Istanbul Florence Nightingale Hospital is Turkey's first Smart-and-Green hospital, certified by TÜV Hessen. It holds JCI and ISO accreditation and treats over 300,000 patients each year. Its strongest specialty is orthopedics, with the first EOS device in Turkey for low-dose imaging.
Istanbul Florence Nightingale Hospital is Turkey's first Smart-and-Green hospital, certified by TÜV Hessen. It holds JCI and ISO accreditation and treats over 300,000 patients each year. Its strongest specialty is orthopedics, with the first EOS device in Turkey for low-dose imaging.
Assoc. Prof. Dr. Esra Özbaşlı is a board-certified OB-GYN with _doctor_8319_years_ of experience specializing in cervical dysplasia diagnosis and treatment through co-testing, PAP-smears, colposcopy-guided biopsies, and LEEP conization. She trained at Istanbul University and Acıbadem University, where she became an associate professor. Dr. Özbaşlı holds certifications in Genital Aesthetics, Cosmetic Gynecology, and da Vinci Robotic Surgery.
Assoc. Prof. Dr. Esra Özbaşlı OBGYN & Women Genital Aesthetics is a private Istanbul clinic for gynecology, obstetrics, and genital aesthetics. The lead surgeon has over 20 years of experience and 10,000+ managed pregnancies. The clinic performs robotic surgery with the Da Vinci system.
Assoc. Prof. Gokhan Demirayak brings _doctor_4773_years_ of gynecology and oncology experience with 900+ procedures performed. The LEEP package may cost around $3,000 – typically including the procedure, pre-op consultation, blood tests, and VIP transfers. Memorial Şişli Hospital holds JCI and ISO 15189 accreditation. Prof. Demirayak specializes in minimally invasive organ-preserving techniques with same-day discharge.
Memorial Şişli Hospital in Istanbul is one of Turkey’s leading multidisciplinary medical centers, operating on a 53,000 m² area with 252 beds, 13 operating rooms, and advanced intensive care units. Opened in 2000, it became the first hospital in Turkey and the 21st worldwide to earn Joint Commission International (JCI) accreditation, confirming world-class standards.
\n\nThe hospital is recognized for its expertise in oncology, organ and bone marrow transplantation (90% organ transplant success rate), IVF, neurosurgery, bariatric surgery, robotic surgery, and genetics. Equipped with cutting-edge technology and specialized centers, Memorial Şişli attracts patients from 167 countries each year, combining top-level medical care with Istanbul’s unique cultural and travel opportunities.
\n","images":[{"base_url":"clinic/634ffae9b76cd","title":"Memorial Şişli Hospital modern clinic building in Istanbul, Turkey"},{"base_url":"clinic/5ba3aa9d874b8","title":"Patient room at Memorial Şişli Hospital, Istanbul with modern furnishings and TV"},{"base_url":"clinic/5ba3aa9ebbdf9","title":"Patient room and lounge area at Memorial Şişli Hospital, Istanbul"},{"base_url":"clinic/634ffa7dd8799","title":"Reception desk at Memorial Şişli Hospital with modern decor in Istanbul"}],"flags":[{"name":"is_hide","value":false},{"name":"has_active_agencies","value":true}],"geo":{"country":{"name":"Turkey","id":46,"alias":"turkey","iso_code":"TR"},"city":{"name":"Istanbul","id":107,"alias":"istanbul"},"address":"Kaptan Paşa Mah, Halit Ziya Türkkan Sok Famas Plaza No:19 D:C, 34385 Şişli/İstanbul, Turkey"},"rating":{"rating":4.6,"google":4.7,"percent_of_satisfied_clients":87},"statistics":{"number_of_reviews":436,"doctors_number":189,"year_foundation":2000},"accreditations":[{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5db982e01da4b.jpeg","name":"International Organization for Standardization","country_code":"CH"},{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5cfa0ad8c533a.jpeg","name":"Joint Commission International ","country_code":"US"}],"agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}]}},{"text":"Lokman Hekim Istanbul Hospital is a JCI-accredited private medical center in Istanbul. It treats 10,000+ patients each year. Core specialties are neurosurgery, orthopedics, spinal surgery, and weight loss surgery.
