Short answer: A patient’s return to their home country does not by itself end the responsibility of the physician and healthcare facility in Türkiye. The surgery itself, discharge, travel information, the follow-up plan, the handling of reported complaints and any necessary new intervention are each examined separately. Still, not every complication or need for revision is a medical error. Liability is determined by the service undertaken, the information provided, professional care, any aesthetic result undertaking and the link to the harm.
Health tourism services often begin with a short visit to Türkiye, but recovery and follow-up can take considerably longer. When the patient is back home and cannot reach the operating surgeon directly, when complaints are answered only by a sales coordinator, or when the patient is asked to return to Türkiye for every problem, a follow-up issue independent of the original surgery may arise.
A legal review should not be reduced to whether the surgical technique was correct. Even if the initial procedure was properly performed, a later complication that was recognised late, warnings that were not explained to the patient, or a reported complaint that was not properly routed may constitute a separate basis for liability. Conversely, the effect on the outcome of a planned follow-up that the patient left by their own choice should also be examined.
Is post-operative follow-up part of the service?
As a rule, medical care is not a single act that ends when the operation ends. The observation required by the procedure, the discharge assessment, medication and care instructions, control needs, and the route to follow if something unexpected occurs also fall within the assessment of professional care. The concrete scope of these obligations is determined by the nature of the procedure, the patient’s condition, the contract and medical standards. [K1, K2]
A health tourism provider that knows from the outset that the patient lives abroad should set up the follow-up arrangements with that in mind. An obligation to provide treatment for an unlimited period, or in every country, cannot be assumed. However, a return to the home country envisaged from the start does not justify completely excluding the necessary explanations and a reasonable follow-up arrangement. If the contract refers to “post-operative support”, it should state by whom it will be provided, through which channel, for how long and within what limits.
Handing over follow-up to another physician or institution does not automatically remove liability either. Whether the need for transfer was explained, whether the necessary records were shared and whether the patient’s route to seek help was identified are all assessed. A patient having to find a doctor in another country is not the same as a planned transfer of control.
Is discharge the same as fitness to fly?
The end of the need for inpatient care does not mean the patient can make a long-haul flight in every circumstance. The timing and conditions of travel should be medically assessed according to the patient and the procedure. An airport transfer being arranged, the hotel stay ending or an inability to change a flight ticket does not replace a medical fitness assessment.
In a legal dispute, not only the date of discharge but also the findings and explanations that accompanied it are important. The file should contain the discharge examination, current complaints, control recommendations and, if any, a travel assessment. The meaning of a short note saying “fit to fly” should be read together with the date and the clinical condition for which it was issued. Where a new symptom appears later, the earlier assessment may no longer be sufficient.
The United Kingdom’s official guidance on treatment abroad also states that, for planned surgery, return conditions and insurance coverage should be researched in advance, and that an airline may ask a physician to confirm fitness to fly. This source shows the importance of travel planning; it cannot be used as a legal rule determining liability under Turkish law. No general flight advice prescribing the same number of days for every procedure should be given. [K3]
Which follow-up information must be clearly given to the patient?
Under the Patient Rights Regulation (Hasta Hakları Yönetmeliği), information must be given in a language the patient can understand. Beyond the basic explanations about the procedure, the care, medication and control needs that affect the patient’s later health should also be made concrete. Simply saying “write if there is a problem” does not always explain whom to contact, how urgently and in which situations. [K2]
| Follow-up topic | Point to clarify | Useful record in a dispute |
|---|---|---|
| Control plan | Which assessments will be made, when and by whom | Dated plan, appointments and notice of any change |
| Medication and care | Patient-specific recommendations, use and practicable care instructions | Prescriptions, care document and record of the explanation given |
| Unexpected situation | Which change requires applying to local health services | Written warnings specific to the procedure and application details |
| Remote communication | Channel, responsible person, limits of the service and response arrangement | Communication texts, records of conversations and referrals |
| Return home | How control will proceed and transfer to another physician if needed | Discharge summary (epikriz), procedure summary and transfer letter |
If a foreign patient was given only a Turkish-language document, the intelligibility of that document is discussed separately. A patient who speaks English does not in every case show that they understood complex medical explanations. If an interpreter was used, their identity and role, the health professional who gave the explanation and the patient’s questions can be recorded. An interpreter does not make medical decisions; they help the explanation be conveyed accurately.
