Journal of Service Science and Management, 2011, 4, 315-324
doi:10.4236/jssm.2011.43037 Published Online September 2011 (http://www.SciRP.org/journal/jssm)
315
Exploring the Factors that Affect the Choice of
Destination for Medical Tourism
Harsimran Gill, Neha Singh
California State Polytechnic University, Pomona, USA.
Received April 13th, 2011; revised May 29th, 2011; accepted June 20th, 2011.
ABSTRACT
Medical Tourism has become one of the latest trends in the tourism industry which has been and has the potential to
continue growing exponentially every year. More travelers than ever before are now travelling abroad to get high qual-
ity medical treatments for less cost. The purpose of my study is to explore the in terest in US travelers in medical tourism.
Results from the survey indicated that “competent doctors”, “high quality medical treatment facility”, and “prompt
medical treatment when needed” where the top three factors before deciding whether o r not to take a trip abroad. The
results will be useful to businesses that are either directly or indirectly involved with this industry, such as insurance
companies, credit card companies, travel agencies, hotels, food and beverage companies, medical facilities and ser-
vices, and spas.
Keywords: Medical, Health, Tourism, Medical Tourism, Destination Choice, Tourism Industry, Health Tourism
1. Introduction
Medical tourism has reformed the traditional health-care
industry and has set a new benchmark for every country
around the globe. More travelers than ever before are
now travelling abroad to get high quality medical treat-
ments for less cost, which includes treatments such as
general surgery, transplant surgery, cancer treatment,
stem cell therapies, dental implant, facial implant, and
liposuction, just to name a few. Both developed and de-
veloping countries are considering investing their infra-
structures in this infant industry to stay on top of the ag-
gressive competition.
Medical tourism as a niche market has emerged from
the rapid growth of what has become an industry, where
people travel often long distances to overseas countries
to obtain medical, dental and surgical care while simul-
taneously being holidaymakers, in a more conventional
sense [1]. This new trend of medical tourism is different
from the traditional model. In the traditional model, pa-
tients travelled from less developed nations towards more
developed nations where treatment quality would be
much advance and significantly better. However, in the
current medical tourism model, there is a flow of patients
in both directions, i.e. from developed to developing and
vice-versa [2,3].
The rise in medical tourism has opened up opportuni-
ties for many businesses. A report by Deloitte Center for
Health Solutions estimates that by 2017, about 15.8 mil-
lion US patients will receive care outside of the country,
resulting in a potential “opportunity cost” to US clinics
of about $373 billion [4]. Among others there are few
specialized medical travel agents, like MedRetreat, can
choose from a menu of 183 medical procedures from
seven different countries: India, Thailand, Malaysia,
Brazil, Argentina, Turkey, and South Africa. Medical
Tours International has sent more than 1300 patients in
2005 to abroad and has got medical personnel to assist
patients with trip planning and travel decisions. Another
example would be PlanetHospital, California based, that
screens providers to ensure quality of care and assists in
connecting patients to intern ational health care providers.
They have various steps in initial screening process:
whether the patient is in proper condition to travel,
choosing appropriate physician and destination, digitalize
records and send them to physicians in destination coun-
try, arrangement of conference call between potential
patient and physician from foreign country. Also, nearly
two-thirds of physicians who work for PlanetHospital
have either fellowships with medical societies in the US
or UK, or are certified for a particular specialty by a
medical board [5].
The purpose of my study is to explore the interest of

Exploring the Factors that Affect the Choice of Destination for Medical Tourism
316
US travelers in medical tourism. Students from a western
university participated in data collection. The study will
offer insights into factors that people might consider
when addressing their medical needs in the future. The
results could be useful to businesses that are either di-
rectly or indirectly involved with this industry, such as
insurance companies, credit ca rd companies, travel agen-
cies, hotels, food and beverage companies, medical fa-
cilities and services, and spas. Moreover, in this era of
globalized health care, businesses can survive by under-
standing the needs of this market, and by incorporating
the demands of potential patients.
