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CONSIDERATIONS ABOUT DENTAL TOURISM DEVELOPMENT
AND ITS SPECIFIC MARKETING IN ROMANIA
Elena, Enache1
Manuela-Rozalia, Gabor2
Cristian, Morozan3
Abstract:
Worldwide, the "actors" of the tourism market identified new needs, this aspect leading to the
appearance of various forms of tourism such as: adventure tourism, city-breaks, cultural tourism, religious
tourism etc. At the same time current economic development, marked by the recession of recent years, has led
directly to the emergence of a social phenomenon: increase of unemployment rate in developed countries
with major implications manifested from one to another in the global economy: incapacity of insurance to
cover a wide range of medical services, discrepancy between prices for these services, increasing mobility of
citizens. All these are direct causes of emergence, and especially development, of a new form of medical
tourism, dental tourism. This form of tourism directing tourists from developed countries into developing
countries. Romania has a significant potential to develop this form of tourism, recommended by the following
advantages: highly qualified doctors, comparable lower prices, cultural, natural and anthropogenic
resources. This paper is an argued proposal for the marketing in this field, which can be transformed into a
competitive advantage for Romania.
Keywords: medical tourism, dental tourism, marketing, online promotion
JEL Classification: I11, I13, I15, M31, M37.
1. Introduction
The 21th century consumer needs have generated and developed into a rapid pace,
both new forms of marketing (health services marketing, promotion through social media,
IT&C support advertising, rapid distribution, online shopping etc. ) as well as new forms
of tourism (adventure tourism, cultural tourism, medical tourism, city-break etc.). New
forms of tourism listed above, and others are already supported by government programs,
creating in a very short time market niches for developing countries and especially
competitive advantage for them in the international tourism market. Countries like India,
Hungary, Turkey, South Korea are now in the top of medical destinations, and this
competitive advantage is also possible because they are practicing proper and supported
marketing. On the other hand, it is well known that Romania is a country with a great
tourism potential. Also, it is known the success of Romanian doctors who drain their
professional activity abroad. Therefore, we consider that Romania - by practicing a proper
marketing - could be mapped into the trajectory of countries that are in the top destinations
for medical tourism as, for example, in the adventure tourism Romania is one of the first
ten developing countries in the world.
Among all types of specific marketing (services, medical etc.), which is the
guaranteed for success “combination” of these tourist destinations for medical tourism?
This paper aims therefore to create - for the beginning - a debate framework for this market
actor which can bring to Romania a well-deserved place among the destinations for travel
combined services and medical treatments. Further we present evolutions and perspectives
of the worldwide medical tourism and a number of aspects about dental tourism in
Romania, and in the last part of the paper, we propose a suitable marketing for these
services.
1PhD Professor, “Constantin Brâncoveanu” University of Pite ti, e_enache2005@yahoo.com
2PhD Associate professor, “Petru Maior” University of Tîrgu Mure
3PhD Associate professor, “Contantin Brâncoveanu” University of Pite ti
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2. Global medical tourism - development and perspectives
Lately, medical tourism is a peculiar tourist phenomenon who took a global special
extends due the increasing of the tourists’ mobility, economic changes benefic in some
developing countries and unstable economic climate in the developed countries like USA
or Germany. In the last decade, the dimensions of this socio-economic phenomenon led to
the formation of specialized research teams, using the internet to publish their own studies,
providing complete and comprehensive information about medical tourism. One of those is
publishing reports named “Patients Beyond Borders”, thus providing useful information
both for actors-consumers (and we propose for that the tourists-patients terminology) and
actors-offers of the travel and medical market.
One of the important information provided by Patients Beyond Borders is related to
the potential of this market, which in 2012 had the structure presented into Table 1.
