The University of Texas
― M.D. Anderson
cancer center professor Euishin Edmund Kim, M.D. urged Korean people
don't waste their energy flying to the US for medical treatment, because Korea's
medical tech. is as good as any other country's. An article (Apple Daily,
Taiwan, 6-22-2015) by Taiwan's
Veterans General Hospital physician Dr. Ton (唐宗詠)
points out that so many Taiwanese expatriates living abroad (with
permanent resident card) and/or
foreign citizens of Taiwanese origin
flied a long way back to Taiwan for medical treatment. ――
Taiwan's medical-insurance system costs them much less than that in other
countries, e.g., the price for
a plaster cast in USA almost
equals one month salary of a Taiwanese
orthopaedics resident-physician, so, some
Taiwanese or Taiwanese American, etc, would rather bear the pain caused by
their illness and long-distance trip to save lots of their money.
http://www.appledaily.com.tw/realtimenews/article/new/20150622/633042/
(包山包海包全球的台灣健保)
◆
Taiwan's medical &
health performance is so
successful (e.g. life expectancy, infant mortality and maternal mortality, are
better than U.S., although we spent only one-quarter of USD (PPP) in health expenditure.)
that former leader of health government,
Dr. Ye Ching-chuan, was invited to testify
at an US senate committee hearing on this issue (http://blog.udn.com/yestaipei/18685477)
. An article by China Medical University
(Taiwan) Professor Ma (馬文隆)
stated Taiwanese studies on liver cancer
lead the world in the past (http://gicm.cmu.edu.tw/adv.html )
also proves Taiwan's medical tech.
is as good as most countries in the world.
◆
However,
according to
WEF<Travel
and tourism competitiveness report>(released at 4-6-2017),
Taiwan's "Physician density" ranks world
No. 65 (No. 57 in 2015's report).
Apple Daily
6-30-2018 pointed out Taiwan's only pride left, health
insurance, includes no preventive health care and health
promotion, and will worsen within next 10 years for
political factors. Taiwan only ranks world 45th position in Lancet's
Healthcare Access and Quality Index released in 2017
(based on mortality from causes amenable to personal
health care in 195 countries and territories, 1990–2015:
a novel analysis from the Global Burden of Disease Study
2015),
some
chronic disease
items got very low scores,
e.g., Leukemia score 49, Kidney
disease 50, Gallbladder & biliary 57,
Hypertensive Heart Disease 60,
diabetes mellitus
58, etc. Please ref. to the table as below:
Moreover, are there some serious
problems in Taiwan's medical system ―― hospitals and
medical personnel (including medical doctors, nurses and
hospital leaders) ?!
●Apple Daily,
(8-18-2018):
"The rich see Doctors, the poor enter grave ?
(有錢看病、沒錢等死)"?
/
former medical gov. leader 楊志良。 Popular TV
star 白冰冰 said (June
2017) : "The rich cut in a queue to see Doctors,
the poor are on the way to die (有錢免排、無錢等埋)"
!?
●
Apple Daily, 12-30-2017: Amending
the law of Taiwan's medical services is criticized as "Decriminalization".
Taiwan's medical-service environment is getting worse (台灣醫院免責?
醫療環境再惡化).
Patients in
Taiwan will be difficult to put to the proof in their legal cases.
●
United Daily News (5-30-2017): The
biggest problem of Taiwan's medical care is too short diagnostic time, without a
completed examination in most cases, usually, patients are already in serious
condition when symptom became clear. /
Dr. Huang D.F., president of Dr. Sun Yat-Sen Cancer Center.
●
Apple Daily (6-4-2017): Taiwan's critical
problem ――
Preventive Health-Care service is behind. /
former medical gov leader Young (楊志良).
● A
famous M.D., Hsu or Xu Da-Fu (許達夫)'s book
"Exposing the truth of modern medical circle
in Taiwan - misdiagnosis &
medical errors"
("誤診誤醫", published by the China
Times, 2012) criticizes :
(1)
Taiwan's hospitals focus
on profit/benefit and ignore patients' rights (in Ch.1
"Taiwan's medical system is ill")
―
The whole medical
circle already went the wrong route, it gonna be too
late if most influential and enthusiastic persons do not
spend efforts on completely changing our medical
education to boot physicians' medical spirits.
(2) Medical
students only learn Pathology and the way how their
professors
doing malicious
competition and internal struggle for the power and
money, and lack of Ethics knowledge as well as Humanism
quality.
●
Taipei City mayor Ko : Taiwan has not
established a culture of honesty
,
each time being in National Taiwan University Hospital's meeting, the 1st thing
crossing mind always is "who performed the operation (surgery) ?", M.D.s always
take it personally ... (
'無法真正做到對事不對人')
/ buzzorange.com/2015/05/29 " The phony culture in Taipei City Hall
- 整個社會都在說謊？！柯文哲揭露市府假面文化" http://www.chinatimes.com/realtimenews/20170611002397-260407
★◎
< No.1 ranks on US Google, Bing, etc, test
at 2-6-2018 etc >
pic.
above: This websites group's ranked No.1 on
US Google by
keyword "Medical Doctors in Taiwan"
at
2-6-2018, 1-28-2018.
pic.
above: This websites group's ranked No.1 on
US Google by
keyword "physicians in Taiwan"
at
2-14-2018.
pic.
above: This web-site's ranked No.1 on Google by "medical Doctors in Taiwan"
test at
5-
20-2017, 4-26-2017.
