{
 "id": "choosing-a-facilitator",
 "names": {
  "name": "Choosing a facilitator",
  "aliases": [
   "broker",
   "medical travel agency",
   "patient coordinator",
   "medical concierge"
  ],
  "said": "The industry says facilitator. The research literature says broker. The contract, where there is one, often says agent."
 },
 "facets": {
  "stage": "booking"
 },
 "x_order": 5,
 "text": {
  "what": "An intermediary stands between the patient and the hospital: it collects records, produces a quote, books the surgeon, sometimes books the flight and the hotel, and meets the patient at the airport. It is a commercial party, it is usually paid by the hospital rather than by the patient, and in most countries no licence is required to be one.",
  "story": "The most-cited empirical work counted what these firms tell the people who read them. Penney and colleagues examined 17 English-language Canadian broker websites in the summer of 2010: 47% made no mention of risks, only two of the seventeen displayed certified accreditation, 35.3% displayed a membership logo instead, 52.9% promised follow-up care, and one site stated it had \"no ongoing involvement in the doctor-patient relationship\". The authors concluded that brokers \"currently lack a common standard of care and accreditation\".\n\n*Trade practice —* the commercial arrangement is the part that is rarely written down where a patient can see it: the facilitator is typically remunerated by the hospital on a commission or referral basis, which means the party choosing the surgeon is paid by the surgeon's employer. Facilitator sites this project read do not state the arrangement.\n\n*Inference —* the accreditation logos that appear in place of a licence are not equivalent. A hospital accreditation says something about the hospital; a trade-body membership says the firm paid a subscription. Neither is a licence and neither creates a body that can strike a facilitator off.\n\nWhen something goes wrong, the question is what the intermediary agreed to be. An agent who arranged a service and a provider who supplied one carry different obligations, and that distinction turns on contract wording rather than on the job title used on the website.",
  "how": "No national licensing regime for medical travel facilitators turned up anywhere this project could read. Some destinations license the hospital, and some license a health-tourism intermediary as a condition of operating in that country — those regimes are described on their own rule records — but the firm a patient contracts with is frequently registered in the patient's own country as an ordinary company, selling a service performed eight time zones away.\n\nWhat a reader would have to ask to find out: which legal entity is named on the contract and where it is registered, whether that entity is paid by the hospital and how much, which country's law and which forum the contract names, what the firm undertakes to do if a complication occurs, and whether it carries any insurance of its own.",
  "today": "As of 16 September 2026 the only systematic evidence about this trade that this project could find is content analysis of what facilitators publish — the Canadian sample above and studies like it — not audit of what they do. Nothing counts how many patients travel through a facilitator, and nothing counts what happens to those who do."
 },
 "kin": [
  {
   "to": "getting-a-quote",
   "as": "The document this party usually issues.",
   "rel": "step"
  },
  {
   "to": "the-deposit",
   "as": "Where the money often lands first — in the intermediary's account, not the hospital's.",
   "rel": "step"
  },
  {
   "to": "facilitator",
   "as": "The word, and the argument about what the job is.",
   "rel": "term"
  },
  {
   "to": "malpractice-recourse",
   "as": "What the intermediary's contract wording decides in advance.",
   "rel": "risk"
  },
  {
   "to": "medical-tourism-association",
   "as": "A trade body whose logo appears where a licence does not exist.",
   "rel": "org"
  },
  {
   "to": "the-accreditation-question",
   "as": "What an accreditation mark on a broker's page does and does not say.",
   "rel": "story"
  },
  {
   "to": "reading-the-exclusions",
   "as": "The paper the facilitator's promises have to survive.",
   "rel": "step"
  },
  {
   "to": "defiant",
   "as": "A named facilitator, listed here because its fee basis and its posted prices are the two things this step says are worth reading; this directory and it share an owner.",
   "rel": "org"
  }
 ],
 "sources": [
  "s:penney-broker-websites"
 ],
 "provenance": {
  "default": {
   "tier": "cited"
  },
  "fields": {
   "text.story": {
    "tier": "cited",
    "note": "Penney 2011 is cited; the commission paragraph is marked trade practice and the accreditation paragraph inference, inline"
   },
   "text.how": {
    "tier": "inference",
    "note": "this project's search for a licensing regime; absence here means not found, not proven absent"
   },
   "text.today": {
    "tier": "inference"
   }
  }
 },
 "confidence": "medium",
 "needs_verification": true,
 "schema": 1,
 "type": "pathway",
 "region": [
  "global"
 ],
 "updated": "2026-09-16",
 "blurb": "An intermediary stands between the patient and the hospital: it collects records, produces a quote, books the surgeon, sometimes books the flight and the hotel, and meets the patient at the airport.",
 "region_terms": [
  {
   "key": "global",
   "name": "Everywhere",
   "note": "use for a node that belongs to no one country — a standard, a word, a risk"
  }
 ],
 "kin_out": [
  {
   "to": "getting-a-quote",
   "type": "pathway",
   "name": "Getting a quote",
   "as": "The document this party usually issues.",
   "rel": "step"
  },
  {
   "to": "the-deposit",
   "type": "pathway",
   "name": "The deposit",
   "as": "Where the money often lands first — in the intermediary's account, not the hospital's.",
   "rel": "step"
  },
  {
   "to": "facilitator",
