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MARKETING STRATEGIES OF DENTAL TOURISM SERVICE PROVIDERS IN
THAILAND
Gabriel Deucher, Mahidol University International College, Thailand
[email protected]
Abstract
The phenomenon of medical tourism is growing around the world due to various
reasons. The main drivers behind the emergence of medical tourism are typically considered
as notably lower treatment expenses, significantly shorter waiting time, lower transportation
costs and the emergence of internet marketing. However, medical service providers in such
medical hubs also face certain obstacles. These barriers include a negative perception of the
quality of medical services among potential foreign patients, the risk of legal issues and the
lack of follow-up treatments. Dental tourism, as a sub-branch of the broader industry of
medical tourism, is no exception to these drivers and barriers. By using various marketing
tools and strategies dental service providers intend to foster drivers on one hand and
overcome barriers on the other hand. This research aims to make a clear and insightful
understanding on how small private dental clinics in Thailand use their marketing activities to
attract foreign tourists. A pure qualitative approach is used to collect data from 20 owners and
managers of small private dental clinics in four medical tourism destinations in Thailand. The
results from the interviews identify a range of marketing methods that are considered as
effective in order to support drivers, reduce or overcome barriers, and consequently attract
foreign tourists. The results also uncover marketing tools that are considered as less useful or
not effective among foreign tourists. However, it is apparent that no single, universal, holistic
marketing strategy can be applied by every dental clinic. The different circumstances, that a
dental clinic is surrounded by, determine which marketing tools are effective and which
marketing tools dental clinics in the context of dental tourism should make use of in order to
support drivers and overcome barriers.
Keywords: medical tourism, dental tourism, drivers and barriers, services marketing,
marketing mix
Introduction
Medical tourism has grown explosively in the present century with thousands of
patients moving to countries abroad in search of medical care1. “The globalization of
healthcare has given rise to a new form of tourism that is commonly known as health
tourism”2. Especially patients from developed countries with comparatively high costs of
medical care “are increasingly looking beyond their countries of residence for healthcare
treatment”3. This new form of service industry – some call it health tourism, some call it
medical tourism4 – is attracting strong interest5 mainly due to its forecasted significant future
growth6. It is estimated that the global health tourism industry would have a value of up to
100 billion US$ in 2012 and that medical tourists will comprise 4 percent of the total travel
population5. Medical tourism is lucrative for any host country because the average medical
tourist spends 362 US$ per day, whereas a non-medical tourist only spends the amount of 144
US$ per day. Therefore, medical tourism offers significant value adding5.
Thailand is a fast developing player in the industry5. Medical tourism is seen “as an
area of future growth that will boost national development in the wake of the financial
crisis”7. According to Cohen8 an exact estimation of the number of medical tourists in
Thailand is rather difficult because relevant data is not available. However, other reports and
articles estimate the number somewhere between 1 and 1.4 million6,9-11 originating mainly
from developed countries such as the United States, Japan, Australia and United Kingdom, as
well as from developing countries such as Bangladesh, Myanmar, and Cambodia2,8. With a
projected overall value of 1.8 billion US$5, medical tourism is an integral part of Thailand’s
tourism and healthcare2.
One prominent sub-niche of medical tourism can be identified as dental tourism, since
demand for dental treatment abroad is growing5 and rising number of patients are traveling
overseas to obtain dental care12. Connell4 even states dentistry among others will probably
become “the core element of medical tourism”. Leggat13 argues that “dental tourism, like its
broader cousin medical tourism, is becoming a global industry” that “shifts from being a local
service and enters a competitive global marketplace of cross-border economic transactions”12.
The reasons behind the growth of medical and dental tourism include drivers such as
high costs and long waiting time at home, low costs at the destination country, “new
technology and skills in destination countries alongside reduced transport costs and internet
marketing”4, just to mention a few. However, medical and dental tourism also faces certain
obstacles which might hinder or reduce the growth of the industry. Such barriers include
foreign patients’ perceived risk regarding the quality of care, legal issues in the event of
negligent treatment at destination countries, and missing opportunities for follow-ups.
