Medical Tourism And The Issues Of Its Sustainability Commerce Essay

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In the recent decade, it is noted that there has been a dramatic growth in the number of people travelling abroad for medical treatment. This annotated bibliography contains ten articles that discusses about the topic medical tourism and the issues of its sustainability. The research also mentions about the different types of medical tourism and its popularity in different countries.

This field of tourism has already emerged as the main source of income for several countries. India, Thailand and Singapore are the major medical tourism destinations in the world. Many authors have already mentioned in their journals and articles about this form of tourism as, first world care at third world price. The geographical attraction of certain places has been creating a further boom in the medical tourism market as many tourists pursue medical tour as part of their pleasure trip.

Medical tourism has reversed the old system of wealthy people flying to developed countries for better treatment. Today, the issues like long waiting list, higher cost etc forces the people to travel to the developing countries for getting the cheapest and best treatment. The issues which affect the sustainability of medical tourism have also been explained in the articles. Some of the issues help medical tourism to remain sustainable while others have created a negative impact on it.

Medical tourism has a lot of positive aspects that attract the tourists but the negative side of it has always left the patients in a dilemma before pursuing medical tour. The article explores both the positive and negative aspects of medical tourism that decides upon its sustainability. There are even moral issues associated with certain types of medical tourism and those are also demonstrated in the research.

Brown (1987, cited in Richard, 1990, p.1) argued that the meaning of sustainability was strongly dependant upon the context in which it was applied and whether its use was based on an ecological, social, or economic perspective. The sustainability of medical tourism in social and economic perspective is explored in this work. Further report shows how medical tourism can become a sustainable form of tourism.

1. Horowitz, M.D. (2007). Medical Tourism: Globalisation of the Healthcare Marketplace. Medscape General Medicine journal. Vol. 9. (Issue 4). Pp 33.

The article discusses about the growth in number of people travelling overseas to obtain medical, dental and surgical care. As a result of higher health care costs in developed countries, people prefer flying abroad to developing nations like India and Thailand for medical treatment. The research also discusses about the transformation from the olden days scenario, where people travel to developed nations for advanced health care to the new trend called medical tourism. Most of the physicians at these tourist destinations hold post graduate degrees obtained from the industrialised nations and also may have practised in these nations after the training.

India, Malaysia, Singapore and Thailand have become popular for cardiac and orthopaedic surgery while the countries in Central and South America has build a good reputation in cosmetic surgery and dental care. The medical services offered in India cost only about 10% of those in the United States. As dental and cosmetic surgery are not covered by the companies that provide health insurance, patients from Canada and United Kingdom pursue Medical Tourism to get the procedure done at the lowest and attractive cost.

People also travel to the medical destinations as some of the treatments like stem cell therapy are restricted in the industrialised nations and are available at these places. People desiring to do procedures like drug rehabilitation would travel abroad for privacy. Some people often make medical tour as a part of their vacations at some luxurious places.

Modern technology helps the tourists to investigate and find the proper destination. People could arrange healthcare anywhere in the world through internet and can also approach the agents for advice.

The research also states that, the revenue generated by destination countries by providing medical services to foreign patients can be used to improve the quality of care given to the citizens of those countries.

I have Chosen this article as it highlights the emergence of medical tourism and its sustainability in developing nations. It also discusses about the increasing popularity of medical tourism and states that almost 1.2 million patients travelled to India and 1.1 million travelled to Thailand in the year 2004. It is also estimated that by 2012 medical tourism in Asia could generate revenue of approximately $4.4 million. It also explores various reasons which make people pursue medical tour to these destinations.

2. Ivy, T., & Calvin, C. (2005). Supplementing growth with medical tourism. Special Report: Medical Tourism. Vol. 9. (issue 8). Pp 306 - 311.

