The skyrocketing cost of living, low salaries, constant political meddling in professional conduct and the general political course of Turkey have triggered an exodus of Turkish doctors.
Feridun Meriç, New York
When the Justice and Development Party (AKP) came to power in a landslide victory in 2002, health was one of the first matters the government tackled immediately and fairly competently. The so-called revolution in health transformed the country’s medical landscape and provided a better (and universal) healthcare service to a large segment of the population who had been more or less deprived of the options usually enjoyed by affluent people. But after two decades in power, the AKP’s health policies have become synonymous with incompetence, nepotism and the same ills that had afflicted Turkey’s fraying healthcare system before the 2000s.
The most visible aspect of this downward spiral is the growing exodus of doctors from the country. More and more physicians are taking off their white uniforms for a better career elsewhere. According to statistics released by the Turkish Medical Association, 1,405 doctors sought to relaunch their career abroad in 2021 after growing disillusioned with the conditions in Turkey. To grasp the gravity of the situation, it must be borne in mind that only 59 doctors left the country in 2012. In the course of a decade, that number has surged dramatically. How things reached this point is a long story interwoven with the larger conundrum that has recently befallen Turkey’s political system and social setting.
Things came to a head last week when doctors went on a nationwide strike on Doctors Day to protest low salaries, staff shortages and tremendous pressure at work. Before physicians took to the streets, President Recep Tayyip Erdoğan dismissed their complaints, saying: “Let them leave, if they want to leave. We can replace them with new medical school graduates.” But it did not take long for the president to backtrack on his public remarks. On Doctors Day, the president came full circle, grudgingly conceding that physicians play an indispensable role in public health and that the nation owes them a lot. But his turnaround did little to soothe the growing number of disgruntled doctors whose fortunes are not independent of the political and economic course of Turkey.
Needless to say, overflowing hospitals and overwhelming schedules during the COVID-19 pandemic have tipped the scales against healthcare workers in the past two years. The high cost of living literally pushed the limits of doctors’ endurance, as soaring inflation shrank people’s purchasing power and ate away at their savings following the depreciation of the Turkish lira against the US dollar and the euro. While the steady decline in doctors’ economic wellbeing constitutes the core of their despair, it is not the only problem that bothers them. It is how politicians conceive of them and how violence against physicians persists. It is the eroding respect for doctors that has caused them to begin thinking about changing careers or fleeing the country.
In this respect, the recent showdown between doctors and the Erdoğan administration is the embodiment of all things that have gone wrong in the past several years. It exposes the government’s lack of respect for the talented workforce in various departments of public service, including but not limited to those in healthcare. The devastating consequences of a post-coup purge also hit the health service hard as thousands of doctors lost their jobs in the frenzy of a political witch-hunt. The politicization of hospital boards and the sharp decline in the quality of service, which is indeed a byproduct of larger economic problems that threaten the entire country, are among the chief causes of Turkey’s health crisis.
No less important is the culture of impunity that fails to protect doctors against violence posed by the relatives of patients. More and more doctors face physical assaults from people who seek to avenge the loss of their loved ones, putting the blame squarely on physicians with little evidence of malpractice or malign intent on the part of healthcare workers during risky surgeries. In other cases, patients sometimes simply dispute the treatment prescribed by doctors and get into fights with them inside the hospital. While many ordinary citizens avoid targeting administrative officials and members of the judiciary even if they are unhappy with their decisions, medical workers appear to be easy targets. They get blamed for anything that goes wrong in hospitals. What aggravates this situation is the lack of any legal remedy since attackers get away with a lenient punishment or none at all. In most cases, they are simply released after a brief interrogation in police custody. The bottom line is that beating a doctor is not a crime in Turkey.
The recent political dispute involving doctors was not lost on the ruling party’s elite members. Dr. Eyüp Çetin, president of the Konya Medical Union, parted ways with the AKP last week after he felt alienated by Erdoğan’s remarks against doctors. In his letter of resignation, he lamented the dramatic consequences of the political discrediting of the medical profession. The demonization, he noted, only leads to more violence against doctors.
The prognosis is hardly promising, if not totally catastrophic. Turkey can ill afford to experience another brain drain such as the one that stripped the country of valuable human capital after the post-coup purge in the first two years following 2016. But as things currently stand, there is little faith that the state of affairs will improve in this political context. As long as the country has a large number of well-educated, purged civil servants languishing in its sprawling prison system on dubious grounds after political trials, the predicament of doctors is bound to persist. Who gives a damn about doctors? Who really cares or needs them? Patients certainly do. But the moment of reckoning will not arrive until the total collapse of the entire health system.
*Feridun Meriç is a New York-based Turkish writer and analyst. After many decades in journalism, he is now mostly focused on fiction, technology, art, culture and in between.