Understand Health Travel Patterns and Destinations Choices



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People travel for different reasons. When one understands the factors that affect travel, it is easier to plan health tourism marketing and advertising campaigns.

About the Author

About the Author

Maria Todd is frequently hired as a consulting expert and trusted authority on health travel business development. She works on marketing, advertising and public relations campaigns for medical groups, individual physicians, hospitals and ambulatory surgery facilities and other healthcare providers as part of her regular duties on a daily basis. In this article, she shares insights about reasons for health travel, destination choices, and travel patterns.

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Do you know the 8 key reasons for patient travel choices? Read this article to learn the myths and realities of health tourism destination development from Maria Todd.

8 key reasons why people choose one destination over another

  • Distance
  • International Connectivity
  • Attractiveness
  • Cost
  • Itinerary Convenience
  • To attend specific events, or to visit specific practitioners, facilities, or to access specific treatments and providers of international renown and expertise
  • National Character, and
  • Image
In general tourism trends, the less time and money it takes to travel to a place, the more people will travel there. So why is it that medical and dental tourism provider marketing rarely mentions these two elements and the price of the travel when marketing their products and programs?
Perhaps it is ignorance about the importance of destination in medical tourism choices. Perhaps it is ego? Perhaps a bit of both.
Many medical and dental tourism providers boost price to the top of their advertising thinking people buy medical and dental tourism services solely on the providers’ fees and costs. Nothing could be further from reality. On SurgeryShopper.com we placed a price transparency price comparison tool on the website and it gets the most action and engagement of any other single page on the site.  When people call, they mention that after plugging in the variables from prices they find on the internet from India, Mexico, Thailand, Malaysia, Korea, Turkey, and other countries. They end up booking with us because of distance, cost, national character, image, and itinerary convenience.
They also place high value on predictability of healthcare provider licensing, credentials verification, language, malpractice insurance norms and regulations, and cultural alignment.  As Chief Transformation Officer of the company, I learned how important these elements are to American patients living in America over the past 40+ years, and I built the price comparison tool when I realized that lowball prices for surgery didn’t fool patients. After all, most are very prudent shoppers when they have to pay 100% from their pockets for medical and dental tourism services. 
And for their employers who are slowly transitioning to cost containment options that include medical travel, the employers and plan fiduciaries and their underwriters and reinsurers are also skeptical of sending patients on an international journey to access care for many of the same reasons.

That being said, while concerns about time, distance and money are relevant for the majority of people, some tourists, including medical and dental travelers are attracted to faraway places. This is especially true of wealthy and/or fashionable travelers. So in this instance as well, advertising low prices isn’t a concern to these travelers. These elite and discriminating travelers go where they want, when they want, and seek out the finest in accommodation and care with world renown providers and facilities.  They seem to want to pay more and get more. 

Diaspora and cultural ties may be another reason to choose to leave the USA and all it has to offer in healthcare. The presence of cultural connections means that a medical or dental traveler at their most vulnerable can feel a sense of familiarity while they experience a new place without needing to adjust to language, food, or contend with international medical culture shock. They may also have support systems (friends and relatives) nearby. 

Destination attractiveness

Tourists have always traveled to destinations they find attractive. It is difficult to generalize about what tourists find attractive, so for that, we rely on branding research and persona development to determine our ideal patients and where they reside, and what will attract them so that they “cross the road” in search of something they cannot find at home. 
Keith Pollard and his associates and editors published an IMTJ article years ago that focused on destination attractiveness for medical tourism. They knew it would attract readers who desired to understand what makes a destination attractive in order to market that health tourism destination effectively in other regions. Many read it. Few took it seriously. A pity. The article had some excellent insights. But their new business model requires payment to read content. That too is a missed opportunity, but their choice. Perhaps you can locate it on the internet. 

