In Jamaica, a push to market island getaways — with a side of surgery

MONTEGO BAY, Jamaica — This beach town is better known for its marijuana than for its medical expertise.

But a few blocks from the ocean, a new medical center is nearing completion. Flanked by lush palm trees and decorated with a bright yellow grid, it could be confused for a resort — and that’s the point.

Jamaica, like other developing nations before it, is trying to boost its economy by wooing “medical tourists” to fly in for an inexpensive knee replacement or nose job. The private entrepreneurs opening the medical complex here are all in.

The twist: They don’t just want to attract American patients who need surgery. They also want to persuade American doctors to fly in to do those sinus repairs and arthroscopies — while enjoying a Caribbean vacation.

As an enticement, they plan to encourage the doctors to bring their families and offer them discounts at resorts tailored to their interests. The typical visiting doctor “would probably come and operate for a couple days and go play golf and hang out with his family for a couple days,” said Dr. Konrad Kirlew, a Stanford-trained radiologist who’s leading the plans for the medical complex, called GWest Centre.

Jamaica is among a handful of Caribbean nations that see a golden opportunity in a dysfunctional American health care system that’s left millions with high deductibles or no insurance at all. Caribbean governments figure they’ve got a built-in advantage, because their islands are much closer to the US than other would-be hubs for medical tourism, like Thailand and Singapore.

Here in Montego Bay, GWest is eying discounts, not yet finalized, in the range of 25 to 40 percent — meaning that a knee replacement that costs $50,000 before insurance in the US might cost somewhere in the ballpark of $35,000 here.

The Jamaican government believes such discounts can lure more than 100,0000 medical tourists to the island within the next decade, bringing in perhaps $600 million in revenue.

That’s a bold goal. It’s also quite a long shot.

A long history of hype

In 2008, the consulting firm Deloitte projected that, by 2017, about 16 million Americans would travel abroad annually for medical care. That market never materialized.

“This is a business sector where there’s a lot of marketing hype,” said Leigh Turner, a University of Minnesota bioethicist who has studied medical tourism.

There’s a long history of that hype in Jamaica.

“The country has tried repeatedly to float a trial balloon and then to attempt to have that wishful thinking be realized,” said Irving Stackpole, a Rhode Island-based consultant who specializes in international medical travel. “And it takes significantly more than that in order to make a medical destination successful.”

Jamaica’s problems are many: The country isn’t known as a leader in medical care. Its infrastructure isn’t built to handle an influx of aging patients; many businesses aren’t even wheelchair accessible. And entrepreneurs like Kirlew have to pay high duty fees to import some medical equipment.

Diane Edwards, president of Jamaica’s economic development agency, acknowledged Jamaica can do more to address accessibility. She said she and her team are drafting legislation to expand duty-free imports of medical equipment. She also wants to raise standards and certification requirements for medical facilities and personnel.

Then there’s the challenge of attracting US doctors to fly in for working vacations.

Other medical tourism ventures have tried this and failed; it’s a tough sell for doctors who are busy at home to regularly fly back and forth. It also leaves them at legal risk, because they are unlikely to be covered by their usual malpractice insurance when practicing for profit overseas.

Going after ‘the savers’ and ‘the stress busters’

None of that daunts Konrad Kirlew.

A trim man of 56 who could easily pass for two decades younger, Kirlew speaks thoughtfully and exudes competence. He did his medical training at Stanford and UCLA, and practiced in Florida for a few years before returning home to Jamaica.

He and four other partners invested in building GWest from the ground up. Their mission: to create a space where they could practice at the same standard as in the US, Kirlew said in an interview last month in the cramped office he’s temporarily sharing with his assistant.

He’s well-aware of the challenges in launching a successful tourism business. But he said the business can thrive by serving local Jamaican patients even if Americans don’t flock in. Indeed, on an afternoon last month, several dozen local patients tapped at their phones or murmured quietly with one another as they waited for appointments.

GWest isn’t ready to start marketing to international patients yet. The two spaces most key to bringing in medical tourists — a surgical suite and an eight-bed inpatient facility — won’t begin construction until August.

And GWest still needs to get international accreditation. And recruit American physicians.

Kirlew said he’s had preliminary conversations with about 10 interested American doctors. He sees a way to grow that network by reaching out to US doctors originally from Jamaica or with family there, who might welcome a trip to go home or see their relatives. He’d like to recruit them from multiple cities and geographic areas, so US patients flying to Jamaica for a procedure could see the same doctor back home for follow-up care.

In theory, that’s a promising approach, but “what I’ve yet to see is really good scientific data comparing the outcomes and risks and benefits of medical tourism versus conventional medical care,” said Dr. Joshua Jacobs, a past president of the American Academy of Orthopaedic Surgeons who practices at Rush University in Chicago.

To make the pitch to American patients, Kirlew and his team hired an Atlanta-based marketer, Karl Temple, with a background in corporate travel.

Temple, who plans social media pushes and webinars along with live events, has built profiles of seven types of patients who may be interested. Among them: “the savers,” focused on getting the best deal, and “the stress busters,” who like the idea of a relaxing recuperation post-surgery on Jamaica’s famed beaches.

Most patients are expected to pay in cash, since US insurers generally don’t offer coverage for overseas procedures (though a few have done test runs of the idea).

A ‘Jamaica dialysis holiday,’ with few takers so far

Intense marketing in the US will likely start next year. For now, one facility at GWest is getting started with an easier sell: marketing dialysis for international patients passing through Jamaica on cruises or staying at nearby resorts.

Such services can make a Caribbean vacation possible for patients with kidney disease. But the treatment isn’t the point of the vacation.

“We want Jamaica to be the country where you don’t have to hesitate” about visiting, said Dainty Powell, a 39-year-old dialysis nurse and owner of GWest’s dialysis center. She spent most of her career working in London before returning home to Jamaica two years ago to start the business with her partner.

To cater to those tourists, Powell runs her clinic not unlike a spa.

Just about everything in the space is lime green, Powell’s favorite color, other than the six black plush chairs lined up beside six bulky dialysis machines. In the lobby, leaflets emblazoned with images of an orange sunset and crystal-clear turquoise water invite patients to splurge on a “Jamaica dialysis holiday.”

Powell sends drivers to shuttle tourists to the center, and allows them to schedule early-morning and late-night dialysis sessions so as not to interfere with a day of sightseeing. And she sends nurses to bring them Jamaican patties, a savory pastry that’s a local favorite.

She also charges international patients approximately $250 per session, about two and a half times more than locals. (She says she’s able to keep the cost down for Jamaican patients because they reuse the same filter on subsequent visits.)

But the empty chairs on a recent afternoon underscore how challenging it may be to build a thriving business. No patients had come in that day and none were scheduled. Since December, just about a dozen international patients have gotten dialysis treatment. None of them used insurance to pay.