What you need to know before coming to Turkey to receive medical treatment?
Dr. Hüseyin Afşın İlhan, Esq.
In recent years, Turkey has become one of the major destinations for healthcare tourism. A growing number of individuals worldwide have been visiting Turkey to avail themselves of cutting-edge healthcare technology, competitive prices, and famous Turkish hospitality.
For sure, the Covid-19 pandemic slowed patient inflow significantly for the last two years. But now, the borders are open, and those who would like to get medical treatment in Turkey have bought their tickets already. That's why I would like to take this opportunity and discuss patient rights in Turkey and what to look out for when striking a deal with a Turkish healthcare facility and healthcare services intermediary.
- Patient Rights in Turkey in a Nutshell
All patients, whether foreign or local, have certain rights in Turkey. The Regulation on Patient Rights recognizes those rights. According to the law, patients have the following rights in Turkey:
- The right to benefit from healthcare services in line with justice and equity: Patients have the right to avail themselves of healthcare services as per their needs and in line with justice equity. Healthcare services referred to in the regulation also contain preventive medical services.
- The right to request information: This right enables patients to request all relevant information regarding the medical services extended by a healthcare facility. Healthcare service providers are bound to establish an information desk with qualified personnel.
- The right to choose or switch to another healthcare services provider: Patients can choose the healthcare provider freely. Likewise, patients can choose to change their healthcare service provider. However, certain exceptions apply: First, if the attending physician believes that such change in the healthcare provider might endanger the patient's life, she must inform the patient. Second, if the attending physician believes that transferring a patient from one medical facility to another would pose a life threat, she can resist the patient's request to move to another healthcare facility.
- The right to choose and change physicians: Patients have the right to get to know the physicians from whom they will be receiving treatment, and they may request information regarding the physicians. Healthcare services providers are bound to provide all necessary information to the patients, including the physicians' names, duties, and qualifications. Similarly, patients have the right to switch to other physicians or request consultations from other physicians.
- The right to receive diagnosis, treatment, and care in line with medical standards: Healthcare services providers must render all diagnosis, treatment, and post-treatment care services with modern technology as per current medical practices. Diagnosis, treatment, and other services must comply with medical standards and laws. For example, euthanasia is prohibited in Turkey.
- The right to receive appropriate medical care at the medical facility: The personnel at the medical facility has to extend proper medical care to the patient. In line with this principle, a terminal patient has the right to receive appropriate medication that reduces pain and grief.
- Right to privacy and confidentiality: Healthcare service providers must respect their patients' privacy. In this respect, healthcare service providers must observe reasonable privacy during diagnosis and treatment and not let unrelated persons be present during medical care and attend treatment. Likewise, healthcare service providers must keep all patient information confidential and avoid disclosing them without patients' consent unless there is a valid reason to disclose it as per legal or moral principles. For example, if you are diagnosed with Covid-19 disease, the healthcare provider must report you to the Ministry of Health.
- Right to physical integrity: This principle is one of several other principles in the regulation that puts an utmost emphasis on a person's absolute authority over her body. As per this principle, no one can interfere with a person's bodily integrity without her consent or contrary to her consent unless otherwise allowed by the law.
- Consent Requirement: The governing principle is that a healthcare facility cannot treat a patient without consent. This principle comes with various exceptions: If a patient cannot communicate and her guardians or legal representatives are not present, the consent requirement can be overlooked. This exception especially applies in medical emergencies.
- The right to refuse treatment: Unless otherwise required by the law, patients have the right to refuse treatment or stop an ongoing treatment. In such a case, the healthcare facility must explain the potential danger of rejecting the treatment to the patient or her legal representatives and obtain the patient's or her legal representatives' written acknowledgment.
- Adoption of unorthodox treatment methods: If traditional medicine application does lead to any positive result, the healthcare service provider may adopt alternative treatment methods if the proposed alternative method previously is understood to be beneficial after being tested on animals and the patient consents to the alternative treatment. In addition, alternative treatment methods can only be applied if it is probable that the alternative method will not worsen the patient's health vis-à-vis traditional medicine.
- The right to receive treatment in a secure environment: Healthcare service providers must maintain security in the facilities.