Travel cost and value propositions for medical and dental care

The cost of a visit to a particular destination will affect the number of tourists that travel there. In general, the more expensive a trip is, the lower the demand. A quick flight to St George, Utah, for example, from anywhere in the USA will average around $350 per person. The travel time will be anywhere from 2-7 hours. The hip replacement will cost under $20,000 inclusive of surgeon, anesthesia, prosthetic implant, facility fees and hotel stay for two people. 
Cost is both absolute and relative. It is absolute in that, if a medical or dental travel itinerary is priced at $1,000 and the patient doesn’t have have $2000 (inclusive of companion ticket) plus visa fees and costs, and passport fees to spare, he/she simply cannot afford the trip. Most people are shocked to learn that international medical travel prices only include some of the fees and that the travel and hotel cost for a patient and companion can be more expensive than the entire consultation and surgery!
Cost is relative. People compare the cost of something with its perceived value. Even if they have the $1,000 but do not believe that the trip provides value for money they will not travel there. Plain and simple. 
Then again, as I mentioned previously, with distance, an inverse relationship between cost and demand exists for more affluent patients. For these patients, the higher the cost; the higher the demand!  So it is critical to decide which segment of the market you intend to pursue.
The affluent segment of the market perceives an intrinsic link between cost and quality. As well as quality, these travellers are willing to pay extra for the privilege of visiting “exclusive” resorts, not cheap rooming houses set up with self-catering in a questionable part of town devoid of creature comfort infrastructure.
On the other hand, this inverse relationship also exists to a certain extent in average tourists. If a trip or a surgery or service is priced too low, people may think that it is of a low quality.  This is one fact that many medical tourism providers refuse to embrace for whatever reason. People avail of light services (checkups, consultations, etc.) while already present at the destination for another reason. Then they come back with more time and planning for more extensive treatments and services. 

Do you need help with a destination development strategy for your medical or dental tourism program or cluster?


For years, I’ve recommended a strategy to pair event marketing and medical or dental tourism services where the strategy makes sense to do so.  The strategy piggybacks off the concept of “bleisure” travel. (Bleisure is a combination neologism from business + leisure.)

Major events help to boost the tourist infrastructure quality and safety of most destinations. For example, many hotels and a rail system were built in South Africa in preparation for the 2010 World Cup and for the Olympics in China. Unfortunately, neither location deftly used these enhancements to properly advance their health tourism destination attractiveness as they could have. Now they suffer oversupply which can have negative effects on tourism over the long term. Turkey and South Korea make the mistake of holding many events, but then insult medical tourism visitors with higher prices simply because they are foreigners!  Mexico has headed in this direction as well. Why not take a gun and just shoot the goose that lays the golden eggs as soon as you see it!

Tradition plays a part in tourism destination choices – including medical, dental and wellness tourism

Certain destinations, (Greece, Russian, Ukraine, Tunisia, Spain, Italy, France, Switzerland, and others) have particular medical and wellness habits that are rooted in decades of tradition, such as balneology and thalassotherapy.  Unfortunately, too many providers assume incorrectly that having the water nearby without the services, culture, language, or infrastructure improvements is adequate to attract visitors for these wellness services. 


Image is an important factor in people’s travel choices. The image of a location is the perception that people have of a place, gathered from the media and popular culture. There are real problems with image when bad things happen to good people and innocent bystanders. Crime, walkability, terrorism, civil uprisings, health epidemics like Zika, and other perceived risks impact medical and dental tourism destinations for years after the incident.
People seek out less drama when they expect to be vulnerable due to challenges with mobility or the influence of pain medications.
Other locations simply don’t give prospective visitors the image that they are a health travel or Healthcare or Wellness Center of Excellence destination.

Pleasure Trips

But for visiting a spa, people don’t think of medical tourism or dental tourism as a “pleasure trip”. 

There are several key types of pleasure trips, including: Resort Vacations; Touring Vacations; Outdoor Trips; City Trips; Theme Parks and Cruises. 

Many novice marketers have the mistaken impression that people suffering post operative pain, swelling, temporary disfigurement and bandages, crutches, drains, dressings, and the effects of pain medications have any interest in combining a “pleasure trip” with their health care in situations that place them among large groups of strangers or activities at resorts or tour groups, or outdoor physical activities or the rigors of theme park vacations or the risk of turbulence in rough seas on a cruise. While the idea “sounds” intriguing, after 40 years in the business, that’s just more nonsense you hear at medical tourism industry association events. 

Understand this if you don’t glean anything else from this article: Resort travelers make up 80% of all pleasure trips. They tend to be less interested in activities than other pleasure travelers. Instead, they are interested in a high standard of food and beverages and quality entertainment. As a post-operative patient, the risk of nauseous stomach upset and pain will cancel out any desire for exotic ethnic foods, beverages and expensive theatre tickets or other entertainment.  To see this promoted by medical tourism advertisers is the mark of a novice who has yet to learn!

