For decades, the term “medical tourism” conjured two distinctly different images: the affluent traveling to tropical destinations for nip/tucks or other elective surgeries and, in some parts of the world, individuals crossing borders to find care that wasn’t available close to home. While these markets still exist, the medical tourism industry of today is largely composed of patients traveling to receive tertiary care in specialties such as cardiovascular, orthopedics, weight loss, and more.

Designers say the drivers of this change have a lot to do with culture and the ever-evolving healthcare market. Looking at medical tourism from an American perspective, Mohammed Ayoub, design principal at HDR (New York), says the rising cost of healthcare is driving customers overseas for lower-priced surgeries and care. For Europeans, he says, the draw is new and different treatments that often get tied up in regulations or extended approval periods in their home countries.

More than 1 million Americans are expected to travel outside the U.S. for medical care in 2014, according to Patients Beyond Borders, a consumer medical tourism resource. Globally, approximately 11 million patients go abroad for medical treatment, with top healthcare destinations spanning the globe from Brazil and Costa Rica to India and Singapore.

Daniel Polachek, vice president/design principal at HGA Architects and Engineers (Minneapolis), says another factor that’s changing where people look for care is the ability to speed up the process. “Depending upon the severity of the medical condition and financial resources available to patients, many find that they can be treated more quickly by travelling to another destination,” he says.

Patients have also grown more confident that they can get as good or better care delivered to them for less money than what they’d pay to local providers. Part of that relates to the fact that facilities are recruiting physicians from well known medical schools and entities around the globe. “We’re seeing a higher level of care in more countries now,” Polachek says.

The combination of all these factors—lower costs, faster turnaround, physician competency—is expanding the appeal of medical tourism from the affluent and well-insured to a broader range of people looking for cost-effective choices and the same quality outcomes as more traditional healthcare offerings.

New world market
To attract these clients, healthcare organizations are focusing on achieving a high-enough throughput for programs to be sustainable, usually by targeting health issues that are easier to diagnose and treat through specialties such as cardiology, dentistry, and orthopedics.

But how do you design a facility to appeal to a broad patient base, which might include local and regional populations as well as tourists? For one, designers say that rather than tailoring spaces to specific clients and procedures, they’re likely to pursue a more timeless aesthetic that has universal appeal. “A hospital that’s catering to medical tourism is very keen on the design,” says Christine Guzzo Vickery, vice president and senior interior healthcare designer at HGA Architects and Engineers. “They really get that design can attract or detract patients.”

Health City Cayman Islands, a 140-bed tertiary facility specializing in cardiovascular and orthopedic health services, opened in early 2014. Damon Romanello, executive director and managing principal, Studio+ (Fort Myers, Fla.), says his client requested a Western world aesthetic to attract its targeted American clientele. “From a fit and finish and interior design standpoint, it’s very much like what you would see in the States,” he says, including the use of wood materials, natural light, and views to the outdoors.

For the design of the Embryo Clinic IVF Unit in Thessaloniki, Greece, Panos Voulgaris, creative director/partner at MALVI (Thessaloniki), says the desire was to create a space that would translate the clinic’s medical expertise and stand apart from competitors. “There aren't any one-size-fits-all solutions regarding medical tourists, other than the fact that they should feel as if the facilities and staff are catering to their specific needs in order to make them feel at home, away from home,” Voulgaris says.

Similar to any international healthcare project, cultural considerations need to be made, too, starting with the arrival sequence.  Patients may be arriving via a variety of transportation modes and speaking a range of languages, all with luggage in hand. Polachek says the design of lobby and registration spaces should provide plenty of room and account for varying expectations of privacy and service.

Most medical tourism patients also travel with family members, with numbers varying according to culture. This can impact the size and layout of public and clinic spaces, including waiting areas and patient rooms. For example, Vickery says in some Asian cultures, it’s tradition to make a meal for visitors, so a hospital would need to provide kitchen facilities for families as well as added seating and table options. Other facilities accommodate families with expanded cafeterias that serve a variety of ethnic foods catering to international palates.

Cultural norms can also affect layout, such as the location of the bathroom. While in the U.S., it’s desirable to make the travel route to the bathroom as short and safe as possible, in many Asian cultures, patients don’t want to see a bathroom from their beds. “It’s a learning experience of trying to blend everything together and come up with the right solution,” HGA’s Polachek says.

Looking ahead
Within this balancing act of world-class care and cultural expectations, designers and architects say the market is ripe for growth as more patients look for cost-effective care options. “The established [medical tourism facilities] have an advantage in that they’ve got the reputation and the credibility,” Polachek says. ““Some organizations new to medical tourism are focusing on keeping customers within their region from travelling abroad by providing improved services and environments, making it more convenient to stay home.”

The opportunity for designers and architects, he says, is to understand where each client is in their evolution and to help them by designing a facility that’s going to adapt as they grow.

MALVI’s Voulgaris agrees: “Patients seeking quality care abroad should have the opportunity to receive the best possible treatment in environments that can help them get through the experience in the most positive way.”

Anne DiNardo is senior editor of Healthcare Design. She can be reached at

For more on medical tourism, check out these case study projects:

Medical Tourism Spotlight: Healthpoint

Medical Tourism Spotlight: Health City Cayman Islands