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Providing care across the strait

An established healthcare system including English-speaking medical staff positions Taiwan for health tourism. By JULIAN TAN

Taipei in Taiwan

Taiwan aims to attract medical tourists with its diverse culture, affordable cost of living and long history of medical research and expertise. Easing cross-Strait travel restrictions is a big step forward for the country to increase the number of Chinese visitors, particularly health tourists, and ultimately to fulfil its vision of becoming a medical tourism hub.

“Our first priority target group is the Mainland Chinese and overseas Chinese communities, followed by others in Southeast Asia, Japan, North America and Europe,” says Dr Wu Ming-Yen, secretary-general, Taiwan Nongovernmental Hospitals and Clinics Association (TNHCA). “We estimate the expected healthcare income for 20 participating hospitals [all are members of the Taiwan Task Force on Medical Travel] to be near US$100 million.”

At the Medical Travel World Congress held in Kuala Lumpur early this year, Dr Ko Chen-en, chief adviser of the Taiwan Task Force on Medical Travel and chairman of Chung-Hua Institution for Economic Research, presented Taiwan’s perspectives on growing medical travel. He noted Taiwan’s century of healthcare experience beginning with western medical practice in the 19th century. Milestones and achievements have included the launch in 1895 of Taiwan Medical Hospital, now the National Taiwan University Hospital, and enforcing stringent education standards that dictate that students spend an average of 12 to 13 years on basic medical courses, internship appointments and professional training and research in medical school before he or she becomes a board-certified physician.

To safeguard the quality of medical services offered in Taiwan, the Medical Care Act was enacted by the Taiwan Department of Health (DOH) in 1986 requiring statutory accreditation of hospitals and accreditation renewal is mandatory for medical centres, regional hospitals, district hospitals and clinics. Last year, the Taiwan Joint Commission on Hospital Accreditation – the pride of the country’s medical profession – passed the International Society for Quality in Healthcare International Accreditation Programme for Standards Assessment, while the Taiwan Task Force on Medical Travel was formed by the DOH and TNHCA. 

Taiwan has three JCI-accredited hospitals – Min-Sheng General Hospital in Taoyuan, Taipei Medical University-Wan Fang Hospital and the Koo Foundation Sun Yat-Sen Cancer Center in Taipei. Areas of medical expertise in Taiwan include liver diseases, dental care, craniofacial surgery and herbal medical among others. Treatments are said to be 20 to 50 percent of the cost in the US and priced 10 to 20 percent lower than in Singapore and Thailand. Taiwan’s potential to serve international patients is also being promoted at health-focused events, including the Medical Tourism North Asia this July and MEDIPHAR – Taipei International Medical Equipment & Pharmaceuticals Show in November.

In a bid to push tourism figures from China, Taiwanese carrier China Airlines recently announced its plan to cut scheduled Hong Kong-Taiwan passenger flights from July 4 and focus instead on weekend chartered flights to the Mainland – a move welcomed by the medical industry, including Liao San-San, coordinator, Department of International Health Care at Min-Sheng General Hospital.

“Without direct cross-Strait flights, Mainland Chinese patients may choose to receive healthcare in Hong Kong rather than Taiwan. However, the capacity of Hong Kong healthcare is limited. With the availability of direct flights, China patients will have more access to quality healthcare,” Liao tells IMTJ.

Since last year, the Taiwanese government has granted foreigners a maximum six-month stay for medical purposes. Health tourists can apply for a visitor visa with proof of their financial status and relevant medical documents.

Hospital staff across Taiwan whom IMTJ spoke to, cite the advantages of advanced equipment and technology, highly skilled doctors, reasonable medical fees, access to speedy care, secure infrastructure, cultural diversity and an affordable cost of living. “Due to a well-established national health insurance programme, Taiwan hospitals provide highly accessible modern technologies and specialists without waiting time. Physicians are trained in English – many in the US and Europe. On average, doctors receive 12 to 13 years of comprehensive and strict domestic medical training and many have received advanced training overseas,” says Liao. “Taiwan offers a safe and clean environment, and the Taiwanese are renowned for their friendliness and hospitality. In terms of distance, Taiwan is closer to the US and Canada than Thailand, Singapore or India.”

Tseng Hsiao-Chi, manager, Health Management Section at Cathay General Hospital, says: “Although we are not an English-speaking country, our doctors are all trained in English at medical school and medical charts are written in English. So for the most part, communicating with doctors in English is not a problem and English-speaking medical staff are available as well.”

However, challenges still prevail for Taiwan’s medical tourism and they include lack of advertising and awareness, Liao notes. “The Taiwan government prohibits healthcare providers from having marketing or promotional activities. Due to lack of marketing experience, Taiwan is rarely cited in medical travel topics. Lack of public awareness is one of the biggest disadvantages of Taiwan’s medical tourism. The relatively un-established tourism industry may not be as attractive as in Thailand or Singapore.”

