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  • Schedules of WTO Members with Specific Commitments on Tourism Services

Treatment of the sector in negotiations

Tourism services, like other services covered by the General Agreement on Trade in Services (GATS), were included in the services negotiations that began in 2000.

One of the earliest documents was a proposal for a GATS Annex on Tourism, originally sponsored by the Dominican Republic, El Salvador and Honduras ( S/C/W/127 and S/C/W/127/Corr.1 ). The proposal had two main aspects: more comprehensive treatment of the tourism sector (with respect to classification issues), and the prevention of anti-competitive practices. As part of the plurilateral process, a joint request was made by a group of developing countries, asking for improved tourism commitments for all modes of supply.

  • Proposals and related negotiating documents on tourism services

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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.

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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.

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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.

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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.

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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 ).

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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 .

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Timeline of research keyword appearance.

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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.

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Travel Marketing, Tourism Economics and the Airline Product pp 3–27 Cite as

The Tourism Industry: An Overview

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Part of the Tourism, Hospitality & Event Management book series (THEM)

This chapter introduces its readers to the concept of tourism. It sheds light on the rationale for tourism, as it explains the tourists’ inherent motivations to travel. It also describes different aspects that together make up the tourism industry. Tourists travel to destinations that are accessible to them. They require accommodation if they are visiting a place for more than 24 h. Leisure and business travellers may also visit attractions, and engage themselves in recreational activities. Hence, the tourist destinations should have the right amenities and facilities. In this light, this chapter clarifies how destinations may offer different products to satisfy a wide array of tourists. Tourism products can include; urban (or city) tourism, seaside tourism , rural tourism , ecotourism , wine tourism , culinary tourism , health tourism, medical tourism , religious tourism , cultural (or heritage) tourism , sports tourism , educational tourism , business tourism (including meetings, incentives, conferences and events), among others. In conclusion, this chapter lists major points of interest in North America to clarify how diverse destinations may be appealing to different tourists, for many reasons.

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Camilleri, M.A. (2018). The Tourism Industry: An Overview. In: Travel Marketing, Tourism Economics and the Airline Product. Tourism, Hospitality & Event Management. Springer, Cham. https://doi.org/10.1007/978-3-319-49849-2_1

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Chapter 1. History and Overview

1.1 What is Tourism?

Before engaging in a study of tourism , let’s have a closer look at what this term means.

Definition of Tourism

There are a number of ways tourism can be defined, and for this reason, the United Nations World Tourism Organization (UNWTO) embarked on a project from 2005 to 2007 to create a common glossary of terms for tourism. It defines tourism as follows:

Tourism is a social, cultural and economic phenomenon which entails the movement of people to countries or places outside their usual environment for personal or business/professional purposes. These people are called visitors (which may be either tourists or excursionists; residents or non-residents) and tourism has to do with their activities, some of which imply tourism expenditure (United Nations World Tourism Organization, 2008).

Using this definition, we can see that tourism is not just the movement of people for a number of purposes (whether business or pleasure), but the overall agglomeration of activities, services, and involved sectors that make up the unique tourist experience.

Tourism, Travel, and Hospitality: What are the Differences?

It is common to confuse the terms tourism , travel , and hospitality or to define them as the same thing. While tourism is the all-encompassing umbrella term for the activities and industry that create the tourist experience, the UNWTO (2020) defines travel as the activity of moving between different locations often for any purpose but more so for leisure and recreation (Hall & Page, 2006). On the other hand, hospitality can be defined as “the business of helping people to feel welcome and relaxed and to enjoy themselves” (Discover Hospitality, 2015, p. 3). Simply put, the hospitality industry is the combination of the accommodation and food and beverage groupings, collectively making up the largest segment of the industry (Go2HR, 2020). You’ll learn more about accommodations and F & B in Chapter 3 and Chapter 4 , respectively.

Definition of Tourist and Excursionist

Building on the definition of tourism, a commonly accepted description of a tourist is “someone who travels at least 80 km from his or her home for at least 24 hours, for business or leisure or other reasons” [1] . The United Nations World Tourism Organization (1995) helps us break down this definition further by stating tourists can be:

  • Domestic (residents of a given country travelling only within that country)
  • Inbound (non-residents travelling in a given country)
  • Outbound (residents of one country travelling in another country)

Excursionists  on the other hand are considered same-day visitors (UNWTO, 2020). Sometimes referred to as “day trippers.” Understandably, not every visitor stays in a destination overnight. It is common for travellers to spend a few hours or less to do sightseeing, visit attractions, dine at a local restaurant, then leave at the end of the day.

The scope of tourism, therefore, is broad and encompasses a number of activities and sectors.

Spotlight On: United Nations World Tourism Organization (UNWTO)

UNWTO is the United Nations agency responsible “for the promotion of responsible, sustainable and universally accessible tourism” (UNWTO, 2014b). Its membership includes 159 countries and over 500 affiliates such as private companies, research and educational institutions, and non-governmental organizations. It promotes tourism as a way of developing communities while encouraging ethical behaviour to mitigate negative impacts. For more information, visit the UNWTO website .

The North American Industry Classification System (NAICS). Given the sheer size of the tourism industry, it can be helpful to break it down into broad industry groups using a common classification system. The North American Industry Classification System (NAICS) was jointly created by the Canadian, US, and Mexican governments to ensure common analysis across all three countries (British Columbia Ministry of Jobs, Tourism and Skills Training, 2013a). The tourism-related groupings created using NAICS are (in alphabetical order):

  • Accommodation
  • Food and beverage services (commonly known as “F & B”)
  • Recreation and entertainment
  • Transportation
  • Travel services

These industry groups (also commonly known as sectors) are based on the similarity of the “labour processes and inputs” used for each (Government of Canada, 2013). For instance, the types of employees and resources required to run an accommodation business whether it be a hotel, motel, or even a campground are quite similar. All these businesses need staff to check in guests, provide housekeeping, employ maintenance workers, and provide a place for people to sleep. As such, they can be grouped together under the heading of accommodation. The same is true of the other four groupings, and the rest of this text explores these industry groups, and other aspects of tourism, in more detail.