Medical service providers in Thailand such as private dental clinics face further obstacles
especially regarding foreign tourists’ inertia and uncertainty of going overseas, or their
loyalty to national healthcare. By using their marketing tools medical service providers aim to
overcome these barriers, even though the promotion and marketing of medical tourism is a
considerable challenge7.
As of today little is known about how medical service providers – let alone smallsized private dental clinics – react to drivers and barriers and what strategies they use to
attract foreign medical tourists in order to remain competitive in this global industry. No
scholar has systematically conducted any research regarding marketing activities of small
private dental clinics in Thailand aiming to attract foreign patients so far.
The aim of this research is to explore how small private dental clinics in Thailand
market their services to foreign tourists The objective is to examine what marketing-related
efforts these clinics undertake to remain competitive, how they make use of the above
mentioned drivers, and how they try to reduce or overcome barriers they face when
attempting foreign patients. The findings of the study will be a first attempt to explain both
useful and less useful marketing activities towards foreign tourists – from the perspective of
small private dental clinics.
Methodology
This study follows an exploratory research design as it aims to examine and
investigate marketing activities of small private dental clinics in Thailand which intend to
attract foreign tourists. The goal of this research in particular is to explore how these dental
clinics react to drivers and barriers of dental tourism. In-depth information was gathered by
interviewing owners and managers of such private dental clinics in order to collect useful and
required information. Qualitative research is deemed to be more effective than a quantitative
approach when exploring the phenomenon of marketing in the context of SMEs as it is useful
to get deep insights into behavior, motivation and attitudes and is concerned with
understanding a rather than measuring or testing something15,16. Therefore, a qualitative
research approach is the most appropriate data-collecting method and the required
information was collected and analyzed accordingly.
The target population of this research is small private dental clinics in major tourist
destinations in Thailand. These centers of tourism include the following destinations:
Bangkok, Pattaya, Hua Hin, and Chiang Mai.
As it is impossible to determine the exact number of small private dental clinics in
Thailand which partially target foreign tourists as their customers a non-probability sampling
approach was adopted to gather data. In a first step, ten private dental clinics in the above
mentioned tourist destinations were identified as suitable for the sample by making use of the
convenience sample technique (online research). The owners and managers were contacted
via phone or e-mail in order to verify their willingness to participate in the study and answer
in-depth questions. In a second step, after conducting interviews with the informants, further
private dental clinics were identified by making use of the snowball sampling technique
where additional informants were recruited by existing informants.
The aim of this study regarding sample was to have a final in-depth interview sample
size of a maximum of 30 informants, which is a reasonable size to conduct qualitative
data17,18. However, to meet the goals of this research, the interviews were conducted only
until a point of saturation has been reached. Saturation in this context means, that it appears
that no new information can be obtained by conducting further interviews19.
In order to achieve a better and more profound understanding of the marketing
activities of small private dental clinics in Thailand targeting foreign tourists and to find
answers to the research question the data collection was carried out by using qualitative indepth interviews with the informants. These interviews were held face-to-face on a one-toone basis and recorded. A semi-structured questionnaire, which is said to be particularly
effective for collecting data from owners or managers of SMEs20, with open questions guided
the interview. The questionnaire consisted of two key areas; introducing questions regarding
drivers and barriers of dental tourism, and specific questions regarding the 7 Ps of the
extended marketing mix, which aided as a guideline for the process.
Results
A thematic analysis is suitable to explore and analyze the collected data since it is
regarded as an effective technique to identify related themes and patterns and to discover
relationships among the themes and patterns. The analysis was conducted making use of a
process consisting of six phases. These steps included the transciption of the collected data,
familiarization of the collected data, coding, searching for themes, reviewing the themes, and
finally defining and naming the themes.
