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Shortage of hospital pediatricians a serious problem: official

2012/05/30 20:40:38

Taipei, May 30 (CNA) The distribution of pediatricians in hospitals around Taiwan is uneven, which leads to a situation of serious cases being transferred to bigger hospitals, Deputy Health Minister Lin Tzou-yien said 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 the pediatrics departments in rural district hospitals, in particular, is quite serious, he said.

With the exception of the Taichung branch of Mackay Memorial Hospital, the pediatrics departments of rural district hospitals around Taiwan are normally closed at night, which means there no emergency pediatrics services, Lin said.

But even at Mackay, 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 the central city of Taichung, and they are on a work rotation for outpatients, emergency cases and on-call services, said Lu Li, chief executive of the Raising Children Medical Foundation, citing the foundation's findings.

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, according to Wu Mei-hwan, president of Taiwan Pediatric Association. Among the 3,000 licensed physicians, 300 are still in training, she said.

The figures show there are only 2,700 practicing pediatricians in 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 of children's doctors to the private sector, she said. The other problem is low payment, she added.

National health insurance reimbursement in emergency cases involving seriously ill children is comparatively low, according to Wang Jou-kou, 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 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 (US$840), 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 of Health is working to increase the health insurance reimbursement in such cases by the end of the year.

The department will also offer higher insurance reimbursement payments and special funding to encourage rural district hospitals to provide round-the-clock pediatric emergency services, he said.

(By Chen Ching-fang and Elizabeth Hsu)
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