In the middle of last month, the Ministry of Education approved the establishment of a department of Chinese medicine at National Yang Ming Chiao Tung University (NYCU), the first national university to have such a department.
NYCU would be able to recruit 30 students to major in Chinese medicine each academic year.
The approval has triggered objections among those in the Chinese medicine sphere. A similar thing once happened in the field of Western medicine.
In September last year, the ministry approved the establishment of post-baccalaureate programs in medicine at National Tsing Hua University, National Chung Hsing University and National Sun Yat-sen University.
As Taiwan is in the middle of an election campaign, the objections cannot be underestimated, especially when those in the Chinese medicine sphere are known for their solidarity.
The ministry’s approval of a Chinese medicine department at NYCU should be applauded, but the reaction from Chinese medicine physicians is understandable.
However, if they are opposing the ministry’s approval simply because of the health insurance budget issue, which has limited Chinese medicine’s development in Taiwan, those in the Chinese medicine sector should work toward changing the health insurance system rather than questioning the higher-education admissions mechanism.
If the number of the Chinese medicine departments increases, with more students devoting themselves to specializing in Chinese medicine, the future of Chinese medicine in Taiwan should be considered promising. Should Chinese medicine physicians not be more supportive of the ministry’s arrangement?
In retrospect, the government’s long-term human resources estimates for the medical sector have been highly questionable.
In the 1970s, to address a shortage of doctors in rural areas, the government set up the National Yang-Ming College of Medicine with the goal of recruiting and training 120 medical students each year.
Meanwhile, the Council for Economic Planning and Development (now the National Development Council) commissioned academics to study and project supply and demand of physicians in Taiwan. They found that Taiwan would have enough doctors by 1995, and by 2000, there would be an oversupply of doctors.
It is fortunate that the council did not believe the findings, or adopt them when implementing further policies.
At the time, who would have guessed that after a decade or so, a universal health insurance system would be launched? Without the establishment of a new medical school, the healthcare system that caters to people’s needs today would not have been formed.
In addition to the questionable estimates of supply and demand, the prediction of what medical specialties should be emphasized was also untrustworthy. From 1975, when the National Yang-Ming College of Medicine was established, to 1995, when the health insurance system was initiated, the physicians Taiwan was lacking the most were those specializing in branches that did not have clinical practices, such as radiology, pathology, anesthesiology and psychiatry. The most popular four branches were internal medicine, surgery, obstetrics and gynecology, and pediatrics.
However, a decade after the launch of the health insurance system, graduates of medical schools are no longer interested in the four most popular branches anymore.
Given that academics cannot correctly estimate supply and demand of physicians in the near future, how can the government make sure the medical sector is sufficiently staffed?
Hence, the government and its agencies should ask: If the estimates are inherently inaccurate, what would be more serious, too many physicians or a shortage of physicians?
The new Chinese medicine department would only affect the supply and demand of Chinese medicine physicians after a decade. There is every reason to believe that as Taiwan is becoming an aging society, more people would be dealing with chronic diseases. Demand for Chinese medicine would certainly increase.
Most of the current physicians were born in the period after World War II, ie, they are baby boomers. Many of them are about to or have already retired. After this year, they would be aged 65 or older. Although they might still be willing to contribute to society, their energy and well-being could soon decline.
In this sense, a shortage of physicians is far more serious than an oversupply.
Even if Taiwan might have to deal with an oversupply of physicians 10 years from now, the problem of being unable to meet people’s medical demands is more serious than having more Chinese medicine physicians each year.
The ministry has made the right decision. If those in the Chinese medicine sector want to protest, they should ask the Executive Yuan to review the health insurance system budget issue, rather than fighting the Ministry of Education’s plan.
Chang Hong-jen is an adjunct professor at National Yang Ming University’s Institute of Public Health.
Translated by Emma Liu
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