Julie Munro

MTQUA query leads Visa to correct $439 billion error for medical tourism industry.


MTQUA Medical Travel Quality Alliance inquiry leads Visa to correct its report and admit $439 billion is not value of medical tourism industry.

August 21, 2016 – Scottsdale, Ariz. and Bangkok – Visa has corrected an error it made in reporting earlier this year that the value of the global medical tourism industry was $439 billion.

“The valuation was clearly a mistake but it was already spreading across the internet like a weed,” said Julie Munro, president of Medical Travel Quality Alliance (MTQUA).

Download PDF press release.

“We asked Visa to check this figure,” said Munro, who first noticed it was curiously identical to a value for the wellness tourism while reviewing content for the joint MTQUA – International Air Transport Association (IATA) Medical Travel Specialist Diploma program for travel agents.

She noted that online bloggers and news aggregators tend to accept even outrageous statements if they come from seemingly reliable sources.

“We all have a responsibility to stop transmitting this false information as it can wrongly influence government and private spending and investment in many countries around the world,” Munro said.

Visa has issued the following statement:

Visa’s recent study, Mapping the Future of Global Travel and Tourism, included a figure that estimated the size of the medical tourism industry at $439 billion… Upon further review and based on additional information, Visa will be updating that figure at about $50 billion based on industry consensus. We apologize for the confusion this may have caused.

“$439 billion is a widely cited figure for wellness tourism, a completely different sector, as we reported in our 2013 study for the Global Wellness Institute (GWI),” said Ophelia Yeung, GWI Senior Research Fellow. “I suspect that someone confused medical tourism with wellness tourism, a common mistake that is not doing a favor to either industry.”

Estimates for global medical tourism were first presented about ten years ago by management consulting firms McKinsey & Co. and Deloitte. Today, the global medical tourism industry is widely described as around $50 billion in value.

“It hasn’t grown eight-fold in the past couple of years,” said Munro.

On July 27, 2016, the Medical Tourism Association (MTA) issued a press release: Medical Tourism Industry Poised for 25% Year-Over-Year Growth by 2025. The release cited the (now incorrect) Visa figures, saying “the medical tourism industry was valued at a staggering USD 439 billion.”

Responding to Visa, MTA president Renee-Marie Stephano replied, “We will not be distributing information without appropriate clarification.”

Medical Travel Quality Alliance (MTQUA, https://mtqua.org), an independent international organization founded in 2009 to promote the special safety and quality needs in treatment and care of medical tourists, publishes the Top 10 World’s Best Hospitals For Medical Tourists™ and Best Practices in Medical Tourism. Medical tourism certification from MTQUA is the only global evidence-based review of quality of care for hospitals, clinics, agencies, and related medical tourism services and providers.

CONTACT: Caroline Bodanis caroline@mtqua.org
Telephone (USA) +1 602-635-4664; (Thailand) +66 85 902 4500

7 trends to watch in medical tourism in 2016


7 trends to watch in medical tourism in 2016 – a baby boom, hot new destinations, and ethics – from industry leader Medical Travel Quality Alliance.

March 2, 2016 – Bangkok and Scottsdale – A global baby boom in 2016 is one of seven trends and issues that will affect the medical tourism industry this year, according to industry leader Medical Travel Quality Alliance (MTQUA, https://mtqua.org)

“This will be a very interesting year. Prepare for a baby boom in medical tourism and plenty of debate around the kind of treatment medical travelers get in hospitals, and by doctors and agents,” says Medical Travel Quality Alliance president Julie Munro.

Download PDF release.

Americans will be looking for baby surrogates in countries from Cambodia to Ukraine; Chinese will be looking to America for surrogates and as a place to give birth; and everyone from Australians to Zambians will be asking for gender selection along with advanced and leading edge fertility treatments.

Some agencies and clinics, especially in Bangkok and California, are already preparing to handle up to 300 patients a month.

Chinese baby boom“Established agents are going bankrupt, there’s talk of corruption and questionable practices. I expect to see hot debates over ethics and medical traveler rights, especially considering the recent treatment of medical tourists by the Dominican Republic,” says Munro.

