The South Korean Netflix series The Trauma Code: Heroes on Call is a story about front-line medical staff who perform emergency treatment to save lives with insufficient resources, incapable or incompetent administration, and a society that misunderstands them and their duties. The drama epitomizes Taiwan’s medical system as it stands today.
At this year’s Taipei International Book Exhibition, National Taiwan University Hospital (NTUH) superintendent Wu Ming-shiang (吳明賢) said: “National Health Insurance has altered the medical ecosystem, and an unreasonable practitioner payment system is leading to young and new doctors’ unwillingness to take up work on the front line.”
That revealed the essence of the problem.
Despite Wu’s candor, several prominent members of the medical community have instead chosen to blame young doctors for “pursuing profit,” disregarding the more fundamental issue: When the system makes it so difficult to provide life-saving treatment, leaving it is perhaps the more rational option.
No matter whether it is emergency trauma care, internal medicine, family practice, obstetrics or pediatrics — or even fields of medicine long seen as “easy,” such as ophthalmology, dermatology and nursing — all medical workers face similar difficulties: excessively long working hours, high stress, low salaries and inadequate resources, yet they still bear society’s misplaced expectations and face the risk of medical malpractice suits.
By comparison, earnings from self-paid care services such as plastic surgery and performing routine health exams are much higher, the work hours more reasonable and the risks of being sued much lower. It is no wonder that younger doctors and medical staff are increasingly turning to those fields, unwilling to burn out within the hospital and medical system.
Wu said that last year, NTUH’s Hsinchu Branch had four outpatient surgeons who left at the same time in favor of private practice that offers monthly salaries as high as NT$700,000 — far higher than the salaries for hospital positions. That phenomenon is not only a personal choice, but is also the result of a system that does provide front-line medical staff with the respect they deserve.
The issue has never been a lack of medical staff, but rather the lack of medical professionals’ willingness to stay on. The South Korean government’s mistakes being placed on full display led to medical professionals across their nation to go on strike.
If Taiwan does not reform its misallocation of resources, it might face a situation in which more fresh medical graduates choose to go into private practice, or forgo practicing medicine in Taiwan altogether for greener pastures overseas.
If they lack reasonable salaries, resources and support, nobody would be willing to take on long-term overwork and low remuneration. That is a market choice, not an issue of ethics and morals.
Established medical professionals in Taiwan complaining and blaming younger doctors does not help to change our shared reality. They should reflect on why under our current system, saving lives has become almost not worth doing.
The Trauma Code: Heroes on Call reveals some hard truths. We need to resolve those issues. We must reform health insurance payments and improve the work environment to make it worthwhile for doctors to return to providing life-saving medical care.
Lu Chun-wei is a dermatologist and assistant professor at Chang Gung Memorial Hospital.
Translated by Tim Smith
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