This article mainly discusses about the role of private sector and the Government of certain countries in the growth of medical tourism. Well developed indigenous medical systems and emergence of new technology have played an excellent role in supporting medical tourism among western countries for several years. Among the Asian countries, this form of tourism is a new trend and it is the private hospitals in those countries that account maximum for attracting foreign patients. Bumrungrad hospital in Thailand was one among the first few hospitals to focus on this field. Government has also led the development of this industry in several countries like Malaysia where a committee has been formed for the promotion of health tourism. Similarly the government of Hong Kong has been making attempts to market its traditional medicine.

The article also mentions about the decline in number of foreign patients visiting the United States. Tightening of the immigration rules and security check is one among its main causes. As a result of this more patients especially from the Middle East move to France, UK, Germany and Australia as alternatives. Still the market potential in these countries is very less compared to the Asian countries.

Growth of this industry is very much related to the quality of medical services provided as patients travel abroad with lot of expectations. The article mentions about certain hospitals in Australia that focus not only on cancer but on various specifications of skin cancer. Hence to support this, nurses are specially trained and are called Oncology nurses. The quality of service is even supported by the hardware investments such as MRI or Gamma Knife machines and software investments as well. Certain hospitals also provide non medical services to its foreign patients such as logistics and accommodation. London Bridge Hospital provides direct airport pick up is an example mentioned in the article.

The article concludes by stating about the marketing reforms. Websites, transparent pricing schemes, in-flight magazines etc has become the main platform for advertising. Certain hospitals have even started their agencies in other countries. Cromwell hospital in U.K is one among those which has offices in India and Pakistan.

I've chosen this article as it mentions about the effect of Government and private sector on the sustainability of Medical Tourism. It also points about the industry's sustainability issues in United States even though the author hasn't discussed much about it. It also states about the impact of quality of service on medical tourism to remain sustainable and concludes specifying the ways of advertising used by the hospitals.

3. Turner, L. (2008). Cross-border dental care: 'Dental tourism' and patient mobility. British Dental Journal. Vol 204 (issue 10). Pp 553-554.

The article characterises dental tourism as an example of globalisation. It is a fact that dental surgeries are the most expensive among all medical procedures and are not covered by most of the insurance providers. There are several reasons which lead people to travel overseas for getting their dental procedures done. Huge cost of this procedure at the home country itself is a reason that makes people fly abroad to countries where it is done at much lower cost. Secondly the long waiting list at the home country to get access to a local dental doctor makes people think about pursuing dental tourism. It is also understood by the people that lower prices doesn't result in lower quality of the dental procedure.

Even though dental tourism is considered as an example of globalisation, the author mentions that the movement of dental tourists in countries like U.K, U.S and Australia are more regional compared to other areas of medical tourism. Most of the people from United Kingdom move to countries like Bulgaria, Hungary, Croatia, Romania and Poland. Similarly the Americans and the Australians move to their neighbouring countries rather going to countries which are far away.

Apart from the benefits of Dental Tourism, there are even certain risks associated with it. Most of the dental procedures are done in episodes that create difficulty for the people flying down from far away countries considering the validity of their visas. Dental surgery may create further complications even if the procedure is successfully done. In such cases people will be helpless as they have to depend on the local dentists and end up spending a huge amount of money. Moving legally against such negligence of care is not practical as the dental tourism companies make the clients sign liability forms which states, if legal actions are to be initiated, the clients should turn to the courts of the country where the dental hospital is situated.

Despite all the risks associated, number of people moving abroad for dental surgeries keeps increasing as they find the risks are negligible compared to the benefits and hence there is an enormous growth in dental tourism.

I've chosen this article as it deals about an interesting area of medical tourism. The article explores the benefits and risks associated with dental tourism and mentions that the risks are negligible compared to benefits. Thus the issues related to the sustainability of dental tourism have been discussed in the article.

4. Bramstedt, K.A., & Jun, X. (2007). Check list: Passport, Plane Ticket, Organ Transplant. American journal of transplantation. Vol 7(issue 7). Pp 1698-1701.

This article is about organ transplantation between people from different countries, also known as transplant tourism and the role of insurance companies on such issues. The sources of organ are often from citizens of the country where transplant is performed or can be the living donors whom the recipients bring abroad.

