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Health Tourism After COVID-19: The Road Ahead Updated

Health Tourism After COVID-19: The Road Ahead Updated June 3, 2020
COVID-19 The Road Ahead

Date: 3rd June 2020
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    Transcript

    Health Tourism After COVID-19: The Road Ahead Updated
    Irving Stackpole & László Puczkó

    László Puczkó

    Ever since we had the first session, so many things changed. We thought that would be really the time to revisit the discussion and keep you updated on the developments and how strategies, activities from developments can be influenced and can be fine-tuned to the expected opening up after the virus.

    I’m going to talk about some key issues and key topics, as well as some obscure developments, especially about the business side. Then I will pass the microphone on the chairman to Irving, who will address the medical tourism aspect. I think it’s important that we all we all understand the same approach and we are very much aligned. So very briefly, we understand how tourism as an umbrella term includes medical tourism and includes wellness tourism with an overlap between the two. This is how we look at the industry or the scene, if you wish, because now we can observe there is a convergence between the medical side of traditional medical side and the wellness side, and the lines are less and less clear and more like blurred, which gives more opportunities, obviously, also certain challenges because we need to have a better understanding of both ends of the spectrum.

    I think we have to agree that there are a large number of services and programs that can be incorporated into any travel activity, since we understand that travel as such contributes to your well-being and you feel better even if you go to a business trip, you have a cultural visit. If you have visiting friends and family, gastronomic trade doesn’t matter what it is, it contributes to your well-being. It doesn’t make you has stressed because you would need to be doing either medical activity or awareness activity as a core expectation was a core motivation. We understand that this is where the whole industry, the travel industry and leisure industry have great opportunities. Then I would need to include health care as well, that we need to look at how services, options, opportunities can be added to the current service options and service venues that can improve our guest’s well-being.

    Probably. I need to highlight just one little item here, which is the motivational definition, which is what we call a self-gifting, since often that’s more like a wellness tree. We also understand that having new breasts, which will be a medical intervention, is a self-gifting activity. The motivational side comes from a very different angle. My overview in the next 15 minutes, it will be very much looking into the motivational aspects and less so on the infrastructure aspects. If you look at operators’ websites, everybody will tell you, I have five pools, I have 10 saunas, I have 12 treatment beds and I have three yoga decks which are all fantastic and all very nice. Especially after the pandemic, when people will have a different understanding of travel, different understanding of health risks, different understanding of satisfaction as well. They would really find people really need to find out that you are offering something which is really related to the core motivation, not just telling them that you have certain elements of infrastructure. I will give you examples of that. We also understand, and I don’t think it’s ever been more important than now that we need to look at healthspan and not lifespan.

    When we talk about health, travel, health motivated travel, even the World Health Organization has been suggesting that for quite some time, that we need to move on from the lifespan, understanding that how many years we are living, how many more years we have left. We need to understand that whatever we have left, whatever we are doing, it would need to be more health conscious. That’s a very different understanding, not just how societies will look at themselves, but have operators as well as destination management bodies and governments. Because I know you have government representatives here tonight as well.

    We need to consider how the health aspects, how the health services, how the wellbeing improving components can be and should be incorporated to pretty much any kind of travel and have the health-conscious travelers. The medical benefits can be further improved and provide something which is local and based on the local resources. I don’t know how many of you have been involved in experience, creation and development. This is my little toy.

    Health

    I absolutely love it to create these experiences and I would like to create just one or two approaches because they have been changing significantly due to be where and one is the Covid approach by the three Escadrille, which is satisfaction, surprise and sacrifice. We want to be on satisfaction. You wanted to have surprise and we had to sacrifice, especially for bonus trips. It’s often very standard. We have cheap tickets. We want to have high a high degree of satisfaction, a high degree of surprise, we don’t want to sacrifice much. Obviously after the post Covid, we will have a very different scenario, at least short term. We will have a large chunk of these three essays now dedicated to sacrifice. Perception’s a destination’s, its time, its health risks. First of all, the barriers will be the sacrifice and not the not high enough satisfaction that requires a different kind of communication, different kind of segmenting, different kind of value propositions.