○
○
★
★1.
serious Corruption
- ready to pay a bribe?
According to
<Transparency
International>
studies (
July 9,
2013),
"Have you or anyone in your
household paid a bribe to one of these 8 services in the last 12 months?" Taiwanese
people think the institution needed to be paid bribery most is judiciary
system, second is Taiwan's
medical and health services,
the number of Taiwanese paying a bribe is higher than global average. (
Apple Daily 7-10-2013,http://www.appledaily.com.tw/appledaily/article/headline/20130710/35139300/
) ◎
<Transparency
International> of Germany
also
found the percentage(%) of Taiwanese respondents who
felt
medical
and health services were
one of corrupt/extremely corrupt institutions in this
country/territory is 47%.
The Liberty Times (1-10-2017): The
hospital M.D. got brokerage or kickback in various forms - e.g., money,
presents/gifts, joining international seminar or conference sponsored by
medicine business, or money that contributed to some foundations ... It's a
complicated Symbiotic relationship (benefit each other).
PS
◆
pic.:
東森電視; Global News TV - 寰宇綜合, 3-21-2018, 6:40 pm
"醫師好辣" - "unspoken secrets in Taiwan's operation
rooms": Patients usually prefer the first
operation in each day, this happened that 3
patients all paid bribery to the famous surgeons
for having the 1st operation, and all of them
had it
......
◆
The finding of the 2013 Global Corruption
Barometer (GCB), ( the
Gallup Poll to interview 114,000 people
in 107 countries all over the world): 36%
of people (surveyed in TW) who had
used any of eight government services in
the past year had
paid a bribe (the number is
higher than global average).
<NOWnews> , (7.10.2013)–
Taiwan is
the 18th worst corruption country in 95
countries surveyed. (重度貪污國家第18名)
<Apple
Daily> (7.11.2013): Apple daily's survey
found 75.07% Taiwanese people think
corruption in Taiwan is actually worse
than GCB's report.
◆
<Transparency
International>
, Taiwan, Dec 9, '05
Taiwan's Corruption Index : medical 32%
ps: this proved Taiwanese medical service is a long
lasting rotten circle.
◆
National Health Insurance
committee members think
Taiwan's Admin. Department
treat National
Health Insurance as their
own gold-mine or pocket
money - withdraw it as much
as possible (成了自己的金庫予取予求)
◎★
< No.1 ranks on US Google, Bing, as well
as
Baidu of China, Yandex of Russia, etc, test
at 2-6-2018 etc >
pic.
above: This websites group's ranked No.1
on
US Bing by
keyword "physicians in Taiwan" at
2-6-2018.
pic.
above: This websites group's ranked No.1 on
US Google
by
keyword "Medical Doctors of Taiwan"
at
2-6-2018.
pic. above: This
websites group's ranked No.1 on
Yandex of
Russia by
keyword "medical doctors in Taiwan"
at
2-6-2018.
pic. above:
No.1 "medical
Doctors in
Taiwan" on
US Yahoo at
2-17-2018.
(upper 3 are ads)
pic.
above: This websites group's ranked No.1 on
US Google
by
keyword "physicians of Taiwan"
at
2-6-2018.
◎★
◎★
★2.
worse Medicine
The
Apple Daily (6-30-2018): Medicine (drug store) is a criminal business for their
entire life.
The Apple Daily (2-20-2016, Prime News):
according to clinical experiences, many generic drugs are not as effective as
brand drugs... TVBS news reported at 7-15-2015 that
(http://news.tvbs.com.tw/life/news-608090/)
in order to maximize the profit, Taiwanese hospitals always cut down
the price while
purchasing medicines from pharmaceutical
factories, this results in international brand drug companies are/were not willing to
sell their brand-name medicines to Taiwan, therefore, the quality of
prescription
medicines in Taiwan is from bad to worse (用藥品質越來越差)
. Former Minister of Health
(楊志良)
criticized that Taiwanese hospitals do not like to improve medical employee's (M.D.s
and nurses) welfare by using their
surplus
profit. Many hospitals run their business by "medicine to cover
medical" strategy, which is, earning profit by medicine price differences to
cover hospital's expenses. If things go on this way, Taiwanese
patients will not have good brand-name medicines even being willing to pay on
own dimes in the future, more and more international drug companies may pull
back from Taiwan's market for unreasonable high medicine price
disparities.
Apple Daily of Taiwan
reported at 6-22-2015 that
Taiwan's hospitals already used medicines
made in Taiwan to replace int'l brand stuffs, and then, recently even don't like
to buy some local's medicines (最近甚至連台廠藥都做不下去),
till now, money can't buy some important
antibiotic medicines.
The
United Daily (9-1-2015)'s article
"medicine is cheaper than candy"
(by 楊志良):
Almost all International
pharmaceutical factories/companies had
already
withdrawn their business from Taiwan many years ago, Those
companies having brand drugs within term
of a patent show no interests in
Taiwan's market, This "Black Hole"
resulted in "bad medicines/drugs drive
out good"...
