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• Types of Tourism in İstanbul

Health Tourism

Health tourism, as the primary motivation, includes the types of tourism that contribute to physical, mental and / or mental health through medical and healthy life-based activities, increase the capacity of individuals to meet their own needs, and enable them to perform better duties as individuals in their environment and society. Health tourism is a general term (UNWTO) expressing the subtypes of wellness (thermal, spa, spaturism and medical (medical) tourism.

In Türkiye, it can be told that İstanbul  is the center of medical tourism. Medical tourism is one of subheadings of health tourism described as " a tourism activity including usage proven healing sources and services (interventional and non-invasive)" İstanbul  has an important potential in terms of technology, infrastructure and personnel. Its historical and natural richness, geographical location and cultural assets make İstanbul  an attractive destination for medical tourism. Most of the hospitals providing services in the field of health tourism in Türkiye are located in İstanbul . In İstanbul , which is the center of medical tourism, significant progress has been made in health tourism with the cooperation of the accommodation sector, insurance sector, communication sector and other stakeholder sectors ( İstanbul  Development Agency - ISTKA).

United Nations World Tourism Organization (UNWTO) https://www.e-unwto.org/doi/epdf/10.18111/9789284420858  

İstanbul Development Agency (İSTKA) https://www.istka.org.tr/media/1074/t%C3%BCrkiye-ve-%C4%B0stanbul-b%C3%B6lgesi-nde-turizm.pdf

Journal of Hospitality and Tourism Issues

Kütüphaneme ekle.

Investigation of The Effect of Medical Tourism Potential Perception in Türkiye on Behavioral Intention

Şükran Karaca Esra Özkan Önem Muhammed Yıldız

Medical tourism includes domestic and international travel of individuals to protect and improve their health. This tourism type continues to attract the attention of both countries and individuals all over the world. In order to be an effective factor in the medical tourism sector, where serious investments are needed, it is necessary to offer a quality service at affordable prices. In addition, promotional activities related to medical tourism potential should be improved. The aim of this study is to examine the effect of perception of medical tourism potential on behavioral intention in Türkiye. In this context, data were obtained from 540 people that aged 18 and over living in Türkiye by online survey technique. In the analysis of the data, confirmatory factor analysis and path analysis were performed within the scope of structural equation modeling. As a result of the analyzes made; It has been seen that the perception of attractiveness and opportunity for medical tourism in Türkiye has a positive effect on behavioral intention, while the perception of competence has a negative effect on behavioral intention. In line with these results, various suggestions were made to increase the potential for medical tourism.

Anahtar Kelimeler

Tourism , Medical Tourism , Health Tourism , Behavioral Intention

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Türkiye’de Medikal Turizm Potansiyeline Yönelik Algının Davranışsal Niyete Etkisinin İncelenmesi

Medikal turizm sağlığın korunması ve iyileştirilmesi amacıyla, bireylerin ulusal ve uluslararası seyahatlerini kapsamaktadır. Bu turizm çeşidi tüm dünyada artan bir ivmeyle gerek ülkelerin gerekse bireylerin ilgisini çekmeye devam etmektedir. Ciddi yatırımlara ihtiyaç duyulan medikal turizm sektöründe etkin bir faktör olabilmek için kaliteli bir hizmeti uygun fiyatlarla sunabilmek gerekmektedir. Ayrıca sahip olunan potansiyel ile ilgili tanıtım çalışmalarına önem verilmelidir. Bu bağlamda çalışmanın amacı, Türkiye’ de medikal turizm potansiyeline yönelik algının davranışsal niyete etkisinin incelenmesidir. Bu kapsamda Türkiye’de yaşayan 18 yaş ve üzeri 540 kişiden çevrimiçi anket tekniği ile veriler elde edilmiştir. Verilerin analizinde yapısal eşitlik modellemesi kapsamında doğrulayıcı faktör analizi ve yol analizi yapılmıştır. Yapılan analizler sonucunda; Türkiye’de medikal turizme yönelik çekicilik ve imkân algısının davranışsal niyet üzerinde pozitif bir etkisi varken yeterlilik algısının davranışsal niyet üzerinde negatif bir etkisi olduğu görülmüştür. Elde edilen bu sonuçlar doğrultusunda medikal turizmin potansiyelini artırmaya yönelik çeşitli önerilerde bulunulmuştur.

Turizm , Medikal Turizm , Sağlık Turizmi , Davranışsal Niyet

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Medical Tourism: What Is Health Tourism & Where Is It Popular?

William Cooper

Marketing Director

Medical tourism – also called health tourism – is a huge and booming industry spanning the entire globe. In 2020, the value of the global health tourism sector was around US$54 billion , but by 2027 it is expected to almost quadruple in size to US$207 billion .

But what should you expect if you are thinking of becoming a medical tourist yourself? Where are the best places for medical tourism in the world right now? In this article, we’ll go through everything you need to know about medical tourism.

In this article

• What is medical tourism?

What are the best countries for medical tourism?

What’s the difference between medical tourism and travelling for treatment.

What is medical tourism and what are the best countries for medical tourism?

Medical tourism is as old as time itself. People in ancient societies were known to travel great distances to seek the expertise of physicians and spiritual healers in other parts of the world. In early modern society, patients would make long journeys to spa towns, where they could receive medical treatments in hospitals and recover in peace.

Today, here are many reasons someone might become a medical tourist, from the cost and quality of treatment , to gaining access to treatments that are not widely available in your home country. Medical tourism can combine medical procedures with a holiday, and many are now also choosing to spend their time working abroad as digital nomads .

So, what is medical tourism?

Medical tourism , otherwise known as health tourism , is when people travel for medical treatment to another country. It’s a trend that has been growing rapidly since the COVID-19 pandemic, with the global medical tourism market projected to grow at a rate of 15–25% year-on-year over the next decade.

Medical tourism is often associated with people from lesser-developed countries with poorer health systems travelling to more advanced countries to receive high-quality medical care. Patients may also choose to travel to countries that specialise in the type of treatment they need.

That said, with the cost of healthcare increasing exponentially in recent years, medical tourism has started to become more common for people in developed countries, who travel to less-developed countries to receive low-cost medical treatments.

Indeed, patients from countries that don’t have a universal health system can often save thousands of dollars on medical treatments by travelling abroad, making medical tourism an attractive option for people who are uninsured or underinsured , as well as for those who have reached their insurance coverage limit in their home country.

Is healthcare ever really ‘free’?

We look at which countries provide healthcare to all citizens.

Many medical tourists now also go in search of elective and cosmetic treatments such as plastic surgery , hair transplants , breast reductions or cosmetic dental procedures . Fertility treatment is also becoming a common reason for people to become medical tourists.

One of the biggest markets for medical tourism is the United States. Due to the high cost of medical treatments in the US, more than 2 million Americans travel abroad for medical tourism every year (accounting for roughly 9% of all medical tourists worldwide ). The cost savings speak for themselves – the OECD points out that a heart valve treatment costing US$150,000 in America may only cost US$9,250 in Poland.

In 2019, Patients Without Borders estimated there to have been around 21–26 million cross-border patients worldwide, each spending an average of US$3,500 per visit.

There is now a large and ever-growing number of medical tourism companies around the world. Many provide initial consultations in the patient’s home country before flying them out to a foreign country for treatment.

The patient can often expect to stay in luxurious accommodation while they are undergoing treatment, and some companies will also provide medical professionals from the patient’s country of origin. The price of the patient’s flights and hotel are often included in the price, and the patient may even have an opportunity to enjoy a short holiday while receiving their care.

Healthcare differs abroad and prices vary significantly

Do you know how much medical treatment costs abroad.

Choosing the right destination for a medical tourism trip will depend on several factors. These include:

Quality of care

According to McKinsey , 40% of people who travel for medical tourism go in search of higher quality treatment than they can find at home . For this reason, medical tourists often look for countries with highly-developed healthcare systems, access to the best quality doctors and medical equipment, and easy access to treatment (for instance, short waiting lists). Different countries may specialise in certain types of treatment, making it hard to say which countries are the definitive ‘best’ for all types of medical tourists.

Naturally, medical tourists tend to choose countries where healthcare is cheaper . Many medical tourists specifically seek private healthcare in foreign countries to guarantee their quality of care, but this will usually incur a cost . Even so, with access to shorter waiting times and higher-quality treatment, many medical tourists consider these costs to be worthwhile, especially when compared to the cost of treatment in their own country.

Tourism opportunities

As a medical tourist, you may end up spending several weeks or even months in a foreign country while you undergo treatment and recovery. For this reason, medical tourists tend to opt for countries that are safe , pleasant and perhaps even offer opportunities for them to work abroad . Medical tourists will often combine their medical treatment with a holiday , leading many to choose tourism hotspots as their medical tourism destinations.

With that said, according to data from the International Medical Travel Journal , these countries rank as the top 10 medical tourism destinations in the world:

Medical tourists per year (2019)

Medical care can vary widely between countries

We look at the countries with the best healthcare in the world.

Other countries that ranked highly for medical tourism in 2019 included Russia (200,000 visitors), USA (200,000), Belarus (150,000), Spain (140,000), Poland (100,000) and Germany (100,000).

However, it is important to remember that the most popular countries are not necessarily the best . Different countries offer different standards of healthcare, and may specialise in different types of treatment.

The best places for medical tourism are those that can offer the best treatment for you at the best price .

In a 2011 report on medical tourism, the OECD gave the following figures as an illustration of the price medical tourists could expect to pay for treatment in foreign countries. Notice how certain treatments are especially cheap in some countries.

Cost per treatment (USD$)

Heart valve replacement

Hip replacement

Gastric bypass

Breast augmentation

Breast reduction

Nose job (rhinoplasty)

Dental implants

Just because you are travelling to another country or region for medical or wellness reasons doesn’t necessarily mean you are taking part in medical tourism .

Medical tourism is defined as travelling to another country specifically for cheaper, more accessible treatment . The majority of medical tourists travel for elective treatments (for instance, plastic surgery or dental work) that are available in their home country, albeit at a higher cost. Some medical tourists also travel to receive higher-quality treatment than they would find in their own country.

‘ Travelling for treatment ’ is different to medical tourism in the sense that those travelling for treatment are more likely to be referred by doctors in their home country.

For instance, as an expat you may at some point require specialist treatment that is not available in your home country. In these instances, you may be referred by your doctor to a hospital in a different city or region, a different country, or perhaps your home country, in order to undergo this treatment.

This is a common practice, even in highly-developed countries. It is especially common if you are living in a remote area with limited access to hospitals, a small country with limited health facilities such as Andorra, or if you are living in a poorer or less-developed country where access to healthcare is limited .

While it is becoming hard to separate the statistics for the number of people who travel for essential treatment vs. medical tourists , there are several key differences between travelling for treatment and medical tourism :

Medical tourism

Travelling for health

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How can international health insurance help?

If you are covered by international health insurance , you may be entitled to receive treatment at private medical facilities . This is to ensure you receive the best-quality treatment and care, and so that you are more likely to find medical professionals who speak your native language .