Table 1 - Estimated number of medical travelers by country for 2012
Country Number of tourist
Brazil 180,000
Costa Rica 30,000-45,000
India 300,000-700,000
Korea 81,000-150,000
Malaysia 670,000 (80%+ patients from adjacent Indonesia)
Mexico 200,000-1,100,000 (higher number is mostly due to undocumented
Hispanics in California, Arizona, Texas returning home for care)
Singapore 400,000-610,000 (70% patients from adjacent Indonesia)
Taiwan 170,000
Thailand 920,000-1,200,000
Turkey 110,000
United States 600,000-800,000
All others 800,000-2,200,000 (Includes intra-EU travel)
Total Estimates 2012 4,461,000 to 8,016,000
Source: Patients Beyond Borders - Estimated number of medical travelers by country: 2012,
www.patientsbeyondborders.com
(Note from the provider of the data: Please note that some of the numbers have been listed as ranges
due to large reporting disparities (e.g. Deloitte, McKinsey, Gallup, Economist, diverse reporting methods
at various health and tourism ministries).
Analyzing the estimated data on patient-tourists, by country, for 2012, we find that
this new form of tourism, the medical one, mobilizing a large number of such tourists,
between 4,461 million and 8,016 million people, representing a significant proportion of
those who traveled in 2012. Therefore, we consider that, in terms of marketing and
potential, it is a growing market that offers to Romania the possibility of "joining" to it.
The team at Patients Beyond Borders also offers a top - estimated, of course - of the
most popular destinations in the world for this purpose, according to the data into Table 2,
among the reasons for which they are claimed (according to www.patientsbeyondborders
site. com) being the following:
Government and private sector investment in healthcare infrastructure
Demonstrable commitment to international accreditation, quality assurance, and
transparency of outcomes
International patient flow
Potential for cost savings on medical procedures
Political transparency and social stability
Excellent tourism infrastructure
Sustained reputation for clinical excellence
History of healthcare innovation and achievement
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Successful adoption of best practices and state-of-the-art medical technology
Availability of internationally-trained, experienced medical staff
Table 2 – Estimated top destinations by treatment
Country Treatment Comment Approx
savings
Antigua Addiction and
Recovery Crossroads Centre, a 12-step addiction and recovery
program founded by Eric Clapton, has welcomed
international patients from 30 countries.
40%
Barbados Fertility/IVF Barbados Fertility Centre offers IVF and a host of
fertility treatments at 40-60% savings. Success rates
are improved over conventional strategies by offering
a stress-reduced environment in a resort setting.
40-50%
(IVF)
Brazil Cosmetic
Surgery Luxury medical travelers often visit the world-renown
Ivo Pitanguy Clinic. 20-30%
Costa Rica Dentistry Dentist's lobbies in San Jose and swanky suburb
Escazu are filled with Americans and Europeans
seeking savings on expensive restorative and cosmetic
work – crowns, bridges, implants, dentures. Meza
Clinic is fully accredited by the American Academy of
Cosmetic Dentistry.
30-70%
Hungary Dentistry Germans, Austrians, Swiss and other patrons flock to
Hungary for cost savings on dental work. One town –
Gyor – in NW Hungary, boasts more than 150 dental
clinics serving international patients.
40-75% (for
restorative
and cosmetic
procedures)
India Orthopedics,
Cardiology India is the world's medical travel "thrift" destination
with savings of 60-90% on an array of procedures.
Harvard-affiliated Wockhardt Hospital has performed
more than 20,000 heart procedures, with 98%+
success rates (surpassing US and EU standards).
50-85% (for
restorative
and cosmetic
procedures)
Israel Fertility/IVF Israel is one of the world's top producers of medical
instrumentation, and a well-known center for
inexpensive fertility treatments.
30-50%
(IVF)
Malaysia Health
Screenings Malaysia is medical travel's best-kept secret, with
fluent English spoken everywhere and cost savings
comparable to India in less culturally jarring setting.
Savvy patients can obtain a full executive "well-man"
or "well-woman" screening - including vision, dental,
hearing, MRI, PET Scan - for around $US1500 - more
than enough savings to pay for a vacation in Kuala
Lumpur and environs.
70%
(Executive
Health
Screening
Mexico Dentistry,
Bariatrics Monterrey boasts four first-rate American-accredited
hospitals offering bariatrics and weight-management
programs to obese Americans at 40-60% savings.
Each year more than 50,000 Americans cross borders
into Mexico for dental work alone.
30-60%
(Dentistry)
40-70%
(Bariatrics)
Singapore Cancer Singapore ranks 6th in healthcare worldwide (compared
to the US 36th ranking (source: World Health
Organization). For cancer, Singapore's clinics and
hospitals boast some of the world's best diagnostics.
