Trends & Innovations in Management and Entrepreneurship Readiness of Thailand Hotels, Hospitals, and Tourist attractions in Medical Tourism OPEN ACCESS Volume: 8 Special Issue: 1 Month: September Year: 2020 P-ISSN: 2321-4643 Impact Factor: 3.122 Citation: Jawcharoenrux, Warat, and Chai Ching Tan. “Readiness of Thailand Hotels, Hospitals, and Tourist Attractions in Medical Tourism.” Shanlax International Journal of Management, vol. 8, no. S1, 2020, pp. 26–31. DOI: https://doi.org/10.5281/ zenodo.4030572 Warat Jawcharoenrux & Chai Ching Tan School of Management, Mae Fah Luang University Abstract Thailand is well-advancing itself into tourism, and medical tourism is also in the emerging list of focus at national policy level. This research aims to provide a structured assessment into the factors signicant to reect the readiness nature of the medical tourism in the northern parts of Thailand. To accomplish this, this research examines the interrelationships of various tourism types and the standardized criteria established and advocated by the Thai government, which leads to giving clarity of tourism context for medical tourism. Readiness state and its stimulating antecedent and consequential variables would be made concrete by means by qualitative in-depth interviews in support of quantitative based approach for its multi-dimensional nature, which include, possibly, aspects of structure, process, outcome, human and technology, policy, and environmental conditions in the context of medical tourism. During Covid-19 period, which presents challenges to collect data from the visitors of medical tourism, the three stakeholders would be targeted, namely hospitals, the hotels in the neighborhood perimeters of the hospitals, and tourist destinations. Introduction Globalization and accelerated development of technologies, such as medical, telecommunication and social-media technologies, has turned medical tourism as an important part of tourism (Nilashi et al., 2019), serving as an option for patients to access medical services that offer better benefit-cost trade-off deals (Burkett, 2007). Apart from medical purposes, both prevention and cure (de la Hoz-Correa, Munoz-Leiva, and Bakucz, 2018), patients also take the opportunities to travel as tourist (de Arellano, 2007). Nevertheless, important reasons motivating the patients to “travel with the express purpose of obtaining health services abroad” (de Arellano, 2007: 193) are to avoid costly procedures in their home countries, and to access the medical services not attractive to home-country, evidenced, for instance, by lacking of availability of services and lengthy waiting list (Burkett, 2007). Nevertheless, research efforts on medical tourism are rather fragmented, and usually focus on one perspective or domain, such as brokerage medical services (Turner, 2007), national competitiveness level (Ganguli and Ebrahim, 2017), and customer-perceived value 26 Unique Research & Consultancy Services SHANLAX International Journal of Management (Hallem and Barth, 2011). In addition, due to difficulty of data collection relating to medical tourism context, many researches were accomplished at conceptual level (Connell, 2013), exploratory (Hallem and Barth, 2011), qualitative analysis (Ganguli and Ebrahim, 2017) level, or engaging with few expert opinions by use of mathematical, analytical approaches such as DEMATEL-fuzzy TOPSIS (Nilashi et al., 2019). To get away with the data collection difficulty, Abubakar and Ilkan (2016), instead, surveys the local patients receiving medical care as proxy voices to imply emphasis on destination trust and online words-of-mouth as important drives to intention to travel to use the hospital services. Consequently, this research establishes the objective which aims to incorporate various stakeholders’ views to assess the readiness of medical tourism services in Chiang Rai, Thailand. Literature Review “Readiness” is an ultimate aim of the objective of this research. To get a better reliable and valid picture of what “readiness” means, literature review is used, and the end outcome can be used to guide the model development and data collection. Readiness state of the change recipients is an important construct as it infers commitment and the acceptance of the change-affected stakeholders (Armenakis, Harris, and Mossholder, 1993; Meyer, Srinivas, Lal, and Topolnytsky, 2007), and determine whether a change intervention, such as in succeeding in medical tourism, will ultimately be successful or not (Self and Schraeder, 2009). Accordingly, readiness is a degree to which the affected stakeholders are readily disposed themselves to participate in the undertaking (Stevens, 2013). The extant literature identifies many factors important to influence the readiness states of the stakeholders involved in the undertaking. These factors can be acknowledged as the drivers or characterizing restraining forces to influence the decisional balance toward readiness and actions (Stevens, 2013), which can be inferred to apply to medical tourism context as follows: • Cognitive mechanisms such as the level and a need of consciousness-raising i.e. awareness of the problem and solutions. • Emotional disposition such as emotional arousal related to medical tourism. • Valence proposition in that the stakeholders recognize the values and the positive impact of medial tourism. • Efficacy in that there is certain level of confidence of the stakeholders that the medical tourism market will succeed. • Social capital or support to facilitate medical tourism services. • Encouraging mechanism such as the rewards or benefits the stakeholders perceive will receive by attending to medical tourism opportunities. • Contextual factors. • Urgency of change perception of the stakeholders – To succeed the implementing readiness programs, the change participants should be stimulated to a state of urgency of the change, and also the organization should also incorporate the necessary mechanisms of change, such as organizational learning, to gradually mold awareness of urgency to changes for transformation (Tan, 2018). To make use of the drivers, restraining and contextual factors to exert effective transformation (Lewin, 1951), this research further applies concept of process maturity so analysis can be performed to identify possible patterns of relationships of the antecedent variables