The patient, too, is expected to give accurate health information and to cooperate with the follow-up plan explained to them. However, a defence that the patient did not follow an instruction that was never given to them, or that was not explained understandably, cannot be weighed in the same way. Medical records are therefore important both for the patient’s claim and for the health provider’s defence.
How are complaints sent remotely assessed?
Who the complaint reached, what it said, when it was read, whether it was passed on to the physician and how it was answered are separate questions. A general reassurance from the coordinator is not the same as a clinical assessment by the physician. Whether the condition described in the message required an examination or urgent attention may later become a subject of expert review.
Sending a photograph does not make a full medical assessment possible. It is important that the health provider states the limits of remote assessment, refers the patient to a local in-person examination where it considers this necessary, and records that referral. The fact that the patient is physically far away does not automatically justify giving no response; yet it also does not create an obligation to diagnose every problem remotely.
Distinguishing messaging from lawful remote health services
The Regulation on International Health Tourism and Tourists’ Health (Uluslararası Sağlık Turizmi ve Turistin Sağlığı Hakkında Yönetmelik) states that remote health services may be provided within the framework of the specific regulation governing them. The Regulation on the Provision of Remote Health Services (Uzaktan Sağlık Hizmetlerinin Sunumu Hakkında Yönetmelik) contains special rules on authorisation and on the system used. Appointment reminders, the transmission of documents and the provision of medical services should not be placed in the same category. The existence of an ordinary messaging account does not by itself show that a remote health service infrastructure compliant with the regulations is in place. [K4, K5]
While the patient is in another country, the rules of that country on the practice of the profession and on data transfer may also become important. Authority in Türkiye should not be taken as authority to provide unlimited health services in a foreign country. This uncertainty increases the need to explain the necessary local application and to define the limits of the service from the outset.
How is a complication distinguished from a follow-up failure?
A complication, by itself, does not show that the physician was at fault. However, calling an event a complication does not end the review of liability. The foreseeability of the risk, the measures needed to prevent it, the information given, early recognition, timely intervention and proper referral should each be examined separately.
A claim that the first operation contained an error is different from a claim that a problem arising later was not properly managed. Both may exist in the same event, or only one of them may. Asking an expert only “is the surgical technique appropriate?” does not explain a later delay. The chronology should show which information was available on which date and how that information should have been handled.
Liability also requires that causation be established. A late response does not by itself show that the entire final harm arose from that delay. Medically, it is examined whether an earlier assessment would have prevented or reduced the outcome. Conversely, if it is argued that the result was unavoidable, this too must be explained with concrete records and reasons. [K1]
How does an aesthetic result undertaking affect the revision dispute?
In aesthetic procedures, depending on the nature of the dispute, the provisions on the contract for work (eser sözleşmesi) and the Court of Cassation’s approach to obligations of result come into play. In that case the assessment is not limited to whether a bodily complication developed. The appearance agreed between the parties and the scope of the procedure are compared with the result achieved. [K1, K8]
In determining the result undertaken, pre-operative photographs, examination notes, drawings, personalised correspondence and the medical limitations explained are important. The objectively determinable claim of a defect should be distinguished from a later change in personal taste. It is also examined whether a simulation or sample photograph was used as an exact expected result or for explanatory purposes.
Does the defence that the patient “accepted the risks” remove the aesthetic result obligation?
Describing the risks specific to a procedure does not in itself remove the aesthetic result that was undertaken. Likewise, the fact that the aim was an aesthetic appearance does not make meaningless a claim that the patient was operated on without adequate information. The validity of consent, medical care and the result of the work are separate matters for examination.
