The Business School

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The Business School ...

    Wellness Tourism

    Course Leader:

    Melanie Smith (Visiting Lecturer)


Melanie Smith is a Senior Lecturer in Cultural Tourism Management from the

    University of Greenwich in London, UK. She has written two academic

    articles on Wellness Tourism: Smith, M. K. (2003) „Holistic Holidays: Tourism

    and the Reconciliation of Body, Mind, Spirit‟, Journal of Tourism Recreation

    Research, Vol. 28, No. 1. & Smith, M. K. & Kelly, C. (2004) Stop the World I want to get off! Is Holistic Tourism becoming the Ultimate Route to Escapism?

    Tourism: The State of the Art II, Glasgow, June. She is also currently co-

    editing a special edition of the journal Tourism Recreation Research on Wellness Tourism, as well as undertaking a large research project on holistic


    Wellness Tourism

Introduction and Rationale:

This course focuses on the development and management of health and

    wellness tourism, an important contemporary growth sector. Not only are

    many people increasingly concerned about their physical, social and

    psychological wellbeing in their everyday lives, but they are also prepared to

    travel long distances to experience different forms of wellness tourism. This

    ranges from the immersion of the body in the healing waters of a spa to the

    quest for spiritual enlightenment in an ashram, or even cosmetic

    enhancement through surgical treatments or beauty therapies. This course

    will examine the range of motivations that drive this diverse sector of tourists, the products that are being developed to meet their needs, and the

    management implications of these developments.


    1) To understand the nature and scope of the wellness tourism product

    2) To analyse the motivations and profiles of wellness tourists

    3) To evaluate marketing and promotional strategies in wellness tourism

    4) To assess the management of wellness tourism centres

Learning Outcomes:

On completion of this course the students will be able to:

    1) Define wellness tourism

    2) Appreciate the diversity of wellness tourism products

    3) Understand the nature of demand for wellness tourism

    4) Know how to manage and market a wellness tourism centre

Indicative Content:

    1) Definitions of health and wellness tourism and product development

    2) Motivations and profiles of health and wellness tourists

    3) Geography of health and wellness tourism: national and regional


    4) Marketing health and wellness tourism

    5) Managing health and wellness facilities (e.g. spas, hotels, retreat centres)

    6) Spa tourism

    7) Holistic tourism


    8) Spiritual tourism

    9) Medical tourism

    10) Yoga tourism

    11) Regional health and wellness tourism: Central and Eastern Europe

    12) Guest speaker: Health and wellness tourism in Hungary

Main Learning and Teaching Activities:

Lectures and seminars will constitute the principal mode of teaching for this

    course. Lectures will serve to introduce theories and concepts, and seminars will

    be used to consolidate knowledge through discussion and debate. Students will

    be introduced to a variety of examples from a range of countries.

Assessment Details:

Method of Length Weighting Outline Details

    Assessment %

    Individual 2,500 100% Students will be given a fictional case study report 3,000 of a proposed new wellness centre in

     words Hungary. They will be asked to produce a

     development strategy for the centre.

    Deadline : Tuesday 20th December 2005

Assessment Case Study:

    ‘Fantazia’: A Proposed New Spa Development Project

Imagine that you are a wellness tourism consultant. You have been asked to

    write a development strategy for a proposed new wellness centre in the west of

    Hungary. You should prepare a report detailing your recommendations for the

    centre’s development. The project should be presented in two parts:

    a) a 15 minute presentation of your main recommendations during

    Week 7 of the course

    b) a complete report of 2,500-3,000 words to be handed in on thTuesday 20 December

The centre at present has the following characteristics:

    ? It is located in a small village close to Gyor near the Austrian and

    Slovakian borders, only 1 hour from Bratislava and 1.5 hours from

    Vienna. Budaest is 2 hours away.

    ? The centre is newly built and has three wellness pools of different

    temperatures, one of which is a mineral spa.


    ? The centre also has a dentistry centre, two massage rooms and one

    beauty treatment room. There is also a large auditorium which could hold

    up to 80 people.

    ? The centre is sited in a small park with access to a wood and a river.

    There is one main cycling path.The village has few attractions only one

    church, the remains of a castle, two pansios and several small shops.

    ? The centre owners have already built several holiday apartments, which

    they hope to sell. They are wondering how many more they should build.

    ? The owners are unsure about the current name of the centre and their

    promotional materials are limited. At present, they have one leaflet in

    Hungarian and German but no website.

The owners of the centre therefore require advice on the following:

    ? Overall management of the centre

    ? Potential expansion of the centre

    ? Product development

    ? Increasing demand

    ? Marketing and promotion

    ? Possible funding sources

Marking Criteria:

Criteria Excellent Very Good Satisfactory Poor Absent


     Audit of the

    centre‟s existing


     Knowledge of


    issues to be


     Understanding of

    the wellness

    tourism market

    (supply and


     Degree of

    creativity and

    innovation in




     Style, structure

    and referencing

Recommended Texts:

     (Please note that this is a relatively new subject area. As a consequence,

    there are fewer books and articles than for other subjects please also refer to the materials supplied by the tutor)


    Douglas, N. et al. (2001) Special Interest Tourism: context and cases,

    Chichester: John Wiley & Sons.