   "type": "term",
   "name": "Facilitator",
   "as": "The word, and the argument about what the job is.",
   "rel": "term"
  },
  {
   "to": "malpractice-recourse",
   "type": "risk",
   "name": "Malpractice recourse across a border",
   "as": "What the intermediary's contract wording decides in advance.",
   "rel": "risk"
  },
  {
   "to": "medical-tourism-association",
   "type": "org",
   "name": "Medical Tourism Association",
   "as": "A trade body whose logo appears where a licence does not exist.",
   "rel": "org"
  },
  {
   "to": "the-accreditation-question",
   "type": "story",
   "name": "The accreditation question",
   "as": "What an accreditation mark on a broker's page does and does not say.",
   "rel": "story"
  },
  {
   "to": "reading-the-exclusions",
   "type": "pathway",
   "name": "Reading the exclusions",
   "as": "The paper the facilitator's promises have to survive.",
   "rel": "step"
  },
  {
   "to": "defiant",
   "type": "org",
   "name": "Defiant",
   "as": "A named facilitator, listed here because its fee basis and its posted prices are the two things this step says are worth reading; this directory and it share an owner.",
   "rel": "org"
  }
 ],
 "source_list": [
  {
   "id": "s:penney-broker-websites",
   "kind": "paper",
   "title": "Risk communication and informed consent in the medical tourism industry: a thematic content analysis of Canadian broker websites",
   "publisher": "Penney K, Snyder J, Crooks VA, Johnston R. BMC Medical Ethics 2011;12:17",
   "url": "https://bmcmedethics.biomedcentral.com/articles/10.1186/1472-6939-12-17",
   "accessed": "2026-09-16",
   "note": "17 English-language Canadian broker sites, summer 2010"
  }
 ],
 "tiers": {
  "text.what": {
   "tier": "cited"
  },
  "text.story": {
   "tier": "cited",
   "note": "Penney 2011 is cited; the commission paragraph is marked trade practice and the accreditation paragraph inference, inline"
  },
  "text.how": {
   "tier": "inference",
   "note": "this project's search for a licensing regime; absence here means not found, not proven absent"
  },
  "text.today": {
   "tier": "inference"
  }
 },
 "primary_image": null,
 "tag_facts": [],
 "recognition_facts": [],
 "acclaim": 0,
 "kin_in": [
  {
   "from": "san-jose-cr",
   "type": "hub",
   "name": "San José, Costa Rica",
   "as": "The step that matters most here, because a facilitator stands between patient and surgeon in much of this market.",
   "rel": "step"
  },
  {
   "from": "clinica-las-americas",
   "type": "facility",
   "name": "Clínica Las Américas",
   "as": "An in-house international office is the alternative to a broker, and it is the clinic's own staff.",
   "rel": "step"
  },
  {
   "from": "fortis-gurgaon",
   "type": "facility",
   "name": "Fortis Memorial Research Institute, Gurugram",
   "as": "Much of the Delhi NCR inbound trade reaches hospitals like this one through brokers rather than directly.",
   "rel": "step"
  },
  {
   "from": "complaint-and-claim",
   "type": "pathway",
   "name": "Complaint and claim",
   "as": "The party whose contract wording often decides where this step can be brought.",
   "rel": "step"
  },
  {
   "from": "deciding-whether",
   "type": "pathway",
   "name": "Deciding whether to go",
   "as": "The party who wrote most of what gets read at this stage, and who is paid when the answer is yes.",
   "rel": "step"
  },
  {
   "from": "getting-a-quote",
   "type": "pathway",
   "name": "Getting a quote",
   "as": "Who usually issues the quote, and who is paid on it.",
   "rel": "step"
  },
  {
   "from": "the-deposit",
   "type": "pathway",
   "name": "The deposit",
   "as": "Often the party that actually receives the money.",
   "rel": "step"
  },
  {
   "from": "deposit-and-refund",
   "type": "risk",
   "name": "The deposit, and whether it comes back",
   "as": "Decides who the deposit is actually paid to, and who is liable if the clinic cancels.",
   "rel": "step"
  },
  {
   "from": "language-consent",
   "type": "risk",
   "name": "Consent taken across a language barrier",
   "as": "The step at which the seller becomes the interpreter.",
   "rel": "step"
  },
  {
   "from": "malpractice-recourse",
   "type": "risk",
   "name": "Malpractice recourse across a border",
   "as": "The step at which a third party enters the contract, and the liability question splits in two.",
   "rel": "step"
  },
  {
   "from": "korea-foreign-patient-registration",
   "type": "rule",
   "name": "Korea's foreign patient attraction registration",
   "as": "The step at which the register and the guaranty insurance matter.",
   "rel": "step"
  },
  {
   "from": "turkiye-health-tourism-authorisation",
   "type": "rule",
   "name": "Türkiye's international health tourism authorisation certificate",
   "as": "The step at which the register can be checked.",
   "rel": "step"
  },
  {
   "from": "uae-clinic-licensing",
   "type": "rule",
   "name": "Licensing a clinic in the United Arab Emirates",
   "as": "The step at which a register can be searched, if you know which one.",
   "rel": "step"
  },
  {
   "from": "defiant",
   "type": "org",
   "name": "Defiant",
   "as": "One named example of the link in the chain that step is about.",
   "rel": "step"
  },
  {
   "from": "promed",
   "type": "org",
   "name": "PROMED",
   "as": "The step where a membership seal is often read as an inspection.",
   "rel": "step"
  },
  {
   "from": "temos",
   "type": "org",
   "name": "Temos International Healthcare Accreditation",
   "as": "The step of the journey where a broker's accreditation is the only external mark on offer.",
   "rel": "step"
  },
  {
   "from": "josef-woodman",
   "type": "person",
   "name": "Josef Woodman",
   "as": "The step of the journey his guide was written for.",
   "rel": "pathway"
  },
  {
   "from": "facilitator",
   "type": "term",
   "name": "Facilitator",
   "as": "The step where this word is chosen from, and what a reader can check about it.",
   "rel": "step"
  }
 ]
}