The Rise of Medical Tourism: Key Trends & Numbers
To understand the urgency of this conversation about sustainability, it can be helpful to understand the scale and speed of growth of medical tourism. The medical tourism market is estimated to have a global value of somewhere between USD ~31-80 billion in the last few years, depending on the measure and source. Various projections suggest that by 2030-2035, the market will grow to somewhere between USD 150-300+ billion.
The growth rate is high, with CAGR (compound annual growth rate) estimates ranging from approximately 10-20% (and potentially higher, depending on the segment, treatment type, and region).
Cost savings are another factor of interest. Many patients report savings of 40-80% on specific procedures or outcomes as compared to their home country.
Regionally, Asia-Pacific is a leading region — both as a source and a destination. Countries like India, Thailand, Malaysia, and Korea are emerging leaders as destinations.
Treatment types sought include: cosmetic surgery, dental care, orthopedic surgery, cardiovascular treatments and increasingly, specialized or complex care in specific markets, as well.
Putting these together: medical tourism is no longer niche — it is a significant part of mobility of global health care, and its footprint is growing (in many ways).
Environmental Impacts: What the Research Says
While the environmental aspect has historically received less attention, there are several new studies and case studies that show how medical tourism might over-stress all forms of ecological systems:
Carbon Footprint of Travel: Research shows that air travel is one of the most significant sources of carbon emissions in the case of medical tourism. Patients are frequently taking trips over long distances (including return trips, perhaps even for follow-ups) which is another significant contributor toward greenhouse gas emissions.
Facility Energy Use & Infrastructure: Hospitals themselves, typically extensive facilities with elaborate machinery for purposes like long-term stays and intensive care, are energy intensive (usage of energy for cooling, sterilization, ventilation, etc.). Likewise, when hospital destinations scale their services, there is an increased demand for energy, water, and reliable waste disposal. If the energy grid is composed of fossil fuel, or a source of water is more limited, the impact can be profound.
Medical Waste & Disposal: Medical activities can produce hazardous waste (e.g. sharps, biological waste, chemicals). Disposal methods vary, and in many areas, safe disposal practices (like as, autoclaving and incineration to standard) may be unregulated and/or under-resourced.
Tourism Infrastructure Overload: Beyond hospitals, there are ancillary demands from patients and accompanying persons - hotel stays, water use, travel, food services. Increased traffic can overstress infrastructure (roads, sewage, lodging), especially in areas that are not relatively prepared for large volumes.
Resource Use: Water use can be elevated (sterile conditions, laundry, cooling, and landscaping resort facilities) in areas that may already be water-stressed. There may also be increased demand for imported medical supplies, resulting in enhanced upstream environmental costs (manufacturing, shipping).
Social & Ethical Challenges
The following are the significant issues observed in the world:
Equity and Access
It is feared that in the host nations, local patients will be driven out of the best hospitals or even that the most qualified healthcare facilities and medical personnel will serve the foreign patients at the expense of the residents. This may increase disparities in the access of health care.
Quality and Standards and After-op Care.
Follow-ups may present problems, even though pre-treatment may be good, the patients come home. Post travel complications or infections are possible. There may be the absence of legal recourse or transparency. In addition, not every facility is accredited and controlled in the same way.
Medical Ethics Concerns
- In cases of organ transplant tourism (where national legislation or regulation is lax) pressure may be coercive, trafficking may occur, or unscrupulous procedures may be done.
- Marketing/advertising which gives a false impression to the patients (e.g. claims are too high, risks are lower than they are).
- Cultural or linguistic barriers may complicate interpretation of informed consent.
Workforce and Working Conditions
Hospitals located in popular areas for medical tourism might have pressures for high utilization which could be a cause for overworked staff, fatigue, or less than ideal working conditions. If the staff are recruited overseas, there might also be “brain drain” issues in poorer regions.
Economic Leakage & Local Development
Medical tourism may be a way to bring foreign currency into a country, a portion of that income will often go to the regional economy as politicians and other interested parties have financial interests in the activity. Much of that revenue will go to international companies, medical supplies, high-end segments, or facilities that are owned by foreign interests, essentially "leaking" from any direct benefit to local economy. The benefits to local populations may not be uniform; some may or may not directly benefit from the tourism. Also, if nature/tourism spots are used frequently such tourism activities may have an ecological and social toll on local uses.
Case Studies
It can be informative to consider where some places are succeeding (or failing) and learn from that.
Sustainable case study: Jordan Medical Tourism
- Research on sustainable medical facilities in Jordan via the Jordan Medical Tourism Network investigates how the integration of environmental practices and interest of stakeholder groups can assist with sustainability.
- The research proposes a framework that incorporates four business strategies driven by value creation while managing environmental footprint, responding to needs of local communities and maintaining high quality of care.
India as a Major Hub
India generates millions each year by serving two million patients from different countries. Estimates put the total for the medical tourism sector approximately USD 9-10 billion for the year 2022. Patients come from dozens of countries for what can be from simple treatments to complex procedures.