    That’s what I would really invite all of you to revisit and feel free to ask questions now or even later even of this webinar, because this is a massive challenge and it’s a very different way of looking at our own services. Looking at our demand and probably just to elevate mood a little. Since this evening, too many of us, you know, that’s probably a face mask that our guests, especially those who are the heads on a stick. I know it’s very stupid. I know it’s not very motivating. Don’t forget, enjoying a good glass of wine also contributes to your well-being and how you can do that. When you’re wearing a mask, you have to really think about it. How much of the satisfaction may go away and becomes a sacrifice? This is a little bit of debate with Irving we have been discussing. It’s probably a little bit too complicated charge, I really, really wanted to discuss it with you, at least to raise the point. I know we can revisit it later, even since it’s understood that based on all the webinars and all the full cost research companies, that travelers will look into distance, will look into the location. We will look into brands and we look into your desires. Based on all these parameters, I just want to list the key issues here. These are do you travel short or somewhere close because you worried you may not be able to come back or you want to go far because you want to be remote.

    You will go to brands which are unknown because you think it’s small, it’s boutique. You understand that it wouldn’t be too many people, or you want to go to big brands saying that they have a new protocol of covid of cleaning up processes and you trust it. You want to be a place which is popular and busy because then you have all the services. Should anything happen or you want to be secluded and being far away or as a last parameter, you want to go to be tried and proven. You mean that you know how it goes. You know what to expect, you don’t want any surprise. I want to minimize the sacrifice, or you say, oh God, I really don’t know when I can travel again. As soon as I am physically possible, I will look at my bucket list and I start to travel and how the health travel will fit in this segmentation approach. Obviously, you might say that I would like to play around with those units and to long and try to go far and bucket list. How can I how can I do that? We have this is what you need to do, and this is what you need a little bit of help with advisors. I have to tell you, since this can be one option, that you change it around a little, soon you might find out that your next guests actually want to go somewhere which is far away on the bucket list. And they still want to have no friends whatsoever. This is what you need to work on. I need to understand – we need to understand your guests in a very different way.

    Health

    We have four options here. If nothing else, try to remember this. You can create one solution, which is basically just relabeling your style into your business unit or you classify the whole process of your activities to every single aspect of your services would be looked at and created. You can have entertainment, which is basically just entertain under the wellness umbrella. You will see the example in a minute, or you decide that you want to be a permanent address, the collective element, and you want to focus on one aspect of the business approach. You do have everything in the forest, and you do the first bathing, and you do the energy of the space and everything focused on that. And you have the attacks in the forest and so on. I mean, in one aspect you don’t care about the others. You do have to make decisions. Neither of them is better nor worse. They are choices. You need to look into what you have on site, what you have as a brand, what you have as guests, what you used to have as guests and what you want to have as well. What you want, you have as and want to want to develop, I invite all of you to try to identify your existing services and also your directions and options that you have in front of you.

    These don’t give you a couple of examples, and one specific photo will be or could be disturbing to you, to certain people here, and I’m already sorry about that for this very direct imagery.

    Health

    I really wanted to tell you that this is a situation where if you wanted to create violence experiences, now you can have awareness. I don’t know if you tried this. You know, how is the tuna, which actually was well, or you going to be well, eating that kind of tuna or both. It doesn’t matter. You have a great challenge from the consumer world, from any part of the world, which would really challenge your core business proposition. That’s why you need to visit which of those four directions you can do, because now you can buy a tuna. You can do. This is what we call perineum sunning in this photo. Should you be offended by that? I’m really sorry about this, but you really need to be aware what your challenges are and just basically showing your private parts to the sun, because this is the best way of taking energy. It’s very peculiar. It’s very weird. Well, this is what let’s say was the influencers have been banging on recently. Is it really wireless or is it just about attainment or is it just a little bit of that illusion? It’s up to you to decide, but we need to know that you have to identify your opportunities and your real market is nothing wrong about this. It doesn’t harm anyone. It’s weight. Not everybody would be very comfortable with doing this.

    Health

    This is what’s happening in the market, apart from just having a treatment room and a couple of treatment beds. This is also part of the business proposition as we speak, such as this, which is the traditional healing activity in Japan with the volcanic activities heating from under. You need to have the umbrella, otherwise you may be burnt. And this is not something that you would be doing intentionally. If this entertainment, is it healing process, is it a heritage activity? Is it tradition or is it a natural healing process? What is this? You really have to do your homework and to understand your opportunities and then introduce them appropriately to the segment that would appreciate if some people would come here because it’s fun, it’s entertaining. Instagram and some others also come because I understand the benefits of it. Both of those segments can come in even a couple more as well. It’s your choice which of those guys you actually want to keep an octopus.

    I’m sure most of you know what you excuse this user experience, we believe it’s more like, well, being experiences and even more appropriately responsible, validating experiences. You need to create those. They don’t just happen. You have to orchestrate them, their journeys, their stories, derechos. We have to create them. We have to introduce them. That’s a very different world from just operating a spa or having a couple of treatment rooms.

