The distribution of pediatricians in hospitals around Taiwan is uneven, which leads to serious cases being transferred to bigger hospitals, Department of Health Deputy Minister Lin Tzou-yien (林奏延) said on Wednesday, in response to questions about pediatric services in the country.
“We have many pediatricians,” but 62 percent of them run their own private clinics, said Lin, a pediatrician by profession.
While all serious cases are taken to hospitals, there are only a few pediatricians there to deal with emergency situations, Lin said.
The manpower problem in pediatrics departments in rural district hospitals, in particular, is quite serious, he said.
With the exception of the Greater Taichung branch of Mackay Memorial Hospital, the pediatrics departments of rural district hospitals around Taiwan are normally closed at night, which means there are no emergency pediatrics services, Lin said.
However, even at Mackay hospital in Taichung, seriously ill children who may require surgery are transferred to a bigger hospital in Kaohsiung, a three-hour drive away, he said.
Presently, there are only three pediatricians at Mackay hospital in Taichung, and they are on a work rotation for outpatients, emergency cases and on-call services, Raising Children Medical Foundation chief executive Lu Li (呂立) said.
Four times a month on average, the three pediatricians are each required to work a 36-hour shift, he said. Because of their heavy workload, whenever a serious case comes in, the patient is usually transferred to a bigger hospital, he said.
Currently, 3,000 of the 4,000 qualified pediatricians in Taiwan have a license to practice, Taiwan Pediatric Association president Wu Mei-hwan (吳美環) said.
Among the 3,000 licensed physicians, 300 are still in training, she said.
The figures show there are only 2,700 practicing pediatricians in Taiwan. With 62 percent running their own clinics, hospitals are left seriously understaffed, Wu said.
“Because of the heavy workload, pediatricians working at hospitals tend to want to leave,” she said.
However, the workload is not the only factor contributing to the exodus to the private sector, she said.
The other problem is low pay, she added. National health insurance reimbursement in emergency cases involving seriously ill children is comparatively low, said Wang Jou-kou (王主科), director of the Department of Pediatric Cardiology at National Taiwan University Hospital.
For example, he said, for a risky and difficult surgical operation to treat a narrowing of the pulmonary arteries, it requires two to five hours of work by a team of three surgeons when the patient is a child.
However, the insurance reimbursement for the operation is NT$25,000, compared with NT$42,000 in the case of an adult patient, which involves a less difficult and quicker procedure, Wang said.
Asked about the situation, Lin said the department was working to increase the health insurance reimbursement in such cases by the end of the year.
The department would offer higher insurance reimbursement payments and special funding to encourage rural district hospitals to provide round-the-clock pediatric emergency services, he said.