    Novelli, M. (ed.) (2004) Niche Tourism: Contemporary Issues, Trends and

    Cases, London: Butterworth-Heinemann.


    Garcia-Altes, M. (2005) „The Development of Health Tourism Services‟,

    Annals of Tourism Research, Vol. 33, No. 1, pp. 262-266.

    KPMG Consulting (2002) The Marketing Concept of Health Tourism in

    Hungary, Budapest: Hungarian National Tourism Office.

    Monteson, P. A. & Singer, J. (2004) „Marketing a resort-based spa‟, Journal of

    Vacation Marketing, Vol. 10, No. 3, pp. 282-287.

Puczko, L., Bacharov, M. & Eory, E. (2005) „Spa, Bath, Therme: What‟s

    Behind the Labels?‟, Journal of Tourism Recreation Research, Vol. 31, No. 1.

    Smith, M. K. (2003) „Holistic Holidays: Tourism and the Reconciliation of Body, Mind, Spirit‟, Journal of Tourism Recreation Research, Vol. 28, No. 1.

Smith, M. K. & Kelly, C. (2005) „Holistic Tourism: Journeys of the Self?‟,

    Journal of Tourism Recreation Research, Vol. 31 , No. 1.

Useful Websites: (Spas in Hungary) (Spa Marketing in Hungary) (European Spa World Project) (Medical Tourism) (The British Complementary Medicine Association)

     5 (Institute for Complementary Medicine) (The British Wheel of Yoga) (Holistic Centre) (Holistic Centre)


    Teaching Programme

Week 1

    Lecture 1: Special interest tourism and the growth of wellness tourism Seminar 1: Course overview

Students will also be asked to think about their own relationship to wellness in terms of:

    ? Physical needs

    ? Psychological needs

    ? Spiritual needs

    ? Creative needs

Lecture 2: Definitions of health and wellness tourism: product development

    Seminar 2: Wellness tourism in Hungary

    Students should prepare a brief list of Hungary’s wellness tourism products and attractions. We will analyse:

    ? Hungary’s wellness tourism offer

    ? The quality of Hungary’s spas and wellness products

    ? The nature of demand for Hungary’s wellness tourism

    ? The marketing of wellness tourism in Hungary



Week 2

Lecture 1: Demand for wellness tourism: motivations and profiles of wellness tourists

    Seminar 1: Role play activitiy

    Students will be allocated one of the following products:

    ? Spa tourism in Eastern Europe

    ? Medical tourism in India

    ? Yoga tourism in Spain

    ? Spiritual tourism in Thailand

    ? Beauty spa tourism in the Caribbean

    For their given product, they should discuss the following:


    Typical Likely tourist Draft of a holiday Marketing attractions and profiles and package or activities and activities linked to motivations programme channels the given product

Lecture 2: Marketing wellness tourism

    Seminar 2: Content analysis: wellness tourism brochures

Students will be given a range of wellness tourism brochures, and they will be asked to

    comment on the following:

    ? Presentation of given wellness product

    ? Special attractions and activities

    ? Packaging of product

    ? Promotion of product

    ? Pricing of product

Week 3

    Lecture 1: Wellness tourism in Central and Eastern Europe Seminar 1: Discussion about definitional and marketing issues

    Lecture 2: Spa tourism in Hungary Seminar 2: Case studies

    Students should read the following paper in preparation for this class:

    Spa, Bath, Thermae: What’s Behind the Labels?


    (forthcoming in special edition of Tourism Recreation Research,

    on Wellness Tourism, 2006 edited by M. K. Smith & C. Kelly)


More and more people are using health related services and not only those who go

    to see their GP. Many of those health services, except medical services, are labelled

    as wellness, fitness or more recently holistic ones. People, especially from western

    societies are looking for health type services and locations during their holiday, too.

    They can find many spas, baths, thermae, health or healing resorts in various

    destinations. Health consciousness has become one of the main social trends in

    many countries, and the more unusual the given health or spa service (and its name)

    the more popular, the range and variety of such services. One can wonder, however,

    if these health as well as often tourism service providers and their services are really

    different or just the label they use differs somewhat. Data show that various forms of health tourism have played an increasingly important

    role in tourism globally in recent years, and this trend is also likely to dominate the

    supply of tourism in many Central and Eastern European countries in the near 1future. Owing to the rich abundance of natural healing assets, such as water,

    climate, caves or mud, and to relatively moderate price levels, which are recognized

    as a competitive advantage internationally, CEE countries have become the most

    important participants in the international market of health tourism.

    Background to health tourism

    Health as motivation to travel has always been popular since Ancient times until

    nowadays; just thinking about the Roman thermae, the Turkish baths, the French

    coastal or mountain resorts, the Japanese onsens or the Alpine healing resorts. This

    fact is widely accepted by professionals and researchers (e.g. Bacon 1998,

    Henderson 2003), however, there have always been more popular forms of health

    services that received special attention. The quite varied motivations of visitors using

    these services get reflected in the supply, too, e.g. some use these services for

    relaxation (e.g. in tropical spa resorts of the Caribbean), some as a form of stress

    release (e.g. a rejuvenation week in an Austrian wellness hotel), while some for

    curing well definable illnesses (e.g. in medical hotels or hospitals of Hungary).

