title: Motivation, justification, normalization: talk strategies used by Canadian medical tourists regarding their choices to go abroad for hip and knee surgeries.
abstract: Contributing to health geography scholarship on the topic, the objective of this paper is to reveal Canadian medical tourists' perspectives regarding their choices to seek knee replacement or hip replacement or resurfacing (KRHRR) at medical tourism facilities abroad rather than domestically. We address this objective by examining the 'talk strategies' used by these patients in discussing their choices and the ways in which such talk is co-constructed by others. Fourteen interviews were conducted with Canadians aged 42-77 who had gone abroad for KRHRR. Three types of talk strategies emerged through thematic analysis of their narratives: motivation, justification, and normalization talk. Motivation talk referenced participants' desires to maintain or resume physical activity, employment, and participation in daily life. Justification talk emerged when participants described how limitations in the domestic system drove them abroad. Finally, being a medical tourist was talked about as being normal on several bases. Among other findings, the use of these three talk strategies in patients' narratives surrounding medical tourism for KRHRR offers new insight into the language-health-place interconnection. Specifically, they reveal the complex ways in which medical tourists use talk strategies to assert the soundness of their choice to shift the site of their own medical care on a global scale while also anticipating, if not even guarding against, criticism of what ultimately is their own patient mobility. These talk strategies provide valuable insight into why international patients are opting to engage in the spatially explicit practice of medical tourism and who and what are informing their choices.
authors.affiliation: School of Geography and Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada. Electronic address: camerkl@mcmaster.ca.
authors.forename: Keri
authors.initials: K
authors.lastname: Cameron
authors.affiliation: Simon Fraser University, Canada.
authors.forename: Valorie A
authors.initials: VA
authors.lastname: Crooks
authors.affiliation: School of Geography and Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada.
authors.forename: Vera
authors.initials: V
authors.lastname: Chouinard
authors.affiliation: Simon Fraser University, Canada.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Snyder
authors.affiliation: Simon Fraser University, Canada.
authors.forename: Rory
authors.initials: R
authors.lastname: Johnston
authors.affiliation: Simon Fraser University, Canada.
authors.forename: Victoria
authors.initials: V
authors.lastname: Casey
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D002170:Canada; D002755:Choice Behavior; D005260:Female; D006801:Humans; D008297:Male; D057193:Medical Tourism / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D033262:Narration; D036301:Qualitative Research
keywords: Canada; Hip replacement; Hip resurfacing; Knee replacement; Medical tourism