The
United Daily, the Apple Daily (9-3-2015,
Prime News): Taiwanese
government's new policy - patients
paying the part not covered by NHI use
brand drugs, is criticized as creating a
"class distinctions"
(class antagonism),
but some cases found generic drugs are
not as effective as brand drugs, UDN
also mentions medical government lacks
of ability to admin. the bigger and
bigger drugs/medical device market
paid at patient's own expense...
★
news
◆Hinet &
台灣新生報 news : Taiwanese
prosecutor do not file prosecution against Huang (秀傳醫療體系總裁黃明和)
for suspicious having earned huge amount of
medicine price differences by
establishing an empty-shell company.
◎
○
○
pic. above:
Medical human rights in Taiwan
pic.
above:
one
surgeon performs many operations
simultaneously - happened quite
often in Taiwan
Dr.Xu's
book /
by The
China Times
◎
★
★3.
Surgery
Apple Daily (9-18-2017)
reported that "fake surgery" (substitute-surgeon operates
illegally) did happen in
Chang
Gung Mem. Hospital, Taiwan.
Apple Daily (5-13-2015)
reported that Taiwanese people have an
"Obsession"
―
famous is best,
hence, an evil trend "one surgeon performs many operations
simultaneously" (「跳台開刀」)
prevails, which is a
long-lasting cooperate module
―― a
best-known
surgeon-physician
walks and looks around several
operating
tables in different
operation rooms
(all are in his name), and selects a major one to perform a most
important part of that surgical procedure, the rest are taken
over by 'unknown or less famous' physicians. (http://www.appledaily.com.tw/appledaily/article/headline/20150513/36547459/)
A
famous M.D., Hsu or Xu Da-Fu (許達夫)'s book
"Exposing the truth of modern medical circle
in Taiwan - misdiagnosis &
medical errors"
("誤診誤醫", published by the China
Times, 2012) also criticized this by a real
example, a patient complained : the
substituted
surgeon was not the one on the agreement
document with patient's and his in-charge
physician's signatures, that substituted doctor even did
not know which part needed to be performed
operation when he was there in the
surgical suite, after the surgery,the patient's
wound has become inflamed...
Dr. Xu explained this sort of
story indeed happened frequently (經常發生) in
today's hospitals, particularly, in major
hospitals, because each best-known medical
doctor has many patients, it's hard for the
doctor
to take care of everyone, hence, substituted
surgeons doing operations for best-known
M.D.s is quite often (常見), particularly, for
those famous physicians in charge also
working as teachers, lots of things keep
them very busy.
Dr. Xu suggested every
patient must keeps in mind who is your M.D.
in charge, and if you see a substituted
doctor showing up in surgical suite, just
refuse him to do the operation, unless you are
in an emergent situation.
●
東森電視;
Global News TV - 寰宇綜合, 3-21-2018, 6:40 pm
<unspoken secrets in Taiwan's operation room> "醫師好辣
- 開刀房不告訴你的事", discussed the phenomenon
― "one
Doctor performs several operations at the same
time", and
small Doctors perform operations for top Doctors
without notifying patients
Full text
: https://www.youtube.com/watch?v=gT2p7b4ZTQg
pic. left:
In
medical centers or large hospitals, you may gave
surgery by "students",
in
small hospital, you may have operation by
"master teachers"
.
pic. left:
It's very possible
that
resident-Doctors (sometimes, or even
CR MD)
replaced top MD to perform operations without
notifying patients.
pic. left:
The larger hospitals,
the more possible small MDs do operations for
top MDs .
pic. left:
even in
training-purpose
cases, quite
many "teacher" MDs still leave operation suites.
pic. left:
It was this way
years ago, security guards did operation, MDs
became their "assistant".
●蘋果日報
◆
Apple Daily
(5-13-2015) reported that a
famous physician (ranking top 100 in Business
Weekly) in Taiwan's Taichung
Veterans General Hospital performed 5 operations
at same time, that caused a woman's death and
his new name - suspicious
crime of fraud.
(http://www.appledaily.com.tw/appledaily/article/headline/20150513/36547449/)
(中榮名醫同時五台刀 涉詐欺 害婦送命
疑沒進開刀房也領獎金 /
廉政署鴨子划水蒐證數月後，發現《商業周刊》百大良醫沈男 兩年內疑有十件跳台開刀情況)
◎
◎
★ 4. Leaking
patients' medical records is a normal social behaviour in Taiwan
The United
Daily News (聯合新聞)
1-3-2017 <Where's Taiwan's medical
ethics ?> :
In Taiwan, journalists are not used to
respect patients' privacy... our
hospitals' members do not know very
clearly the principle of protecting
patients' privacy...(黃達夫)
Apple Daily (3-5-2017): A large hospital's
nurse took a picture of the patient without any permission
during brain operation
in surgical suite
and then spread that photo through
Instagram. That nurse also remarked "It's so exciting
to see human's brain!".
pic.:
The United
Daily News (聯合新聞)
1-3-2017 <Where's Taiwan's medical
ethics ?>
◎★
★ 5.
