We all know that medical tourists are traveling for healthcare needs only to save themselves money, right? If one follows most of the popular media, it would be easy to conclude that this is the reason a patient may travel internationally. Due to the documented savings in medical costs of up to 80 percent less than costs of some procedures in the United States, travel to save money has frequently been advanced as the sole motivation of the tourist/patient.
However, is this an adequate answer for those marketing medical tourism destinations? Does this not suggest a representation of medical tourism as little more than a commodity; therefore, the least expensive reputable destinations are certain to dominate? Surely, other factors are in play as prospective patients have over 50 countries actively courting some portion of the fast-growing medical tourism market.
Another additional factor that would seem logical in destination selection for medical travel is the perceived quality of care available. It certainly makes intuitive sense that for something as crucial as medical treatment, the pursuit of quality may be a major factor in selecting an alternative destination to one’s hometown, but this line of thought has some difficulties to it. How is a prospective patient to judge quality? Most US doctors are as ignorant as the layperson in knowing about and understanding the level of services available at international sites, so they can be of little assistance. Unlike many purchases, there is not yet a significant, readily identifiable social media presence on the internet, such as Trip Advisor, where past patients may evaluate their experiences. It is challenging becoming knowledgeable about the relative levels of quality of care of multiple hospitals within one’s home city, let alone understanding the quality of care at medical facilities hundreds or thousands of miles away.
On this issue, destination marketing for leisure and medical travelers appear to share common ground; both types of travelers are often selecting a destination sight-unseen, so marketing messages may be especially important. Given this situation, what are the factors by which a traveler chooses an international location? The short answer is, in truth, we do not yet know, but research from leisure tourism may provide some models to help us investigate as well as cite some indicators by which we can compare medical tourists with leisure or business travelers.
This is not to say that research into leisure travelers has uncovered all the motivators that affect their destination decisions. The reasons behind why individuals travel has been a question pondered by psychology since the inception of the discipline. In fact, some of the first individuals to call themselves “psychologists” were interested in this aspect of human behavior. Destination marketers have pursued similar answers to this question to assist them in distinguishing their destination from the thousands of other destinations a leisure traveler might select for travel. Precise answers continue to elude both psychologists and marketers, but there have been discoveries in tourism motivation of the leisure traveler that may help us approach this question of medical tourist selection of their care destination.
Initial study into this question is being undertaken by some destinations. One city, Guadalajara, México, is actively pursuing some indications of medical tourist motivation through both their marketing efforts and academic research. Their model may be a useful one for other cities to consider.
Using a concept frequently applied to general tourism studies, the Guadalajara Convention & Visitors Bureau (CVB) is looking at what are called “push” and “pull” motives of its guests travelers. “Push” motives are those factors which encourage a person to consider travel somewhere. Rather than simply accepting the “common wisdom” that cost is the prime motivator for travel, Guadalajara is investigating additional motivations such as availability of treatment, cultural roots of the travelers, specialization of treatments, and other factors that may not have been considered yet. In these explorations, traveler demographics are important, and something recognized by nearly all medical destinations, but psychographic dimensions are also being explored by Guadalajara CVB.
These dimensions also apply to the “pull” motivations of travelers. In other words, once the decision to travel is made, how is a particular destination selected? The answer to this may be even more important to a destination’s marketing efforts; incorporating both rational and affective or emotional reasons. What are the traveler perceptions of not only the hospital facilities but of the general area in terms of safety, friendliness, competence, cultural familiarity, support, ease of travel, etc.? It is in the realm of “pull” motivations that the greatest unknowns may reside.
Perhaps even more important than answers to the “what” questions is to gain an understanding of the factors that explain “why” decisions in destination selection are made. Harvard marketing professor Gerald Zaltman has suggested that 95 percent of any purchase decision is concealed in affective factors. Zaltman advances the notion that quantitative marketing instruments, such as surveys and focus groups, may actually make “pull” motivations more difficult to detect, for responses are limited to the alternative answers offered by the researcher. While such techniques can help clarify demographics, a more comprehensive view and understanding can be obtained through individual in-depth interviews designed to get at the elusive emotions that drive consumer decisions.
His work is being confirmed in such far-reaching fields as neurobiology and anthropology, and the general tourism arena is beginning to take note of these findings. As recently as early July 2010, Travel Weekly – the weekly trade journal for tourism – featured an editorial by its editor-in-chief Arnie Weissmann, proposing that investigating the questions of “why” and the emotions underlying them, is the wave of the future for tourism marketing.