    We suggest you understand your unique value propositions, not unique selling propositions, unique value propositions have mentors not only advisers, but mentors also who can help you to implement. I’m sure many of you would have lovely ideas from today, from other webinars as well, from the story’s records. The trick is how you can implement those ideas to your very special situations. You need mentors to help and to help you through the changes of the implementation and the development. Also, what are your stories? These are just images, what you are standing for. What is the core story that guests can be related to? Your guests can take home and can find themselves in that story. Again, it sounds very simple and very easy, believe me, that that’s really isn’t working on four continents. It’s a very difficult job.

    It’s a beautiful job, it really takes time. Probably since the business is still not hasn’t yet picked up, this is a time that we can and should be revisiting this. So often people say that hucksterism, luxury, if you ask me, it would be more like a necessary luxury and luxury necessity, the necessary luxury items, we all need that and we all need to pursue that. Probably more like absolutely true. We need to look at it in a very different way. Some of these things will be expelled. More in the upcoming book that we wrote with Irving. We give you exercises and tasks that you can follow, and you can engage a discussion with us. He will be more than happy to help you with your development and your journey. You know, it’s been great story. You’re having a journey, really this is a journey because we have to talk to your guests in a very different way. You will find out that even those who wouldn’t even come close to as far as soon as they understand what’s developing, improving benefit of your service can be they would come and engage and take that opportunity, even if it’s not as if it’s not a wellness center. Since you understand the whole process of developing experience creation, your opportunities will be way wider, and your guests will have a more fulfilling and better being improving experience. I believe this is the moment to give back the presentation to Irving and he’s taking on to the medical tourism side. Thank you.

    Irving Stackpole

    My hope is to take a few minutes and run through what I believe to be critical market dynamics regarding medical tourism, health, tourism in the post Covid time. It was a treat participating with Laszlo in the development of the book as we were about to publish it, of course, COVD-19 hit and we were very encouraged to see that the vast majority of the content was relevant, even in the COVID-19 environment, which speaks to the need for fundamental information about marketing. And that’s our background at Stackpole & Associates, For this particular presentation, I’d like to focus on more external factors and market dynamics than in particular service lines, although I will delve a little into which service lines, in my considered opinion, will emerge first and which will emerge most slowly. The factors in the health, tourism and medical tourism markets and in the health care markets are, first of all, the external factors. And we understand what an external factor is now that we’ve encountered the novel coronavirus and Covid-19 that is an external factor along with the imposed travel restrictions. One cannot have health tourism if one can’t get from point A to point B, and then that changes as. Travel restrictions are lifted, how will that impact health tourism?

    Demand and supply drive all markets. The demand for health tourism is driven by both the travel markets, the demand for in the travel markets, as well as the psychology that’s dominant at the moment and the psychology that’s likely to emerge as the markets break free from its current deepfreeze supply and capacity will also be affected. The supply of health-related providers is will they be there when the health travelers are looking for them? Some health providers, some wellness providers, some medical services providers will not survive the current economic contraction. So how we do that, how we manage to navigate the difficult times that we’re going through now may make the difference in some cases between those who have capacity and are available for health consumers as they look up and look around. And those that for a variety of reasons may not survive this this time. Then what is the road to recovery? What does it look like?

    Health

     

     

    I’m showing the relationship between the frequency of a certain service on the left-hand side of the graph and the acuity or complexity of the service on the other side of the graph. As you can see here, the market for health tourism breaks down into two major market segments, the low acuity, high frequency side of this graph. That’s in large measure the types of services and markets, supply and demand that Lazlo is referring to. Then the other side, which is the highly complex, relatively speaking, lower volume, higher unit value side of the graph. One side of the graph refers to high volume, low unit value, and the other side of the graph refers to low volume, high unit value in the classic. That’s a classic. In the medical tourism literature and many of the studies, the focus is on this low volume, high unit value side of the market. I can assure you, and Laszlo has testified that the high volume, low unit value is by far the larger part of the health tourism market globally.

    Health Tourism

    Overall, the Market factors, the dominant components are destination stability, and this boils down to perception, there are a variety of measures of destination stability. The bottom line at this juncture has to do with consumer perception. Is your destination seen as being safe, not safe in a physical security perspective, but clean? What’s the risk that I’m going to get sick by traveling to your destination? Then baked into that question is, of course, access and travel, can I get to your destination, which is a critical question these days in the travel industry as well as in the health tourism markets, there’s quite a discussion about how markets are opening back up, how to travel to where. I live in Portugal, for example, is beginning to open up from certain source locations and travel to other destinations, is beginning to open up. Who’s opening up and where those restrictions remain? These are a complex array of issues that a consumer would have to navigate if she were interested in getting from point A to point B in order to consume your health and wellness services.

