In recent years, Türkiye has built a remarkable success story in health tourism. With its strong healthcare infrastructure, skilled physicians, modern hospitals and internationally recognized standards of care, it has taken its place among the countries providing healthcare to millions of international patients. Yet today, it is time to ask ourselves a new question: Can we sustain this success? The central issue in health tourism is not simply growth. It is making that growth sustainable. When we speak of sustainability, we often think only of its economic dimension. Health tourism, however, is a much broader ecosystem. Financing models, human resources, quality standards, digital infrastructure, international trust, patient satisfaction and national reputation are complementary elements. A weakness in any one of these links can affect the entire system. Today, private healthcare providers are trying to maintain their operations amid rising costs, increasing personnel expenses and intense international competition. At the same time, the public healthcare system faces a substantial burden from growing demand. In this context, health tourism should be viewed as a strategic field that contributes to the sustainability of the healthcare system, as well as an activity that generates foreign currency. There is an important point to consider here. Competition based on price may increase patient numbers in the short term, but it can undermine quality, brand value and trust over time. Health tourism should grow through quality, trust and the creation of sustainable value, rather than a race to offer discounts. In my view, this is one of the main reasons behind the sector’s recent transformation. Human resources are another essential consideration. Healthcare professionals’ knowledge, experience and motivation are this sector’s greatest strength. From physicians and nurses to coordinators and interpreters, the entire team plays a central role in shaping the international patient’s experience. Sustainable success is impossible without investment in people. Digitalization has also become an integral part of health tourism. Patients are not merely purchasing treatment. They expect rapid access to information, reliable communication, transparent management of the process and digital follow-up that continues after treatment. Countries and institutions that can meet these expectations will be the winners of the future. For me, one of the most important questions in health tourism is this: Who picks up the bill? Although this may initially sound like an economic question, it is fundamentally a strategic one. Who bears the cost of acquiring patients? Who finances investment in digital marketing? Who organizes international promotional activities? Where do insurance systems fit into this structure? Which areas receive government incentives? Without sound answers to these questions, establishing a sustainable structure for health tourism will not be easy. The countries that succeed in the years ahead will be those that strengthen their financing models, invest in people, uphold quality standards and build international trust, alongside welcoming more patients. Türkiye has more than enough potential to achieve this. To do so, however, we must approach health tourism as a strategic field of development encompassing health policy, the economy, education, technology and international cooperation, rather than simply as a marketing activity. No success can endure unless it is sustainable. Health tourism is no exception. The future of health tourism will be shaped by countries that can build trust, as well as by technology and investment. In the next article, we will examine why trust has become the most valuable capital of this new era in health tourism. Behlül Ünver President of the World Health Tourism Platform

The New Paradigm of Health Tourism – Part 15 When discussing health tourism, we often describe ourselves: our hospitals, physicians, technology, prices, flights, hotels and Türkiye’s opportunities. These matter. Sometimes, however, we must begin with what patients think. A person travelling thousands of kilometres for treatment entrusts health, time, money and perhaps one of life’s most vulnerable periods to another country, alongside choosing a hospital or physician. Perhaps the most important question is: why should a patient choose us? The journey begins before the hospital We imagine it begins at the airport, but it often starts much earlier, on a phone screen. Patients research illness and treatment, compare physicians, hospitals and countries, read experiences, view social media, ask relatives and their own doctor, contact an intermediary and request a second opinion. An impression of Türkiye forms before arrival. We must build trust digitally. Websites, physician biographies, first responses, response speed, clear treatment plans and previous patients’ experiences all influence the same decision. What is the patient really buying? People can compare a car’s specifications or a hotel’s location, photographs and reviews. Patients often cannot fully assess healthcare’s technical quality in advance. Trust therefore becomes central. They want to know whether the doctor understands them, why treatment is recommended, its risks and alternatives, who will meet them, how they will reach the hospital and what happens to accompanying family members. Above all: “Who will be beside me if something goes wrong?” A reassuring answer can matter as much as advanced technology. The patient is not always the sole decision-maker Marketing only to patients overlooks other influences. Families, referring physicians, insurers, public institutions and intermediaries may be decisive in different countries. A previous patient’s recommendation may outweigh advertising. Diaspora communities can be powerful bridges. Understanding a market means understanding everyone influencing the decision. Who is the patient? Who influences the choice? Who pays? Which channel is trusted? Where does information about Türkiye come from? If the answers differ by country, acquisition methods must differ too. Digital reputation is a form of capital Patients can gather extensive information about a Turkish physician within minutes from anywhere in the world, including others’ accounts. Poor communication can affect more than one patient; a well-managed journey can also have far-reaching benefits. Institutions must manage communication and digital reputation alongside advertising budgets. A WhatsApp response, the language of a report, how physicians present themselves, a clear quotation and a follow-up call are all part of the brand. A small professional interaction can sometimes create trust that major campaigns cannot. Price or uncertainty? Price matters, but patients do not always choose the lowest figure. Uncertainty also matters. Unexpected additional charges can undermine an apparently cheap offer. Patients ask what is included and what happens if further tests, intensive care or complication management