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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

!ntroduction
Lately, medical tourism became very popular among travellers and moreover, they pursue the value of money and uality !"ristow et

al# $%&&'# (lastic surgeries are one of the reasons for medical tourism nowadays# Moreover, plastic surgeries have increased its popularity recently !(ar) et al#, $%%*'# South +orea is now promoted as the best destination to travel for plastic surgeries !Tang, undated'# It is also stated that tourist choose South +orea because it,s cheap and ualitative !Ibid'# Therefore the author has chosen

South +orea 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# -ccording to .noth !&**/', in tourism management it is very important and useful to understand the motivations of travellers to visit a certain country for particular reason# Moreover, Swarbroo)e and Horner !$%%/' add that

numerous motivators always affect the tourists# -dditionally, various tourists travelling for the same reason may have different

motivators !Ibid'# -ccording to 0ice !&**/, p#&&/', 1Motivation is the mi2ture of wants, needs and drives within the individual which see) gratification through the ac uisition of some e2perience or ob3ect4# Moreover there are different theories, which can be applied for the

motivation

and

customer

e2perience#

5h

and

(izam

!$%%6'

evaluated that the motivation of tourists should be criticised by push and pull theory# 7onetheless, .noth !&**/' additionally suggest drive theory and e2pectancy theory as a motivation process# Moreover he applies drive theory as an emotional motivation and e2pectancy theory as cognitive# Therefore, there are various )inds of motivations, which can be specifically e2plaining the reasons and behaviour of tourists# 8hen a traveller has decided on the destination and purpose of going the actual consumer e2perience starts !Hanefors and

Mossberg, &**6'# (lastic surgeries are very famous among all genders and generations nowadays# 7onetheless, not much

research has been done on motivation of consumers to travel to South +orea for plastic surgeries, services# Handley !$%&%' has researched on how medical tourism ma)es South +orea sustainable country# In sciencedirect#com researcher has found many papers about rural tourism in South +orea, but not much about medical tourism# -ccording to 9u and +o !$%&$', there is a gap in research on medical tourism in South +orea# Motivation and customer e2perience was in a great study at all times# 1:Many researchers see) a continuum construct to e2plain tourist

motivations4!8oodside and Martin, $%%6, p#$&'# In our modern $& st century it is needed to understand your customers, motivation and to evaluate the post;purchase e2perience# -ccording to "ansal and <iselt!$%%=', there is a great section of research where the

motivation and decision ma)ing is highly discussed# 7onetheless, there are not enough studies about motivation for medical tourism, even though the concern about medical tourism is growing rapidly in past few years !9u and +o, $%&&'# 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 )now the wants and needs of tourists !9u and +o, $%&&'# >urthermore, 8ong)it and Mc+ercher !$%&=' add that there is only a little research has been done which goes in more details for medical tourism#

Motivation and Customer Experience " #efinitions and Concepts


Tourist$s Motivation Process Motivation is an influencing factor on the behaviour of the consumer !(rebensen et al#, $%&$'# .noth !&**/' distinguish motive and motivation? referring to him, motive is what induces person to commit an activity, whether motivation always include the ob3ect of the activity# Moreover Solomon et al# !$%%@' evaluate motivation as guidance of consumer# -ccording to 9oon and Aysal !$%%B' motivation is a response to wants and needs of the consumer# - lot of sub3ects describe motivation from different angles# (ar)s and

.uay !$%%*' consider motivation in two waysC conscious and unconscious# Meanwhile, .noth !&**/' view motivation as cognitive or emotional process# Moreover, there is a process of motivation suggested by .raham and 8einer !undated'? (ar)s and .uay !$%%*'? .noth !&**/'# They divide the process of motivation into five elementsC choice of behaviour, latency of behaviour, intensity of behaviour, persistence of behaviour and conscious or unconscious reactions# -ll 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 heDshe last to reach the desirable outcome and the behaviour after the result is achieved !Ibid'# However, Hoyer et al# !$%&=' e2amine four factors influencing motivationC personal importance, values, needs and goals of the consumer, ris) of the activity and reasonable incompatibility with the position of the consumer# "esides these two theories, Schiffman and +anu) !$%&%' 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 setbac) will affect the set goals# It is really important to understand the motivation of tourists and process of their thin)ing to choose this particular destination and what affected their decision !(rebensen et al#, $%&$'#

Consumer Motivation Theories There are different types of motivators which ma)e tourist travel

