As a guest to Let's Talk Business, Hüseyin Bozkurt, DDS and chairman of Medicana's board of directors, told Today's Zaman that his company will soon launch an initial public offering (IPO) to become a publicly traded company in a bid to finance the large investment projects it has planned. Bozkurt also revealed that Medicana is open to investment offers and joint ventures provided that it will contribute to the company's growth in the health industry.

With seven state-of-the-art medical hospitals in İstanbul and Ankara and more planned in other cities, Medicana is privately financed and managed by a premier hospital group in Turkey. "We can compete with European rivals easily," Bozkurt claimed. "The group employs the latest available technology in medical science and hires the best doctors and technicians in the country." Medicana is the largest group in Turkey staffed with professors and instructors from medical schools.

The group has invested $350 million so far for building new hospitals and refurbishing existing ones. It caters to a variety of clientele, from VIPs to regular citizens with state-financed health coverage. The Medicana International Hospital, located in Beylikdüzü, an upscale neighborhood in İstanbul, is designed to offer services with international standards. "We provide health and wellness services for heart surgery, advanced cancer treatment, cosmetic surgery, a fertility clinic, brain surgery and organ transplant in this hospital," Bozkurt said, adding that Medicana's surgery success record is well above the world average.

The Medicana chairman described the group as the "trendsetter" for the health industry in Turkey as it incorporates other well-known illness treatment centers in the nation. It employs 500 doctors. "We are the largest private group whose staff provides presentations and research papers in seminars and conferences in Turkey," Bozkurt said.

Situated on 30,000 square meters, Medicana Beylikdüzü was built with quake-resistant technology and equipped with environmentally friendly features. In the event of a major disaster, most halls and lobby areas can be converted to treat the wounded by providing space for more beds. The Beylikdüzü hospital has four intensive care units and is located next to the E-5 highway, a major transportation artery in İstanbul, thereby providing easy access to emergency services.

Medicana different from others

What makes Medicana different from others, Bozkurt said, is the fact that it is the only private hospital in Turkey that can offer most health services in one location. Access to overnight patient rooms is separate from same-day treatment rooms, which is convenient and maintains hygiene. The floors and walls are coated with anti-bacterial, anti-static and anti-allergic paint to maximize patient comfort.

Medicana Ankara International, which opened its doors in October, is the latest addition to the group. The hospital, the largest private health center in Ankara, is designed with the amenities a five-star hotel for its VIP patients. "We assigned the whole floor to our VIP patients," Bozkurt said, indicating that they are targeting diplomats, bureaucrats and dignitaries in the capital. The Ankara branch is equipped with an advanced cancer treatment center, a dialysis unit, and emergency and intensive care units.

"As far as health tourism concerned, we are trying to promote Turkey as the most important destination country in the region," Bozkurt said, underlining that patients can receive treatment at half the cost they pay in Western Europe or the US. Bozkurt noted that he toured the world's major hospitals and said he believes the quality of health care Medicana provides reaches and even exceeds the standards applied in those hospitals. "What we lack," he said, "is the promotion and public campaign to make Turkey known all over the world."

Bozkurt also believes Turkey can benefit by having its citizens abroad receive major health services in Turkish hospitals. He mentioned that half of the population of Turkish expatriates has reached retirement age and that they can be a good market for the Turkish health industry. "We can offer competitively priced surgery and operations to Turks living in Germany, Belgium, Austria and France," he said. This, however, requires Turkey's close cooperation with respective countries to extend the coverage beyond national boundaries. "Since we are a privately funded company, only the Turkish government can negotiate such contracts with other countries," Bozkurt noted.

Mentioning that many people from the US and Europe go to India, Singapore and other Far Eastern countries for health and spa reasons, Bozkurt argued that Turkey can do better in attracting those customers as it is geographically closer to the countries of origin. Turkish health companies view Europe and the US as important markets for health tourism because of Europe's aging population and the 46 million people in the US who are uninsured.