Not to mention that tour operators, hoteliers and resort managers, amusement park operators and cruise ships don’t really want post-operative patients as customers until they are fully recovered.  This is because they don’t want their hotel lobby to appear (or smell) like a hospital ward, they aren’t prepared to keep post-operative patients safe or sufficiently entertained. Furthermore, to attempt to reasonably accommodate them is too far a departure from the hotel’s, cruise ship’s or attraction’s ideal customer. They worry that no matter how hard they try, it won’t be enough and that they will risk physical injury to the client or dissatisfaction that could implicate their brand.

Touring vacations make up about 14% of all trips taken in the USA as “road trips”. 

Touring vacations are trips in which people visit a variety of tourist attractions in different areas.
The pace is often physically strenuous, and these trips are not focused on a single destination, but rather visit a large number of destinations within a region.
These touring adventures are usually self-planned and self-driven. That’s why travel agents are not consulted for medical or dental tourism travel packaged with touring. 
Only 20% of touring itineraries are package deals. Package deals often include tour bus travel.  Tourists that take this type of trip are seeking beautiful scenery and lots of activities, and it’s the activities part that often nixes out a post-operative patient from the mix.
Unlike a medical or dental treatment focus, touring vacations have no single focus, last an average of eight days and are usually planned one to two months in advance. 
Outdoor trips that focus on hunting, fishing, hiking, cycling, photography expeditions, safaris, etc., represent about 10% of pleasure trips.   About 60% of outdoor tourists stay in a camp site or caravan park; others will stay with friends or in motels — neither of which are appropriate for many post-operative patients. For one thing, you get dirty on these trips. That’s not what the doctor meant when they advised to keep surgical wounds clean and dry. 
Outdoor tourists tend to rely mostly on the advice of friends in deciding where to travel.  What’s the likelihood that their friend can zero in on a place that has outdoor attraction that the patient and travel companion will enjoy and the doctor or dentist that they need to visit to solve a medical or dental problem? Get real! 
One pleasure trip that a low percentage of medical and dental patients may enjoy is a modified city break.  But where the strategy falls apart is that the majority of visitors taking a city break – even to a destination like Las Vegas or Orlando, is that city trips tend to be short, impulsive getaways over a weekend. These travelers tend to stay in elegant hotels and eat in fine-dining restaurants. So we go  back to the argument of nausea, vomiting, and pain. That’s a mismatch.
Another mismatch: They are also interested in the nightlife offered by bars and nightclubs. That’s not happening with most post-operative patients or their companions. On the other hand, city break visitors may be interested in monuments one has to climb, museums where one must walk or stand for long periods.  For every day in bed, it generally takes two or more days to recover and get one’s stamina back to normal. The average city break happens over a weekend. That’s a mismatch, too.
Worse is the fact that the percentage of pleasure trips that plan city breaks in general tourism is approximately 7% – the percentage of those that would elect medical and dental services in the same trip is even lower. Setting your strategy for this is not going to amount to much volume or revenue.
Next to last but not least is the category of theme park visitors. The average trip lasts 4 days and is usually family oriented. Medical and dental tourism are not usually family tourism events unless it is the child who is the patient. Yes, the child could be accommodated in a stroller or wheelchair, but the minute the child becomes fatigued or uncomfortable, that’s the end of the visit. And the prices for most theme park visits these days is too high for the entire family to go and cut the visit short.
Lastly, cruise travel accounts for only 1% of pleasure trips, is planned three months in advance, lasts six days, and once you board the boat if one suddenly decides they have overestimated their ability to enjoy the trip post-operatively, it is a big ordeal to get off the boat prematurely, before the end of the cruise. And to go before the surgery, one risks infection, illness, or injury that could cause the surgery to be postponed or canceled. 

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Maria is a bestselling author and a top healthcare industry influencer and thought leader. She has excellent references and a huge project portfolio spanning 40+ years in healthcare business development and management.

She holds 25 copyrights, several trademark registrations, and shares several patent applications for software inventions.

She’s been recognized with numerous industry lifetime achievement awards for her work in contracted reimbursement, managed care, physician integration and alignment, and health tourism in the USA and 116 countries. 

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