In a first step all MP3-recordings of 20 conducted interviews were carefully
transcribed and saved in a Word file. In a second step, the researcher profoundly familiarized
himself with all transcribed interviews by reading and re-reading the data corpus. In addition,
notes of initial interesting data were taken and gathered in a list of ideas with relevance to the
research question. In the third phase of the analysis the collected data was coded according to
a deductive approach. In particular, every data of the interviews that is interesting, repetitive
and/or relevant to the underlying theory of drivers and barriers of dental tourism and the 7 Ps
of the marketing mix and the research question was marked and coded. This theory-driven
approach of coding resulted in hundreds of coded data extracts. In the next step all collected
codes with similar patterns were collated and combined into a first rough set of possible subthemes and themes, out of it resulting 16 sub-themes. In the last two steps these sub-themes
were reviewed, scrutinized again, further reduced and eventually combined in 7 broader
themes before being named. After having conducted the deductive thematic analysis the
following 7 relevant themes have emerged as the result:
Pricing Strategies for foreign tourists
The first sub-theme covers that some owners or managers of private dental clinics
perceive foreign tourists as highly price sensitive who normally opt for the lowest possible
price available. Therefore, the dental clinics have to adapt their price level and offer rather
low prices. Other dental clinics claim that lowest possible prices are not imperative. What
foreign tourists care more about is good quality and clean facilities. The owners and
managers with this particular view suggest a more reasonable price level. What all clinics
share in common is the belief that the price level of dental treatment in Thailand, in general,
has to be lower than in the home countries of the foreign tourists in order to be attractive for
them. The second sub-theme under the theme of pricing strategies for foreign tourists unveils
that only a minority of the interviewed owners and managers of small dental clinics are in
favor of promotions and price reductions. The reasons behind this strategy are that some
foreign tourists are price sensitive “discount hunters” who would always purchase the
cheapest or least expensive service. Furthermore, some informants claim that promotions
have the positive effect of receiving highly desired attention from foreign tourists. Yet, the
vast majority of informants reject the effectiveness of promotions. While some admit their
usefulness for local Thais they also agree that promotions and discount are not a useful
strategy to attract foreign tourists. Due to the lower price compared to their country of origin
foreign tourists don’t care about further price reductions anymore. What is more important to
them is the quality of the treatment and the hygiene of the facilities. The informants also
believe that promotions with very low prices can have a negative effect on the reputation and
image of the clinic among foreign tourists. They fear that foreign tourists would perceive
reduced prices and promotions as a sign of low quality.
Product, service and quality
The first sub-theme discloses further services, in addition to the core product of dental
treatment, are a vital and effective strategy to attract foreign tourists. These by-products
generally aim to improve the foreign tourists’ well-being and convenience and offer enhanced
service experience. The second sub-theme indicates that the quality of dental treatment in
Thailand is perceived as substandard and inferior compared to Western countries among
many foreign tourists. The reasons behind this perception are various: some informants point
out that the low prices they are able to offer are associated with low quality. Others mention
the assumption of inferior materials, instruments and poor education of dentists as reasons for
the negative perception of the quality of dentistry in Thailand among foreign tourists. Yet, the
informants do not agree and contradict this opinion undoubtedly. They claim that the quality
of dentistry in Thailand is similar to Western countries due to a handful of reasons: dental
education is universal nowadays, and materials and instruments used are the same as
anywhere in the world. Some informants go a step further and argue that the quality of
dentistry in Thailand is even superior compared to Western countries. The employment of
more staff and the investment of more time results in improved service and better quality,
according to some informants. Nevertheless, the mostly negative perception among foreign
tourists towards the level of quality of dentistry in Thailand remains. Therefore, effective
strategies aiming to convince potential foreign patients of a high standard of quality are
imperative for dental clinics. According to the informants such useful methods include wordof-mouth recommendations among friends and family members, testimonials, the display of
dentists’ curricula, cooperation with intermediaries such as medical travel agents, and the
declaration of the origin of materials and instruments used.
Communication with foreign tourists
The first sub-theme covers that websites are a very significant channel, if not the most
important, for small private dental clinics to communicate with and attract foreign tourists.
