Medical tourism: Sea, sun, sand and … surgery

Abstract

Medical tourism, where patients travel overseas for operations, has grown rapidly in the past decade, especially for cosmetic surgery. High costs and long waiting lists at home, new technology and skills in destination countries alongside reduced transport costs and Internet marketing have all played a role. Several Asian countries are dominant, but most countries have sought to enter the market. Conventional tourism has been a by-product of this growth, despite its tourist packaging, and overall benefits to the travel industry have been considerable. The rise of medical tourism emphasises the privatisation of health care, the growing dependence on technology, uneven access to health resources and the accelerated globalisation of both health care and tourism.

Introduction

It is a truism that tourism is supposed to be about relaxation, pleasure and an increase in well being and even health. Even with the rise in cultural tourism and notions of tourism also being a learning experience, such learning too is expected to be relaxing and quite different from classroom memories. Tourists need not necessarily be hedonists, but they anticipate a beneficial outcome. In the past decade the attempt to achieve better health while on holiday, through relaxation, exercise or visits to spas, has been taken to a new level with the emergence of a new and distinct niche in the tourist industry: medical tourism. This paper seeks to provide a first assessment of this emerging phenomenon.

Some of the earliest forms of tourism were directly aimed at increased health and well being: for example, the numerous spas that remain in many parts of Europe and elsewhere, which in some cases represented the effective start of local tourism, when ‘taking the waters’ became common by the 18th century. By the 19th century they were evident even in such remote colonies as the French Pacific territory of New Caledonia, while the emergence of hill stations virtually throughout the tropics further emphasised the apparent curative properties of tourism and recreation in appropriate, often distant, therapeutic places (Smyth, 2005). Somewhat later, recreation and tourism shifted seawards in developed countries, and extended from elites towards the working classes, and sea bathing became a healthy form of recreation (e.g. Gilbert, 1954). Other sports, such as golf, cycling, walking and mountaineering, similarly became part of the tourist experience and were supposedly pleasurable ways of combining tourism and well being. Even more recently tourists have travelled in search of yoga and meditation. The legacy of all this is the continued presence of ‘health tourism’ where people visit health spas, for example in Kyrgyztan (Schofield, 2004), with the primary purpose of beneficial health outcomes.

With the partial exception of some spas, none of this has involved actual medical treatment, but merely assumed incidental benefits in amenable, relaxing contexts. This paper is a preliminary attempt to examine a contemporary elaboration of this—the rise of ‘medical tourism’, where tourism is deliberately linked to direct medical intervention, and outcomes are expected to be substantial and long term. A distinct tourism niche has emerged, satisfying the needs of a growing number of people, mainly in developed countries, benefiting both themselves and a growing number of destinations, principally in developing countries.