Descriptive Analysis of International Bariatric Surgery Tourism Services: A Focus on Low-Cost Medical Tourism in Turkey

Cost savings

The primary reason for the growth of bariatric surgery tourism in Turkey is the significant cost savings compared to other countries. The average cost of bariatric surgery in Turkey is between 50-70% lower than in the United States and Western Europe (Ozdemir & Gurses, 2018) [2].

High-quality healthcare

Turkey has a well-developed healthcare infrastructure with highly skilled healthcare professionals. Many Turkish hospitals are accredited by the Joint Commission International (JCI), which signifies adherence to international healthcare standards (Ozdemir & Gurses, 2018) [2].

Government support

The Turkish government has implemented policies to promote medical tourism, such as easing visa restrictions, offering tax incentives, and investing in healthcare infrastructure (Ozdemir & Gurses, 2018) [2].

Geographical location

Turkey's central location between Europe, Asia, and Africa makes it an easily accessible destination for medical tourists (Ozdemir & Gurses, 2018) [2].

Advantages

Cost savings

As mentioned earlier, significant cost savings are the primary advantage of bariatric surgery tourism (Crooks et al., 2010) [1]. Access to specialized care Traveling for bariatric surgery allows patients to access specialized care that may not be available in their home country (Crooks et al., 2010) [1].

Shorter waiting times

Bariatric surgery tourism can help patients bypass long waiting lists in their home country (Crooks et al., 2010)[1].

Disadvantages

Risk of complications

The risk of complications is higher when undergoing surgery abroad due to factors such as language barriers and unfamiliarity with the healthcare system (Crooks et al., 2010) [1].

Difficulty in follow-up care

Traveling for surgery can make it challenging to receive appropriate follow-up care, which is crucial for bariatric surgery patients (Crooks et al., 2010) [1].

Ethical concerns

Medical tourism may divert resources from local healthcare systems, exacerbating healthcare inequities (Crooks et al., 2010) [1].

Patient safety is a paramount concern in bariatric surgery tourism.

Accreditation and certification, such as JCI accreditation, can help ensure that healthcare providers adhere to international standards (Ozdemir & Gurses, 2018) [2].

Patients should research the credentials of the healthcare providers and the facilities before making their decision. In order to fulfill their weight loss goals for obese patients.

Additionally, seeking the assistance of medical tourism facilitators can help patients find accredited hospitals and qualified surgeons (Lunt et al., 2011)[3].

Impact on destination countries

Medical tourism can boost the economy of destination countries through increased revenue and job creation (Connell, 2013)[4]. However, there may be negative consequences, such as diverting resources from local healthcare systems and exacerbating healthcare inequities (Crooks et al., 2010)[1].

Impact on source countries

The outflow of patients seeking bariatric surgery abroad can lead to a loss of revenue for domestic healthcare providers. It can also provide an incentive for source countries to improve the accessibility and affordability of bariatric surgery within their healthcare systems (Lunt et al., 2011)[3].

Positive patient experiences and word-of-mouth

Positive experiences of patients who have undergone bariatric surgery in Turkey contribute to the growth of medical tourism. Word-of-mouth recommendations play a significant role in attracting more patients (Connell, 2013)[4].

Online presence and marketing

With the widespread use of the internet, Turkish healthcare providers and medical tourism facilitators have effectively marketed their services online, making it easier for prospective patients to access information and compare options (Lunt et al., 2011)[3].

To minimize the risks associated with bariatric surgery tourism, patients should: Thoroughly research the destination country's healthcare system, accreditation, and certification of healthcare providers and facilities (Ozdemir & Gurses, 2018) [2].

• Consult with their primary care physician and specialists in their home country before deciding on bariatric surgery abroad (Crooks et al., 2010) [1].
• Obtain detailed information about the surgical procedure, potential complications, and postoperative care (Crooks et al., 2010) [1].
• Arrange for follow-up care with healthcare providers in their home country before traveling for bariatric surgery (Crooks et al., 2010) [1].