    Another component that’s always an issue has to do with economics. In this context, it has to do with inflation. We are, by all standards, on the brink of significant global inflation, whereas we’ve had an extraordinary period of stability. We will see significant inflation. We’ll see certainly recessions in many developed economies and most economies. How will that impact purchasing power parity? How will it impact my ability with my euros to purchase services in the United States or in Argentina? The next item is capacity. This tragic and difficult pandemic has significantly impacted the capacity of service providers to deliver health and wellness services. Some hospitals, some clinics remain closed either through external orders or because their staffing isn’t available, staffing isn’t available or because the hospital or clinic hasn’t yet made the pivot.

    The transition from urgent pandemic related demand to returning to elective procedures is critical. Then finally, an enormously important is your reputation and your brand. What is the dominant opinion held of your destination? What is the dominant opinion of you as a healthcare provider? What are those opinions among your key audiences? These are critical questions and will be extraordinarily and newly important as we progress out of the deep freeze of Covid-19 into a recovery period and a thawing of the markets.

    One of the issues in a health tourism conversation has to be about tourism and about the travel and the dynamics of travel in these markets.

    Health

    This is very recent data from FlightTracker24. You can all access this. It’s a fascinating track or keeps track of all of the airplanes that are in the sky around the world at any given point in time. You can see that after emergency lockdown orders were imposed, the number of commercial flights plummeted to a low at about April 18th and is still remained low. You can see there’s just a little uptick there on June 2nd. This is a seven-day moving average. I know personally, I live in the flight path of the airplanes going into and out of Lisbon Airport. Recently over the past few days, we’ve actually begun to hear airplanes again.

    To put his to put this in historical context, this is a chart that shows the seven-day moving average of total flights from May and 16 to March and 20. You can see here how after the global lockdown, the World Health Organization and other government governmental organizations declaring emergency, the number of flights plummeted dramatically. If you can’t get from point A to point B, that’s immediately an issue with access in these markets. How will this change? What will happen? There was a famous study done by the E.U. back in 2006 that predicted that in the case of a pandemic and yes, they actually did do a very in-depth study of this that they anticipated the sophisticated researchers of the time predicted a V shape recovery from a pandemic event in the EU and globally. In a V shaped recovery, one would see a dramatic decline, a rapid return to something like normal.

    Health

    The other type of recovery is a U. Shaped recovery, which is the kind of recovery we had after the 2008/2009 Great Recession. What we can expect, however, in this case is neither a V or U, something more like a Nike swoosh as can be seen here from the estimates or projections by the World Travel and Trade Council. I think I got that World Tourism and Trade Council analysis showing that it would be more like a Nike swoosh depending on when the lockdowns were relinquished.

    What this doesn’t take into account is any resurgence or flare up in infections in any particular location. My hunch is that there will be some flare ups in some locations and some destination locations which will cause some return to lockdown. I think we’re going to see a period of release, lockdown, release, lockdown. The recovery is going to be more like a jagged swoosh and a gradual return. Some things won’t return. The impact on capacity in this pandemic has been significant because supply health care resources was diverted to serve the demand for Covid-19 treatments. There was a period there was a period that where few elective nonurgent procedures were scheduled. The question is, can we turn the faucet back on? The best thinking about this is that some percentage, some proportion of what a very robust elective market for health and wellness services had been, some percentage of that will not come back for reasons that we can talk about. But in order to adapt that we as providers and we as destination managers, management organizations need to adapt to those changes, not necessarily fight against them or well against them, to actually adapt to the opportunities that those changes present.

    Health

    A recent article from The Economist described tens of millions of surgeries are being postponed as the result of a pandemic, which immediately creates the question, well, when you open the floodgates back up, that’s going to create a surge of pent-up demand. Well, yes, there may be surges in certain categories, as I said earlier, for sustainable growth, there may be some portion of the middle market that will not return because alternatives have been found or because of the psychology and behaviors that have been impacted by the pandemic and the intense communications, the intense media messages around this. Cases of coronavirus here I live in Europe. You can see this heat map that shows where the cases have been dominant and in certain countries, France, Spain, Italy, my all my respect, all the respect in the world to those in the audience from those countries, they have been very hard hit by this illness and especially with regards to deaths and the way the illness has impacted its capacity. Contiguous countries, smaller countries where the illness haven’t hasn’t impacted it as deeply.