to the medical tourism’s readiness variables, and the readiness variables. The process maturity is of four levels (cf. McCormack and Johnson, 2001; McCormack et al., 2009), namely: http://www.shanlaxjournals.com 27 Trends & Innovations in Management and Entrepreneurship • Ad-hoc readiness: The medical tourism-theme and the related processes are unstructured and ill-defined. • Defined readiness: The basic processes and themes of medical tourism are defined and documented. • Linked readiness: Organization and involving management that employ process management with strategic intents and results monitored on medical tourism related business. • Integrated readiness: The supply chain involving medical tourism is well integrated and everyone pays significant commitment and investment attention. There are also other versions of readiness scale, such as Capability Maturity Model Integration (CMMI), which states five levels of maturity levels, namely incomplete level (level 0), performed (level 1), managed (level 2), defined (level 3), quantitatively managed (level 4), and optimized (level 5) (Kupla and Johnson, 2008; Paulk, Weber, Garvia, Chrissis, and Bush, 1993). Method A mixed method approach is used by using qualitative mode of data collection, but is quantitatively supported by means of importance-performance analysis (IPA) so that a clear pattern of variable-relationships can be synthesized, which, ultimately, is aimed to build theory. IPA is originally introduced by Martilla and James (1977) and since then, has been applied widely to diversified fields such as tourism (Boley, McGehee and Hammett, 2017), and the purpose is to reflect the perceptual gaps between the action zone and the expectation. The IPA has three steps (cf. Bi, Liu, Fan, and Zhang, 2019). First, the researcher mines for useful information (the data collection stage, performed by in-depth interviews, and are conceptually supported by the literature review), then it is followed by assessing each attribute’s performance and importance relevant to characterize the readiness or factors needed to succeed in medical tourism, and lastly, constructing the IPA plot, as shown in Fig. 1. Fig. 1. The IPA Plot There are four clusters of strategies suggested by the IPA plot in accordance to the state-gaps as shown in Fig. 1, namely Q1 (“keep up the good work” strategy, which are major strengths and potential competitive advantage of the products and services), Q2 (“concentrate here” strategy, which are areas of major weakness of the products and services), Q3 (“low priority” strategy, 28 Unique Research & Consultancy Services SHANLAX International Journal of Management which are areas of minor weakness of products and services), and Q4 (“possible overkill” strategy, which may waste the limited resources) (Boley, McGehee, and Hammett, 2017). In short, through IPA, the medical tourism industry can find ways (strategies) to close the discrepancies between what the stakeholdersthink is important and their actual perceptual performances. Results A careful observation of the nature and scopes of drivers to supporting or restraining the success of medical tourism in the markets, as presented in the literature review section, seem to describe the necessary mechanisms as parts of the unfreezing of mindsets needed to establish readiness, which is a concept advocated by Lewin’s (1951) 3-stage model of change: unfreezing, transforming, and freezing, to suggest active efforts of the change recipients. The IPA (Importance-Performance Analysis) format is used to capture the states and scopes of readiness supporting medical tourism, and the analysis is integrative making use of qualitative-quantitative data. The qualitative data is structurally organized in tabular form as shown in Fig. 2 so that there are some distinctive patterns of relationships which can be synthesized to assist model or theory development – a typical characteristics of qualitative research. Fig2. The Conceptual Model Based on Fig. 2, which is a result of the literature review and captures mixed approach configuration in data collection and analysis approach, the following specific research objectives are established: • Objective 1 – Aim to identify the readiness factors for the three supply-side medical tourism players, namely hospitals, hotels, and tourist destination, and provide an IPA structure in the organization. • Objective 2 – Identify the three important factors that play antecedent roles to the readiness attributes gaps as reflected in the IPA, namely contextual factors (i.e. government policy, macro level), drivers and enablers, and restraining factors. • Objective 3 – Study and explore for the patterns of relationships of the readiness factors and their antecedent variables, being judged by the readiness levels. • Objective 4 – To explore how the residents perceive the medical tourism development. • Objective 4 would adapt the study by Suess, Baloglu and Busser (2018). http://www.shanlaxjournals.com 29 Trends & Innovations in Management and Entrepreneurship Conclusion Medical tourism is in Thailand’s national agenda (The Ministry of Tourism and Sports Thailand, 2017), partly motivated and stimulated by Thailand’s competitiveness capability in the tourism sector, as reported in the Travel & Tourism competitiveness report 2019 (World Economic Forum, 2019). Nevertheless, published research works on medical tourism are not easily available, leading to this research aiming to fill the gaps through four objectives, which establishes a readiness structure similar to Lewin’s (1951). In particular, the readiness structure involves studying the readiness attributes in the different players of medical tourism, namely hospitals, hotels, and tourist destinations, their antecedents, and their patterns of relationships as categorized in terms of readiness level. References 1. Abubakar, A.M., & Ilkan, M. (2016). Impact of online WOM on destination trust and intention to travel: A medical tourism perspective. Journal of Destination Marketing & Management, 5, 192-201. 2. Armenakis, A. A., Bernerth, J. B., Pitts, J. P., & Walker, H. J. (2007). Organizational change recipients’ beliefs scale: Development of an assessment instrument. Journal of Applied Behavioral Science, 43, 481-505. 3. Armenakis, A. A., Harris, S. G., & Mossholder, K. W. (1993). 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