We are the hub for medical tourism!

In Colombo on Thursday, Economic Development Minister Basil Rajapaksa told the Government Ayurvedic Medical Officers’ Association that medical tourism is becoming increasingly popular in the world and that Sri Lanka could become a top medical tourism destination.

He was of course basing himself on the growth of tourists visiting the country for its multiplicity of indigenous medical solutions: Ayurveda, Unani and traditional ‘Sinhala Vedakam’. Can this success be repeated by the Western medicine sector?

Medical tourism is indeed a fast-growing industry. Rather than deal with inflated health costs in the developed countries, some companies pay employees to take ‘medical vacations’ in countries where procedures are cheaper and savings of up to 80 percent are possible.

The growing importance of this industry was underlined by the US $ 134 million-grossing hit film ‘The Best Exotic Marigold Hotel’, the premise of the plot of which was the outsourcing of medical care to that country.

However, a foreign expert told this writer that Sri Lanka would find it difficult to compete in the outsourced medical procedure market because the health care sector here compared unfavourably with competitors such as India and Panama.

Private hospitals

The government health care sector, being free, is flooded with patients far beyond its capacity, the more affluent overspill providing the private sector with its customers. However, there is little difference between state and most private sector hospitals, except that the latter charge the patients and tend to be air conditioned.

Ayurveda treatment

Consider, for instance, an acquaintance’s recent odyssey in a leading private hospital. Being in considerable pain, he paid for and ‘channelled’ a specialist physician, receiving the first place on the list.

He duly received a text message on his mobile telephone, reminding him of the time of the appointment. Half an hour before the appointment was due, he telephoned the hospital and asked whether the doctor was on time. He was told to telephone later. Instead, he travelled to the hospital.

Arriving ten minutes early, he asked the reception if the doctor was on time, to be told they did not know, but to go upstairs and wait. Going upstairs, he asked the desk there what time the doctor would arrive and was told he was on his way and to take a seat.

Hoping to get a seat near the consulting room, he asked for the room number. He was told that the room would be allocated only after the doctor arrived. Resigning himself, he informed the desk he was first on the list and sought a chair.

Consultation room

The number of patients waiting to see doctors was greater than the number of seats. Consequently, he found somewhere to sit with difficulty. Forty minutes after the appointment was due, he went to the desk and asked when the doctor was expected. ‘Soon’ he was told, but no room had been allocated. He went back to his seat but, lo! Somebody else had occupied it.

He then went downstairs to make a complaint, to find the reception deserted! Locating the ‘complaints and suggestions’ register, he wrote his complaint, that (a) he was a patient, ergo sick and (b) he was a paying customer, ergo in a contractual relationship with the hospital; hence he should not be treated as a member of a bovine species.

As he finished, the public address system announced that the doctor had arrived (one hour after the due time) and gave the consultation room number.

Making his way to the consultation room, he found another patient with the doctor. Returning to the upstairs desk, he asked why, when he had reminded them before going downstairs that he was first in the queue, they had allowed another patient to go in. They phoned around and then told him to go in and meet the doctor.

Returning the consultation room, he found the doctor examining the earlier patient. Embarrassed, he explained what had happened, and the doctor said he would be seen immediately after the current patient.

Having seen the doctor, he took his prescription down to the hospital pharmacy, to be told that one of the drugs was not available. On his request, they telephoned the pharmacy of another hospital of the same group to find out if the medicines were available there, and told him they were.

The long-suffering acquaintance then went to the second hospital’s pharmacy, where he was told one of the prescribed medicines was not available, but that they had informed the staff of the first pharmacy of this when they telephoned!

This invalid’s anabasis was in a rather expensive private hospital, not in a government one - in which he would have been treated free. He had paid for every service, but the hospital did not keep its side of the bargain, treating him, a patient in pain, abominably.

Waiting patients

This experience is not exceptional, but typical of the treatment meted out to patients in private hospitals. The problem lies not with the medical staff (although it should be mentioned that almost every doctor is late for appointments) but with the administration. The hospital’s mechanism for keeping the patients informed is abysmal: in this case, mobile texting could have been used to inform the patient that the doctor would be delayed.

Staff on the customer interface are, frankly, untrained and incompetent. The number of seats provided for waiting patients is grossly inadequate. The toilets are unhygienic. All told, the managerial arrangements are far below par with the medical ones.

There may be excellence in nursing and medical care, but this is not sufficient to offset organisational inadequacies, particularly where they affect the patient.

Sri Lankans will put up with an awful lot, and bad treatment in hospitals is one of them. It is because they do not complain that the service is so bad. However, people from developed countries have much higher levels of expectation. If they are to be attracted to this country for medical tourism, the private hospitals had better shape up.