are needed, and whether reviews and medicines are covered. Predictability matters alongside price. A higher, clearly defined offer may feel safer than a cheaper uncertain one. Communication is therefore also risk management. Physician choice and country choice are connected Patients may choose a physician, hospital, treatment method or the story of someone treated previously, rather than Türkiye itself. Country, hospital and physician brands are interdependent. A strong national healthcare brand supports physicians, while strong physician brands reinforce Türkiye’s reputation. Balance is essential. Institutions must not disappear behind personal brands, nor should physicians’ scientific and clinical reputations become invisible as institutions grow. Patients see the whole as one experience. Marketing continues after arrival The real test often begins in Türkiye: airport reception, interpretation, registration, consultations, tests, physician communication, navigation, family information and discharge. These shape perceptions. A gap between advertising and actual experience can destroy trust quickly. Perhaps the most important brand management is reducing the distance between the promise and the experience. Discharge is not the end of the journey After returning home, patients may need postoperative checks, medicines, rehabilitation, laboratory-result sharing, assessment of a possible complication or information for their local physician. They will ask: “Can I still reach my doctor in Türkiye?” This may be one of our strongest opportunities to differentiate. A second opinion before travel, treatment in Türkiye, digital follow-up at home and coordination with a local physician can create a continuous journey. Bringing patients to Türkiye demonstrates marketing success; remaining beside them afterwards demonstrates brand success. One patient can be worth a thousand advertisements Satisfied patients remain powerful advocates. People making health decisions may trust someone with the same experience more than an unfamiliar advertisement. Satisfaction can spread through families and communities. Each international patient is a potential reference for Türkiye. We should create an experience worth sharing, rather than constantly asking for posts. Perhaps we have been asking the wrong question. More advertising, fairs, social media and promotion have their place. But the patient asks something simpler: “Why should I entrust my health to you?” Every strategy should first answer that question. The answer lies in scientific competence, reliable hospitals, transparent communication, accurate information before treatment, attentive care in Türkiye and continued relationships after return. The choice forms long before the hospital door. Sometimes the deciding factor is the feeling: “They will truly look after me here.”

Health tourism, tourist health services and Türkiye’s integrated country experience When discussing health tourism, we often refer to our hospitals, physicians, technology and price advantage. These demonstrate a country’s healthcare capacity. Yet the decision to seek treatment in another country is not based solely on a comparison of clinical capabilities. Flight time, direct access, visas, language, cultural familiarity, the companion’s experience and overall trust in the destination all form part of the same decision. One of Türkiye’s major advantages is its position at the centre of a vast geography. When assessing this advantage, however, we must not confuse two distinct concepts. A person who travels to Türkiye specifically to receive healthcare and a visitor who suddenly needs medical care while in the country for a holiday, business or another reason do not belong to the same patient group. Both must receive safe, high-quality care, but their reasons for being in Türkiye, the way their services are organised and what they signify for Türkiye’s health tourism performance are different. In this article, I examine why Türkiye is chosen not only for its healthcare institutions but as a complete country experience, why the distinction between health tourism and tourist health services matters, and how that distinction should be reflected in statistics, planning and promotion. What does a four-hour flight radius really mean? Official sources state that Türkiye can reach approximately 1.3 to 1.5 billion people within a four-hour flight radius. The figure naturally varies by source and method of calculation. What matters is that much of Europe, the Middle East, North Africa, the Balkans, the Caucasus and Central Asia can be reached within the same day. The Investment Office of the Presidency of the Republic of Türkiye also reports that Turkish Airlines flies to 356 destinations in 132 countries. [1, 2] In healthcare, distance is not measured only in kilometres. It matters whether the patient can fly directly, return for a pre-operative assessment or follow-up, whether a companion can arrange travel easily and whether either can return home quickly when necessary. Accessibility is a direct part of the treatment decision, particularly in dentistry, ophthalmology, IVF, aesthetic surgery, orthopaedics, rehabilitation and procedures requiring follow-up. Even so, it would be wrong to treat the four-hour map as an automatic patient market. Not every reachable population constitutes a health tourism market. Income levels, health insurance, local treatment capacity, visa rules, language, political relations, payment habits and the people or institutions influencing patient decisions vary from one country to another. Geographic access is an important starting point; the real market emerges only when needs and relationships of trust within that population are analysed. People do not choose Türkiye only for its hospitals A patient arriving in Türkiye does not experience treatment in isolation. A spouse, child or another relative may travel with them. Treatment may last a few days or require weeks of rehabilitation. During that period, accommodation, transport, nutrition, communication, worship, daily needs and the companion’s time must also be managed. Türkiye’s historical and cultural heritage, familiarity with different faiths and ways of life, developed tourism infrastructure, range of hotels, cuisine, climate and diversity of cities create significant value. Family and cultural ties with Turkish communities in the Balkans, Central Asia, the Caucasus, the Middle East and Europe also make trust easier for some patients. Many people may already have visited Türkiye as tourists, become familiar with the country through Turkish television and media, or heard positive experiences from people close to them. None of these factors can replace clinical competence. However, when a patient is choosing between comparable treatment options, a destination that feels familiar, accessible and manageable for a companion may influence the decision. Limiting health tourism promotion to images of operating theatres, medical devices and physicians therefore tells only part of