Spice Route

Medical Tourism in India

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As the healthcare scene in India is changing with new age developments that are spurred by a technical edge this has also made the country a hot spot for medical tourism. 

Scientifically and technologically, Indian Healthcare has shown a lot of potential in the past decade, growing at a rate of 15% with a current estimation of being a $65 billion industry and is likely to touch $260 billion by 2020. The latest development in healthcare revolves around continued focus on clinical excellence and warm patient experience driven by innovation. Year 2019 is going to be an exciting year for Indian Healthcare with deeper penetration of global players in the market. Digitalization and thrust on innovation to drive efficiencies and patient experience will be the key differentiator.

The Structure

India is at the cusp of a medical revolution curtesy a slew of innovations that are being driven on the basis of human intellect and technical finesse. There are several first class medical centers like Narayana Healthcity known for its Cardiology and Heart Transplants, AIIMS Delhi known for all specialties and Srichitra Institute Kerala known for Neurology, Epilepsy and DBS. Both government and private sectors are doing exceedingly well in pioneering medical institutions in India. The leading healthcare providers are tertiary care units which specialize from treating all ailments across the disease spectrum, including transplant and complex cancer surgeries. The Indian Healthcare system is today all about quality healthcare. A large number of health institutions from both the public and private sectors offer multi-specialty and super specialty services. We have 37 Joint Commission International (JCI) accredited hospitals and over 513 National Accreditation Board for Hospital (NABH) accredited hospitals. Several private providers have a chain of hospitals across the country. Clinical outcomes in these leading hospitals are comparable to those of internationally recognized facilities. Big private and public hospitals provide high-end world-class quality treatment for Oncology, Pediatrics, Cardiovascular, Neurology, Urology, Nephrology, Orthopaedics among others.

Cancer Care

One of the most deadly ailments that is seeing an unfortunate spurt in the country is cancer. The rising incidence has also see a spurt of new age treatments as well. Esperer BioResearch recently launched two health supplements Es- Fortitude (nourish, protect &recovery) & Es- Invigour (base formula)  that aim to bring optimal efficacy of the main therapy in cancer disease management to ensure better quality of life of patients across the globe. Raktim Chattopadhyay, Founder & CEO Esperer BioResearch avers, “it is our endeavour to work towards a better quality of life for cancer patients. We believe that “Personalized Medicine” is our chance to revolutionize health care. Nutritional imbalance has a direct impact on the cancer disease and our quest is to mitigate the risk that stems from nutritional deficiency in cancer patients.” One of the most relevant syndromes that increase as cancer progresses is cachexia that compromises the life of the patient and irremediably causes weakness and death. Hypermetabolism is correlated with clinical and biological markers of cancer cachexia and is associated with a shorter survival in metastatic cancer patients. Thus, there is a need for preparing the body for the treatment, during the treatment and during recovery stage. All three phases are different and require nutritional care basis the cell biology of the body. Dr. Radheshyam Naik, MD, HCG Hospital, Bengaluru says, “cancer is a term that encapsulates many different diseases with different changes in different metabolic pathways in different cells in different parts of the body no single metabolic therapy is right for every person. A scientific formula that can aid in maintaining the quality of life of the patient along with maintaining the nutritional balance is a promising progress. We look forward to prescribing such effective health supplements and revolutionary formulas for cancer care in the future.”

Effective Tools

Each year about 1,60,000 women are detected with breast cancer in India (GLOBOCAN 2018 database). A majority (~90-95%) of early stage (Stage 1 &2) breast cancer patients get chemotherapy to avoid cancer recurrence. Currently, there is minimal awareness about tests that predict the risk of cancer recurrence. As a result,  even patients with low risk of recurrence are often over-treated and consequently bear various toxic effects of chemotherapy treatment that reduces their quality of life. The benefit that early-stage patients receive from chemotherapy is usually low. Since most early-stage patients do well without chemotherapy, this makes accurate risk prediction an all-important prerequisite for effective treatment. It is therefore necessary to detect low-risk instances to avoid over treatment in the form of chemotherapy, given its side effects and the toll it takes on the patients’ quality of life. CanAssist Breast is a test to tell if chemotherapy is needed in early stage breast cancer. Dr. Manjiri Bakre, Founder and CEO, Oncostem explains, “with all the advances in science, treating breast cancer isn’t as frightening as it might have been earlier.  With the growing realization that each patient is unique, and each patient’s tumour is as unique due to inherent genetic differences a clear move away from the one-size-fits-all approach is evident especially in the treatment of cancer patients. Today, not all women diagnosed with early-stage breast cancer need to undergo chemotherapy. OncoStem’s CanAssist-Breast is designed to classify patients depending on the risk of cancer recurrence. By analysing the patient’s tumour biology, CanAssist-Breast identifies ‘low-risk’ patients who will have minimal benefit of adding chemotherapy to their treatment and ‘high-risk’ patients who will benefit the most by adding it.” Cancer is a heterogeneous disease, meaning differences exist not only between cancer cells from various patients, but also between cancer cells within a single patient. Dr. Niti Raizada, Sr. Consultant Medical Oncologist & Hemato-Oncologist, Vikram Hospital, Bengaluru, says, “precision therapy matches the most effective treatment to the individual cancer patient based on the molecular profiling of the specific cancer, and can be divided into two categories that include precision chemo-targeted therapy and precise therapeutic procedures. Precision chemo-targeted therapy is the use of the correct drugs prescribed that assures maximum benefit with minimum risk or toxicity for the patient. Precise Therapeutic measures could include surgery and radiation therapy tailored to the for individual patient’s needs.”

