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Medical Tourism Destination Attractiveness – The Lake Wobegon Effect

Medical Tourism Destination Attractiveness – The Lake Wobegon Effect June 3, 2016

Marketing, research and business development consultant in healthcare, human services and senior living.

Destination attractiveness

Medical Tourism & Destination Attractiveness

Destination attractiveness
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The Lake Wobegon Effect in Medical Tourism

Lake Wobegon, according to Garrison Keillor’s famous radio introduction, is a place where “… all the women are strong, all the men are good-looking, and all the children are above average” Of course, this humorous parody overstates the pride all us feel in our families, towns and, yes, our countries. This overestimation of one’s own qualities and comparisons to others’ is so common, that social scientists have labeled and quantified this bias as, “The Lake Wobegon Effect”.

This phenomenon is often called “pride of place”. Its effects can be seen widely in medical travel literature. Press releases, brochures and emails from each country describe the beauty, charm and attractiveness of that destination for international medical travelers. This self-description is genuine and even honest; there are many extraordinarily beautiful places on the earth inhabited by charming, eager and well-trained people.

But of course, Lake Wobegon is fictional, and the self-stated, superlative attractiveness of every destination is too. What have been lacking from the international medical travel literature are objective comparisons of one destination to another.

Medical Tourism Destinations

Attracting Travelers
Attracting Travelers

From a tourism perspective, there are several published ratings and rankings, which compare destinations. For example, the World Economic Forum publishes The Travel & Tourism Competitiveness Report, containing The Travel & Tourism Competitiveness Index (TTCI).

Travel & Tourism Competitiveness Index
Travel & Tourism Competitiveness Index

The TTCI is comprised of several factors (see the graphic), has evolved through collaboration with multiple global partners, and is used widely by countries and destinations to guide initiatives and investment. In other words, it’s a widely used, reliable and relatively bias-free assessment of the comparative attractiveness of countries as destinations.

Certainly,  countries which rank highly should take justifiable pride in this comparative accomplishment. There are further questions, however, for the medical travel markets.

  • How does this ranking impact international medical travel?
  • What is/are the relationships between this type of ranking and the comparative attractiveness of these countries as medical travel destinations?
  • What can be learned, for example, by Portugal to improve its ranking vis-à-vis Spain?

Also, it should be noted that several countries on this TTCI list do not currently, or have not in the past, encouraged medical services exports (“inbound” medical travel).  There may be several reasons. Some countries are operating at or near capacity, and do not want to encourage medical services exports, fearing that foreigners will displace local patients. Other countries with public health systems have concerns about actual or perceived equity in the utilization of facilities and human resources.

These and other factors were taken into consideration by my colleagues, Chris Robertson and John Geenty at Northeastern University and me in the development of a Medical Travel Destination Index (MDTI).  MDTI is a comparative attractiveness ranking for destination countries in medical travel. The preliminary results of this comparative attractiveness research were presented at the IMTJ Medical Travel Summit in Madrid.

While this first medical travel destination ranking is far from complete, it offers two distinct benefits from the absence of any such ranking. First, it begins what should be a constructive dialogue within the sector about the role of destination in consumer choice in medical travel. Second, the ranking contains five transparent components, offering countries the opportunity to analyze where they are strong, and where further initiatives can improve their comparative rankings.




Marketing, research and business development consultant in healthcare, human services and senior living.

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