Blanket exclusion-of-liability wording in standard forms is reviewed against TBK Articles 115–116 and the provisions on unfair terms in consumer law. The patient’s signature is important in showing what explanation the document contains; it cannot be read as a pre-emptive forgiveness of all defects or as permission for every future operation. [K1, K2, K6]
Does proposing a revision mean the error has been accepted?
A proposal for revision is not in itself an admission of fault. The proposal may have been made because of a change during healing, failure to reach the expected result, a correctable defect or a different medical need. The physician’s explanation, the reason for the proposal and its relation to earlier records should be assessed. A message such as “let us redo it free of charge” may, however, carry weight as evidence depending on its scope and context.
For the patient, it must be clear what the revision will remedy, how its success and risks were explained, and which costs will be covered. Waiving only the surgeon’s fee is different from undertaking the hospital, anaesthesia, product, medication, transport and accommodation costs. Accepting a revision offer does not automatically amount to a waiver of earlier losses; any separate release or settlement text to be signed should therefore be reviewed carefully.
If the patient’s trust in the relationship has broken down, refusing to undergo another operation with the same person is not in itself unlawful conduct. On the other hand, it cannot be said that every cost of a different centre chosen by the patient can be loaded onto the first provider. Health need, safety, a suitable alternative, reasonable cost and the duty not to increase the damage are assessed together. Bodily integrity cannot be compelled to resolve a monetary dispute.
Is new consent required for a revision?
The scope and risks of the new operation must be explained separately. Consent to the first operation does not cover an unlimited scope for a later, different intervention. Particularly where a new method, a different anatomical area, a different anaesthesia or an additional product is involved, these changes, which affect the patient’s decision, should be made concrete. The patient having accepted the earlier procedure does not mean they accepted the new one. [K2]
Offering the revision free of charge does not lower the standard of information. It is important that the patient is given time, is able to understand the proposal, can obtain a second opinion and is told that refusal is an option. Medical necessity and emergency exceptions are assessed under their own conditions; a planned revision accelerated by sales pressure cannot be confused with them.
Can the costs of re-treatment abroad be claimed?
Treatment costs incurred in a foreign country are not excluded from a claim merely because they were invoiced by an institution outside Türkiye. For compensation, however, the link between the procedure and the original event, its necessity and its reasonable cost must be shown. Where a report only states that “the patient had been operated on in Türkiye before”, the connection between the present problem and the earlier procedure should be explained separately. [K1, K7]
An emergency intervention that could not reasonably have been expected is not assessed in the same way as a planned aesthetic change chosen months later. The patient’s access to treatment where they live, their fitness to travel again, the nature of the solution offered by the first centre and whether it responded in time are examined. The meeting of a health need should not be delayed merely in order to gather evidence for the future.
Re-treatment invoices, the amounts paid, medication and care costs, and the necessary transport and accommodation documents are separated out. The need for an accompanying person must be shown; for loss of earnings, work and income documents are submitted. The foreign price level should not automatically be reduced to the public tariff in Türkiye; yet no foreign invoice should be accepted without scrutiny either. Medical necessity and economic reasonableness are examined with reasons.
Whether these costs fall within the policy is addressed in our article on complication insurance in health tourism.
Can a refund and a revision cost be claimed together?
The relationship between the legal consequences being claimed should be clearly set out. Rescission, a price reduction or free repair under the defective-work provisions is not the same item as additional compensation for damage. Claiming both the full original price and the full cost of obtaining the same service again may raise an argument of double recovery in the concrete case. Usable service, refunds made and insurance payments should be shown in the calculation. [K1, K7]
For the refund of a package price and the cancellation conditions, you may also consult our article on cancelling a treatment package and refund of fees.
Does the patient’s failure to follow the control plan remove liability?
The patient must follow the recommendations explained to them in a suitable and understandable way, report important complaints and give accurate health information. However, to reduce or remove liability, the effect of the patient’s conduct on the damage must be made concrete. Leaving Türkiye is not, by itself, an event that ends all of the physician’s obligations.