    These countries, these destinations may have a story to weave about their comparative safety and comfort. The question is to borrow a theme from an old movie, if you build it, they will come. If you clean it, will they come if you create deep cleaning protocols and convey narrative and messages and use symbols to communicate that your place is clean, that your clinic is at the state of the art for standards of cleanliness? I know that there are a number of organizations that are offering these standards now. For example, Temos is offering an industry leading set of standards around cleanliness in the post Covid period. We’ll see more of these emerge. Are they going to be enough? What it’s going to take is really testing and I have a demonstration here.

    Testing will become pivotal to how a destination conveys its safety, certain types of testing. They have already gotten into some trouble in that they have proven not to be as reliable as had been hoped and expected. How these factors testing perceived cleanliness, access, how these are navigated by destinations and providers is represented or alluded to in this type of relation, in this type of relationship? Acuity provider and destination for consumers at the low acuity end of the scale, the destination is far more important than for consumers at the high acuity end of the scale.

    My common joke about this is certainly not a joke, my common reference about this is that one would not go to Rochester, Minnesota, in the dead of winter for serious surgery. You would go to Mayo Clinic, which happens to be in Rochester, Minnesota, and in the dead of winter is a particularly challenging place. If you were going for a cosmetic, possibly a noninvasive treatment, you would want to go to a place that was far more appealing, far more aligned with your desired agenda for wealth, for health and wellness.

    So, going back to this segmentation model where I believe based on our research and experience and our conversations with providers and governments today seem to indicate that the vanity slash hedonism end of the market of the frequency and acuity market. We’ll come back very quickly. This demand for looking good has been pent up. I see a surge in demand for hair transplants, cosmetic procedures, weight loss procedures and certain other certain other procedures. In environments where the control upon visitation, the control upon inbound travelers is very strict. It will be very interesting to see how that mitigates or how that dilutes the rate of return to normal or the rate of growth of consumption in those marketplace areas. I’m thinking in particular of the garden in Seoul and the return of the cosmetic surgery markets there, the high acuity market, the demand for immediate exigence services certainly there and will be also among the earliest segments of the market to come back tentative. We’re going to have a tentative re-engagement by consumers.

    We’re going to see local travel before distant travel. We’re going to see first vanity and hedonism market segments come back. We’re going to see second, very high acuity market services come back in third and slowly will be the middle market and some portion of the middle market will not return. It has either moved on. It has developed new tolerance for whatever it was it would have sought its services for in the past, or it has reengaged with telehealth, telemedicine and novel ways of resolving its debt, consumer categories, demands for services. We’re going to see extraordinarily tentative attitudes among a vast majority of the consumer markets in the segmentations that Stackpole and associates have done of consumer markets. Over time, we used to see around 18, 12 to 20 percent of market being what we would refer to as fretful warriors, people who are always worrying and are fretful about every detail.

    We think that temporarily we may see 40 percent, 50 percent of the market being fretful warriors. How we address those individuals without being condescending or without dismissing their concerns is going to be very revealing and extraordinarily important. Another extremely important component to re engagement is will be telehealth solutions to the particular challenges that consumers are facing. The big, big issue is fear versus risk tolerance. How we segment our markets based on these characteristics will determine which destinations in which consumers will move ahead and frankly, at the expense of others, because many of the markets will open up very slowly.

    Questions & Answers

    QUESTION:  the US impose restrictions for traveling and for the medical and medical travel?

    Irving Stackpole Well, there’s the short answer is probably what restrictions are in place now that they are being lifted, there are still, as far as I know, significant controls in place.

    I’ve seen pictures of major airports in the United States that look like big empty halls, which is really they are without the without the people. And I expect to see some biometric monitoring, a key entry point. And who knows, I hate to say this because I don’t want to politicize it. Given the geopolitical tensions between the United States and many other potential source locations, I think that there will be some politicization of entry into the United States for any purpose, including health, tourism.

    László Puczkó That, I think is going to be a very political question, not a business question at the moment. I think it’s not just us and society, other countries as well. That’s also a health care related issue. Sadly, in many countries, it’s become a political issue as well. And the tool I really honestly, I don’t know. And I think its very early stage, especially given the uncertain situation in many cities. I think not just because of the college, also for the because of the I said events that we have seen the last couple of days.

    QUESTION:  Lazlo is the three X model based on facts and research.