!Swarbroo)e and Horner, $%%/'# Garious authors and researcher

L0 B@,*

suggest theories# Moreover, particular type EEif of tourism efficacy,several locus of control'# >or e 2ample, if a pe rson thin)s as followsC I will study is
hard tonight, I will get abetter gradeon tomorrow,s math test,, hisDher e 2pectancy will behigh# approached by numerous theories of tourist motivation# 1(ush and Instrumentality# This is theperson,s perce ption of theprobability that pe rformance will lead to a specific outcome # It is related to the individual,s be liefs or e 2pectations pullthat factors are have central concepts in tourist motivation literature4 EEif heor shebe s in ace rtainway, heor shewill ge t certain things,, !7adler and Lawler, &*//, p# $&6'# Thefollowing casecan beone e2ampleof high instrume ntalityC !(esonen, $%&&, p#/&'# +lenos)y !$%%$' .noth !&**/' claim that EEif I get abe tter gradeontomorrow,s math te st,I willand ge t anEinmath,,# Instrumentality ranges from &to F&# Thevalue &instrume ntality indicates that in every tourists, ma)ing process there is outcome a pull !a and push the se cond outcome decision !grade EE-,, in math' is ce rtain without the first better grade on tomorrow,s math test'# >urthe rmore, F& instrumentality indicate s that the first outcome !a be tte r grade on tomorrow,s math test' is!&**/' a necessary and sufficient factor# Moreover Murray !&*=6' cited .noth interprets these conditionof these condoutcome!gradeEE-,,in math'# Groom,se2pectancy the ory canbedepictedas follows !see>igures &and $'#

own capacitie s to bring s)ills to bear and influe nce outcomes !e#g# se lf;concept, self;

/*%

two factors as 1need4 and 1press4# +im and Lee !$%%%' discovered
(ublic library customer motivation model

that there is always betweenwill push and pull factors# (ush -s Groom !&*@H' pointed a outlin) that individuals be motivated if the y meet three factors in tourism industry are inside which are influencing be lieve that the de sired be havior is instrume ntal factors in achieving the vale nt outcome# In
other words, theindividuals must e 2pect that if they be havein ace rtain way, the y will re ceivecertain things#>inally, y must e2pe ct that they arecapableof performing traveller to proceed a the holiday, whether pull factors are the outer; be havior that is instrume ntal toachievingtheoutcome# "aseduponGroom,s e2pectancy theory, it is possibletoconstruct neral model of directed and ma)e a traveller to choose a particular age destination over how customers are motivate d to use library products in public library settings !see >igure='# some >irst other country !.noth, &**/? +lenos)y, $%%$? of 9oon and Aysal, of all, thee2pe ctancy repre sents thecustomers, pe rception how hard it will be to access library products and the probability of the customers, successful $%%B'# Moreover, (esonen !$%&&' considers pull belie factors tourism achieveme nt of access to library products# Second, thecustomers vethatin the y can find the library products that they are loo)ing for through their acce ss to products# Third, the library products differe nt vale nce theauthor,s custome rs to satisfy of the ir as a magnetism of thehave destination# To for the point view information needs# criteria# >irst, they must value the behavioral outcome vale nce# Second, the y must

push and pull theory is more applicable to this case, as in medical tourism motivation there are e2ternal and internal factors, which
>igure &# Groom,s e 2pe ctancy the ory

affects their decision#

>igure &C <2pectancy Theory !Groom, &*@H'


>igure $# Groom,s e 2pe ctancy the ory

-nother theory suggested by Groom !&*@H' citied Lee !$%%/' is e2pectancy theory# 8eber !&**/' evaluated e2pectation as one of the most influencing motive to travel# (izam and Milman !&**='

e2plain

e2pectancy

theory

as

tourist,s

perception

about

destination# Moreover, Schiffman and +anu) !$%&%' elaborate e2pectancy theory as a previous e2perience of a traveller in a past# -ccording to Shiffman and +anu) !$%&%, p#&6&', 1In a mar)eting

conte2t, people tend to perceive products attributes to their own e2pectations4# Lee !$%%/' stated that e2pectancy theory also appears to generate a positive result in a tourist,s perception# Moreover .noth !&**/' stated that e2pectancy theory is a cognitive process as it includes thin)ing and rationale deliberation#

<2pectancy theory consists of three main inseparable parts that will lead to motivationC e2pectancy, instrumentality and valence

!Shepperd and Taylor, &***? Lambright, $%&%'# Instrumentality is one of the components of this theory !Groom, &*@H citied Lee, $%%/'? it is a measure of chances that the outcome will be according to the tourist,s perception# Galence belongs to values formatted by a tourist about destination and how the goal of the consumer is achieved by this particular destination !Ibid'#