MTQUA, a key industry player, providing medical travel certification and standards, medical travel advisories, best practices, and medical traveler bill of rights, identifies these seven key trends and issues for the medical tourism industry for 2016.

1. A medical tourism baby boom.

Traditional fertility treatments, commercial surrogacy contracts, and “birthright” tourism will all see greater numbers mainly because Chinese couples now can have more than one child per family. Many Chinese, Brits, Americans and Australians will also be exploring gene editing, three-person embryo procedures, and other emerging ethically-borderline processes.

2. Demand for guarantees by patients and doctors.

Bankruptcies, rumors of FBI investigations, charges of patient trafficking make medical travelers more careful in choosing facilitators and providers.

3. Growing questions about the quality of results.

The first medical travel advisory on the medical tourism industry, from MTQUA, made many people ask if enough is being done to protect medical tourists from higher risk to their safety and lower quality of care and outcomes.

4. Medical travel specialization in degree and diploma programs at universities and colleges.

Gulf Medical University in Ajman, UAE is among the first to offer formal courses in aspects of medical tourism.

5. The next “hot” medical travel destinations.

As Cuba opens up to American tourists, medical tourism promoters and bloggers are already claiming it is a great treatment choice for medical travelers. Not so fast, say the Cayman Islands and Iran.

6. Slowing of outbound government-sponsored medical travel.

Governments sponsoring outbound medical tourists, such as Dubai, Saudi Arabia, Kazakhstan and Nigeria are cutting back medical travel budgets, searching for cheaper alternative destinations and demanding better clinical outcomes.

7. Certification and accreditation confusion.

Certification and accreditation programs generally suggest that industry leaders have arrived at a consensus for standards and best practices. In medical tourism, this is not the case so far, though progress continues to be made.

The detailed trends report may be found here.

Medical Travel Quality Alliance (MTQUA, https://mtqua.org/), founded in 2009, is an independent international organization that develops and promotes the highest standards of excellence in delivering treatment and care to medical travelers and health tourists. It certifies hospitals, clinics and medical travel service providers worldwide for safety and quality in support of treatment, care and services for medical tourists, and issues an annual list of the Top 10 World’s Best Hospitals for Medical TouristsTM.

Caroline Bodanis
Email caroline@mtqua.org
Telephone (USA) +1 602-635-4664, (Thailand) +66 85 902 4500

Our team

Who we are

about-julieJulie W. Munro
President and Founder

Julie Munro is president and founder of the Medical Travel Quality Alliance (MTQUA, www.mtqua.org), which she founded in 2009 in order to build an awareness in the public, the media and the health care sector of problems in medical tourism that she and her staff directly observed and experienced that often prevent patients from getting the best outcomes. Since the 1980s she herself has been an international patient, as have been her family members. She has worked at the Hospital for Sick Children in Toronto, and other Canadian hospitals in patient care.

She is one of the pioneers of medical tourism and has been an industry leader since founding her landmark medical tourism company, Cosmetic Surgery Travel, in 2003. She has been a medical travel care manager and facilitator for thousands of clients and has a keen, practical understanding of health care operations and opportunities around the globe.

Ms. Munro sits on the Advisory Board of Medical Tourism Development Program of Gulf Medical University, United Arab Emirates. She leads the MTQUA medical tourism curriculum development program for universities and educational institutes.

She publishes and writes for MTQUA’s Inside Medical Travel newsletter, and contributes to several health care and medical tourism print and online publications including the U.S. Healthcare Finance News, and the U.K. International Travel Insurance Journal (ITIJ) Medical Travel Review. She is author of Care And Management of Traveling International Patients, the most downloaded and influential paper in medical tourism.

She is a popular speaker, frequently addressing private health care groups as well as medical tourism and health care conferences in Asia, Europe and the U.S. on current issues in medical tourism.

about-carolineCaroline Bodanis
Services Director

Caroline Bodanis manages all client relationships and projects, and communications. She is an educator turned marketing professional with extensive online business experience and international direct marketing experience, as well as teaching, training and conference development.