The reason behind this is that foreign tourists who intend to visit dental clinics in Thailand
and engage dental service do extensive online research ahead of their travels. As a
consequence, a pre-selection of suitable and eligible dental clinics happens at the country of
origin of the foreign tourist and before the travel begins already. This requires dental clinics
to have a website which is appealing, attractive and flawless in order to earn the tourists’ trust
and to avoid being excluded as an eligible clinic during the pre-selection process. Moreover,
it is critical for dental clinics aiming to attract foreign tourists to attain top results in Google
Search. These top results can be achieved by making use of Search Engine Optimization
(SEO) which is very effective. These online marketing activities are often outsourced and
managed by professional services. However, the downside of SEO and online marketing is
that since many clinics do it and want to be on top of Google Search results, prices for
effective SEO services increase and become more and more expensive. Social media is
considered as not useful to attract foreign tourists. Nevertheless, many clinics are present on
different social media channel solely because it can support the SEO efforts. The second subtheme discloses that many foreign tourists perceive foreign language proficiency of dental
clinics’ staff as inferior and therefore as a barrier. Nevertheless, only a minority of the
informants agrees with the foreign tourists’ perception and believes that the foreign language
skills of dental clinics’ employees are in fact a problem. The majority of informants, in
contrary, believes that nowadays language proficiency of staff at small private dental clinics
in Thailand is on a level which is appropriate and good enough to communicate with foreign
tourists without the danger of misunderstanding. Moreover, the informants mostly agree that
good foreign language skills are essential for any dental clinic to attract foreign tourists. In
detail, small private dental clinics in Thailand follow various strategies in order to both
improve foreign language proficiency of their staff and to overcome potential language
barriers. These strategies include the employment of translators, utilization of translation
cards, language training for staff, and an effective and appropriate employee selection.
Combination of dental treatment and touristic activities
This theme shows that small private dental clinics aiming to attract foreign tourists
heavily rely on the attractiveness of the destination where they are located at. The destination
is required to offer various touristic activities that range from beach, shopping and nightlife to
culture in order to be considered as a suitable and attractive holiday destination by foreign
tourists. The primary reason of most foreign tourists is not to receive dental service only, but
the combination of leisure or holiday activities and dental treatment.
The role of the staff
This theme unveils that the roles of dentists on one hand and dental assistants and
receptionists on the other hand significantly differ with regard to the task of attracting foreign
tourists. The curricula of dentists can be a strong driver to convince foreign tourists of the
quality of treatment. As a result dentists can play an active role in attracting foreign tourists.
Conversely, the role of the other employees of the dental clinic, including assistants and
receptionists, generally is considered as minor to irrelevant in reference to attracting foreign
tourists. Nevertheless, they still play a vital role in the context of loyalty. The role and the
task of them are generally considered as rather keeping and retaining existing patients as
opposed to attracting them.
Waiting time and convenience
This theme indicates that the waiting time for foreign tourists to receive dental
treatment at small private dental clinics in Thailand in general is relatively short and
considered vital. Dental clinics which cannot offer soon or immediate treatment face a huge
disadvantage since the waiting time of foreign tourists often is limited. Furthermore, they can
select from a range of various clinics and often pick the service provider that offers
immediate treatment. More than one day of waiting is too much for many foreign tourists.
Likewise important is a fast reaction to e-mail inquiries by foreign tourists. Not answering
such e-mail requests quickly enough is considered as a missing opportunity for dental clinics.
The reason behind this is that foreign tourists often send online inquiries to more than just
one dental clinic and then select the dental clinic with the fastest reply. Again, more than 24
hours is too much time to wait for an answer for most foreign tourists. Also the actual
treatment time is required to be as short as possible because of the limited time that foreign
tourists normally spend in Thailand. Moreover, the results also suggest that the waiting time
at the clinic and the whole treatment process should not only be short but also convenient and
comfortable.
Earning trust
This theme covers that earning trust from foreign tourists is rather difficult for small
private dental clinics in Thailand. Nonetheless, building such trust and confidence among
foreign tourists is imperative for every dental clinic in order to remain competitive and
therefore considered as a main strategy to attract foreign tourists. Dental clinics follow
various methods to achieve this goal of earning trust. One useful strategy appears to be
extensive communication with foreign tourists which includes openness, honesty, good
English skills and a lot of talking with the aim of a mutual understanding. Also the
appearance of the clinic is considered as important and useful to earn trust, including the first
impression and the hygienic condition of the clinic. The usefulness of the clinic’s logo,
however is controversial. While some informants claim that it can build trust among foreign
tourists, others are convinced that the role of the logo is not important. As for testimonials, it
is apparent that this method of building trust in the clinic and its services is among the most
effective if not the most effective. However, the use of testimonials also involves a certain
risk of gaining mistrust if they are not managed effectively.