These medical facilities may not always be in the country or region you are living in. In these cases, your insurer may arrange a ‘ medical evacuation ’ or Medevac for emergency life or limb-threatening medical treatment when it is not available locally.

As an expat or digital nomad with international health insurance, you may also find that your policy covers you not just in one country, but within a much wider ‘ coverage zone . This is to ensure you can receive high-quality medical treatment wherever you move in the world.

Some international health insurance policies offer you worldwide coverage, while others cover specific continents or regions. (Expats in the United States may need special USA-only policies, as the healthcare system is very different there.)

Unsure which insurance product you need?

We compare domestic, international and travel insurance.

What you should know about travelling abroad for medical care

Undergoing medical treatment is stressful at the best of times . For patients who need to travel to another country for treatment, the stress is likely to be significantly greater.

That’s why it’s important to remember these things when travelling abroad for medical care, whether you are travelling for essential care or for medical tourism:

Bring a spouse or relative

Travelling for any medical procedure can be extremely nerve-wracking , so you will want to have someone you love nearby. Many medical tourism operators are accommodating of guests, and if you are covered by international health insurance your insurance provider will usually cover at least one person to travel with you.

This person can support you while you are recovering , both emotionally and when it comes to running errands – this will be extra-essential when you are recovering in a foreign country.

Choose a reputable operator

If you are travelling abroad for medical tourism, it’s essential to choose a provider with a strong reputation .

These operators are more likely to have access to the best hospitals and medical professionals, and a good track record with plenty of patient testimonials under their belts. They should also be able to find doctors who speak your native language. And they will be responsible for keeping you safe while you are abroad, so it’s important to know their patient duty of care .

If you are covered by international health insurance, you won’t need to worry – your provider will be able to connect you with a medical facility within their own network . At William Russell, we have 40,000 such facilities in our own global network who have helped people get the best possible experience when seeking medical assistance abroad.

Always consult your insurance provider

If you are an expat or digital nomad with international health insurance and considering getting surgery abroad as a medical tourist, it’s important to speak to your insurer.

Undergoing elective treatment in a foreign country, especially if it is one outside your coverage zone, may jeopardise your insurance policy. If something goes wrong while you are abroad – either as a result of your treatment or in any other context – you may not be able to make a claim through your insurance provider. If you develop complications while in your coverage zone as a result of your treatment abroad, these may also not be covered.

The silver lining is that your insurance provider may be able to help you seek and fund the cost of treatment through your existing policy. That’s why it’s always best to consult your insurer first.

Where are the best places in the world to live and work?

We look at the 5 best countries for expats and digital nomads, coverage that travels with you.

For expats and digital nomads living abroad, international health insurance can give you total peace of mind when it comes to seeking medical care.

With international health insurance you’ll benefit from our global network of 40,000 private medical facilities, with doctors who speak your language and medical evacuation cover included in case you need life or limb-threatening emergency treatment that is not available locally.

Speak to William Russell today to learn more about how international health insurance could help to access high-quality medical treatment worldwide.

Looking for international health insurance?

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Health Tourism: Exploring the Industry, Types, and Top Destinations

April 23, 2023.

Health tourism, also referred to as medical tourism or wellness tourism, is a rapidly growing sector within the global tourism industry. It encompasses a diverse range of activities and services, all aimed at improving or maintaining an individual's health and well-being. This article presents an overview of the health tourism industry, discusses different types of health tourism, examines the top 100 destinations, and provides insights into the number of travelers engaging in health tourism. ‍

Definition of Health Tourism

Health tourism is broadly defined as the practice of individuals traveling outside their country of residence to seek medical treatments, procedures, or wellness experiences. The motivations behind such travel may vary but often include factors such as cost savings, access to specialized treatments, shorter waiting times, or the opportunity to combine medical procedures with leisure travel. ‍

Types of Health Tourism

• Medical Tourism: This category of health tourism focuses on individuals that travel for medical treatments and procedures abroad. Common medical treatments sought by medical tourists include elective surgeries, dental treatments, fertility treatments, and cosmetic procedures. Often, providers offer medical tourism packages that include treatment costs, physician fees, ground transportation and, in some cases, hotel accommodation.
• Wellness Tourism: Wellness tourism, on the other hand, emphasizes the pursuit of well-being through activities and experiences that promote physical, mental, and spiritual health. Examples include spa treatments, yoga retreats, and mindfulness workshops.
• Preventative Healthcare Tourism: This type of health tourism revolves around the concept of proactive health management. Travelers in this category may seek routine medical check-ups, diagnostic tests, or alternative medical treatments to prevent potential health issues.

Top Destinations for Health Tourism

While it is beyond the scope of this article to provide an exhaustive list of the top health and medical tourism destinations; some notable countries and regions have emerged as leaders in this industry, particularly for combining medical and wellness services. These include:

• Thailand: Renowned for its state-of-the-art medical facilities and cost-effective treatments, Thailand has become a popular destination for medical tourists from around the world.
• India: With its combination of advanced healthcare infrastructure, skilled medical professionals, and affordable treatment options, India has emerged as a prominent player in the health tourism sector.
• Singapore: Known for its high-quality healthcare system, Singapore attracts health tourists seeking top-notch medical treatments and wellness experiences.
• Turkey: Offering high-quality medical care at competitive prices, Turkey has become a preferred destination for health tourists, particularly for cosmetic procedures and dental treatments.
• Hungary: Hungary is well-known for its dental and medical spa tourism, thanks to its high-quality services and natural thermal springs.
• Costa Rica: This Central American country has made a name for itself in the medical tourism industry by providing affordable, high-quality healthcare services in a beautiful natural setting.
• South Korea: Boasting world-class healthcare infrastructure and cutting-edge medical technology, South Korea is a top destination for cosmetic surgery and advanced medical treatments.
• Malaysia: Offering a range of healthcare services at competitive prices, Malaysia has become a popular destination for medical and wellness tourism in     Southeast Asia.
• Brazil: With its expertise in cosmetic surgery and dental treatments, Brazil attracts health tourists from across the globe.
• Spain: Spain's modern healthcare infrastructure and affordable treatment options make it an attractive destination for European health tourists.

Travelers Engaging in Health Tourism

The number of travelers engaging in health tourism has been steadily increasing in recent years. According to the Medical Tourism Association, the global medical tourism industry was valued at $58.6 billion in2020, with an estimated 14 million patients traveling for medical treatments each year. This figure is expected to grow at a compound annual growth rate (CAGR)of 12% through 2025, reaching an estimated market value of $142.2 billion.

Wellness tourism, on the other hand, has also witnessed significant growth in recent years. According to the Global Wellness Institute, the wellness tourism market was worth $639 billion in 2019 and is projected to grow at a CAGR of 7.5%, reaching $919 billion by 2022. This growth is driven by the increasing global demand for health and wellness experiences, as well as the rise in disposable incomes and greater awareness of preventive healthcare measures.

Several factors have contributed to the growth of health tourism. Some of these include:

Cost Savings: One of the main driving forces behind the growth of health tourism is the potential for significant cost savings. The cost of medical treatments and procedures can vary dramatically between countries due to factors such as labor costs, government subsidies, and differences in the cost of living. By traveling to countries with lower healthcare costs, health tourists can save a considerable amount of money. For example, a heart bypass surgery in the United States may cost around $100,000,while the same procedure in India could cost approximately $7,000. These cost savings can be particularly attractive for patients who are uninsured, underinsured, or require elective procedures that are not covered by insurance.

Access to Specialized Treatments: Another factor driving health tourism is the opportunity to access specialized treatments that may not be available or have limited availability in one's home country. This can be due to a lack of cutting-edge medical technology, a shortage of medical professionals with specialized skills, or restrictive regulations on certain treatments. Health tourists may choose to travel abroad to receive state-of-the-art care or treatments that are considered experimental or unapproved in their home country.

Shorter Waiting Times: In some countries, patients may face long waiting times for certain medical treatments or procedures due to factors such as limited healthcare resources or high demand. These waiting times can be particularly challenging for patients with chronic pain, deteriorating conditions, or urgent medical needs. Health tourism offers the opportunity for patients to bypass these waiting times and receive the necessary treatments more quickly. For example, a patient in the United Kingdom may face a waiting period of several months for a hip replacement surgery, while the same procedure could be readily available in countries such as Spain or Turkey.

Higher Quality of Care: Some health tourists perceive that the quality of care in another country may be higher than what is available in their home country. This perception can stem from factors such as the reputation of the destination country's healthcare system, the use of advanced medical technology, or the expertise of the medical professionals. For example, Singapore is renowned for its world-class healthcare system, attracting health tourists seeking top-notch medical treatments and wellness experiences. Additionally, countries like South Korea have gained a reputation for excellence in cosmetic surgery, drawing patients from around the world to receive high-quality care from skilled surgeons.

Combining Medical Procedures with Leisure Travel: Health tourism also offers the unique opportunity for individuals to combine medical treatments or wellness experiences with leisure travel. Many health tourists choose to extend their stay in the destination country to explore the local culture, visit tourist attractions, or simply relax and recuperate in a beautiful setting. This combination of medical and leisure travel can contribute to the overall well-being of the patient and enhance their recovery process. For example, a patient undergoing dental treatment in Costa Rica might also take the time to visit the country's beautiful beaches, rainforests, and national parks during their stay.

Health tourism has emerged as a significant sector within the global tourism industry, fueled by factors such as cost savings, access to specialized treatments, and a growing focus on wellness and preventative healthcare. As the industry continues to expand, more countries are investing in their healthcare infrastructure to attract health tourists, offering a wide range of medical and wellness services to meet the diverse needs of these travelers. With the increasing popularity of health tourism, it is essential for healthcare providers, governments, and tourism organizations to work together to ensure the highest standards of care and services for health tourists while promoting sustainable and responsible practices within the industry.

Image credits: Image by <a href="https://www.freepik.com/free-photo/top-view-glove-with-stethoscope_9469085.htm#query=health%20tourism&position=25&from_view=search&track=ais">Freepik</a>

Gha standards accredited by isqua.

A Global Authority in Medical Tourism Accreditation

Medical travel facilitator certification.

GHA’s Medical Travel Facilitator Certification is conducted online and focuses on validating the capacity of facilitator companies to provide appropriate services to clients that enhance safety and patient experience along the entire Medical Travel Care Continuum (patient journey) as appropriate to the to the particular healthcare provider and the facilitator company’s business model.

UN Tourism | Bringing the world closer

• All Regions
• Exploring Health Tourism – Executive Summary

The ETC/UNWTO publication on Exploring Health Tourism aims to provide a better understanding of the growing segment of wellness and medical tourism. The study introduces the evolution of health-related tourism products and services from all around the world and provides insights into the current situation of the industry, as well as the future potential. It also includes a comprehensive taxonomy that serves as a common reference for tourism destinations operating in this field, as well as a practical toolkit to assist NTOs and DMOs with their planning and management of health-related tourism activities.

Click here for the full version of this publication.