Turkey holds a $400 million share in $120 billion health tourism in the world today. Approximately 200,000 tourists visit Turkey for health reasons every year, mostly to get eye treatment, dental examinations and plastic surgery. The cost comparison makes Turkey an attractive market for consumers. For example, laser surgery on both eyes costs 3,000-5,000 euros in Europe, whereas it costs 1,500 euros in Turkey, including flights and three-night hotel accommodation.

Bozkurt appreciated the reforms the Justice and Development Party (AK Party) has undertaken in the health industry since 2003 and said it paved the way for private investors to build hospitals and medical centers at an unprecedented pace. He cautioned, however, that a lot needs to be done. At the top of the list is the 30 percent cap on government contribution payments for services rendered in private hospitals in order to prevent misuse and abuse. "It simply does not add up in offsetting our costs and does not make any sense," he said. According to a new law, private hospitals can bill the government only for 30 percent of what they charge the patient.

Turkey needs more nurses

"This cap covers not only services the doctor provides but also other services like blood work, MRI imaging, etc.," Bozkurt said. "The government is asking us to foot the bill and to provide services at a loss." He warned they have no choice but to withdraw from the system and stop accepting people with state-funded health insurance.

Medicana, like many other health institutions in Turkey, is plagued with a lack of nurses and health technicians. Bozkurt is advocating a plan to establish a private medical school to educate students to fill empty slots in hospitals and medical centers. Statistics show that Turkey is lagging behind EU countries in terms of the number of nurses employed. While 731 nurses work per 100,000 people in the EU, this number is 131 nurses in Turkey. The numbers are much worse when it comes to health technicians for services such as MRIs and angioplasties, he added.

Bozkurt explained that Medicana's plans include getting a firm hold in at least 10 major cities nationwide. Bozkurt cautioned, however, that the group's main motivation is not the money. "If we wanted to make money, we would have ventured into a different sector," he argued, emphasizing that hospitals are open 24 hours and that the staff can't simply punch out at usual business closing hours. "It is a very difficult occupation," he said, "as nobody is enthusiastic to pay a visit to the hospital except for much-cherished pregnancies. … We wanted to help people, get them well and feeling good about their health."

In a bid to regulate the health industry, the Turkish government has revamped the licensing process for private hospitals and restricted the opening of new ones. The Ministry of Health is charged with distributing licenses, and the decision is based on the analysis of market need to prevent clustering and mushrooming in specific areas. There is also a yearly cap on the number of hospitals that can be opened. The quota for 2009 is already filled.

The Medicana group is holding onto new projects until the dust clears in the market, which has been shaken by the global economic slowdown. "Up to a certain point, the group had been financing the expansion with its own financial resources," Bozkurt said. "New hospitals like the ones Beylikdüzü, Ankara and Konya required external financing." Because these state-of-the-art hospitals are expensive to build, the group used long-term loans that usually fall due in eight or nine years.

Bozkurt also mentioned that there is shortage of doctors in Turkey. "We need to double the number of doctors to adequately address the deficiency in the system," he said. He criticized the concentration of so many doctors in some state-funded hospitals despite a shortage in others. "It is simply bad human resources management," he said. In EU countries, the number of doctors per 100,000 people is 400 while that number is 140 in Turkey.

He also expressed his frustration about Turkey's slow-moving bureaucracy, and he criticized laws preventing foreign doctors from practicing in Turkey. Current law mandates that doctors working in Turkey have to be Turkish citizens and that they need to hold a diploma from a Turkish medical school. Parliament adopted a law in 2007 lifting those requirements, but then-President Ahmet Necdet Sezer vetoed the law, citing preferential treatment of foreigners over natives.

Bozkurt said Medicana attaches importance to its patients' privacy and confidentiality and safeguards hospital records. The only time the hospital shares information is for legitimate reasons, such as a court ruling that requests disclosure or in compliance with an official investigation as directed by the law. The group abides by the rules of the patient bill of rights and provides liability coverage for malpractice.

Todays Zaman