2. Literature Review
2.1. Medical Tourism
In order to grasp the notion of “medical tourism”, “health
tourism”, or “wellness tourism”, it is essential to com-
prehend th e definition and the context under which th ese
terms are used interchangeably. “Wellness tourism is the
sum of all the relationships and phenomena resulting
from a journey and residence by people whose main mo-
tive is to preserve or promote their health. They [people]
stay in a specialized hotel which provides the appropriate
professional know-how and individual care. They require
a comprehensive service package comprising physical
fitness/beauty care, healthy nutrition /diet, relaxation/ me-
ditation and mental activity/education” [6]. According to
Bookman and Bookman [7], “the sale of high-tech medi-
cal care to foreigners has come to be called medical or
health tourism”. Tabacchi defines health tourism as “any
kind of travel to make yourself or a member of your fam-
ily healthier” [8]. Although some writes have used the
term “medical tourism” to incorporate all forms of
health-related tourism [9] it seems to be more useful to
distinguish ‘medical tourism’ as one involving specific
medical interventions [1].
Although there are various definitions and terms used
to define the act of travelling abroad for medical pur-
poses, but for this research a more holistic definitio n will
be applied. “Medical tourism is the act of travelling
abroad [across international borders] to obtain various
types of health and wellness treatments” [10]. This defi-
nition will provide a comprehensible approach of the
term medical tourism.
A study conducted in Swiss hotel groups revealed that
guests visiting any particular country for medical reasons
should be approached differently based on their expecta-
tions of visit, and their understanding of the terms “well-
ness” and “cure”. So, if hotels around the world want to
be ahead of competition, then they have to customize
their marketing approach based which segment of tour-
ists they are planning to capture: those who come for
medical treatments or those who are travelling for pure
relaxation [6]. Also, it implies that health policy makers
must value these two distinct groups and work with tour-
ism service providers to address the expectations of cus-
tomers. Moreover, hotelier should design rooms, facili-
ties and service environment to assure customer satisfac-
tion of the highest level because it will help promote
business and customers will recommend the ho tel to oth-
ers which will promote reputation and spread go od word-
of-mout h [11].
Another revolution in the traditional hotels segments is
brought by “focused factories”. According to Devon M.
Herrick [5], “these are specialty clinics and hospitals
where tasks and procedures have been streamlines for the
highest efficiency”. In other words, developing countries
have built and continuing on expanding hotels that can
serve as medical clinics, so that patients feel that they are
vacationing.
The exceeding demand of various products and ser-
vices that may or may not be produced in a country has
resulted in strong political and economic collaborations
of nations all around the world. Today more and more
countries are signing trade agreements to take advantage
of lower labor and material costs, fewer tariffs and quo-
tas, and reduced barriers. Keith Pollard, director of Brit-
ish Web site Treatment Abroad, told CNN that “he
doesn’t foresee a boom in medical tourism within the EU
[European Union], he believes the new legislation will
encourage patients to seek treatment abroad and help
create a European health care market” [12].
The developing countries can take advantage of rising
outsourcing opportunities in fields such as entertainment,
telemedicine, distance learning, and travel services. Two
major factors that are contributing towards these fields
are raising income in developed countries and relatively
low prices in developing countries [13]. It means as the
income rises, people will have more disposable income
and would like to purchase goods and services from
countries that offer at relatively competitive prices. In
other words, there is an inverse relationship between
rises in income in developed countries that facilitates
higher demand in developing countries [13]. According
to Bookman and Bookman, “a country or specific facility
may be able to achieve competitive advantage in the
marketplace by leveraging various non-clinical factors,
including proximity to target patients and the ease of
travel between two locations” [7].
The convenience of travelling from one point to an-
other can be promoted by top-notch infrastructure of de-
veloping countries. Usually when people think of India’s
local transportation system, they imagine jam-packed
buses, poorly constructed roads, bullock carts and horse
carriages, and hand-pulled rickshaws. While India is at-

Exploring the Factors that Affect the Choice of Destination for Medical Tourism317
tempting to improve its transportation infrastructure,
there are other countries such as Republic of South Korea,
Taiwan, and Singapore who have successfully incorpo-
rated new infrastructure, new technology and developed
human resources [14]. However John Connell, 2005,
says that India has upgraded its technology, absorbed
western medical protocols and emphasized low costs and
prompt attention to become most important global desti-
nation. He goes about saying that while such situations
have now radically changed but the perception of inade-
quacy remains [1].
