Health, Wellness and Tourism: healthy tourists, healthy business ...

also has strong cultural similarities with France and it is a country where the people speak
fluent French. Finally the geographical proximity between France and Tunisia seems to play
an important role in the choice of medical tourists.
“My first criterion was the fact that the first country to have done surgery for tourists was
Tunisia, so they are more experienced than the others, the second criterion was the proximity:
a two-hour flight is very manageable, and finally the third criterion, the language. In Tunisia,
unlike in Eastern Europe, Thailand or Brazil, all the doctors speak French! It’s important to
be able to easily discuss operating techniques, etc., without asking myself whether I was
properly understood…????”
As regards the use of the Internet, the functional value of the tool lies in its ability to ensure
remote contact between medical tourists and service providers (surgeon and/or tour operator).
Novak and al (2000) considered the ease of contact as a component of a “compelling online
experience”. Through an empirical study, Heinonen (2008) highlighted how well companies
respond to customers’ inquiries using technology such as e-mails. E-mails have the potential
to improve patients’ perception of the accessibility of their managed care organization and
healthcare providers (Moyer, 1999). Therefore, several medical tourists think that the Internet
and particularly e-mails are an efficient tool to communicate with their surgeon or tour
operator.
“Doubts, questions, I immediately send an e-mail to my surgeon who replies to me within the
day, he reassures me, tells me not to hesitate to ask any questions that pop into my head and
that it's normal to be anxious. I appreciate this permanent contact.”
Several studies have also shown the usefulness of electronic mail as a medium for patientphysician
communication, as they make it possible to gain time, and improve convenience
and access to medical care for purposes such as renewing prescriptions, communicating
laboratory results and making appointments (Sciamanna et al. 2007).
In our case, it was found that administrative issues inherent to the medical tourism package
are easily and well handled by electronic communication.
“Did you send him the pictures directly by e-mail or through the website? The surgeon has to
see your pictures to make a diagnosis and assess the cost!
Then his assistant will send an e-mail or call you, anyway, the written estimate will surely be
sent by e-mail and then to show you agree, you will need to send him the confirmation of your
plane ticket reservation!”
Other studies have found that follow-up care is among the main reasons why patients use emails
(Nelson and Stewart, 1993, Houston and al, 2004).
The same finding is observed in a medical tourism context, where the follow-up is performed
remotely. The patient sends photos of the evolution following the operation to the doctor, who
examines them and then gives advice and/or renews prescriptions to the patient.
“He remained available after I got back, by e-mail and by phone and even on live chat…!
Regarding the e-mails, it’s useful to send him photos showing the progress of healing for
example!” “I just had my surgeon on the phone a moment ago, and after observing the
photos, he thinks all the same that I have a stitch that went off under the nipple…”
In the context of our study, the Internet is not only a means used to ensure remote contact, it’s
also the main source of information for medical tourists. The Internet is a wide source of
information that allows customers to access more customized information with minimal effort
and cost (Alba et al. 1997). Through forums, travelling patients can easily get information
with minimal effort.