Two female front desk employees speak to a male guest in a hotel lobby.

It is typical for the entire tourist experience to involve more than one sector. The combination of sectors that supply and distribute the needed tourism products, services, and activities within the tourism system is called the Tourism Supply Chain. Often, these chains of sectors and activities are dependent upon each other’s delivery of products and services. Let’s look at a simple example below that describes the involved and sometimes overlapping sectoral chains in the tourism experience:

Tourism supply chain. Long description available.

Before we seek to understand the five tourism sectors in more detail, it’s important to have an overview of the history and impacts of tourism to date.

Media Attributions

Front Desk © Staying LEVEL is licensed under a CC BY-NC (Attribution NonCommercial) license

  • (LinkBC, 2008, p.8) ↵

Tourism according the the UNWTO is a social, cultural and economic phenomenon which entails the movement of people to countries or places outside their usual environment for personal or business/professional purposes.

UN agency responsible for promoting responsible, sustainable, and universally accessible tourism worldwide.

Moving between different locations for leisure and recreation.

The accommodations and food and beverage industry groupings.

someone who travels at least 80 km from his or her home for at least 24 hours, for business or leisure or other reasons

A same-day visitor to a destination. Their trip typically ends on the same day when they leave the destination.

A way to group tourism activities based on similarities in business practices, primarily used for statistical analysis.

Introduction to Tourism Copyright © 2015, 2020 by NSCC is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

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GLOSSARY OF TERMS

Enjoy this glossary that we've compiled over the years to provide a helpful reference for tourism professionals, students and volunteers with a passion for product development, sustainable tourism, destination development and experiential travel.

Affinity group / Travellers

All-Inclusive Travel

Appreciative inquiry

Benchmarking

Best Practice(s)/Best Practice Mission

Business Visitor

Call to Action

Commissionable Tour

Content curation

Community tourism partnerships

Creative economy

Custom Travel Package

Customer lifecycle

Customized market

Customer experience

Customer experience management

Demand Generator

Destination

Destination Assessment

Destination Development

Destination Management Company (DMC)

Destination Management Organization (DMO)

Destination Marketing Organization (DMO)

Destination Marketing vs. Destination Management Organization

Digital Placemaking

Domestic Tourism

Dynamic Packaging

E-marketing

Educational Travel

Emotional Marketing

Emotional Touchpoint

Enabler/Helping Organizations

Experience broker

Experience economy

Experience Design

Experiential marketing

Experience provider

Experiential travel

Explorer Quotient EQ™

Export Ready

FIT (Fully Independent Traveller)

Hub and Spoke

Ideal/valued guest

Inbound Tourism

Inbound Tour Operator

Incentive Travel

International Tourism

Interpretation

Learning Travel

Major market segment

Market Ready

Mass market

Moment of truth

Net promoter score

Net-rate pricing

Niche market

Online travel agency (OTA)

Outbound tour operator

Overtourism

Path-to-purchase

Piloting Experiences (aka Trial Run)

Place Making

Place Marketing

Perceived value

Product Extension

Product Life Cycle

Receptive tour operator

Regenerative Tourism

Responsible tourism

SEO vs. SMO

Service Economy

Sharing economy

Shore Excursion

SMART Goals

Social media

Social networking

Special Interest Package

Split Itinerary

Spousal Programs

Stakeholders

Storytelling

Supply vs. demand thinking

Sustainable Development

Sustainable Tourism

Tourism economy

Tour Operator

Traveller/Visitor

Travel Package

Traveller Ready

Travel Supplier

Travel trade

Travel Wholesaler

User Experience

Visitor centric model

Visitor economy

Visitor experience

Visitor Experience Design

Visitor Friendly Communities

Visitor lifecycle 

Word of Mouth

Appreciative Inquiry: An approach to engaging conversations that encourage imagination, innovation and flexibility with stakeholder groups, and builds on the positive attributes that already exist.

Clusters: Businesses that benefit from working together to create and market tourism experiences that meet the needs of niche markets.

Content Curation: The act of discovering, gathering and presenting digital content that surrounds specific subject matter and funnelling it in relevant ways to enhance your online presence. 

Community Tourism Partnerships: A mutually beneficial commitment between multiple businesses and government organizations to leverage their respective retail, service, community or program deliverables to develop and deliver innovative ways for travellers to experience their community’s rich culture, art, nature and cuisine offerings - often through packaging and marketing - to add new business opportunities and revenues to the community.

Creative Economy:

Describes economic systems where value is based on creative and imaginative qualities rather than the traditional resources of land, labour and capital. It represents the business opportunities, generated from use of people’s creative imagination and an intersection between creativity, culture, economics and technology dominated by images, sounds, texts and symbols.

Customer Lifecycle: The creation and delivery of value to the customer at every touchpoint in the engagement cycle; in tourism this means from they time they decide to travel, to the time they are at home telling stories and sharing photos.

Customized Market: Tailoring a tourism product or experience to the specific needs of an individual customer. Generally practiced by companies whose products are very expensive or unique, and who have significant specific information on their customer to design and deliver ‘what they want, when they want, where they want it and with whom!’ 

Customer Experience: A blend of an organization’s physical performance, the senses stimulated and emotions evoked, each intuitively measured against customer expectations across all moments of contact.

Customer Experience Management: The processes used by a company to track, oversee and organize every interaction between a customer and the organization throughout the customer lifecycle. The goal is to optimize interactions and all touchpoints, from the customer's perspective, to foster customer loyalty.

Destination Marketing Organization vs Destination Management Organization:

In recent years, the DMO acronym has been used to refer to traditional destination marketing organizations whose primary function is to promote and market the destination, tourism businesses, services, transportation, associated retail stores, restaurants, and events. Many also invest in primary research to inform decision-making. The alternate use of the term DMO (management) refers to organizations that include the promotion and research functions and also invest in broader industry development and stakeholder development activities.