Türkiye’s real value. Hospital care and the country experience cannot be separated A patient’s impression of a country does not begin at the hospital door. The visa application, air ticket, airport reception, local transport, hotel, interpretation and hospital admission can build trust or increase anxiety before the patient even meets the physician. After treatment, access to a pharmacy, suitable nutrition, information for the companion, fitness to fly and the follow-up plan remain parts of the same experience. For this reason, the relationship between healthcare providers and the tourism sector should not be reduced to reserving a hotel room or arranging a transfer vehicle. When airlines, airports, accommodation providers, travel and insurance companies, local authorities, diplomatic missions and healthcare institutions work in isolation, the patient is forced to bridge the gaps between them. Türkiye’s experience in reception, accommodation and tourism services provides a strong foundation for health tourism. Yet healthcare requires greater sensitivity in timing, privacy, accessibility and clinical suitability. Transporting a patient after surgery is not an ordinary tourist transfer. The accommodation needs of a person undergoing rehabilitation are also different from those of a standard holiday package. Tourism expertise must be redesigned around the requirements of healthcare. Health tourism and tourist health services are not the same The Regulation on International Health Tourism and Tourist Health, dated 26 April 2025, clearly defines this distinction. Healthcare received by foreign nationals who come to Türkiye temporarily for health purposes, as well as by Turkish citizens residing abroad, falls within the scope of international health tourism. Tourist health services refer to healthcare provided for a sudden illness or emergency to foreign nationals who are temporarily in Türkiye for another reason. [3] Patient group Purpose of travel to Türkiye Planning implications Planned health tourist Travels to Türkiye specifically to receive healthcare. Market development, treatment planning, travel and follow-up are organised in advance. Tourist health Is in Türkiye for a holiday, business or another reason and develops a sudden illness or emergency. Emergency access, insurance, regional capacity and multilingual guidance become priorities. Citizen residing abroad Travels temporarily to Türkiye to receive healthcare. Diaspora links, social security, family ties and continuity of care should be assessed separately. These groups may receive care in the same institution, but they are not in Türkiye for the same reason. A planned international patient has selected Türkiye, a physician or a treatment in advance. A person receiving tourist health services chose Türkiye for a holiday, business or another purpose and developed a healthcare need afterwards. This is not merely a matter of terminology. It directly affects promotional budgets, workforce planning, insurance relationships, service capacity and performance assessment. Different stories within the same total Combining every foreign national or patient living abroad into a single total may show service volume, but it cannot explain health tourism success on its own. If a tourist treated in an emergency department after an accident while holidaying in Antalya, a patient who travels to Istanbul for planned cancer treatment and a Turkish citizen living in Europe who returns for an annual check-up are counted in the same statistic, we cannot understand which markets choose Türkiye or why. This distinction also matters for economic calculations. The treatment, accommodation, transport and companion expenditure of a planned health tourist can be organised in advance. Expenditure arising under tourist health services usually results from an unexpected need, emergency care or travel insurance. Both sources of revenue are valuable, but their origins and sustainability are not the same. A sound data system should separately track at least the purpose of travel, planned or emergency admission, country of residence, citizenship, clinical specialty, payment source, companion status, repeat visits and post-treatment follow-up. The 2025 regulation requires healthcare facilities and intermediary organisations to enter complete, accurate and current data into the HealthTürkiye Portal. [3] The value of this infrastructure lies not merely in producing a record count, but in revealing the geographies, services and patient groups for which Türkiye is genuinely preferred. Receiving treatment in Türkiye and choosing Türkiye for treatment It matters when a foreign visitor receives healthcare in Türkiye. The more meaningful indicator for health tourism policy, however, is whether that person deliberately chooses Türkiye when a health need arises. That choice is shaped collectively by clinical outcomes, the physician’s reputation, waiting time, technology, price, access, culture and trust in the country. Instead of looking only at the total number of patients, we should monitor the share arriving for planned care, which treatments bring patients from which countries, how they found Türkiye, how many return and how many recommend Türkiye to another patient. Tourist health data should be assessed separately in relation to emergency capacity, travel insurance, seasonal demand in tourism regions and patient safety. Such a distinction does not diminish health tourism. On the contrary, it makes Türkiye’s real competitive strength visible. It also prevents us from overlooking the particular needs of emergency healthcare provided to foreign visitors in tourism regions. Bringing Türkiye’s strengths together in one journey Türkiye combines healthcare infrastructure and tourism expertise within the same country. Its extensive flight network, strong accommodation capacity, healthcare services across different cities, thermal resources, cultural diversity and skilled workforce form a valuable combination. Yet the mere coexistence of these assets does not automatically create an integrated health tourism model. Shared standards and clear responsibilities are needed if patients are to experience them as one seamless journey. Destination promotion should explain not only the treatment package, but also where the patient will stay, what the companion can do, accessibility for people with disabilities, dietary and worship needs, the safe time to travel after treatment and whom the patient will contact after returning home. A physician’s assessment should determine which treatments can be combined with tourism activities and which require rest and medical supervision. Reducing health tourism to a holiday package may put patient safety at risk. Türkiye’s value is greater than the simple sum of a good hospital and an attractive tourism destination. The right model brings healthcare, transport, accommodation, the companion experience and continuity after treatment together under the same understanding of quality. What we measure tells us what to improve