No.1 hospital in Taiwan FTV(民視) <Taiwan History(台灣演義)> 4-16-2017 , "Taiwan
University Medical School" (for
details pls ref to youtube
https://www.youtube.com/playlist?list=PLf2VRok0uRO2bH10tnVg9rWCIGeddXcSk)
● ●
Taiwan University Hospital had
major medical achievements,
including Asian No.1
records
●
Taiwanese Medical Doctors/physicians' social status is not as
good as before
(After National Health Insurance putting into
effect,
Taiwanese people's consciousness rises,
and usually make treatment requests to
their M.D.,.. resulting in
Physician-Patient relationship under tension)
● ●
"High
physicians cure the nation" / Former NTU dean Lee (李鎮源)
urged freedom of expression and human rights in
Nation's Day
of '91,
and called physicians together, eventually, only 50- out of
1000+ NTUH physicians joined that protest.
Reports pointed out Taiwanese physicians're afraid of
speaking freely which may damages their future, since so many
elites were killed in 228 political event, some victims got
serious consequences for sort of minor mistakes, all these
experiences and perspective deep rooted in some medical
people's mind, and became motive to fight
back.
●
Taiwan
University Medical School lacks humanism
thoughts
(Taiwan's current social value system is rapidly
changing the culture in medical circle /
Dean of NTU medical school (張上淳) advised that
always keep in mind a love-based,
"patient-centered", and humanistic-care thinking
)
◆
Many medical school
students' parents scared SARS and ignored the situation that insufficient
numbers of doctors confronting SARS, hence, those parents
pressed the government to pull 300 intern students out of hospital by reporting
"something" to the Control Yuan that Educational government already
neglected its duty. ◆
Some state hospital paused
emergency and regular medical services (門診),
about 1/3 clinics there stopped their services by all kinds of "reasons" you can
imagine. 124 nurses in a medical center in Southern Taiwan refused to take
care of SARS patients and then resigned, some M.D.s also resigned for the same
reason. ◆
Some medical center found hospital
infection and took "block & isolate " strategy, the next day more and more
patients at ward escaped from that hospital, Taiwanese government received
reports from all major medical centers in Northern, Central, Southern Taiwan, the
hospital president, and Infection Control directors concealed
SARS outbreak within the hospital to avoid losing face, avoid dropping
profit-performance, and/or avoid being sealed off the hospital, this
serious situations became major cause that Taiwan's SARS
continued to spread larger and larger. ◆ The work ethics, concealing
SARS outbreak, delaying reporting to center government or rejecting SARS
patients to avoid profiting worse are the most important reasons resulting in
hospital onset of infection and spreading SARS from bad to worse in Taiwan.
◆
Mass media reported a few
years ago that very few NTU medical students like to take
medical-ethics sort course, although
Medical educators are increasingly stressing the importance
of training in the ethical issues encountered in clinical
practice ( National ChenKun University
- http://ped.hosp.ncku.edu.tw/chinese/xoops/modules/tinyd/index.php?id=11).
★
7.
Nurse
Taiwan Hospitals'
illegal situation is serious
(醫院違法的問題非常嚴重)
◆
<The China Times> (6-24-2018) : A nurse of NTUH
connected wrong Hemodialysis pipeline
(tap running water replaced
bacteria-free medical water) to patients
doing kidney dialysis in ICU (Intensive
Care Unit) resulting in 1 weak died a few
days later, and several may be affected.
Dirty water into blood vessels may
caused Sepsis, NTUH accepted too many
patients and lacked S.O.P. for risk
management. <Liberty tumes>,
7-6-2018, <Apple Daily>, 7-7-2018:
Chinese Medical University Hospital had
similar mistake at 2-23-2018, one
patient was affected, National CK Univ.
Hospital at 5-24-2018 misused bleach to
do kidney dialysis, fortunately, the
machine was shut down for abnormal
detective signal, National Taiwan
University Hospital at May 25 & 26, 2018
affected 6 patients, 2 patients died,
not caused by this, based on initially
judgment. ◆
<United Daily News> (3-3-2017) :
Unlike
developed countries, Taiwan legislation has not
protected
nurses/patients ratio.
◆
<The Liberty Times>
5-12-2017 : New labor policy ("一例一休")
worsen the
the ratio of nurse and patients in
medical centers and regional hospitals. ◆ <United Daily News> (12-31-2013,
<台灣醫安問題 須誠實面對> >) :
The ratio of nurse and patients, 1:20,
was heard
many times...
◆ <The Liberty
Times> reported at 5-11-2015 - Taiwan hospitals'
means for exploitation of nurses include
:
◆Voluntary
Servitude Contract to sell oneself (綁約賣身契)
, heavy work only get you salary lower
than that in previous year ... ◆ Nurses
were asked to give up vacation for overtime
works, or for on-call working a shift on duty, all
these extra working hours were converted to an outcry
price, may be as low as NT50 (USD1.7 or so) per hour. ◆performance
bonuses
(「績效獎金」), allowance
(「工作津貼」)
, faked salary on
book... all became hospitals' weapon to
control nurses.
Nurses can't get
overtime payment, which can not be found by routine
labor-checks. (
加班沒有加班費，而勞動檢查也永遠查不到的結果。)
◆
Fake
nurses/patients ratio.
