Observations on healthcare – US vs. Turkey

Below are some of my observations and impressions on Turkish healthcare as compared to the American system.  Some good, some bad, some indifferent.

The Red Crescent is the equivalent of the Red Cross

In Turkey, one can get almost any prescription drug they want without a prescription.  The pharmacists need the prescription for insurance purposes.  But a person can get what they need if they have the money for it, without a prescription.  There are some “controlled” drugs for which a person absolutely needs a “green” prescription.  (I guess green is the go light!)  But other than that, getting meds is pretty easy.  In the U.S., you need a prescription whehter you have insurance or not, for everything.  One big difference is that American drugstores sell everything – there is a pharmacy counter usually in the back of the store for prescription meds.  But there is a lot more available “over the counter” that we don’t actually get from the pharmacists such as lower-grade pain killers, cold medicines, etc.

In Turkey,  prescription medicines come in the original packaging from the pharmaceutical company.  So if a person needs to take an antibiotic for 10 days, but it comes packaged in a 15-day pack, then that’s what they get and pay for.  No additional labels are added except for a possible handwritten note with dosage information.  In the States, except for a handful of exceptions, drugs usually are counted out to the specifics of the doctor’s prescription.  They are repackaged, and re-labeled for the patient’s use.  No wonder we have such long lines at the pharmacies in the U.S.!

American Prescription Bottles

In my experience, I find that doctors will more easily write a prescription here in Turkey for people they know, without having seen them as a patient.  In the U.S., this is a HUGE no-no!  I’m not saying it isn’t done.  We all appreciate when a doctor will write a prescription and call it in for us after a telephone conversation.  But it is rare in the U.S., that a doctor will risk his license for things like, “I have back pain.  I need something stronger!”  I was shocked when a doctor here, who works for Parliament, offered me a prescription for the “allergy” on my face.  It was very kind to offer, but we weren’t in a medical setting, or even having a related conversation.  The doctor had never seen me as a patient.   The offer came “out of the blue”.  Besides, I don’t have an allergy.

Typical Turkish Packaging

In Turkey, doctors and medical students have recently gone on strike to protest the Full Workday Law. “The Full Workday Law aimed to prohibit doctors working at public institutions from working at private practices of their own or other private institutions in addition to that. It also introduced a performance evaluation system for faculty members who work at university hospitals, matching the system currently in place at state hospitals.” http://www.worldbulletin.net/?aType=haber&ArticleID=72763.  The performance-based evaluation system is also slated to tie university doctors’ salaries to the number of patients they treat. Doctors who are instructors at univeristies often have a very small income.  They supplement their income by having a private practice as well.  This law forces them to make a choice, private practice or public institution.  I can only imagine how many instructors will have to leave their jobs. It has also forced doctors to take on more patients than they can handle.  Lines of patients are forming, doctors are becoming over-worked.

According to Law Number 1219, foreign doctors are forbidden to work in Turkey, with very limited exceptions.  In  the U.S., foreign doctors can get a visa to work in particular settings until they get permanent residence status.  They do not need to be a citizen.  As of 2006, Turkey had 1.6 physicians per 1,000 people, two times less than the OECD average of 3.1.  http://www.takingupresidence.com/turkey/employment/foreign-doctors.7.html. It just doens’t make sense to me.  If you need more doctors, why not let more in?  My understanding is that the ban also includes doctors that come to Turkey to teach.  It seems to me that sharing and teaching of medical techniques and technology should have no boundaries!  It’s not like I am suggesting that Turks allow lawyers to practice!  Geesh!

Mental healthcare in Turkey is still relatively new.  Psychologists and psychiatrists meet the same obstacles as they did in the US generations ago.  People here sort of look at mental healthcare as taboo.  They don’t talk about it.  That being said, I do hear that more and more people are seeking out help for their children, even if not for themselves.

A few months ago, I met a couple of missionaries who were working on obtaining and providing heavy-duty wheelchairs to those in need here in Turkey.  Wheel chairs are not something commonly seen in the streets.  The sidewalks are so poorly made and often too high, that wheelchairs could never maneuver them.  It’s great work that the couple are doing here.  Now, if only standards could be enforced for the building of sidewalks!  In this way, Turkey could really follow America’s lead.

And finally –

Being married to a Turkish citizen, I was quickly added to his health insurance plan.  Nice right?  No additional payments necessary.  Now that doesn’t happen easily in the US!

That’s all for now!

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7 thoughts on “Observations on healthcare – US vs. Turkey

  1. T,

    With you being married to a Turkish citizen, can you buy property in Turkey and have in put in your name or must it be put in your husbands name only?

    • Funny you should ask that. We actually looked at a lovely property this weekend. It was very big, full of rocks, but big. Looked like a nice place to build.

      I know that foreigners can buy property here. Vacation areas are filled with Brits! I don’t know what it entails or how it changes the dynamics of the sale – taxing, etc. I’ll let you know when I get to it, or if I happen to stumble across that info.

  2. Health care in the US has become a major industry since the introduction of private health insurance. It’s too much about the Benjamins, and not enough about taking care of people. You and I saw part of the very ugly side of this when working on those pharmaceutical antitrust cases.

  3. Very interesting topic indeed! Thank you for pointing out the problem of disabled people to even go out of their homes in most areas of Ankara, this is something i am always observing and it’s a pity disabled people becomes even more dependent on others simply because the side-walks are not properly designed and built! In that sense, I think the US is an example for the rest of the world, including my own country in which only recently things have started to change.

    As for prescription drugs. People normally take more prescriptions than necessary when it is a long treatment simply not to wait for an appointment and stand the queues. I prefer the American system of prescription drugs because it prevents many of them from being wasted, buying the dose you need should be the rule (at least, from my point of view :)).

  4. Thanks for this article! I’m a medical student in the UK and was thinking about emigrating to Turkey, so this is quite useful in helping make a decision. That link you posted about them making it hard for foreign doctors makes a reference to passing a law in 2009. Is there any update on this? I know you’re not an expert in this field, but anymore information you could share would be greatly appreciated! =)

    • Hello and thanks for reading my blog! You are right, I am no expert in the field. I can’t practice law here since I am not a ctizen. I have not heard of any updates, but I don’t keep up with it either. YOu probably read in the Hurriyet that there is an exception, but it is very difficult to get. You may try checking with your Embassy in Turkey. If I see or hear anything, I will let you know. Laws change kind of quickly here and I know there have been recent changes in healthcare.

  5. Hi Terry,

    I am marrying a Turk which we thought he and I would settle in the US. However, his parent is ill and we were talking about me going there. I am a US Educated Doctor. I came upon your article and am very interested in learning more.

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