there are a number of factors that hinders the full participation of Brazil in that segment. Despite having world-renowned professionals, last year the country received less than 50 thousand medical tourists, while other countries with a lower health infrastructure received hundreds of thousands. It is a difficult task to list all the complicating factors and impediments that contribute to this scenario, however, among the principals are:DefinitionThere is a lack of a defined strategy of the private sector, which is common to all hospitals, clinics and other providers of medical services. In this framework, each provider serves as they imagined being the best in the market. Having been isolated, they reduce the scope of its dissemination and consequently the prospects for success in other markets that are unaware of their existence or are simply not known. Acting together and with a well-defined strategy reduces the individual costs of the business and increases the chances for return on investment, especially for the so-called clusters of health.IndifferenceThere is notorious indifference of the public sector for the medical tourism activities within and outside the country. When such a thing takes place, the public sectors actions are ineffective, and often leave much to be desired, as they do not work together with the private sectors to take effect.Joint EffortThere is an evident need of concatenated and joint efforts between the public and private sectors. Although attempts occur, they are usually in isolated events without continuity or presentation of results for the segment. Despite the low transparency of actions, the results fall short of ideal for this whole industry.PoliticsDespite the good infrastructure of the country, some politicians are in charge of key areas like tourism and healthcare, and do not deal properly with travel in high seasons or other usual problems for big cities. Common situations in the world can turn into discouragement to tourists when they occur almost simultaneously; excessive violence in the main cities, chaotic traffic, poor transportation systems, lack of structure in the cities with which to receive those who speak other languages, among other obvious reasons.Country ImageA negative image of the country within the international media also presents a problem. Unfortunately, it seems that the world has more negative than positive information of Brazil. Upon their arrival to Brazil, many tourists are surprised and dazzled to find that we are a modern and well-developed country. Very little to nothing is done by the authorities to prevent excessive negative exposure or even try to improve the image of the country within the world.FocusHospitals are not focusing on areas in which they excel nor have a defined and established trademark (brand) used to attract everyone, everywhere. They imagine that selling an image of efficiency across all medical specialties, that they will be more attractive. It is great that a hospital holds excellence in many different specialties; however, there needs to be a clear identification of the areas that stand out and separates them from their competitors, by focusing for example on the rate of success in certain procedures.PublicityAccreditation systems, whether national or international are not being