The
Evaluation
of The Effectiveness of The Hospitals by government can
not find something like nurse working in
the name of technician,
nurse-license was used for fake
statistics...
details pls. ref. to
Taiwan enrolled nurses general union
(護理工會) and Taiwan Labour Front (台灣勞工陣線)
web-site
http://labor.ngo.tw/news/news-now/189-news20150511
or
Liberty Times
http://news.ltn.com.tw/news/life/breakingnews/1313447 ◆
The capital (management) side
completely controls unreasonable
payments, in
spite of that the government reiterated on-call
time should be count for working hours,
but investigation this time found 96%
nurses' on-call time has not included in
their
wages, Taiwan's hospitals seriously violated the law.
(違法的問題非常嚴重。) ◆
Next TV
(壹電視/正晶限時批)
at 9-27-2015:
The ratio of nurses and patients in Taiwan's hospitals is absurd. (都太離譜了)
◆
<The China Times >
(1-12-2016):
Taipei City
found all hospitals it check
violated
the labor law.
◆
<The Liberty Times>,
<The China Times >, <The United Daily>
at 12-30-2015: 87% of
Taiwan's large hospitals had
surplus in their balance sheet of 2015,
but staff/labor
costs decreased from 45.86% downto
40.06%, medical staffs are still in a "Sweat
factory" status, hospitals used their surplus
on "arms race" - aesthetic
medicine, Proton
Therapy, Heavy particle therapy,
high-end medical check, The da Vinci sys.,
etc.to
attract people to pay on their own dimes
so that hospitals will have more surplus,besides,
medical resources concentrate on metro
large hospitals, it's unfair to remote countryside
patients, in the future, it
is expected to exhibit a polarizing
outcome
― middle and smaller sized
hospitals likely will closed, only small
clinics and metro hospitals left or
survived.
ps: TW
amended the law
http://www.chinatimes.com/newspapers/20170407000409-260114
◆ The
possibility of that some nurses (and some top
MDs, even the admin. sys) of major
medical-center hospitals are political lap-dogs
can not be excluded. They are not just
doing nothing (join protests) to avoid damaging
their future, but doing the powerful's
bidding to create a 'bright future'.
feb. 2018
◎★
★
8.
Abuse or use too little
medical resources
<United Daily News> (12-31-2013)
by president of Dr. Sun Yat-Sen Cancer Center : after a surgical operation,
a woman cried piteously 8 hours for belly pain and then died, there's no any
medical doctor came to take a look at her even her families look for help 9
times before her death... For saving some money, some hospital
admitted using recycle-bag for tube-feeding ...
<Apple Daily>
of
Taiwan ( 6-22-2015 ) points out in some
cases acesodyne (painkiller止痛藥) is not allowed to be given for some
terminally ill cancer patients in
Hospice-palliative care after his having signed a give-up-emergency-treatment
agreement. It's wrong that hospitals think money higher than
humanity.
<The Liberty Times> reported at
5-26-2015 that Taipei mayor Ko expressed Taiwan's hospitals abused ECMO
(extracorporeal
membrane oxygenation), taking National Taiwan University Hospital as
example, till now ECMO has been used for 1800 times, 10% of them won't save
those patients' life - from the first place they should know.
<Exposing the truth of modern medical circle
in Taiwan>:
Taiwan's M.D.s are accustomed to give
patients lots of prescription medicine
more than needed.
★
◎
★
9.
lots of FAKE medical records
<United Daily News>
(12-31-2013,
<台灣醫安問題 須誠實面對> >)
article <Facing Taiwan's medical safety issue> by Dr. Huang
D.F., president of Dr. Sun Yat-Sen Cancer Center : In
addition to those fakes created by Taiwanese government and
enterprises, one more "fake" has been hidden in extreme dark
side - that's Taiwan's medical record. The patient's
record usually is used for medical studies and NHI benefit
package, it look OK in form, but the quality is from bad to
worse. Taiwanese government usually see only with one
eye on or turn a blind eye to fake or cheating things as long as you have
contribution to Taiwan's GDP...
<United Daily News> (12-11-2013,
<台灣假的病歷
誰來監督?> (章貢):) : Fake medical
records of patients include - 1. made by copy & paste way,
2. evading the crucial part & lacking of clinical
symptom, 3. irrelevant or not speaking in details, 4.
creating something from nothing (so patients will be in bad
situation for any legal case in the future), 5. substituting
on for another (by unqualified staffs), 6. add/delete/modify
something - for evaluation, investigation or legal problems.
(1.蕭規曹隨、複製貼上式
2. 避重就輕、缺乏臨床症狀 3. 牛頭馬嘴、語焉不詳 4. 無中生有、讓病人處法律劣勢 5.
移花接木式(由尚未立法的護理師等，甚至什也不是的記錄員處理拼湊 ) 6. 塗改增修式 -
遇評鑑、抽審、或法律糾紛時如此處理 ......)
