The ladies of Dominican medical tourism

In exclusive, CHT Magazine talks with Maite Del Toro Toral and Amelia Reyes Mora, official members of the Dominican Health Tourism Association, organizer of the 4th. International Congress of Health and Wellness Tourism, which is based in the Dominican Republic.

In our country, medical tourism is not a new phenomenon, it has been practiced for more than two decades, especially with plastic surgeries and other procedures. But this has happened spontaneously and informally, without having a structure that supports the entire value chain of this industry. Precisely for this arises the Dominican Association of Health Tourism (ADTS), in view of public-private alliances to promote international accreditations and regulatory framework to strengthen the quality and safety of the supply of health services for the benefit of local patients and International Hence our meeting with Maite of the Toro Toral and Amelia Reyes Mora, of the Dominican Association of Health Tourism, with whom we discussed this phenomenon gaining strength in our country, about the celebration in the country of the 4th. International Congress of Health and Wellness Tourism, the main activity of the sector throughout the Caribbean; a multisectoral integration platform, business promoter and great investment opportunities.

How would you define the “health and wellness tourism”?

Amelia Reyes Mora (ARM): Health tourism is divided into two groups: medical and wellness. The first is a planned act where a person leaves their region or country of residence to receive medical, dental and / or surgical care, generally motivated by cost savings and receive quality services with privacy. It is the direct result of the globalization of health services. While the second performs activities aimed at relaxation, homeopathic treatments, lifestyle changes, yoga, spas, spiritual retreats, retirement homes, among other activities. However, even if they are different segments they complement each other … Here it is important to note that health tourism should not be confused with tourism medicine, which represents a response to an eventuality of a tourist who visits a country or region to walk or work, is say, for reasons that are not your health care. Tourist medicine is related to the emergency and emergency services presented to tourists who visit us and represents a relevant segment when positioning ourselves as a safe destination.

How has our country opened to this trend?

Maité Del Toro Toral (MDTT):Patients travel to the Dominican Republic for different reasons depending on their place of origin and personal conditions. The main motivation being the significant savings represented by health costs in the Dominican Republic in relation to more developed countries. Its excellent cost-effectiveness is highlighted. We have highly qualified specialists, of which a significant percentage have been trained abroad to complement their training. Likewise, the lack of adequate coverage or medical insurance in other countries makes us a destination with a great attraction for health tourists. On the other hand, the strategic geographical situation of the island allows us to attract nearby tourists in whose countries they do not have the sanitary infrastructure and the range of medical offer that the country has. In addition, another important reason to visit us is the long waiting lists of some countries forcing patients to seek our services to receive a rapid response to their health needs.

Which iniciatives has the Government been executing for its success?

MDTT:The Dominican government has supported the tourism industry in the understanding of its great power to generate jobs, capture foreign exchange and generate productive chains. However, in order to continue the growth of this sector and strengthen its competitiveness, it is required to be able to diversify our offer and be innovative, which is why the Tourism Development Council (CONFOTUR) as the organ of the Dominican state responsible for ensuring compliance with the law 158 -01, modified by laws 184-02, 318-04 and 195-13, issued resolution number 49 of 2014 on health tourism projects. The spirit of this resolution is to promote investment with the highest quality standards, technology transfer in this niche market, actions that would strengthen the security of the destination and in turn allow the future development of the establishment of communities for retirees. Additionally, as a result of the interinstitutional agreement signed on May 5, 2015 between the Ministry of Tourism (MITUR), Ministry of Public Health (MSP), Dominican Medical College (CMD) and the Association of Hotels and Tourism (ASONAHORES), an entity that Dominican Association of Health Tourism (ADTS) is part of its board of directors, working points were established by consensus. Among the actions agreed and executed, it is worth mentioning the establishment of a council and formulating the regulatory framework of the sector, as well as the creation of the Health Tourism Directorate by the Ministry of Tourism, strengthening its structure to be able to integrate health As exportable product. The integration and signing of alliances of different governmental entities such as the Ministry of Foreign Affairs (MIREX), Export and Investment Center (CEI-RD), National Competitiveness Council (CNC) with the ADTS in order to support, disseminate and promote The different initiatives of health tourism organized by the association, has been a great step to build trust and under public-private partnership organize the activity in our destination.

And from the private sector?