Lokman Hekim Istanbul Hospital is a JCI-accredited private medical center in Istanbul. It treats 10,000+ patients each year. Core specialties are neurosurgery, orthopedics, spinal surgery, and weight loss surgery.
Prof. Cem Yalçinkaya, a gynecologic-oncologist with 19 years of experience, specializes in LEEP procedures at JCI-accredited Anadolu Medical Center. The treatment may cost around $3,900 USD – typically covering both the LEEP procedure and endocervical curettage. Affiliated with Johns Hopkins Hospital, the clinic follows American treatment standards and offers interpreter services.
","text_type":"mt_wow_description","best_texts":{"techniques":"LEEP with endocervical curettage","good_fit_for":"LEEP combined with endocervical curettage","why_its_ranked":"Comprehensive HPV PCR testing covers 24 high-risk genotypes alongside Thin-Prep cytology before LEEP. Procedure includes endocervical curettage. Surgeon is a gynecologic oncologist; clinic holds JCI accreditation and Johns Hopkins partnership."},"agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}],"procedure_prices":[{"prices":{"price_from":970,"price_to":1300,"currency":"USD","id":44190},"diagnostic":{"id":498,"name":"Breast biopsy","alias":"breast-biopsy"}},{"prices":{"price_from":200,"price_to":200,"currency":"USD","id":46623},"diagnostic":{"id":128,"name":"Consultation with a gynecologist","alias":"consultation-gynecologist"}}],"reviews":[],"clinic":{"id":87,"alias":"anadolu-medical-center","name":"Anadolu Medical Center","short_description":"Anadolu Medical Center is a multidisciplinary facility providing American treatment standards at affordable prices in Istanbul (Turkey). Anadolu Medical Center's affiliation with the Johns Hopkins Hospital, one of the best medical facilities in the USA.
\n\nOncology, hematology-oncology, urology, neurosurgery, women's health, IVF, and check-up are the leading specialties at Anadolu Hospital.
\n\nThe medical center is among the Top 10 hospitals in the world, according to the Medical Travel Quality Alliance (MTQUA), an international organization that promotes high standards of health care for medical tourists.
\n\nPatients from the United States, the United Kingdom, Romania, Bulgaria, Azerbaijan, Kazakhstan, Uzbekistan, and Nigeria choose Anadolu Medical Center.
\n\nThe Anadolu Medical Center is a highly regarded medical facility located on the coast of the Marble Sea. It is renowned for its professionalism, cleanliness, and attention to detail. The staff is polite, attentive, and responsive to patients' needs. Highly trained and skilled doctors are available for comprehensive examinations and treatments, and the recovery room is bright and comfortable, with a beautiful view. Patients have benefited from the services of an excellent translator, Elmira, and the support of coordinators Zakhida, Bakhtygul, and Amina. The clinic also offers a transfer service from the airport to the hotel and back, as well as booking a hotel conveniently located 10-15 minutes away. Anadolu Medical Center is the perfect choice for a successful treatment and recovery.
\n\nProf. Dr. Tolga Taşçı brings _doctor_9677_years_ of gynecologic expertise, specializing in oncology and surgical procedures. The LEEP package may cost around $5,500, typically covering the procedure, one-day hospitalization, pre-op tests, and airport transfers. As a gynecologic oncology specialist trained in Turkey and the UK, he has performed numerous cervical excision procedures. The JCI-accredited hospital provides 24/7 academic physician care with interpreter services.
VM Medical Park Pendik Hospital is a JCI-accredited multi-specialty hospital in Istanbul. It specializes in neurosurgery, obstetrics, and gynecology. Over 150 physicians treat patients from Europe, North America, and beyond.
Dr. Yusuf Başkıran specializes in gynecology and minimally invasive surgery with training from Turgut Özal University. The LEEP package at Istinye University Liv Hospital Bahçeşehir may cost around $3,500 – typically covering the procedure, consultation, operating room fees, and 1-day hospital stay. This university-affiliated hospital offers free interpreter services and transfers for international patients.