ISBN : 978-92-844-2030-8

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Why Patients Are Turning to Medical Tourism

Statistics, Benefits, and Risks

Planning Ahead

Frequently asked questions.

Medical tourism is a term that refers to traveling to another country to get a medical or dental procedure. In some instances, medical tourists travel abroad seeking alternative treatments that are not approved in the United States.

Medical tourism is successful for millions of people each year, and it is on the rise for a variety of reasons, including increasing healthcare costs in the United States, lack of health insurance, specialist-driven procedures, high-quality facilities, and the opportunity to travel before or after a medical procedure.

According to a New York Times article from January 2021, pent-up demand for nonessential surgeries, as well as the fact that many Americans lost their health insurance during the coronavirus pandemic led to a surge in medical tourism once other countries re-opened.

However, there are specific risks that come with traveling overseas for surgery. If you're thinking of pursuing a medical procedure in another country, here's what to know about the benefits and the risks.

Medical Tourism Benefits

The most common procedures Americans go abroad for include dental care, cosmetic procedures , fertility treatments, organ transplants , and cancer treatment.

This is not to be confused with having an unplanned procedure in a foreign country due to an unexpected illness or injury.

Among the reasons a person might choose to go abroad for a medical procedure are:

Lower Costs

Medical tourists can save anywhere from 25% to 90% in medical bills, depending on the procedure they get and the country they travel to. There are several factors that play into this:

• The cost of diagnostic testing and medications is particularly expensive in the United States.
• The cost of pre- and post-procedure labor is often dramatically lower overseas. This includes labor costs for nurses , aides, surgeons , pharmacists, physical therapists , and more.
• High cost of malpractice insurance—the insurance that protects medical professionals against lawsuits—in the United States.
• Hospital stays cost far less in many overseas countries compared to the United States. In other words, quality care, hospital meals, and rehabilitation are far more affordable abroad for many people.

For someone who doesn't have insurance , or someone having a procedure that is not covered by insurance , the difference can be enormous.

Popular Countries for Medical Tourism

Dominican Republic

South Korea

Culture and Language

Many immigrants prefer to have treatments and procedures done in their country of origin—a sensible decision, considering just how much language barriers alone can affect the quality of their care.

Furthermore, at least 25% of immigrants and noncitizen residents in the United States are uninsured, compared to 9% of American citizens. Children with at least one noncitizen parent are also more likely to be uninsured.

Practicalities aside, many people choose to have their procedure done in their country of origin simply because it allows them to be close to family, friends, and caretakers who can assist them through their recovery .

Insurance Incentives

Some insurance companies have started promoting medical tourism. The reason behind this is simple: savings for the insured means savings for the insurance provider and vice versa.

Several insurance providers, including Aetna have programs specifically geared at promoting safe medical tourism. Some insurance providers even offer financial incentives for medical tourism, like discounts on medical bills .

That said, many insurance companies will not pay for surgery performed outside of the country unless it is an emergency.

Luxury and Privacy

Medical tourism is a lucrative business for many countries, and much of the money brought in by medical tourists is reinvested into the local economy and health infrastructure.

The effect of this is apparent in the spa-like luxury that some foreign hospitals offer, providing medical tourists the opportunity to be pampered during their stay for a fraction of the cost they would pay at home.

Some facilities offer hospital rooms that are more like a hotel suite than a traditional hospital room. Other hospitals offer one-on-one private nursing care, which is far more generous and attentive than the staffing ratios that most hospitals allow.

Medical tourists who seek that added layer of privacy can find it abroad. Many can return home from their "vacation" without anyone knowing they had a procedure at all.

Vacation in a Foreign Country

Medical tourists often take advantage of their stay in a foreign country to travel for pleasure by scheduling a vacation before or after their procedure.

This is an especially inexpensive way to travel to a foreign country, especially if their insurance provider is paying for the flight and the cost of staying is low. 

While it seems logical to recover on a beach or in a chalet by the mountains, keep in mind that it's important not to jeopardize your recovery.

Swimming isn't recommended until your incisions are completely closed. You may not feel up to doing much more than napping in the days following your procedure, either.

Don't let your vacation disrupt your recovery. Any time you have a procedure done, especially a surgery, it's important to listen to your body, take your medications as directed, and follow your doctor's recommendations closely.

Bypassing Rules and Regulations

Some travelers seek surgery abroad to bypass rules that are set in place by their own government, insurance company , or hospital. These rules are typically in place to protect the patient from harm, so getting around them isn't always the best idea.

For example, a patient may be told that their weight is too low to qualify for weight loss surgery . A surgeon in a foreign country may have a different standard for who qualifies for weight loss surgery, so the patient may qualify overseas for the procedure they want.

Talented Surgeons

Surgeons in certain countries are known for their talent in a specific area of surgery. For example, Brazilian surgeons are often touted for their strong plastic surgery skills .

Whereas in the United States, insurance companies might only cover cosmetic procedures if it is medically necessary, cosmetic surgery is often free or low-cost in Brazil's public hospitals—giving cosmetic surgeons there ample practice.

Thailand is reported to be the primary medical tourism destination for individuals seeking gender reassignment . It is often easier to qualify for surgery and the cost is significantly reduced. Surgeons are performing the procedures frequently, and as a result, many have become quite specialized in them.

It is often surprising to many medical tourists that their physician was trained in the United States. Not all physicians are, of course, but a surprisingly high percentage of them working in surgery abroad are trained in English-speaking medical schools and residency programs and then return to their home country. These physicians often speak multiple languages and may be board certified in their home country and a foreign country, such as the United States.

Medical tourism isn’t limited to countries outside of the United States, either. Many people travel to the United States for medical care due to the country's cutting-edge technology, prescription medication supply, and the general safety of healthcare.

Medical Tourism Risks

The financial and practical benefits of medical tourism are well known, and you may even know someone who had a great experience. Nonetheless, the downsides of medical tourism can be just as great if not greater. Sometimes, they can even be deadly.

If you are considering a trip abroad for your procedure, you should know that medical tourism isn't entirely without obstacle and risks. These include:

Poorly Trained Surgeons

In any country—the United States included—there will be good surgeons and bad. And just as there are great surgeons abroad, there are also some surgeons who are less talented, less trained, and less experienced.

Regardless of what procedure you are getting or where, you should always do some preliminary research into the surgeon or physician who will be treating you as well as the hospital you will be treated at.

In the United States, it is fairly easy to obtain information about malpractice lawsuits , sanctions by medical boards, and other disciplinary actions against a physician.

Performing this research from afar can be challenging, especially if you don't speak the local language. Yet countless people take the risk anyway, without knowing whether the physicians who will treat them are reputable.

A physician should be trained in the specific area of medicine that is appropriate for your procedure. For example, you should not be having plastic surgery from a surgeon who was trained to be a heart doctor. It isn’t good enough to be a physician, the physician must be trained in the specialty .

Prior to agreeing to surgery, you should also know your surgeon’s credentials : where they studied, where they trained, and in what specialty(s) they are board-certified. Do not rely on testimonials from previous patients; these are easily made up for a website and even if they are correct, one good surgery doesn’t mean they will all be successful.

Quality of Staff

Nurses are a very important part of healthcare, and the care they provide can mean the difference between a great outcome and a terrible one.

A well-trained nurse can identify a potential problem and fix it before it truly becomes an issue. A poorly trained nurse may not identify a problem until it is too late. The quality of the nursing staff will have a direct impact on your care.

Once again, it's important to research the hospital staff where you will be having your procedure done. Read the reviews but don't trust them blindly. If you can, seek out a recommendation from someone who can vouch for the medical staff where you will be going.

Quality of the Facility

While researching healthcare facilities for your procedure, you want to learn not just about the quality of the facilities themselves, but about the country's healthcare system as a whole.

In some countries, there is a marked distinction between public hospitals and private hospitals. In Turkey, for example, private hospitals are considered on-par with hospitals in the states, while many locals will advise you to steer clear of public hospitals if you can.

You will also want to seek out facilities that are internationally accredited. In the United States, the Joint Commission evaluates hospitals and certifies those that provide safe, quality care. The international division does the same for hospitals outside the United States.

Once you have a few options for potential facilities, you can start to investigate specifics. For one, you should find as many pictures and reviews of the facility as you can. Ask yourself whether the facility is state of the art or whether it seems dirty and outdated.

You will also need to find out if the facility has ICU level care available, in case something goes wrong. If not, there should be a major hospital nearby so that you can be transferred quickly.

To learn more about a healthcare facility, consider joining expat groups on social media for the city or country you will be traveling to. Ask the group for recommendations, or inquire about any positive or negative experiences they may have had at a particular facility.

Flying Home After Surgery

Any surgery comes with risks, including infection and blood clots . Flying home increases the risk of blood clots, especially on long-haul flights that are longer than four hours.

Try to avoid flying home in the days immediately after surgery; waiting a week will decrease the chances of developing a blood clot or another serious complication during the flight.

For longer flights, plan on getting up and walking up and down the aisles each hour to improve blood flow in your legs. You might also benefit from wearing compression socks with your doctor's approval.

If you are taking blood thinners or are at-risk of blood clots , be sure to talk to your doctor about how you can reduce your risk of blood clots after your procedure and while traveling.

Furthermore, you should know the symptoms of blood clots and stay alert.

Unplanned Illness

Any time you travel abroad, you run the risk of catching an illness that you have never been exposed to or that your body is not prepared to fight off. This is especially a concern when spending time in a foreign hospital.

If you have a sensitive stomach, you may also want to think long and hard about having surgery abroad. The food is often very different in foreign hospitals, and in some areas, there is a risk that even the water will be upsetting to your body.

Having diarrhea or postoperative nausea and vomiting makes for a miserable recovery experience, especially if you do not have a friend or family member nearby who can help you through it.

Before you travel abroad, check with your doctor to see if you need any vaccines to travel to your destination or if there are any foreign illnesses you should be aware of. Picking up an illness abroad, particularly after your surgery, can potentially be life-threatening.

Language Barriers

If you are having surgery in a country where English is not the primary language, you will need to make preparations in order to be able to communicate with the staff.

You may be pleasantly surprised to learn that the staff speaks your primary language well. If not, then you will need to consider how you will make your wishes and needs known to the surgeon, the staff, and others you will meet.

Whether you are at home or abroad, remember to speak up and advocate for yourself to make sure your needs are met. If you don't speak the local language, download a language translation app on your smartphone and don't hesitate to use it to communicate your needs. Hiring a translator is another option.

A Word About Transplant Tourism

Transplant tourism is one area of medical tourism that is strongly discouraged by organ and tissue transplant professionals in multiple countries. Most international transplants are considered “black market” surgeries that are not only poor in quality, but ethically and morally wrong.

China, for example, the country that is believed to perform more international kidney transplants than any other country, is widely believed to take organs from political prisoners after their execution.

In India, living donors are often promised large sums of money for their kidney donation, only to find out they have been scammed and never receive payment. Selling an organ in India is illegal, as it is in most areas of the world, so there is little recourse for the donor.