If the health provider claims that the patient refused control, it must show when and how control was proposed, why it was necessary and what consequences were explained to the patient. The patient may argue that the appointment request was not met, that the return date was set by the provider or that no local examination was recommended. The file is assessed on the basis of these mutual records.
Under TBK Article 52, the effect of the injured party’s conduct on the occurrence or increase of the damage may lead to a reduction or other consequences. However, a defence that “the instruction was not followed” must not be left without medical reasoning and an explanation of causation. A claim that a later physician’s intervention increased the damage should be investigated in the same way. Where there are several causes, their respective effects should be shown separately. [K1]
Against which person or institution is a claim made?
The operating physician, the physician who took on the follow-up and the person running the health facility may hold different roles. A hospital that does not set up a control and communication system, does not route an application to the relevant health staff or does not keep records is significant from an organisational perspective. The physician’s liability, however, is assessed by reference to their own medical decisions and conduct.
An intermediary company’s failure to carry out the communication or follow-up function it undertook may give rise to separate liability. For this, it must be determined what service was promised to the patient and what caused the failure. The requirement in the health tourism regulation for a call infrastructure does not mean that every coordinator has the authority to make a medical diagnosis at any hour. [K4]
An application to the insurer is made on the basis of the policy. Complication insurance and a physician’s medical liability insurance are different products. A cost excluded from one cover may be the subject of another claim or of a liability claim directed at the health provider itself. An insurer’s rejection letter does not by itself determine the physician’s lack of fault or the patient’s unfairness.
The liability of the intermediary and the agency is examined separately in our article on intermediary company and agency liability in health tourism.
What do the Court of Cassation decisions say on follow-up and revision?
Return home and follow-up: 6th Civil Chamber of the Court of Cassation (Yargıtay 6. Hukuk Dairesi), E.2024/2732, K.2025/3451
In the decision dated 15 October 2025, the claims of a patient who returned to Greece after limb-lengthening surgery were examined. The medical assessment in the file, consent and the findings about the patient’s withdrawal from follow-up resulted in the rejection of the pecuniary damages claim being upheld. The appeal concerning non-pecuniary damages was rejected because of the amount. [K9]
This decision shows the importance of the follow-up plan and of patient conduct. However, it cannot be concluded that all foreign patients lose their rights by leaving Türkiye. For the decision to be applied to another case, the control need that was explained, what the patient did and how that affected the damage must be compared.
Re-treatment abroad: 6th Civil Chamber of the Court of Cassation, E.2022/747, K.2023/1785
The decision dated 11 May 2023 concerns a dispute over implant and prosthetic treatment carried out in Türkiye for a patient living in Germany. In the file, re-treatment in Germany, transport and other costs were claimed, and technical deficiencies and the optional rights under the contract for work were assessed. The partial acceptance decision given after an earlier reversal was upheld. [K7]
The decision shows the importance of subsequent treatment documents from the foreign country and of choosing the right claim. It should not be concluded that every expense claimed in the petition was accepted. The claim, the expert assessment and the result ordered should be read separately; the historical amounts in the file are not the current treatment tariff.
Aesthetic result: 6th Civil Chamber of the Court of Cassation, E.2024/1507, K.2025/1137
In the decision dated 19 March 2025, an aesthetic eyelid procedure was addressed within the framework of a contract for work and the result undertaken. A report stating that there was no technical fault and that the emerging condition was a complication was not accepted as sufficient. The decision stated that, in the concrete case, the promised result had not been achieved, that the defendants’ liability should be accepted and the compensation claims examined, and the rejection decision was reversed. [K8]
This decision shows that, in a revision dispute, it is not enough to rely only on the statement that “there was no medical error”. However, a reversal decision does not mean that a specific compensation was definitively paid to the patient. The concrete undertaking and the current appearance should be assessed through expert review.
How should evidence be preserved and what should be asked of the expert?