Patients visit for diagnosis, then head home for
treatment. John's Hopkins International Medical Centre
in Singapore specializes in cancer treatments.
30-40%
South
Africa Cosmetic
Surgery,
Cardiac
The classic "Surgeon & Safari" cosmetic surgery
destination. World's first heart transplant performed at
Christiaan Barnard Medical Center in Cape Town
40%
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Country Treatment Comment Approx
savings
Thailand Everything Thailand boasts world-renown Bumrungrad
International, the grandaddy of international hospitals
and Asia's first American accredited facility, with 225
US board certified physicians and surgeons. BI
welcomes 400,000 international patients annually from
120 countries, including 25,000 American patients each
year. Thailand also known for meticulous cosmetic
surgery, including gender reassignment. Dr. Preecha
(the King (Queen?) of transgender procedures, has
performed 3500 sex reassignment surgeries
40-75%
Turkey Vision Closer to the US and EU and a coveted tourist
destination, Turkey has more American-accredited
hospitals (41) than any other country. Tourists take
vacation breaks for inexpensive eye check-ups and
LASIK treatments. Dunya Goz World Eye Centers,
based in Istanbul, have centers all over Europe and
Asia.
40-50%
(LASIK)
Source: Patients Beyond Borders – Estimated top destination by treatment,
www.patientsbeyondborders.com
Looking at the data in the table above, we note – on the practice of dental tourism –
that the countries of the former Eastern European communist region, like Hungary are
among the top destinations recommended by these specialists.
About the value dimensions of this medical tourism market, globally, this experts
group considers that is around 24-40 billion USD, and about 8 million tourists-patients
who, on average, spend between 3,000 and 5,000 dollars, an amount that includes health
care, transportation, border costs, accommodation etc. Also, it is estimated as an emergent
market, with a growth rate of 15-20%, with higher rates in the North and South-East
Europe and South Asia. Dental tourism is a niche segment of the tourism industry, with a
rapid growth that is still studied globally.
3. Aspects of dental tourism development in Romania
In a study entitled “Romania Dental Market Analysis”, published by RNCOS Industry
Research Solutions from India (as the press release) in October 2010, the Romanian dental
tourism market has a strong growth potential. At that growth has contributed the current
economic recession which, for example, in the U.S. or any other developed country in the
world, has led to the unemployment increasing. In turn, the unemployment has, as a direct
result, the medical uninsured population growth. The economic aspect is accompanied –
according to the authors – by attractive prices for medical services in Romania, thus our
country being a strong competition to those already established in the practice of this new
form of tourism in the Middle East and Latin America.
Prices attractiveness is complemented by very high specializations, on international
standards, of the Romanian dentists, by short period of treatment, by massive investments
in new technologies and by the large number of existing dental clinics in Romania, being
estimated an increase of about 17 % of the market in 2010-2012. RNCOS Industry
Research Solutions specialists also appreciate that dental tourism market in Romania is
only at the beginning of development, with a great potential.
Moreover, in this report, Romania is presented as one of the most popular
destinations for dental tourism in Europe, this form of tourism enjoying government
support and promotion worldwide in order to develop this additional dental services and
tourism market.
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Internationally, Romania is presented as one of the best candidates for dental tourism,
according to the UK promoting website (http://www.dentalimplantro.co.uk/). Main
arguments are: a Romanian valuable specialty educational system, retrieved in eleven
profiled universities; quality standards and low prices, many and varied opportunities to
practice at the same time leisure and recreation tourism (mountain tourism in the
Carpathian mountains, the monasteries of Moldova, castles of Transylvania, the Danube
Delta and the Black Sea etc.).
According to the same sources from UK, for many Italian people Romania was an
important and preferred destination for dental tourism, promoted by strong Romanian
community from this country. In recent years, also increased the number of patient-tourists
from Hungary, even this country holds first place where in the dental tourism.
One reason for this sector spectacular growth was the support of the government
policy in 1997, after which private dental services are beginning to make their appearance,
offering dental services comparable to the international ones, as well as dental implants,
aesthetic services. Moreover, for foreign citizens coming to Romania, the dental services
are mainly: dental implants, crowns, whitening, facets, dentures etc.