As of 19th January 2007 there were nearly 95,000 patients waiting for organ transplant in the United States. In 2004, approximately 26,500 organs were transplanted. In the same period over 7000 patients died waiting for transplant. It is also projected by the United network of organ sharing that by 2010, there would be100000 patients waiting for kidney and the average waiting list would be 10 years. Taking all these to account, the insurance company are taking steps to address the problems of organ availability, long waiting list and higher cost, hence promoting transplant tourism. Some medical insurance companies have even bundled travel and health care to one single package.

The article has also mentioned about the ethical terms of transplant tourism. In some cases of living donors from countries where guidelines do not exist, they would have been expressly paid to donate. Forced spousal donation may also happen. Apart from that the authors have also discussed about the safety issues of transplant tourism. It is mentioned that living donor transplant gives the better outcome but there are certain clinical risk associated. When a donor travels to a foreign country there will be travel risks and also complications due to poor hygiene in overseas hospitals. The epidemic communicable diseases are also a big risk for the living donors from abroad. Another complication associated is the long term care of donors. One of the authors has mentioned his experience where he finds many U.S donors lacks personal health insurance. In such cases there is a risk of financial burden for such donors when the coverage from the recipient's policy ends.

The author also mentions about the multiple victims of the transplant tourism practices. They are the donor, the recipient and the overseas resident patients awaiting transplant. Countries like Australia and New Zealand have created a system of double waiting list, one for residents and the other for non residents. The non residents will have access only if it is determined that no suitable allocation can be made to the residents.

The article concludes by specifying that the practice of organ tourism is not ethical even though increasing transplant availability is a worthy goal.

This article has been chosen as it deals with the issues of organ tourism also known as transplant tourism. The article discusses about both the benefits and even the unethical nature of organ tourism. The increasing statistical figures of people waiting for transplant show that transplant tourism remains sustainable.

5. Budiani-Saberi, D.A., & Delmonico, F.L. (2008). Organ Trafficking and transplant tourism: A commentary on the Global Realities. American Journal of transplantation. Vol 8(issue 5). Pp 925-929.

This article deals with an unethical practice of transplant tourism known as organ trafficking. Certain people selling organs are not only the donor sources as their main focus would be money. Organ trafficking can involve means of threat, abuse of power and other means of exploitation such as giving or receiving of payment or benefits to achieve the consent of a person having control over another person. The financial consideration becomes the main priority instead of health concerns by making organ, the main commodity of commercial transaction.

The authors have also clearly mentioned that not all medical tourism involving the crossing of borders by the transplant recipients or donors are associated with organ trafficking. Transplant tourism is legal and there are different rules in different countries regarding the transplant of organs.

The article explores about the extent of organ trafficking. Countries such as Pakistan and Philippines do not have any legal procedures for organ transplant. These countries do not even release the data of number of foreign patients travelling there. It was estimated by WHO in 2007 that, 5 - 10% of kidney transplantation around the globe occur as a part of organ trade. It was also estimated that at least 100 nationals from countries such as Saudi Arabia, Malaysia, Taiwan and South Korea travelled abroad for commercial kidney transplantation yearly. Few people from Australia, India, United States, Canada, Japan, Oman and Morocco also travelled as tourists for trafficked organs. The most shocking observation was in China where 11,000 transplants were performed from executed prisoners.

China has recently adopted Human Transplantation Act that bans commercialism and as a reason of this, the number of transplants to foreign patients has been reduced by 50%. Israel also would prohibit the insurance reimbursement for Israelis who perform transplant from countries where buying or selling of organ is illegal.

The article concludes by specifying about the approach of organizations such as WHO in finding alternatives to combat this commercialisation. At a regional consultation held in Kuwait by WHO, it opposed transplant tourism that includes brokerage. It crafted statement eyeing towards certain goals that include the development of legal framework on organ transplantation and making it transparent in every country. The statement also mentions that the insurance companies should not support this illegal practice.