In the period ahead, assessing health tourism performance will require indicators more informative than the total number of foreign patients. Planned health tourists and tourist health cases should be reported separately, with analysis by market, specialty, city, payment source and patient journey. Countries with strong flight connections but limited patient flows should be compared with those that choose Türkiye despite more limited access. We can also monitor the length of stay of companions, repeat visits for treatment, returns for follow-up, complaint resolution times and the proportion of patients arriving through referrals, alongside the number of incoming patients. This would show more concretely how tourism infrastructure adds value to healthcare and how healthcare strengthens the national brand. Türkiye can reach a vast geography. It has one of the world’s most extensive international flight networks, strong healthcare institutions and decades of tourism experience. The central challenge is to manage the difference between being reachable and being chosen. Success in health tourism cannot be measured by placing every foreign patient in Türkiye under the same heading. Success means that when a healthcare need arises, people deliberately choose Türkiye, feel safe while here and can confidently describe their experience after returning home. Our hospitals are not the only reason Türkiye is chosen. But unless we manage the entire country experience in a way that adds value to healthcare, we will not make full use of our advantages. Sources [1] Investment Office of the Presidency of the Republic of Türkiye, Strategic Location. Türkiye’s access to a population of 1.3 billion within a four-hour flight radius and the Turkish Airlines network. [2] Republic of Türkiye Ministry of Transport and Infrastructure, statement on Türkiye’s access to approximately 1.5 billion people in 67 countries within a four-hour flight radius. [3] Regulation on International Health Tourism and Tourist Health, dated 26 April 2025 and numbered 32882; definitions of health tourism and tourist health, and registration obligations.

The New Paradigm of Health Tourism – Part 7 The new paradigm transforming health tourism worldwide is being shaped by the integration of technology into healthcare, alongside a wider range of services. Last week, we considered how health tourism extends beyond medical tourism and is becoming an ecosystem centred on quality of life, wellness and healthy ageing. New service areas alone will not bring about this transformation. The real change is taking place in how healthcare is delivered. The world is now discussing smarter, faster, safer and more personalised healthcare, as well as better treatments. Artificial intelligence lies at the centre of this transformation. How will artificial intelligence change health tourism? For many years, competition in health tourism largely revolved around hospital numbers, technology investment, physician quality and price. Success was assessed through incoming patient numbers and revenue. In the future, competition in health tourism will be between the digital healthcare ecosystems countries create, rather than hospitals alone. Digital experience will be an important element of competition in this new era. Before travelling to Türkiye, a patient will be able to receive a preliminary assessment through AI-supported systems, obtain recommendations for suitable hospitals and physicians, follow treatment in their own language and receive remote monitoring after returning home. Health tourism is becoming a comprehensive patient experience that begins and continues digitally, as well as a physical journey. People or artificial intelligence? The answer is clear. Artificial intelligence will not replace physicians; used correctly, it will become one of the most powerful tools supporting physicians and other health professionals. Healthcare is shaped by trust, empathy and human relationships, as well as data. Technology can accelerate processes, reduce risks and strengthen decision support. Yet it is still a person who reassures the patient, understands them and gives them hope. The future of health tourism will therefore rest on a model in which people and technology create value together. Artificial intelligence can shape the future of health tourism, but cannot create trust, empathy or the human touch on its own. AI may change the future of health tourism. Those who succeed will be the ones who empower people through technology. When a patient travels thousands of kilometres to another country, they purchase trust alongside treatment. AI can recommend the right hospital, analyse treatment options and accelerate processes. Yet a person still holds the patient’s hand, understands their anxiety and creates a sense of trust. Success in the future will belong to countries that offer advanced technology and a high level of human care together. A new field of competition in health tourism In the coming years, countries will compete through digital patient experience, AI-supported decision systems, remote healthcare, data security, personalised treatment plans and multilingual digital communication infrastructure, as well as hospitals. Patients are buying a safe, straightforward and seamless experience alongside treatment. In the past, countries competed through hospitals. Today, they compete through digital infrastructure. In the near future, competition will be between countries that integrate AI into healthcare most effectively. An important opportunity for Türkiye Türkiye has significant advantages through its strong hospitals, skilled workforce and experience in health tourism. If supported by AI, digital health applications and international data management, these strengths could make Türkiye a leading country globally as well as regionally. Success will belong to those who integrate technology most effectively with a human-centred approach to service. Türkiye has not arrived late to health tourism. In the AI era, it stands at the same starting line as many other countries. With the right strategy, it has an opportunity to become a leader in digital health tourism. Successful transformation, however, depends on protecting ethical principles and personal health data, and using AI with people at the centre. Perhaps it is time to measure success not only by how many patients arrive, but also by why they choose us, how much trust we build, the experience we offer and the sustainable value we create. In the future, quality will matter more than quantity. Last week, we described the new paradigm of health tourism as “a journey from treatment to wellness.” This week, we see that AI and digital transformation will be the principal drivers of that journey. But one fundamental truth must be remembered: AI can shape the future of health tourism, yet cannot create trust, empathy or the human touch alone. Perhaps the greatest competitive advantage will be the ability to bring AI together with trust, ethics and human-centred service.