Discussion and Conclusion
The above findings, including themes and sub-themes, display that private small
dental clinics in Thailand make use of various marketing strategies and activities to attract
foreign tourists and to remain competitive. The following chapter will relate these findings
with the underlying theory of medical and dental tourism, in particular with drivers and
barriers of dental tourism.
Pricing Strategies for foreign tourists
As displayed previously, the first sub-theme indicates that foreign tourists are
perceived as price sensitive. Managers and owners of small private dental clinics in Thailand
agree that the price of dental treatment in Thailand needs to be lower than in the country of
origin of the foreign tourists in order to be attractive. These findings are in accordance with
the existing theory of drivers of dental tourism. A wide range of scholars claim that the main
factor driving patients abroad for medical treatment and pulling them to dental tourism
destinations such as Thailand appears to be of financial nature. Horowitz & Rosensweig10 see
the relatively low costs at developing countries as key driver, whereas others identify high
and ever increasing costs at the country of origin as reason for medical tourism6,21. Also
Turner12 mentions high cost of dental care in developed countries as the pushing main driver
whereas Loubeau24 identifies low cost in developing countries as the pulling main reason for
dental tourism. Another driver in this context appears to be the lack of insurance or
underinsurance of many foreign tourists5 causing them to seek for less expensive alternatives
abroad. By following a marketing strategy of lower and competitive prices the small private
dental clinics support and further enforce this driver and aim to remain competitive.
However, one of the main concerns regarding dental treatment in Thailand among
foreign tourists is a perceived lower standard of quality of care. Turner12 claims that quality
of dental care abroad is a serious concern among foreign tourists. By offering very low prices
dental clinics run the risk of being perceived as a cheap clinic with cheap prices and cheap
quality of care. Obviously, this needs to be avoided in order to attract foreign tourists.
Accordingly, most dental clinics claim to offer reasonable instead of very cheap prices. By
following a pricing strategy with not too low, but rather reasonable prices the dental clinics
are able to reduce the risk of being perceived as a provider of substandard service with
inferior quality. In essence, the same rationale applies for the uselessness of discounts for
foreign tourists. A consequence of discounted prices is again a negative perception among
foreign tourists of poor services and quality of care. Naturally, a reputation of low quality
should be avoided since it is one of the main barriers of dental tourism. Even though pricing
strategies cannot reduce or overcome this barrier of perceived lower quality, they could
enforce them if used wrongly and significantly harm the attractiveness of the dental clinic
among foreign tourists. It is therefore vital for a small private dental clinic in Thailand aiming
to attract foreign tourists to follow a pricing strategy of low, yet reasonable prices and to
abstain from promotional activities such as offering discounts.
Product, service and quality
The findings indicate that offering additional services and by-products to the actual
core-product of dental treatment is essential for dental clinics aiming to attract foreign
tourists and widely used. These extra services generally intend to enhance the well-being of
the tourists as well as their convenience. This marketing strategy corresponds to another
driver of dental tourism. Enderwick & Nagar5 mention in this context that medical tourism
offers significant value adding. Not only is dental treatment in Thailand cheaper than in the
country of origin of foreign tourists, it often also offers more, which results in more value for
money paid. To follow a strategy of offering more than just the core product of dental
treatment does not only support a driver of medical tourism but also intends to escape
increasing competition among dental tourism service providers. According to Enderwick &
Nagar5, medical tourism is claimed a national industry by about 50 countries and competition
is growing. Countries in South Asia and Southeast Asia are among the fastest developing
players in the industry. Therefore, the marketing strategy of offering by-products to dental
treatment intends not only to support the driver of added value, but also aims to fight and
reduce the barrier of increasing competition in the context of medical and dental tourism.
The second sub-theme shows that managers and owners of dental clinics believe that
foreign tourists perceive the quality of care in Thailand as inferior compared to Western
countries. This is in accordance with the existing theory about barriers of medical and dental
tourism. According to scholars, perception of the quality of medical treatment in developing
countries is rather negative among foreign tourists4,12. On the other hand and contradictory to
this point of view, other scholars and reports claim that the improvement of medical care in
developing countries nowadays acts as a key driver for medical and dental tourism instead6,25.