    Irving Stackpole The question was so tough it locked him up. I can respond until he comes back. Yes, it’s based on empirical research associated with patient satisfaction and its correlates. There is good behavioral research behind the three US model. And to another question or another point that I heard, I read in the attendee question list and thank you for all these wonderful questions. The term sacrifice doesn’t refer to anything necessarily religious or spiritual. It has to do with what you have to give up getting the benefit. If I have to travel from my home in Lisbon to an obscure village in central Argentina to take advantage of goat yoga, I have to give up a lot to get that benefit so that usually that kind of cost is baked into what’s considered, quote unquote, price. Laszlo and others didn’t invent this, he’s leveraging it, I think, intelligently.

    He’s referring to that as a component of this mix that we need to look at in segmenting our consumer and customer data between our consumer and customer data.

    QUESTION:  How do you both speakers feel about the covid-19 free certifications?

    Irving Stackpole What a great question, first of all. Second of all, Pro Vida love Costa Rica and the certifications are symbols. Certain certifications come from organizations that have significant substance and heft behind them. Some certifications are nothing more than stickers that are applied to willing vendor windows or willing websites. If I know that, then risk averse consumers will research these certificates. And I think we’re going to see a growth in consumer understanding of and sophistication about certification credentialing. And we will see that consumers will be able to pull back the veil and see which certifications substantive and which ones are merely window dressing. That’s my view on certification.

    I think the symbols are important and I think the substance behind the symbols will become progressively more important as these markets open up and as consumers get better educated and better self-informed about what they mean.

    QUESTION:  Could you expand a bit more why Telehealth is in the low part of the engagement. My guess is that, on the contrary, due to travel restrictions, these types of services will grow fast and early.

    Irving Stackpole Yes, they already have grown fast and very early in systems in the United in the UK and the US have put a lot of heft. First of all, a lot of the barriers, historical barriers associated with telehealth, telemedicine were removed, diluted or perforated to allow providers and consumers to go online with each other and far more widely and at a significantly greater degree than ever before. And that Jeannie’s not going back in the bottle. Consumers like being able to talk to their provider on the phone to show them their booboos, get a prescription handled, or just say take an aspirin and call me in the morning to interact with their provider. That’s absolutely huge. And the evidence for this, it’s all over the place. The biggest one is that there’s been a positive explosion in the number of, quote unquote, telehealth platforms that are available for providers around. The early market entrants to that space were playing by a very complicated set of rules, governmentally imposed regulations and rules. And there’s risk here that those early market entrants will be eclipsed by leapfrogged by some of these new, faster, more agile market entrants. We will see significant additional growth in telehealth, in telemedicine, in their applications to consultation. The degree of number of the number or proportion of people who’ve got second surgical opinions, for example, used to be relatively modest and now that number is going to grow significantly. When I referenced, I put it at the bottom of the list, I wasn’t putting it at the bottom of the list. I was including it as an extraordinarily significant and important new dimension in these market dynamics.

    QUESTION:  Thank you. Will medical visa and Covid test become the new normal for medical travelers?

    Irving Stackpole OK, so the end of the question has to do with the markets returning and the markets will return. The question is how quickly and how quickly they return is dependent on the usual sort of market variables, also whether or not over the next few months in a particular destination location or the source location, if there are any resurgences of the virus. If there are upticks in cases in a destination location and there’s a requirement to reinstate lockdowns in that location or vice versa, that will immediately crimp or stem the flow of consumers in that pathway.

    Remember, the health tourism markets overall globally are heavily regionalized. And in that regionalization, which may be altered because of the coronavirus, which is very interesting question we haven’t delved into yet, maybe on the next webinar we will. In that regionalization, there will be expansion and contraction, expansion and contraction. And to the extent that the destination locations are able to implement biometric screening, testing on arrival, security around isolation for individuals who reflect any early symptoms, to the extent that they’re able to do that, they will protect that flow, that regional flow of consumers.

    To the first point in this person’s question, there are these suggestions of having immunity passports that have been labeled, which is a very interesting idea in Wuhan, where this particular virus emerged, the consumers, the individuals in Wuhan on their mobile phones have an app that’s either green, yellow or red. And if you’re green, you can go wherever you want to go. You can go into the grocery store, you can go into the Apple store, you can go into the office building. If it’s yellow or red, you cannot. We don’t live in that environment. Some people have suggested that on passports we’ll get a sticker that is good for a certain period of time. I just don’t know logistically how that would work. And other people have suggested other tools that could be used. There’s some very interesting technology emerging in this regard. Again, this isn’t a technology discussion. It’s really a market-based discussion.