The reason for choosing this article is, it highlights about the ill practices of transplant tourism. Medical tourism has become a platform for organ trafficking. It also mentions about the extent of organ trafficking and the measures taken by WHO to fight them.

6. Pennings, G. (2002). Reproductive tourism as moral pluralism in motion. Journal of medical ethics. Vol 28(issue 6). Pp 337-341.

Reproductive tourism is a part of medical tourism where people, for obtaining desired medically assisted reproduction, travel form one institution, jurisdiction or country where treatment is unavailable due to certain restrictions, to another institution, jurisdiction or country. The restriction or rules may not necessarily be legal but can be the personal moral convictions of health care provider, policy of institution etc. Many European countries, Australia and United States haven't put much restriction on it and U.S has known this phenomenon especially for abortion for a long time. The tourists who perform reproductive tourism are called fertility tourists.

The author has focused on Belgium as he is more familiar with it. A study states that 30% of patients coming for IVF treatment in Belgium are from abroad. Also 60% of patients requesting oocyte donation are also from abroad with the French accounting for the highest in number. Lot of patients fly from Germany as oocyte donation and IVF are not allowed in the country.

Long waiting list, lack of expertise and cost can also be the factors which lead people to consider reproductive tourism other than the moral reasons and treatment unavailability. In most of the countries, cost for all IVF cycles are not reimbursed.

Apart from the factors that leads people pursue this kind of tourism, the article also discusses about certain solutions to avoid it. The author mentions that the best solution is to adopt a soft law that does not impose strict prohibitions or obligations on anyone in all countries. The law does not reflect the moral position of any group as the post modern society has got multitude of morals and religious views. It can also be avoided if the treatment is done only to citizens of the country. Prevention of people from crossing borders for this kind of treatment can also be practiced. An example of such kind of prevention mentioned is about Ireland putting ban on Irish women flying to the Great Britain for abortion.

The author concludes the article by expressing his take on the pluralistic society with multitude of morals and values. He mentions that reproductive tourism is the solution found by the minorities when moral conflict occurs.

This article has been chosen as it explores an odd part of medical tourism known as reproductive or fertility tourism. This category of medical tourism has certain moral values revolving around it and different people in the society have different views on it. The sustainability of medical tourism is always associated with the moral values and views of the people. Different ways to avoid Reproductive tourism has also been discussed in the article.

7. Denise, S. (2009). Ayurvedic Tourism in Kerala: Local Identities and Global Market. In Tim, W., Peggy, T., & Chang, T.C. (Eds.), Asia on tour: Exploring the rise of Asian tourism. (Pp 138-148). Oxon: Routledge.

Ayurveda is the major medical tradition and the key element of India's tourism market. It is also linked with cultural tourism as it includes mostly the traditional way of treatment. The Westerners and the citizens of Southeast Asia and West Asia are the most among those attracted towards Ayurvedic tourism. Ayurveda is most popular in Kerala, the south western state of India and is also been visited by the people from Northern part of the country. Ayurvedic practitioners represent it in a traditional context as well as in the context of modernity.

. Migration of workers from Kerala to the gulf countries along with many new age Gurus account for increasing the popularity of Ayurveda in the global level. Lots of Ayurvedic pharmaceuticals and clinics have been opened world wide recently. The clinics in South Asia have developed many Ayurvedic resorts that attract tourists overseas. Ayurvedic Tourism is even promoted by the major hospitals that sell bio medical and surgical services to the patients abroad by offering trips to Ayurvedic centres during patient's recovery period. The geography of Kerala is an added advantage for Ayurvedic tourism market in India.

In the recent years, Ayurvedic practitioners have found a new technique for marketing Ayurveda to make it more acceptable in all parts of the world. It has been accomplished as a mode of relaxation and massage rather than the complicated system of diagnosis and healing. This attracted more and more tourists from several parts of the world and thus became major source of income for the resorts in the country. The students who graduate in Ayurvedic medicine started getting recruited in the resorts and their demand keeps rising. They could also earn huge salaries from it but they waste their talent as the people being treated are those with out any kind illness and so, they have nothing much to do with the things they actually studied.