    In the tourism sector where consumers fundamentally purchase experiences, it is

    inevitable that not only tour operators but guests will also define (or label) the type of

    trip they are purchasing. There are therefore many definitions of health tourism and

    of spas. This also allows operators to capture guests with fundamentally mutual 2motivations too, and to classify such tourists as medical or wellness or holistic

    guests depending on their opinion about themselves. The intermediate position which

    leaves many visitors between these groups indicates how important it is to know the

    characteristics and expectations of the consumer before attempting to formulate

    definitions and to set up service lines and/or communication messages.

    Medical tourism

    Medical (or therapeutic) tourism involves using the services available at a site for

    providing therapy, or staying at a medical resort where the minimum length of stay is

    normally defined typically for the purpose of curing certain diseases. The main focus

    of therapeutic services, which are typically based on a natural curative factor (e.g.

    medicinal water, medical cave, micro climate, medicinal mud), is therapy, which is

    only complemented by tourist services and attractions. In this case, theoretically,

     1 KPMG Consulting (2002): The Health Tourism Marketing Concept, Hungarian National Tourist

    Office, Budapest 2 „Holistic health = high level wellness” (


treatments are the stimulus for potential visitors. Medical tourism typically, although

    non-exclusively involves the receipt of specific services prescribed by a specialist

    who can be either a resident specialist to the destination or can prescribe the

    necessary treatments at the visitors‟ place of residence. In these cases medical

    visitors are considered to be patients rather than tourists. All that said, however, it is not impossible to find therapeutic facilities operated

    without the presence of any natural curative element. Those therapies can be based

    on processes and activities, and partially on some other resources, such as thermal, i.e. hot, but not medical waters. Interestingly enough, while in CEE medical spas form

    the base for health tourism, in North America medical spas are seen as new arrivals. As Brown (2002)observed …spa and medicine viewed as complimentary and inclusive, is indeed the current trend. Spas again grow and now add doctors to their 3staff while hospitals and clinics add alternative therapies to their facilities.

    Wellness tourism

    45Wellness is an artificially created term from well-being and wholeness and the term was coined in the USA (in 1959) and has a brief history in Europe. Wellness is

    supposed to create harmony in (mental, physical, spiritual or biological) health in

    general; and has stronger ties with changing lifestyle or doing something healthy than with curing a specific disease. People consuming wellness services tend to show

    higher health-awareness than others. They want to stay healthy or, want to be

    healthier or want to prevent diseases through lifestyle, healthy nourishment and regular physical exercise. (Proving that wellness basically represents a certain

    lifestyle, interestingly, almost all USA universities of colleges have a wellness guide 6for their staff and students.) Wellness addresses human health in a holistic or

     3 Brown, M.T. (2002): Spa and Medicine, Mindful o the past, movement of the future, Spa Management, Feb, f

    4 Well-being is the state of having arrived at the full development of reason: reason not in the sense of a merely intellectual judgment, but in that

    of grasping truth by "letting things be" (to use Heidegger's term) as they are.” Fromm, E.: The nature of well-being,

    5 KPMG Consulting (2002): The Health Tourism Marketing Concept, Hungarian National Tourist Office, Budapest

    6Seven Dimensions of Wellness ( Social Wellness: is the process of creating and maintaining healthy relationships through the choices we make.This also refers to our ability to relate ? well to others, both within and outside of the family unit.

    Physical Wellness: signifies the process of making choices to create flexible, cardiovascularly fit, energetic, and strong bodies The choices we make are ? related to exercise, nutrition, rest and sleep, intentional and responsible sexual choices, stress management, management of injuries and illness, and the

    responsible use of alcohol and other drugs.

    Emotional Wellness: is the ability to understand your own feelings, accept your limitations, and achieve emotional stability. ? Intellectual Wellness: is the process of using our minds to create a greater understanding and appreciation of the universe and ourselves. Intellectual ? wellness is not dependent on intelligence or ability; rather it requires making connections, appreciating natural connections, examining one's opinions

    and judgements, and questioning authority.

    Environmental Wellness: is the process of making choices which will contribute to sustaining or improving the quality of life in the universe. This ? dimension includes responsible choices regarding the use of air, water, land, and energy so that future generations of each species may survive and

    thrive. The recognition of interdependence of humans, other animals, plants and all of nature is a central tenet of environmental wellness.

    Spiritual Wellness: is the process of discovering meaning and purpose in life, and demonstrating values through behaviours. Spiritual wellness includes ? acceptance of the concepts of wholeness, unity, diversity, individual uniqueness, and the need for community as well as personal responsibility to

    oneself and that community.

    Occupational Wellness: is the process of making and maintaining choices related to work which include choosing a job for which you are well suited, ? well-trained, and from which you gain satisfaction. It includes staying current in one's chosen field, helping to create a healthy organizational

    environment which contributes to your own and others' well-being. Career wellness also requires balancing work with the rest of your life.


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