With its blue coasts, warm climate, thermal hot springs, storied history, and culinary delights, Turkey has nearly always been an epicenter for international tourism. Located at the conflux of southern Europe, the Middle East, Africa, and the Balkans, the country’s geography and culture appeals to all varieties of visitors, and its economy is supported by millions of travelers each year.

But as Turkey works to keep its foothold during a global recession, its leaders are seeking new ways to sustain the tourism economy. Taking demographics and international spending patterns into account, government ministers, business owners, and land developers are beginning to embrace a new trend: healthcare tourism.

An aging population, combined with the need to provide the most advanced healthcare services to both local citizens and visitors from abroad, has led to national investment in public-private healthcare projects that will combine Turkey’s already robust tourism industry with its culture of wellness. The Turkish government is poised to invest significantly in its healthcare infrastructure in the years ahead, pairing public dollars with private investment to make its hospitals and clinics more innovative and competitive.

While significant healthcare infrastructure exists in Turkey’s urban centers, several new projects and billions of investment dollars will be needed to support the national initiative, particularly in more rural or developing areas. As a result, local industry groups are seeking out expertise from United States-based architecture and engineering firms that have significant experience in international healthcare and senior living design.

“Human beings have a single priority, which is health. Turkey should be a candidate for being the health center that welcomes all citizens of the world with its fully equipped hospitals, specialists, and high technologies,” says Ibrahim Artukarslan, president of the Turkish Health Tourism Organization (TUHETO), an organization that works to position Turkey as a global healthcare destination for patients seeking cutting-edge medical treatments and facilities. “Health tourism is one of the most important business models and economic dynamics today.”

Due to improvements and new regulations within the past 10 years, Turkey’s hospitals and clinics parallel and often exceed international medical standards, and its leaders are in position to grab a share of the medical tourism market.

According to the Turkish Accredited Hospitals Association, a group of 12 member institutions working within 28 hospitals and 17 satellite clinics, Turkey has the highest number of hospitals accredited by Joint Commission International (JCI), which ensures global safety and quality standards in more than 80 countries.

Turkish physicians and staff are at the forefront of liver, kidney, and pancreas transplantation; bone marrow transplantation; cardiovascular surgery; plastic surgery; robotic surgery; oncology; and neurosurgery techniques. In addition to its top medical standards, Turkey can provide services at a significantly lower cost—a primary driver for people who choose to travel abroad for care (see sidebar).


A cultural and architectural exchange
To help broaden the knowledge base of Turkish healthcare educators, officials, investors, and facility operators who are participating in these new initiatives, LEO A DALY, an international architecture, engineering, planning, interior design, and program management firm headquartered in Omaha, Nebraska, and with a regional office in Istanbul, is actively working with government officials to help envision the future of medical and tourism facilities in Turkey.

In February, a group of LEO A DALY healthcare experts hosted a symposium in Istanbul, which was intended as a cultural exchange—an opportunity for the firm to contribute not only to Turkey’s economic growth but also its design vision.

LEO A DALY has designed hospitals and medical centers throughout the world, incorporating evidence-based design strategies and sustainable, technology-driven solutions for its clients.

At the symposium, LEO A DALY presented multiple examples of innovative healthcare designs—ranging from large-scale hospital campuses to small-scale clinics and senior living facilities—that can serve as a model for future healthcare tourism projects in Turkey.

Because visitors’ needs will be varied, a one-size-fits-all design approach will not be possible. Some patients will be transient: traveling to undergo advanced medical treatment at an affordable cost, staying for their short-term healing and recovery process, and perhaps bringing their families for an extended holiday. Other patients will be more permanent: looking for a place to retire, or to access long-term independent-living and assisted-living arrangements.

“There is a distinct difference between ‘health tourism’ and ‘medical tourism,’ and the two terms should not be used interchangeably, from a design standpoint,” says Ann Jones, RN, MBA, AOCN, a LEO A DALY healthcare strategist and clinical operations specialist. “Medical tourism is about traveling for a specific type of care, whereas when you’re talking generally about health tourism, you’re talking more about a lifestyle choice.”

