Medical tourism is again being celebrated post-Covid-19 as a “booming industry”, promoted with breathtaking numbers that promise massive economic benefit. However, behind the headlines lies a reality that is often at odds with the hyperbole and unrealistic projections. In both quantity and quality, these fragmented markets are not as big or as seamless as their cheerleaders would have you believe.

This article sets out to demystify the facts versus fiction shaping medical tourism, highlights the diverse segments driving consumer and patient flows, and calls for sober, realistic numbers from benchmark markets.

Some definitions, please!

One of the problems when attempting to determine the size of these markets is that the definitions that are widely used are fuzzy. The most popular term, ‘medical tourism’, was coined by journalists, associations, and travel agencies in the 1990s to describe consumers from developed economies, like the US and the UK, travelling to less developed economies, like Costa Rica and Hungary, for elective medical and dental procedures. The juxtaposition of these two inherently conflicting words, ‘medical’ and ‘tourism’, created media buzz and attracted significant attention. Almost everything under the sun was considered medical tourism at one point or another.

The European Union (EU) has attempted to create a taxonomy of terms corresponding to the market reality. Its Directive 2011/24/EU, which came into effect in 2013, grouped cosmetic and simple dental treatments, as well as more complex procedures (e.g. surgery, IVF), under the term ‘health tourism’. Subsequent studies have attempted to create a more nuanced nomenclature, but, unfortunately, ‘medical tourism’ remains the most widely used term. Fundamentally, all these markets represent cross-border trade in services, described by the World Trade Organization (WTO) under the General Agreement on Trade in Services (GATS).

One of the facts about this phenomenon is that, unlike travel and tourism or healthcare insurance, medical tourism is not an industry or sector, or even a single market. There is no SIC code or other agreed-upon way to measure medical tourism. The cross-border trade in wellness, health, and medical services is a set of highly fragmented, regionalised export and import markets.

Another popular misnomer is to insert the words ‘inbound’ or ‘outbound’ when describing the movement or flow of consumers or patients across international borders. These terms confuse market dynamics. People who travel across a border to consume wellness, health, or medical services and then return to their country of origin represent an export from the destination country. A patient travelling outbound from the UK, and inbound to Hungary for dental treatments, is an export for Hungary and an import for the UK. Got it? It’s a little like ‘flammable’ and ‘inflammable’ – they both mean the same thing, although in the case of cross-border trade, the added words only add confusion.

The hyperbole of market size

The medical tourism market is regularly inflated in trade reports, investor presentations, and by destination marketers, sometimes unintentionally and sometimes with intent. Medical tourism revenue projections swing wildly – for instance, some global forecasts put market value at over US$186 billion by 2034,
with optimistic annual growth rates of over 16%. Others forecast up to $273 billion by 2032, while others still project the global market size to be $475 billion by 2032. This discrepancy reveals conflation of the definitions of what is being counted as ‘medical tourism’ spending.

Scratching just below the surface, you can see how to generate conflicting numbers by tossing ‘health tourism’, ‘wellness tourism’, ‘medical tourism’, and ‘related spending’ into one pot, making data interpretation nearly impossible for strategists and policymakers. The lack of standardised methodologies for counting cross-border treatments, bundled travel, and post-treatment stays presents genuine challenges for stakeholders seeking clarity. The following examples are illustrative only and are not the most egregious.

Example #1: wide range in Turkey

In 2016, Turkey’s official statistics reported health tourism revenue at $700 million, while industry associations suggested revenue between $2.3 and $3 billion, and one organisation cited $5.8 billion for that same year. Such a variance in estimates is common in the popular and trade press – and in official-looking reports from major global consultancies.

Example #2: India’s big claims

In 2022, according to the Times of India, the country’s Finance Minister said: “Medical tourism in India is estimated to be around $9 billion… Approximately two million patients visit India each year.” And another oft-cited report estimates India’s medical tourism market at $10.4 billion. This would mean the average spend would be $4,500–$5,200 per person. Given that most medical travellers to India (almost 80%) come from developing and war-torn countries such as Iraq, Bangladesh and Afghanistan, is this feasible?

Segmenting the markets

The heterogeneous nature of these markets is often overlooked in reports that focus solely on size. And the markets are highly segmented:

Wellness tourism: includes spa retreats, yoga, detox treatments, and holistic wellness vacations. Wellness-seekers typically spend less per visit than other sub-segments, prioritise relaxation, and are driven chiefly by prevention rather than treatment

Cosmetic surgery and elective procedures: these consumers seek access, affordability, quality, and privacy for elective procedures like rhinoplasty, dental reconstructions, joint replacements, or fertility interventions. This elective sub segment is dynamic when sought-after procedures are unavailable, not covered by insurance, or have long wait times at home

Complex medical/surgical interventions: driven by urgent health needs such as cancer therapy, cardiac surgery, or organ transplants, this group typically requires robust hospital infrastructure and advanced care. For many of these patients, the choice to travel and the destination selected are influenced by intermediaries such as their doctor, their hospital at home, their embassy, and others. The number of these exigent travellers is far lower than the other sub-segments, although the unit value per person is always significantly greater.

In wellness markets, the customer is almost always the consumer, whereas in more complex care, the consumer (sometimes ‘patient’) is guided by others with more experience or expertise.

The relative relationships of these highly fragmented market segments can be depicted in the relationship between volume, or frequency, and the complexity of the services being sought.