E-marketing: Electronic marketing, using the Internet and other forms of electronic communications to communicate in the most cost-effective ways with target markets.

Emotional Marketing: Getting your target audience to connect with your product, service, and brand at a very basic and fundamental level; emotionally.

Enabler/Helping Organizations: In the context of tourism, an enabler or helping organization describes the business-to-business entities that support the development and promotion of tourism to foster growth in the industry, drive consumer awareness, develop product, promote, market and help to sell a destination. Examples include: destination marketing organizations (DMOs), economic development agencies, tourism departments/ministries within government, Chambers of Commerce, etc.

Experience: An experience is something that is personally encountered, lived through and affects the individual. It may involve observation or participation; be active or passive, planned, opportunistic, personal or shared.

Experience Broker: An individual who coaches local area businesses so that they may deliver a high-quality experience aligned with guest expectations; the experiential broker then acts as an intermediary between experience providers and guests to identify market opportunities.

Experience Economy: A five-tiered economic framework, founded by Joe Pine and James Gilmore, that defines experiences as a distinct economic offer, one that creates a specific atmosphere that engages the customer in memorable ways. It provides an economic understanding of where businesses can focus to meet the consumer demand for: commodities, goods, services, experiences and transformation.

Experiential Marketing: A holistic approach to customer relations and branding that focuses on making an emotional and physical connection with the customer, rather than merely describing features and benefits.   Experience Provider: Individuals, companies or organizations that create holistic travel opportunities by sequencing and staging activities, personal encounters and authentic experiences that are designed to create long-lasting memories and customer loyalty. Experience providers consciously create memorable activities by staging a theme, harmonizing positive cues and eliminating negative ones, mixing in memorabilia and engaging all five senses.

Experiential Travel: Travel that connects you with the essence of a place and its people by engaging visitors in a series of memorable travel activities revealed over time that are inherently personal, engage the senses and make connections on an emotional, physical, spiritual or intellectual level. It responds to the desire to venture beyond the beaten tourist paths, dive deeper into authentic, local culture, connects with people and enriches their lives.

Explorer Quotient (EQ™):

An innovative market segmentation tool from Destination Canada [add hyperlink:  https://www.destinationcanada.com/en/tools ] that looks at attitudes, personal beliefs, social values and travel values to better understand current and prospective customers and what drives people to seek out certain types of visitor experiences. This information helps target your focus and investment in product and market development, promotions and sales activities.

Export Ready:

Refers to a business that markets to and through national and international travel trade distribution sales channels, understands commission or net rate pricing, agrees to trade bookings and has a cancellation policy.

Familiarization tours are provided through a collaboration of tourism partners to receptive tour operators, travel agencies, travel writers and influencers and others to provide information about a certain experience or destination at no or minimal cost to invited participants.

FIT (Fully Independent Traveller): Originally FIT was an abbreviation for a foreign independent tour. Today, it is most commonly used for flexible or fully independent travel describing a type of travel that does not incorporate a packaged tour but is customized for the traveller by a tourism professional who sells travel, such as a tour operator or travel agent.

Ideal/Valued Guest: The visitors with the greatest potential to strengthen to grow your business or destination. Knowing their attitudes, values, motivations and demographic profile is essential to designing value-based, emotionally connecting travel experiences.

Inbound Tour Operator:

An operator who packages multiple elements together in a variety of ways (accommodation, shuttles, experiences, meals, admissions) to bring visitors from external markets to a destination.

Incentive Travel:

An organizational management tool that uses an exceptional travel experience to motivate and/or recognize participants for increased levels of performance in support of organizational goals.

Major Market Segment: A large market of travellers identifiable as having particular customers with specific buying characteristics (e.g. family, business, festivals, motor-coach).

Market Ready:

Refers to a business that markets to potential travellers; communicates with potential travellers year-round and is able to accept advance reservations.

Mass Market: The un-segmented market in which tourism products and services are available, positioned and sold to any traveller (e.g. museum admissions, airline tickets, cruise), or large geographic regions (e.g. USA, Germany).

Moment of Truth: A moment of truth is usually defined as an instance where a visitor comes into contact with businesses or destinations in real life, or online. It provides the opportunity for either party to make an impression or change an impression about the business.

Net Promoter Score:

A metric designed to monitor customer engagement, reflecting the likelihood that travellers will recommend a destination to friends, family, or colleagues.

Net-Rate Pricing:

The net rate is the price without the commission included. The tourism business or travel trade distributor can mark-up the rate with  the margin they wish to make, or an amount which is contractually agreed upon to secure business. Companies that work with net rate pricing include receptive tour operators (e.g., Jonview), tour operators (e.g., Virgin Holidays), Destination Management Companies, travel agencies and packaging partners.

​ Niche Market: A business focus on a small, defined part of a larger market that has a need for a product or service that is not being addressed by mainstream providers. Common to small businesses aiming to differentiate themselves. Companies succeed by narrowly defining a group of potential customers and serving them well (e.g. Girls Getaway Weekends, Weddings, Spa seekers).

Online Travel Agency (OTA):

A travel website that specializes in the sale of travel products to consumers without the assistance of a person. Some agencies sell a variety of travel products including flights, hotels, car rentals, cruises, activities and packages (e.g., Travelocity, Expedia, Trivago).

Outbound Tour Operator:

An operator who packages and sells travel products to people within a destination who want to travel abroad.

Operator: Refers to all business (private, public, not-for-profit) that operate a tourism asset that provides value to a visitor. It is a broader reference than the traditional ‘tour operator’ or ‘receptive operator’ and includes everyone and everything such hoteliers, attractions, restaurants, transportation, outfitters, wilderness operators, trails, heritage properties etc.

Path-to-Purchase: The steps customers take as they move from being aware of the travel opportunity to actually purchasing travel.

Perceived Value:

The worth that a product or service has in the mind of the consumer that shapes how much he or she is willing to pay.

Receptive Tour Operator:

A Canada-based tour company that specializes in tourism experiences and manages products and services for incoming visitors most often booked through international tour operators. Receptive tour operators play an important role in the packaged travel industry.