Indeed, TUHETO recognizes the term “healthcare tourism” as encompassing four subcategories: 

  • Medical tourism: visitors seeking specific surgical procedures and recovery facilities;
  • Thermal/spa tourism: visitors seeking the country’s thermal hot springs and spas;
  • Geriatrics tourism: visitors seeking a long-term retirement facility in proximity to medical care; and
  • Healing nature: visitors seeking a broader experience of spirituality and wellness within nature. 

At the heart of Turkish culture is a focus on spirituality and healing—reflected in its architecture and its plentiful thermal baths—and a dedication to family, which is reflected in all aspects of daily life. Taking all of these factors into account, architectural concept designs will need to resemble a hybrid of a medical care facility, a vacation resort, and a long-term care facility, depending on the goals of the client and unique properties of the site.

“In these projects, the question is: How do we design around three important aspects of life: our personal life, our spiritual life, and our emotional well-being?” Jones says.


Izmir Health Campus: A model for wellness
In one example, LEO A DALY recently partnered with a Turkish landowner and developer to create the concept design for the 368,000-square-meter Izmir Health Campus in Izmir, Turkey, a project that will incorporate the best of hospitality, residential, healthcare, and senior-living design.

The design includes 132,000 square meters of housing, dining, hotel, retail, and cultural facilities, as well as geriatric and nursing care facilities, surrounded by outdoor amenities, such as gardens, a sports and fitness zone, a camping area, and walking paths.

While the property for the Izmir Health Campus is located in proximity to existing major medical centers, it is not designed to be an outpatient/inpatient hospital. Rather, the site serves as a senior retreat setting that would be spiritually and emotionally restorative as a patient is in the process of rehabilitating physically, explains Kevin Donahue, AIA, NCARB, LEED AP, LEO A DALY executive director and senior living specialist. The design would support a feeling of “home,”
with options for independent living, assisted living, and hospitality for visiting families—with clinical support for those who need nursing supervision.

“Seniors make decisions about where they live based on how easily they can access medical care,” Donahue says. “So if we can expand a freestanding senior living campus to offer real clinical services, we can provide a way of managing a disease or an ailment, while still allowing people to maintain their individuality and independence.”

In a healthcare tourism project, particularly one catered for a senior population, certain design elements are essential: home and hearth; community interaction and fellowship; enclosed courtyards promoting safety for individuals with memory loss; outdoor views for emotional wellbeing; entertainment and movement for exercise and cognitive support; and most importantly, shared experienced with staff and family members.

“It’s important to remember that aging is not an illness; it’s a developmental phase. We are still developing and moving forward spiritually while our bodies are going backwards,” Donahue says. “When we design the built environment, we must pay attention to the connectivity with families. We want the families to stay, even if they are coming from far away. We want them to visit and stay engaged.”

When merging hospitality with healthcare, an architecture firm must balance service excellence with a design that feels comfortable and approachable, Jones adds.

To meet the varied needs of Turkish healthcare clients and developers, architectural and engineering advisors will need a strong portfolio in a variety of market sectors.

“To help a client that is looking to develop a multifaceted destination or resort, a firm needs to have experience in designing various types of projects such as hospitals, hotels, and senior living communities, instead of being ultra-specialized in only one project type like healthcare,” says Arthur Smith, NCARB, LEO A DALY senior associate and senior project manager. “We have a tremendous opportunity here as design leaders—and the challenge for us will be to give vision to that opportunity.” HCD

Lauren Pinch is Corporate Public Relations Manager, and Dilek Hocaoglu, Chamber of Architects, UIA, is Regional Director for Eastern Europe, CIS and North Africa, at LEO A DALY. For more information on LEO A DALY, please visit www.leoadaly.com.