Is the Growth of Thailand’s Medical Tourism Industry Sustainable?

Thailand is one of the most attractive medical tourism hubs in the world. The country’s total number of foreign medical patients rose from two million in 2012 to 3.4 million in 2018. This is nearly three times the corresponding figure for Malaysia, another regional hub. Although the Covid-19 pandemic adversely affected the industry, it has since recovered, with total foreign patients reaching three million in 2024.  The industry generates substantial foreign exchange earnings for Thailand, estimated at US$9 billion in 2019. Such earnings are reliable as the average spending of medical tourists is relatively high and less sensitive to price increases over time. 

Thus, it is unsurprising that Thailand’s policymakers continue to support medical tourism as an important source of growth.  While this optimism is warranted, there are mounting concerns about medical tourism’s negative spillover effects on Thais’ access to health services. There remains debate about the net gains that medical tourism brings to Thailand.

For starters, there are long-standing concerns about how medical tourism may lower the quality and increase the cost of medical services provided to locals. The higher financial incentives offered in private hospitals in the medical tourism market also result in the “brain drain” of medical manpower from public hospitals to private ones. This could push the cost and price of private medical services higher. These developments could lead to further deterioration in the quality of public healthcare services. 

However, concerns about the effect of medical tourism on public healthcare services may be overstated. The size of foreign patient inflow is likely to be overestimated. Without systematic official records, the number of foreign patients is based on the number of hospital visits by foreign visitors, regardless of their true purposes. If only patients who fly in to receive medical treatment are included, the actual number of medical tourism patients is only around 25 to 50 per cent of the current (and often-cited) figures. This would pose a lighter burden on public healthcare services.

The impact of medical tourism on brain drain in the sector is also more nuanced. The types of medical treatments tourists seek differ from those of locals. The top three services in medical tourism are orthopaedics, cardiac, and cancer, jointly with diabetic ulcers. In contrast, the top medical problems in Thailand are obesity, diabetes, and kidney disease. As such, the types of medical professionals the two sectors need are different. Hence, the impact of brain drain on the public healthcare sector would be less than imagined.  

…the Thai government needs to strengthen its monitoring and regulatory systems if it wants to support the sustainable growth of its medical tourism industry. This should begin with better data collection in the industry.

Treatments in medical tourism usually require lengthy doctor-patient pre-treatment consultations. These treatments are often one-off but they require long recovery periods involving intensive care provided mostly by nurses. Thus, medical tourism is likely to increase the demand for nurses more than other categories of medical professionals.  

The medical treatment sought by local patients in public hospitals primarily involves continuous monitoring coupled with ongoing adjustments of treatment protocols, which includes medication regimes to ensure optimal health outcomes. These tasks require direct personal interaction and professional judgment. Medical doctors are needed to perform them. Hence, medical tourism is more likely to exacerbate the public-to-private brain drain among nursing personnel (and less so medical doctors).    

After the pandemic, many governments worldwide have been ramping up their healthcare capabilities in preparation for the next healthcare crisis. Some countries, such as the United Arab Emirates and Saudi Arabia, have attempted to upgrade their healthcare capabilities by offering investment incentives to entice foreign private hospitals to set up their affiliates. The post-pandemic resurgence in medical tourism might be temporary. A slowdown in foreign patient inflow creates excess capacity. Any plan to increase medical service capabilities, especially in the number of professional nurses, must take into account this possibility. Despite its political sensitivity, the Thai government should consider encouraging the medical tourism industry to import foreign nurses as a way to enlarge a flexible pool of medical manpower in the industry.

Some policy attention is also needed on an emerging trend in the post-pandemic era, namely, the growing segment of wellness-related medical tourism such as cosmetic services, bariatric services (for example, weight-loss programmes), and Lasik eye surgery. These services, which are motivated by pleasure and happiness, provide opportunities to smaller service providers such as specialised hospitals and clinics. Due to the nature of such services, consumers can only ascertain the quality of such services after undergoing treatment. There is a risk that some small service providers may offer lower-quality services at lower prices and, in the process, drive higher-quality services out of the market. In the worst-case scenario, fraudulent business conduct could jeopardise the industry’s overall image. Hence, stronger regulatory oversight is needed in this emerging market. 

In addition, the rapid growth of the wellness-related market could pose new brain drain problems. In particular, the rapid expansion of the wellness market could motivate the recruitment of freshly graduated medical doctors into this market segment, drawing them away from providing basic healthcare services. This form of brain drain could adversely affect Thailand’s medical service capability in the long term. 

Overall, the Thai government needs to strengthen its monitoring and regulatory systems if it wants to support the sustainable growth of its medical tourism industry. This should begin with better data collection in the industry. In addition, more attention is needed to address the complex and evolving medical manpower challenges in the industry. 

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