<2pectancy theory is very important in tourism as it is also composing from the opinions of other people travelling to the same destination, therefore the e2pectations will increase and wants of the consumer will raise as well !Schiffman and +anu), $%&%'? 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 !"os ue and Martin, $%%6'# <2perience of the tourist in particular destination plays a great role in forming satisfaction !Meng et al#, $%%6'# Satisfaction is a fulfilment of customer needs and posterior assessment of the e2perience gained during stay in destination !Sanchez et al#, $%%@'# -ccording to Devesa et al# !$%&%' satisfaction and motivation are main measures in tourist,s behaviour# Moreover, Ihi and Ju !$%%6' regard gratification and consumer participation in the process of travelling as inseparable elements# Ionsumer e2perience has a great influence on the tourist,s satisfaction and creates a perception of the destination# Hoyer et al# !$%&=' wrote that there could be satisfaction as well as dissatisfaction of the destination# Ionsumers are pursuing of e2clusive e2perience from their travelling !0ageh et al#, $%&='# Martin;0uiz et al# !$%&&' include service e2perience, service value, uality, convenience and price as ma3or components in creation of customer e2perience# <2perience in the same destination may vary according to the type of tourist !Sheng and Ihen, $%&=? Ihang and Horng, $%&%'# Moreover consumer e2perience is very individual process !Ibid'#

Moreover they say that e2pectations of the tourist are an essential part of the whole e2perience# Scheng and Ihen !$%&=' brea) down

e2perience into two partsC active and passive# -ccording to them, active includes replenishment of )nowledge and development of intelligence, while passive is more about leisure# Satisfaction appears during and after the e2perience# Tourist,s satisfaction depends on the uality of service and provision of the goods !+im,

$%&&'# <2perience 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 ta)e into consideration all needs and wants of the traveller#

%evie& of existing empirical research in medical tourism motivation


Segmentation 'y motivation in healthcare and spa tourism -ccording to "ieger and Laesser !$%%$', segmentation is very important in tourism industry# 0id et al# !$%&=' e2plain that motivation is one of the factors to be included in the segmentation process# Dubai Department of Tourism K Iommerce Mar)eting !$%&$' indicates spa tourism as part of medical tourism# <rdeli !$%&&' divide travellers according to the various types of spas, therefore they can achieve higher percentage of tourists basing on their motivationC spas for debilitated care, for cardio care, for breathing issues, alimentary issues and for nervous disorders# -ccording to Ma) et al# !$%%6', there are a huge variety of motives, which are driving people to travel# >irst is recreation, therefore they assume that the segment is business or employed people who are

see)ing for escape and rela2ation !Ibid'# Tawil !$%&&' states that the motivation of the lu2urious people is better facilities and uality service# Moreover, he adds that these

people are usually less price sensitive# Ihen et al# !$%&=' made a research of what is the motivation of elder travellers# He found out that the main motive of them is see)ing of health treatments# -nother factor, which was ta)en into consideration, was the provision of a warm atmosphere# (esonen et al# !$%&&' have created different clusters according to types of travellers# 5utdoor travellers are see)ing for 3oyful and recreational spa e2periences, 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 !"eh and "ruyere, $%%/'#

Motivation in medical tourism -s stated by Li et al# !$%&=', if the country or the companies are aware of the motivation of the travellers or guests, they may better interpret their consumers, behaviour# The learning process of the consumer is a )ey success to satisfy hisDher needs !Ibid'# -ccording to Ihen et al# !$%&=' there are several motivators of medical tourists? the main areC en3oyment, pleasure and practice of various services# -nother leading motivators suggested by Singh !$%&=' includeC price of medical services, confidentiality of treatments, and

certification of specialists# However, Laesser !$%&&' have mentioned that the main factor affecting the motivation of medical tourists is to care or improve something in their appearance# -nother 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 !9e et al#, $%&&'# -lso they added that the personnel play a great role in deciding whether to go or no# >our motivators were presented by Loti)asthira !$%&%'C to recover and heal the sic)ness, to receive the services of plastic incision, to get therapeutic chec) up and to correct and enhance the overall well;being# Musa et al# !$%&&' identified five main factors, which analyse the motivation preciselyC how good is the assistance, the cost, spiritual aspect, cultural aspect and the additional services provide# The most important factor influencing the motivation is the uality of serviceC the history of the destination about medical tourism, accessibility, the variety of serviced provided and the reputation of the destination !Ibid'# There are plenty of motivators, which are affecting traveller decision# Moreover, >arma)i !$%&$' stated that the motivation is considered to internal as well as e2ternal? therefore it is important to )now how to affect the tourist motives for travelling#