2.2. Benefits of Medical Tourism
Cost is one of the foremost determinants for patients
seeking care from hospitals in foreign countries. Often,
surgeries in developing countries will cost just a fraction
of what one might pay in the USA or the UK [10]. Along
with cost savings, a patient can expect state-of-the-art
technology that is same or even better than western stan-
dards [15]. As an example, India is one of the developing
countries that have “capitalizing on its low costs and
highly trained doctors to appeal to these medical tourists”
[1]. There are various reasons due to which foreign hos-
pitals charge less for treatments: lower labor costs, little
to no third party involvement, transparency in package
pricing, limited collab orations between health care facili-
ties and physicians, and lower costs of malpractice litiga-
tions [5]. Also, price differential wars have resulted in
immense competition among developing countries. India
has significantly succeeded in capturing this segment of
tourist because it has developed the capability to offer
“bypass operations for about a sixth of cost in Malaysia”
[1]. Along with the cost of treatments, medical tourists
are seeking out for countries that have significantly less
currency fluctuations. After Thailand’s currency collapse
in 1997, the Thai government focused its resources to
attract medical tourist, especially for plastic surgery, to
yield higher revenues [16]. When medical tourism was
flourishing as an industry, dollar was relatively weak to
other foreign currencies. However, the absolute differen-
tial in medical prices has been so large that adverse ex-
change rates have not been a major consideration for
medical tourists from the US [17].
Although cost is main the determinant of decision
making to travel aboard, but having to wait for longer
periods to get a treatment in developed countries is mak-
ing this transition happen quickly. Even for the countries
where government health-care system is in place, like
Britain and Canada, patients are reconsidering to get their
treatments from their home countries. Also, it gives the
opportunity for developed countries to “clear their back-
log by sending patients to foreign countries for expedient
care, at low cost, without expanding local capacity” [18].
In 2005, the waiting times for hip and knee replacement
were 21.8 and 28.3 weeks, respectively, in British Co-
lumbia, Canada, in contrast to service within a few days
of referral in most medical tourism destinations [19].
Moreover, cost can be of significant importance to
those who do not have insurance. According to Sharon
Reier (2004), about 38 percent of the uninsured and one-
quarter of those with insurance would travel abroad for
care only if savings exceeds $10,000. A research con-
ducted by Oxford Analytica discovered that more than 45
million US citizens do not have health coverage and
those who do they are not very satisfied with health-care
services [20,21].
Another rationale for Americans to leave their comfort
zone and travel to foreign countries is quality of health
care. Many potential patients might think that cultural
differences, mainly language and background, will make
it difficult for them to communicate with their foreign
health care service providers. However, the cultural bar-
riers are reduced by having educated and English speak-
ing staff physicians and nurses. American Medical Asso-
ciation (AMA) introduced set of guidelines for medical
tourism that included proper follow-up care, letting the
patients know about their legal rights, informed risks for
surgical procedures, and information on long flights and
vacation activities [16].
People are realizing that they can save money by com-
bining health needs along with vacation desires. Several
companies are emerging that provide bundled packages
which include air fare costs, accommodations from air-
port to hotels, cost of surgery, room and board expenses
in hotels, and local sight-seeing costs [10]. Often times,
the surgeries are not very intrusive and has fast recovery
time. “The principal hospital group in Singapore, Raffles,
arranges airport transfers, books relatives into hotels and
helps to arrange lo cal tours” [1]. This shows that tour ism
industry along with needs of patients from developing
countries resulted in creation of medical tourism.
The issue of privacy makes medical tourism more
popular because no one prefers to be on the headlines of
media. “Some medical procedures, such as sex changes,
have become small but significant parts of medical tour-
ism, especially in Thailand, where recuperation and the
consolidation of a new identity may be better experi-
enced at a distance from standard daily life” [1]. Fur-
thermore, it means that unlike in US, patients personal
medical records cannot be viewed by a third party [4].
