I Went to Istanbul for Medical Tourism!

But it didn't go exactly the way I expected.

For the audio version of this article, read by the author, go here.

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Photo by Ibrahim Uzun on Unsplash

A year and a half ago, I developed a strange pain in the big toe of my right foot. It persisted longer than expected, and it finally became difficult to walk. So when Michael and I happened to be getting medical checkups in Bangkok last year, I had it examined by a podiatrist.

I learned I had something called hallux rigidus: essentially, arthritis of the big toe, caused by “bone spurs” — that is, little growths in the nearby bones of my foot.

The pain was very unlikely to ever go away, my doctor said, but he explained my various options, including surgery. The price for this surgery (at one of Bangkok’s top hospitals) was $5600 USD.

At the time, I was on SafetyWing’s Nomad Insurance — travel insurance for only “medically necessary” procedures, true, but being able to walk seemed to be fairly necessary to me.

Infuriatingly, SafetyWing refused to give me an answer about whether they’d pay for the surgery. (And three months later, they also denied payment for even that initial consultation with the foot doctor. So the answer was clearly, “No, this procedure is not covered.” Which you’d think they could’ve just, you know, said.)

But in all the time it took to get a clear answer from SafetyWing, a strange thing happened: the pain in my foot mostly went away. I could walk again!

I ultimately came to the conclusion that I had subconsciously changed the way I walked — a testament to how amazing and complicated the human body is.

Plus, I bought different shoes.

The big takeaway is I went on with my life.

But by the end of 2023, some of the pain had come back. Worse, I realized that I had become so cautious that I was avoiding activities I had previously enjoyed. Michael and I are extremely active — mostly because we enjoy it, but also because we like how this increases the odds of our being able to stay active for as long as possible.

Being active all over the world!

Last month, I knew that we were going to be in Istanbul, Turkey — a city that is known to have excellent (and affordable) medical care. So I said to Michael, “I think I should finally have that surgery on my foot.”

Michael agreed, and what follows is the story of what happened.

Spoiler alert: if I had to do it all over again, there are a few things I’d do differently.

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Istanbul is famous for its “medical tourism.” There’s lots of first-rate medical facilities, which often cater directly to tourists. But the cost of living here is much lower than in many Western countries, making everything a relative bargain for people like Michael and me.

In fact, he and I lived in Istanbul for almost three months in 2021 (and loved it), and it was extremely common to see foreigners out and about sporting bandages — often, for cosmetic surgeries like nose jobs, face-lifts, and hair implants.

We also have friends who had previously had surgical work done here, and we knew one who had used a “medical advocate” to help them arrange everything.

They highly recommended that advocate, so I contacted her and explained what I needed done. I sent her my x-rays from Bangkok, and she found the right doctors, and then spelled out two different options:

• If I paid via credit card, the operation would cost $6500 USD, and it would take place at Acibadem International Hospital.

• If I paid cash, it would cost $4000, and it would take place at Kolan Hospital.

Kolan Hospital.

We liked these prices. My research suggested that in America, the surgery would cost anywhere from $8000 to $70,000. My gut told me that in our hometown of Seattle, it would be at least $20,000.

I still keep a “full” insurance policy back in America, but despite my $9000 annual premium, it has a ridiculously high deductible of $6000 — and also 20% on any “specialist” care after that. And since the American healthcare system is clearly insane, I was assuming there would be “hidden” costs — co-pays, for example, and my paying for expensive prescriptions and outrageously priced convalescent equipment — that would push our post-insurance costs to at least $10,000, or maybe way beyond that if there was any kind of ridiculous “out of network” issue.

And since SafetyWing had ultimately declined to cover the surgery back in Bangkok, I assumed that our current travel insurance provider, Genki, would not cover it in Istanbul either.

But what was this deal about the two different hospitals — and the steep discount for paying in cash? Our advocate had assured us that it would be the same two doctors either way, but we wouldn’t get a receipt at the cheaper hospital. This seemed a bit dodgy: was it legal? And how would we get that much cash in a foreign city?

Our independent investigation confirmed that paying in cash is, in fact, a very common practice in Turkey (and also nearby Greece).

I asked the advocate if the quality of medical care would be the same in both hospitals, and she assured me it would be.

Again, our independent investigation confirmed this. Our medical advocate was of the opinion that unless we needed a receipt for insurance purposes, we’d be crazy to pay $2500 more for the exact same surgery by the exact same doctors.

In the end, we agreed to go with the cash option. We scheduled the initial consultation with the doctors for a little less than a week after our arrival, with the actual surgery two days after that. I figured that would give me time to get that much cash — either Turkish lira or US dollars.

We had committed no money at this point, and Michael and I planned to use that initial consultation to decide for sure whether we’d ultimately go through with the surgery. In addition to the “cash” issue, we were also a little concerned that the doctors had decided the exact surgery I needed, even before an examination, just based on some screen-shots of x-rays from Thailand the year before.

Even apart from its medical care, Istanbul is very worth seeing — easily one of the most fantastic cities on Earth.

We arranged for an Airbnb fairly close to the hospital, but once in Istanbul, getting $4000 cash turned out to be more difficult than anticipated. My American credit union had advised me to raise my daily ATM limit, and then simply go into any local bank for the money. But we tried three different Turkish banks, and none allowed this.

Meanwhile, cash machines in Turkey do sometimes give US dollars: since the lira has been so unstable and inflationary, many locals prefer dollars. But these cash machines also have ridiculously high fees — anywhere from six to ten percent — and they often have their own daily limits.

We solved this problem by raising the daily limit with my credit union, then going to a shopping mall, which had a variety of cash machines with high daily limits. We ended up paying a six percent fee, which added $240 to our cost. I also wasn’t thrilled about carrying that much cash, or even keeping it in our apartment for a few days.

Istanbul has plenty of malls, but you’re a fool if you don’t visit the Grand Bazaar and the endless warren of shops that surrounds it!

We were planning to meet with the doctors on Monday, but on the Saturday before, we had dinner with a very tuned-in Turkish friend, Farouk, and we told him all about why we were in town.

He listened and said, “I am very sorry to say that Kolan is not a great hospital. It is second or even third-tier.”

I instantly began freaking out. This was my worst nightmare coming true! Had I made a huge mistake in trusting our advocate? But Farouk did say that the hospital where my doctors typically worked — Acibadem — was one of the best in the city.

That night, I relayed our conversation with Farouk to our medical advocate via text. She assured me once again: it was all perfectly fine, and I had nothing to be worried about.

I was still worried. That Monday meeting with the doctors was now more important than ever. If anything at all seemed off, we planned on simply walking away — and then scheduling another appointment at one of the hospitals Farouk had recommended. After all, we’re nomads, which gives us great freedom: we were already planning to be in Turkey for almost three months.