TBY talks to Dr. Evren Keleş, CEO of Vehbi Koç Foundation American Hospital, on its role within Koç, the Health Sciences Campus, and working with the MD Anderson Cancer Center.

Dr. Evren Keleş
Evren Keleş is a professor of neurosurgery who specializes in the treatment of adult brain tumors.

What is American Hospital's role in Turkey's health sector?

The hospital is fully owned by the Vehbi Koç Foundation, which was one of the first foundations of the Turkish Republic. Although the American Hospital may be categorized as a private institution, it is unique in terms of its mission. The hospital is the most profitable private sector healthcare institution in Turkey, including all the big name chains. The Koç Group, however, does not benefit at all from this financial success. After allocating funds necessary to maintain the hospital, every penny of profit generated is used to support the Koç University School of Medicine and the new Koç University Health Sciences Campus. Our funds, which today are used mainly for construction and medical infrastructure, will soon be available to further support research. American Hospital has two characteristics that make it special. First is the brand name, which has been extremely strong for several decades. This fact has been further strengthened since 1995, following the hospital's acquisition by the Vehbi Koç Foundation. Another essential characteristic that is unsurpassed by any other hospital in Turkey is the number and quality of our physicians. This is important in a society in which people seek “star physicians" and believe that even their cancer can be cured by a prominent surgeon. We provide a safe and institutionalized environment not only for our patients, but also for our healthcare and support personnel. Another aspect that can be considered atypical about the American Hospital is the fact that it is one of the very few hospitals not to have a business relationship with the government. These factors are reflected in our revenues; 50% derives from individuals, and the remaining 50% from high-end private insurance policies.

How will the Koç University Health Sciences Campus assist in improving medical education in Turkey?

The campus itself will probably not have an effect on medical education in Turkey, but Koç University School of Medicine may potentially impact how medical schools in Turkey function. Our goal is to educate future leaders of medicine with the highest professional and ethical standards, who knowledgeable in terms of the scientific basis of medicine, and skilled in the prevention and treatment of disease, compassionate with exemplary bedside manners, and committed to a lifetime of learning. We focus on the high academic productivity of our faculty and expect the pursuit of outstanding research, as well as a high faculty-to-medical-student ratio, the early involvement of medical students in research with significant time dedicated to research projects, a flexible and innovative curriculum that is being questioned and revised continuously, and maximizing the use of novel learning methods and simulations, rather than classical didactic classroom teaching. We believe that starting a new medical school from scratch allows out-of-the-box thinking not only for curricular affairs, but also for administrative structuring. Another aspect that is new to the academic medical community in Turkey is the use of the established methods of Koç University for academic evaluation, appointment, promotion, and reappointment of faculty. The introduction of North American standards into medical research and education is unlikely to be achieved by government institutions in Turkey, as their priorities are understandably different. Similarly, the kind of medical education that focuses on research and basic sciences is not the main concern of foundation-based universities in Turkey, as, by definition, it requires a constant influx of funding. Instead, these institutions concentrate on “transferring" high-caliber academic physicians and surgeons that they can benefit from in the private healthcare setting. At this point, Koç University and the Vehbi Koç Foundation have a distinct advantage and unique opportunity toleverage healthcare-generated resources in support of medical education.

How has your cancer treatment evolved since the inclusion of the MD Anderson Cancer Center in 2010?

Our Comprehensive Oncology Program is separate from our radiation oncology business within MD Anderson. Until the fall of 2006, the American Hospital lacked radiation oncology because that had been set up in the Italian Hospital in Taksim, Istanbul, together with medical oncology and cancer rehabilitation. Our main decision there was to bring radiation oncology into the hospital so that all lines of service were combined. In those days, the president of MD Anderson had a policy of expanding MD Anderson's services around the world. We were in the process of looking for radiation oncology, they were looking for a partner, and we came together to see if it would work. We agreed that the radiation oncology center would function the way the main center and satellites in Houston do. In their business model, the satellites are connected to the main center through imaging and data sharing resources. The main principle is that any patient who enters any center receives uniform treatment through the use of identical instrumentation technology from physicians, nurses, and technicians trained by MD Anderson. All quality control systems are identical and every patient undergoes a peer review process in terms of the treatment to be received. We treat approximately 300 new patients per year; this is in line with our original feasibility study and both sides are pleased with this relationship. Multi-disciplinary care is much talked about in Turkey, but is usually limited in scope. In addition to all those essential disciplines and figures involved, we add cancer coordinators, nurse navigators, dieticians specialized in cancer care and chemotherapy patients, and psychologists who are dedicated to cancer patients and their families. Furthermore, we have a cancer rehabilitation program linked to this, as well as social workers, and I can say that we are also currently building one of the first and major programs enabling the survivors of cancer to deal with their problems, which has long been neglected in Turkey.

“ Our main decision there was to bring radiation oncology into the hospital so that all lines of service were combined. "