Some procedures are not approved by the US govern-
ment that makes developing countries an attractive op-
portunity to acquire such treatments [10]. Lee goes about
explaining the importance of governmental support to
enhance tourism industry especially for developing coun-
tries [22]. For example, Singapore Tourism Board (STB)

Exploring the Factors that Affect the Choice of Destination for Medical Tourism
318
launched two marketing campaigns: “Singapore Medi-
cine’ in 2003 and ‘Uniquely Singapore” in 2005 that an-
ticipated S$30 billion earnings and attracting 17 million
visitors by the year 2015. Another type of procedure that
might not be offered in countries like Britain and US is
abortion. However, countries such as India have fewer
regulations that are seen as attractive options for couples
who would prefer to get an abortion. Also, procedure
such as “stem cell therapy for heart failure, unobtainable
by many patients in industrialized countries, is available
in the medical tourism marketplace” [18]. Some patients
leave US to get treatments that are not approved by
medical specialty societies, academic health centers, and
the Food and Drug Administration. For example, a shark
cartilage is not scientifically accepted cancer treatment in
US However, patients travel elsewhere to get this treat-
ment in hopes of getting better through any means [1 7].
People use credit cards for it provides a better means
to fulfill immediate demands and needs that can be re-
paid later. It generates more flexibility for travelers to
carry a credit card that acts as an international currency.
According to Weaver [23], credit card companies like
Visa is promoting the universal use of its cards with the
catchphrase “It’s everywhere you want to be”. The use of
credit cards provides the travelers with less concerns
about arranging the money instantaneously, and hence
give them more freedom and mobility to use the credit
cards as needed in near future [23].
There have been various types of questions arising
from different fields of study, and all of them focus on
the privatization of health care that is being offered to
medical tourist in developing countries compared to the
type of service offered to poor people of that country.
One researcher wrote that “ethics is not only a question
of making up one’s mind and following one’s conviction.
It is also a question of listening to other persons’ per-
spectives and opinions, and perhaps convincing others if
you are sure about your own opinions” [24]. India has
been subject of question about health services offered to
their citizens who have little to no access to basic health
care and have high infant and maternal mortality rates
[1].
The quality of health care is very important determi-
nant right after price because people have this perception
that if something is offered of lower cost, so they might
not receive better quality. In order to address this prob-
lem, developing coun tries are hiring physicians that have
internationally respected credentials as well as training
from developed countries like US, Australia, Canada or
Europe. At present there are more than 120 hospitals
abroad that are accredited by the Joint Commission In-
ternational (JCI), and 20 hospitals that are accredited by
the International Standards Organization (ISO). More-
over, some foreign hospitals are managed by affiliated
US health care facilities like Cleveland Clinic and Johns
Hopkins International [5]. JCI-accredited Wockhardt
hospitals offer open heart surgeries for $8,500 in India,
as compared to $100,000 in the US and $28,000 in the
UK [25]. According to Jesse McKinley [26], Americans
have growing app etite for nips and tucks, and it was evi-
dent from 12 million procedures performed in 2008.
2.3. Costs of Medical Tourism
People are still pondering over usefulness and b enefits of
medical tourism because they do not have enough
knowledge about this industry. So, various consulting
and non-profit organizations are making an attempt to
market their services for those who are seeking to travel
across borders for health reasons [10]. The quality of
these services will set apart one provider from another,
and it will also give them a competitive advantage over
one another. Also, in some of the extreme forms of such
travel, like where patients require euthanasia are dis-
couraged due to high expected risks in procedures [1].
There is a lack of communication between institutes
from both developing and developed countries. As a re-
sult, if a person seeks medical treatment in developing
country like India, then there is no way that US insurance
company could communicate and arrange payment for
the treatment considering that the procedure is covered in
the US [10]. A lack of insurance portability discourages
prospective clients to obtain treatment in developing
country [7]. Among other procedures, cosmetic surgeries
are not covered by insurance. As an example, a face-lift
in Costa Rica costs about a th ird of that in the US, rather
less in South Africa [1]. On the other hand, since 2006,
there have been attempts made by the West Virginia leg-
islation to provide financial rebates to state employees
who seek health care at medical tourism destinations
“including first-class flights for patients and a companion,
plus recovery in a four-star hotel and other incentives
like bonuses and sick leave” [12,18]. On the other hand,
some insurance companies consider the shift of patients
to get medical treatment abroad as an incentive because
they will have to pay less. For example, United Group
Programs in Boca Raton, FL, is saving its employers 50
percent of health care costs by cutting employee contri-
butions to zero [12]. According to Josef Woodman [27],
“several insurance companies have begun to pilot pro-
grams together for medical tourism. One of the first was
Companion Global HealthCare, which is affiliated with
BlueCross BlueShield of South Carolina. United Health-
care, Aetna, WellPoint and Health Net of California now
have medical travel and medical tourism packages.