ARM:The Dominican Health Tourism Association is a private non-profit entity that seeks to position the Dominican Republic as a reliable destination for the sustainable development of health and wellness tourism. For this, it brings together the value chain of the sector, promoting best practices, transparency and compliance with local regulations and obtaining international certifications and accreditations. The integration of business entities such as ASONAHORES, CONEP and financial entities such as the Banco Popular Dominicano, among others, supporting initiatives to raise awareness and promote the destination of the ADTS, are examples of the commitment and teamwork that has been generated. The investment in technology and new centers that comply with local regulations and respond to international standards in tourist areas, as well as in Santo Domingo and Santiago, is proof of the growth of the Dominican offer abroad. It is important to highlight that not everyone who wants to be a provider of health tourism services has the guarantees, experience and certifications to compete in the demanding international market. Expert advice is required, having an organizational culture of excellence and quality, where continuous improvement and patient-centered care play a fundamental role. In addition, have international departments in health centers that provide technical, language and logistic support, thus ensuring continuity of care. It is favorable to establish international alliances with other centers, contracts with international insurance, telemedicine programs and continuing education in the understanding that health tourism is a two-way activity.

What roles does the health professionals playn on this field? Are they supportive?

MDTT: Health professionals play a fundamental role, from specialist doctors to nurses and technical staff, so strategic planning of human capital in the short, medium and long term is a priority. Health professionals are the most responsible for patient experience. This new niche represents a great opportunity to expand your market and patient portfolio, as well as to internationalize your services. It also means a great challenge because it is a very competitive market where certifications and accreditations, as well as having cutting-edge technology, play a preponderant role.

To which needs does the ADTS arise? Who is part of it and under what guidelines / approaches do you work?

MDTT: The ADTS emerges with the vision of positioning the Dominican Republic as a leading country in the Latin American and Caribbean region, in sustainable health and wellness tourism. We work informing, advising and providing support services to connect the national and foreign public with health and wellness services of excellence in the DR. We coordinate our efforts hand in hand with health and wellness centers, hotels, health risk managers, patients and professionals in the health and tourism sectors. We also collaborate with the Government, supporting efforts to improve certification processes and improve the quality of care. Likewise, raising awareness and managing support to facilitate the reception of health tourists in the Dominican Republic. The Association is managed by a board of directors chaired by Dr. Alejandro Cambiaso and has a council of advisors, strategic allies and individual and corporate membership. For more information you can visit our web portal: adtusalud.org.

Where do yo currently focus your efforts?  

MDTT:The main challenge facing the Dominican Republic to position itself as a competitive health tourism destination is to guarantee the quality and safety of the service offer. The country must make a greater effort to improve quality throughout the health system, so it is essential that local qualification criteria, management protocols and infection prevention are met. Likewise, it is important to motivate the country’s health centers to seek international accreditations, which drives a process of changing organizational culture throughout the health system, focusing on patient-centered care. This will result in better health indicators for the Dominican population, while supporting the development of an exportable product. This requires an adequate regulatory framework, as well as a government and private strategy for the incentive and exploitation of this industry, which raises the competitiveness and quality of health services, capturing foreign exchange, generating jobs and encouraging the transfer of technology, knowledge and investigation. Also important is the development of a local quality seal, the formation of clusters, ensuring the security of foreign investments and promoting productive chains.

Which has been your biggest achievements so far?

ARM: The formal history of health tourism in the country is relatively recent. However, health tourism has been in the DR for several decades. In less than five years we have managed to create a broad awareness of the issue in the sectors with the greatest impact to organize the niche. The most important achievement we have achieved through the work of the ADTS has been to generate healthy competition based on quality, which makes health centers pursue international certifications and accreditations to be able to enter this market, which is translates into better processes and health services for Dominicans and tourists. In addition, place the topic of health tourism on the national agenda by integrating and calling on the support of the public and private sectors. Thus, our initiatives currently have the support of the Presidency and Vice Presidency of the Republic, the Ministries of Tourism, Health, National Competitiveness Council, National Free Zones Council, RD Export and Investment Center (CEI-RD) National Association of Hotels and Restaurants (ASONAHORES) and National Council of Private Enterprise (CONEP), among other important entities. We have two editions of the Health Tourism Guide of the Dominican Republic, by the Medical Tourism Association (MTA) and the Dominican Association of Health Tourism (ADTS), which include health centers and industry professionals with the guarantees to provide these services. The guide teaches, step by step, how and where to receive health care in our country, estimated budget, most popular procedures, ideal places to recover and more frequent concerns that a potential traveler may have.

How do you visualize the future of the country and the region in this aspect?

ARM:There is no doubt that it is a challenging and highly competitive future, however, it is very promising for our country, since this activity has a high potential to generate well-paid jobs, expand our horizons and markets, strengthen local medicine, stimulate the transfer of technologies, knowledge and open the doors to develop retirement tourism. A motivating and important fact is that in the survey carried out in 2017 by the Medical Tourism Association (MTA), in which the Medical Tourism Index (MTI) 2017 places our country in the 5th. place as a health tourism industry with the greatest potential (this survey was conducted in 41 countries). MTI is a global metric and a new type of performance measure based on the attractiveness of medical tourism destinations. This index considers multiple factors, such as the environment, the patient’s experience, the culture of the country, the quality, facilities and costs of the services, reputation of the destination, security, among others. According to the MTA, in 2013 80% of those who traveled stated that the need for savings was their main motivation and 64% of them had no medical or dental insurance, or had to face high deductibles. The savings that travelers who visit the Dominican Republic can get are substantial, they vary depending on the treatment or service required, but on average they are more than 60%. Considering the growing demand of potential markets, especially from the US, Canada, Caribbean Islands and Dominican absent, high medical costs and long waiting lists in developed countries, we see that our country and the region will continue to increase health tourism. In particular, the increase in installed capacity in health for Dominicans (new centers and services whose designs are based on international standards) favors this projection.

