Surgeon and entrepreneur Dr. Devi Shetty has outlined his plan to make Grand Cayman the “capital of medical tourism for the western hemisphere” within the next seven years.

The man behind Health City Cayman Islands believes the hospital’s growth will accelerate with the construction of a new multi-million dollar cancer centre within the next 12 months.

He expects patients to come largely from the wider Americas region rather than the US, as first envisaged.

“The big thing that is going to happen for Cayman is not the American tourist. It is the medical tourist coming from other Caribbean and Central American countries,” he said.

Health City currently gets around 40% of its patients from overseas. In an interview with the Compass during a visit to Cayman last week, in which he spoke with government heads at a regional trade summit, Shetty said he hopes that can increase to 90%.

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He said the hospital was already offering surgeries at a considerably cheaper cost than US institutions, and he expects that to come down further as Health City handles more patients.

Dubbed the ‘Henry Ford of medicine’, the 66-year-old entrepreneur and philanthropist is founder and chairman of Narayana Health, a chain of 21 medical centres in India.

During his visit, he sat down with the Cayman Compass for a Q&A, to talk about plans for the hospital, the islands’ place in the global healthcare puzzle and why he still performs heart surgeries every day.

Compass: Five years on from the opening of Health City, how is it measuring up to the original hopes?

Dr. Shetty: It is much more than what we thought. It has far surpassed our imagination and, more than anything else, the kindness and goodwill from the local population is really rewarding.

In terms of making an impact on the local population it has gone very well.

How has the health tourism element gone?

What we have noticed is that the response from the Caribbean and Latin American countries has been extremely positive, not only in terms of patient flow, but in terms of acceptance of our doctors. Our doctors go there [to other islands] and examine their patients and help them out with their healthcare needs.

Essentially, we are becoming a pan-Caribbean operator rather than a Caymanian entity. We did not think this was going to be a big activity but it has been.

Has it turned out to be more of a regional market, rather than sourcing patients from the US?

We do a fair number of patients from the US and Canada but it is not a huge number. We are also very excited with the Caribbean region, mainly because of the proximity and relevance and long-term sustainability.

US healthcare will take some time. I think it takes some time for the US medical population and the tourism population to accept. These are not self-paying patients, they are all paid by some third party and they have their own way of directing patients to wherever they want.

Every two years, we look at our strategy and we realise that right now we should be concentrating predominantly on the Caribbean and Central America and not spending major resources in the US. There is no doubt the US is becoming more introverted.

Health City Cayman Islands
– photo: Taneos Ramsay

What else is planned to attract health tourists?

Becoming a full level healthcare provider will also make a difference. We have heart care, we do not yet have oncology. Generally, medical tourism is dependent on major interventions and cancer is one major reason why people travel from one country to the other. We realised that very late and started taking action. Hopefully, within a year we will have a very advanced oncology facility and that will make a big difference for the Caribbean, as well as the US population because oncology services in the US are very expensive.

Do you have the capacity to step up with demand?

Our greatest advantage is we envisaged huge growth from day one. That is the reason why, when the hospital project was planned, everyone thought we may buy an acre. We bought 60 acres of land because we believe this will become massive and go up to a huge number of beds. We have no geography or manpower limitations. One of the greatest problems which every hospital on the planet faces is skilled manpower. Back home, we have 18,000 people working in our organisation. About 15% of the heart surgery done in India is done by us. We do the largest number of kidney transplants, liver transplants, bone marrow transplants. We have over 9,000 top-class nurses working with us. We just buy them the air ticket and they are here.

How many heart surgeries do you do currently and how do you see that increasing in the next few years?

We can go up to any level. We can go up to a few thousand beds, no problem. We are used to managing big hospitals. Currently, we are doing 25 heart surgeries every month. In terms of surgical volumes, we could comfortably do four or five times what we currently do [in the existing facility].

Does the economic model of the hospital require multiple surgeries a day?

That is the foundation of building this institution. That is the only way you can improve quality and cut cost. Ultimately, surgery is all a numbers game. You keep on doing it, you get good at it. As the number increases, it becomes cheaper. (Health City estimates its heart surgeries cost around a quarter of similar procedures in the US.)

Is the Health City hospital self-sustaining?

We passed the break-even point some time ago. We have a good number of patients from Cayman itself but a fair number of patients from overseas (40%) and we believe the overseas market will grow significantly.

Does there need to be a mindset shift for the concept of health tourism to take hold in a bigger way?

It is nothing but economic realities. As long as they can afford to pay, they will get it done in their own town. The main reason people travel is affordability, the second reason is quality. We cannot say that quality of healthcare in the US is poor. It is good. If people will travel, it is for economic reasons.

What other things might happen for medical tourism to become a bigger industry?

The big thing that is going to happen for Cayman is not the American tourist. It is the medical tourist coming from other Caribbean and Central American countries. The main reason people travel is heart operations, cancer, this is a very major issue. The treatment lasts for months. It is not just the treatment costs, it is family staying in the US for months. Loss of wages, separation from family. [There] is a huge psychological trauma involved in the process. We believe Cayman will emerge as the medical tourism destination for central America and the Caribbean region.

We understand you still work as a surgeon. Is this correct?

I see about 60-80 patients and do at least one or two heart surgeries a day. I am a doctor and always want to remain a doctor. I love interacting with the patients, I love my operations. Everyone should do what their heart says. I can never be a good administrator. I am good in surgeries, I love surgeries. I am essentially an artist. I like to create things.

What else is planned for Health City?

Medical education and technology. We are building strong, very robust electronic medical records which we want to make available to hospitals in this region. One of the main reasons mistakes happen in healthcare is paper and pen. We have to replace that with digital tools. In 10 years, it will be dramatically different – 90% of the hospital beds will be critical care beds. Whatever we are doing in the ward or the room will be done at home online.

Where do you see the future for Cayman and health tourism?

Cayman will emerge as the capital of medical tourism for the entire western hemisphere within the next five to seven years time. It is a natural extension for Cayman. It is the ideal destination for skilled people to settle down. That is one extremely important reason. Not many islands offer the security, first world infrastructure and extremely supportive government. It is safe for doctors to bring up their families. These people have options. They can go anywhere in the world.

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  1. A Canadian friend told me something I did not know. Not only does Canada have socialized medicine, private medicine is illegal.
    So if you need a hip replacement you might have a 3 year wait in agony. If you pay your surgeon to operate on you he can lose his license.
    So here is a big market for non life threatening surgery.