They’re mostly being covered through employers. It’s
very early to tell what the acceptance level is going to be,

Exploring the Factors that Affect the Choice of Destination for Medical Tourism319
but those plans are in place” [27].
The lenient terms of litigation and poor justice system
in developing countries makes it difficult for patients to
earn their rights of undertaking legal proceedings [7].
One major problem with poor malpractice laws is lack of
communication between the physicians from developing
countries with that of developed countries. It has resu lted
in physicians from high ly litigious nations to not endorse
offshore treatments to their patients as they are afraid of
putting their reputation at stake. Furthermore, conse-
quences of adverse outcomes, even death in some cases,
would be difficult to fight for in foreign courts as the
patients of their families are asked “the claims would
have to be adjudicated in a foreign court” [18]. There is
hesitation from the perspective of a physician and a pa-
tient, which is why the medical tourism industry has not
matured much.
There is also a possibility that the patient was not
aware about some pre-existing health problems which
were brought to surface either prior to or during treat-
ment in foreign hospital. This could result in breach of
contract from physicians’ point-of-view because he or
she was not aware about the condition [5].
Sometimes hindrances of obtaining follow-up care
discourage patients to travel. If the patient undergoes a
less intrusive surgery then chances of recovering soon
increases, but if the surgery or treatment is complicated
then there are more complicacies involved: mental,
physical, and financial considerations [10].
Media has adequate power to stir mystification in the
minds of travelers especially when they are considering
going abroad for medical treatment or vacation. For ex-
ample in 2003 when SARS outbreak appeared, media
exaggerated on the disease that resulted in negative im-
pacts on global tourism [28]. The 9/11 tragedy the Mus-
lim countries had lost tourist because the fear grew in the
minds of travelers. On February 14, 2005 Gulfnews.com
reported that a manager of one of Malaysian hospitals
has said “since 9/11 people started looking to the Eastern
world for holidays and we are tr ying to capture a fraction
of these people”. Americans have seen enough of turbu-
lence in foreign countries which has resulted in low con-
fidence levels to travel abroad for medical treatments,
like terrorists’ assaults that killed many foreigners in
New Delhi, drug wars in Mexico, and antigovernment
demonstrations that stranded thousands of tourists at the
Bangkok airport [17].
The differences in cultural backgrounds play an im-
portant role in tourists’ decision making process. Ac-
cording to Law [29], media plays an important role in
altering destination of choice more for Asians as opposed
to Westerners. It becomes primary concern of tourism
planners to addr ess this topic prior to gaining confiden ce
of Asian clients [29].
3. Methodology
An exploratory study was conducted to understand the
factors that affect the choice of destination for medical
tourism: tools used for researching information on medi-
cal tourism, sources to seek medical advice, factors con-
sidered important for seeking medical care outside of the
US, and choice of destination country, which is ex-
plained in details under Data Analysis section. Data was
collected using a survey method from a total of one hun-
dred and ninety-four students. The participants were re-
cruited from various disciplines at a western University.
They were provided with a br ief introduction of the term
‘medical tourism’ prior to handing out the survey.
The participants answered a 3 page survey sharing
their opinions and beliefs on medical tourism. A class-
room setting was chosen to administer the data collection
process. A researcher was available to respondents for
any questions.
The first few questions focused on respondent’s profile
and remaining were centered on various factors impact-
ing their decisio ns for travelling abroad for medical tour-
ism. The questions were adopted from previous studies
exploring this topic [10,30].
4. Data Analysis
4.1. Respondent’s Profile
Figure 1(a) shows that my sample consisted of 46%
males and 54% females. The sample was close to equal
distribution between males and females. Hence, there is a
good probability to get the point-of-view from both
males and females and their understanding of medical
tourism.
Figure 1(b) shows the age groups of the sample: 63%
were 21 - 23 years; 16% were 24 - 26 years; 15% were
18 - 20; and 6% were 27 and above.