Then there is the final outcome: how well the organ works after the surgery is complete. With black market transplants, less care is often taken with matching the donor and recipient, which leads to high levels of rejection and a greater risk of death. Furthermore, the new organ may not have been screened for diseases such as cytomegalovirus , tuberculosis , hepatitis B , and hepatitis C . It is often the new disease that leads to death, rather than the organ rejection itself.

Finally, transplant surgeons are often reluctant to care for a patient who intentionally circumvented the donor process in the United States and received their transplant from an unknown physician.

It is important to arrange your follow-up care prior to leaving your home country.

Many physicians and surgeons are hesitant to take care of a patient who received care outside the country, as they are often unfamiliar with medical tourism and have concerns about the quality of care overseas.

Arranging for follow-up care before you leave will make it easier to transition to care at home without the stress of trying to find a physician after surgery .

Just be sure to inform your follow-up care physician where you are having your procedure done. After you return, they will also want to know what prescription medications you were given, if any.

What are popular countries for medical tourism? 

Mexico, India, Costa Rica, Turkey, Singapore, Canada, and Thailand are among the many countries that are popular for medical tourism.

How safe is medical tourism?

Medical tourism is generally considered safe, but it's critical to research the quality of care, physician training, and surgical specialties of each country. There are several medical tourism organizations that specialize in evaluating popular destinations for this purpose.

What countries have free healthcare? 

Countries with free healthcare include England, Canada, Thailand, Mexico, India, Sweden, South Korea, Israel, and many others.

A Word From Verywell

If you are considering medical tourism, discuss the risks and benefits with your doctor, and consider working with your insurance provider to arrange a trip that balances financial savings with safety. (Also, before you embark on a trip overseas for your procedure, make sure you are financially prepared for unexpected events and emergencies. Don't go abroad if you don't have enough money to get yourself home in a crisis.)

A medical tourism organization such as Patients Without Borders can help you evaluate the quality and trustworthiness of healthcare in various countries. Making sure a high level of care is readily available will lead to a safer, more relaxing experience.

Centers For Disease Control and Prevention. Medical Tourism: Getting medical care in another country . Updated October 23, 2017.

University of the Incarnate Word. Center for Medical Tourism Research .

Patients Beyond Borders. Facts and figures .

Kaiser Family Foundation. Health coverage of immigrants . Published July 2021.

Paul DP 3rd, Barker T, Watts AL, Messinger A, Coustasse A. Insurance companies adapting to trends by adopting medical tourism . Health Care Manag (Frederick). 2017 Oct/Dec;36(4):326-333. doi: 10.1097/HCM.0000000000000179

Batista BN. State of plastic surgery in Brazil .  Plast Reconstr Surg Glob Open . 2017 Dec;5(12):1627. doi:10.1097/GOX.0000000000001627

Johns Hopkins Bloomberg School of Public Health - Global Health Now. Brazilians' risky right to beauty . Published May 2018.

Chokrungvaranont P, Selvaggi G, Jindarak S, et al. The development of sex reassignment surgery in Thailand: a social perspective .  Sci World J . 2014 Mar;2014(1):1-5. doi:10.1155/2014/182981

The Joint Commission. For consumers .

Centers for Disease Control and Prevention. Blood clots and travel: what you need to know . Reviewed February 2021.

Hurley R. China harvested organs from political prisoners on substantial scale, says tribunal . BMJ . 2018 Dec;363(1):5250. doi:10.1136/bmj.k5250

Ambagtsheer F, Van Balen L. I'm not Sherlock Holmes: suspicions, secrecy, and silence of transplant professionals in the human organ trade . Euro J Criminol . 2019 Jan;17(6):764-783. doi:10.1177/1477370818825331

Centers for Disease Control and Prevention. Transplant Surgery. Key facts . Reviewed January 2019.

By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.

Our Response to COVID-19 →

Complementary & Alternative Medicine

Health and wellness tourism today.

According to the World Health Organization (WHO) health is a state of physical mental and social well-being and not merely the complete absence of disease or infirmity. In accordance with this definition wellness can be equated with health. Health and wellness involves several well-being dimensions including physical mental social sexual emotional cultural spiritual educational occupational financial ethical and existential dimensions. ‍

This article represents an attempt to develop an understanding of current health and wellness tourism around the world. The aims are to:

• clarify concepts because of the usual incipiency and lack of conceptual rigor regarding health and wellness tourism
• qualify procedures and patient safety as crucial factors
• importance of destination branding.

Brief History: Health and Wellness

Past ancestors: Ayurvedic Medicine (India 3000 BC) Chinese Medicine (Emperor Sheng Nung 20382698 BC) Thai Traditional Medicine Japanese Onsen Russian Steam Bath Tell el Amarna Therms (Egypt 1350 BC) Greek Thalassa (Hippocrates 460355 BC) Roman Thermae/Balnea Publica (II BCIII AC) Arabian Medicine (8th-15th century Al Razi 850923) Turkish Haman Dead Sea Salts Baths Egyptian Mansuri Hospital (Cairo 1248).

Travellers came from all over the world Native American Sweat Lodge Mexican Temazcalli Australian Aboriginal Steam Baths Mineral Springs in Spa near Liége (14th) Climatotherapy (XVIII/XIX Centuries) in Madeira and Canarias Islands Scientific Medicine (19th century). Recent years: 1959  Inauguration of Golgen Door Spa in California 1987  Official beginning of the Global SPA industry  SpaFinder Magazine 1991  International SPA Association  ISPA (USA) 1996  European SPA Association. ‍

In health and wellness tourism quality/excellence safety and ethics are deeply connected.

ESPA (Brussels) 1998  Guide of the 100 Best SPAS of the World 2003  Spa Asia Magazine 2007  Medical Tourism Association  MTA USA 2007  I Congress on Medical Tourism Worldwide Munich 2008  I International Health Tourism Congress Turkey  Association of Improving Health Tourism 2008 onward -- Congress took place in different cities in Turkey 2008  First Annual World Medical Tourism Association Congress 2008 onward.

Congress took place in different cities in USA 2010/2012  Annual European Medical Travel Conference (EMTC)  Venice Barcelona Berlin 2012  I International Conference on Health and Tourism Faro Portugal 2013  International Medical Travel Exhibition and Conference Monaco 2014  II International Congress on Health and Tourism Albufeira Portugal. ‍

Emergent Paradigms on Health and Medicine

Preventive Medicine promotes healthy lifestyles and diets stress management intellectual stimulation and fitness with a focus on wellness assessments versus illness. ‍

‍ Predictive Medicine individual health promotion based on diagnostics of genetic and environmental determinants. ‍

‍ Holistic Medicine whole-being meaning physical well-being mental awareness and wisdom spiritual harmony and equilibrium. ‍

Integrative Medicine brings together orthodox Western medicine/Allopathic and other Eastern holistic medicines  Chinese Ayurvedic and Indigenous knowledge and environmental consciousness. Integrative medicine emphasizes wellness wholeness and a preventive approach to health. Western medicine is based on an illness model concerned with treating disease rather than enhancing wellness. ‍

‍ Anti-Aging medicine that combines all those preceding paradigms. ‍

Definition: Health and Wellness Tourism

Health and wellness tourism includes travelling both nationally and internationally to places and facilities such as hospitals clinics thermae thalasso wellness SPAs and fitness centers and wellness resorts. ‍

In 2012 it was estimated that a million medical tourists travelled around the world for outbound/ inbound medical tourism.

The purpose of health and wellness tourism is medical care and health beauty relaxation recovery and rehabilitation treatments. There are more than a hundred-million health and wellness tourists around the world each year. Health and wellness tourism includes medical tourism elderly age tourism disability tourism thermal tourism and thalasso-therapy tourism. ‍

Wellness Tourism

Wellness tourism includes consumers who travel to maintain their well-being and life satisfaction through the experiences of healthy treatments. Wellness has to do with quality of life. In a holistic approach to health (Chinese ayurvedic and integrative medicines) wellness treatments and therapies restore the vital balance among bodies mind and spirit toward equilibrium and health harmony. This harmony re-balances and restores the energy flow bringing about overall well-being. ‍

Health Tourism

Health tourism refers to patients who travel nationally or internationally for healing therapies in hospitals and clinics. Health tourism includes medical tourism aesthetical/plastic tourism thermal tourism and thalassotherapy tourism. ‍

Medical Tourism

Medical tourism involves travel to hospitals and clinics for medical treatments in different areas including cardiology gynaecology neurology ophthalmology oncology orthopaedic transplants preventive medicine artificial insemination anti-aging medicine and plastic reconstructive medicine.

Medical tourism is also known as medical travel health tourism health travel healthcare tourism healthcare abroad medical overseas and overseas medical.Medical tourism has two components: inbound and outbound. In 2012 it was estimated that a million medical tourists travelled around the world for outbound/inbound medical tourism.

Medical tourism is a $100 billion global industry. The most important destinations include Argentina Austria Belgium Bolivia Brazil Chile Colombia Costa Rica Cuba Cyprus Czech Republic Dubai El Salvador France Germany Greece Guatemala Hungary India Israel Jordan Malaysia Mexico Philippines Poland Singapore South Africa South Korea Spain Sir Lanka Thailand Tunisia Turkey United Arab Emirates Venezuela and Vietnam. ‍

Aesthetical Tourism

Aesthetical tourism includes aesthetic surgery and treatments. In aesthetic/plastic tourism the most important countries are the United States and Brazil. Other destinations are Argentina Austria Belgium Bolivia Costa Rica Cuba France Germany Greece Hungary Italy Poland South Africa Spain Tunisia Turkey United Arab Emirates and Venezuela. ‍

Quality/Excellence and Safety

Within the scope of healthcare the quality of procedures and patient/client safety is strongly connected. Quality is the level of excellence ensured by a continuous managerial system.Safety is the condition/state of being secure from hurt/ injury and aims to prevent accidents and contagious diseases. It includes protective devices to prevent hazardous accidents and nosokomeion diseases. ‍

Quality/Excellence and Main Safety Components

Safe Environment air quality water quality reduced noise and visual pollution free of radiation pollution (magnetic electric nuclear) natural or recreated pleasant landscape - healthy trees bushes and flowers.

‍ Architectonic Requirements Modern and pleasant-looking healthcare facilities that enable the fast physical mental and spiritual well-being of patients and that makes their relatives and visitors rest and relax.

The main architectonic requirements are operating rooms located in sterilized areas lounges designed as living rooms and libraries assuring safety patient well-being and reduced time in integrated examination rooms on the same floor special architectural design that allows optimization of patient flow within the hospital and aims to prevent infections floors walls and ceiling materials must be easy to clean and disinfect walls painted with soft colors such as blue green and pink natural lighting and ventilation and healthy plants. ‍

Medical tourism hospitals must have a specialized staff which can speak different languages fluently namely the official voice of the patient's country.