The following should be set out in sequence: the pre-operative condition, the moment of discharge, the return to the home country, the first complaint, the reply given and the dates of the second treatment. Where messages carry a time difference, it should be explained which time zone the displayed time belongs to. The original files of photographs should be preserved; copies of the same image with altered dates should not be used. Advertising photographs and clinical follow-up images should be kept separate.
- Which documents show the scope of the procedure and the result undertaken?
- Are the discharge and the travel assessment appropriate to the patient’s condition on that day?
- Are the control and care instructions sufficient, understandable and practicable?
- On what date should the reported complaints have led to which assessment or referral?
- Could an earlier intervention have prevented or reduced the alleged damage?
- What are the necessity, scope and reasonable cost of the revision, and is there an effect of the patient’s conduct?
Under HMK Article 266 et seq., technical matters may be the subject of expert examination; the final assessment of legal liability belongs to the court. The translation of a foreign report and, where necessary, its certification are considered according to the nature of the document. If there is a risk of losing evidence, a preservation of evidence (delil tespiti) may be considered. However, the patient must not postpone urgent or necessary treatment merely until that procedure is completed. [K10]
For the procedure of obtaining records, see how to obtain patient files and medical records; for the expert stage, see objecting to the expert and forensic medicine report in a malpractice case.
How are the route of application, time limits and settlement terms determined?
In a consumer dispute arising from private health services, the choice between the consumer arbitration committee (tüketici hakem heyeti) and the consumer court, the current monetary limit and the nature of the claim are determined. Before the consumer court, the condition precedent of mediation and its exceptions are examined. For a claim arising from public health services, administrative application and full judicial review (tam yargı yolu) apply; for a claim against an insurer, the policy and the related procedure are assessed separately. [K6]
The law applicable to a foreign patient and the international jurisdiction of the court must also be examined separately. Because Article 26/4 of Law No. 5718 on Private International and Procedural Law (MÖHUK) contains an exception for services that must be provided in another country, it cannot be assumed in every case that the law of the patient’s country of residence applies. The contract, the tort and, if any, the nature of a package tour must each be examined under their own conflict-of-laws rules. [K11]
Limitation periods for mandate, contract for work, defective service and tort claims have different provisions. TBK Articles 72, 146–149 and 478, together with TKHK Article 16, must be read together but assessed claim by claim. It cannot be said that every file has a single five-year period running from the date of surgery. Proposals for revision or complaint correspondence also do not stop the period in every case. The statutory effect of mediation on the period must be calculated separately. [K1, K6, K12]
If a settlement is to be made, the first treatment, the revision and later losses should be listed separately. Who bears the flight, accommodation, anaesthesia and new product costs, the timing of payment and whether future losses that may arise are reserved should all be clear. A general document stating that all rights end upon acceptance of the revision should not be signed without examining its scope and validity.
For the general rights of foreign patients, see our guide to malpractice and compensation for foreign patients in health tourism and the medical malpractice and physician error cases page.
Conclusion
Post-operative responsibility in health tourism is not a matter that ends when the patient crosses the border. A follow-up plan set up from the outset, clear consent, clarity about any aesthetic result undertaking, a medical response to complaints and documentation of treatment carried out abroad matter together. A well-prepared file assesses the initial intervention, the subsequent management and the patient’s conduct separately, anchoring each claim to its real basis.
Frequently Asked Questions
Does the doctor’s responsibility end when I leave Türkiye?
No. Returning to the home country does not by itself end the existing responsibility. However, the control plan explained to the patient, the patient’s conduct and their effect on the damage are examined. The scope of follow-up is not unlimited; it is determined by the contract and by medical necessity.
Is a late reply to a WhatsApp message malpractice?
Not every delay is malpractice. The content of the message, the person it reached, the circumstances in which a reply was required and the effect of the delay on the damage are examined. A complaint requiring clinical assessment that is brushed aside by a sales representative alone may matter for whether proper referral was made.
Is an offer of a free revision an admission of fault?
