Medical Tourism: Establishing a Sustainable Medical Facility by Durgham Darwazeh A thesis presented to the University of Waterloo in fulfillment of the thesis requirement for the degree of Master of Environmental Studies in Geography - Tourism Policy and Planning Waterloo, Ontario, Canada, 2011 © Durgham Darwazeh 2011 Author’s Declaration I hereby declare that I am the sole author of this thesis. This is a true copy of the thesis, including any required final revisions, as accepted by my examiners. I understand that my thesis may be made electronically available to the public. ii Abstract Imposing the principles of sustainable development on medical tourism is vital to maintaining the three pillars of a strong nation, namely, the environment, the economy, and the local community. The three research objectives of this thesis are: 1) to determine the primary factors that motivate foreign patients to travel abroad for medical services; 2) to define the role that stakeholders play for developing the medical tourism sector; and 3) to develop an implementable framework for establishing a sustainable medical facility. These objectives help lay the foundations for a medical tourism facility that would respond well to the future demands of international patients, and would remain competitive with other medical facilities in the global market while also improving local quality-of-life and remaining within ecological constraints. Therefore, this research adopts a case study methodology to examine a framework developed through the literature review to determine how it fits in reality. In addition, this research provides a starting point to define further the primary roles of the medical tourism network for developing the medical tourism sector. iii Acknowledgements Of the many people who have been enormously helpful in the preparation of this thesis, I am especially thankful to Dr. Amelia Clarke for her help and supervision in guiding me through to its successful completion. I would also like to warmly acknowledge Dr. Stephen Smith (Professor, Cross-Appointed to Environmental Studies) for his guidance and input throughout the process of this research, as well as Lori McConnell (Graduate Program Assistant) who went out of her way and provided me with details about thesis proposal requirements. This has helped me a lot for establishing my thesis properly. A very special recognition needs to be given to the Organizations that allowed me for collecting data via interviews: the United States Agency for International Development, Jordan Tourism Board, Jordan Investment Board, Jordan Hospital, Al-Khalidi Medical Center, King Hussein Cancer Center, Specialty Hospital, Private Hospital Association, and the Directorate of Health and Environment. I would like to extend my sincere gratitude to the University of Waterloo for the use of their resources, such as online databases and library, without which the compilation of this thesis would have been extremely complicated. In addition, a special thanks to my Father and all my friends for their consideration and motivation. I dedicate this dissertation to my family for their unconditional love and support in every way possible throughout the process of this course, this dissertation and beyond. iv Contents List of Figures: .................................................................................................................................... viii Glossary ................................................................................................................................................. ix 1 Chapter one: Introduction to Medical Tourism ............................................................................. 1 1.1 Introduction ............................................................................................................................... 1 1.2 The Rise of Medical Tourism ................................................................................................... 2 1.3 Medical tourism factors ............................................................................................................ 3 1.4 The Need for Sustainable Development in the Medical Tourism Sector .................................. 4 1.5 Research Goal and Objectives .................................................................................................. 6 2 Chapter Two: Literature review- Medical Tourism - .................................................................... 9 2.1 Introduction to Medical Tourism .............................................................................................. 9 2.1.1 The Definition of Medical Tourism .................................................................................. 9 2.1.2 The Attributes of Medical Treatments and Health Treatments ......................................... 9 2.1.3 The Medical Tourism Market ......................................................................................... 10 2.1.4 The Globalization of Medical Tourism ........................................................................... 11 2.1.5 The Service Groups Marketing of Medical Tourism Sector ........................................... 14 2.2 Medical Tourism Factors ........................................................................................................ 16 2.3 Medical Tourism Stakeholders ............................................................................................... 21 2.4 Establishing a Sustainable Medical Facility ........................................................................... 23 2.4.1 Medical Tourism Facility‟s Framework.......................................................................... 30 3 Chapter Three: Methodology ...................................................................................................... 38 3.1 Introduction ............................................................................................................................. 38 3.2 Case study ............................................................................................................................... 39 3.3 Data Collection ....................................................................................................................... 40 3.4 Data Analysis .......................................................................................................................... 41 3.5 Reliability and Validity ........................................................................................................... 43 4 Chapter Four: Finding ................................................................................................................. 44 4.1 Country Analysis..................................................................................................................... 44 4.1.1 Political ........................................................................................................................... 44 4.1.2 Social Element ................................................................................................................ 45 4.1.3 Economy ......................................................................................................................... 47 4.1.4 Sustainable development ................................................................................................. 49 4.1.5 Tourism ........................................................................................................................... 51 4.2 Medical Tourism ..................................................................................................................... 54 4.3 The Medical Tourism Network in Jordan ............................................................................... 57 v 4.4 Introducing Medical Tourism Network‟s Stakeholders .......................................................... 61 4.4.1 Non-governmental Organization/Non- Jordanian Organization ..................................... 61 4.4.2 Government Organization: .............................................................................................. 64 4.4.3 Private Organization: ...................................................................................................... 64 4.5 The Role of Medical Tourism Network‟s Stakeholders.......................................................... 65 4.5.1 Facilitators ....................................................................................................................... 66 4.5.2 Guidance ......................................................................................................................... 67 4.5.3 Service Providers ............................................................................................................ 68 4.5.4 Association representatives ............................................................................................. 70 4.6 The Characteristics of a Medical Tourism Facility ................................................................. 71 4.7 Developing a Medical Tourism Facility ................................................................................. 77 4.7.1 Accreditation ................................................................................................................... 78 4.7.2 Skilled physicians ........................................................................................................... 78 4.7.3 Medical Technology ......................................................................................................