It should be noted the advantage that Romanian dentists are good English speaking
persons, communication with foreign patients being not an impediment to the development
of dental tourism in Romania.
To support the fact that in Romania the prices for dental services are very affordable,
we present comparatively in Table. 3 some prices used for health care in the European
Union (Germany and Italy) and in our country.
Table 3. Comparative prices of major dental services
Rates (euro)Dental procedure Italy Germany Hungary Romania
Temporary filling 37 - free 3,5
Filling - 100-150 60-80 15-22
Extraction - 300 70 6-15
Dental implant - 1,200-3,000 1,000 400
Crown 1,000-1,800 - 255 110-140
Complete prosthesis 2,000 - 560 135
Source: http://stiri-medicale.clinicistomatologice.ro/turism-stomatologic.html#right_col
Many studies in the field of health tourism (http://worldental.org/dental-
tourism/cheap-dental-tourism-growing-fast-romania/4025/) argue that Romania will
become one of the most affordable dental tourism countries, because:
patients will find affordable prices for quality dental services;
dental treatment periods are relatively short;
dental offices are equipped with top devices of medical technology;
specialized staff is highly trained;
huge innovations in cosmetic dentistry are also possible to be exploited. This is
particularly important because cosmetic dentistry is the most expensive in the highly
developed countries and, usually, is not covered by a standard insurance policy.
4. Dental tourism marketing
The proposal of appropriate marketing forms for dental tourism starts from and takes
into account the profile of tourist-patient for dental services and tourism, result of an
American specialist’s complex research (research conducted by Vequist on 1,800 subjects).
He has the following socio-demographic characteristics:
gender: female
average age: 36 years
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education: at least college – for 34% of the investigated subjects
revenues: high
marital status: in general, unmarried persons
living environment: urban
An endogenous feature highlighted by the quoted study, refers to the fact that the
profile of this tourist-patient type develops professional influence on others around him
and, therefore, we can deduce that he is an innovative consumer. For marketers this feature
is... perfect! Receptivity to new products and services is required by any market actor.
If this is complemented by the influence on the group membership, then we can
recommend to the medical tourism, particularly to the dental tourism, on a personal
relationship-based marketing. The more welcome is this feature, the more professional
influence reflects on colleagues, meaning people with similar socio-demographic
characteristics (often educated, high income etc.), that will positively appreciate and
understand the message becoming, in turn, potential customers.
The marketing types that can be used, in parallel, in dental tourism based on their
interdependence are:
- branding;
- digital and online marketing;
- website development: online advertising, email marketing, social media;
- blog marketing;
- public relations;
- video-marketing;
- event management: event marketing, event branding, event consultation.
5. Conclusions
Internationally, already circulate the dental marketing expression, with advice like
this: “make sure that «online smile» of the company which use online marketing leaves a
first good impression to the site visitor”. This advice is based on the adage, now classic,
which teaches us that a smile is a good visit card. Also, it matters more the specialists'
opinions which practice the dental marketing and collaborate with institutions such as the
American Academy of Cosmetic Dentistry (AACD). Following studies in the field, AACD
showed that nine out of every 10 adults in America consider an attractive smile being an
important social asset and eight out of 10 believe an unattractive smile makes a person less
appealing to the opposite sex (according to www.medicaltourimmarketing.com).
In conclusion, Romania must take into account and align to these trends in tourism
and health, and travel agencies, tour operators and dental offices conceive but, especially,
promote on the online support attractive complementary travel-dental services packages at
competitive prices. It would be a real developing opportunity of this new tourism form and
gaining the competitive advantage in this market with growth potential.
The health tourism development is seen as a priority by the ministries involved, but
tourism infrastructure leaves much to be desired, passing, yet through a period of
reorganization, together with the overall infrastructure of Romania, which is one of main
weaknesses of tourism in our country. There are necessary an authority concerted effort at
all levels and a viable strategy that can be implemented and applied to solve the problem as
quickly as possible. It is received a very favorable message from doctors and tour
operators, and if it will be supported effectively, not only in words, then in Romania could
be attracted significant revenues.
The liberalization of medical market in the EU space would be another strong point
for the development of dental tourism in Romania. As in developed countries health
tourism brings about 3.4% of GDP, in Romania it can happens too.
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