Elsevier

Tourism Management Perspectives

Volume 25, January 2018, Pages 29-40
Tourism Management Perspectives

Sand, surgery and stakeholders: A multi-stakeholder involvement model of domestic medical tourism for Australia’s Sunshine Coast

https://doi.org/10.1016/j.tmp.2017.11.002Get rights and content

Highlights

  • Research is conducted through the lens of domestic medical tourism.

  • Stakeholder insights are collected from residents and public sector organisations.

  • Findings suggest that while domestic medical tourism promises much, stakeholder management is key to its conception in emerging destinations.

  • A multi-stakeholder involvement model (MSIM) for domestic medical tourism is proposed.

Abstract

This paper explores the developments of domestic medical tourism for Australia's Sunshine Coast. Most studies have characterised medical tourism to be an outbound phenomenon, where affluent tourists select mostly developing destinations for elective surgeries due to cost, quality or faster access to treatments. However, studies concerned with domestic medical tourism remain highly implicit. Employing a case study perspective of the Sunshine Coast, Australia, this research explored the potential for domestic medical tourism to be conceived. This research found that while most stakeholders considered the region to be well-suited for medical tourism, three issues presented some barriers to its development. The three issues were residents' access to hospital facilities, lack of cooperation and hostile attitudes between practitioners. This research shows the contested battlegrounds of domestic medical tourism initiatives, and how the development of a multi-stakeholder involvement model of medical tourism can bring desired outcomes to fruition.

Introduction

The understanding of domestic medical tourism remains an under-researched area. While Hudson and Li (2012) had investigated domestic medical tourism from within an American perspective, they asserted that there needs to be further studies of this phenomena elsewhere. The paucity of research related to domestic medical tourism may be attributed to the widely accepted notion that medical tourists are primarily travelling across international borders (Connell, 2013, Reddy et al., 2010, Smith et al., 2011). However, a broad definition of medical tourism reflects the primary purpose of travel for elective surgery (Wang, 2012, Wongkit and McKercher, 2013). As such, the value of incorporating both domestic and international medical tourism trends will provide rich insights to a fast evolving and lucrative tourism sector. Additionally, there may be wide variations in terms of quality and types of medical services across different regions within a country, as articulated by Gan and Frederick (2011). While official medical tourism statistics may not exist, Youngman (2015) estimated that there are 6 million international medical tourists, and another 4 million domestic medical tourists globally as at 2015. However, Australia is a relatively small player in this market, with the majority of medical tourism practiced in Asia-Pacific, Central Europe and South America (Ganguly and Ebrahim, 2017, Junio et al., 2017, Sandberg, 2017). Nonetheless, some media reports have emerged to show that more than 10,000 inbound medical tourists visited Australia in 2013 (West, 2014). These visitors were estimated to have contributed almost A$26 million to the nation on the back of direct and indirect economic initiatives (Medew, 2014). The literature reveals that data is somewhat available from an international mobility perspective, though domestic medical tourism remains under-reported. Such a gap in knowledge justifies the need for this research to be undertaken to better conceptualise the development of domestic medical tourism.

Section snippets

Literature review

To help frame this research, the review of the literature will examine the typology of medical tourists, motivations for medical tourism, destinations chosen and the concerns with these developments. Synthesising the literature will provide an overall state of medical tourism scholarly work, and highlight the existing gaps surrounding domestic medical tourism. The literature reviewed show that much of the knowledge is embedded from a demand-side perspective, which triggers the need to

Study area

The Sunshine Coast is a popular domestic tourism destination region within Australia (Pike & Mason, 2011). Comprising of a hinterland and more than 100 km of sandy beaches, the Sunshine Coast region has a large proportion of its visitors from within Queensland, as it is an accessible one-hour drive from the state capital, Brisbane (Sharma & Dyer, 2009). Tourism is the main industry sector for the Sunshine Coast, and the region is visited by its primary target markets such as families and

Justification for a domestic medical tourism perspective

This section will discuss the justifications for the research to adopt a domestic tourism perspective. First, as earlier discussed, cost and quality are key determinants for medical tourism demand. In this regard, while Australia is perceived to have high quality healthcare, Deloitte Australia (2011) found that medical tourism is not as price-competitive vis-à-vis other destinations such as Thailand, Singapore or Malaysia. This indicates that there is likely to be some demand, though somewhat

Methodology

This research employed a case study approach to obtain insights that aid in the conceptualisation of a multi-stakeholder involvement model (MSIM) of domestic medical tourism. Broadly, a case study is essentially a unit of analysis (Stake, 1978). As such, a case may be selected from the lens of investigating individuals, communities, organisations or a destination region (Baxter & Jack, 2008). However, Flyvbjerg (2006) cautioned against using case studies to generalise findings. Instead, the

Results

The results section has been divided to assist with discussing the data in a progressive manner to help address the research aims and objectives. First, participant awareness of medical tourism is discussed. Next, the role of domestic medical tourism as a desirable form of tourism development for the Sunshine Coast is explored. Subsequently, the challenges of developing domestic medical tourism practices for the Sunshine Coast are examined. Following this, recommendations as to how domestic

Discussion and contributions

Overall, this research sought to investigate how domestic medical tourism may be developed from an exploratory investigation of the Sunshine Coast. Positioning the Sunshine Coast from a domestic tourism perspective is warranted given the lack of price-competitiveness vis-à-vis other medical tourism destinations around the world. The research contributes to a more nuanced understanding as to how destinations can become medical tourism destinations by considering a range of key issues that needs

Conclusion, limitations and future research

In conclusion, medical tourism is experiencing significant growth in many parts of the world, and appears to be an appropriate fit should some regions such as the Sunshine Coast decide to pursue this market as a growth strategy. However, as this research has shown, the medical tourism perspective should adopt a more inclusive nature to facilitate developments from both a domestic and international perspective. Yet, amidst the potential for domestic medical tourism, it is essential for all

Acknowledgements

This research was undertaken with the support of a A$1,000 university engagement quick start grant.

Aaron Tham is Lecturer in Tourism, Leisure and Events Management within the School of Business at the University of the Sunshine Coast. Aaron's research areas include social media and its impact towards tourism consumer behaviour. His other research interests are in the areas of medical tourism, disruptive innovation and culture and heritage branding.

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    Aaron Tham is Lecturer in Tourism, Leisure and Events Management within the School of Business at the University of the Sunshine Coast. Aaron's research areas include social media and its impact towards tourism consumer behaviour. His other research interests are in the areas of medical tourism, disruptive innovation and culture and heritage branding.

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