","text_type":"mt_wow_description","best_texts":{"why_its_ranked":"Performed in a JCI-accredited hospital's Gynecologic Oncology Department with robotic and laparoscopic surgery. The doctor specializes in minimally invasive gynecologic procedures."},"agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}],"procedure_prices":[{"prices":{"price_from":50,"price_to":80,"currency":"USD","id":60494},"diagnostic":{"id":270,"name":"Papanicolaou test (PAP analysis)","alias":"papanicolaou-test-pap-analysis"}},{"prices":{"price_from":200,"price_to":200,"currency":"USD","id":61806},"diagnostic":{"id":457,"name":"Consultation with creation of treatment plan ","alias":"consultation-with-creation-of-treatment-plan"}}],"reviews":[],"clinic":{"id":765,"alias":"istinye-university-liv-hospital-bahcesehir","name":"Istinye University Liv Hospital Bahcesehir","short_description":"Istinye University Liv Hospital Bahcesehir is a university hospital affiliated with the Liv Hospital Group. Its main specialties are organ transplant, cancer treatment, neurosurgery, and urology. The hospital reports a 91.7% donor organ acceptance rate.
Dr. Berra Önsoy is an obstetrics and gynecology specialist in Istanbul, Turkey. The clinic offers general gynecology, pregnancy follow-up, and aesthetic gynecology. Specializations include genital rejuvenation, labioplasty, and vaginal tightening. The practice also supports gynecologic oncology follow-up and colposcopy for early cancer detection.
Dr. Önsoy has around 30 years of experience in women's health. She completed her specialization at Taksim Training and Research Hospital in 2001. The team offers non-surgical options like FemiLift laser and PRP treatments. Diagnostic tools include pelvic ultrasound, transvaginal US, and hysteroscopy. Patient coordinators speak English, Russian, Arabic, and German.
","text_type":"short_description","agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}],"procedure_prices":[{"prices":{"price_from":120,"price_to":0,"currency":"USD","id":50909},"diagnostic":{"id":37,"name":"Ultrasound","alias":"u.s."}}],"reviews":[],"clinic":{"id":6553,"alias":"dr-berra-oensoy","name":"Dr. Berra Önsoy – Kadın Hastalıkları ve Doğum Uzmanı","short_description":"Dr. Berra Önsoy is an obstetrics and gynecology specialist in Istanbul, Turkey. The clinic offers general gynecology, pregnancy follow-up, and aesthetic gynecology. Specializations include genital rejuvenation, labioplasty, and vaginal tightening. The practice also supports gynecologic oncology follow-up and colposcopy for early cancer detection.
Dr. Önsoy has around 30 years of experience in women's health. She completed her specialization at Taksim Training and Research Hospital in 2001. The team offers non-surgical options like FemiLift laser and PRP treatments. Diagnostic tools include pelvic ultrasound, transvaginal US, and hysteroscopy. Patient coordinators speak English, Russian, Arabic, and German.
","images":[{"base_url":"clinic/6a7919785da26","title":"Waiting area at Dr. Berra Önsoy Clinic, modern lounge with city view in Turkey"},{"base_url":"clinic/6a79197a43d51","title":"Modern waiting room at Dr. Berra Önsoy Clinic in Turkey with city view"},{"base_url":"clinic/6a79197c5a9a3","title":"Modern waiting room at Dr. Berra Önsoy Clinic in Istanbul with comfortable seating"},{"base_url":"clinic/6a79197e0ebf0","title":"Reception area at Dr. Berra Önsoy Clinic, modern gynecology facility in Turkey"}],"flags":[{"name":"has_active_agencies","value":false},{"name":"is_hide","value":false}],"geo":{"country":{"name":"Turkey","id":46,"alias":"turkey","iso_code":"TR"},"city":{"name":"Istanbul","id":107,"alias":"istanbul"},"address":"Şenlikköy, Eski Halkalı Cd. No:3/19, 34153 Bakırköy/İstanbul, Türkiye"},"rating":{"rating":0,"google":4.7,"percent_of_satisfied_clients":0},"statistics":{"number_of_reviews":0,"doctors_number":1},"accreditations":[],"agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}]}}],"meta":{"total_count":8,"total_pages":1}},"clinicsMeta":{"total_count":8,"total_pages":1},"clinicsCount":8,"clinicsCountByEntity":{"clinic_count":10},"doctors":{"doctors":[{"doctor":{"id":7284,"alias":"veysel-sal","name":"Veysel Sal","clinic_id":410,"photo":"doctor/65cf13820ab76","first_year_working":2010,"created_at":"2024-02-16T07:49:21.302+00:00","short_description":"Dr. Veysel Sal is a professor and gynecologic oncology surgeon at Memorial Bahçelievler Hospital. He specializes in the surgical treatment of female reproductive system cancers. Dr. Sal treats complex gynecological conditions in Istanbul. He works at a JCI-accredited facility recognized for its superior safety standards.