◎★
★
10.
completely FAKE evaluations by
the government
◆
Apple Daily
(6-2-2015, "完全造假的醫院評鑑"
by
呂享諧M.D.
http://www.appledaily.com.tw/realtimenews/article/new/20150602/621194/):
The
fake evaluations
of the hospitals by government were done by officials and
hospitals, those "mutual understand" fake items include
hospitals employing ghost nurses and temporary nurses who
will be fired after the evaluation, fake SOP, fake meeting
records ... the evaluation results - different level
of hospitals, may affect up to 10 billion + dollars annual
income by hospitals.
◆
Next TV(壹電視/正晶限時批)
at 9-27-2015: 6
false shows in the evaluation of Taiwan's hospitals
False evaluations are everywhere in Taiwan, from army, fire-extinguish dept., to
many other businesses... including hospitals.
Since Taiwan's government informs
the time for evaluation, hospitals have plenty of time to plan everything in
details for a false results.
1. In evaluation day, hospitals request rookies to
take a day off or specially arrange evaluation-committee members going specific
route, in there they only meet senior medical staffs.
2.
Hiring people for short
term or taking administration staff into statistics
make a beautiful ratio of nurse and
patients.
3.
For dealing with
evaluation, hospitals limit the number of outpatients, decrease the number
of inpatients, and patients in emergency room waiting for a inpatient-bed.
4.
Medical doctors and
nurses are busy in paper works for evaluation, decreasing the time to take care
of patients.
5.
Hospitals are busy for evaluation or authentication, so as to create a false
image of perfect administration and high degree of medical skill.
6.
In evaluation day, hospitals request all medical staffs give
evaluation-committee members "model standard answers" (『標準答案』).
◎
pic
above:
During
evaluation time, all the surgical suites in a
very busy hospital were empty, Medical Doctors took one
day off。
photo "Apple Daily's Next TV (壹電視/正晶限時批)" 9-27-2015.
◎
★11.
shady
& shabby deals in medical circles -
●
money
brief from
Broadcasting
Corporation of China (BCC)exclusive interview former minister of
Health, Dr, Yang C. L.,
rpt. of
2011/04/14 United Daily News (聯合新聞網),
and 2011/04/18
The China Times (中國時報)
◆ pharmaceutical
factories and opticians tried every efforts in offering all kinds of attentive
services to target physicians, paying check for their going
abroad and meal is just "basics", "extras" are, e.g.,
taking the initiative to sponsor a certain foundation,
arranging local entertainment girls together with them
during a
medical conference in mainland China, etc. Some physicians even have a
"wife" in each province of China.
◆ He
was told
certain price
is needed forsome
top positions like provincial
hospital president or assistant
administrator.
◆
The Liberty
Times (8-28-2013) : according to latest report by dept. of
labor, 6 out of 21
sweatshop hospitals are
state hospitals,
their illegal deeds include giving no overtime payments for
overtime workers, etc.
◎
● politics
◆
Hospital's
long-standing
malady that Dr. Yang (楊志良) exposed is just
the tip of the iceberg, ugly dark sides of Shiroi
Kyotō (Taiwan's hospital and medical doctors)
and pharmaceutical
factories are inseparable, closely
linked. Pharmaceutical
factories focus on public
hospitals joint purchasing projects (聯合採購標案),
major battle fields are 退輔標、軍聯標、署聯標、市聯標, hospital's
president actually is the key man in the shadow, although
avoiding purchasing things on the surface. Besides,
political connections help, hospitals
usually buy politicians, say, legislator's letter.
◆
Next TV(壹電視/正晶限時批)
at 9-27-2015: "Terrible
white terror in Taiwan medical services"
1. "Auditing &
expense/budget controlling" becomes inspection-committee
members' means for revenge (核刪成為審查委員報復手段)
2. The reasons for cut off some expenses is
groundless, leading to patients missing best time for
curing. ( 核刪理由"莫須有"錯失治療黃金時間)
3.
In order to push patients to pay on their own dimes,
inspection-committee members not only cancel some expenses,
but also double deduct it (倒扣).
4.
Encouraging using drugs/medicines made in Taiwan,
influencing medical doctors' judgement and decision.
5. Taiwan government may blames inspection-committee
members sometimes cut off some expenses without good
reasons, but, actually, committee members just followed the
government's "hint" to do it.
◎
pic left:
"complicated relationships between medical
businesses and politicians?",
photo
"Apple Daily's Next TV (壹電視/正晶限時批)" 9-27-2015
pic. right:
"White terror
in Taiwan's medical field" ,
photo "Apple
Daily's Next TV
(壹電視/正晶限時批)" 9-27-2015
◆
I personal encountered some
suspected cases concerning collusion
between medical staffs and politics ...
★12.
Taiwanese
M.D. crime rate global No. 1
● TVBS 2012/07/27: Taiwanese
M.D. were accused easily and frequently, hence "crime rate" is world No.1
--- In average, one Medical Doctor was accused per day, one
was convicted per month.
●
Commonwealth
Publishing Group (遠見) magazine, ettoday.net/news 2012/07/11:
The conviction rate (preliminary
trial , district court judgment) of
Taiwanese physicians is 24.5％.
★
★13.