Figure 1(c) depicts the ethnicity of sample: 49% were
Asian/Asian American; 22% were Caucasian; 20% His-
panic/Latino; 4% were Middle Eastern; 3% were Hawai-
ian/other Pacific Islander; and 2% were African Ameri-
can. This shows that diverse ethnicities were represented
in the sample.
Figure 1(d) shows that 88% of people travelled out-
side the US, while 12% didn’t. In other words, majority
of the sample have visited to place outside the US, and
they might have fairly good experience of travelling
abroad.
Figure 1(e) illustrates the average number of trips taken
in a year: 69.6% took 1 - 2 trips; 25.8% didn’t take any trip;
4.1% took 3 - 5 trips; and 0.5% took 5 or more trips. It
hows that about 70 percent, or two-thirds of our sam- s

Exploring the Factors that Affect the Choice of Destination for Medical Tourism
320
(a) (b) (c)
(d) (e)
Figure 1. (a) Gender; (b) age group; (c) ethnicity; (d) travelled outside US; (e) average travel in a year.
ple, have taken at least one to five trips in this current
year. Only 26 percent approximately did not travel this
year at all. It is an interesting observation to see that even
those who did not travel in this current had some valu-
able inputs regarding various factors and opinions on
medical tourism.
could be because that the present generations of people
are more technology savvy than older generations. Their
second pick was getting recommendation from their pri-
mary physician in the US to decide which destination is
better suited for their health needs. Although, this tool
was about one-seventh of the previous one, but un-
doubted my sample seems to be concerned about the
risks involved in foreign destination, so they preferred to
seek advice from someone they trust. The third tool that
they chose as important was asking friends and family if
anyone has gotten any procedures done. The word-of-
mouth seems like one of the important sources for seek-
ing medical advice.
4.2. Tools Used for Researching Information on
Medical Tourism
Figure 2 illustrates on tools that the sample would use to
research information on medical tourism: 73% preferred
online research; 10% relied on family physician’s opin-
ion; 8% relied on family and friends; 6% relied on testi-
monial of hospitals abroad; and 1% each for printed bro-
chures, videos providing tours, and television reports.
The chart below shows that majority, seventy-three per-
cent, picked online research as a very important tool. It
4.3. Sources to Seek Medical Advice
In Figure 3 the sample picked the sources that they
Figure 2. Prefere nces of background rese a r ch.

Exploring the Factors that Affect the Choice of Destination for Medical Tourism321
Figure 3. Sources to seek medical advice.
would consider to seek medical advice: 51.5% chose
hospital-patients relation department abroad; 19.6% chose
medical travel agent; 19.6% chose online research; 4.6%
chose personal doctor(s) advice; 4.1% preferred to con-
tact through family and friends; and 0.5% chose study
abroad programs. So, clearly the top pick was hospital-
patient relations department in the foreign country fol-
lowed by online research and medical travel agent. This
chart could be helpful to businesses who are interested in
learning where their perspective target market would
seek advice for medical traveling.
4.4. Factors Considered Important for Seeking
Medical Care Outside the US
Figure 4 tells us which factors the respondents seem to
consider for seeking medical care outside the US: 65%
focused on success rate for my-type-of-procedure per-
formed; 17% looked at number of my-type-of-procedure
performed; 10% focused on complication rate for my-
type-of-procedure performed; 7% focused on the country
of destination; and 1% looked for relative ease of travel.
The respondents were critically thinking about which
Figure 4. Factors considered important for seeking medical
care outside the US.
factor(s) would affect them and it is reflected in their
responses.
4.5. Choice of Destination
Figure 5 shows the top choices of destination for travel-
ling abroad for medical purposes were: Japan, South Ko-
rea, Singapore, Mexico, and India. The respondents
picked the countries th at they would consider if they had
to make the decision of travelling for medical purposes.
Frequencies were analyzed for this figure. Japan was
ranked the highest by 82 respondents, 21% of the sample;
South Korea was chosen by 40 respondents, 10% of the
sample; Singapore was chosen by 31 respondents, 8% of
the sample; Mexico was chosen by 24, 6% of the sample;
and India was chosen by 22 respondents, 6% of the sam-
ple.
4.6. Factors Considered before Choosing
Destination Outside the US
Figure 6 shows the factors from most important being
five, to least important being one. As it is displayed on
the chart, medical facilities and services, local primary
doctor’s recommendation, and governmental policies and
laws were among the most important choices. The two
choices that were relatively important were hotels and
food/beverage qua lity and general tourism supply.