Health Hues

One of the biggest milestones is Ayushman Bharat which is a centrally sponsored programme anchored in the Ministry of Health and Family Welfare (MoHFW). This includes two major health initiatives, the Health and Wellness Centres (HWCs) and Pradhan Mantri Jan Arogya Yojna (PMJAY). “Most important amongst all has been the focus on digitalisation throughout the world especially for Doctors. For maternal and Child healthcare has been the implementation of Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), which aims to provide assured, comprehensive and quality antenatal care, free of cost, universally to all pregnant women on the 9th of every month.  The current government is working towards ensuring end ending of preventable maternal deaths in the country,” says Dr.Kishore Kumar, Founder Chairman, Cloudnine Group of Hospitals. Healthcare has evolved in recent years to become more patient-centric. The emergence of precision medicine is a manifestation of this fact. Unlike previously, physicians are now working on the premise that no two patients are the same, even if they have the same disease. Genetic testing has also helped devise more personalized treatment protocols. “There is a rising interest in Epigenetic which allows us to understand what environmental factors trigger the onset of diseases to which patients are genetically predisposed. Additionally, the emergence of robotic technology and machine intelligence is revolutionizing surgery and giving it greater precision. To improve healthcare delivery, electronic health records give physicians easy access to the entire medical history of the patient, making it easy to identify when a patient is due for a checkup or preventive screening. Telemedicine has made it possible to schedule virtual consultations, improving primary healthcare access to patients living in rural/remote areas. The proliferation of wearable tech has made it possible to monitor the vitals of patients in real time, and detect diseases at an early stage,” says Dr. Babina N.M, CMO, Jindal Naturecure Institute.

Ailments on the Rise

“We are witnessing rising trends in lifestyle diseases but also have significance prevalence of communicable diseases at the same time. Depending on the age group we see many patients with heart disease, diabetes and stress related disorders. There is also an increasing prevalence of cancer diseases supported by early detection which helps better outcomes. As average life expectancy is improving, there is growing incidence of age related joint problems, hypertension, diabetes and eye problems. Among children, we witness all kinds of infections, congenital disorders like heart defects and some rare tumours,” says Dr. Ritu Garg, Zonal Director, Fortis Memorial Research Institute. Regular preventive health checks and close monitoring of health indicators along with maintaining stress free healthy lifestyle is the key to minimize ailments. A healthy diet, regular exercise, no alcohol or smoking and developing good hobbies help lead a stress free day and keep diseases at bay.

Medical Tourism

The talent pool that performs successful life-saving surgeries and cost effectiveness are two of the biggest factors which have contributed to the rise of medical tourism in India. Foreigners who travel to India for medical tourism are given full support by the government as well as hospitals. The cost of surgery, living expenses for the accompanying family, post treatment medicines and support are provided at one-fifth the cost of what they would have to pay in American or European countries. Majority of patients visiting India for medical treatment are from the Middle East, Africa and CIS countries. Indian doctors have an excellent reputation all around the world for their accurate diagnosis, treatment planning and high expertise as surgeons. Most famous doctors in developed countries like US, UK are Indians. “What works for India is the fact that patients get first world treatment at third world costs. The best treatment that is available anywhere in the world is available in India and with no waiting list and approximately 1/5th to 1/10th of the cost. One very important thing is that both the cure and care aspect for the patient is handled very well by the reputed hospitals in India. The hospitals have accreditations like JCI, NABH which certify the safety and the standard at Indian hospitals is at par with the best institutions in the world,” says Dr. Deepshikha Raj, Senior Manager, International Marketing Vikram Hospital Bangalore. A recent Harvard Medical School survey showed that Americans treated by Indian doctors lived longer and treatments offered to patients in India are at par with international standard. According to Ministry of Tourism, GOI, India’s medical tourism industry could grow by 200% by 2020, hitting $9 billion, which is a very big number. In 2015, it was a $3 billion industry, and the expected growth clearly proves that today, India the most favourite destination for medical tourism.