A new generation of healthcare facilities is emerging that is very different from familiar institutional models. Based on patient-centered care and healing the whole person these health centers are spiritual sanctuaries with gardens fountains natural light art and music. Research is learning how human emotions are linked to disease and that healing is promoted by surroundings that reduce stress and engage the senses in therapeutic ways. Jain Malkin ‍

Hotel Structure and Services

The hospital (hospital like a hotel) requires healthcare humanization beautiful lounges several restaurants and cafeterias shops exhibition galleries musical concerts conference halls containing simultaneous translation systems and catering and laundry facilities specializing in the healthcare sector. A hospital is primarily a hotel in which health services are provided. Acibadem Turkey ‍

Technological Accuracy/Modern Technology

The latest international technology is put into service including accurate diagnosis equipment a fully equipped digital radiology department accurate radiotherapy treatments cyber-knife robotic surgery systems advanced cardiology ophthalmology and orthopaedics diagnosis treatment equipment and organ transplants. ‍

Professional Healthcare Qualifications: Surgeons Doctors and Others

Professional staff includes a high-qualified board of internationally certified surgeons and doctors specialized in different medical fields highly qualified anaesthesiologists qualified nurses and others health professionals. ‍

Multi-Language Staff Communicating Skills

Medical tourism hospitals must have a specialized staff which can speak different languages fluently namely the official voice of the patient's country. Good communication is very important to the safety and well-being of patients and their relatives. ‍

Scientific Affiliation

Hospitals and clinics develop protocols with universities/ colleges and research centers. Turkey Acibadem is affiliated with Harvard Medical International and Anadolu Health Center with John Hopkins Hospital. ‍

Healthcare Humanization

It is very important that patient-centered healthcare include a warm and tender environment attention to each individual patient's needs respect of cultural roots alimentary traditions and religious beliefs and patient participation in musical and theatrical groups. ‍

Accreditation and Certification

In medical/aesthetical tourism it is important to attest to the excellence and safety of healthcare services for clients from other countries. The most important international accreditation institutions are the Joint Commission International (JCI) Canadian Council on Health Services (CCHSA) Deutche Akkreditierrungasstelle Chemie (GMBH) Commission on Laboratory Accreditation of the College of American Pathologists Clinical Laboratory Accreditation Certificate ISO 15189 and ISSO 9001:2000 Medical Tourism Association (MTA Certification) International Society for Quality in Healthcare (ISQUA) European Society for Quality in Healthcare (ESQH) International Organization for standardization (ISO) Trent Accreditation Schemes (TAS) King's Fund Health Quality Services (KFHQS) and International Society of Aesthetic Plastic Surgery (ISAPS). ‍

High Standard of Ethical and Professional Deontology

In health and wellness tourism quality/excellence safety and ethics are deeply connected. The aesthetical surgeons must avoid making several surgical operations while informing the client/patient of the dangers of multiple aesthetical surgeries. ‍

Importance of Branding Destinations

Health and wellness brand destination becomes more important to promote the image of high-quality healthcare in a location (city region country). Seeking to attract international patients from around the world partners and stakeholders should work together to develop network synergies health and wellness clusters. Hotels and resorts become healthcare facilities for prior and post-surgery medical travellers. ‍

Attractive and Competitive Advantage of a Destination

The attractiveness and competitive advantage of medical/ aesthetical tourism are competitive prices on a global scale international accessibility and proximity international accreditation/certification and excellence.

Excellence is defined as a high-level of holistic quality (several levels and parameters) which exceed expectations including accredited hospitals qualified doctors certified surgeons qualified anaesthesiologists qualified nurses and others professionals advanced technologies efficacious therapeutic procedures faster medical services affiliation with universities and research centres humanization of healthcare beautiful hospitals hospitality/hotel structure linguistically competent teams healing climate pleasant environment/ landscapes healthy gastronomy and partnership with luxury hotels and resorts. ‍

About the Authors

João Viegas Fernandes is a founder and president of the Associação Portuguesa de Turismo de Saúde e Bem  Estar  APTSBE (Health and Wellness Tourism Portuguese Association). He is also the architect and advisor to Algarve Region Health & Wellness Tourism Cluster and Destination Branding. He is considered a visionary pioneer and expert in health and wellness in Portugal.

As a professor he conceptualized a discipline in health and wellness tourism which he teaches in the School of Management Hospitality and Tourism of Algarve University. He has lectured in various universities in Portugal Spain and Brazil and is researching health and wellness tourism around the world.

Fernandes is a consultant in this area both nationally and internationally. Fernandes has spoken at several conferences in Portugal Spain Brazil Turkey Cape Verde and Monaco on sustainable health and wellness tourism. He is the author of the book ThalassaThermae SPA-Salute Per Aqua (Lisboa Portugal 2006).

He also is co-author of several articles and books including SPAS Centros Talasso e Termas: Turismo de Saúde e Bem-Estar (Lisboa Portugal 2008) and Turismo de Saúde e Bem-Estar no Mundo: Ética Excelência Segurança e Sustentabilidade (São Paulo Brazil 2011).

Fernandes was the chairperson of the I International Conference on Health and Tourism (Faro Portugal 2012) and the II International Congress on Health and Tourism (Albufeira Portugal 2014). He is an advocate of increased cooperation in health and wellness tourism among the eight countries which speak Portuguese. ‍

Filomena Maurício Viegas Fernandes is a medical doctor and specialist in public health. She was the health delegate in several municipalities in the Algarve region and has been responsible for a number of programs on public health.

She has delivered presentations at various international conferences and is considered an expert in health and wellness tourism. Fernandes has been researching and teaching health and wellness tourism in the School of Management Hospitality and Tourism at Algarve University.

She is the co-author of several articles and books including SPAS Centros Talasso e Termas: Turismo de Saúde e Bem-Estar (Lisboa Portugal 2008) and Turismo de Saúde e Bem-Estar no Mundo. Ética Excelência Segurança e Sustentabilidade (São Paulo Brazil 2011).

Fernandes was a member of the organizing committee of the I International Conference on Health and Tourism (Faro Portugal 2012) and is coordinating the II International Congress on Health and Tourism in Albufeira Algarve Portugal in 2014.

Informed Decision-Making in Medical Tourism: The Significance of Clinical Outcome Reports

The synergy between telemedicine services and medical tourism marketing, elevating visibility: advanced seo strategies for medical tourism websites, crafting success: building an effective content marketing plan for medical tourism, navigating the future: emerging trends in medical tourism and their marketing implications, crafting a winning brand strategy for medical tourism facilities, the benefits of multi-language marketing in medical tourism, revolutionizing customer service in medical tourism with ai: a paradigm shift, exploring niche markets in medical tourism, continue reading, rengeneration therapy helps adults rejuvenate health and vitality, stem cells: a second opportunity at life, a leap of faith, featured reading, medical tourism events and conferences: a marketing goldmine, navigating cultural competence in medical tourism marketing: a global approach, medical tourism magazine.

The Medical Tourism Magazine (MTM), known as the “voice” of the medical tourism industry, provides members and key industry experts with the opportunity to share important developments, initiatives, themes, topics and trends that make the medical tourism industry the booming market it is today.

The Astounding Growth of Medical Tourism

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Medical tourism is a type of tourism that is on the rise around the world. Coming in many different shapes and forms, medical tourism is often sought by people in search of reduced priced cosmetic surgery, better healthcare systems than what is available to them in their home country or to obtain access to facilities or procedures that are not available to them at home. But what exactly is medical tourism and what does it look like? Read on to learn more…

What is medical tourism?

Medical tourism definitions , types of medical tourism, medical tourism companies, medical tourism in india, medical tourism in turkey, medical tourism in brazil, medical tourism in thailand, medical tourism in the czech republic, further reading.

Ever heard of ‘Turkey teeth’? It seems like a lot of people have them, and that’s just one example of so-called medical tourism.

Medical tourism is when you travel to another country (or another part of your home country as a domestic tourist ) to undergo a particular medical procedure. More often than not this is purely cosmetic, although of course people do need to travel for life-saving medical treatment sometimes too.

In the past, this generally meant people travelling from third world or less developed countries to obtain medical treatment in countries that can provide better healthcare systems. Now, it is often the other way round – people will travel to ‘developing’ countries as they can often get this treatment cheaper.

There is also the need to travel to different countries sometimes as the treatment you may want or need might not be available in your home country. For example, some cancer drugs are only available in the US meaning people will often travel from other countries to try it.

The CDC website defines and describes medical tourism as follows:

Medical tourism is when a person travels to another country for medical care. Each year, millions of US residents participate in medical tourism. Medical tourists from the United States commonly travel to Mexico and Canada, as well as countries in Central America, South America , and the Caribbean.

People may travel to another country to get health care for many reasons, including:

• Cost: To get treatment or a procedure that may be cheaper in another country.
• Culture: To receive care from a healthcare provider who shares the traveler’s culture and language.
• Unavailable or Unapproved procedure: To get a procedure or therapy that is not available or approved in the United States.

The most common procedures that people undergo on medical tourism trips include dental care, surgery, cosmetic surgery, fertility treatments, organ and tissue transplantation, and cancer treatment.

Of course this definition uses Americans as an example, but it works broadly too. The World Health Organisation also have a similar definition of medical tourism:

Medical tourists elect to travel across international borders to receive some form of medical treatment  

• Treatments may span the full range of medical services  
• Most common: dental care, cosmetic surgery, elective surgery, and fertility treatment – OECD, 2010 

No agreed definition of medical tourism exist; as a result methods applied by countries vary substantially  

• Some countries count foreign patients’ visits to hospitals whereas others count the entry of individual patients into the country  
• Other countries record nationality but not place of residence of patients, can be problematic when migrants return to home country for treatment – WHO, 2011

There are different types of medical tourism to consider. As mentioned, some visits are for cosmetic treatment whereas some are for life-saving medical treatment. According to Madre Healthcare (an Indian company specialising in medical tourism), these are the top 10 types of medical tourism…

• Dental/dentistry
• Orthopedics
• Cosmetic/plastic surgery
• Bariatric surgery 
• Fertility treatment
• Eye surgery
• Ears, nose and throat
• Organ transplants
• Rehabilitation 

There are various companies who have capitalised on the increase in people travelling for medical purposes, offering overall package deals making it easier for you to book these trips. These specialist travel agencies will facilitate the whole process. This includes arranging access and appointments as well as travel, visas, accommodation and more. Some even sort out sightseeing and activities for the rest of your trip!

According to IMARC , the global medical tourism market is set to grow even more in the next 5 years. It is also becoming more regulated, meaning people can feel safer when travelling for medical purposes. There are so many different medical tourism companies operating from each country, meaning you can find the perfect company to help organise your trip without any language barriers or confusion.

Simply search for ‘medical tourism company based in’ followed by your home country if you are looking for someone to help you navigate booking medical treatment abroad!

Some well-renowned medical tourism company examples include:

• MedicalHeathCare (UK, facilitating treatment in Turkey, Belgium, Poland , Croatia, Hungary, and Czech Republic)
• Fortis Healthcare Limited (India, facilitating treatment in Dubai, Sri Lanka and India)
• American Medical Care (USA, facilitating treatment in Costa Rica, Mexico and Nigeria as well as the USA)

Medical tourism destinations 

There are certain places where medical tourism is most popular. These include many European countries as well as central America, Asia, the USA and more! Below you’ll see some of the leading destinations when it comes to medical tourism. Find out what makes them so popular!