Discriminations
in Taiwanese hospitals
●
Taiwan Television Enterprise (TTV)
Commonhealth Magazine (康健雜誌, issue No.184)
<Some specific patients bear the stamp of
suffering >: Some
patients go to hospitals out-of-town, or even
go to several
clinics each in different hospital ――
what's patients' secret behind ? the answer is ,
e.g., some Melancholia (depressive disorder) patients do
it this way, another case is when some physician found
his patient is Psychiatry patient as well, he showed
impatient and pushed his patient to go consulting
Psychiatry M.D., so that this patient feel himself
a sub-patient in medical service。
(brief, author：吳佳璇)
●
Taiwan
University Hospital
,
"The
jewel in the crown of health care providers",
is
suspicious of discriminating elderly people (or all
people) living alone in medical examination - stress-free anesthesia colonoscopy,
NTUH staffs seem not welcome this group of people,
who are
not allowed to do this examination alone,
or even accompanying by another old people or a young
household caregivers who is
specialized at taking care the elderly. NTUH does
not allow the examinee to do anesthesia colonoscopy unless a
younger family member coming together. This unreasonable
condition is not written in the signatured agreement, and
never let examinee know in advance, furthermore, it's
ruled by men, not a 'institutionalization', which means
some cases are fine, some others may not be permitted.
(ps: On
Dec. 2016, NTUH added "Together with a family member or
a friend is a must for examinee to do anesthesia colonoscopy
" on the agreement) ps:
FTV HD
民視台灣台 , <新聞大解讀> , 3-1-2018
8:52pm:
Taiwan will enter a "zero families age"("零家屬時代").
★
★14.
only
3 min. for each patient
The United
Daily News (聯合新聞)
1-3-2017 :
How can those
M.D.s spent 2 minutes on those patients with complicated
or serious condition... Fast medical diagnosis (100+
patients per clinic) may increase the probability of
incorrect judgments... (黃達夫)
Dr. Ye Ching-chuan
(former
leader of health government, 葉金川) blog (6-30-2009): Taiwanese go
to clinics 15 times per year, 3 minutes with M.D. each time, in
contrast, Americans go to clinics 4 times
per year, 15 minutes each time；TTV(台視常春, 3-1-2011):
Taiwanese patients talk with M.D. for 3 minutes only
(看診3分鐘，該跟醫生說甚麼...)；CTS(華視, 5-19-2010): A popular M.D. in Kaohsiung spent 1.4 minutes in average on each
patient...
★
★15.
Half
failed to pass health inspection
The Liberty
Times (11-29-2016): Half of random-selected hospitals failed
to pass (Food and Beverage
Sanitation or
environmental Sanitation
) health inspection.
★16.
all of us
are
unwanted clients
●
United Daily, 2-3-2018,
https://udn.com/news/story/11319/2966710
Taiwan's hospitals
have an unspoken rule ― inpatients staying in ward
more than 28 days might be "forced" to be discharged from
hospital, many turn into "unwelcome tramp" wandering from
one hospital to another, although there's no this kind of
laws or regulation made by the government. Most
of these sad people are stroke patients.
●
<China Times Weekly> (8-28-2015
~ 9-3-2015, No.1958)
article "The crisis of Taiwan's Medical & Health services"
(by Taipei
City Hospital leader /黃勝堅) : "When
medical solutions become too commercialized, and lose humanistic care and
respect, sooner or later, Taiwan's medical systems will face a severe
challenge of breaking down..."。
●
impact of DRGs (new version of insurance)
―
negatively
affect patients in Taiwan as below:
◆
Patients with multi diseases may become
unwanted clients (medical negligence,
Chinese namely "人球") - hospitals may filter
patients, reject some or deal with their
disease only one at one time - hence
patients waste lots of time for it..
◆
The number of items to be paid at patient's
own expense increases if you want same
quality of treatment as before or a complete
& precise medical examination.
◆
Patients may be asked to discharge earlier
even they have not healed or recovered
completely, if you 'd like to be in ward for more
days, pay on your own dimes, because DRGs
push hospitals to discharge patients 3~5
days after treatments or operation, otherwise the hospital
will absorb additional cost
―
which means
losing money.
◆
Do those examinations only for the item why the
patient is hospitalized at this time.
◆
If a patient needs 2 surgeries, hospital
will find some "reasons" to push the patient
leave hospital after his/her 1st operation, then
the patient pays extra efforts to be in hospital again
for his 2nd operation.
◆
If a M.D. 's patients' amounts of
medical expense covered by insurance are over
the budget's upper limit, this MD physician's
"performance" (績效) will be reviewed or
examined by his hospital.
Details
pls. ref. to <今周刊>(Business Today)
10-31-2014
★17.
Fake medicine
Apple Daily 2-24-2017, 3-7-2017 :
Crestor (a most popular blood-lipid
lowering drug by AstraZeneca), ranking No.1 sales-amount covered
by Health Insurance in 2016, was faked by illegal Syndicate. Since the
circumstance is from bad to worse, the government declared
to retrieve
all Crestor.
The Liberty Times , 3-15-2017 : The leader
of National Health Insurance stated medical people pointed
out faking drug is because the price of
brand or regular medicines was cut down to bottom... they choose to
fake the most popular
drug if have to be illegal...
