Medical Tourism in Developing Countries

78 ● Medical Tourism in Developing CountriesMedical TechnologyThe physical capital described above comes alive with the application ofmedical technology that works with, for example, pacemakers, artificialjoints, and silicone breasts. Technology is also embedded in laboratory teststhat include biochemistry, hematology, microbiology, serology, histopathology,and transfusion medicine. Diagnostic services including imaging, cardiology,neurology, and pulmonology all rely on state-of-the-art medicaltechnology. Mumbai’s Thyrocare, the world’s largest thyroid testing laboratory,illustrates how specialized medical technology, in conjunction with aircargo and distribution systems, can yield 200 percent annual growth ratesin diagnostic industries. 53In addition, the growth of telecommunications and information technologyenables diagnosis, treatment, and medical education in what has cometo be called telemedicine. Facilities have sprung up in India, the Philippines,Thailand, and Malaysia to enable telemedicine, and in the process, theyhave expanded the range of services that can be traded in the health sector.These services now include diagnosis and clinical consultations via regularmail or electronic methods, as well as the sending away of laboratorysamples for analysis (in Thailand, for example, 17 national telemedicineunits are connected to 3 teaching public hospitals, 14 regional hospitals,7 provincial hospitals, and 20 community hospitals 54 ). New words havebeen introduced to describe this cross between technology and communications:telehealth, telepathology, teleradiology, and telepsychiatry.Although telemedicine falls under the WTO Mode 1 type of trade, it isnevertheless relevant for medical tourism (Mode 2) for two reasons. First,many hospitals in developing countries simultaneously offer medical servicesto international patients and are the outsourcing site for Western medicalestablishments. Indeed, a hospital like Apollo doesn’t just see patients.To the contrary, at night its computers do billing and insurance claims forAmerican hospitals and insurance companies. Technicians read and interpretX-rays and CAT scans e-mailed from abroad. Also, these hospitals hostclinical trials for Western companies such as Pfizer and Eli Lilly. 55 To furthersatisfy demand, LDC firms have sprung up to perform medical transcriptionservices for Western health providers. One such company, HealthScribeIndia, set up in 1994, was originally funded by Indian-American doctorswith the aim of providing outsourced medical transcription for Americandoctors and hospitals. 56 It served as a model for numerous other businessesin the mushrooming telemedicine industry. The concurrent expansion oftelemedicine and medical tourism enabled the industries to benefit fromspillover effects and reinforce one another.