Medical Tourism—A Linguistic Approach (Part II)

In Part I of our report, we discussed the linguistic considerations of outbound medical tourism, and in Part II, we discuss the other side—inbound medical tourism. Both present unique linguistic challenges for healthcare providers and consumers.

Part II: Inbound

According to consulting firm McKinsey & Co., "an estimated 40% of all medical tourists are looking for the world's most advanced technologies, worrying little about the proximity of the destination or cost."²

The majority of these seek treatment right here in the United States.

Despite the stance from some that things have gone terribly wrong with United States health care, and despite the forces within our own insurance system that have driven costs up, there is no denying that the U.S. is a destination for cutting-edge treatments and procedures. Most commonly, foreign patients come to have cancer treatment, orthopedic surgery, cardiovascular treatment, and cosmetic procedures.

Rosanna Moreno of Memorial Hermann Hospital (part of the Texas Medical Center) says, “Most [foreign patients] are drawn by the state-of-the-art medical technology for which the United States and the Center, in particular, are known. Many come for the pioneering treatments not available anywhere else. Others come because the wait for care in their home country is too long. While, some come simply because they can afford the best of the best and they know they can find it here."³

Will this trend of foreign visitors seeking care in the United States continue? The research says yes.

The aforementioned Deloitte study forecasts an annual increase of 3%. Some 3.5% of inpatient procedures at U.S. hospitals were performed on international patients, many of them from Canada. By 2011, Deloitte suggested that those numbers could rise to as much as 800,000 patients annually. 

Places that are currently major centers for inbound medical tourism include the following:

• Texas Medical Center
• Univ. of Pittsburgh Medical Center
• Harvard Medicine
• Johns Hopkins Hospital
• Cleveland Clinic
• Mayo Clinic
• Cornell Medical School
• Duke University School of Medicine
• Memorial Sloan-Kettering Cancer Center 

Successful centers for inbound medical tourism enhance the patient experience by offering accommodations for family within the hospital, a wide range of ethnic cuisine as part of the hospital menu, suite-like rooms, tours and travel assistance, shopping excursions, and more.

Linguistic Issues Affecting Inbound Medical Tourism

The issue of language as it relates to health care is not a new one. In fact, all 50 states now have laws that address the issue of language access in health care settings. Seventeen states have language access laws addressing insurance providers and/or managed care organizations. These laws help protect the rights of everyone who comes to a U.S. hospital and who does not speak English, regardless of their insurance status or country of origin.

But U.S. hospitals vary widely when it comes to the quality of language accommodations offered, as well as the success of inbound tourism. Hospitals and other health care providers have two primary concerns when it comes to language issues: marketing and patient interaction.

Marketing

Imagine that Yourtown General Hospital, which has never reached out to international patients, suddenly notices a spike in patients from Germany. This is likely due to the large community of Germans that lives in Yourtown. They’ve been telling their friends and family back home about Yourtown General’s excellent orthopedics department.

So Yourtown General’s board of directors decides that they would like to actively target this audience, and asks the marketing department to develop a campaign to attract Germans.

Where to begin? Today, the first answer is likely to be the Internet. If Yourtown General wants to make an impact on Germans doing research online, they will develop a localized version of their website—requiring thorough translations of both menus and content into German.

Next, Yourtown General might try to develop relationships with care providers in Germany such as general practitioners or physical therapists, in order to gain more referrals. This marketing effort may require the creation of print collateral that is uniquely German in language and style.

Patient Interaction       

Any hospital that is serious about serving the international community will set up a department devoted to every aspect of patient care. They will help the patient coordinate visa assistance, travel planning, lodging reservations, as well as recreational activities such as tours. This is where the local convention and visitors’ bureau may be of assistance as well.

In order to do this in a linguistically appropriate manner, the hospital will either need to find a full-time employee who is truly bilingual or use an on-call interpretation service. Such services are cost-effective ways to increase the quality of interaction and make everyone feel more comfortable when a bilingual employee is not available. Telephone and video interpretation are also good ways to bridge the language barrier.

It’s important to note that federal guidelines discourage the use of patients’ family members, friends, or children as interpreters. This can be tempting to a hospital that finds good interpreters in short supply, but it is not a good option.

Written translations are crucial components of the experience of an international patient—medical records, discharge instructions, and consent forms are just a few of the documents involved. According to Nataly Kelly in Medical Tourism Magazine, many facilities address this need by having interpreters perform “sight translation.” In this process, an interpreter reads the English document and tells the patient what it means in the target language.

Needless to say, this practice isn’t ideal, nor is it safe. That’s why at the Mayo Clinic, one of the top destinations for inbound medical tourism, they make a clear distinction between oral interpreting and written documents. Jane Hughes, the supervisor of Mayo’s language department, says, “Translations of key written materials are either provided by in-house translators or outsourced according to policy.”⁴

Conclusion

It’s clear that medical tourism, in both the inbound and outbound forms, is a trend which will only continue to grow as consumers become more educated about their options.  If The United States is to capitalize on the inbound medical tourism market, it will take a firm commitment to cultural and linguistic understanding, as well as a willingness to provide foreign patients with a complete experience that goes above and beyond merely obtaining health care.

References:

1. Medical Tourism: Consumers In Search Of Value. Deloitte Center For Health Solutions. 2008
2. Van Dusen, Allison. “U.S. Hospitals Worth The Trip.” Forbes. May 29, 2008.
3. Moreno, Rosanna. “Five Essentials For A Successful Inbound Medical Tourism Practice.” Medical Tourism Magazine. Jul/Aug 2009.
4. Kelly, Nataly. “Talking the Talk—Obtaining Culturally and Linguistically Competent Health Care in the United States.” Medical Tourism Magazine. Jul/Aug 2009. 

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