Conclusion and %ecommendations


To conclude everything from above, motivation drives people to act

!Schiffman and +anu), $%&%'# Motivation is the phenomena, which gives us an answer on why people do something !8illiams, $%%$' and ma)es it clearer to recognize the reasons behind !+ay, $%%='# -ccording to 8illiams !$%%$', products, in this case services, have a special value to the consumer, therefore it will create an e2perience afterwards# "esides, destination perception plays a great role in consumers, motivation !7icoletta and Servidio, $%&$'# The author has researched on the motivation, customer e2perience and satisfaction as well as two theories on the motivation in this paper# <2pectancy theory and push and pull theory !.noth, &**/, Groom, &*@H cited in Lee, $%%/' are the theories which are mostly applicable to e2amine motivation of the tourists !+ay, $%%='# 7onetheless, there can be still a gap in understanding human,s motivation to travel !Ibid'# It is important to understand motivation and e2perience of the customer, so South +orea may increase the uality 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 studyC national tourism board of South +orea, researchers on motivation and people who are interested in consumer behaviour#

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(ar)s, L# and .uay, 0#(# !$%%*' (ersonality, values, and motivation# )ersonality and $ndi#idual /i!!erences, H/!/', @/B;@6H# -vailable fromC httpCDDwww#sciencedirect#comD M-ccessed $% 5ctober $%&=N# (esonen, L#, Lau))anen, T#, +omppula, 0# !$%&&' "enefit

segmentation of potential wellbeing tourists# "ournal o! 1acation Mar*eting, &/!H', =%=;=&H# -vailable fromC

httpCDDonline#sagepub#comD M-ccessed %= 5ctober $%&=N# (esonen, L#-# !$%&$' Segmentation of rural touristsC combining push and pull motivations# Tourism and %os&itality Management, &6!&', @*;6$# -vailable fromC hrca)#srce#hrDfileD&$H/%/ M-ccessed &$

5ctober $%&=N#

(izam, -#, Milman, -# !&**=' (redicting satisfaction among first time visitors to a destination by using the e2pectancy disconfirmation theory# $nternational "ournal o! %os&itality Management, &$!$', &*/; $%*# -vailable fromC httpCDDwww#sciencedirect#comD M-ccessed &B 5ctober $%&=N#

(rebensen, 7#+#, 8oo, <#, Ihen, L#S#, Aysal, M# !$%&$' Motivation and involvement as antecedents of the perceived value of the

destination e2perience# "ournal o! Tra#el

esearch, B$!$', $B=;$@H#

-vailable fromC httpCDDonline#sagepub#comD M-ccessed $& 5ctober $%&=N# 0ageh, -#, Melewar, T#I#, 8oodside, -# !$%&=' Asing netnography research method to reveal the underlying dimensions of the customerDtourist $nternational e2perience# "ournal, 2ualitati#e Mar*et esearch: An

&@!$',

&$@;&H*#

-vailable

fromC

httpCDDwww#emeraldinsight#comD M-ccessed %* 5ctober $%&=N# 0ice, I# !&**/' 3nderstanding 'ustomers. $nd ed# 52fordC

"utterworth;Heinemann# 0id, 8#, <zeudu3i, I#5#, (robstl;Haider, A# !$%&=' Segmentation by motivation for rural tourism activities in The .ambia# Tourism Management, H%, &%$;&&@# -vailable fromC

httpCDDwww#sciencedirect#comD M-ccessed &H 5ctober $%&=N# 0itchie, "#8#, "urns, (#, (almer, I# !$%%6' Tourism research methods. $ntegrating theory with &ractise. 52fordshireC I-"

International# Sanchez, L#, Iallarisa, L#, 0odriguez, 0#M#, Moliner, M#-# !$%%@' (erceived value of the purchase of a tourism product# Tourism Management, $/!=', =*H;H%*# -vailable fromC

httpCDDwww#sciencedirect#comD M-ccessed && 5ctober $%&=N#

Schiffman, L#.# and +anu), L#L# !$%&%' 'onsumer beha#iour. &%th ed# 7ew LerseyC (earson <ducation, Inc# Schwe)endie), D#, 9eo, M#, Ali3asze), S# !$%&=' 5n Slimming (ills, .rowth Hormones, and (lastic SurgeryC The Socioeconomic Galue of the "ody in South +orea# 4hen 'ulture $m&acts %ealth. (lobal .essons !or 5!!ecti#e %ealth esearch, &H&;&B=# -vailable fromC

httpCDDwww#sciencedirect#comD M-ccessed %B 5ctober $%&=N# Seoul TouchAp# !$%&$' )lastic surgery stats - medical tourists. -vailable fromC httpCDDwww#seoultouchup#comD)orean;plastic;

surgery;statistics;medical;touristsD M-ccessed $$ 5ctober $%&=N#

Sheng, I#8# and Ihen, M#I# !$%&=' Tourist e2perience e2pectationsC uestionnaire development and te2t narrative analysis# esearch,