    QUESTION:  Next one for you with the protest that is happening throughout the US cities. What do you think is the world’s perception of the US as a destination at this time? Do you think that the US will be able to overcome any negative perceptions? And how long do you think it will take for positive perceptions to happen?

    Irving Stackpole OK, this is a this is a very good question with regards to branding and this also goes back to the chart that I showed about the relationship between the acuity of the services that you’re seeking and the importance of the destination. If you’re looking to have a blip or a plastic gun and have your eye lit, whatever, you’re looking to have a simple cosmetic procedure done, you’re probably not going to go to the United States unless you’re extraordinarily wealthy. If you’re looking to have a very good third heart valve replacement and you’ve got other comorbidities, of course, you want to go to Mayo, you want to go to Stanford, you want to go to the mass general, you want to go to Emory, you want to go to a place where you feel safe and secure and where the complexity is met by the sophistication of the provider.

    In that case, Rochester, Minnesota. Stanford, California. Boston, Massachusetts. Atlanta, Georgia, they’re less important than the provider themselves. This disruption and welcome back, last hope doesn’t sound like we’ve made too much progress since you left and returned, this disruption in the US cities will we’ll remedy it, will it will be resolved. What the long-term impact of that will be is anybody’s guess. In terms of world class health care, the United States has its tertiary cautionary systems are among the best in the world. Its academic medical centers, the ones I just rattled off, are among the best in the world. There will always be demand to that extent how America’s image in the world is damaged or affected by these protests.

    QUESTION:  what do you mean when you say wellness? Tourism must be luxury? What kind of luxury are you talking about? And can you give an example?

    László Puczkó Well, it’s not a luxury, as we understand this case and the Christo’s and the golden embellishments need to be able to be in an intangible luxury or a necessary luxury. And not in the tangible components, in the intangible benefits of it, since free time has become a luxury even more so than ever since we didn’t have any free time, we had all the free time, if you wish. I didn’t actually give any free time now. Creativity is good for me and really makes me feel happier, makes me feel better, makes me look better. It really is going to be a luxury, not in the traditional sense that it has to be five stars. It has to be the butler service or whatever it is. It’s not that that’s gone. We still have markets. We still have Middle East markets. We still have the Southeast Asian markets. We still have Russian market, Russian speaking markets where the tangible components of a luxury still very, very important. Now we have a large section of the market and especially I think is going to be growing significantly who really appreciate and label some very basic activities as luxury. Just sitting on the beach and enjoying a sunset and having an alcoholic or not beverage in your hands and at the same time taking and enjoying given the rain in that beach, that’s going to be a luxury.

    I think we need to redefine luxury that has been going on for a while. That’s redefining the meaning of luxury, at least redefining it by segment and market. I believe the last couple of months really taught us that some very, very basic things can become luxury very soon, and then that’s a revelation to us and the markets will respond to that. Again, it’s not a mass market thing. Those who want wanted to become drunk on the beach still want to become drunk on the beach. They really will appreciate the small items. And this is when the well-being improving or services or any item or resource that that is local and contributes to your well-being will become as a luxury thing and guests will label it as luxury. We don’t necessarily need to do that. We do it.

    QUESTION:  On the topic of healthy food, we see a shift in consumer demand towards more food that strengthens the immune system and more potassium and higher vitamin C, good fagots and such things. Do you see health cuisine gaining more importance in the wellness spectrum?

    László Puczkó That’s a wonderful question. I think we can repeat that a couple of times and you know, when someone says healthy food, I start to laugh. Not because it’s not an important question is because the same item of food item has been labeled healthy or terribly unhealthy in the last 15 years back and forth, depending on which school you are following or which medical approach or cultural approach or whatever it is fashion you are following, I really don’t know. Obviously, there is a dietician understanding of healthy food should be like, it doesn’t necessarily mean that it is it is pleasurable at the same time.

    And when someone gives you kale juice for the fifth day running in the morning, you will question that. Is this really that important to be healthy because it’s disgusting or not? Because you may find that actually did love Kale. Just I don’t know. I don’t I don’t think this is that I’m not belittling your question. Just more like it’s very difficult to answer your question in the sense of healthy food, because people say that the Mediterranean diet is the one that we all should be pursuing. Some others say that that’s very nice, it makes you fat or it’s a risk that it can make you fat because you’re eating a lot of oils. I think it’s more like the measure and the measure of anything and the balance of everything.