Knowledge, technology and innovation are reshaping global strength. Healthcare stands at the centre. Hospital, bed and patient numbers alone no longer explain success. What makes a country a genuine leader: infrastructure and numbers, or research, technology, skilled people and public trust? Future leaders will develop systems, produce knowledge, guide technology and strengthen partnerships, alongside providing treatment. AI, robotics, digital platforms, biotechnology and personalised medicine matter. Yet equipment can be purchased; knowledge, trust, scientific ecosystems and people require long-term vision. Knowledge, Technology, Trust and People The pandemic demonstrated healthcare’s importance for economic stability, confidence, security and reputation. Leading countries invest strategically in research and technology. Knowledge supports innovation; technology supports competitiveness; trust supports sustainable success. Universities, hospitals, companies and public institutions need shared objectives. Leadership includes medicines, devices, responsible AI integration, ethical data management, international cooperation and sustainable human-centred care. Türkiye’s Next Objective Türkiye’s investments, workforce and health tourism achievements provide a strong position. The next objective should include technology, digital solutions, research and university–industry–public cooperation. Success should also mean less illness, better chronic disease management, stronger prevention, improved quality of life and reduced need for care. Strong systems keep communities healthy, alongside treating disease. Joint research, education, knowledge sharing and technology development with partner countries strengthen regions as well as nations. Technology in the Service of People AI supports decisions, robots support surgery and digital systems analyse data. People still build trust. Healthcare also involves conscience, ethics, compassion and respect. Leaders will use technology in people’s service. Real leadership prepares tomorrow’s world today through research, innovation, people, partnership and trust. Will we follow future systems or shape them? The answer depends on a shared vision for science, technology and the workforce, and the courage to begin building now. Behlül Ünver President, World Health Tourism Platform

Global healthcare is undergoing a major transformation. Health tourism now connects technology, AI, digital platforms, insurance, academic cooperation, investment and national brands, alongside travelling for treatment. It has become an area of strategic competition involving economic development, technology production and diplomacy. Türkiye’s investments over the past twenty years have built modern hospitals, strong infrastructure, skilled people, advanced technology and an advantageous position. The question now is where we want to be in 2028 and beyond. Quality, Access and Sustainability Successful systems must be cost-effective, accessible and sustainable as well as deliver quality. Financing will become increasingly central. Who pays, from which resources and for how long matters alongside care quality. Ageing, chronic disease, costly technology and growing demand require new solutions. Future systems must use resources efficiently and reach all parts of society. Health tourism, properly planned, can support this sustainability. The 2028 Vision Competition will favour countries building brands and trust, developing technology and knowledge, offering digital solutions and creating international influence. By 2028, Türkiye should improve quality, visibility and global institutional brands, becoming a preferred centre for high-value services. The ministries of Health, Culture and Tourism, Trade and Foreign Affairs, YÖK, universities, public and private providers, insurers and sector representatives must share a vision. Health tourism should be a lever strengthening the system’s quality, sustainability and international effectiveness. The 2035 Goals By 2035, Türkiye should be a global hub developing health technologies and AI solutions, delivering international education, exporting management models and helping shape healthcare investment. The Turkic republics, Gulf, Balkans, Africa and South Asia offer strategic partnership opportunities. Türkiye should contribute knowledge, experience and joint projects to system development. Remote care, AI diagnostics, personalised medicine, big data, digital experience and international networks will shape the future alongside mobility. Our existing strengths support these ambitions, but achieving them requires vision and planning today. A strong bridge between 2028 and 2035 can turn Türkiye from a regional participant into a global healthcare power: a country producing knowledge, developing technology, investing and helping shape the future.

Relationships between Türkiye and the Turkic states are gaining a new healthcare dimension alongside cultural and economic ties. Shared history, culture, social connections and developing political relationships support stronger cooperation. Turkic states are investing in infrastructure, workforce, technology and internationally aligned services. Türkiye’s experience, professionals, facilities and health tourism achievements make it an important regional reference. This quiet transformation across our ancestral and closely connected regions increases demand for internationally integrated systems. Türkiye offers both a model and institutional capacity for joint projects. Affinity extends beyond diplomacy to history, culture and strong human bonds. A Partnership Beyond Patient Mobility Develop joint healthcare projects. Train physicians and other professionals. Build university partnerships. Invest together in health technology. Cooperate in pharmaceutical and device production. Create sustainable system models. Health tourism matters, but future success also involves shared knowledge, investment, education and technology. Turkic states should work together to create value, develop and grow stronger. Their shared past builds trust; their shared future offers hope. Uzbekistan, Kazakhstan, Kyrgyzstan, Azerbaijan and Turkmenistan are experiencing significant transformation. Türkiye’s role should be a strategic partner sharing experience and creating value together. The Organisation of Turkic States’ vision can be supported by congresses, technology centres, university networks, digital platforms and regional investment. These partnerships offer global as well as regional opportunities. As I often express through Mevlânâ’s words: “Those who share feelings understand one another, even beyond a shared language.” Our objective should be a shared healthcare future. Working together strengthens regions as well as individual countries. Shared understanding, vision and objectives offer an important opportunity for the Turkic world. Behlül Ünver President, World Health Tourism Platform

