Does Responsibility End When Treatment Ends in Health Tourism?

Can Türkiye build a system that not only treats international patients, but also manages their recovery journey after they return home?

Behlül ÜnverPresident, World Health Tourism Platform

Healthcare institutions devote considerable effort, time and resources to reaching new patients in the health tourism sector. They conduct international promotional campaigns, allocate digital advertising budgets, establish call centres, recruit multilingual staff, enter into agreements with agencies and build patient referral networks in different countries. The purpose of all these efforts is to earn the trust of a new patient and encourage that person to choose Türkiye for healthcare.

But once a patient has made an important decision, travelled to our country, trusted our institution and completed treatment, how does our relationship continue?

Does the healthcare provider’s responsibility end when the patient is discharged and returns home? Or is that precisely when the real relationship of trust begins?

This is one of the issues in health tourism that has not received enough attention:

Post-treatment care and follow-up—in other words, aftercare.

Do not forget existing patients while seeking new ones

One of a healthcare institution’s most valuable patients is someone who has already chosen it. That person does not know the country, the institution, the physician and the quality of service merely through advertising; they have personally experienced the entire journey. They know how they were welcomed at the airport, how they communicated with their physician, what the hospital service was like, how discharge was managed and how they were treated after returning home.

Even so, many institutions invest far less effort in maintaining relationships with existing patients than they do in acquiring new ones. Treatment is completed, the patient returns home and communication gradually declines. Sometimes the patient is contacted when a follow-up appointment is due; sometimes, because no problem is assumed to have occurred, the relationship ends altogether. Yet the end of treatment does not mean that all the patient’s questions have ended. It still matters whether medicines are being used correctly, how wound care is progressing, where follow-up tests will be performed, how nutrition and activity should be managed, which symptoms require medical attention and whom to contact if a complication occurs. When patients are left alone with these questions in their own country, the positive experience they had in Türkiye can gradually give way to uncertainty.

Discharge is not the end of the healthcare journey

The post-treatment period is not only about patient satisfaction. It is also directly related to patient safety.

According to patient-safety evidence from the U.S. Agency for Healthcare Research and Quality (AHRQ), approximately 20% of patients discharged from hospital may experience an adverse event within the first three weeks. Around three-quarters of these events are considered preventable or capable of being mitigated. These figures do not measure medical tourists directly, but they demonstrate how sensitive the post-discharge period is for every patient.

For medical travellers, the process can be even more complex. The patient is not simply returning home from hospital; they are returning to another country, another healthcare system and, in many cases, a location from which the treating physician is not physically easy to reach.

In a study conducted by the U.S. Centers for Disease Control and Prevention (CDC) with 11 states and territories, 93,492 people were assessed and 517 were found to have travelled abroad for medical care during the previous year. Of those who received care abroad, 5% reported a complication; 67% of those who experienced a complication sought healthcare again after returning home.

This finding points to an important reality:

A medical traveller’s treatment does not end at the border; only the location where care is delivered changes.

Aftercare is more than a phone call

Aftercare should not be reduced to a phone call a few days after discharge asking, “How are you?” That call matters, but it is not enough on its own.

AHRQ recommends that the clinical team contact patients two or three days after discharge. During this conversation, the patient’s condition, medications, follow-up appointments, services needed at home and what to do if a problem arises are reviewed together.

In health tourism, this model needs to be more comprehensive.

Before discharge, the patient should receive a care plan in their own language, with medicines and follow-up dates clearly stated. All necessary medical documents should be provided, and a responsible contact person should be identified for the period after the patient returns home. The follow-up process should not be limited to the first few days.

Depending on the procedure, a personalised follow-up schedule can cover 48 hours, one week, one month, three months, six months and one year. Tests sent by the patient can be reviewed by the treating physician; online consultations can be arranged when necessary; and information can be shared with the patient’s doctor at home. A strong aftercare model does not wait for the patient to encounter a problem. It reaches the patient before a problem develops.

We should not remind patients of ourselves only when selling a service

Communication with the patient after treatment is not limited to clinical necessity.

At appropriate intervals, a healthcare institution should remind the patient that it remains present, ask about their health and make them feel supported when needed. This does not mean sending constant advertising or steering the patient towards another procedure.

The right kind of communication means offering health guidance, reminding the patient of follow-up dates, conveying a short message from the physician, asking about recovery and keeping accessible channels open whenever help is needed.