Not by itself. The reason and context of the proposal are examined. However, correspondence in which a concrete deficiency is clearly acknowledged may serve as evidence. A free revision does not mean that hospital, anaesthesia, travel and accommodation costs will also be covered.
Must I have another operation with the same doctor?
You cannot be forced to submit to a bodily intervention. The financial consequences of consulting another physician are assessed on the basis of medical necessity, a reasonable solution, safety, costs and the duty not to increase the damage. The first physician’s offer of a revision does not in every case exclude other treatment costs.
Can a report from my doctor in my country serve as evidence in Türkiye?
The author of the report, its content, the findings it relies on and its link to the first procedure are important. Depending on the Turkish translation and the nature of the document, certification may be required. A foreign report does not automatically bind the court; it is assessed together with other records and, where necessary, expert review.
Is dissatisfaction with the result enough to claim revision costs?
Personal dissatisfaction is distinguished from the failure to achieve an agreed aesthetic result. The undertaking, the medical limits, the previous appearance and the current result must be determined. An allegation of an objective defect or of breach of contract requires a more concrete review than a mere expression of dislike.
If the insurer does not pay, can I not claim treatment costs from anyone?
Insurance coverage and the legal liability of the health provider are separate. If the conditions exist for a cost falling outside the policy, you may apply to the physician, the health facility or another liable party. Conversely, payment by an insurer does not always mean that physician fault has been accepted.
Should I have evidence preserved before a revision?
It may be useful in files where the current condition will change; whether it is necessary depends on the concrete case. Appropriate photographs, examination and report records are also important. Urgent or necessary health care must not be delayed merely because evidence preservation is awaited.
Sources and legal bases
K1 — Law No. 6098, Turkish Code of Obligations (Türk Borçlar Kanunu); in particular Articles 49–56, 112, 115–116, 146–149, 470–478 and 502–506. Official text.
K2 — Patient Rights Regulation (Hasta Hakları Yönetmeliği); Articles 15–18, 24–25 and 31. Ministry of Health institutional publication.
K3 — UK Foreign, Commonwealth & Development Office, “Medical emergencies, treatment and hospitalisation abroad”; sections on planned treatment and return home. Official guidance. Not used as the source of liability under Turkish law.
K4 — Regulation on International Health Tourism and Tourists’ Health (Uluslararası Sağlık Turizmi ve Turistin Sağlığı Hakkında Yönetmelik), Official Gazette, 26 April 2025, No. 32882; Articles 6–7. Official Gazette.
K5 — Regulation on the Provision of Remote Health Services (Uzaktan Sağlık Hizmetlerinin Sunumu Hakkında Yönetmelik), Official Gazette, 10 February 2022, No. 31746. Ministry of Health institutional publication.
K6 — Law No. 6502 on Consumer Protection (Tüketicinin Korunması Hakkında Kanun); Articles 5, 13–16, 68, 73 and 73/A. Official text.
K7 — Court of Cassation, 6th Civil Chamber, 11 May 2023, E.2022/747, K.2023/1785. Full text and citation verified. Decision record.
K8 — Court of Cassation, 6th Civil Chamber, 19 March 2025, E.2024/1507, K.2025/1137. Decision record. Full text reviewed; it is a reversal decision.
K9 — Court of Cassation, 6th Civil Chamber, 15 October 2025, E.2024/2732, K.2025/3451. Full text and citation verified. Decision record.
K10 — Law No. 6100, Code of Civil Procedure (Hukuk Muhakemeleri Kanunu); Articles 199, 219–224, 266–281 and 400 et seq. Official text.
K11 — Law No. 5718 on Private International and Procedural Law (Milletlerarası Özel Hukuk ve Usul Hukuku Hakkında Kanun); Articles 24, 26, 34, 40 et seq. Official text.
K12 — Law No. 6325 on Mediation in Civil Disputes (Hukuk Uyuşmazlıklarında Arabuluculuk Kanunu); Articles 16 and 18/A. Official text.