    That’s more like what healthy diet really is. Again, some people don’t eat tomatoes because they grow at night and they take the negative energy of space. So what do I know? That can be hard, say I love it, some others say that it’s not healthy at all because spiritually it’s a dark food. I think by now, people have access to all sorts of wisdoms and ideas and menus and cards and all that. Service providers would need to think really twice, five times and 10 times what they labor is healthy and what kind of options they provide and what kind of allergies they are catering for, because that’s becoming a very complicated issue and even a risky issue, having allergies. Yes, health issue is really becoming some hot topic right now. What is healthy food that’s really off to your guests and probably to yourself to decide what on Wednesday morning will be it as healthy? Because it’s just such a difficult task. And I wouldn’t like to be a food and beverage director at the moment or even a chef, for that matter, because that’s that’s a very challenging job.

    QUESTION:  Can you share your views on travel for a community building, correcting personal health risk factors and apologize if I don’t say this correctly, private health care for disease reversal and or sustained while being.

    Irving Stackpole First of all, those are robust market segments. Those were robust market segments, pre covid. And I think once we go through this crucible, this period of disruption and modification of risk versus reward, we’re going to see consumers on the other side who are even more sensitive. And what Laszlo is saying about necessary luxury or luxurious necessity, it’s defined by the consumer and health and well-being in the face of a global pandemic, strikes one as being extraordinarily important. And on the other side of this particular period, I think we’ll see renewed interest in exactly these types of themes.

    László Puczkó. And not just that, it obviously is an ancient lifestyle approach and philosophy, and which includes the healing aspects of diet and everything. I think what’s important here the evidence is you can provide some backup evidence that this has been tested, not just clinically tested by time, the grandmothers and the uncles and the ancient citizens have been using certain things for certain benefits, for a certain reason and not talking about the mumbo-jumbo and the shamanistic very questionable approaches, which some of which also have reference here. But more like can you provide the necessary evidence that is first of all, it is safe. Second, it’s tested clinically, so certainly don’t have any kind of risk associated. I can personally benefit from it, which is to be collecting a large number of wellbeing or happiness all around the world from Sweden, Denmark and Japan and other Asian countries that are big countries. There are many countries do have the ICA guy and the various other approaches that some 20 something I collected recently. And there is a there is a reason for that. And there are some foundations and since you mentioned your radar, I would like to refer to this that often sold as a treatment and not a medical or a lifestyle approach. It’s a fancy spa beach. Does the idea of beach, the sesame oil and blah, blah, blah, and it’s lovely? And people take it because it’s exotic, it’s nothing to do with the parasite. And when you need to provide assistance, when I said storytelling, when I told you that you have to provide the journeys again, it’s not belittling your readers. It’s more like how you can introduce it, that there is evidence, there is a beginning. There is a medium, there is an end to it.

    It’s not it’s not a five-hour training program that you become an aggravating specialist if your doctor is being trained for years and practice and all that, and it has the spiritual component. When you talk about immune boosting treatment services, packages and opportunities, certainly, yes, that’s true. I think my personal answer is yes. How you are introducing it and how you are convinced and. Guest, as well as service providers, hosts that would provide you the space and facilities to actually deliver those treatments and services.

    That is the tricky issue here, because a national health administration may not approve the FDA. You may not approve or haven’t approved all those interventions and then it becomes a critical thing. You need to do your homework to understand how anything, even if it’s mentioned and if it is approved by generations of having a pandemic or certainly puts ancient things into a very different category, know the bats and the various other things are still safe or can we still trust those things? And also, don’t forget that we have so many mostly politically correct words, like people who make advantage of you trusting some promises. Was it politically correct? I think it probably will. Opportunists, I would say opportunists and who can sell you anything and everything that it would boost your immune system to prevent you from getting this. And the supplement business is probably the best business in the world at the moment or has been.

    To differentiate yourself so real, you are your urine. You do know what you’re talking about. You have the evidence, you have the protocols, you have the follow ups that people can pursue it. Even if they got home from your place, you have to provide that guest journey. Otherwise, it becomes like a little puzzle, not the picture you would need to provide. How it is going to be something that I can practice even when I get back home, is not just a one treatment, which I took five times during my stay and then onwards. Whatever. I need to go to your lovely, tangible luxury place to start to refer to the previous person’s question. I can’t necessarily do it in my home.

    Many thanks for participating in today’s webinar.


    Stackpole & Associates is a marketing, research & strategy consulting firm focused on healthcare and seniors’ services markets. Irving can be reached directly at istackpole@stackpoleassociates.com.

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