This opinion is congruent with the judgment of a majority of the managers and owners of
small private dental clinics who claim that quality of care nowadays in is on a same level
compared to developed countries, by reason of technological change and return migration of
skilled health workers7. However, due to this discordance among scholars it cannot clearly be
determined if the quality of care at dental clinics in Thailand is a driver or a barrier. Yet,
irrespective of this ambiguity, dental clinics in Thailand aiming to attract foreign tourists are
obliged to convince potential patients of a high standard of quality. Marketing strategies
intending to support the driver of increased quality of medical care in developing countries
and marketing strategies intending to reduce or overcome the barrier of negative perception
of quality of care are manifold. They include such activities as testimonials, the display of
dentists’ curricula, cooperation with intermediaries such as medical travel agents, the
declaration of the origin of materials and instruments used and word-of-mouth
recommendations among friends and family members. Yeoh, Othman & Ahmad23 support the
usefulness of word-of-mouth in particular and claim that this strategy is principally a rather
powerful marketing tool which is useful to convince and attract individuals.
Communication with foreign tourists
The results clearly indicate that online activities related to marketing, including a
website, are considered as a very useful and necessary strategy to convince and attract foreign
tourists. These results are in accordance with the sparse existing literature about the
significance of online marketing for dental and medical tourism service providers. Scholars
claim that the rise and importance of internet marketing is a key driver behind medical and
dental tourism4,12. However, with rising competition locally and regionally among dental
clinics, effective and successful internet marketing is becoming more difficult. Nowadays,
activities related to online marketing require specialized knowledge and expertise. In
particular Search Engine Optimization (SEO), a technique that aims to improve results on
search engines, is a useful strategy many small private dental clinics utilize in order to be
noticed online by foreign tourists. Yet, this specialized knowledge about SEO is often beyond
the skills of managers and owners of dental clinics and therefore they are required to
outsource these tasks to professional services. Clearly, such professionalized services come at
a price and raise the question if small private dental clinics with little financial power are able
to compete with big hospitals which have significantly larger online marketing budgets. As
mentioned previously, literature about online marketing in the fields of dental tourism is very
rare. In order to get a clearer picture and a better understanding of how online marketing is
executed and why it is of such importance, the phenomenon of internet marketing in the
context of dental tourism needs to be further investigated, particularly how small private
dental clinics compete with large hospitals.
The findings about language proficiency display that owners and managers consider
language as a barrier of dental tourism and an obstacle to attract foreign tourists. The reason
behind this is a negative perception of foreign tourists towards the foreign language literacy
of small private dental clinics’ staff, in particular of dentists. In this regard, it needs to be
stated clearly that there is no evidence of inferior foreign language skills among dentists in
Thailand in general. The language barrier derives from the foreign tourists’ perception only.
However, for dental clinics it is therefore vital to reduce and overcome this language barrier
and, as a consequence, change the foreign tourists’ perception of potential language issues. In
order to achieve this, dental clinics make use of tactics and techniques to fight language
barriers which include language training of the staff or the employment of translators, only to
mention a few. Remarkably, now scholar has mentioned language as a barrier of dental or
medical tourism so far. In this context, the perception language issues can be identified as a
new barrier of dental tourism in particular and medical tourism in general that has not been
described in literature yet. It would be interesting to further investigate on this barrier,
especially on the actual and not perceived language proficiency of dentists in Thailand.
Combination of dental treatment and touristic activities
The overall attractiveness of a destination, including various touristic activities, is
highly important for dental service providers aiming to attract foreign tourists. To be located
in such tourism destinations as a small private dental clinic is a direct answer to the barrier of
what some scholars refer to as the risk of traveling itself with serious health conditions10,24.
By offering various tourist products the foreign tourists are able to combine dental treatment
with leisure, extend their stay at the destination and do not run the risk of traveling with
serious health conditions. In short, foreign tourists are able to recover in an attractive
environment before traveling back home. To be located in a, from a touristic perspective,
attractive destination is therefore a highly useful marketing strategy to effectively reduce and
in the best case even overcome this mentioned barrier. In addition, attractive destinations of
dental clinics also appear as a competitive advantage over destinations with less touristic
activities on offer, since competition is becoming fiercer5. It is therefore highly recommended
for operators of small private dental clinics to be located in known tourist destinations, to
support tourism development and, in specific, to offer bundled packages consisting of dental
treatment, accommodation and a range of leisure activities.