Responsible Tourism:

Any form of tourism that can be consumed in a more responsible way. It minimizes negative economic, environmental and social impacts; generates greater economic benefits for local people and enhances the well-being of host communities, improves working conditions and access to the industry; involves local people in decisions that affect their lives and life chances; makes positive contributions to the conservation of natural and cultural heritage, to the maintenance of the world’s diversity; provides more enjoyable experiences for tourists through more meaningful connections with local people and a greater understanding of local cultural, social and environmental issues; provides access for physically challenged people; and is culturally sensitive, engenders respect between tourists and hosts and builds local pride and confidence.

SEO vs SMO: Search engine optimization (SEO) is different than social media optimization (SMO). In a nutshell, SEO optimizes your website for rankings with search engines through the use of select keywords, optimizing HTML and backend coding, meta description, alt tags, headers etc. SMO is about optimizing the content to increase brand and encourage sharing by your viewers through various social media channels.

Service Economy: Services represent a diverse group of intangible economic activities such as restaurants, hotels, shoe-shining, physiotherapy, computer repair, a home inspection before buying a house ... and the list goes on!

Sharing Economy:  An emerging and trending business concept based on the ability for individuals to rent or borrow good and services rather than buy them. Leading examples that are shaping how we think about this business model are Airbnb and Uber.

Social Media: Social media are works of user-created video, audio, text or multimedia that are published and shared in a social environment, such as a blog, social networking site, photo or video hosting site.

Social Networking: The interaction between a group of people who share a common interest. Using websites such as Facebook and Twitter to network and share information and media. Individuals and businesses can use social networks to further customer relationships and extend the customer lifecycle.

Storytelling: Storytelling involves a two-way interaction between a storyteller and one or more listeners in person, online or through other means of communication. It is a first-person narrative that accompanies an experience, offers personal insights and can reflect the passion, values and humour of the experience provider/storyteller. Done well, it engages travellers.

Supply vs. Demand Thinking: Supply thinking is tourism that is built on what a company wants to sell vs. what the demand from the marketplace is looking for.

Sustainable Travel: Tourism that takes full account of its current and future economic, social and environmental impacts, addressing the needs of visitors, the industry, the environment and host communities optimizing environmental resources while, helping to conserve natural heritage and biodiversity; respecting the socio-cultural authenticity of host communities, their built and living cultural heritage and traditional values; contributes to inter-cultural understanding and tolerance; and ensures viable, long-term economic operations, providing socio-economic benefits to all stakeholders that are fairly  distributed within host communities.

A term used in the travel trade to describe: (1) fare/rate from a supplier  (2) class or type of fare; (3) published rates from a supplier;  and (4) official publication compiling rates or fares and conditions of services

Touchpoint: A touchpoint is any time a customer or potential customer comes in contact with your brand–before, during, or after they purchase something from you or interact with your business. Identifying your touchpoints is a vital step towards understanding the customer journey from their perspective and building positive engagement every step of the way.

Tour Operator:

 A company that creates and/or markets packaged tours and/or performs tour services.

Tourism: Is defined as: “The activities of persons traveling to and staying in places outside their usual environment for not more than one consecutive year for leisure, business and other purposes.” Source: The World Tourism Organization.

Tourism Economy: An important economic driver, the tourism economy focuses on the value created by tourism businesses (private, not-for-profit, government) that generate sustainable visitor activities. It is a sectoral lens that has been commonly used to understand the contribution tourism businesses and visitors bring to a community.

Traveller Ready:

Refers to a business which has all of its licenses, permits and insurance in place in order to operate legally (also known as Visitor Ready).

Travel Trade: The distribution network of companies (operating at a national or international level) that resell travel products to visitors that have been reserved and purchased from other tour operators or travel businesses. This includes: •    Travel agencies - companies that offer travel services and assistance to groups and individuals including, documentation, ticketing, booking for transportation and/or accommodation. •    Tour operators - companies that bring together separate travel components (such as airline seats, hotel rooms, activities and attractions), into one package. Examples of tour operators include: Thomas Cook (UK), DERTOUR (Germany), Scenic Tours (Australia), Tauck Tours (US) •    Online travel agencies (OTA’s) – OTA’S specialize in offering planning sources and booking capabilities. Major OTA’s include: Expedia, lasminute.com, Travelocity.

Travel Wholesaler:

A company that purchases large blocks of rooms, tickets, etc., and then resell them as tours products or packages to travel agents. They do not sell to the general public. Packaged elements are purchased in exchange for a commission or a reduced fee, known as a tariff. These companies target bulk transactions for the larger the volume, the better the discount.

User Experience:

User Experience (UX) encompasses all aspects of the visitor's interaction with your company. This includes their pre-travel information search experience, booking, selection of products, services and experiences, plus their online and face-to-face interactions across all touchpoints.

Visitor Centric Model:   A visual representation of a way of thinking about tourism that places the visitor at the heart of the model, the starting point for tourism planning, development, promotions and delivering on the brand promise.

Visitor Economy:

The visitor economy refers to the widespread and often unseen benefits from dollars spent by travellers. It encompasses everything that attracts visitors to a destination and everything that makes a place special, distinctive and capable of engendering price and interest in a place worth experiencing. The full impact of the visitor economy is felt when the multiplier effect of tourist spending ripples throughout the entire economy, supporting job creation, infrastructure development, community building, strengthening the brand and engaging visitors in memorable experiences. A successful visitor economy requires managing all of the components in an integrated and long-term way with a clear focus on the needs of the visitor the destination is trying to attract.

Visitor Experience: The sum of all perceptions, senses stimulated, emotions evoked and interactions a traveller has with the people, places and cultures of a destination, the communities and businesses they encounter.

Visitor Lifecycle: All physical and emotional touchpoint a traveller experiences with a tourism business and destination as he/she moves through the stages of pre-trip considerations and purchase, engaging with the place, people, products and services, plus their post-trip reflections and actions. Together this influences loyalty, the potential for a long-term relationship with the traveller and their desire to revisit and/or refer.