Choice of Destination Country
Number of Respondents
Figure 5. Choice of destination country.

Exploring the Factors that Affect the Choice of Destination for Medical Tourism
322
Figure 6. Factors considered before choosing destination outside the US.
5. Limitations
One of the major limitations of this study is its sample.
Since, all of the respondents were students from various
academic disciplines, so there is a probability that some
of them did not have prior knowledge of the term ‘medi-
cal tourism.’ As a result, it is possible that they cou ld not
represent their opinions accurately. Although a brief in-
troduction of medical tourism was mentioned prior to
handing out the surveys, but it might not have addressed
all the potential questions that respondents might have
had at that time.
Another limitation of this study is its sample size. A
total of 194 respondents participated in this study. It
would be incorrect to relate the opinions delivered by the
respondents to the total population. Even though the
numbers of participants were fewer, but their opinions
were well thought, and they clearly demonstrated critical
thinking before making decision to travel abroad for
medical purposes. Besides, the respondents could be po-
tential tourists, but have not yet considered decisions of
this nature. So, even though they might comprehend the
term ‘medical tourism,’ but there is no assurance that th e
sample would consider the options ch osen had they been
a medical tourist before. In other words, if the sample
becomes immediate customers of medical tourism, they
might focus on a variety of different factors, which they
might not have consid ered for this study.
6. Conclusions
Medical tourism is a growing phenomenon that will con-
tinue to spread its charm on the health-care indu stry. One
of the major reasons that will desire patients to travel
abroad, especially from a developed country to a devel-
oping country would be the skyrocketing costs of medi-
cal treatments. Additionally, there are various other fac-
tors that will contribute to the flow of medical tourism in
developing countries: opportunity to vacation, privacy
and anonymity, fewer waiting lines, and some procedures
that are not offered in developed countries. It will be fas-
cinating to observe the trend set down by the next gen-
eration of medical tourist and the factors that they might
consider more important than others. For example, online
research was one of the major tools used for searching
information on medical tourism, and it might continue to
grow importance by the potential medical patients who
will consider travelling in near future.
Despite the opportunities and growth of medical tour-
ism industry, there are few limitations that have resulted
in comprehension of medical travelers. Some of them are
lack of primary knowledge, health insurance companies
does not cover all costs, weak malpractice laws in de-
veloping countries, hindrances to obtain follow-up care,
and outbreak of disease and rebellious attacks. Besides, if
the medical procedure needs to be taken care of immedi-
ately, then some of these limitations might not apply in
those cases. If the medical treatment is very intrusive,
then cost might be the main determinant of the visit;
however, if less intrusive medical procedure needs to be
done then some of the limitations will be brought to sur-

Exploring the Factors that Affect the Choice of Destination for Medical Tourism323
face. In other words, types of procedures will determine
the tourists’ willingness of focusing more in support of
medical tourism or not.
Additionally, medical tourism needs to be explored
further to learn about its significance and importance,
and any changes in future demand. It would be helpful if
additional research was conducted on this topic, as it
would give an opportunity to share and learn from
other’s insights. Most prominently it will be interesting
to explore perceptions of actual medical tourists. For
example, which factors they considered more important
than others, and also the reasoning behind their choices.
Other important aspect would be their experiences with
follow-up care. Although learning a topic provides an
opportunity to critically think about related issues, but
making the actual decision needs more preparation.
Moreover, it will be exciting to compare and contrast
between the choices made by actual medical tourists as
opposed to potential medical tourist. It would give an in-
depth understanding of the rationale that goes behind
decision making process.
This study mainly focused on potential medical tour-
ists and factors that they considered important before
travelling out of the US. Many factors were explored to
get a glimpse of what could potentially be the medical
tourism market: sources to seek medical advice, impor-
tant considerations before seeking medical care outside
the US, choice of destination country, considerations
before choosing th e destination outside the US, and tools
used for researching information on medical tourism.
The outcomes from the above questions will give a good
understanding of the shift in demand among current and
potential medical tourists. The results could be beneficial
for businesses that are operating in health-care and tour-
ism related industries, by incorporating the needs of the
market.
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