There are consistent standards across hospitals, managing environmental impacts (particularly with larger hospital clusters), and ensuring adverse effects on the local population are minimized.
Case of Thailand
Thailand is another featured destination, receiving millions of medical tourism visits each year, with many accredited facilities, and has a time-honored tradition of blending medical care with wellness and leisure travel.
In Thailand, there is tension in balancing medical tourism growth with natural resource conservation (water, waste, pollution), hosting infrastructure capacity, and maintaining their local health system as adequate.
Drivers of Sustainable & Responsible Practice
In light of the problems, what factors can promote the improvement of medical tourism? Some levers are:
Regulation and Accreditation
International accreditation of hospitals (e.g. JCI, NABH in India) is part of the solution. Regulators or governments in the source and destination countries could create rules over safety or how to provide transparency, informed consent, patient follow-up, waste management etc.
Environmental and "green hospitals"
Hospitals could be built with energy-saving designs (solar, LED, better insulation etc), water-saving fixtures, rainwater harvesting systems, cleaner sources of energy, environmental waste management systems etc. Patients may choose to utilize facilities that have sustainability credentials.
Providing Clear and Accessible Information to Patients
When patients have trustworthy information on outcomes, risk, environmental practices, costs including travel, and post-operative care, they can better inform themselves on decision making.
Supportive Infrastructure & Policy Incentives
Governments will provide some tax-shield (or subsidies) for hospitals that develop green infrastructure; develop strong, legally respected, responses to medical malpractice across jurisdictions; develop medical visa regimes that are patient friendly but safe; travel policies that apply a carbon offset facet to travel, etc.
Community Engagement & Fairness
Community members are engaged in the planning processes, jobs stay in the community, environmental and social costs to the local community are not externalized, and local access to health is not jeopardized for the sake of economic growth.
Technology, Telemedicine, and Hybrid Models
Telehealth helps to reduce travel for both patient consultations and follow-up. Remote monitoring, digital health records, mobile health can minimize the reliance of patients on travelling in specifically for a health check.
Integration with Sustainable Tourism
Medical treatment can also be paired with wellness or tourism in a manner that respects the environment and culture, i.e., one that could involve eco-lodging, sustainable food sourcing, or tourism practices that are less carbon intensive.
Towards a Sustainable Vision: What Might the Future Look Like?
How will a long-term, sustainable, "planet-and-people friendly" medical tourism sector look like 10-20 years from now?
“Green Accredited Medical Tourist Hubs” emerge: hubs that have access to hospitals, lodging, transport, and tourism services associated with strong environmental credentials. These hubs may achieve international recognition, flipping the argument for sustainability to the selling proposition itself.
Patient Decision-Making Preferences Evolve: In addition to “how cheap?” or “how quick?”, we see many patients will expect transparency about environmental footprint, ethical standards, safety, and community benefit. Patients will place weight on reviews and certifications more than they do now.
Hybrid Care Models: Patient travel may be reduced, as tele-consultations and remote monitoring become common. For example, only the surgical procedure occurs overseas, with pre and post care occurring in the patients' homes or as remote support.
Circular Supply Chains & Local Purchasing: Hospitals purchase more of their supplies locally, reducing imported medical waste from packaging and applying recycling and reuse methods where safe, eliminating single-use plastics whenever possible.
Stronger International Legal and Ethical Frameworks: An increased number of cross-border agreements ensuring patient rights, malpractice liability, protection against exploitative organ trade and unethical practices, and standards surrounding medical waste and environmental compliance.
Carbon Offsetting and Travel Innovations: Airline and travel infrastructure may become greener; offsets may improve, making carbon emissions from travel a less troublesome burden. Trending more sustainable lodging and transport options, for accompanying persons.
Inclusive Development: Ensuring that local health systems are strengthened, not depleted. That is, whatever hospital expansion takes place will benefit local communities, create jobs, and improve public infrastructure, etc.
To Conclude…
Can Medical Tourism Be Sustainable?
To summarize: Yes — unless it is automatic. The growth of medical tourism can be unsustainable in many parts of the world if it does not take the environmental, social, ethical, and economic compromises into consideration, and proactively manage them.
For the sector to flourish over the long-term — for patients and host destinations — incentive structures must be aligned. That is, the regulations, transparency, and consumer awareness must evolve at the same rate as growth, and investments must evolve even if they do not yield a shortcut to profit (e.g. investment in eco-infrastructure for the community benefit), to protect both planetary and social capital.
A medical tourism destination or hospital solely focused on volume, cheapness, and a quick profit, will run into environmental degradation, loss of trust (required for success), regulation repercussions, and eventual loss of competitive edge. In contrast, a medical tourism destination or hospital that builds in sustainability, ethics, and inclusivity through the infrastructure, policies, and committee membership, is more likely to end up with a resilient, respecting, and durable medical tourism offer.