The role of the staff
As opposed to receptionists and dental assistants it appears that the dentists play a
vital role to attract foreign tourist. In particular, the curricula of dentists can be a key factor to
convince foreign tourists of the quality of care. These results clearly reflect what is known
from existing literature covering drivers and barriers of dental and medical tourism. To be
specific, a key driver behind dental tourism is the increased quality of medical care in
developing countries4,6,23 due to improved education and the return migration of skilled health
workers7. Hence, a curriculum explicitly showing achievements, education received at
renowned institutes and education received abroad is a very effective strategy to support
above mentioned driver. Furthermore, by strategically displaying the curricula of the dentists,
the dental clinics also efficiently fight the barrier that is known as perceived risk regarding
quality of care12, as this negative perception can be reduced when potential patients know
about the actual curricula, including achievements, attended universities and specialization,
of the dentists. It is therefore recommended to personalize the dental treatment and overall
experience at the clinic and to communicate this accordingly. Potential foreign patients need
to know about the dentist’s curriculum in order to be convinced of the quality offered. This
strategy aims to earn the foreign tourists trust and is therefore a strategy that likely enables
potential patients to become actual patients.
Waiting time and convenience
As the results display, short waiting time and a certain convenience of receiving
dental treatment is considered as essential for foreign patients. The waiting time can
determine whether a foreign patient decides to engage in dental treatment or not. These
findings also correlate with existing literature that classifies low speed of required treatment
due to long waiting lists at the home country as a key driver behind dental tourism10,12,21-23.
Therefore, it is essential for small private dental clinics to offer uncomplicated and quick
booking processes and treatments. By this effective marketing strategy dental clinics further
support this existing driver, gain a competitive advantage and are attractive as dental tourism
providers for foreign patients. Hence, it is highly recommended for small private dental
clinics aiming to attract foreign tourists to further ease and simplify all processes involved.
This includes the access to useful information, quick response to inquiries, simple booking
procedure, short waiting time to get an appointment, short waiting time at the clinic, and
simple paying methods.
Earning trust
It is commonly known that earning customers’ trust and confidence in a company’s
services is a rather difficult undertaking. This is mainly because services are of intangible
nature which, under normal circumstances, cannot be tried and tested before being purchased,
as opposed to tangible products25. Marketing efforts aiming to earn trust are therefore
explicitly important for service providers like dental clinics. The results of the interviews also
disclose that earning trust is highly difficult, yet a very vital strategy to attract foreign tourists
and remain competitive. Therefore, the answers of the informants confirm the existing theory.
In addition, the marketing efforts of small private dental clinics aiming to earn trust directly
intend to reduce the barrier of perceived risk regarding quality of care among foreign
tourists12. In particular the usage of testimonials appears to be an effective strategy that
enables dental service providers to build trust in their services. It is therefore highly
recommended for dental clinics to offer various activities that boost the potential foreign
patients’ confidence in the services offered, including proactive communication, transparency
and appealing appearance of the facilities.
In summary, small private dental clinics in Thailand aiming to attract foreign tourists
follow diverse marketing strategies and activities that directly, intentionally or not, support
certain drivers behind dental tourism. These strategies include lower prices, adding more
value by outstanding service, convenience, effective online communication and the
attractiveness of the destination. Likewise, these dental service providers also fight certain
barriers and aim to reduce or even overcome them by different activities. These include
strategies to earn trust, reasonable pricing and high language proficiency among others. For
future research on the topic of dental tourism and marketing strategies it would be useful and
interesting to explore the perspective of the tourists, the potential patients. In particular, it
would be interesting to uncover the impact of the various marketing activities and to test how
potential patients react to these marketing activities. Furthermore, it needs to be stated that
the identified marketing activities only relate to a few drivers and barriers of dental tourism.