The industrial revolution changed production, electricity accelerated industry and the internet redefined access to information. Artificial intelligence is now opening a transformation in healthcare. Physicians, AI, robots and digital technologies are becoming active parts of one ecosystem. Diagnosis, treatment, surgery, rehabilitation, management and health tourism are all affected. AI systems learn, analyse, compare and generate recommendations. Physicians develop expertise through years of education and experience, while AI can analyse scientific information across radiology, pathology, cardiology, oncology, dermatology, genetics, neurology and other fields. The future should combine human and technological capabilities for better decisions. AI as Clinical Support International studies show advanced models performing strongly on American medical licensing examinations. The important question is how physicians can work with AI to deliver safer, faster and more accurate services. People remain central. Empathy, ethics, experience, trust and humane care cannot be fully replaced. AI can strengthen decision support. Robotics and Advanced Technologies Three-dimensional imaging, augmented reality, high-resolution endoscopic vision and robotic platforms support precise surgery. Some applications show surgeons supporting operations across long distances. Communication advances may expand these capabilities. The article envisages quantum computing and AI contributing to drug discovery, personalised cancer care and genetic analysis, with implications for the health economy. Digital twins could model organs or physiology, enabling proposed treatments to be assessed digitally before use. Such developments may support personalised care and reduce complications. Hospitals Are Changing Some hospitals use robots to welcome and guide patients. AI supports laboratory analysis, interaction assessment and decisions. Logistics, medicines, stores, navigation and administration may increasingly use autonomous systems. The objective is to give professionals more time with patients. Next-Generation Health Tourism Future journeys may include AI-supported assessments, record analysis, risk maps and personalised planning before travel, advanced care in Türkiye and remote follow-up at home. Competition will increasingly involve technology development, data management and digital ecosystems alongside hospitals, patient numbers and prices. Türkiye’s Opportunity Infrastructure, people and experience provide a foundation. Türkiye should also develop AI, robotics, platforms and strategic data capabilities. Will we observe the future or help design it? Knowledge production, responsible data management and the ability to unite people and technology will be central strengths. Combining health technology with AI can also influence the wider economy. Healthcare is a strategic field connecting treatment, technology, data and international competition. The new era has begun; we must help shape it. Behlül Ünver President, World Health Tourism Platform

Medicine, longevity, hospitals and technology have advanced dramatically. AI, robotics, digital platforms and personalised medicine are reshaping services. These achievements raise a fundamental question: what is the true purpose of healthcare? Is it more hospitals, patients and surgery, or longer, healthier and happier lives? Consultations, procedures, equipment and expenditure matter, but do not alone demonstrate a healthy society. More treatment does not always mean more health. Spending rises while obesity, diabetes, cardiovascular disease, cancer and mental health problems persist. Healthy life expectancy does not necessarily improve at the same pace. “Health systems should create societies that need hospitals less.” Protecting Life and Well-Being The principle attributed to Şeyh Edebali, “Let people live so that the state may live,” expresses an understanding relevant to health policy. Protecting life includes prevention, healthy living, quality of life, mental and social well-being and peace of mind, alongside treatment. The Turkish words “sağlık” and “sıhhat” offer a meaningful distinction. Treatment addresses disease; health encompasses physical, mental and social well-being; “sıhhat” evokes balanced and peaceful living in a broader sense. Future systems should protect this holistic well-being. Prevention and Responsible Technology Prevention, nutrition, physical activity, mental health, improved environments and early diagnosis should be central. AI may help identify risks, anticipate chronic disease and personalise advice. Technology alone is insufficient. Trust, ethics, fairness, conscience, compassion and dignity remain essential. Whether described as healthcare, wellness, longevity, healthy ageing or health tourism, the shared purpose is protecting and improving people’s well-being. Health Tourism’s Wider Purpose Prevention, healthy ageing, rehabilitation, functional medicine, wellness and longevity will become more prominent alongside treatment travel. Türkiye’s infrastructure, experienced people, location, thermal resources and expertise provide opportunities to create health as well as treat illness. A well-known Ottoman verse expresses the value of health: “No worldly power can equal a single breath of well-being.” People’s health is among their greatest riches and strengthens the state. Measure the Life Made Possible We should measure how many people can live healthy, peaceful and productive lives alongside how many receive treatment. The most successful systems will produce health and holistic well-being. “Let people live so that the state may live.” “No worldly power can equal a single breath of well-being.” True value begins with protecting health and quality of life. Strong societies and states offer health, well-being and hope alongside treatment. Behlül Ünver President, World Health Tourism Platform