She has been responsible for creating, developing and managing the websites of several health care providers in the U.S. and Asia, and manages the MTQUA website, our newsletter Inside Medical Travel and other publications. She is an expert in email marketing and has conducted direct mail marketing and email marketing campaigns for more than 25 years.

about-sandraSandra J. Millar
Director of Standards

Sandra J. Millar was instrumental in developing the MTQUA Medical Tourism Certification program and standards. She is an international health care specialist with more than 30 years experience in health care practice, international patient services, marketing, and tourism program development.

Mrs. Millar has held several senior health care management positions. She was COO of Aruna Health Care, a licensed hospital for addiction treatment in Phuket, Thailand. She founded the international patient department at Samitivej Hospital, one of Thailand’s top ranked hospitals. For eight years at the hospital, she was engaged in strategic planning, international marketing, policy and operational protocols, patient consultations, paralegal and insurance resolution, end-of-life family counseling and patient safety issues, and participated in JCI accreditation. She headed the international division at Phyathai II and Phyathai I hospitals in Bangkok.

In Canada, Mrs. Millar was Senior Disciplinary Judge and board member of the Ontario College of Nurses and ad hoc advisor to the Ontario College of Physicians and Surgeons for seven years, making judgments on cases that included issues of patient harm, professional discipline and medical ethics. She has been senior advisor to national, provincial and municipal governments, and a partner in private consortia for the development of health care investment opportunities in Saudi Arabia, Jordan, Viet Nam and Thailand.

about-janetJanet M. Geddes
Finance and Governance Senior Advisor

Janet Geddes is a senior consultant with extensive international experience in health care, banking, insurance, hotel/hospitality, and real estate in the U.K., Western and Eastern Europe, the Middle East and Asia.

Ms. Geddes’ work includes restructuring debt on health care facilities in Thailand, cosmetic surgery clinics and spa centers in Asia and Europe. She is an Accredited Mediator and has participated in dispute resolution in insurance and banking. She is a Certified Company Director and sits on the board of a private industrial company in India.

She has substantial international experience in the hotel/hospitality sector including at board level and covering all stages from construction through to opening and operations. She has extensive experience working with the leading international accounting firms and as director of an accounting and audit practice in Thailand.

about-donnaDr. Donna Robinson
Clinical Advisor

“Dr. Donna” owns and operates MedConsult Clinic in Bangkok. Since she founded it in 2004, it has become the most popular medical clinic in Thailand serving expatriates and travelers.

She has been a practicing physician in Thailand for more than 25 years working as a specialist in occupational and public health as well as general practitioner and family medicine specialist. She is licensed in both the U.K. and Thailand – one of a small handful of foreign doctors in Thailand licensed to practice in the country by the Thailand Ministry of Public Health. She has admission privileges at Bumrungrad International Hospital, considered by many to be the world’s most popular hospital for medical tourists.

She may be contacted through the clinic’s website.

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Dominican Republic Dangerous For Medical Tourists, Risks Too High In India, Mexico, Thailand, South Korea: New MTQUA Report


Dominican Republic is dangerous for medical tourists, risks too high in four other countries: new report from Medical Travel Quality Alliance.

December 21, 2015 – Bangkok and Scottsdale – A new medical tourism report out today from Medical Travel Quality Alliance (MTQUA) warns travelers not to have medical procedures done in Dominican Republic, and puts four countries on a watch list.

The Medical Travel Advisory, the first ever issued by the medical tourism industry, identifies an excessive number of deaths and life-threatening infections of medical tourists in Dominican Republic, and cautions medical tourists about specific safety risks in Thailand, Mexico, India and South Korea.

Download PDF release

“We urge medical travelers to seek an alternative to the Dominican Republic,” says Julie Munro, president of MTQUA. “At least four people this year alone have died after surgery that we know of. Dozens more acquired life-threatening infections they had to treat in hospital back home. This is unacceptable.”

Dominican Republic dangerAs many medical tourists start planning in January for medical travel later in the year, MTQUA cautions them to take great care when considering medical or surgical procedures in Thailand, South Korea, India and especially in Mexico, where deaths from weight loss and plastic surgery in certain clinics in the border towns of Tijuana and Mexicali have been widely reported in the American media.

Conditions in these countries present unreasonable and unwarranted risk, and possible life-altering harm including poor quality results, disregard for medical traveler safety, and even death, according to MTQUA.

