| Abstract | During the last decade the number of in ternational patients receiving medical treatment in foreign countries has b een continuously growing in popularity. Whilst the origins of medical travel for health benefits can be traced back thousands of years and clinics in wester n countries have long received foreign patients, the emerging trend in contempor ary medical travel is the flow of patients from developed countries seek ing treatment in developing nations. However, while most previous studies have identified this phenomenon as ‘medical tourism’, this study argues that this term should be appropriated only when medical treatment is combined with a holiday trip to foreign destinations. In this study, it is suggested that a pr oper conceptualisati on of international medical travel should be defined as an international extension of hospital outshopping behavior that ha s been observed for sometime on a regional level. Ostensibly, western patients travel to receive treatment in developing countries mainly because of the prohibitive cost of home treatments, or to avoid long waiting lists at home, and in order to e xploit the price adva ntages of medical procedures in developing countries. It is, nontheless, far fro m clear that cost differences and deteriorating conditions of health care in developed countries are the main drivers of the internationa lization of medical services. To shed more light on this phenomenon and deve lop a general model of the decision- making process of international hospita l outshopping, I based the conclusions on a comprehensive narrative analysis of the lived experience of 27 patients from developed countries who traveled to receive invasive medical treatment at the largest hospital in Th ailand, Bumrungrad International. The hospital has been described as emblematic for the trend of internationalization of health care and a model that many other hospitals in Asia follow. The findings reveal a clear underlying pattern of push and pull factors. While acute dissatisfaction with deteriorating conditions of health care, such as high cost of treatment, long waiting time, and low service quality, in developed countries is initially driving patients to seek alternative health care abroad, sustainable medical outshopping is based on pull factors in wh ich foreign hospitals provide a highly satisfying positive experience that emoti onally provokes patients to return. This model clearly refutes the apparent per ception of medical tourism as price- based, de-personalized “off the shelf” c onsumption of health care services. Instead, the incidence of returning patients is based on a profound patient satisfaction, and even bonding, to doctors and other health care personnel. Ultimately, the study suggests that successf ul health care destinations should provide international patients unexp ectedly pleasant ex periences through organizational and technological innovati ons and service qua lity, as well as organizational quality and emotional quali ty in patient-docto r and patient-nurse relationships. This can help them to attain a considerable volume of sustainable international trade in medical services. |