Factors Affecting Motivation and Customer Experience of Medical Tourism

Factors Affecting Motivation and

Customer Experience of Medical

Tourism: Case Study of Plastic Surgeries

in South Korea.

Ivanova Maria

Higher Diploma in International Hotel and Tourism Management

HTMi Switzerland

Introduction

Lately, medical tourism became very popular among travellers and moreover,

they pursue the value of money and quality (Bristow et al. 2011). Plastic

surgeries are one of the reasons for medical tourism nowadays. Moreover, plastic

surgeries have increased its popularity recently (Park et al., 2009). South Korea

is now promoted as the best destination to travel for plastic surgeries (Tang,

undated). It is also stated that tourist choose South Korea because it’s cheap and

qualitative (Ibid). Therefore the author has chosen South Korea as a case study in

the research paper. In modern and dynamic tourism industry it is an essence to

evaluate the motivators of people travelling. According to Gnoth (1997), in

tourism management it is very important and useful to understand the

motivations of travellers to visit a certain country for particular reason.

Moreover, Swarbrooke and Horner (2007) add that numerous motivators always

affect the tourists. Additionally, various tourists travelling for the same reason

may have different motivators (Ibid). According to Rice (1997, p.117),

“Motivation is the mixture of wants, needs and drives within the individual

which seek gratification through the acquisition of some experience or object”.

Moreover there are different theories, which can be applied for the motivation

and customer experience. Oh and Pizam (2008) evaluated that the motivation of

tourists should be criticised by push and pull theory. Nonetheless, Gnoth (1997)

additionally suggest drive theory and expectancy theory as a motivation process.

Moreover he applies drive theory as an emotional motivation and expectancy

theory as cognitive. Therefore, there are various kinds of motivations, which can

be specifically explaining the reasons and behaviour of tourists.

When a traveller has decided on the destination and purpose of going the actual

consumer experience starts (Hanefors and Mossberg, 1998). Plastic surgeries are

very famous among all genders and generations nowadays. Nonetheless, not

much research has been done on motivation of consumers to travel to South

Korea for plastic surgeries’ services. Handley (2010) has researched on how

medical tourism makes South Korea sustainable country. In sciencedirect.com

researcher has found many papers about rural tourism in South Korea, but not

much about medical tourism. According to Yu and Ko (2012), there is a gap in

research on medical tourism in South Korea. Motivation and customer

experience was in a great study at all times. “…Many researchers seek a

continuum construct to explain tourist motivations”(Woodside and Martin, 2008,

p.21). In our modern 21st century it is needed to understand your customers’

motivation and to evaluate the post-purchase experience. According to Bansal

and Eiselt(2003), there is a great section of research where the motivation and

decision making is highly discussed. Nonetheless, there are not enough studies

about motivation for medical tourism, even though the concern about medical

tourism is growing rapidly in past few years (Yu and Ko, 2011). It is considered

that the more studies will be done on this topic the more tourists will receive

greater level satisfaction and future perception of the country, as the country will

know the wants and needs of tourists (Yu and Ko, 2011). Furthermore, Wongkit

and McKercher (2013) add that there is only a little research has been done

which goes in more details for medical tourism.

Motivation and Customer Experience – Definitions and Concepts

Tourist’s Motivation Process

Motivation is an influencing factor on the behaviour of the consumer (Prebensen

et al., 2012). Gnoth (1997) distinguish motive and motivation; referring to him,

motive is what induces person to commit an activity, whether motivation always

include the object of the activity. Moreover Solomon et al. (2006) evaluate

motivation as guidance of consumer. According to Yoon and Uysal (2005)

motivation is a response to wants and needs of the consumer. A lot of subjects

describe motivation from different angles. Parks and Guay (2009) consider

motivation in two ways: conscious and unconscious. Meanwhile, Gnoth (1997)

view motivation as cognitive or emotional process. Moreover, there is a process

of motivation suggested by Graham and Weiner (undated); Parks and Guay

(2009); Gnoth (1997). They divide the process of motivation into five elements:

choice of behaviour, latency of behaviour, intensity of behaviour, persistence of

behaviour and conscious or unconscious reactions. All these elements have a

great affection on the motivation of a person as it measures the purpose, the

effort given to achieve the goal, how well can he/she last to reach the desirable

outcome and the behaviour after the result is achieved (Ibid). However, Hoyer et

al. (2013) examine four factors influencing motivation: personal importance,

values, needs and goals of the consumer, risk of the activity and reasonable

incompatibility with the position of the consumer. Besides these two theories,

Schiffman and Kanuk (2010) appraise movement of the motivation process. They

assert that needs can be never appeased, novel needs appear when auld ones are

satisfied and achievement or setback will affect the set goals.