The New Paradigm of Health Tourism – Part 14 Behlül Ünver – President, World Health Tourism Platform We have long used numbers to describe success in healthcare: consultations, operations, beds used, tests and billed revenue. All matter, but none alone shows whether care is truly efficient. Efficiency means delivering care to the right patient, at the right time and place, by the right professional and with the right resources. Perhaps our question should extend from “How much service did we produce?” to “How much value did it add for the patient?” Volume and efficiency are different A physician seeing many patients or a hospital performing many procedures may appear highly productive. But shorter consultations, unnecessary tests, repeat visits, inappropriate levels of care or returns caused by complications can mean high volume without real efficiency. Healthcare volume is not the same as efficiency. The objective should be the best possible health outcomes through appropriate resources. Alongside patient numbers, we must assess time to correct diagnosis, treatment outcomes, repeat visits, complications, readmissions, experience and resource use. Payment models shape behaviour Payment arrangements may appear technical, but are among management’s strongest tools. Over time, systems tend to produce more of the outputs for which providers and professionals are paid. Fee-for-service may increase revenue as procedures increase. Bundled payment emphasises the cost and organisation of an entire treatment episode. Capitation can encourage prevention and resource management. Outcome- and quality-linked models recognise the result for the patient as well as the procedure. No model is perfect; each has advantages and risks. The priority is alignment with health policy objectives. Payment shapes behaviour, organisation and even healthcare culture. Why do SGK and SUT matter in Türkiye? The Social Security Institution, SGK, and the Health Implementation Communiqué, SUT, are important determinants of healthcare financing. Institutions use this system to assess which services qualify for reimbursement and under what conditions. Tariffs therefore influence investment, organisation, developing service areas and working practices, alongside revenue. The more important question, beyond whether prices are high or low, is whether payment encourages appropriate care. Can an institution improving quality, reducing complications, maintaining the right level of care, preventing unnecessary procedures and reducing readmissions receive economic support? Or does the system mainly reward volume? Without the right connection between payment and clinical quality, financially rational behaviour may differ from what is best for patients. Policy should bring these closer together. More value beyond procedure numbers Value-based healthcare is increasingly discussed internationally. It assesses the system’s value through patient outcomes alongside activity. Surgical success can include complications, readmissions, functional recovery, satisfaction and quality of life after treatment. This encourages providers to consider the whole journey. Efficiency then takes on a different meaning. It means avoiding unnecessary care, reducing complications and repeat visits, and achieving the right outcome with appropriate resources. How should public performance be measured? Public hospital performance should include waiting times, outcomes, complications, readmissions, bed turnover, resources, patient and employee satisfaction, educational capacity and research, alongside consultations, surgery and revenue. The same applies to staff performance systems. A system rewarding only greater activity can create an imbalance between quantity and quality. Quality, teamwork, safety, education and outcomes should carry weight. Care is a team result: physicians, nurses, technicians, pharmacists, physiotherapists, administrators and others contribute to the same journey. The right care at the right level Directing every problem to a hospital, every hospital visit to an advanced centre and every patient to a specialist may create unnecessary pressure. Strong primary care, referral pathways, chronic disease management, home care, remote care and prevention improve experience and reserve expensive hospital capacity for those who need it. Sometimes efficiency means preventing the need for services. Monitoring diabetes before complications, controlling hypertension before stroke and avoiding unnecessary elderly admissions are valuable, though less visible, outcomes. Outcomes and bundled care in health tourism Offering only a procedure price can trap Türkiye in price competition. We should aim for high healthcare value. An orthopaedic package could cover assessment, surgery, admission, rehabilitation, complication management and digital follow-up. An oncology journey could combine diagnosis, molecular assessment, planning, medicines, supportive care and monitoring. This offers price transparency, improves process management and builds an outcome-focused brand. The “net health value” discussed last week is relevant here. Success should include the capacity, technology, workforce and clinical quality contributed to the system, alongside revenue. The same question for public and private providers Funding, responsibilities and patient profiles may differ, but the fundamental question remains: how much health value do we create for the resources spent? Private providers must closely monitor investment sustainability, costs and experience. Public providers carry responsibility for access, equity and financial sustainability. Türkiye should discuss flexible combinations of payment methods according to service, disease group, institutional role and intended outcomes. Bundled payment may suit some services, capitation others, and outcome- and quality-linked payment selected specialised treatments. What matters is the behaviour and results created. After years of asking how much service we produce, perhaps it is time to ask how much value that service genuinely adds for patients. The most successful system may be the one delivering the best outcomes to the right patient, at the right time and place, with the right resources. Perhaps real efficiency means doing what is needed more effectively.