★
★18.
sexual
harassment in hospitals
The China Times
<中國時報> 3-8-2018:
according to investigation/survey,
80% female physicians met sexual harassment,
... a female physician of Cathy Hospital had different views and said the
percentage of harassment to nurse probably higher because they are young and in
lower status (8成女醫曾遭性騷擾,
女醫反應兩極 ... brief)
★
This sites were among top ranks by
Chinese keywords "comment Taiwan hospitals" as well as
"comment Taiwanese MD" on US Bing, Yahoo,
US Google, etc
pic. above: No.1 by Chinese keyword "comment Taiwan hospitals" on US
Bing,
tests at 2-9-2018
pic. above: No.1 by Chinese keyword "comment Taiwan hospitals" on US google,
2-6-2018, 4-19-2017, 1-22-2017,
6-11-2016,
2-21-2016
pic. above: No. 2 by keyword "comment Taiwan hospitals"
in Chinese on US Yahoo,
at 2-9-2018.
pic. left : No. 1 by keyword "comment Taiwan hospitals"
in Chinese on US Google,
at 2-18-2018.
pic. right : No. 1 by keyword "comment Taiwan
physicians"
in Chinese on Google Taiwan,
at 2-18-2018.
pic. left : No. 1 by keyword "comment
Taiwanese physicians "
in Chinese on Yahoo Taiwan,
at 2-18-2018.
pic. right : No. 1 by keyword "comment
MD in Taiwan "
in Chinese on US Bing,
at 2-18-2018.
pic. above: This
websites group's ranked No.1 on Baidu of China by
keyword
"medical doctors in Taiwan"
at
2-6-2018.
★
★ 19.
Court Doctors
Apple Daily,
4-27-2018: Taiwan got only 3 court Doctors / legal
medical experts can do operations.
★
★
20.
inspection failure - hospital & long-term care problems
United Daily,
8-14-2018: Taipei Hospital big fire, in recent 6
years, 5 fires, 36 died, 185 wounded in nursing home (long
term care facilities).
Apple Daily,
8-14-2018: 6 fires in 7 years.
★ 21.
MDs and patients taped each other secretly for self-protection
2-5-2018 (about 10 : 30 am) , one of my families went to NTUH (National Taiwan Univ. Hospital )
for CVA emergent treatments.
(1) 119 ambulance and emergency technicians (from SongJiang fire
brigade) - excellent, fast and quick.
(2) NTUH emergency room - CR MDs are quick to see the patient, they
did some check-ups (heart, etc), basic diagnosis and followed SOP - did not give patient rtpa
because there's no proof that it's still within 3 hours since stroke probably
happened.
(3) NTUH emergency room - CT scan in afternoon, MRI at about 8 pm.
(4) NTUH emergency room - nurses did some examinations, e.g.,
drawing blood for tests, some pretty good, some pretty
bad.
(5) All wards are occupied, the patient was in
a medical mobile bed in hospital's aisle, like many others. According to
experiences, many may wait in cold aisles or even at very freezing gate room for
more than one or a couple days ......
(6) Care-givers - not difficult to hire one because many related business
agents
look around in emergency room to provide care givers ( NT 2200-1600 for 24
hrs cares), although the number of hospital-contract care givers are not enough for
demands. ( In contrast, gov. long-term care system is
much worse, some may wait a couple of months for none or no-good care givers )
(7)
patient thinking, speaking normally.
2-6-2018
(1) Be hospitalized at noon, in a 3-beds
ward.
(2) CR MD and attending MD well explained all
about ... blockage of the brain artery causes ischemic stroke (CVA), it's a
"小中風". MRI shows other part of the brain may be
risky, the main mission is to avoid new CVA happening. The blockage will be
there ... Recovery is not too easy because the patient is aged
94-95.
2-7-2018
(1) after one day's queue, moved to
1st class ward. MD said that staying in hospital may
have risk of being infected even in first-class ward, because nurses,
MDs, care-givers and visitors may bring virus to the ward, and the
hospital does not provide them with anti-bacterial cap and clothes to
protect weak inpatients.
However,
according to some internal doc. , NTUH prohibits
medical-alcohol spray or those kind use for anti-virus
inside the ward, and no
any electric heater (halogen, etc) is allowed to be used ...
sometimes the temperature of the 1st class ward (2 large window) seems
bit colder for weak patient than that in crowded 3-beds ward.
(2) a MD or physical therapist from Rehabilitation Dept. tests
the patient - walking seems back, but still slant to the right more or less.
(3) attending MD look over, after
treatments, the symptoms of breathing, swallowing problems improved.
2-8-2018
attending MD, physical
therapist, nutritionist came, CR MD came twice.
Patient had chest X rate and heart echo. Feb. 9
(Fri.),
MD declared she is OK, and can be discharged from
hospital next Mon. to avoid being infected.
Feb. 10,11, 2018 care-giver helps
physiotherapy, patient under observation...
2-13-2018 patient is OK, and is discharged from hospital. CR
MD got excellent attitude, and believed it's reasonable to use
anti-virus alcohol spray in the ward to protect very old
weak patients.
< No.1 ranks on US Google, Bing, etc, test
at 2-6-2018 etc >
●
2-5-2018 (about 10 : 30 am) , one of my families went to NTUH (National Taiwan Univ. Hospital )
for CVA emergent treatments.