Word of Mouth:

The phenomenon of a particular message or recommendation being passed from an individual to his/her contacts through the internet or to the public at large through online means such as TripAdvisor, blogs, comment sections, YouTube, Instagram, etc.

UN Tourism | Bringing the world closer

Tourism – an economic and social phenomenon.

Why tourism? - UN Tourism

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Why Tourism?

Over the decades, tourism has experienced continued growth and deepening ‎diversification to become one of the fastest growing economic sectors in the world. ‎Modern tourism is closely linked to development and encompasses a growing number ‎of new destinations. These dynamics have turned tourism into a key driver for socio-‎economic progress.‎

Today, the business volume of tourism equals or even surpasses that of oil exports, ‎food products or automobiles. Tourism has become one of the major players in ‎international commerce, and represents at the same time one of the main income ‎sources for many developing countries. This growth goes hand in hand with an ‎increasing diversification and competition among destinations.‎

International tourist arrivals (overnight visitors) grew 4% in January-March 2019 compared to the same period last year, below the 6% average growth of the past two years.

This global spread of tourism in industrialised and developed states has produced ‎economic and employment benefits in many related sectors - from construction to ‎agriculture or telecommunications.‎

The contribution of tourism to economic well-being depends on the quality and the ‎revenues of the tourism offer. UN Tourism assists destinations in their sustainable ‎positioning in ever more complex national and international markets. As the UN agency ‎dedicated to tourism, UN Tourism points out that particularly developing countries stand to ‎benefit from sustainable tourism and acts to help make this a reality.‎

What Is Ecotourism? Definition, Examples, and Pros and Cons

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Ecotourism Definition and Principles

Pros and cons.

  • Examples of Ecotourism
  • Frequently Asked Questions

Ecotourism is about more than simply visiting natural attractions or natural places; it’s about doing so in a responsible and sustainable manner. The term itself refers to traveling to natural areas with a focus on environmental conservation. The goal is to educate tourists about conservation efforts while offering them the chance to explore nature.

Ecotourism has benefited destinations like Madagascar, Ecuador, Kenya, and Costa Rica, and has helped provide economic growth in some of the world’s most impoverished communities. The global ecotourism market produced $92.2 billion in 2019 and is forecasted to generate $103.8 billion by 2027.

A conservationist by the name of Hector Ceballos-Lascurain is often credited with the first definition of ecotourism in 1987, that is, “tourism that consists in travelling to relatively undisturbed or uncontaminated natural areas with the specific object of studying, admiring and enjoying the scenery and its wild plants and animals, as well as any existing cultural manifestations (both past and present) found in these areas.”

The International Ecotourism Society (TIES), a non-profit organization dedicated to the development of ecotourism since 1990, defines ecotourism as “responsible travel to natural areas that conserves the environment, sustains the well-being of the local people, and involves interpretation and education [both in its staff and its guests].”

The International Union for Conservation of Nature (IUCN) looks at ecotourism as a significant tool for conservation, though it shouldn’t be seen as a fix-all when it comes to conservation challenges:

“There may be some areas that are just not appropriate for ecotourism development and some businesses that just won’t work in the larger tourism market. That is why it is so important to understand the basics of developing and running a successful business, to ensure that your business idea is viable and will be profitable, allowing it to most effectively benefit the surrounding environment and communities.”

Marketing an ecosystem, species, or landscape towards ecotourists helps create value, and that value can help raise funds to protect and conserve those natural resources.

Sustainable ecotourism should be guided by three core principles: conservation, communities, and education.

Conservation

Conservation is arguably the most important component of ecotourism because it should offer long-term, sustainable solutions to enhancing and protecting biodiversity and nature. This is typically achieved through economic incentives paid by tourists seeking a nature-based experience, but can also come from the tourism organizations themselves, research, or direct environmental conservation efforts.

Communities

Ecotourism should increase employment opportunities and empower local communities, helping in the fight against global social issues like poverty and achieving sustainable development.

Interpretation

One of the most overlooked aspects of ecotourism is the education component. Yes, we all want to see these beautiful, natural places, but it also pays to learn about them. Increasing awareness about environmental issues and promoting a greater understanding and appreciation for nature is arguably just as important as conservation.

As one of the fastest growing sectors of the tourism industry, there are bound to be some downsides to ecotourism. Whenever humans interact with animals or even with the environment, it risks the chance of human-wildlife conflict or other negative effects; if done so with respect and responsibility in mind, however, ecotourism can reap enormous benefits to protected areas.

As an industry that relies heavily on the presentation of eco-friendly components to attract customers, ecotourism has the inevitable potential as a vessel for greenwashing. Part of planning a trip rooted in ecotourism is doing research to ensure that an organization is truly providing substantial benefits to the environment rather than exploiting it.

Ecotourism Can Provide Sustainable Income for Local Communities

Sustainably managed ecotourism can support poverty alleviation by providing employment for local communities, which can offer them alternative means of livelihood outside of unsustainable ones (such as poaching).

Research published in Proceedings of the National Academy of Sciences found that communities in regions surrounding conservation areas in Costa Rica had poverty rates that were 16% lower than in areas that weren’t near protected parks. These protected areas didn’t just benefit from conservation funds due to ecotourism, but also helped to reduce poverty as well.

It Protects Natural Ecosystems

Ecotourism offers unique travel experiences focusing on nature and education, with an emphasis on sustainability and highlighting threatened or endangered species. It combines conservation with local communities and sustainable travel , highlighting principles (and operations) that minimize negative impacts and expose visitors to unique ecosystems and natural areas. When managed correctly, ecotourism can benefit both the traveler and the environment, since the money that goes into ecotourism often goes directly towards protecting the natural areas they visit.

Each year, researchers release findings on how tourist presence affects wildlife, sometimes with varying results. A study measuring levels of the stress hormone cortisol in wild habituated Malaysian orangutans found that the animals were not chronically stressed by the presence of ecotourists. The orangutans lived in the Lower Kinabatangan Wildlife Sanctuary, where a local community-managed organization operates while maintaining strict guidelines to protect them.

