Foreign Patients and International Market

Learn The Clues to The Taboos In Cultural Differences

Global Cultural Differences
Valuable Reference For Health Care Specialists & For Business Professionals 

Are You Crossing Cultural Lines Unprepared?
Ignorance of those differences may lead to loss of major patient  revenues and accounts

  • Asia and the Pacific
  • Australia
  • Europe
  • Central and South America
  • United States and Canada
  • Middle East and Africa

Turkey Directory
For Arab Patients & Their Families


Hospital executives and clinics' administrators, are discovering the cold reality of losing foreign patients due to professional staff ignorance with cultural differences. Since the majority of hospital's foreign patients revenue come from repeat and referrals business, more hospitals are investing the time and money to educate their staff about cultural differences. The reality is that "Offended Patients" will neither return nor will they refer patients from their home countries to the offender hospital!

Typically, a hospital staff not educated about cultural differences is very likely to offend a foreign  patient or his/her family without being aware of such infraction. Clearly, if a certain staff's behavior is not corrected, it will be repeated toward other foreign patients.

Samples of cultural differences and gestures:

  • Arab Patients: A therapist should never drop bread on the floor or even worse step on a piece of bread in front of an Arab patient. 
  • Arab Patients: A therapist who crosses his/her legs, should avoid pointing the sole of his or her shoe to an Arab patient or members of his/her family..
  • Greek Patients: A therapist should not use the The "OK" sign in front of a Greek patient, because it is a signal of a body orifice. 
  • Netherlands Patients: A therapist who tap the center of his/her forehead while looking at a patient from Netherlands, is making a signal that the "Patient is Crazy". 
  • Spanish Patients: A female therapist, while sitting, should not cross her legs in front of a Spanish patient, because it is viewed as "un-feminine" in Spain to do so.
  • Turkish Patients: A therapist should never use the fig gesture in front of a Turkish patient, because it is considered very rude. This is done by clenching your hand into a fist and push your thumb between the first two fingers.
Since the foreign patient market is a multi-billion dollar industry, American hospitals have been reaping the benefits of attracting foreign patients. For example, Johns Hopkins last year's revenue from foreign patients was 200 million dollars and 49% of Hopkins foreign patients came from the Middle East. In fact, many USA hospitals have been generating considerable income from foreign patients. For example, Arab patients will pay large deposits toward their treatments: Tampa General Hospital: Regina Grisales, International Patient Coordinator, “I got a wire for $75,000 for a deposit toward a kidney transplant. The patient isn't even here".  Also, Payments from foreign patients are still free from limitations imposed on many American patients by managed care organizations. Moreover, foreign patients will pay for all services before leaving the hospital while HMO payment is made after 90 - 120 days from date of treatment. 

Also, USA export revenue to Arab countries, almost tripled, with an increase from 5.671 billion in 1988 to 13.6 billion in 1997. This is one of several lucrative world markets which are very attractive to executives (hospitals and companies) seeking to increase their international business. However, when crossing cultural lines, something's as simple as a greeting, may place a multi-million dollar account in jeopardy, or it may cause considerable loss of patients billing revenues.

Certainly, losses due to cultural ignorance are not acceptable. The best approach to protect your organization from facing such losses is immediate staff education about this sensitive area. 

Examples of Cultural Ignorance: Test Yourself and Your Employees


DMS is the leader in directories about international business and health. Please see:

DMS Web Sites & Directories




Doctors' Marketing Service
P.O. Box 748
Lake Forest
California 92609-0748