“We are naming the Dominican Republic because this situation has been going on for years. It is widespread and not confined to one or two clinics. Neither the government nor the medical establishment has shown a clear commitment to fix this. Instead, the country continues to promote itself as a preferred medical tourism destination which is absolutely not the case,” says Munro.

For now, Dominican Republic authorities have shut down one clinic but not other clinics that have been identified as the source of life-altering surgical-site infections in medical travelers in reports from as far back as 2003.

MTQUA calls on the governments and the medical profession of these countries to review specific incidents and the underlying reasons why medical tourists are finding themselves at such high risk so that medical and wellness travel becomes safer and better for all medical tourists.

Medical tourists can keep risks low by using the services of a professional care manager or patient representative at the destination and one who charges a fee for services. Avoid commission agents paid for bringing patients to a hospital or clinic. Hospitals are generally safer than clinics as even registered clinics often don’t follow the same cleanliness and sterile procedures, have unlicensed staff, and are not close to emergency facilities.

Download the full Medical Travel Advisory report as a PDF.

Medical Travel Quality Alliance (MTQUA), founded in 2009, is an independent international organization that develops and promotes the highest standards of excellence in delivering treatment and care to medical travelers and health tourists. It certifies hospitals, clinics and medical travel service providers worldwide for safety and quality in support of treatment, care and services for medical tourists, and issues an annual list of the Top 10 World’s Best Hospitals for Medical TouristsTM.

Caroline Bodanis
Email caroline@mtqua.org.
Telephone (USA) +1 602-635-4664
(Thailand) +66 85 902 4500

Medical tourism at crossroads, fails in quality: Julie Munro, MTQUA president in Dubai


Global medical tourism is failing to deliver quality care to international travelers, Medical Travel Quality Alliance President Julie Munro tells Dubai gathering.

“Medical tourism is at a crossroads,” said Munro. “Because the industry has paid too much attention to the “tourism” part and not enough to the “medical” part, medical travelers have mostly been left without the guidance or information they need in order to get the best results possible.”

PDF version

December 4, 2015 – Dubai – The medical tourism industry has failed to live up to its promise of better quality treatment and care for patients seeking to travel to a foreign country for health care, Julie Munro, president of Medical Travel Quality Alliance (MTQUA, www.mtqua.org), told an audience of 500 at Gulf Medical University (GMU) last week.

Julie Munro MTQUA DubaiDubai Healthcare Authority, as a recent entrant to the industry, has the opportunity to create a support structure that is more patient-focused, she said. Its new complications insurance product is a good example of government commitment to better outcomes and care for medical tourists.

The new program of instruction in medical tourism at Gulf Medical University will also help steer the industry toward higher standards in quality and support for medical tourists.

“Three UAE hospitals have shown they are committed to quality in patient care and support and have received MTQUA medical tourism certification,” said Munro.

These hospitals, Saudi German Hospital Dubai, Al Zahra Hospital, and Thumbay Hospital Ajman have met the international standard of excellence for care and services to international patients and medical travelers. Other hospitals, clinics and medical travel facilitators in the UAE are presently going through the certification process. MTQUA-certified facilities and agencies are in 16 countries.

“We believe that the risk for medical tourists has become unacceptable, making it necessary for us to issue our first medical travel advisory,” said Munro, speaking at the 2nd Annual Conference on Destination UAE Health and Medical Tourism Hub.

This medical travel advisory, the first ever issued by a major medical tourism industry group, warns medical tourists about dangerous conditions in the Dominican Republic. In addition, MTQUA puts four countries, Mexico, Thailand, India and South Korea on a medical tourism watch list due to higher risks to medical traveler safety and quality.

Medical Travel Quality Alliance (MTQUA), founded in 2009, is an independent international organization that develops and promotes the highest standards of excellence in delivering treatment and care to medical travelers and health tourists. It certifies hospitals, clinics, medical travel facilitators and service providers worldwide for safety and quality in support of treatment, care and services for medical tourists; issues the Top 10 World’s Best Hospitals for Medical TouristsTM annually; and authenticates online testimonials.

Caroline Bodanis
Email caroline@mtqua.org.
Telephone (USA) +1 602-635-4664
(Thailand) +66 85 902 4500