For the less complex or lower-acuity services, the consumer is the customer. It is the consumer who shops and makes choices for an attractive solution. For lifesaving and exigent services, the process of identifying and selecting options is very different. Doctors, clinicians, and even insurance companies or embassies may be involved in choosing the destination provider.

And this makes all the difference for marketing and strategy. These market facts are too often ignored or glossed over in the medical tourism literature and reports.

Fictional volume and value: the disputed numbers

One of the most persistent fictions in medical tourism is the exaggeration of international patient volumes and value, often fuelled by bundled definitions and wishful projections. On closer review, very few countries report transparent figures that approach these estimates.

Market reports routinely mix wellness, beauty, fitness, and medical spending. Very few destinations host a significant number of cross-border, surgically complex travellers. The bulk of patient flows is regionally based (e.g. Indonesians going to Malaysia for cardiac services, UK consumers visiting Turkey for plastic surgery).

Further contributing to the fiction is the lack of clarity in the definitions we’ve already discussed:

• Are elective dental patients counted?
• What about foreign residents using nearby hospitals, which are just across the border?
• What about expatriates or business travellers who fall ill and receive treatment?

Without clear guidelines and transparent reporting, inflated value and volume claims will persist wherever they serve the publisher’s intent.

Refreshing realism: Korea and Malaysia

South Korea and Malaysia provide some of the best-documented and realistic numbers in the field, far from the billions promoted in marketing materials, but credible for strategic planning.

South Korea

With hospitals and clinics known for their advanced infrastructure and reputation in cosmetic surgery, fertility, and stem-cell procedures, South Korea’s medical tourism market reached $2 billion in 2024, according to IMARC Group, and is projected to grow to $3.1 billion by 2033, averaging a defensible compound annual growth rate (CAGR) under 5% – much lower than other, breathless global forecasts. In 2024, approximately 1.17 million foreign patients from 202 countries visited Korea for medical services, mainly for cosmetic and high-tech interventions.

Key drivers include:

• World-class medical staff and technology
• Integrated travel-medical processing (hotels,
  transport, translation)
• Government regulation – mandatory hospital registration, liability coverage, streamlined medical tourism packages.

Malaysia

Malaysia, embracing affordable and quality care, was estimated to have a market value of $1.92 billion in 2024, projected to reach $7.54 billion by 2034 at a CAGR of about 14.6%, according to Fact.MR. Destination hospitals and clinics focus on orthopaedic, cardiology, dental, and cosmetic procedures, attracting regional patients who seek high quality and value. About 850,000 foreign patients visited Malaysia in 2022, the majority for mid-market treatments, rather than high-end surgeries.

Drivers include:

• Efficient healthcare infrastructure, rapid device approval
• Strong government support (tax benefits,
  investment incentives)
• Regional dominance for affordable specialty care
• Scrupulous attention to customer journey.

Wellness versus lifesaving travel: critical distinctions

The positioning and marketing of wellness tourism as synonymous with medical tourism creates apparent distortions.  Wellness travellers, who typically seek preventative or rejuvenating treatments, represent a growing, but very different segment from those travelling for elective surgery or urgent or lifesaving care. Beware of market reports that conflate the two, painting an exaggerated portrait of growth.

Key differences:

• Wellness tourism drives high volume, lower spending;
  repeat visits are common
• High-complexity medical travellers are a much smaller market, with higher spending per case, and are associated with greater risks (medical, legal, regulatory)
• Required policies, safety standards, and infrastructure are widely different between segments.

Segmentation and strategy

Recognising and targeting the relevant segments and subsegments is essential for destination marketers and hospital operators. Combining data from spa tourists and cardiac patients results in the misalignment of investment, marketing, and regulatory resources. Focusing on niche opportunities – such as dental packages, IVF cycles, gender-affirming procedures, and orthopaedic joint replacements – yields more reliable returns than blanket promotion of generic ‘medical tourism’.

The risk of pricing disparity

Price discrimination in any of these market segments (higher rates for foreigners) affects market reputation and consumer trust. Consumers and patients, as well as their intermediaries, express concerns about pricing differences between local citizens and foreign medical consumers. Transparent pricing policies add to the credibility of a destination, fuelling sustainable growth rather than short-lived volume spikes.

Conclusion: why reality still matters

The credibility gap resulting from fictional market size and wildly inconsistent patient volume data poses significant threats to the long-term sustainability of these markets.

To develop a destination as a sustainable exporter of reliable, high-quality services, the whole constellation of travel-related services must be available to and supportive of foreign visitors. If destination politicians make claims that never materialise, the businesses that spend money and gear up to meet the anticipated boom will be disappointed at least, and possibly angry.

Strategic planning must be grounded in realistic, segmented data – such as transparent national health ministry reports, travel and tourism data, and audited figures from authoritative sources to build trust and guide investment.

We must move beyond wild-eyed, fantasy valuations and appreciate the nuanced structure of these markets, focusing on distinct subsegments and their respective drivers. By separating wellness tourists from those travelling for lifesaving or major elective procedures, destinations can intelligently allocate resources, tailor marketing, and deliver what consumers, patients, and the public demand: safe, affordable, and transparent care.

In the markets for cross-border wellness, health, and medical services, facts must trump fiction. Only by separating hype from reality can we deliver the sustainable growth and consumer and patient benefits that are often promised but unreliably delivered under the weight of inflated expectations.