It is really important to understand the motivation of tourists and process of

their thinking to choose this particular destination and what affected their

decision (Prebensen et al., 2012).

Consumer Motivation Theories

There are different types of motivators which make tourist travel (Swarbrooke

and Horner, 2007). Various authors and researcher suggest several theories.

Moreover, particular type of tourism is approached by numerous theories of

tourist motivation. “Push and pull factors are central concepts in tourist

motivation literature” (Pesonen, 2011, p.71). Klenosky (2002) and Gnoth (1997)

claim that in every tourists’ decision making process there is a pull and push

factor. Moreover Murray (1938) cited Gnoth (1997) interprets these two factors

as “need” and “press”. Kim and Lee (2000) discovered that there is always a link

between push and pull factors. Push factors in tourism industry are inside factors

which are influencing traveller to proceed a holiday, whether pull factors are

outer-directed and make a traveller to choose a particular destination over some

other country (Gnoth, 1997; Klenosky, 2002; Yoon and Uysal, 2005). Moreover,

Pesonen (2011) considers pull factors in tourism as a magnetism of the

destination. To the author’s point of view push and pull theory is more applicable

to this case, as in medical tourism motivation there are external and internal

factors, which affects their decision.

Figure 1: Expectancy Theory (Vroom, 1964)

Another theory suggested by Vroom (1964) citied Lee (2007) is expectancy

theory. Weber (1997) evaluated expectation as one of the most influencing

motive to travel. Pizam and Milman (1993) explain expectancy theory as a

tourist’s perception about destination. Moreover, Schiffman and Kanuk (2010)

elaborate expectancy theory as a previous experience of a traveller in a past.

According to Shiffman and Kanuk (2010, p.181), “In a marketing context, people

tend to perceive products attributes to their own expectations”. Lee (2007)

stated that expectancy theory also appears to generate a positive result in a

tourist’s perception. Moreover Gnoth (1997) stated that expectancy theory is a

cognitive process as it includes thinking and rationale deliberation. Expectancy

theory consists of three main inseparable parts that will lead to motivation:

expectancy, instrumentality and valence (Shepperd and Taylor, 1999; Lambright,

2010). Instrumentality is one of the components of this theory (Vroom, 1964

citied Lee, 2007); it is a measure of chances that the outcome will be according to

the tourist’s perception. Valence belongs to values formatted by a tourist about

destination and how the goal of the consumer is achieved by this particular

destination (Ibid).

Expectancy theory is very important in tourism as it is also composing from the

opinions of other people travelling to the same destination, therefore the

expectations will increase and wants of the consumer will raise as well

(Schiffman and Kanuk, 2010); hence the destination have to satisfy these needs

and wants to gain trust from the customer.

Formation of customer experience and its affect on customer satisfaction

Satisfaction is very demanding and broad process (Bosque and Martin, 2008).

Experience of the tourist in particular destination plays a great role in forming

satisfaction (Meng et al., 2008). Satisfaction is a fulfilment of customer needs and

posterior assessment of the experience gained during stay in destination

(Sanchez et al., 2006). According to Devesa et al. (2010) satisfaction and

motivation are main measures in tourist’s behaviour. Moreover, Chi and Qu

(2008) regard gratification and consumer participation in the process of

travelling as inseparable elements. Consumer experience has a great influence on

the tourist’s satisfaction and creates a perception of the destination. Hoyer et al.

(2013) wrote that there could be satisfaction as well as dissatisfaction of the

destination. Consumers are pursuing of exclusive experience from their

travelling (Rageh et al., 2013). Martin-Ruiz et al. (2011) include service

experience, service value, quality, convenience and price as major components in

creation of customer experience. Experience in the same destination may vary

according to the type of tourist (Sheng and Chen, 2013; Chang and Horng, 2010).

Moreover consumer experience is very individual process (Ibid).

Moreover they say that expectations of the tourist are an essential part of the

whole experience. Scheng and Chen (2013) break down experience into two

parts: active and passive. According to them, active includes replenishment of

knowledge and development of intelligence, while passive is more about leisure.

Satisfaction appears during and after the experience. Tourist’s satisfaction

depends on the quality of service and provision of the goods (Kim, 2011).