Local hospitals in the country have improved the in patient facilities to meet the demand and to attract foreign patients. Today people pursue Ayurvedic treatment for two reasons. One set of people considered as serious patients undergo the treatment to improve their chronic health conditions while others visit the resorts as a part of pleasure trip.

The reason for choosing this article is that it deals with the field of medical tourism that is even linked with culture and tradition of the region. Not only patients but all kind of tourists pursue Ayurvedic tourism. The chapter discusses about the change of track of Ayurveda from the system of diagnosis and healing to the mode of relaxation and massage. This attracts more tourists and hence makes it remain sustainable.

8. John, C. (2006). Medical Tourism: Sea, sun, sand and surgery. Tourism Management. Vol 27(issue 6). Pp 1093-1100.

The article describes medical tourism as new form of niche tourism. High cost of medical care, long waiting lists, affordable airfare and favourable economic exchange rates have constituted to the growth of medical tourism in the recent years. Though Asian countries are dominating, several other countries have sought to enter this field. The rise of new companies which act as the agents between hospitals and the tourists also account to the growth along with the internet. Proper marketing is being done as the medical care gradually moved to the private sector.

Countries like India, Singapore and Thailand which dominate in the industry have linked medical care to tourism by boosting the attraction of the beaches near by. South Africa and the Latin American countries have also become prominent in the industry in the recent years. The Caribbean states have found it difficult to enter the industry as its prices cannot compete with those of Latin American countries. As a result of this countries like Cuba and Antigua have started to specialise in certain medical fields like skin diseases, dentistry etc.

The Middle Eastern countries have also shown their interest in entering the market and Dubai has built a Health Care City as a result of it. They compete on quality as they are unable to compete on price with the other Asian countries and have given importance to branding. Saudi Arabia has entered the market by linking medical tourism with the pilgrimage visits to the country. Hospitals in certain countries have even started links with airways for promoting the industry.

The article also mentions that the currency fluctuations have a great influence on medical tourism. The author mentioned an example of a hospital in South Africa that went from 30 patients a month in 2003 to none in 2005 as South African currency rose its value against the U.S Dollars.

The author says that marketing of medical tourism is often linked with geography of the destination. As already mentioned in the beginning, some Asian countries link medical tourism with near by beaches, the article also mentions about the link of Ayurvedic tourism in Kerala to the house boats and back waters there. It has also become a part of pleasure tourism where people's primary intention would be touring for pleasure and would visit near by medical centres as a part of it.

This article has been chosen as it mentions about the countries making attempt to enter the medical tourism industry other than those dominating the field and their marketing strategies adopted to compete with the dominants. It also discusses about the link of medical tourism with other fields of tourism and their mutual benefits. Relation of medical tourism to currency fluctuation has also been discussed in the article.

9. Tony, L.H., & George, B.P. (2009). The incorporation of telemedicine with medical tourism: A study of consequences. Journal of hospitality marketing and management. Vol 18(issue 5). Pp 512-522.

The article begins by briefing on medical tourism and its role in different countries. The authors mention about the projected statistics of people pursuing medical tourism which has already been discussed in the previous articles of the annotated bibliography. The factors affecting people to travel abroad for treatment has also been mentioned.

The authors then discuss about telemedicine and mention that it is the use of information and communication systems to support the patients. In the past decade there has been a dramatic growth in the telemedicine technology, though it was established almost half a century ago. The technical part of telemedicine has also been mentioned in the article.

The article also mentions about the influence of telemedicine on medical tourism and its benefits. Telemedicine brings a great value to the patients who fly back home after the treatment as it is used as a follow up to the treatment obtained. Well equipped call centres have been established with trained doctors and nurses receiving calls from the patients. Nurses then make follow up calls to check the progress of the patients.

