VOLUME 23 | JANUARY 2024
A Publication of Local Umbrella Media
H E A LT H N E W S
care. The growth industry known as medical or health tourism has many reputable operators but also, no shortage of bad players. The latter may include, so-called, “facilitators,” who promise to find you top medical care and then refer you to the healthcare provider that pays them top commission. Christian El-Khouri, an industry consultant based in Germany, has seen it all. Growing up, he helped his family in their medical tourism business which his father had started in the late 19070s. Today, Christian consults exclusively with governments, hospitals and other healthcare stakeholders. Previously, though, he spent a decade helping patients and describes medical tourism as a true passion. I talked with him about what’s going on in the world of medical tourism today and got his checklist for finding good care.
Navigating the World of Health Tourism Lessons From 40 Years of Patient Experience By Pamela Tames
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f you’ve ever planned a trip abroad for healthcare, you know it can be a maze, sometimes even a minefield, trying to find suitable care. The growth industry known as medical or health tourism has many reputable operators but also, no shortage of bad players. The latter may include, so-called, “facilitators,” who promise to find you top medical care and then refer you to the healthcare provider that pays them top commission. Christian El-Khouri, an industry consultant based in Germany, has seen it all. Growing up, he helped his family in their medical tourism business which his father had started in the late 19070s. Today, Christian consults exclusively with governments, hospitals and other healthcare stakeholders. Previously, though, he spent a decade helping patients and describes medical tourism as a true passion. I talked with him about what’s going on in the world of medical tourism today and got his checklist for finding good care. You have a unique perspective on medical tourism since your family is in the business. How did the family business get started? I always say I was born into medical tourism because my parents were the first to provide medical tourism facilitation in Germany in the late 1970’s. My father had immigrated from Syria to Germany and spoke fluent German, Arabic and English. He was able to respond to a need to help Arabic speaking patients from the GCC (Gulf Cooperation Council comprises Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) who were seeking treatment in Germany. From there, the company, which is called The MESC International Patient Service GmbH, evolved and grew. How did you learn the business? I’m not sure how familiar you are with the Middle East or the GCC, but typically, the day starts later and goes well into the morning due to the heat and other reasons. So it was quite normal for us to have the phone ring at 2 a.m. at our home because they couldn’t reach anybody in the office. At some point my parents realized it would be a good idea to train myself and my older brother to cover when they weren’t available. They taught us how to handle these calls, ask
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the right questions, and get the details – especially the entire name, because there are very similar name variations in the Middle East. It was a rather tough reign since my parents wanted to ensure we really learned the business from the ground up. All that thorough training – being diligent about every small step in the process – later translated into me being very critical of patient service outside our family company. It’s not a job you take lightly because at the end of the day, it’s a patient or a family member trusting you – a person they might not know – with their health while dealing with all the complexities of traveling to another country with a different culture, language and legal system to receive medical treatment without friends and family close by. It’s incredibly stressful and we take it very seriously. With MESC, your family’s business, where were most of clients coming from and what kinds of services were being offered? Initially, MESC worked with Arabic speaking patients but today the business is international with people coming from Russia, the EU, Africa, Asia and to a lesser degree, the US. We did not target the American market directly, but because the US operates an Army base in Wiesbaden, MESC does get American patients. Essentially, mes operates as the international office of a hospital here that provides primarily diagnostic services. This hospital was modeled after the Mayo Clinic approach of providing integrated, multidisciplinary care. MESC has an exclusive agreement with them to handle both their marketing and patient services. It is a unique arrangement in mesc, being privately owned, is not constrained by the dictates of the hospital group. This gives MESC the freedom to operate in the best interests of the patient. Once a patient gets a diagnosis, MESC helps them find the best treatment in Germany and provides guidance on pricing to help ensure they’re fairly charged. What are important criteria for assessing where to send patients for treatment? The doctors at the diagnostic hospital will often make a recommendation regarding where to go for treatment. Another good option is a university teaching hospitals, since they are very
highly regarded in Germany. MESC uses a screening process that involves meeting with the hospitals, assessing the scope and quality of expertise, and examining any available metrics, such as, complication rates of surgeries. The good thing about Germany is that the standard and quality of care is very high so there are many good hospitals. On the non-medical side, criteria include hospitals having good processes and resources in place for accommodating and supporting El-Khouri,health healthtourism tourismconsultant, consultant,isisbased basedininGermany. Germany. international patients. El-Khouri, This might include offering great halal food for You have a unique In researching medical perspective on tourism, medical Middle Eastern patients, providing noticed lot of tourism sinceI’ve your familythere is in are theabusiness. How did the family business get started? a welcoming experience that helps facilitators out there but not a always say Ilot was into medical tourism to reduce patient stress, and Ihaving ofborn transparency about how because my parents were the first to provide doctors who know how to reassure they’re paid. Why is that? medical tourism facilitation in Germany patients so they feel confident Typically medical tourism in the late 1970’s. My father had immigrated from Syrabout the care they are getting. paid a commission ia to Germanyfacilitators and spokeare fluent German, Arabic – awas percentage of the revenue and English. He able to respond to a need What drives patients to seek careArabicgenerated the patient to help speaking by patients from for thethe GCC in Germany specifically?(Gulf Cooperation healthcare provider. In some cases, Council comprises Bahrain, Kuwait, Qatar, Saudi Arabia, the There is a segment of people who Oman,the commission is up toand 25%. United Arab Emirates) who were seeking treatwant the best healthcare available This is common practice around ment in Germany. From there, the company, and can afford to go anywhere the world. Since 2011, however, which The MESC International Patient whether it be MD Anderson for is calledcharging a percentage commission Service GmbH, evolved and grew. cancer care in the US or University for the referral of an international Hospital of Heidelberg in Germany. patient been allowed How did you learnhas thenot business? Another segment includes people in Germany and constitutes a I’m not sure how familiar you are with the who are looking for better care, the typically, Civic Code. Middle East orviolation the GCC,ofbut the day not the best, but better thanstarts whatlater and goes well into the morning due to the heat andHow other reasons. it paid was quite is available in their home country. does MESCSo get for its normal for us to have the phone ring at 2 a.m. at Germany caters to both these services? our home because they couldn’t reach anybody segments, offering best-in-class The family business’ patient service in the office. At some point my parents realized care in some areas and better care business unit does not take a it would be a good idea to train myself and my than is available in many other commission butthey charges the patient older brother to cover when weren’t availcountries. I strongly believeable. that the for the services provided. The fee They taught us how to handle these calls, level of healthcare service offered for each service being ask the right questions, and get theprovided details –is especially the entire name, becausepay there are in the United States, Israel and itemized and patients us directly. very similar name the Middle Germany are more or less on par. This variations transparentin approach has East. The German healthcare system is fostered trust over the years. MESC NEWS | www.LocalUmbrellaMedia.com over 120 years old and has garnered LOCAL is now seeing the third generation of a trusted reputation. We have the clients’ families solely on the basis of added benefit of strict price controls positive word of mouth. to help protect against corruption. There’s pricing transparency and How can people protect although the pricing is complicated themselves from unfair or illegal and hard to understand at least pricing practices? What should a it exists, establishing a legal limit. patient watch for? The other difference is that In both Germany and the US, Germany has a more conservative you see a tiered pricing structure approach to treatment and some in which the best care is often consider this to be an advantage. the most expensive. However, Instead of jumping to surgical or unlike in the US, Germany has the pharmaceutical intervention, for benefit of very strict price controls example, you’d do rehab or physical aimed at capping what you are therapy. allowed to charge. But as happens
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