By Alison Lowe
Nassau Guardian Business Editor
NASSAU, Bahamas -- Concern has been expressed that The Bahamas is losing out to the Cayman Islands on a potential new revenue stream in light of slow approvals and restrictive work permit conditions for foreign medical specialists.
With plans to launch a stem cell treatment center, an in vitro fertilization (IVF) facility, a cochlear implant center and an international spine surgery program, as well as expand its high intensity focused ultrasound (HIFU) treatment for prostate cancer, Barry Rassin, president of Doctors Hospital Health System Ltd (DHHS), told Guardian Business that, while regulations may play a role for some, work permits for foreign physicians are ultimately “key to all of the programs”.
Barry Rassin stands outside the Bahamas Medical Center in a December 2011 photograph
“Right now, 18 percent of our revenue is coming from medical tourism. That includes tourists who happen to be here, and the HIFU program, and there are a handful that come for all kinds of odds and ends. I'd like to take that to 50 percent. If I had all approvals and permits in place I think that could happen in 18 months,” said Rassin.
However, the businessman said that the Bahamas Medical Council has recently increased the stringency of its work permit process, requiring doctors who come into The Bahamas to perform procedures a handful of times a year to be covered by a $10,000 annual work permit, as opposed to being able to pay a weekly or otherwise pro-rated permit fee.
“If we paid $10,000 per doctor when they are coming in a few times a year, that would price us out of the market,” said Rassin.
Part of DHHS’s strategy to grow its medical tourism business is to present a “one price” offer for procedures, that gives patients the convenience and reassurance of knowing up front exactly what their total medical bill will be before they decide to go ahead.
This “bundling” of service costs will be offered alongside a planned 35 percent reduction on the average US price for the procedure, in the hope that cheaper prices will drive higher volumes of patients to the center.
In addition, Doctors Hospital will emphasize the ability for patients to receive aftercare that they may not get if seeking to have procedures done in cheaper jurisdictions, suggested Rassin.
“We can't compete with Costa Rica, Mexico, India, Thailand or Singapore, their cost structure is so much less. We are creating a model where we want to bring surgeons from the US here with their patients. We believe it's very important to do post op follow up so that a patient coming with their surgeon will be seen over there, come here and get the surgery and then they'll go back and have all the follow up care. If you go to India, have a procedure and you go back, you're on your own because nobody knows what happened there.”
Rassin said he is seeking a meeting with the Ministry of Tourism to see if a collaborative approach can be taken to overcoming current roadblocks with respect to physician permits, which lie in the jurisdiction of the registering and regulatory body for doctors, the Bahamas Medical Council.
“The Cayman Islands has changed it laws to accommodate [medical tourism]. I have a group of surgeons in Charlotte, North Carolina, who are being recruited by Cayman to their hospital. They have no [work permit] fees. They just have to get their credentials in place. So Cayman will take the business if we don’t get this done soon.
“We’re missing the boat, and it’s really more beneficial for the country than it is for Doctors Hospital Health System. I’ll get out-patient surgery out of most of them; they’re in for a few hours, I’ll get a few dollars, but they’re going to stay in a hotel for anywhere from three nights to 14 nights.
“On average a medical tourism patient travels with three other people – just do the math. I think the country will benefit a whole lot,” said the DHHS president.
Many of DHHS’s new treatments are set to be offered in its new Bahamas Medical Center, which opened in October 2012.
DHHS has projected that it could take 18 to 24 months for the Bahamas Medical Center to arrive at a break-even position. The company’s net loss associated with the Bahamas Medical Center more than tripled to $1.135 million during the 2013 financial year. DHHS injected $1.755 million in capital into renovations and equipment for the new center in 2013.
Rassin said he sees the Bahamas Medical Center creating a relatively small proportion of DHHS’s revenue overall, but having a larger impact down the line.
“I think it will feed the system. People will come here and they trust us, they will use other services that we have.”
For each of the international programs that Doctors Hospital hopes to create, Rassin said that local professionals specialized in those areas will be involved.
Rassin said DHHS is already receiving a “lot of calls” about IVF in The Bahamas. Meanwhile, the expectation is that as many as 15 to 20 cochlear implant procedures could be conducted a month at the proposed ear implant facility.
DHHS has been waiting for the Bahamas Investment Authority to determine if it will grant approval for the cochlear implant center for nine months.
“Our population is so small we might have two or three individuals a year in this country who need it. That’s why we’re doing this as a center for North America. The group that is doing this wants to train surgeons out of North America on the procedure and the implant. It’s being used in Europe extensively,” said Rassin, adding that the procedure is not yet approved in the US.
“[The European physicians] want to train [the US physicians] and do the procedure here. They want to put in an audiology lab so we can do the full hearing tests here. They’ve partnered with our local audiologists, so again, using the local population as much as possible and only bringing in a specialist when they don’t exist here.
“I have 40 spine surgeons who’ve joined the faculty who want to come here anywhere from two to four times a year, bring their patients, do their patients and go home,” added Rassin, noting that these would be mostly “routine” spine surgery procedures, but would also include some stem cell spine treatment if the government approves stem cell legislation for The Bahamas.
The Stem Cell Bill was passed in the House of Assembly last Wednesday, and now awaits debate in the Senate.
Messages left for the Ministry of Tourism’s Director of Medical Tourism Carla Stuart and the Bahamas Medical Council’s administrator were not returned up to press time on Monday.
Republished with permission of the Nassau Guardian