#AskMariaTodd: Is there a medical tourism association other than U.S. based trade association?

Many industry newcomers ask me this question often, perhaps not realizing the 7-year history of acrimony between me and the U.S. based trade association in South Florida that co-produces events and does a great deal of marketing of itself as "the" trade association for the industry.

There were others, but a few were threatened out of existence with litigation - one that I founded included among them. Four attorneys (3 from Gainesville, Florida, one from Memphis, Tennessee) and I formed one in 2010 - The Council on the Global Integration of Healthcare, focused more on education and training. The minute we announced this, we got a call from the executives of the U.S. based association in South Florida, with strong words exchanged attorney to attorney - and then my fellow board members and I figured it just wasn't worth the cost and hassle.

Ian Youngman filed a new report on IMTJ yesterday that describes the plight of many noble industry supporters who tried and failed for one reason or another. According to Youngman's "reliable" market research, "a few are active... but they tend to be private hospital associations or tourism associations that have strayed into medical tourism."

Youngman explains that "It costs money to set up and maintain any website, so after the initial enthusiasm, when the founders seek cash from members or potential members, the cash rarely appears." To this statement, I can attest. I spent tens of thousands of my own money to:

• Set up the nonprofit 501C3 corporation (the other group is a trade association in a different category). It would have cost me much more had I not already had training and experience as a paralegal and without the generosity of my fellow board members who were attorneys.
• Develop the Board of Directors
• Plan, design, build and host the website
• Purchase the domain name registration
• Craft the bylaws, membership agreement, mission, vision, and other documents required to set up a non-profit association
• Pay a graphic designer to design the logo
• Order stationery, business cards
• Market the association
• Travel to speak at events around the world
• Sacrificed my billable hours in my business (and countless hours of free time) as a volunteer
• Build alliances with other educational and university-based nonprofits active in global health and economic development
• Attend events at the US Department of Commerce, USAID, and other gatherings relevant to the sector
• and more

To what end? To receive a threatening phone call that ended it all swiftly and at significant financial damage. We had already watched how they contributed to the demise of others. We didn't need to personally experience that for CGIH. As good stewards, we simply capitulated.

I co-founded CGIH because I love to teach new business startups with a desire to enter medical tourism. After we folded it, I realized that I don't need to have a competing association - I just need to teach good lessons. I teach for any non-profit except the South Florida-based association and the GHTC in Turkey.

I won't associate with the former and the latter wore out its welcome by alleging to would be clients that they were my authorized agency and were asking for fees for my appearances and consultation without my knowledge or consent, all the while telling me that there was no budget to compensate me for my work.

There's plenty of corruption out there in the nonprofit world. I can point fingers in all directions of the compass. If there's a need to know their names, I'll tell you privately. My accounts receivable ledger is plagued with bad debt from medical tourism associations. Many accounts in arrears stem from reneged promises by non-profit medical tourism trade associations, many of which are now defunct as Ian duly noted. They requested that I take time from my business to develop a presentation slide deck and my lecture, advance the cost of travel to their location, take the time to speak at and remain in attendance at their events, meet with their attendees. I filled their need for a keynote speaker with an industry reputation and leveraged my loyal industry following to draw market share to their event, and to prepare and deliver a presentation that would set the underlying tone and summarize the core message or most important revelation of the event. Then, without any gratitude, they ignored my invoices to reimburse me for the agreed amounts. Now my Board of Directors requires payment in advance. Period. The honest associations and event organizers always pay in advance without objection.

Here are three things that I have come to believe about this subject of medical tourism association startups, in general

I have been in medical tourism for more than 30 years - before it was a "thing" as is now said in hip cultures. I coordinated more than a thousand medical tourism patient referrals and cases before the executives of the South Florida-based association were out of elementary school. Here are my lessons learned - the hard way:

The medical tourism industry does not need a global association that has no authority or capacity to set voluntary international standards or sell pricey proprietary certifications that expire in a few years that are not recognized worldwide as vital to success.

What we need are affordable solid training and education resources that really don't require the extra cost of affixing a brand and licensed logo of some private benefit global trade association that is not the alpha and omega of the industry. If people want to use precious startup capital to buy what they sell - all well and good.

The medical tourism industry would benefit by regional or national public-private partnership entities that advance a legitimate purpose, are adequately capitalized, have a framework upon which to develop tourism and coordinate education and economic development, and produce economic development results.

Many regional and national "clusters" have been built and failed because they were designed by the U.S. based private benefit consultancy associated with the executives of that association - with the purpose of becoming a future conference host destination (MICE business! Not Medical Tourism business!) with a logo identity but none of the required infrastructure. If you ask the country or regional representatives, they thought that having a recognizable logo would attract patients simply because it existed - as if to say "Come in - We're Open for Medical Tourism Business".

Many spent more than USD $500,000 to do this, of which some was paid to the consultants from the U.S. based private benefit consultancy associated with the executives of that association. Far more was spent on misguided expenditures on logos, banners, travel, conference stand rentals, sponsorships, hosted buyer fam tours, staff time from various executives and local and regional government authorities, website development, printing, stand giveaway SWAG, videos to promote medical tourism, co-publishing agreements for destination directories, special print run books, event attendance, hosted gala dinners and receptions, and more. All this was done without proper destination and product development from the raw goods of hospitals, clinics, doctors and dentists and hotels with excess capacity. To add insult, the cluster lacked an effective marketing plan that actually attracted medical tourism consumer or group health contracted business and/or foreign investment in the sector.

