Evaluate the concept of ‘medical vacation’ as well as the concept of providing health care in a luxury

setting. Is medical care a culture-free product in the sense that medical treatment is universal
regardless of cultures? Should culture be taken into consideration when treating and marketing to
patients from the different parts of the world? What part of the hospital’s marketing mix can be
standardized, and what part should be adapted? Should premium health care be offered to those who
can afford high prices?

A trend known as medical tourism has arisen in the recent years, in which people of highly developed
countries chose to ignore treatment provided in their own countries to fly to less developed parts of the
globe to access a wide spectrum of medical services. About 150,000 and 320,000 Americans fly overseas
each year to access healthcare, according to a 2015 study by the US International Trade Commission
(USITC) (Chambers, 2015). Americans cite savings as the most common excuse to fly overseas for health
services, considering the high cost of healthcare in the US. This pattern is driven by market pressures
and happens outside of the organized healthcare system's perspective and influence. Along with future
benefits, medical tourism poses major issues and obstacles. In developed and developing countries
around the world, this pattern would have a growing effect on the healthcare environment.
Medical vacation here in this case is radically different from the conventional international medical
travel model, where people typically travel from less developing nations to major medical centers for
medical care in highly developed countries that are inaccessible in their own populations (Horowitz et
al., 2007). The expanded access of customers to the global healthcare market needs the development of
a system that forms the medical tourism industry and tackles emerging ethical and cultural issues
relevant to this field and that is the bigger debate to which my brief answer would try to add to. As is
evident from the text of ‘Case 1.2: Medical Vacation: The Globalization of Health Care’ we understand
that the health care and especially luxury and vacation based health care has globalized and expanded
especially in Asia where the costs of luxury medicine are very low as compared to the rest of the world.
Therefore, the globalization aspect of ‘medical vacation’ is extremely important before devising product
strategies and the understanding of international marketing and cultural appropriation are required
before continuing this debate (Cesario, 2018).

Now medical treatment may be universal regardless of the culture; however, medical care especially
luxury medical care should not be considered a culture-free product while devising marketing strategies
and treating patients from different parts of the world. A huge part of a treatment are the conversations
the patients have with their doctors in which doctors try to establish a bond of trust. Medicare
professionals have gone as far as calling them an important part of healing (Ha & Longnecker, 2010).
Many complaints and dissatisfactions from patients are a result of breakdown of this doctor-patient
relationship (Walker et al., 1990). Even the treatment and diagnosis techniques vary in different cultures
and the ethnocentricity is a major reason why there are differing diagnostic and therapeutic traditions.
Now there are two parts to our problem: culture appropriation while marketing and devising a system to
diagnose and treat the patients from different cultures. The presence of complementary, typically
discrepant, explanatory structures that can provide disparate explanations of natural phenomena
complicates patient-provider relationships of cross-cultural treatment. Therefore, the communication
through verbal and non-verbal language becomes important here. The research paper by Maria
Fregidou-Malama and Akmal Hyder published in International Business Review thoroughly discusses
how marketing of health services is impacted by culture. They argue that in order to devise a marketing
strategy, first the dimensions of the national culture must be understood in an effort of establishing
cultural influence which could be best practiced through communication (Fregidou-Malama & Hyder,
2015). The next step is twofold: trust development with the local community and network development
i.e. partnerships with airlines to give packages. Once this is mastered, only then it can be decided that
what part of hospital’s marketing mix can be standardized and what can be adopted.

Figure 1: Marketing strategy framework

Now we answer the question of what part of hospital’s marketing mix could be standardized and what
part should be adopted. The hospitals should advertise their state of the art facilities via content
marketing on social media which is globally reachable. However, it could upload subtitles on its videos
and use automatic translation to regional languages features of social media to connect with the
audiences.

From a marketing standpoint, yes premium health care should be offered to those who can afford high
prices as it would lead to long term survival and growth of the private hospitals and increase greater
sales and profits which could in turn benefit local population as medical facilities would be improved. It
adds diversification to the mix which is very important especially in teaching hospitals where research is
carried out and generates greater employment opportunities for locals and potentially gives a boost to
the tourism industry.

