Traveling cross-border for fertility treatment has been an increasing activity and although COVID-19 has caused a number of restrictions and limitations, patients are crossing borders to get their fertility treatment. Studies show that the prime reasons for cross-border fertility treatment is the lack of availability of these locally, due to either legal restrictions or quality issues. Price has been an indicator, although not the primary, however, it appears that in the COVID-19 era, patients are now willing to pay more and stay locally, if they have such an option.
Greece has been a fertility destination for several years, however, recently, it has managed to attract more patients and from being in the 5th or 6th place in the list of European destinations for cross-border fertility travel, Greece has climbed in the 3rd place, ‘threatening’ to overtake the Czech Republic and figure out in the 2nd place after Spain.
Greece As A Fertility Destination
There are a number of reasons for this development. Firstly, Greece has a long history of medical expertise and investment into medical schools. Not only that, Greek doctors for decades perceived their postgraduate education and training in the most developed medical school environments (such as the UK and the US) as an essential part of their career development. This has created a large pool of high-qualified doctors who offer their services in Greece. Secondly, the long period of the economic crisis in Greece that started in 2009, created an extrovert behaviour in Greek businesses, including fertility clinics, who saw this as an essential need to attract more international patients.
Thirdly, Greece is also a well-known tourist destination and as such, it offers additional reasons for patients to visit the country, not only for their treatment but also for the whole trip experience. However, it is a fact that fertility clinics who take advantage of this benefit are those who are located close to international airport that have traffic throughout the year, as several airports in tourist locations are only seasonal. As a result of being a tourist destination, Greece enjoys a multi-lingual workforce that offers their services in international patient care. Most fertility clinics possess employees who speak several languages. In addition, the vast majority of fertility doctors speak foreign languages as they were trained abroad, mostly English but also several of them speak French or Italian.
Fourthly, Greece enjoys favourable fertility legislation. It allows for egg donation treatment and guarantees strict anonymity of donors, it allows for IVF treatment to single women while it is one of very few European countries in which surrogacy is legal and regulated. Finally, Greece also offers very competitive prices in IVF, mainly due to the low cost associated with the long period of austerity measures.
Unique Characteristics Of Greek Fertility Clinics
For the above-mentioned reasons, Greece increasingly portraits an attractive fertility destination for cross-border patients and it is growing in awareness and patient numbers. There are however a few unique characteristics of Greek fertility clinics, that hinder its rapid expansion, despite the existing positive elements.
Greek fertility clinics, in their majority, lack corporate structure. They are small clinics that are centered around one fertility doctor. This has an effect on their ability to invest in infrastructural development, particularly in expensive laboratory equipment, but also to successfully invest in international marketing to develop their brand name. This specific corporate attitude was the main element behind the success of Spanish clinics that made them number one in Europe. Unless Greece develops such an attitude, it would be very difficult for Greek clinics to be recognized internationally. In addition, as 70% of success in IVF is due to the quality of laboratories and advanced technological equipment, small clinics cannot afford the high-cost investment for such a development and thus, lack in success rates.
Although the majority of Greek clinics are very small and centered around a doctor, as explained above, there are a small number of bigger fertility clinics, particularly inside big hospital groups. Those clinics demonstrate another unique Greek characteristic. Instead of a corporate structure, they portrait a cooperative structure of a number of fertility doctors, who act individually on their own accord and bring their fertility cases to the clinic. Doctors are responsible to charge fees to their patients and they pay the clinic for every medical act they do according to an internal price list. This creates a phenomenon that different doctors advertise or quote different prices to patients at the same fertility clinic. The ‘cooperative’ structure has also important business implications as doctors have no interest in promoting a clinic brand to attract cross-border international patients as they cannot guarantee that they would have a personal gain from such an activity. To the contrary, they prefer to do their own personal branding exercises to attract personal gain. As a result, there are several different brands promoted in the exact same fertility clinic, under different doctor names.
Developing A Corporate Structure
As explained, Greece is a developing fertility destination, however, to intensify this development and try to compete with the leader in the sector, Spain, it has to adopt more and more a ‘corporate’ structure. There is a need for the development of larger corporate entities, where business management would be different from medical management and doctors would be employees of clinics, rather than independent contractors. In this way, Greek fertility clinics would be able to attract funding for investment that would lead to further development, both in medical infrastructure and in international branding and marketing.
This is already happening in other medical fields in Greece, where big funds are investing in the development of private hospitals, however, until now, it has not impacted the fertility sector. Such a development would be essential in reaping the benefits of the positive elements that are present in the Greek fertility sector and further develop Greece as an attractive fertility destination.
Greece is an attractive fertility destination has improved its international position significantly. It has all the potential to further expand and make a huge international impact if the sector straightens some of the long-existing problems mentioned above.
By Dimitris Kavakas, CEO Redia Ltd.