Looking at the Future of Medical Tourism in Asia

Introduction

Medical or health tourism involves a trip to a foreign country with the primary purpose of seeking medical treatment. The patient may undergo a medical, dental, holistic improvement or cosmetic procedure, and the trip typically involves some level of sightseeing or entertainment activities in addition to the ‘treatment’.

On one hand, we are witnessing escalating healthcare costs and long waiting times for medical procedures in Western Countries (Japan, Australian subcontinent, US, Canada and Western Europe). Concomitantly, with the increasing availability of healthcare resources in non-Western countries, more and more Westerners are availing of this global phenomenon called ‘medical tourism’. Rising insurance costs, population growth, and urbanization in Western countries on one hand, and cheaper and less cumbersome international travel, healthcare quality and accreditation, shorter waiting times for surgery, availability of highly trained health professionals in non-Western countries on the other, have catapulted medical tourism to an exploding industry (NASDAQ OMX's News Release, 2019; Medhekar et al., 2018; MT1, 2016).

The market is expected to grow at a compounded annual growth rate (CAGR) of almost 16% during the 2019-2025 period, with the US and UK topping the list of medical tourists, while Asian (and to some extent, Latin American) countries appear to be the most popular medical tourism destinations (Bookman and Bookman, 2007; Crooks et al., 2017). Dentistry, cardiovascular procedures, oncology, and in-vitro fertilization (IVF) procedures seem to be the most sought-after procedures for medical tourists (NASDAQ OMX's News Release, 2019). Globally, more than 21million people travelled abroad to seek medical care of which, 1.4million were Americans, who travelled for cancer, heart-by-pass, dental crowns, cosmetic surgery and other short-stay outpatient procedures. Thailand itself hosted 2.4million medical tourists in 2016 (Medhekar et al. 2018). Similarly, experts predict that the Indian medical tourism market will be worth US$ 8 billion by 2020 (Thornton, 2015), and expect it to grow by 30 per cent annually (Naik & Lal, 2013). Thus, there is no question that medical tourism has flourished considerably over the recent years and keeps changing at a rapid pace. Consequently, this topic calls for further research.

It is no surprise, that there exits considerable exploration in this field. A quick search of literature in Google Scholar featuring the words ‘medical tourism’ in the title yielded almost 13000 results (post-2015). The literature can be categorized under the following broad topics: antecedents (demand-oriented or ‘push’ factors), destination- or supply-oriented (pull factors), scale development, industry trends, consequences-based, negative impacts, challenges and future of medical tourism (A de la Hoz-Correa et al., 2018; Fetscherin & Stephano, 2016; Han & Hyun, 2015; Lee & Fernando, 2015; Suess et al., 2018; Wongkit & McKercher, 2016).

However, extant research on medical tourism mostly ignores the importance of the individual’s threat perception and coping mechanisms, and the roles that these perceptions play in influencing the individual’s decision whether to seek treatment in the first place. In other words, extant studies leave a gaping hole in medical tourism research. What is also lacking, according to the author’s finding, is a concerted effort to build a robust model that also takes into consideration the supply-oriented or ‘pull’ factors of medical tourism.

This is where the author feels that the Protection Motivation Theory (PMT) can play an important role in helping us better understand if and why patients seek medical treatment, because PMT addresses both the threat perception as well as coping mechanism of the patient into account. To the best of the author’s knowledge few, if any, research has looked at medical tourism from the PMT lens. A search on Google Scholar using the keywords ‘medical tourism’ and ‘protection motivation theory’ yielded only one result (Seow et al., 2018). Therefore, the current analysis will address a lacuna in extant research.

It is neither feasible nor necessary to assess all antecedents of medical tourism within the ambit of the current paper. Instead, the author analyzes how some of the most salient factors influence the individual’s threat assessment from the ailment i.e. price differential, reputation of location, facility and physician and referral/word of mouth about destination. Through an extensive review of extant literature, the author presents five propositions involving key elements of the theoretical framework and makes insightful projections about the future of this flourishing industry.