Ecotourism May Also Hurt Those Same Natural Ecosystems

Somewhat ironically, sometimes ecotourism can hurt ecosystems just as much as it can help. Another study in the journal Trends in Ecology and Evolution found that ecotourism can alter animal behaviors in ways that put them at risk. If the presence of humans changes the way animals behave, those changes may make them more vulnerable by influencing their reaction to predators or poachers.

It's not just the animals who are at risk. As ecotourism activities become too popular, it can lead to the construction of new infrastructure to accommodate more visitors. Similarly, more crowds mean more pressure on local resources, increased pollution, and a higher chance of damaging the soil and plant quality through erosion. On the social side, these activities may displace Indigenous groups or local communities from their native lands, preventing them from benefiting from the economic opportunities of tourism.

Ecotourism Offers the Opportunity to Experience Nature

Renown conservationist Jane Goodall has a famous quote: “Only if we understand, will we care. Only if we care, will we help. Only if we help, shall all be saved.” It can be difficult to understand something that we haven’t seen with our own eyes, and ecotourism gives travelers the opportunity to gain new experiences in natural areas while learning about the issues they face. 

Ecotourism also educates children about nature, potentially creating new generations of nature lovers that could someday become conservationists themselves. Even adult visitors may learn new ways to improve their ecological footprints .

EXAMPLES OF ECOTOURISM

The East African country has some competitive advantages over its neighbors thanks to its rich natural resources, paired with the fact that it has allocated over 25% of its total area to wildlife national parks and protected areas. Because of this, an estimated 90% of tourists visit to Tanzania seeking out ecotourism activities. Ecotourism, in turn, supports 400,000 jobs and accounts for 17.2% of the national GDP, earning about $1 billion each year as its leading economic sector.

Some of Tanzania’s biggest highlights include the Serengeti, Mount Kilimanjaro , and Zanzibar, though the country still often goes overlooked by American tourists. Visitors can take a walking safari tour in the famous Ngorongoro Conservation area, for example, with fees going to support the local Maasai community.

The country is also known for its chimpanzees , and there are several ecotourism opportunities in Gombe National Park that go directly towards protecting chimpanzee habitats.

Galapagos Islands

It comes as no surprise that the place first made famous by legendary naturalist Charles Darwin would go on to become one of the most sought-after ecotourism destinations on Earth, the Galapagos Islands .

The Directorate of the Galapagos National Park and the Ecuadorian Ministry of Tourism require tour providers to conserve water and energy, recycle waste, source locally produced goods, hire local employees with a fair wage, and offer employees additional training. A total of 97% of the land area on the Galapagos is part of the official national park, and all of its 330 islands have been divided into zones that are either completely free of human impact, protected restoration areas, or reduced impact zones adjacent to tourist-friendly areas.

Local authorities still have to be on their toes, however, since UNESCO lists increased tourism as one of the main threats facing the Galapagos today. The bulk of funding for the conservation and management of the archipelago comes from a combination of governmental institutions and entry fees paid by tourists.

Costa Rica is well-known throughout the world for its emphasis on nature-based tourism, from its numerous animal sanctuaries to its plethora of national parks and reserves. Programs like its “Ecological Blue Flag” program help inform tourists of beaches that have maintained a strict set of eco-friendly criteria.

The country’s forest cover went from 26% in 1983 to over 52% in 2021 thanks to the government’s decision to create more protected areas and promote ecotourism in the country . Now, over a quarter of its total land area is zoned as protected territory.

Costa Rica welcomes 1.7 million travelers per year, and most of them come to experience the country’s vibrant wildlife and diverse ecosystems. Its numerous biological reserves and protected parks hold some of the most extraordinary biodiversity on Earth, so the country takes special care to keep environmental conservation high on its list of priorities. 

New Zealand

In 2019, tourism generated $16.2 billion, or 5.8% of the GDP, in New Zealand. That same year, 8.4% of its citizens were employed in the tourism industry, and tourists generated $3.8 billion in tax revenue.

The country offers a vast number of ecotourism experiences, from animal sanctuaries to natural wildlife on land, sea, and even natural caves. New Zealand’s South Pacific environment, full of sights like glaciers and volcanic landscapes, is actually quite fragile, so the government puts a lot of effort into keeping it safe.

Tongariro National Park, for example, is the oldest national park in the country, and has been named by UNESCO as one of only 28 mixed cultural and natural World Heritage Sites. Its diverse volcanic landscapes and the cultural heritage of the indigenous Maori tribes within the create the perfect combination of community, education, and conservation.

How to Be a Responsible Ecotourist

  • Ensure that the organizations you hire provide financial contributions to benefit conservation and find out where your money is going.
  • Ask about specific steps the organization takes to protect the environment where they operate, such as recycling or promoting sustainable policies.
  • Find out if they include the local community in their activities, such as hiring local guides, giving back, or through initiatives to empower the community.
  • Make sure there are educational elements to the program. Does the organization take steps to respect the destination’s culture as well as its biodiversity?
  • See if your organization is connected to a non-profit or charity like the International Ecotourism Society .
  • Understand that wildlife interactions should be non-invasive and avoid negative impacts on the animals.

Ecotourism activities typically involve visiting and enjoying a natural place without disturbing the landscape or its inhabitants. This might involve going for a hike on a forest trail, mountain biking, surfing, bird watching, camping, or forest bathing . 

Traveling in a way that minimizes carbon emissions, like taking a train or bike instead of flying, may also be part of an ecotourism trip. Because these modes of travel tend to be slower, they may be appreciated as enjoyable and relaxing ecotourism activities.

The Wolf Conservation Center ’s programing in New York State is an example of ecotourism. This non-profit organization is dedicated to the preservation of endangered wolf species. It hosts educational sessions that allow visitors to observe wolves from a safe distance. These programs help to fund the nonprofit organization’s conservation and wildlife rehabilitation efforts.

