For many German hospitals, treating foreign patients is a way to generate "extra-budgetary revenue." In recent years, however, the number of foreign patients has not been constant; looking back over the past decade, it has in fact declined. Besides political influences, this is also due to a lack of strategic concepts within the clinics. If Germany wishes to re-establish itself over the long term, and successfully, in the treatment of foreign patients, the treatment of international patients must be made a matter for top management.
Setting up international offices and hiring multilingual staff in German hospitals is an important first step. It must also be ensured that SOPs are established to guarantee smooth processes, and that workflows are linked to the right interfaces within the institution.
Strategy First
On its own, however, this is not enough. Rather, a concept must be established at the strategic level around which operational processes are oriented. Knowledgeable staff and external consultants should be involved in developing this strategy. Clinics must have a precise vision of their goals: How many foreign patients can we care for given our capacity? Which specialties are particularly attractive? Which non-medical services do we want to offer?
These and many other important questions must be resolved. So that the product of this work does not ultimately collide with the clinic's other objectives, management must accompany the process. For it is later also management's task to provide the budget needed to achieve these goals.
The overarching strategy must also cover marketing and market development. In 2013, 81.1% of hospitals in Germany used patient facilitators to acquire foreign patients. There is nothing fundamentally wrong with this, but hospitals thereby enter into a dependency that does not allow, or at least makes it riskier, to invest in the care of foreign patients.
Marketing
A marketing and business development mix is advisable. A combination of web-based methods, trade-fair appearances and personal outreach ensures that the hospital is not exclusively reliant on patient agencies.
Once a very popular instrument for market development, trade-fair appearances have been questioned by many, at the latest since the Covid-19 pandemic. Their effectiveness has indeed diminished compared with the past. But if you select the right fairs and events and combine them with self-initiated events at home, you can forge contacts that, in my own experience, last for decades.
Investments must be made for these measures, and sufficient staff must be available. Often it is precisely the staff who are actually supposed to handle inquiries at home who are represented at these events. This is another reason why the provision of appropriate resources by management is required.
Working with Patient Agencies
Cooperation with patient agencies is important and rightly holds a high status. However, care must be taken to ensure that these collaborations are lawful and constructive. What is often problematic here is the picture that emerges in the lobbies and waiting rooms of the clinics. When cooperating with several patient agencies, a hospital lobby often feels more like a bazaar than a clinic.
Here I see the clinics as duty-bound to vet facilitators before contracting them and to create clear rules for cooperation. This serves, on the one hand, to ensure qualified translation, but also to uphold certain house rules. Clear house rules must be established so that the treatment of foreign patients does not collide with the treatment of domestic patients.
Certain rules must also be communicated to the foreign patients. Many domestic patients feel disturbed by the large number of international patients. This is due partly to certain cultural differences, but also to the feeling that foreign self-payers are given preference.
At this point, an exchange must take place between the clinic and patients from the region. The hospital's willingness to engage in dialogue must be communicated openly; one can talk about the reasons, mechanisms and benefits of medical tourism and convey that domestic patients benefit from it.
Conclusion
In addition to the oversight functions of a hospital's governing bodies, the strategic elements of corporate management come into play. It is not enough to offload this work onto a dedicated department. That department must exist and also do a large part of the work, but certain functions can only be performed by management. Running a hospital is certainly no easy undertaking, but the treatment of international patients should also be given the necessary attention in order to avoid conflicts and to ensure the best possible treatment outcomes as well as a scandal-free operation.