Memorial Bahçelievler Hospital is Turkey’s first LEED Platinum-certified hospital. It is part of the country’s largest healthcare network, Memorial Healthcare Group. Its core specialties include oncology, cardiovascular surgery, orthopedics, and robotic surgery.
Dr. Yalcinkaya specializes in LEEP procedures at Anadolu Medical Center, ensuring precise and effective treatment.
Dr. Cem Yalcinkaya is an associate professor and gynecologic oncologist at Anadolu Medical Center. He specializes in fertility-sparing surgeries and robotic procedures for gynecologic cancers. Dr. Yalcinkaya holds a robotic surgeon certificate for the DaVinci system. He successfully passed the European Society of Gynecologic Oncology (ESGO) exam in 2019.
Anadolu Medical Center is a multidisciplinary facility providing American treatment standards at affordable prices in Istanbul (Turkey). Anadolu Medical Center's affiliation with the Johns Hopkins Hospital, one of the best medical facilities in the USA.
\n\nOncology, hematology-oncology, urology, neurosurgery, women's health, IVF, and check-up are the leading specialties at Anadolu Hospital.
\n\nThe medical center is among the Top 10 hospitals in the world, according to the Medical Travel Quality Alliance (MTQUA), an international organization that promotes high standards of health care for medical tourists.
\n\nPatients from the United States, the United Kingdom, Romania, Bulgaria, Azerbaijan, Kazakhstan, Uzbekistan, and Nigeria choose Anadolu Medical Center.
\n\nThe Anadolu Medical Center is a highly regarded medical facility located on the coast of the Marble Sea. It is renowned for its professionalism, cleanliness, and attention to detail. The staff is polite, attentive, and responsive to patients' needs. Highly trained and skilled doctors are available for comprehensive examinations and treatments, and the recovery room is bright and comfortable, with a beautiful view. Patients have benefited from the services of an excellent translator, Elmira, and the support of coordinators Zakhida, Bakhtygul, and Amina. The clinic also offers a transfer service from the airport to the hotel and back, as well as booking a hotel conveniently located 10-15 minutes away. Anadolu Medical Center is the perfect choice for a successful treatment and recovery.
\n\nProfessor Cem Iyibozkurt specializes in minimally invasive gynecologic surgery, including LEEP, at Istanbul Florence Nightingale Hospital.
Dr. Cem Iyibozkurt is a gynecologic oncologist at Istanbul Florence Nightingale Hospital. He specializes in robotic-assisted surgery and minimally invasive oncology. He holds a PhD in Molecular Medicine. Dr. Iyibozkurt trained at the University of Oxford and Florida Hospital. He is a primary practitioner of robotic gynecologic procedures in Turkey.
Istanbul Florence Nightingale Hospital is Turkey's first Smart-and-Green hospital, certified by TÜV Hessen. It holds JCI and ISO accreditation and treats over 300,000 patients each year. Its strongest specialty is orthopedics, with the first EOS device in Turkey for low-dose imaging.
Dr. Esra Ozbasli is a board-certified OB-GYN and Genital Cosmetic Surgeon in Istanbul. She specializes in robotic surgery and women's aesthetic procedures. Dr. Ozbasli practiced as an academician at Acıbadem University for 12 years. She is also ECFMG-accredited for medical practice in the United States.