Stonehouse, Bernard. " Ecotourism ." Environmental Geology: Encyclopedia of Earth Science , 1999, doi:10.1007/1-4020-4494-1_101

" What is Ecotourism? " The International Ecotourism Society .

" Tourism ." International Union for Conservation of Nature .

https://doi.org/10.1073/pnas.1307712111

https://doi.org/10.1371/journal.pone.0033357

https://doi.org/10.1016/j.tree.2015.09.010

https://doi.org/10.5897/JHMT2016.0207

" Galapagos Islands ." UNESCO .

" About Costa Rica ." Embassy of Costa Rica in Washington DC .

https://www.stats.govt.nz/information-releases/tourism-satellite-account-2019

  • Costa Rica’s Keys to Success as a Sustainable Tourism Pioneer
  • What Is Sustainable Tourism and Why Is It Important?
  • What Is Community-Based Tourism? Definition and Popular Destinations
  • How to Be a Sustainable Traveler: 18 Tips
  • What Is Overtourism and Why Is It Such a Big Problem?
  • Defeating Deforestation Through Rum, Chocolate, and Ecotourism
  • Empowering Communities to Protect Their Ecosystems
  • Best of Green Awards 2021: Sustainable Travel
  • Why Bonobos Are Endangered and What We Can Do
  • Why Are National Parks Important? Environmental, Social, and Economic Benefits
  • IUCN President Tackles Biodiversity, Climate Change
  • The World’s Smallest Tiger Is Inching Towards Extinction
  • Ecuador Expands Protected Galapagos Marine Reserve by More Than 23,000 Square Miles
  • What Is Voluntourism? Does It Help or Harm Communities?
  • Regenerative Travel: What It Is and How It's Outperforming Sustainable Tourism
  • New Zealand Aims to Become World's Largest 'Dark Sky Nation'

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Chapter 7. Travel Services

7.3 Tourism Services

Many organizations can have a hand in tourism development. These include:

  • Sector-specific associations
  • Tourism and hospitality human resources organizations
  • Training providers
  • Educational institutions
  • Government branches and ministries in land use, planning, development, environmental, transportation, consumer protection, and other related fields
  • Economic development and city planning offices

Consultants

The rest of this section describes Canadian and BC-based examples of these.

Sector-Specific Associations

Numerous not-for-profit and arm’s-length organizations drive the growth of specific segments of our industry. Examples of these associations can be found throughout this textbook in the Spotlight On features, and include groups like:

  • BC Hotel Association
  • Sea Kayak Guides Alliance of BC
  • Restaurants Canada

These can serve as regulatory bodies, advocacy agencies, certification providers, and information sources.

Tourism and Hospitality Human Resource Support

Tourism HR Canada — formally the Canadian Tourism Human Resource Council (CTHRC) — is a national sector council responsible for best practice research, training, and other professional development support on behalf of the 174,000 tourism businesses and the 1.75 million people employed in tourism-related occupations across the country. In BC, an organization called go2HR serves to educate employers on attracting, training, and retaining employees, as well as hosts a tourism job board to match prospective employees with job options in tourism around the province.

Training Providers

Throughout this textbook, you’ll see examples of not-for-profit industry associations that provide training and certification for industry professionals. For example, the Association of Canadian Travel Agents offers a full-time and distance program to train for the occupation of certified travel counsellor. Closer to home, an organization called WorldHost, a division of Destination BC, offers world-class customer service training.

You’ll learn more about training providers and tourism human resources development in Chapter 9 .

Educational Institutions

British Columbia is home to a number of high-quality public and private colleges and universities that offer tourism-related educational options. Training options at these colleges and universities include certificates, diplomas, degrees and masters-level programs in adventure tourism, outdoor recreation, hospitality management, and tourism management. For example, whether students are learning how to manage a restaurant at Camosun College, gaining mountain adventure skills at College of the Rockies, or exploring the world of outdoor recreation and tourism management at the University of Northern BC, tomorrow’s workforce is being prepared by skilled instructors with solid industry experience.

Spotlight On: Emerit

Emerit is Canada’s award winning training resource developed by Tourism HR Canada in collaboration with tourism industry professionals from across Canada. For more information on Emerit, visit the go2HR website .

Government Departments

At the time this chapter was written, there were at least eight distinct provincial government ministries that had influence on tourism and hospitality development in British Columbia. These are:

  • Tourism, Arts, and Culture
  • Advanced Education, Skills, and Training
  • Transportation and Infrastructure
  • Environment & Climate Change Strategy
  • Forests, Lands, Natural Resource Operations & Rural Development
  • Indigenous Relations & Reconciliation
  • Jobs, Economic Development, & Competitiveness
  • Public Safety & Solicitor General

Ministry names and responsibilities may change over time, but the functions performed by provincial ministries are critical to tourism operators and communities, as are the functions of similar departments at the federal level.

At the community level, tourism functions are often performed by planning officers, economic development officers, and chambers of commerce.

A final, hidden layer to the travel services sector is that of independent consultants and consulting firms. These people and companies offer services to the industry in a business-to-business format, and they vary from individuals to small-scale firms to international companies. In BC, tourism-based consulting firms include:

  • IntraVISTAS: specializing in aviation and transportation logistics advising
  • Chemistry Consulting: specializing in human relations and labour market development
  • Beattie Tartan: a public-relations and reputation management firm

For many people trained in specific industry fields, consulting offers the opportunity to give back to the industry while maintaining workload flexibility.

Introduction to Tourism and Hospitality in BC - 2nd Edition by Morgan Westcott and Wendy Anderson, Eds is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

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Tourism Teacher

What is tourism? A definition of tourism

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Whilst most of us have been tourists at some point during our lives, you might find yourself asking ‘what is tourism?’ or ‘what is the definition of tourism’?

A definition of tourism

Having studied, worked in and taught tourism management for many years, I can tell you that there is no straight-cut answer to this question! In fact, I do tell you- in this YouTube video below!

