Taiwan could face a pediatric surgeon shortage within the next decade, as the nation currently only has 73 practicing specialists, data from the Taiwanese Association of Pediatric Surgeons showed.
While some newborns might face their first moments of life in an operating room if they are born with conditions such as an imperforate anus, intestinal atresia or congenital urinary anomalies, a healthy future is possible — provided the conditions are quickly diagnosed and treated by a professional pediatric surgeon.
However, the number of pediatric surgeons in Taiwan has declined to 73 nationwide, most of whom were 40 to 60 years old, while those aged 30 to 40 made up only 13.9 percent, indicating an impending workforce shortfall within 10 years, the data showed.
Photo: Taipei Times
Association secretary-general Hsieh Ming-yu (謝明諭) on Saturday said that in Taiwan, educating pediatric surgeons is a long process.
A medical student, after graduating college, must undergo two years of post-graduate training, four years of general surgery training and four years of special training in pediatric surgery.
That means at least eight years of training, with another three years of clinical experience usually required for them to become fully competent, he said.
Association chairwoman Chen Yun (陳芸) said that many pediatric surgeons chose to leave the profession despite completing the lengthy training process, largely due to limited caseload caused by declining birthrates, tight work shifts and underallocated National Health Insurance (NHI) points.
For example, imperforate anus surgery is reimbursed at only NT$60,000 (US$1,819) under the NHI system, whereas the same procedure could cost up to NT$6 million in the US, she said.
The pediatric surgeon training system itself is also facing challenges, too, Chen said.
Training hospitals risk disqualification if they fail to meet the minimum number of benchmark surgeries required, she said.
However, the number of pediatric surgeon training hospitals has declined from 18 to 16 due to decreased caseload, with the National Taiwan University Hospital’s Hsinchu Branch and the Tri-Service General Hospital in Taipei being removed from the list, Chen said, adding that Kaohsiung E-Da Hospital is also facing removal.
A pediatric surgeon at a medical center speaking on condition of anonymity said that regulations fail to stipulate whether surgical operations for people aged 18 or younger must be performed by pediatric surgeons, so such operations are often taken over by surgeons from other departments, leading to fewer opportunities and lower income for pediatric surgeons.
When combined with factors such as high work pressure, staff shortages and demanding work schedules, it is increasingly difficult to attract the next generation of pediatric surgeons.
The government should not only boost funding by raising the NHI reimbursement rates for benchmark pediatric surgeries, but also provide incentives such as additional bonuses for operations performed on patients younger than 18, Chen said.
Increasing NHI payments for pediatric surgery would have a minimal financial impact on the NHI system, as the profession’s reimbursements account for just 0.38 percent of the NHI’s global budget, Hsieh said, adding that the adjustment can significantly improve the future of pediatric surgery.
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