Medical tourism facilitators play a significant role in the bariatric surgery tourism industry.

They act as intermediaries between patients and healthcare providers, offering services such as:

• Providing information on destination countries, healthcare providers, and facilities (Lunt et al., 2011) [3].
• Assisting with travel arrangements, accommodations, and postoperative care (Lunt et al., 2011)[3].
• Coordinating communication between patients and healthcare providers, including language interpretation services (Lunt et al., 2011)[3].
• It is essential for patients to choose reputable medical tourism facilitators to ensure that they receive accurate information and support throughout their medical journey.

Governments and policymakers in both destination and source countries play crucial roles in regulating and promoting medical tourism.

They can implement policies that: Ensure patient safety and quality of care by enforcing strict accreditation and certification requirements for healthcare providers and facilities (Ozdemir & Gurses, 2018) [2].

Address healthcare inequities by investing in domestic healthcare systems and providing affordable access to specialized care (Lunt et al., 2011) [3].

Promote transparency and ethical practices within the medical tourism industry, including providing accurate information to patients and ensuring that healthcare resources are not diverted from local populations (Crooks et al., 2010) [1].

Facilitate international collaboration and sharing of best practices in bariatric surgery and medical tourism (Connell, 2013) [4].

Legal and ethical issues related to bariatric surgery tourism are important to consider for patients, healthcare providers, and policymakers.

Some of the challenges include:

Jurisdiction and liability

In the event of medical malpractice or complications, determining jurisdiction and liability can be complex, as patients may have limited legal recourse in the destination country (Cohen, 2012) [5].

Informed consent

Ensuring that patients receive comprehensive and accurate information about the risks, benefits, and alternatives of bariatric surgery is essential for informed consent.Language barriers and cultural differences may complic ate this process (Cohen, 2012) [5].

Exploitation of vulnerable populations

There is a risk that medical tourism may lead to the exploitation of vulnerable populations in destination countries by diverting resources from local healthcare systems and exacerbating healthcare inequities (Crooks et al., 2010) [1].

Privacy and data protection

Protecting patients' privacy and medical data in the context of medical tourism can be challenging, given the differences in privacy laws and data protection standards between countries (Cohen, 2012) [5].

To address these legal and ethical issues, patients, healthcare providers, and policymakers should:

• Advocate for the development of international legal frameworks and guidelines that protect patients' rights and interests in the context of medical tourism (Cohen, 2012) [5].
• Encourage transparency and accurate information sharing by healthcare providers and medical tourism facilitators, including providing comprehensive informed consent materials in patients' native languages (Cohen, 2012) [5].
• Promote ethical practices within the medical tourism industry, ensuring that healthcare resources are equitably distributed and not diverted from local populations (Crooks et al., 2010) [1].
• Strengthen privacy and data protection standards across borders by developing international agreements and harmonizing national laws (Cohen, 2012) [5].

International bariatric surgery tourism, particularly low-cost medical tourism in Turkey, has experienced significant growth due to factors such as cost savings, high-quality healthcare, government support, and geographical location.

While there are advantages for patients seeking bariatric surgery abroad, there are also potential risks and ethical concerns that need to be considered.

Ensuring patient safety and the quality of care through accreditation and certification is crucial through their weight loss journey..

Furthermore, understanding the potential implications for healthcare systems can help inform policies and practices that balance the benefits and drawbacks of medical tourism.

Sources

1.  Crooks, V. A., Kingsbury, P., Snyder, J., & Johnston, R. (2010). What is known about the patient's experience of medical tourism? A scoping review. BMC Health Services Research, 10(1), 266.
2.  Lunt, N., Hardey, M., & Mannion, R. (2011). Nip, tuck and click: Medical tourism and the emergence of web-based health information. The Open Medical Informatics Journal, 4, 1-11. 
3.  Connell, J. (2013). Contemporary medical tourism: Conceptualisation, culture and commodification. Tourism Management, 34, 1-13. [5]