Book review
Connell, John. (2011) Medical Tourism, Wallingford: CABI, 209 pp. ISBN 978-1-84593-660-0. US$ 125.
John Connell’s much-cited 2006 Tourism Management article offered valuable insight into the emergence of contemporary medical tourism. Five years later, Connell has produced a volume that maps out the maturing and increasingly complex field and the new geographies of globalised health care within which medical tourism is embedded. The book offers a refreshingly critical engagement with the social, political and ethical complexities involved, taking clear stances on the socio-economic inequalities out of which medical tourism is derived and thrives. While it joins Bookman and Bookman (2007) and Reisman (2010) in offering up an introductory academic overview of medical tourism, such critique has been absent from much of the extant literature on the topic, which, to date, has been dominated by economic, legal and business management perspectives tracing the contours of the global healthcare marketplace and expounding the opportunities available for pioneering individuals willing to look beyond their ailing home health systems for solutions.
Connell, John. (2011) Medical Tourism, Wallingford: CABI, 209 pp. ISBN 978-1-84593-660-0. US$ 125.
John Connell’s much-cited 2006 Tourism Management article offered valuable insight into the emergence of contemporary medical tourism. Five years later, Connell has produced a volume that maps out the maturing and increasingly complex field and the new geographies of globalised health care within which medical tourism is embedded. The book offers a refreshingly critical engagement with the social, political and ethical complexities involved, taking clear stances on the socio-economic inequalities out of which medical tourism is derived and thrives. While it joins Bookman and Bookman (2007) and Reisman (2010) in offering up an introductory academic overview of medical tourism, such critique has been absent from much of the extant literature on the topic, which, to date, has been dominated by economic, legal and business management perspectives tracing the contours of the global healthcare marketplace and expounding the opportunities available for pioneering individuals willing to look beyond their ailing home health systems for solutions.
Across ten chapters, Connell draws from an extensive assemblage of printed matter (e.g., medical travel company and private hospital websites and brochures, medical travel guidebooks, expat newspapers, in-flight magazines, trade journals, and official statistics) and his travels to many of today’s foremost medical tourism destinations around the world, to both depict and critique the study and development of medical tourism as an industry. While the book raises many key issues, for this short review I limit myself to focusing on two contributions. First, the book engages with current debates about whether use of the term ‘tourism’ is appropriate for health-motivated travel and the value judgements linked to the use of the term (see, e.g., Whittaker 2008). Connell demonstrates how concerns for physical, mental and spiritual well-being have long intimately tied travel/tourism practices (e.g., pilgrimage, escape from urban life and alienation, and discovery of ‘the self’) to therapeutic landscapes and tourism infrastructure (e.g., temples, colonial hill stations, spa, coastal and mountain resorts, and specialised clinics). Contemporary medical tourism builds upon this history. It is linked to increased medicalization, healthcare commodification and the desire for instant gratification, which, together with shifts in concentrations of medical expertise and technologies, produce new geographies of hope:
Medical tourism reinforces privatisation alongside a technological and medicalised view of the health system where medical services can be bought ‘off the shelf’ from the lowest-cost provider, rather than well-being created by remedying the social, political and economic determinants of health: an analogy with the relationship between cosmetic surgery and diet and exercise. (Connell 2011: 158)
The body is increasingly imagined as a thing to be actively worked upon and improved, and overseas travel – facilitated by greater physical, cultural and economic connectivity – enables healthcare consumers to pursue more far-flung alternatives, whether they be biomedical treatments previously inaccessible at home or holistic therapies when biomedicine has been perceived to fail (Connell 2011: 29), upon encountering domestic barriers to their whims, demands and requirements. New types of therapeutic landscapes and tourism infrastructure have developed and made use of one another in response (e.g., transnational hospital chains offering luxurious ‘hospitel’ facilities with integrated medicine).
Second, Connell squarely challenges much of the hype found within both popular and scholarly treatment of medical tourism and its narrow focus on middle-class flows from developed to less-developed countries that fosters an ‘idealised geographical distribution’ (Connell 2011: 115) rather than reflecting and responding to more complex on-the-ground realities where ‘modern well-equipped hospitals… serve the dual role of regional referral centres for patients from poor neighbouring countries and, concurrently, function as low-cost medical tourism destinations for patients from highly-developed nations’ (Horowitz and Rosensweig 2008: 8, in Connell 2011: 59). Connell instead depicts a medical tourism that owes much of its current existence and stability to the diasporic, cross-border and intra-regional flows of patient-consumers that often pass under the radar (see Ormond 2011). In so doing, he draws attention to their shared plights and to the social and political tragedy of privileging the right of patients to travel in order to access quality health care over the ‘right not to have to travel overseas for medical care’ (Connell 2011: 105) in the first place.
Throughout the book, Connell draws attention to the complexity and broad reach of medical tourism, pulling it away from treatment as an obscure niche tourism segment and instead framing it as symbolic of healthcare globalisation. The book demonstrates how medical tourism – both deeply personal and political – can serve as a powerful empirical lens for conceptualising health, care and hospitality in ways that transcend some boundaries while calling attention to others, thus meriting more critical engagement by geographers working across the fields of health, embodiment, development and transnational mobility.
References
Bookman, M.Z. and Bookman, K.R. (2007) Medical Tourism in Developing Countries, New York: Palgrave Macmillan.
Connell, J. (2006) Medical tourism: Sea, sun, sand and surgery, Tourism Management, 27, 1093-1100.
Ormond, M. (2011) Medical tourism, medical exile: Responding to the cross-border pursuit of healthcare in Malaysia. In Minca, C. and Oakes, T. (eds), Real Tourism: Practice, Care and Politics in Contemporary Travel, London: Routledge, 143-161.
Reisman, D. (2010) Health Tourism: Social Welfare through International Trade, Cheltenham: Edward Elgar.
Whittaker, A. (2008) Pleasure and pain: Medical travel in Asia, Global Public Health, 3(3), July, 271-290.
References
Bookman, M.Z. and Bookman, K.R. (2007) Medical Tourism in Developing Countries, New York: Palgrave Macmillan.
Connell, J. (2006) Medical tourism: Sea, sun, sand and surgery, Tourism Management, 27, 1093-1100.
Ormond, M. (2011) Medical tourism, medical exile: Responding to the cross-border pursuit of healthcare in Malaysia. In Minca, C. and Oakes, T. (eds), Real Tourism: Practice, Care and Politics in Contemporary Travel, London: Routledge, 143-161.
Reisman, D. (2010) Health Tourism: Social Welfare through International Trade, Cheltenham: Edward Elgar.
Whittaker, A. (2008) Pleasure and pain: Medical travel in Asia, Global Public Health, 3(3), July, 271-290.