The tourism industry is argued to be the largest industry in the world, providing more employment than any other industry. Note, however, the use of the word ‘argued’. You see, the tourism industry is somewhat grey in nature. Elements that some may consider ‘tourism’, others may not. Some people believe they are ‘ tourists ‘, when others do not. Some things are black and white, and others are not.

In this post I will explain why there is no simple explanation in answer to the question ‘what is tourism?’. I will explain the diversity of the tourism industry and provide a range of definitions of tourism that have been developed by academics and practitioners.

What is tourism?

Tourism is the generic term used to cover both demand and supply that has been adopted in a variety of forms and used throughout the world. 

Tourism essentially refers to the activities undertaken by visitors, also known as the visitor economy. The tourism industry encompasses all activity that takes place within the visitor economy.

This includes activities that are directly related to the tourist, such as staying in a hotel, ordering a meal or visiting a tourist attraction. It also includes indirect activities, such as the transport company which delivers the food to the restaurant in which the tourist eats or the laundry company that has a contract with the hotel for cleaning bed sheets.

It is largely due to the indirect contributions to tourism, that defining and measuring the tourism industry is so difficult!

Tourism comes in many different shapes and sizes and there are many different types of tourism . There is mass tourism , niche tourism and special interest tourism. There is domestic tourism and international tourism . There is inbound tourism and outbound tourism .

Whilst there is a range of different forms of tourism, they all come under the broad tourism umbrella, nonetheless. This is because they all revolve around visitors and they all feed the visitor economy in one way or another.

A definition of tourism

Tourism is a phenomenon with no universally accepted definition, owing to the complexity and individualism of the travellers themselves and the activities that they choose to undertake.

The most widely utilised definition of tourism, proposed by the World Trade Organisation (WTO) and United States (UN) Nations Statistics Division (1994), prescribes that in order to qualify as a tourist one must travel and remain in a place outside of their usual residential environment for not more than one consecutive year for leisure, business or other purposes.

Matheison and Wall (1982) on the other hand, do not impose a timeframe, simply stating that one must travel to a destination temporarily.

Leiper (1979) believed that defining tourism is more complex than this, proposing that there are three approaches that can be taken. The economic stance focuses on tourism as a business, the technical stance focusses on the tourist in order to provide a common basis by which to collect data and the holistic stance attempts to include the entire essence of the subject.

The Cambridge Dictionary define tourism quite simply as; ‘the business of providing services such as transport, places to stay or entertainment for people who are on holiday’.

Read also: – The importance of tourism – Types of tourism: A glossary – Outbound tourism | Understanding the basics – The structure of the tourism industry – Domestic tourism tourism explained – The history of tourism

Whilst such attempts to define the concept of tourism may be useful from a generic perspective, the practical application of such definitions is difficult when applied to specific tourism types, such as those outlined in this post outlining the different types of tourism.

In fact, Robinson and Novelli (2007), in their introduction to the niche tourism phenomena, postulate that tourists have developed as consumers, becoming increasingly sophisticated in their needs and preferences as a result of an emergent culture of tourism.

Despite such acknowledgements of the progressive and adaptive nature of tourism, particularly evident through the limitless introduction of new and niche tourism forms, there appear to have been no attempts to develop the commonly accepted definitions of tourism in parallel.

As such, I would argue that there is a need the definition of tourism to be revisited by academics and industry practitioner, to ensure that it is representative of the tourism industry that operates today.

How would you define the term tourism?

For more information on what makes up the tourism industry, I recommend the key text Tourism: Principles and Practice by John Fletcher, available from Amazon here .

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Healthcare provider signs MOU with Indonesian bank

Tuesday, 05 Mar 2024

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IHH to continue growing across multiple markets

IHH to continue growing across multiple markets

Gleneagles hospital johor nurtures healthcare talents in the state, ihh net profit soars to rm2.95bil in fy23.

Diza (right) and Sipika at the MoU signing.

CLOSE ties to Indonesia has made Malaysia a preferred choice for Indonesians seeking quality medical treatment and tourism, says IHH Healthcare Malaysia chief commercial officer Sipika Singh.

Sipika said this after leading the group’s partnership with Indonesian financial institution Bank Mega.

IHH Healthcare is a healthcare provider with a network of well-known hospitals including Gleneagles Hospitals, Pantai Hospitals and Prince Court Medical Centre.

Sipika and Bank Mega vice-president director Diza Larentie officiated at a signing ceremony on the collaboration.

The partnership enables Bank Mega cardholders to enjoy benefits on services such as health screening and medical travel assistance, which includes pre- admission processes, airport transfers and welcome gifts.

This collaboration reaffirms the two organisations’ shared mission to prioritise the health and well-being of their customers.

At the event, Sipika described IHH Healthcare as a regional leader in providing quality healthcare services that prioritise patients through a team of over 1,300 healthcare professionals, advanced technology and the latest equipment.

“Through this collaboration, we are excited to deliver value-based healthcare options to Bank Mega cardholders who will enjoy preferential pricing, priority appointments and specialised health packages, including discounts on all health screening packages and room and board as well as free airport transfers and body composition tests,” Sipika said, adding that the group would be able to strengthen its position as the preferred Malaysian healthcare provider for Indonesian medical tourists.

For Diza, the partnership aligns with the bank’s aim to provide customers with holistic solutions, especially health-related.

“Health is an essential aspect of one’s overall well-being and we are proud to join hands with IHH Healthcare, to offer our cardholders access to world-class healthcare services in Malaysia.

“In addition, Bank Mega customers may also enjoy choices of payment settlement by converting the payment into instalments using a Bank Mega credit card,” said Diza.

Bank Mega cardholders can reach out to IHH Healthcare Malaysia’s One-Stop Customer Service Hotline at 021-2789 9788 (Indonesia) or www.ihhmalaysia-international.com

Both provide support services in Bahasa Indonesia.

They can also speak with a consultant for assistance on pre-appointment consultation, hospital recommendations, appointments and cost estimates.

For details, visit www.bankmega.com

Tags / Keywords: IHH Healthcare Malaysia

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