How does this translate, monetarily speaking, for the benefit of the country?

ARM: The main advantage of health tourism is that it forces us to raise the quality standards of the services we offer in order to compete internationally, which translates into best practices and results for local patients. It promotes the transfer of technologies and knowledge and promotes the need to ensure local qualifications, as well as international certifications and accreditations. Health tourism is one of the fastest growing productive activities worldwide, representing more than 100 billion dollars annually and 2.5% of air travel, according to figures from the Medical Tourism Association (MTA). Health tourism promotes investment in new projects that contribute to the creation of local jobs, thereby promoting the development of the country. It encourages real estate tourism and retirement tourism, since those who have the capital to acquire second homes, often have the age that puts them at risk of some health condition or, if they are healthy, want to guarantee their safety of medical care Quality in case of eventualities. The productive chains that are created through it represent a great opportunity that benefits the country monetarily. To strengthen this niche it is essential to involve the different sectors that need to be inserted intelligently and proactively. Similarly, the tour operators, travel agencies, hotels, airlines, medical facilitators, health professionals, dentistry, language schools, translators, law firms, international and passenger insurance, universities, real estate, transportation, Pharmacist, certification bodies, accreditors, medical equipment suppliers and the financial sector have great opportunities to diversify their offers to generate wealth for the nation.

Professional profiles

Amelia Reyes Mora. Vice President of the Dominican Association of Health Tourism. President of AF Strategic Communication. Psychologist, Master in Communication and PR. Postgraduate degrees in PR and Human Resources. Speaker in communication and CSR in various local and international forums, with more than 25 years of experience in leading companies. He chairs the Board of Directors of the Dominican Development Foundation. Member of the teaching staff of the Master in Public Management, in Crisis Management, of the PUCMM.

Maité del Toro Toral.Executive Director of the Dominican Association of Health Tourism. Lawyer specializing in corporate law and business administration with more than 10 years of experience in handling legal matters and advice within the health sector, as well as negotiations with local and international health insurance, hospitals and accrediting bodies, positioning as a reference in the medical law and expert in strategic planning and promotion of public-private partnerships for the development of health tourism projects. He is currently a member of the legal committee of the Association of Hotels and Tourism (ASONAHORES) and chairs the firm Del Toro Abogados.

Supports

Executive Director of the Dominican Association of Health Tourism. Lawyer specializing in corporate law and business administration with more than 10 years of experience in handling legal matters and advice within the health sector, as well as negotiations with local and international health insurance, hospitals and accrediting bodies, positioning as a reference in the medical law and expert in strategic planning and promotion of public-private partnerships for the development of health tourism projects. He is currently a member of the legal committee of the Association of Hotels and Tourism (ASONAHORES) and chairs the firm Del Toro Abogados.

Characteristics of a health and wellness tourism destination. The main ones share common factors that have positioned them as premium places, including:

• Public and private investment in hospital infrastructure and cutting-edge technology.
• Demonstrable commitment to compliance with local regulations and international accreditation, as well as quality and safety of health services.
• Reliable statistics and transparency of results, achievements and opportunities for improvement.
• Strong tourism infrastructure and flow of international visitors and patients.
• Cost savings in medical procedures, history of achievements and scientific advances.
• Political transparency and macroeconomic stability.
• Reputation of centers of excellence.
• Successful adoption of best practices and culture of continuous improvement.
• Highly qualified and bilingual medical and technical staff.

Health / wellness tourism lines. Among the main services that health travelers seek are dental, dental implants, general surgery, plastic, cardiovascular surgery, orthopedics, ophthalmology, cancer treatments, infertility, weight loss surgery and executive check-ups. Wellness tourism is an industry six times larger than medical tourism. It covers activities that seek to improve people’s quality of life, through better physical, mental, spiritual and social health. This type of health tourism has had a major boom in the industry of spa places, hot springs and aromatherapy centers, among others.

Quotes:

• “Being a provider of health tourism services requires experience and certifications, expert advice, have an organizational culture of excellence and quality, where continuous improvement and patient-centered care play a fundamental role.”
  “A survey of 41 countries, in 2017, by the Medical Tourism Association ranks our country in the 5th. place as a health tourism industry with the greatest potential ”.