The attraction of international clients for doctors is a quite different proposition today compared to let’s say 20 years or more ago. It might seem that I am trawling a long way into the past to make the comparison, but in fact the history of international patient flow into the UK and London in particular is relevant. Harley Street was for many years a mecca on the international medical tourism trail. The quality of care was perceived to be of the highest and we welcomed our visitors with open arms. This was at a time of a growing independent healthcare market and was definitely a factor in attracting doctors to devote some or all of their practice to the private sector. It was a catalyst for the growth of the sector.
Changing Times For The UK
But times change. Where at one time the UK would have been the destination of choice, other prime international medical capitals emerged to compete for this lucrative market. The success for a consultant rested on a number of factors, not the least of which was the quality of care that they provided and the successful patient outcome.
But as competition increased, the offering became a combination of the provider facilities, i.e. the hospital or clinic, the concierge offering and the all-important price. Foreign purchaser pressure required a concerted effort to impress with the overall package of care for the patient and their family and the value for money. Consultants regularly visited other countries to meet and greet, lecture, see patients in clinics and operate. Many patients were recruited to visit the UK through this process. So essentially it was hard work, but the rewards were high.
Payment Terms Risk
The biggest downside that emerged and remains a major hurdle are payment terms. It is common practice to wait months for payment if not years, where patients are government sponsored. Not only is this a significant cash flow issue but takes an inordinate amount of effort and time. It is a major consideration regarding the management of embassy patients. But this is only one payer group and many others are more than acceptable.
Broadening The Market
An international patient workload covers a multitude of conditions. While surgical interventions might commonly be the obvious one, there are many other planned and unplanned care needs. The management of chronic conditions such as patients requiring dialysis or medication management is not uncommon.
There is an equally large need for primary care for travellers, often requested via hotel concierges, and many hotels have agreements with primary care doctors to visit guests with urgent or unspecified medical support.
The UK has provided many ‘super specialist’ services for international patients that has been instrumental in achieving its current excellent reputation. Both doctors and hospitals have capitalised on some of the specific needs that are required. A prime example would be complex rehabilitation services that are not available, particularly in Middle Eastern countries. Such services require a high level of organisation, not only for the patient but for families, and many of the UK’s independent specialist doctors have become key in this patient flow.
As doctors consider their options in developing a private practice it is less likely today that they would factor the international patient workload as being the key to a thriving practice. They will work collaboratively with providers or embassies to be a part of a significant package of care. Where a provider has developed a salaried model of employment, it is quite possible that an international patient workload will form a significant part of their patient workload and indeed enable continuity of care which can often be missing when dealing with sporadic and individual cases. It is also worth noting that the international workload often provides challenging and unusual pathology that doctors welcome the opportunity to treat.
The skill and expertise of the doctor is key to attracting patients to the UK and was the genesis of the market. Continued growth requires teamwork and a focus on providing excellent patient care with demonstrable outstanding outcomes to ensure the continuation of patient flow from international markets.
This article first appeared in the leading UK healthcare industry journal, Healthcare Markets.
Author : Sue Smith, CEO of the Independent Doctors Federation looks at the ups and downs of building and maintaining an international private patient business in the UK.