“Stay cool, sell stuff cheap, and smile”: Examining how reputational management of dental tourism reinforces structural oppression in Los Algodones, Mexico

- Local industry stakeholders participated in reputational management activities.
- Reputational management activities respond to prejudiced assumptions about the global south.
- Concerns for site reputation encourage practices which perpetuate structural injustices.
- Perpetuation of unjust practices raises concerns for structural exploitation in medical tourism.

Los Algodones, Mexico is characteristic of other medical border towns whose proximity to the Mexico-United States border enables American and Canadian patients to take advantage of economic asymmetries on either side of the border to access desired health care. Los Algodones is unique, however, in its focus on the provision of dental care and claims by local residents that it has the highest concentration of dentists per capita in the world. In this paper, we present an analysis of interviews with employees working in Los Algodones' dental tourism industry to examine interviewees' participation in practices related to reputational management of the industry site. Drawing on our interview discussions, we argue that many of these reputational management practices reinforce structural injustices and raise concerns for structural exploitation in the industry. This analysis nuances ethical considerations for medical tourism by highlighting structural factors informing unjust practices within the industry, factors which might be relevant to other medical tourism contexts.