• Czech Republic

Worth an estimated $5-6 billion (USD), medical tourism in India is a big business. Most people who travel to India for medical treatments do so from Southeast Asia, the Middle East and Africa as well as the SAARC region. The government also has an extended visa regime in order to include medical visas, with a maximum stay of 6 months. India has low costs and up-to-date medical technology, which is what makes it the ideal place for medical tourism. Many doctors have trained in the Western world and speak brilliant English too, so there is much less of a language barrier in place for travelling patients.

The top locations within India for medical tourism are Maharashtra, Chennai and Kerala. In terms of the most popular treatments available in India to medical tourists, they are as follows:

• Alternative medicine
• Bone-marrow transplants
• Cardiac bypass
• Hip replacements 

Costs tend to be around one tenth of what they would be in either the UK or the USA. This is why India is such a great choice: the low cost and solid regulations combined mean you’re getting the best of both worlds.

At the start of this article I mentioned so-called ‘Turkey teeth’. This is a popular phenomenon, especially in the UK – this excerpt from Dental Hygiene Studio sums it up…

‘Turkey Teeth’ is a new phrase to describe super-white, super-square teeth which millennials in particular are keen to get. Social media influencers are going abroad because they are impressed by slick looking clinics and cheaper prices.

Of course, other countries offer this service but it is particularly common in Turkey. With hot weather and plenty of beautiful places to see, bars to drink in and hotels to relax at, Turkey makes for an obvious choice. This is especially true for Brits as the flight isn’t too long! 

Hair transplants are another big one in Turkey. Medical tourism in the country is regulated and has been since 2017. In 2018 alone, around 178,000 people flew to Turkey specifically for medical tourism purposes. The industry is said to contribute around $4 billion (USD) to Turkey’s economy every year, too.

The world’s 5th largest country is popular with tourists for its weather and iconic landmarks, and now for its medical procedures. They have an incredibly reliable healthcare system, said to be the continent’s most efficient – according to the WHO. In many cases citizens of nearby, lesser-developed countries opt to undertake medical procedures in Brazil. But it is also now a global destination for medical tourism!

Treatments are 60-70% cheaper here in comparison to the US and UK. Although, in the case of cosmetic surgery this isn’t strictly true. Highly trained surgeons have been known to charge as much if not more as their US counterparts. But for other treatments you are definitely getting a better deal and a holiday.

Sao Paulo and Florianopolis are the two most popular destinations in Brazil for medical tourism. The government is aiming to make them the two most popular destinations in the whole of South America! Over 50,000 tourists visit these two cities for medical tourism purposes every year, so they’re well on their way to achieving this goal…

While studies from the Thai government may be inaccurate in terms of their numbers, Thailand is still a popular destination for medical tourism. This study shows how the numbers might be skewed. All data should be taken with a pinch of salt! 

Most people head over here for minor elective/cosmetic surgeries. Thailand also offers fantastic spine and orthopedic surgeries and treatment. Their technology is cutting edge, too. Medical tourists visit Thailand from all over the world, with many from Eastern-Med destinations as well as Southeast Asia and Europe. Stats from the past few years show the industry is worth around $600 million (USD) to the country.

Thailand is a fantastic tourist destination regardless. For minor surgeries with a quick recovery time, there are plenty of things to do. And if you’re on strict instructions to just relax after a medical procedure, what better way is there to do it than staying somewhere so beautiful?! 

When searching for medical tourism companies, you’ll find many options for the Czech Republic. With high standards, quality care and a beautiful setting, it is easy to see why Prague (the country’s capital) is such a popular destination for this type of travel.

For pre-and-post-op treatment, there are various spa facilities used in medical facilities. Czech medical teams have great results in terms of cardiology, orthopaedics and neurology as well as cosmetic surgery. Costs are much lower, they have the latest technology and the city has so much to see and do. For those in the UK and other eastern European countries, there is hardly any travel time too!

If you enjoyed reading this article, I am sure that you will love these too-

• Niche tourism: What, why and where
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Medical, Health and Wellness Tourism Research—A Review of the Literature (1970–2020) and Research Agenda

1 Institute for Big Data Research in Tourism, School of Tourism Sciences, Beijing International Studies University, Chaoyang District, Beijing 100024, China; nc.ude.usib@anilgnohz (L.Z.); moc.361@5220niloabgned (B.D.); moc.361@gnay__uyil (L.Y.)

Baolin Deng

Alastair m. morrison.

2 Greenwich Business School, Old Royal Naval College, University of Greenwich, London SE10 9SL, UK; [email protected]

J. Andres Coca-Stefaniak

Associated data.

Data are reported in the article.

Medical, health and wellness tourism and travel represent a dynamic and rapidly growing multi-disciplinary economic activity and field of knowledge. This research responds to earlier calls to integrate research on travel medicine and tourism. It critically reviews the literature published on these topics over a 50-year period (1970 to 2020) using CiteSpace software. Some 802 articles were gathered and analyzed from major databases including the Web of Science and Scopus. Markets (demand and behavior), destinations (development and promotion), and development environments (policies and impacts) emerged as the main three research themes in medical-health-wellness tourism. Medical-health-wellness tourism will integrate with other care sectors and become more embedded in policy-making related to sustainable development, especially with regards to quality of life initiatives. A future research agenda for medical-health-tourism is discussed.

1. Introduction

In 1841, Thomas Cook organized a tour of 570 people to travel from Leicester to Loughborough’s hot springs [ 1 ]. This was the first historically documented tour arranged by a travel agent. However, far earlier, people in Ancient Greece used to travel considerable distances for medical treatment [ 2 ]. Thus, the pursuit of health and medical care has been an essential reason for travel for centuries.

Today, people continue to travel in the pursuit of relaxation, for health reasons, as well as fitness and well-being [ 3 ]. As a response to this growing demand, countries, medical providers, and hospitality and tourism organizations are adapting to offer a broader set of medical, health, and wellness tourism experiences.

The concept of medical-health-wellness tourism has emerged relatively recently as a scholarly field of enquiry in tourism [ 4 , 5 , 6 ]. Although it has been pointed out that travel medicine has existed for 25 years [ 7 ], much of the research related to this has traditionally focused on medical aspects with inadequate consideration given to travel or tourism. Medical-health-wellness tourism can be classified into two primary categories according to a tourist’s choice - obligatory or elective. Obligatory travel occurs when required treatments are unavailable or illegal in the place of origin of the traveler and, as a result of this, it becomes necessary to travel elsewhere to access these services. Elective travel is usually scheduled when the time and costs are most suitable, and the treatments may even be available in the travelers’ home regions [ 8 ]. Other studies have classified these forms of travel and tourism into specific types based on the purpose of the treatment, such as dental tourism [ 9 ], stem cell tourism [ 10 ], spa tourism [ 11 ], springs tourism [ 12 ], IVF treatment [ 13 ], hip and knee replacements, ophthalmologic procedures, cosmetic surgery [ 5 ], cardiac care, and organ transplants [ 14 ].

A consensus is yet to be established on the definitions and contents of medical-health-wellness tourism, and how they interact, including their potential overlaps. Medical travel and tourism, health tourism, wellness tourism, and other similar terms (e.g., birth tourism, cosmetic surgery tourism, dental tourism) tend to be investigated separately in tourism research [ 15 , 16 , 17 , 18 , 19 , 20 ]. Notwithstanding the apparently disconnected nature of published research in this field, medical-health-wellness tourism has become much more popular for a variety of economic, cultural, lifestyle and leisure reasons [ 11 , 21 , 22 ]. Given their rapid development, it seems appropriate to conduct a comprehensive review of the definitions, history, typologies, driving factors, and future directions for these forms of tourism.

This study firstly reviews existing scholarly research through a meta-analysis of medical-health-wellness publications in the context of tourism ( Section 2 ). Then, the method used to analyze the data collected from ISI Web of Science is outlined in Section 3 , followed by a discussion of the research findings ( Section 4 ). Finally, in Section 5 , the conclusions, future research directions, and limitations of the study are presented.

2. Scholarly Reviews and Meta-Analyses of Medical, Health and Wellness Tourism

Previous reviews of the literature and meta-analyses have contributed to clarifying the overall understanding of medical-health-wellness tourism. Existing literature reviews tend to be very broad, spanning health-oriented tourism, medical tourism, sport and fitness tourism, adventure tourism, well-being (Yang sheng in Chinese) tourism, cosmetic surgery tourism, spa tourism, and more.

Medical tourism is an expanding global phenomenon [ 15 , 23 , 24 ]. Driven by high healthcare costs, long patient waiting lists, or a lack of access to new therapies in some countries, many medical tourists (mainly from the United States, Canada, and Western Europe) often seek access to care in Asia, Central and Southern Europe, and Latin America [ 25 , 26 , 27 ]. There are potential biosecurity and nosocomial risks associated with international medical tourism [ 28 ]. One research study collected 133 electronic copies of Australian television programs (66 items) and newspapers (65) about medical care overseas from 2005 to 2011 [ 29 ]. By analyzing these stories, the researchers discovered that Australian media coverage of medical tourism was focused geographically mainly on Asia, featuring cosmetic surgery procedures and therapies generally not available in Australia. However, people tend to engage with medical tourism for a broad range of reasons. In some cases, it is better service quality or lower treatment costs that prevail. In other cases, treatments may not be available locally, or there are long patient waiting lists for non-emergency medical care. Some 100 selected articles were reviewed and categorized into different types of medical tourism depending on the medical treatments they involved, such as dentistry, cosmetic surgery, or fertility work [ 25 ]. An analysis was done on 252 articles on medical tourism posted on the websites of the Korean Tourism Organization and the Korean International Medical Association [ 30 ]. This work enhanced the understanding of medical tourism in Korea as well as identifying the key developmental characteristics. Another research study detailed patient experiences in medical travel, including decision making, motivations, risks, and first-hand accounts [ 31 ]. A literature review was conducted on international travel for cosmetic surgery tourism [ 5 ] and it concluded that the medical travel literature suffered from a lack of focus on the non-surgery-related morbidity of these tourists.

Another set of authors defined health tourism as a branch of tourism in general in which people aim to receive specific treatments or seek an enhancement to their mental, physical, or spiritual well-being [ 32 ]. This systematic literature review assessed the value of destinations’ natural resources and related activities for health tourism. It was argued that most of the research on health tourism has focused on travel from developed to developing countries, and that there is a need to study travel between developed nations [ 33 ].

Wellness tourism is a key area of relevant research as well [ 34 ]. One research study reviewed trends in wellness tourism research and concluded that tourism marketing had so far failed to tap into the deeper meaning of wellness as a concept [ 35 ]. The emergence of health and wellness tourism was explored with their associated social, political, and economic influences [ 13 ]. A review was conducted of the development of wellness tourism using the concept of holistic wellness tourism where it was found that the positive impacts of this type of tourism on social and economic well-being were key to its rising levels of popularity [ 36 ].