$nternational "ournal o! 'ulture, Tourism and %os&itality /!&', *=;&%H# -vailable fromC

httpCDDwww#emeraldinsight#comD

M-ccessed %& 5ctober $%&=N# Shepperd, L#-# and Taylor, +#M# !&***' Social loafing and

e2pectancy;value theory# )ersonality and Social )sychology ,ulletin, $B!*', &&H/;&&B6# -vailable fromC httpCDDonline#sagepub#comD

M-ccessed $6 5ctober $%&=N# Silverman, D# !$%&%' /oing 0ualitati#e research. =rd ed# LondonC Sage (ublications Ltd#

Singh, 7# !$%&$' <2ploring the factors influencing the travel motivations of AS medical tourists# 'urrent $ssue in Tourism, &@!B', H=@;HBH# -vailable fromC httpCDDwww#tandfonline#comD M-ccessed &6 5ctober $%&=N# Swarbroo)e,L# and Horner,S#!$%%/' 'onsumer ,eha#iour in Tourism# $nd ed# 7ew 9or)C 0outledge# Tang, +# !undated' /isco#er South Korea 'osmetic Surgery. -vailable fromC www#academia#edu M-ccessed %6 September $%&=N# Tawil, 0#># !$%&&' Ilassifying the Hotel Spa TouristC -

Multidimensional Jualitative -pproach# $nternational "ournal o! %umanities and Social Science, &!$%'# -vailable fromC

httpCDDwww#i3hssnet#comD3ournalsDGolT&T7oT$%TDecemberT$%&&D&B#p df M-ccessed &6 5ctober $%&=N#

Ganderstoep, S#8# and Lohnston, D#D# !$%%*'

esearch methods !or

e#eryday li!e. ,lending 0ualitati#e and 0uantitati#e research. San >ranciscoC Lohn 8iley K Sons, Inc# Geal, -#L# !$%%@' esearch methods !or leisure and tourism: A

&ractical guide. =rd ed# HarlowC (earson <ducation Ltd# 8ang, H#9# !$%&$' Galue as a medical tourism driver# Managing Ser#ice 2uality, $$!B', H@B;H*&# -vailable fromC

httpCDDwww#emeraldinsight#comD M-ccessed &6 5ctober $%&=N#

8eber, +# !&**/' The assessment of tourist satisfaction using the e2pectancy disconfirmation theoryC a study of the .erman travel mar)et in -ustralia# )aci!ic Tourism e#iew, &!&', ==;HB# -vailable

fromC www#cabdirect#orgD M-ccessed &6 5ctober $%&=N# 8illiams, -# !$%%$' 3nderstanding the hos&itality consumer. 52fordC <lsevier Science# -vailable fromC httpsCDDwww#dawsonera#comD

M-ccessed &6 5ctober $%&=N# 8ong)it, M# and Mc+ercher, "# !$%&=' Toward a typology of medical touristsC - case study of Taiwan# Tourism Management, =6, H;&$# -vailable fromC www#elsevier#com M-ccessed $@ September $%&=N#

8oodside, -#.# and Martin, D# !$%%6' Tourism Management: Analysis, ,eha#iour and Strategy. IambridgeC I-"I# -vailable fromC httpCDDboo)shop#cabi#orgD M-ccessed %6 September $%&=N#

9e, "#H#, Jui, H#O#, 9uen, (#(# !$%&&' Motivations and e2periences of Mainland Ihinese medical =$!B', tourists in Hong +ong# Tourism fromC

Management,

&&$B;&&$/#

-vailable

httpCDDwww#sciencedirect#comD M-ccessed &6 5ctober $%&=N# 9oon, 9# and Aysal, M# !$%%B' -n e2amination of the effects of motivation and satisfaction on destination loyaltyC a structural model# Tourism Management, $@!&', HB;B@# -vailable fromC

www#sciencedirect#com M-ccessed %6 5ctober $%&=N#

9u, L#9# and +o, T#.# !$%&$' - cross;cultural study of perception of medical tourism among Ihinese, Lapanese and +oreas tourists in +orea# Tourism management, ==!&', 6%;66# -vailable fromC

httpCDDwww#sciencedirect#comD M-ccessed &6 5ctober $%&=N#