The expectations and satisfaction of medical tourists related to telemedicine has also been explored in the article. It states that the tourist who experience telemedicine prior to the medical tour will have significantly more satisfaction compared to those experiencing it only after the tour. From the organisational perspective, telemedicine during the post medical tour would be extremely useful as they could get the feedback from the patients and helps them to improve their quality and standard.

The article concludes by mentioning that telemedicine is built into the day to day practice of medical tourism. The authors have also discussed about the adverse effect of telemedicine on medical tourism. If the telemedicine service is of poor quality, it may have a negative impact on the over all experience.

This article has been chosen as it discusses about the link of Medical tourism with certain elements of technology by highlighting the impact of telemedicine on the sustainability of medical tourism. It also mentions about the benefits of telemedicine from the patients as well as the organisational perspective. Usage of telemedicine increases the expectations of tourists pursuing medical tourism and also benefits them in the post treatment period.

10. David, R. (2010). Health Tourism: Social welfare Through International Trade. Cheltenham: Edward Elgar.

Certain topics in this book mention about the risks and dangers associated with medical tourism. The author calls medical industry as an unusual industry as the customers have to pay even if they die on the table. The risks associated with the treatment will be the same at home as well as abroad. The things that differ are the procedures to move legally against the medical providers if any malpractice or negligence occurs and it is not an easy task to sue the medical providers overseas.

The author mentions that there are doctors who perform unnecessary surgery for money even in the United States. Institute of Medicine in U.S has reported that 48,000 to 98,000 patients die in a year due to medical errors. It is estimated by the health care commission that one out of ten patients in hospitals in developed countries fall victim to mistakes such as wrong diagnosis, wrong dosage of drugs etc.

Other risks mentioned are the different kinds of disease in foreign countries caused due to unfamiliar germs in the water and air. When the patients return home, the physician abroad can never give a proper follow up and it will always be difficult for a doctor at home to take up the case of another doctor. Lots of other risks associated with medical tourism have also been mentioned in the book.

It also discusses about the issues regarding medical malpractices. The author says that the doctors are humans and no medical systems are perfect, hence the patients intending to get the treatment should have a detailed contract. Still it is not easy to sue a doctor if anything goes wrong and the author mentions the example of a dentist failing to notice that the patient has mouth cancer before filling the tooth. In such cases, the dentist cannot be easily sued even if he\she belongs to the home country. It becomes even more difficult if the dentist belongs to a different country where the language, the laws and the court systems are different. The agents also would not take the responsibility as the negligence or malpractices are not committed by their staffs, except a few intermediaries like

The author finally mentions that no hospitals would like to loose their name and reputation as the media is strong and also the competition increases. Hospitals would also not wish to be known for employing under qualified doctors.

Topics of this book have been chosen as it explores the risks associated with medical tourism. People travelling to the third world countries would always think about the consequences before making decisions. Medical malpractices, negligence etc have always been a threat to medical tourism along with risks such as diseases in foreign countries as mentioned. Terrorism, road accidents etc are some of the other threats not only to medical tourism but also to all kinds of tourism.


The ten articles of the bibliography briefs about the different issues associated with medical tourism and its sustainability from social and economic perspective. The articles have been summarised from journals and selected chapters of books on medical tourism.

The annotated bibliography begins by discussing about the scope of medical tourism in developing countries like India, Thailand etc. Old system of travelling to the developed countries for better treatment has undergone a change. Higher cost of treatment, affordable airfares etc are the main reasons that lead people to pursue medical tour. There are even people who take treatment abroad for privacy reasons.

Different countries are popular for different medical procedures. It is mentioned in the article that Asian countries are popular for cardiac and orthopaedic surgery, while Central and South American countries provide the best dental and cosmetic surgeries. Medical tourism has become the main source of income in certain countries and the revenue generated is been used to improve the quality of treatment given to the citizens of the country. As the popularity of medical tourism rose, the agents connecting the clients and the hospitals have also grown in number. Lots of internet websites have been developed to support the patients intending to pursue medical tour.

