing industry that represents the splicing of two of the world’s largest industries: health and T&T (travel and tourism). As such, it is bound to have a huge effect across the globe. Thank you for calling attention to it.

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And that's all we have from Dr. Milica Bookman, for now. The media, including this blog, is going gaga over the benefits of medical tourism to patients from America and other western nations. There are also those who crib about this being just another way of sending hard earned dollars abroad. Very few people are willing to discuss the role of medical tourism in building the healthcare infrastructure of developing economies, and what that means to the global economy. Dr. Bookman is one of those people, and it is an honor for us to be able to publish this interview. Thank you, Dr. Bookman and Karla Bookman. For doing this research, for writing the book and for taking the time to answer our questions.