Medical Tourism in Developing Countries

Promoting Medical Tourism ● 145Obstacle II: International Standards andAccreditation/CredentialingWhen shopping around for medical services, potential patients seek evidenceof quality. To the extent that the supplying physician, institution, orcountry cannot provide satisfactory demonstration of quality, consumerswill take their business elsewhere. The inability to provide high and consistentquality facilities, manpower, and processes, and the inability to effectivelysignal that quality, inhibits trade in medical services. As noted byRashmi Banga in her review of the literature, barriers related to standards,certification, and industry-specific regulations are one of the fundamentalbarriers to trade in medical services. 12 To break through these barriers,institutions in destination LDCs strive to abide by international standardsand to ensure certification and licensing. They are not alone—in fact, it isa worldwide trend that makes for a rapidly evolving global environmentand speeds up the expansion of medical tourism.This section introduces international quality standards and discusseshow medical institutions and medical personnel in developing countriesabide by them through accreditation and credentialing, respectively.International StandardsIn countries promoting medical tourism, the public sector, together withprofessional societies and international institutions, strives to uphold minimumstandards. This involves primarily the monitoring of quality, safety,and uniformity. Both medical products and processes are subject to monitoring.Among the former are pharmaceuticals, blood bags, medicaldevices, and implants. The latter includes specific requirements for clinicalevaluations and sterilization procedures. It also includes independentmonitoring of performance and accurate exchange of data as well as uniformlevels of hygiene. Standardization sets rules at multiple levels of detailand strives to micromanage processes such as labeling, premarketing evaluations,post marketing surveillance, et cetera. Even invoices must be clear,in accordance with insurance rules, and must be capable of withstandingscrutiny.Standardization is necessary in order to signal quality, safety, and uniformityto potential consumers. These consumers may be medical touristsbuying health-care services at the point of production (such as Italianpatients in India), or potential consumers away from that point of production(such as Italian importers of medical devices from India). 13 Consumersmight also be source-country insurance companies concerned with the