Improving Care Delivery and Patient Experience for International Medical Travelers

The importance of empathy


An increasing number of patients are leaving their local medical communities and crossing national borders in search of high quality, affordable and timely medical care. While these patients (often referred to as medical travelers, medical tourists or international patients) face challenges similar to individuals receiving care in their local communities, unique differences add to the complexity of care and risk of suboptimal outcome. Accordingly, patient experience is a crucial piece of the care cycle for the patient and the healthcare system alike.


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While an excellent patient experience has obvious benefits to those receiving medical care, it is also associated with better clinical and business outcomes for hospitals. Among several clinical outcome measures, positive patient experience is associated with lower mortality, lower readmission rate and lower hospital-acquired infection rates. Similarly, positive patient experience is associated with higher financial performance, likely due to patient loyalty and emerging reimbursement models rewarding better clinical outcomes.

Nizar N. Zein, MD, the Endowed Chair in Liver Diseases and Chairman of Global Patient Services at Cleveland Clinic, discussed “Improving Quality, Safety and Patient Experience” during the European Medical Tourism & Global Healthcare Congress in Athens, Greece, in May. He stressed the role of empathy as a universal attribute in achieving an outstanding patient experience. However, reaching a high level of empathy among caregivers for international patients often proves challenging.

“Empathy is the ability to see through the eyes of our patients,” Dr. Zein says. Empathy requires effective communication and shared experiences. Language barriers and the need to communicate through an interpreter can hamper effective communication with international patients. Shared experiences are typically lacking, with limited familiarity among healthcare providers of the cultural, spiritual or religious background of patients. People are more likely to feel empathy for a sick neighbor than for patients with dissimilar language, culture or educational background.


Getting beyond these barriers is possible, but it doesn’t happen by accident, Dr. Zein says. Having specialized interpreters is a necessity, but it’s not enough. Caregivers also need education around cultural issues, he says.

“A simple modification of a regular standard of operation to accommodate somebody’s culture or diet or other activities can overcome many barriers,” he says.

Cleveland Clinic’s Global Patient Services team, which facilitated patient visits from more than 120 countries in 2017, regularly holds educational sessions to teach staff about other cultures and to create familiarity with cultural obstacles to achieving the best patient experience.

Some people may be nervous about caring for people from different cultures, but Dr. Zein notes that human traits are more similar across cultures than people might think. Providing medical care to international patients also gives medical professionals an opportunity to build greater expertise in medical problems and diseases uncommon in their local population.

The right services

Dr. Zein also emphasizes that an organization that wants to care for international medical travelers must ensure it is offering services to meet these patients’ unique needs. For example, an international patient may need assistance with transportation and help getting a cell phone and exchanging currency. If their care requires them to stay longer than originally expected, their visa may expire, so they will need the services of an immigration lawyer.


Since international patients almost always travel with their families, health systems need to offer supportive services as well. Patients also appreciate maps and information about area museums, sports schedules, salons and spas, restaurants and fun destinations.

“It takes time put all of these pieces together, but it will ultimately be worth it in terms of increased patient satisfaction and enhanced revenue to the health system,” Dr. Zein concludes.


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