A patient who feels valued not only at the point of payment but also after treatment forms a stronger bond with the institution. This bond affects both repeat choice and recommendations to others. In a systematic review examining the relationship between patient experience and organisational outcomes, 564 full-text publications were assessed and 40 studies that met the research criteria were included in the analysis. One of the strongest findings was that a positive patient experience is associated with both returning to the same institution and recommending it to others. Communication with physicians and nurses, access to services, respect and a sense of trust were particularly influential in repeat choice and recommendation behaviour.

In health tourism, a patient’s recommendation can be more powerful than most advertisements. Healthcare decisions are not made through price comparisons alone. People attach great importance to the experience of someone who has already made the same journey—especially what happened after treatment.

Trust in an institution becomes much stronger when a patient can say: “They contacted me after I returned home. My physician reviewed my results. I could reach them whenever I had a question. I never felt alone.” This is one of the most credible forms of institutional promotion.

Not satisfaction, but relationship management

Institutions generally measure patient satisfaction through surveys conducted at discharge. Yet the patient’s real experience often emerges after discharge. Were they able to obtain their medicines? Did they understand the follow-up plan? Could the physician in their own country access sufficient information about the procedure performed in Türkiye? Could the patient reach the right person when a problem occurred? Did the institution contact the patient again? Until these questions are measured, the patient experience cannot be considered complete.

The performance indicators used by health tourism organisations should include more than the number of incoming patients, treatment revenue and conversion rates. They should also measure participation in follow-up programmes, completion rates for follow-up consultations, response time to complications, repeat-choice rates and the number of new patients arriving through patient referrals.

This approach moves the patient beyond a one-off procedure and places them within a lifelong relationship of trust.

Can continuity be built without digital infrastructure?

Managing the post-treatment journey of thousands of international patients solely through phone calls, messaging applications and individual staff follow-up is not sustainable. A secure digital record is needed to bring together the medical traveller’s treatment history, procedures, medicines, follow-up dates and recovery progress. This system should be more than an archive. It should remind the patient of follow-up dates, provide necessary documents, facilitate online consultations and, with consent, enable secure information exchange with healthcare professionals in the patient’s home country. Artificial-intelligence-supported systems can monitor symptoms reported by patients, flag risks to the clinical team and prioritise patients who need follow-up. However, clinical decisions and responsibility must remain with healthcare professionals. Technology should be used not to replace human relationships, but to ensure that no patient is forgotten.

Where does each party’s responsibility begin?

One of the most important challenges in aftercare is unclear responsibility. Who will follow the patient—the physician, the hospital, the international patient unit, the agency or a healthcare provider in the patient’s home country? This question must be answered before treatment begins. When the discharge plan is prepared, the person responsible for follow-up should be identified, communication channels should be defined and a roadmap for potential complications should be established. The roles of the hospital, physician, agency and healthcare professionals in the patient’s home country must be clear.

Agencies can support patient communication and coordination, but they cannot perform clinical assessment. Digital platforms can facilitate the process, but they cannot replace the physician. Hospitals, meanwhile, should not assume that their responsibility ends when the patient is handed over entirely to another institution after treatment.

Aftercare requires a multi-stakeholder system with clearly defined responsibilities.

A new quality standard for Türkiye

Türkiye should standardise not only pre-treatment promotion and the care delivered in the country, but also the period after an international patient returns home.

For international patients, Türkiye could establish multilingual discharge documents, personalised follow-up schedules, assigned case managers, secure digital health records, online follow-up systems, complication-management protocols and models of cooperation with healthcare professionals in patients’ home countries. Such a system would give Türkiye a significant advantage not only in clinical quality, but also in international trust and brand value. The future of health tourism competition will not be determined solely by which country attracts the patient. What will matter is who follows the patient more safely, who remains present after treatment and who can manage the healthcare journey without interruption.

Institutions can continue to spend substantial budgets on finding new patients. But if they forget the patients who have already chosen them, they may be dismantling their strongest networks of trust and referral with their own hands.

In health tourism, true quality is measured not on the day a patient leaves the hospital, but by whether that patient still feels safe after returning home. The strongest healthcare institutions of the future will be those that not only deliver successful treatment, but also leave their patients with this assurance after treatment: “We have not forgotten you. We will remain with you for as long as your recovery journey continues.”