High hopes for medical tourism

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Medical tourism is seeing healthy growth: almost a quarter-million patients travelled across borders for treatment last year alone. From dental checks to cosmetic surgery, to life-saving procedures, ISO 22525 holds great promise for the sector.


Plastic surgery incision lines drawn on a young girl’s face before a facelift.

From knee to nose surgery, the global medical tourism market has been on the rise for several years now. In 2019 alone, it enjoyed a market size value of USD 44.8 billion. While the coronavirus pandemic will certainly impact the market share, industry analysts predict good growth in the long term.

So why the sudden growth? Medical tourism guidebook Patients Beyond Borders reports that this market has been rapidly expanding as the population ages and seeks medical treatments that are cheaper, involve shorter waiting times and provide more choice in where and when they receive treatment

To access a medical procedure abroad, potential patients can look online for private hospitals, surgeons, doctors, treatments and recovery processes without having to consult with travel agencies or local doctors. ISO recognizes the risks with this approach and is aiming to ensure that there will be International Standards to cover best-practice medical procedures, clinical risk management, safety and improved outcomes for these patients.

ISO technical committee ISO/TC 228 on tourism and related services is developing a new standard covering the service requirements of medical tourism: ISO 22525, Tourism and related services – Medical tourism – Service requirements.




DR Monica Figuerola Martín

Convenor of ISO/TC 228's working group WG 2, Health tourism services

How did you get involved in the ISO technical committee for tourism and related services?
Close-up of doctor drawing lines on a patient's scalp before a hair transplant procedure.

DR Monica Figuerola Martín

As Head of International Business Development in Quirónsalud Hospitals in Spain, and having previously been the Managing Director of Spaincares (the Spanish Health Tourism Cluster) for two years, with a PhD in tourism, I was very interested in the work being done by ISO on medical tourism.

The Spanish national standards body (UNE) suggested that I take part because of my qualifications and expertise and, more generally, my experience and interest in the international tourism industry.

We first needed to define the difference between a “medical tourist”, or “medical traveller”, and a regular “tourist”.

A tourist may need unplanned or emergency medical help while travelling, but a medical tourist has already planned for their treatment in another country and has prepared their travel, accommodation, surgery, treatments and recovery beforehand.

There are a lot of stakeholders in the medical tourism market with more continuing to arrive. Some are small and less well known, but they are taking on patients from all around the world. This raises the issue of whether they have the proper infrastructure, reputation or medical expertise, and how they might not be transparent in sharing the outcomes of the treatments delivered. All providers of medical services must not only adhere to best practice and clinical excellence, they must also continually build trust and offer guarantees of quality assurance by sharing their results. 

We also know that we need to restrict providers who do not meet our guidelines so that patients around the world are less exposed to risk and receive the very best care. This is the only way to deliver a good patient experience and to ensure that the medical tourism sector grows in number of patients, improved outcomes and success, both financially and healthwise.

What aspects of medical tourism will ISO 22525 cover?

Our ISO working group is focusing on the whole chain of the patient experience. There are four key areas in our standard that include the arrangements around pre-travel and pre-treatment, the treatment process itself (surgical or non-surgical), the post-treatment process and recovery, and the follow-up strategies and aftercare when the patient returns home. This ISO standard means that each health centre and other medical stakeholders involved in the medical tourism industry will have reached the benchmark needed to guarantee quality care and patient safety. 

Many countries are seeing the potential of participating in medical tourism as increasing numbers of patients seek treatment abroad, with the promise of a financial windfall. What is concerning, however, is that many patients have little knowledge of what International Standards are or whether the provider they have selected even meets them. While patients can access surveys or feedback from other patients about health outcomes and “satisfaction”, only the work of ISO and its partner organizations can provide effective measures and safeguards. Why, these standards might even save lives!

What are the current trends for people who travel abroad for medical treatment and surgeries?

People are searching for treatment and surgeries that they are unable to find in their home countries due to the rarity of their condition and expertise available to treat it, the expense, lack of health insurance to cover it or long waiting lists. 

The most common procedures performed on medical tourists include cosmetic surgery, dentistry, cardiovascular surgery, orthopaedics (joints and spine), cancer treatments (sometimes experimental or last-resort options), reproductive treatments such as IVF and weight-loss gastric bypass surgery. A lot of people also travel to obtain a range of scans, screens, tests and second opinions.

We are also starting to see interest in spa and wellness treatments, with tourism increasing around these areas as well. These tend to be less medical and more therapeutic as people look for less invasive ways of leading a healthier life.

What do you think the future trends of medical travel will be?

Obviously, in this time of the COVID-19 pandemic, making medical travel plans has been extra challenging. Despite this, I believe that the most important factors for medical tourists will continue to be how they choose their healthcare facility and their willingness to travel to get the best medical care available. 

In coming months, there will also be more effective information for patients and medical professionals on both prevention and protection measures regarding coronavirus. We will continue to seek guidance from the World Health Organization on how to manage the pandemic, and with healthcare facilities achieving ISO standard levels of care, patients will be able to confidently select the medical centre that suits them by looking at the expertise and qualifications of the doctor, the cost of treatment and the comments and ratings by other patients. 

Interestingly, while money is a factor for some, we are finding that cost is reducing in importance for many other patients: effectiveness and safety are their main concerns and will continue to be so. 

What future hopes do you have for ISO 22525?

Today, tourism standards have evolved into real tools that help organizations better position themselves on the market, and that goes for medical tourism as well. Firstly, the ambition is that, when it is completed, ISO 22525 will be widely shared and communicated to all relevant government and private health sectors around the world. Personally, I hope this standard will be the ultimate benchmark in the medical tourism industry, being adopted by the most prestigious healthcare institutions and private facilities in the world. We want all our patients to get the best treatment and outcomes possible, no matter where they choose to travel.

Finally, I believe there are many options available for people to improve their health and choose the medical care they receive, and there are a lot of extraordinary doctors and innovative, state-of-the-art treatments in the world. My advice is to always look for the best medical solution for each case, no matter where it is.

ISOfocus July/August 2020


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Elizabeth Gasiorowski-Denis
Editor-in-Chief of ISOfocus