Assoc. Prof. Dr. Esra Özbaşlı OBGYN & Women Genital Aesthetics is a private Istanbul clinic for gynecology, obstetrics, and genital aesthetics. The lead surgeon has over 20 years of experience and 10,000+ managed pregnancies. The clinic performs robotic surgery with the Da Vinci system.
Memorial Şişli Hospital in Istanbul is one of Turkey’s leading multidisciplinary medical centers, operating on a 53,000 m² area with 252 beds, 13 operating rooms, and advanced intensive care units. Opened in 2000, it became the first hospital in Turkey and the 21st worldwide to earn Joint Commission International (JCI) accreditation, confirming world-class standards.
\n\nThe hospital is recognized for its expertise in oncology, organ and bone marrow transplantation (90% organ transplant success rate), IVF, neurosurgery, bariatric surgery, robotic surgery, and genetics. Equipped with cutting-edge technology and specialized centers, Memorial Şişli attracts patients from 167 countries each year, combining top-level medical care with Istanbul’s unique cultural and travel opportunities.
\n","images":[{"base_url":"clinic/634ffae9b76cd","title":"Memorial Şişli Hospital modern clinic building in Istanbul, Turkey"},{"base_url":"clinic/5ba3aa9d874b8","title":"Patient room at Memorial Şişli Hospital, Istanbul with modern furnishings and TV"},{"base_url":"clinic/5ba3aa9ebbdf9","title":"Patient room and lounge area at Memorial Şişli Hospital, Istanbul"},{"base_url":"clinic/634ffa7dd8799","title":"Reception desk at Memorial Şişli Hospital with modern decor in Istanbul"}],"flags":[{"name":"is_hide","value":false},{"name":"has_active_agencies","value":true}],"geo":{"country":{"name":"Turkey","id":46,"alias":"turkey","iso_code":"TR"},"city":{"name":"Istanbul","id":107,"alias":"istanbul"},"address":"Kaptan Paşa Mah, Halit Ziya Türkkan Sok Famas Plaza No:19 D:C, 34385 Şişli/İstanbul, Turkey"},"rating":{"rating":4.6,"google":4.7,"percent_of_satisfied_clients":87},"statistics":{"number_of_reviews":436,"doctors_number":189,"year_foundation":2000},"accreditations":[{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5db982e01da4b.jpeg","name":"International Organization for Standardization","country_code":"CH"},{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5cfa0ad8c533a.jpeg","name":"Joint Commission International ","country_code":"US"}]}},{"doctor":{"id":9677,"alias":"tolga-tasci","name":"Tolga Tasci","clinic_id":5614,"photo":"doctor/67d81dafc2c34","first_year_working":2004,"created_at":"2025-03-17T13:03:42.688+00:00","short_description":"Dr. Tolga Tasci is a gynecologic oncologist at VM Medical Park Pendik Hospital in Istanbul. He specializes in high-risk pregnancies and reproductive health. Dr. Tasci completed clinical observer rotations at prestigious UK institutions. These include Northern Gynaecological Oncology Centre and Barts Health NHS Trust.
VM Medical Park Pendik Hospital is a JCI-accredited multi-specialty hospital in Istanbul. It specializes in neurosurgery, obstetrics, and gynecology. Over 150 physicians treat patients from Europe, North America, and beyond.
Memorial Şişli Hospital offers specialized care for polycystic ovaries, with Dr. Semra Kahraman leading the IVF department since 2000. A pioneer in infertility treatment, she trained in the USA and Norway, specializing in ICSI, embryo freezing, and preimplantation genetic diagnosis. The hospital holds JCI accreditation and operates advanced fertility centers with cutting-edge reproductive technologies.
Memorial Şişli Hospital in Istanbul is one of Turkey’s leading multidisciplinary medical centers, operating on a 53,000 m² area with 252 beds, 13 operating rooms, and advanced intensive care units. Opened in 2000, it became the first hospital in Turkey and the 21st worldwide to earn Joint Commission International (JCI) accreditation, confirming world-class standards.