It appears that there are still some barriers in particular that are not fought against with useful
marketing efforts. Dental clinics do not have specific strategies related to the barriers of legal
issues or the lack of follow-up treatment. This research was able to facilitate a first insight
into the so far mostly unexplored field of marketing strategies of dental tourism providers.
The findings and conclusions can be used as a starting point for further research and also as a
set of practical guidelines in the context of dental tourism for small private dental clinics in
Thailand.
References
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
Connell, J. Contemporary medical tourism: Conceptualisation, culture and commodification. Tourism
Management. 2012; 30: 1-13.
Heung, VCS, Kucukusta, D, Song, H. Medical tourism development in Hong Kong: An assessment of the
barriers. Tourism Management. 2010; 32: 995-1005.
Patel, N, Mendelsohn, ES, Raghavan, R. Trends in Medical Travel – 2007 Report. 2007. Available from
http://healthcaretrip.org/statistics/2007trends.pdf
Connell, J. Medical tourism: Sea, sun, sand and… surgery. Tourism Management. 2006; 27: 1093-1100.
Enderwick, P, Nagar, S. The competitive challenge of emerging markets: the case of medical tourism.
International Journal of Emerging Markets. 2011; 6(4): 329-350.
Deloitte. Medical Tourism. Consumers in search of value. 2008. Available from
http://www.deloitte.com/assets/DcomunitedStates/Local%20Assets/Documents/us_chs_MedicalTourismStudy%283%29.pdf
Connell, J. Medical Tourism. 2011.
Cohen, E. Medical Tourism in Thailand. 2008. Available from
http://www.graduate.au.edu/Journal/Journal1/Medical%20Tourism%20Dr%20Cohen.pdf
International Journal of Health Care Quality Assurance. Far East and Australasia – Travel and hospitality
industry set to tap into Asia’s US$ 4 Billion medical tourism market. International Journal of Health Care
Quality Assurance. 2006; 19(5).
Horowitz, MD, Rosensweig, JA. Medical Tourism: Globalization of the Healthcare Marketplace. 2007.
Available from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2234298/
Bangkok Post. Medical tourism under threat. 2012. Available from
http://www.bangkokpost.com/opinion/opinion/298805/medical-tourism-under-threat
Turner, L. Cross-border dental care: “dental tourism” and patient mobility. British Dental Journal. 2008;
204(10): 553-554.
Leggat, P. Dental health, ‘dental tourism’ and travellers. Travel Medicine and Infectious Disease 2009; 7:
123-124.
Lee, W, Shih, B-Y. Application of neural networks to recognize profitable customers for dental services
marketing – a case of dental clinics in Taiwan. Expert Systems with Applications. 2009; 36: 199-208.
Wilson, A. Marketing Research: An Integrated Approach. Second Edition. 2006.
Resnick, S, Cheng, R, Brindley, C, Foster, C. Aligning teaching and practice a study of SME marketing.
Journal of Research in Marketing and Entrepreneurship. 2011; 13(1):37-46.
Griffin, A, Hauser, JR. The voice of the customer. Marketing Science. 1993; 12: 1-27.
DePaulo, P. Sample size for qualitative research. Quirck’s Marketing Research Review. 2000. Available
from http://www.quirks.com/articles/a2000/20001202.aspx
Glaser, BG, Strauss, AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. 1967.
Curran, J, Blackburn, R. Small Firms and Local Economic Networks: The Death of the Local Economy?
1994.
Lunt, N, Carrera, P. Medical tourism: Assessing the evidence on treatment abroad. Maturitas. 2010; 66:
27-32.
Loubeau, PR. The globalization of dental care: An opportunity for Croatian tourism. Tourism. 2009; 57(2):
193-199.
Yeoh, E, Othman, K, Ahmad, H. Understanding medical tourists: Word-of-mouth and viral marketing as
potent marketing tools. Tourism Management. 2012; 34: 196-201.
Crooks, VA, Kingsbury, P, Snyder, J, Johnston, R. What is known about the patient’s experience of
medical tourism? A scoping review. BMC Health Services Research. 2010; 10: 1-12.
Booms, BH, Bitner, MJ. Marketing Strategies and Organization Structures for Service Firms. In Donnelly,
J.H. & George, W.R. (eds), Marketing of Services. 1982: 47-51.