Accessibility is a new field of competition in health tourism. We often ask which treatments, markets, prices and promotional strategies will help us grow. A more fundamental question is whether everyone can genuinely access our services. According to WHO, approximately 1.3 billion people, one in six worldwide, experience significant disability. Ageing, chronic disease and longer lives suggest increasing needs. Accessible services also support older people, temporary mobility restrictions, postoperative needs, visual or hearing loss and companions. Accessible health tourism makes the whole journey safe, independent and respectful of human dignity. An Accessible Healthcare Ecosystem Accessibility is a fundamental quality criterion throughout health and tourism. Disability often reflects a mismatch between people and their environment. Someone independent at home can become dependent abroad because a transfer vehicle, room, hospital entrance or device is inaccessible. Systems must respond to different needs. International patients face unfamiliar language, transport, health and safety concerns simultaneously. Reducing uncertainty creates trust. Accessibility Begins Before the Hospital The journey starts with online searches, enquiries and information documents. Can a screen reader use the website? Are captions or sign language available in video consultations? Are documents clear and accessible? Do patients know their transfer arrangements? Are rooms, examinations, imaging, toilets and rehabilitation accessible? Is emergency communication possible? Digital information, travel, transfers, accommodation, hospitals, treatment, rehabilitation and follow-up form one chain. One inaccessible link can undermine the experience. Ramps Are Not Enough Ramps, lifts and wide doors are necessary. Communication, digital access and institutional readiness also matter. Sign language, visual and audio guidance, accessible consent, easy-read information, compatible platforms and adapted remote services should be standard components. The objective is independent decisions, privacy and movement with as little unnecessary reliance on assistance as possible. Good intentions alone are insufficient. Healthcare staff, advisers, transfer teams and hotel employees need training in communication with different disability groups. An Important Opportunity for Türkiye Hospitals, workforce, rehabilitation experience, thermal resources, physiotherapy and tourism diversity provide strengths. Separate accessible facilities do not automatically create an ecosystem. Airports, transport, hotels, city mobility, rehabilitation and digital follow-up need shared standards. Bringing these together could make Türkiye a leader in managing complete journeys. UN Tourism recognises accessibility as an area of transformation and competitiveness. It benefits families with children, older people, temporary health conditions and companions as well as people with disabilities. Investment improves safety and comfort for everyone. Build Accessible Health Corridors Türkiye should establish continuous models for particular countries and needs, from airport arrival to remote follow-up. Hospitals, rehabilitation, thermal facilities, hotels, transfer companies, assistive-device providers and representatives should share a quality system. Multilingual accessible communication and one coordination point should support patients and companions throughout. ISO 21902 provides an international tourism accessibility framework. Türkiye can combine it with clinical quality and safety standards. The objective should include measuring real experience. Design Together with People with Disabilities Users and representative organisations should be design partners. Their experience best reveals which physical arrangements, digital applications and communication methods work. Projects may appear compliant yet create barriers if that experience is ignored. Participation also strengthens ethics, enabling independent, safe and informed decisions. New Measures of Success Alongside patient numbers and revenue, measure genuinely accessible institutions, trained staff, digital access, continuous transfers and accommodation, patient and companion satisfaction, complaint resolution and follow-up. Accessibility claims on websites and promotional materials should receive independent scrutiny. Unexpected barriers can damage institutional and national trust. Health Tourism for Everyone A global brand anticipates diverse needs, protects dignity and includes everyone in the service chain. Accessible health tourism combines human rights, quality, diplomacy and economic opportunity. True quality is measured by how safely and independently the person needing the most support can make the journey. Behlül Ünver President, World Health Tourism Platform

Last week, we discussed sustainability in health tourism and concluded with these words: “The future of health tourism will be shaped not only by technology or investment, but by countries that can build trust.” Today, I would like us to consider why that trust is the most valuable capital in health tourism. Health tourism differs from other sectors. People may make a mistake when buying a car, be disappointed with a hotel, or exchange a product they do not like. But when health is involved, a decision often directly affects a human life. Its consequences also extend beyond the patient. Negative experiences can cause significant damage to a country’s international reputation and healthcare brand. For this reason, an international patient’s first priority when choosing a country for treatment is trust. Of course, price matters. Technology matters. The physician’s experience matters. Yet above all of these stands an invisible value: Trust. Our work across different regions over the years has shown me an important truth. Trust is not built in the same way in every country. Imagine opening a representative office or patient coordination office in the United States. Even if everyone working there is a professional from Türkiye, establishing trust at the outset will take time. The American healthcare system rests on strong institutions, local references, legal safeguards and brand perceptions built over many years. Being good is not enough; you must demonstrate that quality in a way the local community will accept. In contrast, the dynamics of trust are different in the Turkic states, the Middle East and much of Africa. Shared history, cultural affinity, human relationships, cooperation between states and personal references can significantly accelerate the process. Europe has a different structure again. Here, cultural affinity alone does not create trust. Accreditation, international quality certifications, scientific publications, digital visibility, patient experiences, legal frameworks and institutional transparency play decisive roles in decision-making. There is therefore no single model of trust in health tourism. Each region has its own sociological, cultural and economic dynamics. This is precisely why success depends not only on building good hospitals, but also on understanding the target market correctly. It is unrealistic to expect to succeed throughout the world by approaching every country in the same way. This is one reason some of our institutions struggle in international markets today. Marketing strategies are often shaped by our own habits rather than the expectations of the countries we seek to reach. Trust, however, is built by understanding the target country’s culture, analysing its expectations accurately and developing long-term relationships. Health tourism is no longer simply a sector that provides treatment. It is also an instrument of health diplomacy that builds bridges of trust between countries. When a country is trusted, patients are not the only ones who come. Investment follows. Academic cooperation develops. Scientific projects increase. Knowledge exchange between health professionals grows stronger. International brand value rises. That is why trust is health tourism’s most valuable capital. Unfortunately, this capital cannot be bought through advertising campaigns. It is built over years, yet can be lost very quickly through poor practice, inadequate communication or unethical behaviour. Trust resembles the relationship a father builds with his child. It takes years of effort, but one mistake can quickly damage what has accumulated over that time. Once trust is lost in health tourism, rebuilding it is extremely difficult. Türkiye has gained an important advantage through its strong healthcare infrastructure and skilled workforce. Our greatest goal now is to turn that advantage into lasting international trust. The winners in the future of health tourism will be countries where international patients can confidently say, “I trust this country,” rather than simply those with the largest hospitals. In our next article, we will consider how a health tourism brand is built through trust, quality and sustainability, as well as promotion. Behlül Ünver President, World Health Tourism Platform