Bibliography

Cesario, S. (2018). Implications of Medical Tourism. Nursing for Women’s Health, 22, 269–273.
https://doi.org/10.1016/j.nwh.2018.03.008
Chambers, A. (2015). Trends in the U.S Health Travel Services Trade. The United States International
Trade Commission, August, 2.
https://www.usitc.gov/publications/332/executive_briefings/chambers_health-
related_travel_final.pdf
Fregidou-Malama, M., & Hyder, A. S. (2015). Impact of culture on marketing of health services – Elekta
in Brazil. International Business Review, 24(3), 530–540.
https://doi.org/https://doi.org/10.1016/j.ibusrev.2014.10.010
Ha, J. F., & Longnecker, N. (2010). Doctor-patient communication: a review. The Ochsner Journal, 10(1),
38–43. https://pubmed.ncbi.nlm.nih.gov/21603354
Horowitz, M. D., Rosensweig, J. A., & Jones, C. A. (2007). Medical tourism: globalization of the healthcare
marketplace. MedGenMed : Medscape General Medicine, 9(4), 33.
https://pubmed.ncbi.nlm.nih.gov/18311383
Ritzer, G. (2020). The McDonaldization of Society: Into the Digital Age. SAGE Publications.
https://books.google.com.pk/books?id=yBP9DwAAQBAJ
statista. (2020). Global price of a Big Mac as of July 2020, by country (in U.S. dollars). Statista.
https://www.statista.com/statistics/274326/big-mac-index-global-prices-for-a-big-mac/
Walker, H. K., Hall, W. D., & Hurst, J. W. (1990). Peripheral Blood Smear--Clinical Methods: The History,
Physical, and Laboratory Examinations. Butterworths.
Do certain colors have universal connotations, or are their meanings unique to a particular country or
region? Pick a few primary colors and show them to people from your country and gauge their
reactions. In particular, identify the colors that have negative meaning in the culture in question.

Colors do not have universal connotations and are symbolistic of different meanings in different cultures.
Colors have deep profound roots in human history. Throughout the history of human evolution, the
symbolic meaning of colors has simultaneously shifted in many ways, becoming part of the social and
individual experience. Archaeological, historical and ethnographic studies showed that supernatural
conceptions of the symbolism of humans and colors were closely related. Color was an equivalent of the
word and the original vocabulary of color was commonly used in rituals and daily life. The earliest
sources of color symbolism revealed that magic and religion were closely related to color symbolism.

Pakistan is a land of vivid colors with a culture rich in symbolism of colors and even its flag’s colors
bearing meanings behind them. Colors have been part of subcontinental thought and consciousness for
centuries and there is a hidden meaning behind every color choice in every archeological artifact or
celebrations. At the heart of color symbolism is the Indian tradition of relating colors to emotional states
one experiences at certain times of their lives. Colors used in different artworks and paintings we see
around us not only represents the emotional state of the individual artist or the general emotion felt by
people in those times in history in cultural communities but serves as an important symbolic sign for the
expression of our myths, folklore and religious beliefs. We inherited culturally vibrant yet unrealistically
diverse culture where the expressions of colors hold centuries old traditions, celebrations and lifestyles
together and preserved to their true form and meaning.

In a culture with vibrant palettes, white is a color of absence. At funerals and ceremonies that signify
death in the family, it is the appropriate color. In principle, it represents the intrinsic nature of the color
itself; white, as a color, repels all light and colors and thus when one chooses white,
they disconnect from the pleasures and luxuries of life and reduce their daily involvement in society and
life around it.

Red is a color of pronouncement and manifestation. It is one of the most common colors used in our
culture and symbolizes fear. It is believed that in Hindu Mythology, the goddess Durga had red eyes and
red tongue therefore symbolizing her fiery and power. It is also the color worn by brides in marriages as
in comparison to white wedding dresses in western world which symbolize virginity, the red color
symbolizes purity of the lady. Red color is embedded in our psyche; it symbolizes weddings and union. It
is visible from the distance allowing the bride to flaunt her beauty as she commits to a lifetime of
amalgamation. It is a promise of prosperity in her marriage and a good luck charm for her fertility. It is
the color of the fertile clay that reaps harvests and better lives. And without its most feisty ingredient,
red chilies, Pakistan could hardly be celebrated as the land of spices and taste. Red symbolizes vitality
and purity; a certain sensuousness is also conveyed and radiates positive energy.

Green symbolizes nature and is also God's own manifestation. It is a color seen especially in the tombs
of Sufis and metaphysicians. It is a color of prosperity and growth. Pakistan is a nation steeped in
tradition, culture and history that is rich and fabulous. The roads of its ancient history have been
traversed by kings and nations, saints and disciples, rebels and warriors, and they have all played a small
but important role in deciding the understanding of colors today.
Black has connotations in Pakistan with a lack of desirability, evil, inertia, and negativity. It is associated
with the absence of energy, barrenness, and death and reflects rage and darkness. Black is used and is
also used to ward off evil and is also a sign of evil. This symbolism is an age-old Indian custom where a
baby is often usually blessed with a little black dot on the chin or under the ear to fend off the evil eye. 