Experience and satisfaction of the tourists is very important to the destination as

the perceptions are being created during these two processes and it has to take

into consideration all needs and wants of the traveller.

Review of existing empirical research in medical tourism

motivation

Segmentation by motivation in healthcare and spa tourism

According to Bieger and Laesser (2002), segmentation is very important in

tourism industry. Rid et al. (2013) explain that motivation is one of the factors to

be included in the segmentation process. Dubai Department of Tourism &

Commerce Marketing (2012) indicates spa tourism as part of medical tourism.

Erdeli (2011) divide travellers according to the various types of spas, therefore

they can achieve higher percentage of tourists basing on their motivation: spas

for debilitated care, for cardio care, for breathing issues, alimentary issues and

for nervous disorders. According to Mak et al. (2008), there are a huge variety of

motives, which are driving people to travel. First is recreation, therefore they

assume that the segment is business or employed people who are seeking for

escape and relaxation (Ibid).

Tawil (2011) states that the motivation of the luxurious people is better facilities

and quality service. Moreover, he adds that these people are usually less price

sensitive. Chen et al. (2013) made a research of what is the motivation of elder

travellers. He found out that the main motive of them is seeking of health

treatments. Another factor, which was taken into consideration, was the

provision of a warm atmosphere. Pesonen et al. (2011) have created different

clusters according to types of travellers. Outdoor travellers are seeking for joyful

and recreational spa experiences, whether vacationists are motivated by the idea

to get the services of sauna. Moreover, the main motive of heritage tourists is

hygiene of spa services (Ibid). Therefore, motivation is very important to study

to better segment country’s target and achieve higher levels of satisfaction (Beh

and Bruyere, 2007).

Motivation in medical tourism

As stated by Li et al. (2013), if the country or the companies are aware of the

motivation of the travellers or guests, they may better interpret their consumers’

behaviour. The learning process of the consumer is a key success to satisfy

his/her needs (Ibid). According to Chen et al. (2013) there are several motivators

of medical tourists; the main are: enjoyment, pleasure and practice of various

services. Another leading motivators suggested by Singh (2013) include: price of

medical services, confidentiality of treatments, and certification of specialists.

However, Laesser (2011) have mentioned that the main factor affecting the

motivation of medical tourists is to care or improve something in their

appearance. Another important motivation was to feel comfortable in the

medical destination environment (Ibid).

Two of the dominant factors in medical travellers’ motivation were prestige and

notoriety of the destination (Ye et al., 2011). Also they added that the personnel

play a great role in deciding whether to go or no. Four motivators were

presented by Jotikasthira (2010): to recover and heal the sickness, to receive the

services of plastic incision, to get therapeutic check up and to correct and

enhance the overall well-being. Musa et al. (2011) identified five main factors,

which analyse the motivation precisely: how good is the assistance, the cost,

spiritual aspect, cultural aspect and the additional services provide. The most

important factor influencing the motivation is the quality of service: the history

of the destination about medical tourism, accessibility, the variety of serviced

provided and the reputation of the destination (Ibid). There are plenty of

motivators, which are affecting traveller decision. Moreover, Farmaki (2012)

stated that the motivation is considered to internal as well as external; therefore

it is important to know how to affect the tourist motives for travelling.

Conclusion and Recommendations

To conclude everything from above, motivation drives people to act (Schiffman

and Kanuk, 2010). Motivation is the phenomena, which gives us an answer on

why people do something (Williams, 2002) and makes it clearer to recognize the

reasons behind (Kay, 2003). According to Williams (2002), products, in this case

services, have a special value to the consumer, therefore it will create an

experience afterwards. Besides, destination perception plays a great role in

consumers’ motivation (Nicoletta and Servidio, 2012). The author has

researched on the motivation, customer experience and satisfaction as well as

two theories on the motivation in this paper.

Expectancy theory and push and pull theory (Gnoth, 1997, Vroom, 1964 cited in

Lee, 2007) are the theories which are mostly applicable to examine motivation of

the tourists (Kay, 2003). Nonetheless, there can be still a gap in understanding

human’s motivation to travel (Ibid). It is important to understand motivation and

experience of the customer, so South Korea may increase the quality of the

services. The author recommends to broad this topic and does more research to

those who are interested in this study. There are several people who may benefit

from this study: national tourism board of South Korea, researchers on

motivation and people who are interested in consumer behaviour.

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