Given the current extent of globalisation, the notion of getting on a plane to see a doctor is hardly far-fetched. Medical tourism is undertaken for a variety of reasons – lower costs, access to advanced medical technology, higher standards of care or even controversial medical treatments. Mainland China has never been a major medical destination, perhaps with the exception of questionable organ transplants. Undeniably, medical care is an expensive commodity and medical tourism spells big bucks for the host country. China’s desire to jump on the medical tourism bandwagon is therefore hardly surprising. Scenic Hainan is entering the medical industry big time by building a “special” medical zone. Certain hospitals in first-tier Chinese cities already cater to overseas patients, but only time will tell whether their provinces will follow in the footsteps of the southeastern island. How does China stack up against Asian medical tourism contenders like Thailand or South Korea? Without first-mover advantage, has China missed the boat? These questions come amidst the trend of well-heeled Chinese jetting to overseas destinations for medical procedures.

Medical Marketing 101

Seeking treatment overseas is often combined with touristy activities, giving rise to the term “medical tourism”. In developed countries, soaring medical costs are the main motivating factor for heading to countries like Malaysia or Thailand for the same procedures at a fraction of the price. However, the upper echelons of developing countries also cross borders for state-of-the-art medical technology or higher standards of hygiene and skill. Destinations of choice include Hong Kong and Singapore. Countries providing high-end treatment tend to specialise, such as Japan and South Korea, in occupying the cosmetology niche. It therefore remains to be seen how China will position itself in the medical tourism arena. With “grey-market” organ transplants officially outlawed by authorities, China is left competing with the likes of Thailand on cost or taking on heavyweights like South Korea on quality.

Like every great civilisation, China was medically advanced for its time with Traditional Chinese Medicine (TCM) system dating back thousands of years. Highly regarded locally and among the Chinese diaspora, TCM has notably been gaining credibility in Western medicine. Conversely, China’s forays into Western medicine have been controversy-ridden, achieving renown as a destination for questionable procedures like stem-cell treatments and black-market transplants. At the same time, media scandals expose hygiene issues, fraudulent advertising claims, less-than-qualified practitioners and lax industry regulations. A pity, considering that Asians students from India, Nepal and Indonesia flock to Chinese medical universities to read medicine in English.

Sun, Sand, Sea… and Surgery?

Today, medical care for foreigners in China is far-removed from clandestine organ-transplant operations. Far-sighted hospitals in first-tier Beijing and Guangzhou already have departments dedicated to international clientele, bilingual staff and websites. Advance facilities and equipment are definitely available to the well-heeled. Sunny Hainan Island has even gone a step further to unveil plans for a 200 square-kilometre medical zone, signifying China’s first big-time foray into the medical arena. To attract foreign medical institutions, medical joint ventures are exempt from the usual share ceiling –probably banking on idyllic beaches and affordable medical care as a winning formula.

A quick review of medical websites reveals that providers still compete mainly on cost. To ease the decision-making process, some provide side-by-side itemised price comparisons with countries like the US. Others attempt to convince potential customers of China's medical capabilities and infrastructure vis-a-vis competing destinations. Procedures offered are comprehensive, from cardiology to orthopaedics to cosmetology.

Why Go to the doctor in China

With well-heeled Chinese increasingly jetting overseas for the same procedures at higher costs, is China a credible medical destination? Costs aside, China does have its advantages. As an established tourist destination, combining “business” with pleasure may make sense to those having to travel long distances to China. A viable option for illnesses with long recovery periods, affordable convalescing on a beach or a mountain resort with spa treatments thrown in may well speed up the recovery process.

Apart from conventional Western treatments, receiving medical care in China provides the option of combining the best of east and west. Hospitals here have the resources to provide under-one-roof integrative medicine involving TCM, believed to be efficacious in managing chronic conditions. Or one can conveniently find a TCM practitioner nearby.

At the end of the day, in choosing a medical service provider, the crunch comes to medical knowledge, hygiene and skill. Physical well-being is not something to risk under normal circumstances. Hospitals catering to foreigners understand this and endeavour to reassure potential customers through ISO standards or other quality assurances, in an industry beleaguered by mistrust and scandal. But at the end of the day, invasive procedures and pharmaceuticals carry their own inherent risk. Patrons of China's medical industry rationalise that undergoing the same procedure in a developed country does not make one exempt from human error and negligence either.

Besides, for the determined, mitigating the hygiene risk is not an impossibility. There are expats that carry their own syringes and disposables and those regularly undergoing acupuncture can buy their own set of needles. Other discerning consumers skirt the hygiene issue by only undergoing non-invasive procedures in China. For example, completing the invasive part of root canal therapy before coming to China to have crowning done. Moreover, big-name healthcare providers from Korea, Taiwan and Singapore already exist in China. Should more provinces follow Hainan in demarcating “medical zones”, foreign healthcare providers could become easily accessible in China.

With tens of thousands of Chinese flying overseas for medical treatments each year, not to mention capturing the international market, hospitals in China have much incentive to provide healthcare aligned to international standards. Medical care is a product where customers are unlikely to trade quality for price, so China still has a long way to go in quelling years of fear fuelled by medical scandals. A newcomer to an industry with established competitors on every front, it remains to be seen if China can overcome seemingly insurmountable barriers to entry and position itself in a dominant position in the medical tourism arena. The holistic route of combining Western medicine with TCM would seem most logical, but having established players like Hong Kong and Singapore in this niche may not make for a smooth ride.

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Keywords: medical tourism China medical destination China