We don't hire a plumber to wire our house and we probably shouldn't hire conference organizers who happen to own several trade associations to build the medical tourism industry. But again, the market decides what it wants to buy, why, and from whom and what it wants to support. There's nothing illegitimate there.

The purpose of a trade association is to participate in public relations activities such as advertising, education, political donations, lobby efforts, and publishing, but its focus is collaboration between companies. Associations may offer other services, such as producing conferences, networking or charitable events or offering classes or educational materials. Many associations are non-profit organizations governed by bylaws and directed by officers who are also members.

According to Youngman, and which I agree 100%, if you cannot raise support and capitalization through members, the association cannot survive. Therefore, if these failed association startups cannot drive up local membership and support or volunteers to help build and promote the association - perhaps that is the market's subtle way of saying that the value proposition of paying dues or subscription for what it sells is not apparent or nonexistent, or premature, or misaligned.

We live and learn

CGIH never got the chance despite the investment I and my other board members made. For this, I was bitter for several years.

Now I treat the U.S. based private benefit consultancy and its closely associated trade association as irrelevant. I don't worry about it, don't support it, don't benchmark anything I do against it. It is like the rain. It just "is".

As for when it rains, I take out an umbrella so I don't get any on me and I wear galoshes (boots) to protect my shoes from the other consequences of the rain. I don't try to sway, stop or otherwise change the rainfall, make it stop, or validate it in any other way.

While the association markets itself as "the" industry trade association of the world, what they offer has no value to me and I don't accept them as "my" industry trade association.

Their owners seem to gain private benefit competing with me (and many of their would-be members) as they are in a position to influence or control use of the organization's assets for personal gain as founders, directors, or officers. That is between them and the U.S. government, which is not something I care to spend my time or preoccupation. There are many competitors out there - they are just one and the market is "the world". Let them have some. I don't worry about it. "No me importa".

There is no getting even for the damages CGIH and I personally sustained.

The effort to "get back" would distract me from the mission I've chosen, which is:

1. To use the bricks hurled at me to build a legitimate and thriving international consultancy in medical tourism
2. To serve my clients' interests to the best of my ability - ever mindful that they are placing their trust in me to guide them to meet their objectives and measured success - not my own.
3. To be a good steward of my clients' investments in hiring me so that they always earn at least $1 more than they spend on my advice and execution of strategy and never waste their time or money or other assets
4. To establish a legacy to the industry through training, publishing and generosity and thought leadership and sharing of the best practices I can explain and demonstrate

I have learned that none of these things listed above require a trade or membership association; just good, honest business effort and humble service.

After this horrific experience in attempting to launch CGIH in the medical tourism industry, whenever I need to feed my need to spend time on volunteer activities for a non-profit association, I volunteer locally - in service to my community. I generously give of my time and expertise to help with branding, fundraising, membership drives, coordinating education events, staffing the booth at neighborhood events, contributions and helping out as a business owner in the community.

At the global level, I support many industry and humanitarian non-profit associations that align with my personal values and professional aspirations - through my writing, speaker appearances, training workshops, and Board of Directors service.

I also teach at the university level, help professors formulate curricula for healthcare and health tourism administration programs and speak as a guest lecturer at colleges and universities around the world when time permits. In those presentations, I bring students the real life experience of coordinating patient care, marketing medical tourism, and impart my perspective of what will be required of them as industry entrants going forward.

I've discovered that by not having to build and manage a nonprofit in the medical tourism industry I can do more good for more industry stakeholders than as a trade association president trying to split my attention and time. I don't have a need to be the boss or own the association. That's for full time, committed, professional association executives. My personal need for fulfillment at the nonprofit association level is satisfied by being of service and support to the worthy ones. I urge all of you to do the same.

Do good things!

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About Maria Todd

Maria Todd is a 35-year healthcare health tourism industry expert with extensive senior management and program/project execution experience. She brings decades of experience with healthcare and tourism operations management, organizational development, marketing, and accreditation, clinical management, tourism and hospitality strategy across the spectrum of healthcare and health tourism organizations on five continents.

Maria works with physician groups, hospitals, investors, government agencies, pharmaceutical and device manufacturers and health plans. She advises C-level clients, government authorities and clinicians on capacity development, project, program and brand management. She also has extensive experience in health tourism and concierge medicine market penetration planning, marketing, ASC and operating theater management, revenue management, group health benefits and payor contracting and destination development strategies.

She is the author of 6 best-selling medical tourism books published internationally through an business improvement imprint of global life sciences publisher and conference organizer, Informa.

Learn more about Maria's work in health tourism at:

Center for Health Tourism Strategy

MariaTodd.com

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Maria Todd will be appearing as a speaker on the topic of Medical Tourism Destination Development at the upcoming Termatalia event in Arteaga/Saltillo in Coahuila, Mexico this month.

Termatalia is the only trade association that links Europe and Latin America that supports the development of balneario and thalasso health and wellness tourism around the world. More than 25 countries will take part in this event which for the first time will be held in Arteaga/Saltillo in Coahuila, Mexico on September 29-October 1, 2016. Closest airport is MTY=Monterrey, MX.

Please join Maria Todd there where you will meet many spas, balnearios (thermal waters) and thalsso (sea water) resort operators and marketing representatives that can explain their products as part of the medical tourism and wellness resort industry around the world. You will also connect with travel agencies, tour operators and referral coordinators and other supporting industry stakeholders.