The research also mentions about the support given by the government of certain countries for uplifting the industry. Private sectors are also doing proper marketing to attract foreign patients to the country.

Some of the articles in the annotated bibliography highlights about different fields of medical tourism such as dental, transplant and reproductive tourism.

Dental surgeries are the most expensive ones among all medical procedures. Dental and cosmetic surgeries are also not covered by almost all the insurance companies. Dental tourism has certain risks in it as the procedure is done in episodes that make it difficult for foreign patients. But the risks are negligible while considering the cost and waiting list of dental procedures in the developed countries. Certain articles have mentioned about the dramatic increase of dental tourists in recent decade.

Two articles in the bibliography are related to transplant tourism and this field of medical tourism has raised a lot of problems. Transplant tourism deals with organ donation and many countries have strict law regarding donation of organs like kidney. Number of patients in the world, waiting for organs is estimated to be very huge. It is been noted in the article that most of the people in need of organ travels to places where the law and guidelines are weak. In those countries, activities such as forced spousal donation are reported to be very high in number.

The fifth article emphasises about the unethical nature of transplant tourism known as organ trafficking. The research also mentions the statistical figures of people involved in illegal organ trade.

Another field of medical tourism discussed in the research is reproductive tourism. This is considered to be an odd part of medical tourism. People pursue reproductive tourism mainly because those kinds of treatments are against the moral values of their own country and will be unavailable. People will have different views on it and these views and values affect the sustainability of reproductive tourism

The seventh article deals with a form of traditional medical tourism known as ayurvedic tourism. Ayurvedic tourism is said to be the key element of tourism industry in India. The geography of Kerala, the south western state of India along with the practice of ayurveda creates a boom in the tourism market in India. This article even shows the link of medical tourism with cultures and tradition.

Medical tourism is even linked with the geography of places. Articles have mentioned that hospitals in some countries use the beauty of its beaches as marketing strategy of medical tourism in that country. In such cases, people can enjoy the natural beauty along with the medical treatment.

The research also mentions about the role of technology such as telemedicine in bringing an impact on the sustainability of medical tourism. Telemedicine is beneficial for medical tourism in many ways and it has the capability of boosting up the medical tourism market. But in many ways it can be a threat as well, especially when people experience a low quality telemedicine before the tour.

Finally, the research discusses about the risk and danger associated with medical tourism. Medical malpractices and negligence are common issues in medical industry everywhere around the globe. The impacts of these issues get strengthen as patients travel a long way to far away countries. But the research even mentions that bigger hospitals would never wish to loose their name and reputation and hence they would always try to keep away the risks associated.


The articles about medical tourism, its various fields, different aspects, links with other forms of tourism and technology etc has been discussed in the annotated bibliography. This makes only a few articles regarding medical tourism and there are lot of other articles that does a deep research on it. An overview of the subject can be obtained from the research made.

From the articles it is clear that medical tourism has made itself big in the tourism industry in certain developing countries. There are lot of positive as well as negative aspects associated with it. But as a whole, it can be concluded that medical tourism is a sustainable form of tourism. Some recommendations can be made to improve on certain issues:

Organ trafficking is an unethical issue that keeps increasing along with the promotion of transplant tourism. All countries should strengthen their laws to reduce the illegal trade of organs.

Medical providers should always respect the moral values of countries where the patients come from. Reproductive tourism is one such field of medical tourism in which lot of procedures are against moral values and ethics. Hospitals should try to protect those values.

Usage of telemedicine can bring a positive as well as negative impact on medical tourism as discussed in the article. Care must be taken while employing the telemedicine staffs. Well qualified doctors and nurses should be employed as it plays a big role in the course of treatment.

The consequences of medical malpractices and negligence are very big as it deals with life of human. People travel long distances with lots of expectation. Articles have mentioned about doctors performing unwanted surgeries for money. Government should create ways to control such illegal activities as it is not easy for the patients to sue foreign doctors if such things happen.