All in all, although earlier literature reviews provide invaluable insights into medical-health-wellness tourism, there is a lack of studies that approach this concept in a holistic way. This research seeks to redress this balance by delivering a holistic review of the literature with the following objectives in mind: (1) investigating international journal articles across the typologies of tourism outlined above; (2) identifying influential scholars that have significantly contributed to this field; and (3) summarizing key trends in markets, industry development and promotion, as well as policy-making and impacts. In order to achieve this, a systematic review was conducted to analyze research articles in medical-health-wellness tourism published over a 50-year period from 1970 to 2020.

3.1. Data Collection

A two-step approach was adopted for the development of a database of publications for analysis with CiteSpace. The first step involved a search for relevant, high-quality refereed articles in medical-health-wellness tourism. Several academic journal databases, within tourism and hospitality but also including other disciplines too, were searched for relevant articles in medical-health-wellness tourism using a set of selected keywords. The ISI Web of Science and Scopus were chosen for this purpose as a result of their international recognition and comprehensiveness. Articles included in the list of references of selected articles were also considered valid as part of this search, in line with methodological suggestions for systematic literature searches [ 37 ]. Cited articles were also collected from prominent journals, including the Southern Medical Journal, Journal of Travel Medicine, BMC Public Health, Annals of Tourism Research, Tourism Management, Journal of Travel Research, and Journal of Vacation Marketing. Non-tourism related journals were selected as well including Amfiteatru Economic, Asia Pacific Viewpoint, Public Personal Management, and Revista de Historia Industrial. Adding these references not only delivered a higher number of relevant articles to the database, but it also increased its representativeness.

The second step involved using appropriate, valid and representative search keywords. A total of 986 articles were gathered using the following keywords: medical tourism, health tourism, wellness tourism, and spa tourism. After careful sorting of these publications, using their abstracts and keywords, the number of articles in the database was narrowed down to 802. Of these, 615 were obtained using the keywords medical tourism or wellness tourism, 157 were located by searching for health tourism, and 30 were discovered using spa tourism as the search term. Using the above keywords and restricting the search to 50 years (1970–2020), the first article was found to be published in 1974. As a result, the ensuing analysis of the literature comprises the period from 1974 to 2020.

3.2. Data Analysis

The research tool used for this study was CiteSpace, which is a bibliometric analysis software developed by Professor Chaomei Chen of Drexel University based on the Java framework [ 38 ]. This software assists researchers in the analysis of research trends in a specific field of knowledge and presents scientific knowledge structures through visualization. It has been applied to numerous research fields by scholars from many countries. The data processing for this research used the software V.5.7.R2 (64-bit) version.

The data were classified and analyzed to achieve three specific goals. The first and primary goal of this review work was to analyze the content of the chosen articles, including year of publication, authors, journal impact factors, and the institutional affiliations of scholars in this field. The data were then sorted into categories. The order of authorship was not recorded. For multiple-authored articles, each author was given the same level of credit as sole authors. Second, one of the aims of this research was to discover associations in authorships, regions, and affiliations using statistical analysis. Third, the 802 articles were classified into dominant thematic categories applying the approach proposed by Miles and Huberman [ 39 ]. Three flows of analytical activities were targeted here: data reduction, data display, and verification of data. In the data reduction activity, the word count technique was adopted. Through content analysis, each article’s title and full-text body were recorded for word counting. The most frequently appearing words were extracted to represent the main topics of the collected articles. The dominant thematic categories to be explored further based on the content analysis and word count were: (1) tourism market: tourist demand and behavior; (2) tourism destinations: development and promotion; and (3) tourism development contexts: policies and impacts.

Finally, in order to refine the set of topic sub-categories, abstracts, first paragraphs, and conclusions were read to make the most appropriate assignments. This approach contributed to the more advanced stages of development of the classification of sub-categories and, consequently, the verification of findings.

This section presents the results of the data analysis carried out in this study and provides further insights on the methodology adopted.

4.1. Overview of Articles Published

The 802 articles selected were all published in English and in international peer-reviewed academic journals. Figure 1 displays the timeline distribution of the research on medical-health-wellness tourism and shows a steady growth in publications in this field between 1974 and 2020. This growth in scholarly activity is particularly significant from 2010 onwards. In fact, 74.9% of the articles were published between 2013 and 2020.

Number of articles by publication year.

4.2. Source Journals

Initially, the first stage of this literature search involved identifying academic journals publishing research articles on medical-health-wellness tourism. It was found that 38 articles had been published on this topic in Tourism Management, and 24 articles in Social Science & Medicine. Table 1 shows the top ten tourism journals for publications in this field, with Tourism Management in first place.

Tourism journals publishing articles on medical-health-wellness tourism.

Non-tourism journals in fields such as business, economics, and health, also contributed a significant number of publications in this field, as shown in Table 2 .

Non-tourism journals publishing articles on medical-health-wellness tourism.

4.3. Author Productivity and Authorship Analysis

The second aim was to identify the most prolific scholars in medical-health-wellness tourism research. This was achieved using co-occurrence network analysis of the authors of relevant research articles ( Figure 2 ). Each node in the co-occurrence map shown in Figure 2 represents a given scholar. The larger the node, the more articles the authors published on the topic, with the connections between nodes representing cooperation between authors.

Author article productivity.

Among the 2381 authors identified, 1820 (76.4%) contributed to only one article, whereas the remaining 561 (23.6%) authored two or more articles. The three most prolific authors were Jeremy Snyder, Valorie Crooks, and Rory Johnston.

4.4. Author Regions and Affiliations

Another objective was to illustrate the relationships and networks of authors publishing research on medical-health-wellness tourism. An analysis of countries this research originated from was carried out using the CiteSpace software. Figure 3 shows that scholars publishing in this field were distributed across 61 countries. The largest group of authors originated from the USA ( n =197). The second and third largest groups corresponded to Canada ( n = 88) and the UK ( n = 84), respectively, followed by Australia ( n = 70) and South Korea ( n = 65). As shown in Figure 3 , authors from the USA and Canada have made the most significant contributions to medical-health-wellness tourism based on the number of journal articles published.

Country of origin of authors in medical-health-wellness tourism.

As shown in Figure 4 , a significant number of scholars publishing in this field ( n = 47) were affiliated to Simon Fraser University in Canada. This university was followed by Sejong University in South Korea ( n = 13), and the London School of Hygiene & Tropical Medicine ( n = 13) in the UK. The top universities in terms of author frequency were based in Canada, USA, Australia, UK, South Korea, and Hong Kong.

Institutions of authors.

4.5. Thematic Analysis of Research

The fourth research objective was to elicit the prevailing research themes using the 802 articles gathered. First, an analysis of keyword frequency was performed to identify the main research interests. High frequency keywords reflect the research ‘hotspots’ in the field. Using CiteSpace’s keyword visualization analysis function, the keyword co-occurrence knowledge map of medical-health-wellness tourism research was drawn to grasp the research ‘hotspots’ ( Figure 5 ).

Frequencies of research keywords.

Then, content analysis performed on the articles gathered for this study identified three main themes, namely: markets (tourist demand and behavior), destinations (development and promotion), and development environments (policies and impacts). An uneven distribution of research themes is highlighted in Figure 6 and Figure 7 .

Timeline of research keyword appearance.

Themes of research articles.

4.6. Markets: Demand and Behavior

Previous studies have shown that the growth of medical-health-wellness tourism in developing countries is largely linked to lower costs, shorter patient waiting lists, and better quality of care [ 40 ]. Similarly, it is suggested that the inequalities and failures in domestic health care systems often lead to people seeking treatment to travel abroad to obtain it [ 41 ]. In general terms, higher costs, long patient waiting lists, the relative affordability of international air travel, favorable exchange rates, and the availability of well-qualified doctors and medical staff in developing countries, all contribute to this situation [ 42 ].

As the demand for these forms of tourism has risen over time, processes and factors influencing decision-making have attracted growing levels of scholarly enquiry. For example, a political responsibility model was used to develop a decision-making process for individual medical tourists [ 43 ]. A sequential decision-making process has been proposed, including considerations of the required treatments, location of treatment, and quality and safety issues attendant to seeking care [ 44 ]. Accordingly, it has been found that health information and the current regulatory environment tend to affect the availability of medical care.

Multiple factors may simultaneously influence decisions related to the destination for care, including culture [ 45 ], social norms [ 46 ], religious factors [ 47 ], and the institutional environment [ 48 ]. It is suggested that socioeconomic conditions shape medical travelers’ decision-making and spending behavior relative to treatment, accommodation, and transport choices as well as the length of stay [ 49 ]. Perceived value is a key predictor of tourist intentions. More specifically, perceived medical quality, service quality, and enjoyment significantly influence the intention to travel abroad for medical-health-wellness purposes [ 50 ]. Further, perceived quality, satisfaction, and trust in the staff and clinics have significant associations affecting intentions to revisit clinics and the destination country [ 51 ]. An empirical study was conducted and found that physical convenience in willingness to stay and time and effort savings in perceived price were key factors affecting the decision-making related to medical hotels [ 52 ]. In addition, the level of perceived advantages, price perceptions, and willingness to stay were found to differ significantly between first-time patients and those with two or more previous visits. In addition, it was found that community communication was a major factor influencing decision-making. For instance, it is argued that virtual community membership has a strong influence on tourist behaviors and the way information is transmitted [ 53 ].

Compared to other tourists, the mental activity and behavior of medical-health-wellness travelers are quite different. Medical tourists are less likely to question their need for surgery and tend to be much readier to accept it [ 54 ]. The emotion and anxiety conditions of medical tourists differ from others’ experiences of travel and tourism, as well as their giving and receiving of transnational health care [ 55 ]. It has been found that language barriers and parenting responsibilities can be significant challenges, while hospital staff and their own families are often major sources of support for medical tourists [ 56 ]. Furthermore, there are significant differences among visitors from different countries in terms of choices, discomfort, preferred product items, and attitudes towards medical tourism [ 57 , 58 ].

4.7. Destinations: Development and Promotion

In response to the demands of medical-health-wellness tourism, destination development and promotion are attracting growing levels of scholarly interest. Scholars from different countries have discussed the market status of Turkey [ 12 , 59 ], the Caribbean [ 60 ] and Barbados [ 61 ], India [ 62 , 63 ], Canada [ 64 ], and Albania [ 65 ]. Table 3 outlines the most frequently researched country destinations in this respect.

Medical-health-wellness destination frequency in keywords.

The advantages and disadvantages of Turkey were examined and indicated needs for improvements [ 59 ]. In another research study, three years (2005, 2007, and 2011) of actual and projected operational cost data were evaluated for three countries: USA, India, and Thailand [ 66 ]. This study discussed some of the inefficiencies in the U.S. healthcare system, drew attention to informing uninsured or underinsured medical tourists of the benefits and risks, and determined the managerial and cost implications of various surgical procedures in the global healthcare system.