Advantage India

Dr. Bhupendra S Avasthi, Founder & MD, Surya Hospital adds, “Indian medical professionals dominate globally. That has certainly helped India’s emergence as a major medical tourism destination. Excellent clinical outcomes combined with compassion are driving the growth. We are among the top six medical tourism destinations of the world because of advance knowledge, technology, skills of doctors, improved infrastructure, trained paramedics, cost-effectiveness and the confidence our health institutions pass to their patients for progressive healing.” Along with skilled doctors, this country also has special places and controlled environments for healing and treatment process. One of the many reasons why foreigners feel comfortable in India is because there is almost no language barrier here. Indian hospitals provide excellent English speaking doctors and medical staff who understand and can easily communicate with patients from foreign countries. Dr. Alok Chopra, Founder and Medical Director, Daivam Wellness avers, “visa approval for medical reasons are much easier. India provides the best amalgamation of latest scientific technology and ancient healing process. This “best of both worlds” allure boosts medical tourism a few notches. Sometimes the recovery period from a certain illness becomes harder than the treatment itself. In this case, patients are provided with ayurvedic treatments, yoga, meditation, and naturopathy.India gives tourists an opportunity to visit some scenic and awe-inspiring cities rich in culture and heritage. Most of the hospitals and private clinics in the country are now offering a complete Medical Tourism package to foreign patients.”

Tech Talk

The Indian Healthcare sector is evolving rapidly after the introduction of new age innovative technologies. It was a history when the healthcare industry was just based on doctor and patient interaction. Today, the healthcare industry involves real time engagement without any geographical limitations, and all this has been possible with the emerging healthcare technologies. “The latest developments are not only limited to diagnosis, treatment and care of several deadly diseases in humans. It has now moved much ahead, where Artificial Intelligence, Big Data, Blockchain and Cloud Technologies have been implemented to bring healthcare efficiencies and change the healthcare scenario, where at the end, the patient is the beneficiary,” says Dr. Satyajit Kumar Singh, Sr. Urologist & Managing Director, Ruban Memorial Hospital & Ratan Hospital for Women & Child, Patna. Dr. Ruchi Gupta, Founder & CEO, 3Hcare.in adds, “with technological advancements, virtual medicines and command centers made easy not only for doctors but also for patients. Through these command centers, reports of ECG and X rays can be easily achieved. Advanced treatment methods like minimally invasive surgeries have eliminated the need of conventional open heart surgeries, which not only reduces the hospital stay but the patients can make quicker and better recovery. The safety in any procedures (diagnostics to surgery) has gone up and the priority is always given to patient safety.”

Monsoon Care

Food and water borne diseases are very common during the monsoon season. Therefore, eat simple home cooked food as much as possible. In case you are a frequent flyer, keep whole fruits and packed food items with you at all times. Keep yourself hydrated. Mosquito breeding is expected in monsoon season so it is very important to keep your surroundings clean and free form water collection. Eat a lot of seasonal fruits and vegetables, but make sure you wash them thoroughly before consumption. Consume foods rich in Vitamin C to strengthen your immune system. Dr. Pradeep Mahajan, Regenerative Medicine Researcher adds, “although rains bring much-awaited respite from the sweltering heat, it is also a season where communicable and infectious diseases rise in incidence. Contamination of food and water, especially in areas of low hygiene is the chief cause of ailments such as food poisoning, jaundice, typhoid, cholera, among others. Rodent-related diseases such as leptospirosis also cause several deaths during this season. Maintaining personal and environmental hygiene becomes paramount in such cases. Always wash hands and feet (or take a shower) after returning home, wash fruits and vegetables thoroughly and try to eat fresh foods to prevent vector-borne diseases.” There is a need for an effective public-private partnership is emerging in the sector which can help strengthen India’s position as a high potential hub in the medical tourism market.

This story first appeared in Spice Route July 2019 issue here:

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