- The right to have access to religious facilities: Healthcare services providers are obligated to take reasonable measures so as to allow the patients to perform their religious activities. Further, patients have the right to demand a presence of clergy as per their religious beliefs as long as the presence of clergy does not interfere with the medical treatment and disturb others in the facilities.
- Right to humane treatment: This right aims to provide patients peace of mind during their stay at the healthcare facility. The facility needs to accommodate the patients' personal values and be free from any pollution, including noise. Further, the personnel at the healthcare facility have to approach patients kindly and compassionately, especially when informing patients about their health status and the steps to be taken as part of their treatment.
- The right to be accompanied by a person and receive visitors: Patients have the right to be accompanied by their friends and family during their stay at the healthcare facility. Further, healthcare service providers must allow patients to have visitors during their stay. However, physicians may disallow companions and visitors if the presence of such would endanger the patient's health. Today, many healthcare facilities do not allow visitors or limit the number of companions because of the Covid-19 pandemic.
- The right to file a complaint: If a healthcare service provider does not observe the above rights of the patient, the patient has the right to file a complaint at the Ministry of Health. The Communication Center at the Ministry of Health ("SABİM") is the department tasked with receiving and processing patient complaints. Patients can reach out to SABİM by dialing "184" or sending an e-mail to "sabim@saglik.gov.tr". These communication channels are normally designed to serve Turkish-speaking patients. In an effort to remove the language barrier, the ministry has allocated a specific phone line for complaints to be made in German, Arabic, English, Russian, Persian, and French. This number is "+90 850 288 38 38". Therefore, those who do not speak Turkish are encouraged to call this number, and the operators will connect you to the relevant department and provide consecutive interpretations.
- Assurances and Recommendations Specific to Foreign Patients
The Republic of Turkey aims to become one of the primary healthcare tourism destinations. Therefore, the health tourism sector is regulated in Turkey. The legal framework that governs the sector is the Regulation Concerning International Health Tourism and Tourist Health ("Health Tourism Regulation"). The Ministry of Health regularly audits the healthcare service providers and intermediaries to make sure that they comply with the standards set forth in the Health Tourism Regulation.
Intermediaries in the healthcare tourism sector operate like a broker in the sense that they promote services of healthcare services providers in return for a commission for every contract they facilitate between a patient and a healthcare service provider. But they also work as a travel agency in the sense that they make travel arrangements such as accommodation and transportation for patients.
First of all, not every entity in Turkey is allowed to operate in the Turkish healthcare tourism sector. Those entities who want to operate as healthcare service providers or an intermediary must obtain a license from the Ministry of Health, and getting a license requires compliance with specific standards. Those standards applicable to both healthcare service providers and intermediaries are spelled out in the Healthcare Tourism Regulation. From time to time, the Ministry of Health revises the list of licensed healthcare service providers and intermediaries. Therefore, before deciding to work with an intermediary and/or a healthcare services provider, it is highly recommended to check if the intermediary or the healthcare services provider has the required license. Patients can simply check the lists posted by the Ministry of Health or dial "+90 850 288 38 38" to verify that the intermediary or the healthcare service provider is on the ministry's list.
The first advantage of dealing with a licensed healthcare services provider and a licensed intermediary is that they pledged to comply with the standards in the Healthcare Tourism Regulation in order to receive a license. For example, a healthcare service provider must establish an international patient unit in its facilities tasked with handling all communication between the service provider and the patient. Those who work at that facility must satisfy certain eligibility criteria, such as proficiency in a foreign language. Further, only licensed healthcare service providers and intermediaries can perform marketing and promotional activities, and they have to be absolutely correct in the information they provide during their marketing activities.
The second advantage of dealing with a licensed healthcare services provider and a licensed intermediary is that the Ministry of Health closely monitors them, and they can lose their licenses in case of a rightful complaint filed by a patient. On the other hand, if a patient decides to deal with an unlicensed intermediary, for example, in case of non-performance of services, she may not be able to find anyone to respond to her complaints later because the entity may vanish. Considering this fact, I will not be wrong if I say that it is way more secure for foreign patients to work with licensed healthcare service providers and licensed intermediaries if they want peace of mind when they come to Turkey to receive medical treatment.