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

study identifying the motivation of travellers to Thailand generally, and far less on medical
tourist motivation.
Conceptual framework
Theory of consumer motivation
The study of motivation in tourism is obviously important due to its role as a trigger to travel.
Tourism literature emphasises the significance of both push and pull factors in shaping tourist
motivation 6 (Crompton, 1979). Many scholars have worked on the definition of tourist
motivation partially by identifying the underlying reasons for travel. Each individual tourist
motivation framework may not fully explain the circumstance. According to Fodness (1994),
the most common empirical studies on tourist motivation are from the works of Dann (1977),
Crompton (1979), and Pearce and Caltabiano (1983), all of which explored push and pull
motives. Pull factors are the destination’s extrinsic forces, such as attractiveness and specific
features of the destination, perceived by potential tourists and pull people to choose that
particular destination whereas push factors are consumer’s intrinsic forces establishing the
desire to travel and push people to travel in the first place. In other words, according to Bolles
(1975), human behaviour is pulled through the perception of valuable characteristics in the
environment and pushed through the action of motivating drives. Klenosky (2002) further
suggested that a single pull factor of a particular destination can be driven by multiple push
motivational forces. People may have multiple and possibly very different push motivational
reasons for evaluating positively the same pull factor. Likewise, tourists with different
demographic profiles may have different push and pull travel motivations in visiting a
particular place.
Interestingly, according to Chen et al. (2008), no academic literature has shed light on the
types of motivation of consumers visiting medical tourism settings, therefore investigating
those different motivations will help identify the possible leading attributes influencing the
demand since tourists often possess more than one motive (Pearce, 1993, as cited in Chen et
al., 2008). Additionally, as Sangpikul (2008) points out, there is limited research on the pull
motivational factors or destination-based attributes segmentation in a Thai context. According
to Kozak (2002), the destination attributes of a particular destination or pull factors, could be
various and different from one destination to another depending on the perception of travellers
towards a particular destination. According to Lubbe (1998, as cited in Sangpikul, 2008),
travellers’ motivations to visit any particular destination begin when they become aware of
certain needs and perceive that certain destinations may be able to satisfy those needs. Thus,
the investigation of pull factors in Thailand’s medical tourism context is important in
developing a successful marketing program.
Consumer behaviour and decision making
Following Bourdieu’s (1990, as cited in Dressler, 2007) idea of medical anthropology, which
draws on the disciplines of medicine, anthropology and history (Comelles, 2002), to
understand human behaviour, requires the analysis of the intersection of social structure and
cultural construction. Understanding human behaviour in general, and human health seeking
behaviour - the intrinsically motivated behaviour (Deci, 1975, as cited in Deci, 1978) - in
6 Tourism motivation has been defined by several tourism scholars as “a meaningful state of mind which
adequately disposes an actor or group of actors to travel, and which is subsequently interpretable by others as a
valid explanation for such a decision” (Dann, 1981: 211); “a dynamic process of internal psychological factors
(needs and wants) that generate a state of tension or disequilibrium within individuals” (Crompton and McKay,
1997: 427). Crompton and McKay’s definition reflects Murray’s (1938) psychological needs as deep-seated
driving factors of motivation.