In November 2023, Dimple Madaan, a 26-year-old HR professional based in Toronto, flew down to her hometown in Delhi after over a year and a half of living abroad.
The reason for her visit? Homesickness? Yes. Root Canal Treatment (RCT)? YES.
Madaan had gotten an RCT done a few years ago which had started decaying recently with the cap breaking off. A physician she saw in Canada told her that replacing it would cost around CAD 2,500.
But she only had dental coverage of CAD 1,000 under the medical benefits offered by her workplace. So Madaan decided to come back home for the dental treatment.
“I paid CAD 1,500 for the whole round trip, managed to have a trip back home, and got my treatment done.”Dimple Madaan
Madaan, however, is not the only non-resident Indian who decided to opt for medical treatment back home. During the holiday season, a lot of NRIs travel to India – many have medical procedures as a part of their travel itinerary.
According to data from the Ministry of External Affairs, the number of travellers coming to India for "medical purposes" jumped up from 1,39,447 in 2014 to 4,95,056 in 2017.
Doctors tell FIT that NRIs and overseas Indians travelling to India for the same reason have also increased over time.
Why NRIs Travel to India for Medical Procedures
While in Madaan’s case, travelling home was the cheaper option, there are several other reasons why overseas Indians opt for this.
Dr Anant Bhan, a public health policy expert, tells FIT:
“One factor is speed, definitely. In a nationalised healthcare system, like in the UK or Canada, there’s the requirement to go through a general physician and then get a referral, etc.”
Dr Sumit Ray, a critical care specialist and the medical director of a not-for-profit hospital in Delhi, agrees with Dr Bhan. He adds that for the UK's National Health Service (NHS), the queues for non-emergency tests and dental procedures are pretty long.
For some procedures, these waiting periods can be excruciatingly long. For instance, according to a 2020 research published in the Official Publication of The College of Family Physicians of Canada:
"The national median wait time for all referrals (including urgent) was 78 days, or 11 weeks, with 1 in 4 patients having to wait 175 days (25 weeks) or longer for their specialist appointment. One in 10 referred patients had no record of seeing the specialist within 1 year."
On the other hand, in the UK, the average waiting period to start non-urgent consultant-led treatment is 18 weeks or 4.5 months.
However, a Bloomberg report in July 2023 pointed that 99 percent of the constituencies of the NHS were failing to offer diagnostic tests within the maximum waiting time of six weeks, 98 percent constituencies were failing to start referred treatment within the one year waiting period, and 95 percent were failing to start cancer treatment within the maximum waiting period of 31 days.
Ananya* (name changed on request), a 27-year-old from Delhi, has been at the suffering end of these long queues. She went to Canada as a student in 2021. Barely six months into her stay there, in February 2022, she noticed some boils on her private parts.
When they didn’t disappear in a couple days, she went to the emergency room. Ananya tells FIT:
“The cost of emergency wards is CAD 1,000 and after waiting for seven hours, all I got was a consultation with a general physician. She gave me generic painkillers. After multiple requests, I was given a referral to a specialist. Even then, I had to wait for many months for my appointment with the gynaecologist.”
But by the time she could go for her appointment, her health worsened and Ananya was forced to travel to India. Her diagnosis was also delayed to the point that treatment was not possible through medication and she had to undergo two surgeries.
Madaan sympathises with what Ananya had to face. Back in 2022, she too once had to sit in the Emergency Room for over four hours with a raging fever before she could get a consultation with a doctor.
“If you aren’t literally dying, it’s not an emergency. Even walk-in clinics have very long waiting times. It’s only better if you have a family doctor,” Madaan sighs.
The story in the US is quite similar. Pragya* (name changed on request), a 29-year-old based in Austin, tells FIT that for the past two years that she's been living in the US, she's been extremely cautious to the extent that she's (fortunately) not had to visit a healthcare facility yet.
"I had to take my friend to the ER once and getting to the doctor took 10-12 hours. Waiting periods for any procedure or general appointments are months long, and health issues aren't something you can anticipate. If I'm sick right now, I'll just call my doctor in India and seek help. I feel doctors and medication, both, are much more accessible in India. Here, for everything you have to go through a hospital."Pragya
But what also brings the NRIs to India for medical tourism is the cost in many countries. For instance, says Dr Bhan, many dental procedures in countries like the US and Canada are not covered by insurance, and are extremely expensive. He goes on to say,
“In India, if you have the ability to pay, access to healthcare is fairly easy. You can walk into a specialist’s clinic and schedule all of your appointments at the time that works for you. You could schedule all of it during your annual trip home. There’s also some level of trust because you are familiar with the system here and can rely on word of mouth about the doctors.”
Annual Health Check-Ups & Dental Treatments: The Popular Procedures
In fact, a 2008 research paper on the Indian diaspora said, "For overseas Indians, coming to India for medical treatment makes eminent sense in view of long waiting lists in developed countries, uncertain medical expertise in developing countries, and the vast experience of Indian doctors as well as common cultural ethos."
And what are the popular procedures that NRIs get done in India? Dr Ray says that usually procedures that are considered non-emergency (and so have long waiting queues) are the ones that people opt for.
These include dental treatments, diagnostic tests like MRIs and CT scans, minor surgeries like laparoscopic procedures, gall bladder operations, or hernia treatments, etc.
Not just these procedures, overseas Indians, like Pragya, also make it a point to get their annual check-ups done when they visit India.
"I would think it’s easier to do your diagnostic tests in India. In that case, if you go to a clinic here and they ask you to run any tests (and they do often ask you to take many unnecessary tests), you can just tell them that these are the reports you got some 2-3 months back for these procedures."
But, Pragya adds, "I personally get my complete body check-up done, or at least the diagnostic tests, when I visit India because I don’t go to any clinic here at all. So, just on a precautionary basis."
Does This Increase the Burden on India’s Public Healthcare System?
Another question that arises when medical tourism increases is whether this puts a burden on India’s public healthcare systems? Theoretically, it should. But, Dr Bhan tells FIT that practically that’s not the case.
He adds that most overseas Indians prefer to go to private establishments whereas it’s the government hospitals that deal with public health services.
“The thing is also that a lot of primary or secondary GMCs might not have departments like a dental clinic. And tertiary hospitals like AIIMS have long queues. So, only people who might know someone working there would probably opt for it during a short trip home.”Dr Anant Bhan
(At The Quint, we question everything. Play an active role in shaping our journalism by becoming a member today.)