\n\nThe hospital is recognized for its expertise in oncology, organ and bone marrow transplantation (90% organ transplant success rate), IVF, neurosurgery, bariatric surgery, robotic surgery, and genetics. Equipped with cutting-edge technology and specialized centers, Memorial Şişli attracts patients from 167 countries each year, combining top-level medical care with Istanbul’s unique cultural and travel opportunities.
\n","images":[{"base_url":"clinic/634ffae9b76cd","title":"Memorial Şişli Hospital modern clinic building in Istanbul, Turkey"},{"base_url":"clinic/5ba3aa9d874b8","title":"Patient room at Memorial Şişli Hospital, Istanbul with modern furnishings and TV"},{"base_url":"clinic/5ba3aa9ebbdf9","title":"Patient room and lounge area at Memorial Şişli Hospital, Istanbul"},{"base_url":"clinic/634ffa7dd8799","title":"Reception desk at Memorial Şişli Hospital with modern decor in Istanbul"}],"flags":[{"name":"is_hide","value":false},{"name":"has_active_agencies","value":true}],"geo":{"country":{"name":"Turkey","id":46,"alias":"turkey","iso_code":"TR"},"city":{"name":"Istanbul","id":107,"alias":"istanbul"},"address":"Kaptan Paşa Mah, Halit Ziya Türkkan Sok Famas Plaza No:19 D:C, 34385 Şişli/İstanbul, Turkey"},"rating":{"rating":4.6,"google":4.7,"percent_of_satisfied_clients":87},"statistics":{"number_of_reviews":436,"doctors_number":189,"year_foundation":2000},"accreditations":[{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5db982e01da4b.jpeg","name":"International Organization for Standardization","country_code":"CH"},{"logo":"https://s3.eu-central-1.amazonaws.com/bookimed/accreditations/5cfa0ad8c533a.jpeg","name":"Joint Commission International ","country_code":"US"}],"agency_settings":[{"setting_name":"is_new","setting_value":"0"},{"setting_name":"kids_only","setting_value":"0"}]}},{"text":"Dr. Esra Tustas Haberal has 28 years of experience in gynecology and minimally invasive surgery, having performed 900+ procedures. She works at Hisar Hospital Intercontinental, a JCI-accredited center with 3 Tesla MRI and 640-slice CT scanners. Diagnostics start from $50 for a blood hormonal profile. Ovarian PRP therapy costs around $1,500, which covers consultation, injection, anesthesia, and same-day discharge.
Hisar Hospital Intercontinental is a JCI-accredited multi-specialty hospital in Istanbul. It treats 250,000 patients each year. Its core specialties are oncology, hematology, cardiovascular surgery, orthopedics, and bariatric surgery.
The procedure removes a cone-shaped tissue portion from the cervix to test and treat abnormal cells, offering precise intervention.
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She specializes in IVF, vaginal aesthetics, and laparoscopic surgeries, with over 20,000 cases handled. Dr. Comert is certified in Genital Aesthetic Surgery by the European Association of Aesthetic Medicine and Surgery. She also holds certifications in Gynecological Laparoscopy and Hysteroscopy, both approved by the Ministry of Health of Turkey.","advisoryText":"Dr. Esra Cabuk Comert is an Obstetrician and Gynecologist. She specializes in IVF, vaginal aesthetics, and laparoscopic surgeries, with over 20,000 cases handled. Dr. Comert is certified in Genital Aesthetic Surgery by the European Association of Aesthetic Medicine and Surgery. 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Follow-up cytology or HPV test can be done at home."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the clinician's qualifications and the facility's credentials before choosing them","scope":"treatment_abroad","source":{"url":"https://wwwnc.cdc.gov/travel/page/medical-tourism","host":"wwwnc.cdc.gov","quote":"Check the qualifications of the clinician who will be doing the procedure and the credentials of the facility where the procedure will be done.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C2","text":"Check the clinic or hospital is registered with local health authorities and is fully insured","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Check the clinic or hospital carrying out your procedure is registered with local health authorities and is fully 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