Cultural Case Studies Of Medical Tourism In Thailand

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As the world is getting smaller, it is easier for people to travel abroad. Medical tourism, a subdivision of tourism industry, becomes one of the fastest growing businesses with several million US dollars flow. Instead of waiting for availability of medical treatment in the home country, numerous patients choose to go to other countries to receive their health care services. Not only they travel from developing countries to developed countries to get the best medical treatments with the newest technology, but also more voyage to certain third world countries to obtain reliable treatments, yet with economical price. Consequently, several hospitals, especially in developing countries are trying to improve their services to meet the market´s needs. To be able to excel in this fast growing industry, there are various elements that need to take into consideration, which can be divided into two main aspects: the choices of the destination country and the choices of medical facilities offered. The choice of the country mostly comprises of external and uncontrollable factors such as political situations, economical situations and legal issues. The second one, on the other hand, involves with treatments, services and price. Besides the treatments, memorable experiences are the crucial key that play a mandatory role in a customer´s level of satisfaction and, thus, have impact on revisiting decision. It also affects the number of the new customers, as word-to-mouth and Internet reviews are the main factor in decision-making process. Accordingly, healthcare institutes try to introduce hospitality practices and mentalities to their standard of procedures.

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One of the vital international hospitality features is cultural awareness. Culture is the collective believes, knowledge, symbols and etc. sharing and transferring across a group of individuals. It shapes people behaviours, norms, perceptions, expectations, limitations and etc. in that particular group ranging from ethnic, religious to professional levels. From the definition, each society group possesses some certain unique characteristics that shape one´s needs, limitations and expectations. Without multicultural education, it is almost impossible to deliver the customers´ desires. In this paper, the major cultural boundaries and difficulties are discussed and the solutions are given using two main international hospitals in Thailand as examples.

Thailand is the most favourable health care destination in the world due to its relatively stable political and economical situations, and, most importantly, the Thais´ hospitality attitudes. Among several private hospitals worldwide, Bamrungrad hospital is one of the most prominent players in international healthcare business. Successfully incorporate hospitality atmosphere and concepts, Bamrungrad claims to be the world´s first international hospital. As trust plays an important role in the decision of the destination, Bamrungrad is the first hospital in Thailand that accredited with JCI certificate (international standard credential). Aiming directly for international patients, the hospital hires an international management team to further expand its horizon and to create an international working atmosphere within the organization. From pre-arrival to follow up procedures, Bamrungrad manages to conquer geographical constrains using technology. The hospital aslo sets up referral centres in over 20 countries. Patients can easily access to the hospital website with several language options explaining thoroughly the whole arrival processes, including visa, special needs, and facility provided. Several e-mails are sent to the patients in their own native language to confirm their requirements, explaining the registration procedures, and briefly give information about the doctors and the treatment. To overcome the language boundary among the staffs and the patients, Bamrungrad hires over 150 interpreters and personal assistants to support the customers from 190 countries. English knowledge is a mandatory requirement of qualification to work in the hospital and all the doctors must be graduated overseas. This is because the CEOs want the doctors to be able to understand multicultural customer´s needs and be able to fluently communicate to them. Moreover, to avoid further communication difficulties during the trip, the hospital has arranged an in-house travel agency, visa service and pick up service. Throughout the work, the standard of practice including the integration and culture awareness training are regularly updated and uploaded on the hospital´s mobile phone platform. Every employee can access to this application to make sure that everyone are consistently maintain the hospital´s standards of practice. To facilitate specific ethnic guests, Bamrungrad has prepared, for example, Muslim prayer room and special kitchen in accordance to their religious principles.

Another feature that Bamrungrad hospital has mastered is assign personal assistance to the guests during their stay. Each assistant is responsible for maximum five guests and are assigned according to his or her expertized in the guests´ ethnic groups. Besides helping the clients during the stay, it is their responsibility to make sure that each guest´ special requests are delivered, namely; special meal requests, privacy inquiry, and accommodation for the patient´s visitors and family members. Bangkok hospital group is the second player who entered this medical tourism business arena in Thailand. Although Bangkok hospital is considered to be the new entrant comparing to Bamrungrad, it pushes the competition to another level. While Bamrungrad hospital aims directly at medical tourism business, Bangkok hospital starts its game with expats and foreigners who reside in Thailand. Knowing that one of the biggest concern of international clients is language problem; Bangkok hospital offers basic international services such as airport pickup and interpreter service same as those in Bamrungrad´s. Bangkok hospital has stepped up the game by introducing several nationality-specific medical care centres to further facilitate worldwide customers according to their origin countries. These clinics include Kuwait clinic, Japanese clinic, Burmese clinic and etc. The atmosphere, the decoration, the staffs and the doctors in each clinic are arranged and set up according to each nationality common preferences. For example, the personnel in the Japanese clinic are either Japanese or special-trained locals who understand Japanese cultures and mastered in Japanese language. Moreover, the physicians in this clinic must be graduated or trained in Japan. As a result, they are able to speak Japanese and capable of understanding Japanese cultures, behaviours, communication styles and preferences. This strategy smoothens up the discomfort that might occur among the visitors from different countries. This is a smart strategy because different nationalities prefer different level of personal spaces and for some, calm and quiet atmosphere is preferred.

Furthermore, the ethnic-specific clinic strategy also helps the human resource department to select and positioning the employees in each clinic according to their competences to reduce the cultural conflicts between the staffs and the guests. It is also less resourceful, easier and more practical to specifically train the employees according to the nationality of the guests. As a result, those who work in the clinics are profoundly understand the needs, the expectations and the behaviours of that particular group of people.

Realizing the growth in the number of patients from neighbour countries, Bangkok group opened hospital branches in Bangladesh, Myanmar, Cambodia and Vietnam with Thai staffs mixing with the locals. However, unlike in Thailand, Bangkok hospital faced diverse situations in these countries. The biggest difficulty lies in the expectation of the local guests that are dissimilar to travellers´. In their own countries, the patients have different expectations in term of service, treatment and communication style. As a result, these clients still prefer to receive medical cares in Thailand.

To primarily resolve the situation, Bangkok hospital decided to change some of the hospitals abroad into referring centres or on-point diagnostic centres. However, the aim to open fully operate hospitals in these aforementioned countries still exists. In this case, the hospitals fail to understand the cultural differences between the locals and the tourists. One way to solve the problem is to hire more local staffs and setup integration training for both Thai and local employees. Moreover, an in-depth cultural education of that certain countries should be given to all the staffs. In order to serve multinational clients, the international hospitality service should adopt the knowledge of cultural awareness into their practices, since it is a mandatory key to understand the customers´ needs, limitations and expectations. Without multicultural education, it is almost impossible to deliver what customers need. One aspect that should take into consideration is the cultural dissimilarities between local and international customers. By the fact that medical travel is considered a subdivision of tourism industry, culture awareness also plays role in the customer´s satisfaction and decision-making process. It is because medical staffs in many countries might overlook these aspects in their practices, as they consider themselves having different social status to others.

One of the best ways to create cultural knowledge is to educate the employee by organizing training programmes using media, case studies and role-plays. Another possible indirect method that is useful in building cultural awareness is to arrange educational booklets and create standard protocols for the employees to follow.

11 February 2020

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