Purple is the color of sorrow and unhappiness in Pakistani culture; therefore it is rarely worn by people.

Brown is considered a color of mourning in Pakistan as it is the color of withered leaves and is associated
with autumn which brings sadness.
Some managers of McDonald’s, buoyed up by the success in Asia and Moscow, want to 'McDonalize'
the world. Discuss the implications of this statement. Should McDonald's try to standardize its
product mix? What aspects of McDonald's are universal and this can be exported to other countries?
Should the company introduce into the USA the products that are successful in Europe and Asia.

McDonald’s is the American fast food chain giant which has more than 40,000 restaurant locations
worldwide. It is world’s largest restaurant chain by revenue and serves more than 69 million customers
every day in more than 100 countries. In order to answer these questions, we need to first define what
is meant by ‘McDonalize’ here in this context. It is an umbrella term which includes all the processes by
which the fast food restaurants are increasingly dominating more and more sectors all throughout the
world due to increased homogenization of cultures as a result of globalization (Ritzer, 2020). At the
heart of McDonalization are the principles of standardization, efficiency (in division of labor),
calculability, control (quality monitoring) and predictability. At least to some degree, it is important to
standardize McDonaldized systems. Thus, in other cultures, they cannot help but force themselves to a
degree in local markets. While McDonald's can adapt in different ways to local realities, its basic menu
and basic operating procedures remain fundamentally the same all over the world. On the other hand,
product adaptation strategies for Multinational Companies (MNCs) are often considered to be perhaps
the most influential factor for their development. Even though previous research has shown that
standardization increases performance results, more recent theories imply that this might not always be
the case. The choice of standardization versus adaptation of international products is no longer seen as
an inflexible choice in today's globalized world. Instead in light of a given market at a given time,
combinations of the two options are considered. Therefore, McDonald’s seems to practice the approach
of ‘think global, act local.' While the implications of McDonaldization have resulted in improved
revenues and expanded access to more people worldwide for different foods, it has also limited the
selection and choice of products available on the market while making products available uniform,
generic, and bland. Most of the fast food markets are dominated by restaurants that try to emulate the
American style of fast food making and to some people including me they all taste the same.

McDonald’s has successfully practiced global standardization and the concepts of economies of scale
and scope to their advantage for decades. McDonald’s most famous products worldwide French fries,
Big Mac, Happy Meals, Egg McMuffins, Coca-Cola® and Chicken McNuggets are similar worldwide and it
ensures that they taste the same as standardization results in cost savings. These signature products are
universal and can be exported to other countries. However, product adaptation is extremely important
for McDonalds in newer markets where traditional McDonald’s meals might not be popular. If
McDonald’s starts serving beef burgers in certain parts of India or start serving pork based hamburgers
in Islamic countries then it would be in great trouble. While standardization is more profitable,
adaptability makes McDonald’s more relevant to the cultures they are expanding and that is what makes
people walk into their restaurants in the first place if local people are not accustomed to American fast
food taste and lures them in. Adaptation is important for relevance in different cultures as we see in
France, the restaurant interior is an important factor in overall eating experience and McDonald’s
smartly adapted. Moreover, McDonald’s price adaptation based on buying capacity of its customers in
different countries is very interesting. Big Mac was priced at $6.91 in Switzerland and $5.76 in Sweden
while it was priced at $2.17 in Ukraine and $2.34 in Malaysia (statista, 2020). It could be argued that the
price difference could be due to costs of sourcing; however, such pronounced differences clearly
indicate the flexible pricing policy McDonald’s is practicing here.
McDonald’s should not introduce the products which are successful in Europe and Asia to USA because
we have seen products such as McLobster which failed spectacularly soon after its launch. However,
what it can do in order to diversify its menu is to offer newer products that go in line with the favorite
foods of locals. For example, in the south it could venture into steak business and towards the west
coast where people are more conscious about dieting, they can introduce more salads like Sweet
Greens.

BibliographyXRitzer, G. (2020). The McDonaldization of Society: Into the Digital Age. SAGE Publications.
https://books.google.com.pk/books?id=yBP9DwAAQBAJ
statista. (2020). Global price of a Big Mac as of July 2020, by country (in U.S. dollars). Statista.
https://www.statista.com/statistics/274326/big-mac-index-global-prices-for-a-big-mac/