This is where Guadalajara has been remarkably progressive as its model uses the cutting edge applications, which have only recently emerged from the leading marketers in the world. In an approach that may be singular in the medical tourism efforts currently, the Guadalajara CVB is orchestrating efforts between Turismo Médico Jalisco and university researchers to facilitate interviews with former medical tourists who have visited there. Interviews are done using a technique recently developed at Harvard University, aimed at understanding the affective elements in consumer behavior. Supplemented by standard survey research, this promises to provide the most complete picture to date of why individuals have retrospectively chosen a city for medical treatment.
A major difference between the research of leisure travelers and medical tourists is the requirement for confidentiality issues that must first be addressed and potentially resolved in obtaining information in the case of patients. Both qualitative and quantitative research is comparatively easy with leisure travelers as hotel guests and airline manifests can identify the leisure traveler and his or her contact information. Guadalajara is addressing the difficult answer of obtaining patient information by forming a collaborative relationship between the city’s CVB and Turismo Médico Jalisco, an association comprising twelve of the city’s top-quality hospitals. To better understand why US travelers have selected Guadalajara for medical treatment, the member hospitals are cooperating by identifying those travelers and first contacting them to request their willingness to have their names and contact information released for purposes of this type of research. This added effort by the Guadalajara hospitals is exceptional and is directly aiding the Guadalajara CVB in its research, which in turn will provide both it and Turismo Médico Jalisco better insights and tools by which to market their services.
The information promises to aid the CVB in marketing Guadalajara to prospective medical tourists, and may offer a model for other destinations to use in determining reasons as to why medical travelers are coming to their location. The answers discovered by Guadalajara CVB may be, in part, very destination-specific, so each destination may need to conduct similar studies to learn why they appeal to prospective medical travelers. Results may also point to niches not currently being explored for maximum marketing potential.
Another use for the medical tourism research results will be in comparing them to the findings of travel motivation for leisure travelers. May we assume that motivations discovered in leisure travelers, such as influence of family, desire for prestige, or orientation toward adventurism or familiarity and safety – all theories in leisure travel research – also apply to the medical traveler? Guadalajara’s CVB results may provide some indication of how similar or different the medical tourist is from the leisure traveler. Perhaps what we know about leisure or business travelers also applies to marketing to the medical traveler, and we might capitalize on the research done on medical travelers, or perhaps the messages, needs, and appeal are unique to the medical tourist.
In addition, much of the current literature on medical tourism classifies these travelers in a monolithic unit. The Guadalajara CVB model takes into account the type of treatments being sought, positing that motivations may be different for different categories of medical tourists. For instance, do the “what’s” and “whys” of selecting a medical destination differ if a person is seeking life-extending or life-saving surgery compared to those who are wishing to receive treatment that will enhance their quality of life? In other words, do psychographic profiles of travelers differ in a consistent way based upon the care they seek? How do those needs manifest themselves when a trip is considered and a destination chosen? What additional destination elements aid in attracting leaders for executive physicals? How is the medical traveler influenced in his or her decision by family, employers, and media stories?
No one or two studies will be able to answer all these questions, but the Guadalajara CVB model is certainly one of the most comprehensive to date in its attempts. This destination hopes to have at least the first phase of this research done by mid-fall 2010, with its findings then setting the direction for additional research phases. An area that is particularly interesting – given the “newness” of the concept of medical tourism and the relatively small percentage of the population who have traveled for medical treatment to date – are the expectations and fears of prospective medical travelers in contrast to those for whom treatment has been completed. It may be difficult for the current study to tap into the emotions present prior to travel since those being interviewed have completed their journey and its success or failure may color these recollections. Starting with past medical guests, however, establishes a base line from which these future comparisons may be made in the future.
Those wishing further information on this study may contact Dr. Tomas Campos at the Guadalajara Convention and Visitors Bureau (consultoriacampos@gmail.com) or Dan Cormany at the University of Nevada, Las Vegas (dancormany.medtourism@yahoo.com).
About The Author
Dan Cormany is a doctoral student at the University of Nevada, Las Vegas, focusing his studies in the Hotel College on medical tourism. His emphasis is on hospitality’s potential roles in serving the medical tourist. Prior to starting these studies, he worked for 17 years as Dean of Students at Universities in Ohio, Florida and Hawaii, before embarking on a career change to hospitality. His hotel work includes management positions for Loews Hotels, Hyatt Regency, and Wynn Las Vegas. He holds a Master of Arts in College Administration and a Master of Science in Hotel Management.