As regards medical-health-wellness tourism destination development, scholars have explored research from various perspectives. Conceptual frameworks have been developed to include tourism destinations and services in the context of medical and health tourism [ 59 , 67 ]. Advice has been provided from the perspective of public and private hospital doctors [ 68 ]. The principles of designing hospital hotels have been proposed, including proper planning, low prices of tourism services, medical education, creating websites on medical tourism, and health tourism policy councils [ 69 ]. Above all, scholars have posited that meeting or exceeding tourist expectations and requirements should remain the top priorities as regards the effective development of medical tourism destinations [ 69 , 70 ].

Once a medical-health-wellness tourism destination is developed successfully, marketing and promotion are essential to attract tourists. As part of this process, informing potential patients about procedural options, treatment facilities, tourism opportunities, and travel arrangements are the keys to success [ 71 ]. Most tourists rely on the Internet to gather information about destinations, often using mobile devices or personal computers [ 72 ], with websites and social media playing a key role in this respect, and specifically with regards to information about destinations’ medical facilities, staff expertise, services, treatments, equipment, and successful cases [ 73 ]. For example, apps for medical travel are available to attract tourists and promote medical tourism in Taiwan [ 74 ].

Numerous businesses promote medical-health-wellness travel, including medical travel companies, health insurance companies, travel agencies, medical clinics, and hospitals [ 75 ]. Among them, medical travel facilitators play a significant role as engagement moderators between prospective patients in one country and medical facilities elsewhere around the world [ 76 ]. The services offered on medical tourism facilitator websites vary considerably from one country to another [ 77 ]. Although medical travel facilitators operate on a variety of different scales and market their services differently, they all emphasize the consumer experience through advertising quality assurance and logistical support [ 78 ].

Scholarly research has also considered the factors that need to be taken into consideration in medical-health-wellness tourism promotion. This research has suggested that destinations should identify the specifics in their health tourism resources, attractions, and products, seek collaboration with others, and build a common regional brand [ 79 ]. Regional differences should be considered in the process of marketing as medical-health-wellness tourism is a global industry [ 77 ]. International advertisers need to understand the important, contemporary, and cultural characteristics of target customers before promotion [ 80 ]. Similarly, destinations need to portray safe and advanced treatment facilities to dispel potential patient worries and suspicions. Messages related solely to low cost may detract from and even undermine messages about quality [ 71 ]. However, while benefits are highly emphasized online, websites may fail to report any procedural, postoperative, or legal concerns and risks associated with medical tourism [ 81 ].

4.8. Development Environments: Policies and Impacts

The rise of medical-health-wellness tourism emphasizes the privatization of healthcare, an increasing dependence on technology, and the accelerating globalization of healthcare and tourism [ 82 ]. There are challenges and opportunities in the development of these tourism forms. For instance, it has been suggested that medical tourism distorts national health care systems, and raises critical national economic, ethical, and social questions [ 83 ]. Along with the development of medical-health-wellness tourism, social-cultural contradictions [ 84 ] and economic inequities are widening in terms of access, cost, and quality of healthcare [ 85 ]. It is argued that this tourism leads destinations to emphasize tertiary care for foreigners at the expense of basic healthcare for their citizens [ 86 ]. Moreover, in some instances, this phenomenon can exacerbate the medical brain drain from the public sector to the private sector [ 43 , 87 , 88 ], leading to rising private health care and health insurance costs [ 88 ].

While medical-health-wellness tourism is a potential source of revenue, it also brings a certain level of risk to destinations and tourists [ 89 ]. The spread of this type of tourism has been posited as a contributing factor to the spread of infectious diseases and public health crises [ 90 , 91 ]. Medical tourists are at risk of hospital-associated and procedure-related infections as well as diseases endemic to the countries where the service is provided [ 92 ]. Similarly, the safety of some treatments offered has also been the subject of growing levels of scrutiny. Contemporary scholarship examining clinical outcomes in medical travel for cosmetic surgery has identified cases in which patients traveled abroad for medical procedures and subsequently returned home with infections and other surgical complications [ 93 ]. Stem cell tourism has been criticized on the grounds of consumer fraud, blatant lack of scientific justification, and patient safety [ 94 , 95 ]. During the process of medical tourism, inadequate communication, and information asymmetry in cross-cultural communication may bring medical risks [ 96 ].

Medical-health-wellness tourism has emerged as a global healthcare phenomenon. Policy guidance is vital for the development of this sector in the future [ 97 ]. There are policy implications for the planning and development of medical-health-wellness tourism destinations [ 98 ]. Generally, it has been found that the medical-health-wellness tourism sector tends to perform better in countries with a clear policy framework for this activity [ 99 ]. Similarly, scholars have argued the need for a clearer policy framework regulating tourism agencies and the information and services they provide [ 100 ]. The upsurge of these tourism forms presents new opportunities and challenges for policy makers in the health sector. It has been argued that existing policy processes are mainly based on entrenched ideological positions and more attention should be paid to robust evidence of impact [ 101 ]. The UK developed policies focused on ’patient choice’ that allow people who are able and willing to choose to travel further for healthcare [ 102 ]. However, more robust policy making is still required to strengthen national health services and facilitate medical-health-wellness tourism sector development in destinations [ 103 , 104 ].

5. Discussion and Conclusions

5.1. generation discussion.

This study is based on a literature review of 802 articles on medical-health-wellness tourism from 1970 to 2020. Jeremy Snyder was found to be the most prolific author in this field with 45 articles. It has been found that the literature on this topic can be summarized into three themes: markets (tourist demand and behavior), destinations (development and promotion), and development environments (policies and impacts). The scholarly research in this growing field has undergone a shift in emphasis from tourist demand and behavior to the promotion and development of destinations, and, more recently, to policies and impacts.

To attract more tourists, destinations should explore their potential for medical-health-wellness tourism. Accessibility, procedural options, treatment facilities, travel arrangements, safety guarantees, and government policies remain influential factors. In the development and promotion of this form of tourism, childhood vaccinations, oral health, legal frameworks, evaluation systems, entrance systems, and macro-policy continue to be areas of concern and where further research is required. Above all, meeting or exceeding tourist expectations and requirements is the most important consideration to promote medical-health-wellness tourism. Similarly, appropriate policy guidelines and frameworks are necessary to support this form of tourism. Importantly, medical-health-wellness tourism may result in negative impacts on the healthcare service provision for local residents in poorer countries, with tourists from richer countries benefiting to the detriment of local communities. However, if managed successfully, this form of tourism can also be a force for good in terms of fostering the economic development of countries delivering these services.

The results indicated that the research literature is spread across a range of different disciplines and there is not one single venue for publishing in this field. A better integration of the research and improved understanding of the overlaps among medical, health, and wellness tourism is required.

5.2. Future Research Trends

5.2.1. industrial perspective.

Medical-health-wellness tourism will, over time, integrate fully with other healthcare and wellness services. Similarly, medical challenges such as disease prevention and traditional medicine remain essential directions for the future of health tourism. This form of tourism will also integrate further with industries such as wellness culinary tourism, mindfulness tourism, active tourism (including adventure tourism), and even cosmetic surgery tourism, leading to a vast array of potential research avenues linked to health tourism destinations. These futures will greatly promote the physical and mental health of wellness tourists. This is another emerging direction for future medical-health-wellness tourism research.

5.2.2. Destination Development Perspectives

Medical-health-wellness tourism will become more significant forms of tourism and impact the development of different nations and areas. For example, this tourism will integrate with Chinese traditional culture. Traditional treatments and remedies will become more of an advantage and should be a topic for future medical-health-wellness tourism research, as well as in other countries with unique health cultures, treatments, and procedures.

Thailand, Malaysia, and other Southeast Asian countries are favored by tourists from developed countries due to lower costs. In the future, these areas need to focus more on tourism product design, health tourism marketing, community participation, and cross-cultural communication. Developed countries such as the USA, Japan, and South Korea, will use advanced technology and medical equipment to take the path to high-end, high value-added tourism development. This will lead to some new research opportunities.

5.2.3. Tourist Perspectives

Compared with other types of tourists, the needs of medical-health-wellness tourists will receive more attention. Based on previous research, the psychology and perceived value of these tourists are the focus of considerable research. In the future, more emphasis will be paid to people and especially to their psychological and physiological needs. Research on demand will become a more popular topic of this tourism research. Second, the current research on medical-health-wellness tourists is concentrated on the study of tourists in the USA and Canada. Future research should be more dispersed and diversified. Tourists from emerging countries such as Eastern Europe, Asia, the Middle East, and Africa will receive more attention.

5.3. Limitations

This study, inevitably, has a number of limitations, including the relatively modest amount of articles collected. Only articles written in English were considered. The sample number is rather small to represent the general research trends in medical-health-wellness tourism from 1970 to 2020. Therefore, it is desirable to increase the number of publications and expand the time and language coverage of the research articles to gain more insights.

Although the research scope of medical-health-wellness tourism is vast, it lacks in-depth exploration. Current research is fragmented, lacks continuity and comprehensiveness, and therefore cannot be considered systematic. Also, the legal aspects of the development of this tourism, environmental capacity of medical-health tourism, wellness tourism management, and mechanisms of profit distribution for medical-health-wellness tourism are less frequently mentioned in research articles. Innovation in this field and international cooperation, and talent cultivation are also not sufficiently addressed. The methods used in medical-health-wellness tourism research are often simple. Scholars still use traditional descriptive statistics and related analysis methods. The theoretical foundation of medical-health-wellness tourism is still relatively weak. We are in the primary stage of this tourism research and in the development of related tourism products. People all over the world are eager for healthy lives. Medical-health-wellness tourism is likely to play a more important future role in travel medicine and tourism research. Beyond what has been done already, follow-up research should be focused on interdisciplinarity and based on the integration of industries. More theoretical research is necessary to support the future growth of medical-health-wellness tourism.

Author Contributions

Formal analysis, L.Z.; Funding acquisition, L.Z.; Investigation, L.Z.; Supervision, B.D.; Data collection and analysis, B.D.; Writing-original draft, A.M.M. and J.A.C.-S.; Writing—original draft, A.M.M.; Writing—review & editing, A.M.M., J.A.C.-S. and L.Y.; Data collection and analysis. All authors have read and agreed to the published version of the manuscript.

National Natural Science Foundation of China, Grant no: 71673015); Ethnic research project of the National Committee of the people’s Republic of China. NO: 2020-GMD-089; Fundamental Research Funds for the Central Universities of Beijing Foreign Studies University, 2021JS001.

Institutional Review Board Statement

No human subjects were involved in this research and no institutional review was required.

Informed Consent Statement

Not applicable as there were no human subjects.

Data Availability Statement

Conflicts of interest.

The authors have no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Tourism and Health: Understanding the Relationship

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Marmion, M., Hindley, A. (2020). Tourism and Health: Understanding the Relationship. In: Leal Filho, W., Wall, T., Azul, A.M., Brandli, L., Özuyar, P.G. (eds) Good Health and Well-Being. Encyclopedia of the UN Sustainable Development Goals. Springer, Cham. https://doi.org/10.1007/978-3-319-95681-7_16

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