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Have Ailment Will Travel Puerto Rico is making inroads to be the next big medical tourism destination. Friday, August 21, 2009 Beth Kormanik

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As Americans search for health care solutions, they are increasingly realizing that their options are not limited to providers in their city, state or even country. As medical tourism increases, the lesson for hoteliers is to be ready to host them.

Most of the well-known health tourism destinations already were popular tourism spots such as Brazil, Costa Rica and Singapore. Puerto Rico hopes to be the next big destination for medical tourists.

A recent study by consulting giant Deloitte predicted that six million Americans would seek medical travel abroad by 2010, and 10 million by 2010. The number has huge implications for Puerto Rico's hospitality infrastructure and forward-thinking hotels and suppliers who want to serve this niche.

The biggest draw for Americans seeking medical care abroad has traditionally been the lower cost. Treatments can be priced more than half the price than in the United States mainland. Some employers even offer travel reimbursement to encourage employees to go abroad because of the savings.

Mario Gonzalez Lafuente, chief operating officer of the Puerto Rico Tourism Company, said developing medical tourism is part of his organization's strategic vision. He noted that the Puerto Rican legislature enacted a medical tourism task force to market Puerto Rico as an ideal destination.

"There is so much potential. That's why the government supports this initiative."

He said the Deloitte study predicted Puerto Rico's share of medical tourists would reach 240,000 by 2010 and have an economic impact of $420 million.

"Success in medical travel is our success as well," he said. "We market those hotels. They provide a wide spectrum of products."

Medical tourism in Puerto Rico started when residents of neighboring Caribbean nations came to seek out specialized treatment that their home countries did not offer, such as advanced cardiovascular services. With that pipeline solidly developed over the years, the industry wants to branch out to attracting new streams of patients.

Puerto Rico, as a US commonwealth, believes it can be the preferred destination for several reasons. Its currency is the U.S. dollars. American travelers do not need a visa, or even a passport, to go there. The travel time is up to four hours from Chicago or New York vs. upwards of 14 hours to reach Singapore and other Asian destinations.

"The relationship that exists between Puerto Rico and the United States, no other destination can say," according to Milton Segarra, vice president of HIMAHEALTH, the company leading the region's medical tourism movement.

Medical tourists also can rest easier knowing the federal laws of the United States cover activities on the island. Additionally, hospitals there are accredited by the same bodies as those in the States, and physicians there have been trained in the same manner as those in the US, often at American universities.

"Who is going to cover you if something goes wrong? What laws apply?" Segarra said. "It's an additional protection to a person."

Gonzalez Lafuente echoed the point.

"Our single most important point of differentiation that Puerto Rico has over its competition is that we are a U.S. territory," Gonzalez Lafuente said. "For the patient, they can rest assured they will be traveling to a home away from home."

HIMAHEALTH is the island's largest health care provider and claims "centers of excellence" in oncology, urology, cardiovascular and orthopedics. It has five hospitals, and more than one-third of its physicians are U.S. board certified.

As a "medical concierge service," the company handles all aspects of care, from initial referral to the logistics including hotel, ground travel and other details. HIMAHEALTH has contracts with about 15 hotels, from limited-service to five-star hotels, small to large, locally owned to chain. The patient decides where to stay based on insurance coverage and personal preference.

The average length of each trip is between 10 and 14 days, which includes the actual treatment with a recovery process.

"The hotel chains are looking at this," Segarra said. "It's an opportunity."

One pioneering chain in catering to medical tourists is IHG. The company has worked extensively with the nonprofit Medical Tourism Association to prepare hotels to care for patient-guests.

"I believe this is a market that's growing, and we have to be prepared for that," said Carlos Baruki, vice president of sales & marketing for IHG Latin America and Caribbean. "It's not the main business but this is a niche that deserves extra attention and additional standards. It's a customer in a very fragile situation."

After individual IHG hotels began to be contacted by local hospitals and medical associations about providing lodging for medical travelers, the company decided to create a platform for all hotels. It began a pilot program two years ago at a property in Costa Rica and now has participating hotels in Panama, Columbia, Brazil, Argentina, Mexico and Puerto Rico. IHG offers the service at its Intercontinental, Holiday Inn full service and Crowne Plaza brands. Baruki said it is not appropriate for the Holiday Inn Express because the brand does not have full-service restaurants.

Baruki said the key was creating "an environment of confidence, dependability, believability and tranquility." That translated into innumerable details to ensure special care for these guests. To start with, the staff schedules are arranged so the guest interacts with the same housekeepers, waiters and maintenance workers.

"We had to create a familiar environment so the patient and the person traveling with the patient feel more at home by seeing the same faces all the time," he said.

The guest should be assigned a room that is easily accessible, but not too close to elevators to minimize any noise. At hotel restaurants, they should be seated close to the buffet to make their trips easier, and kitchen staff should be able to provide specialized menus. The security department and telephone operators should have the name of the patient and a direct line so they can respond quickly to any emergencies. The hotels also provide CDs and DVDs in the guest's home language, but if a guest wants to explore the local culture the staff will accommodate that as well.

At the end of the stay, the guest leaves with a framed photo together with the staff.

"It's not just check in, check out, how to make up a room," Baruki said. "It goes far beyond that. The hotel personnel should be prepared to really be like a secondary nurse. Not in the medical sense, but in how to talk with the patient and find out areas of how to make these people feel comfortable."

In Puerto Rico, Gonzalez Lafuente also sees a role in promoting the region to the patient-guests' families. Family members may combine the trip with traditional vacation activities such as golfing, gaming, spa/wellness trips, shopping and lounging on the beach.

"We give them a kaleidoscope of products," he said. "It's a stressful time. We cater toward those things they can appreciate."

Armando Rodriguez, executive vice president HIMAHEALTH, said his organization has received the support of the Puerto Rico Hotel Association and has developed strong partnerships with hotels. He said the company also is developing two hospital hotels. One in the resort community of Palmas del Mar on the island's East side, which is designed and should break ground this year, and the other in Bayamon in the San Juan metro region that likely will break ground next year and take two years to build. Palmas del Mar has a golf course, horseback riding and other resort amenities.

"It fits the environment that it's built in," Rodriguez said. "Still, when you come down to it, it's a medical community."