According to Dr Wu, one of the challenges Taiwan faces is a shortage of multilingual environments for foreign patients. Echoing this, Mark K Chan, programme director, International Patient Center at Jen-Ai Hospital in Taichung, says: “The English-speaking level of Taiwan’s hospital staff is not good enough to care for international patients and most are not multilingual, unlike those in Singapore and Malaysia. So there are definitely language barriers for people seeking treatment in Taiwan, unless they speak Mandarin, which may prove to be extremely helpful when dealing with the Mainland Chinese.”

With President Ma Ying-jeou and his Kuomintang government eager to improve relations across the Strait, industry players are optimistic that Taiwan’s quality healthcare would become more accessible to people not only from China but also beyond. “With a new government in place, hospitals may now be getting the full support that may prove to be instrumental in Taiwan’s success in the medical tourism field. It [air accessibility to China] will open up many doors. I am sure that this will greatly benefit Taiwan’s medical tourism and ultimately its track records against other Southeast Asian countries,” Chan says.

 

Contacts

 

FIVE OF TAIWAN’S HOSPITALS WITH FOREIGN PATIENT CARE UNITS

Cathay General Hospital (CGH), Taipei

Inaugurated in 1977, the 801-bed hospital has an International Medical Affairs department specialising in cardiology and orthopaedics. A heart bypass procedure here costs US$18,000, US$12,000 for angioplasty, US$9,000 for hip replacement and US$10,000 for knee replacement. Health examination packages start from NT$8,000 (US$263) for half day and NT$21,800 (US$717) for full day.

Patients can make appointments by phone and have access to their primary doctors, as well as exclusive hospital wards that are equipped with wireless internet and multi-channelled TVs, customer services in Chinese, English and Japanese, post-treatment care and airport pickup. A consulting web page is designed to give instant message reply on the clients’ health and health check concerns.

CGH’s doctors are mostly trained locally and about 10 to 20 percent have received training abroad, including the US and Japan. Some 2,200 international patients visit each month for inpatient services, 100,000 for outpatient services and 1,300 for health examinations. Most of its international patients come from the US, Canada and Japan.

Chang Gung Memorial Hospital (CGMH), Taoyuan

CGMH launched its International Service Center in April 2007, offering the assistance of an international coordinator for patients’ enquiries by email or phone, to make their appointments with doctors, arrange transport and accommodation and provide reception, registration and discharge services. The 9,000-bed hospital collaborates with travel and hospitality partners like Highness Hotel and Allstate Travel for accommodation and travel arrangements.

It serves overseas Chinese from the US and 65 percent of international patients are from Asia, including Japan, Hong Kong, Macau, China, Malaysia, the Philippines, Indonesia and Vietnam. “There are almost 500 international patients hospitalised in our hospital and the number excludes outpatient service,” says a hospital spokesperson. A liver transplant surgery costs US$43,000 to US$64,000.

CGMH has its own specialty centres in fields like craniofacial, reconstructive microsurgery, joint replacement, hematopoietic stem cell transplantation, cardiovascular and voice beauty. To enable more people to benefit from its care, the Xiamen Chang Gung Hospital recently opened in China’s Xinyang Industrial Zone with 500 beds.

Jen-Ai Hospital: Tali, Taichung

Jen-Ai’s International Patient Center (IPC) was launched in 2003 to serve the growing needs of foreign communities in Taichung. Services include complimentary onsite interpretations in English and Japanese, preparing diagnosis and certification documents, translating medical documents for use after the patient returns home and simplifying financial transactions. Doctors at Jen-Ai were mostly trained in Taiwan, while the remaining – nearly 20 percent – received training in the US, Japan, China, the UK, Australia and New Zealand. IPC has received accolades such as the “Very Good English Environment Award” in 2004 and 2006 and the “Certificate of HONcode Website Accreditation” from Health On The Net Foundation in Switzerland.

To date, IPC has recorded over 6,000 international patient visits including 1,500 patients of 72 different nationalities, mostly expatriates. Over 80 percent of all patients come from the US, Canada, the UK, South Africa, Japan, India, Thailand, the Philippines, Australia and New Zealand. “The highest record of patient visits in one month is currently at 215,” says programme director Mark Chan, adding the top markets are the US, Japan and Canada.

“Our hospital passed the Taiwan National Hospital Accreditation late last year… With Taiwan gearing up for medical tourism, there may be a slight possibility of pursuing JCI accreditation in the near future, but only time will tell,” Chan says.

Min-Sheng General Hospital, Taoyuan

Min-Sheng opened in 2001 and five years later, became the first in Taiwan to attain JCI accreditation. One-tenth of its doctors have had training in the US, Europe and Japan, while the remaining were trained locally – about 80 percent of them at the elite National Taiwan University Hospital. The physicians are also fluent in English. The 600-bed hospital currently partners with several US insurance companies and accepts direct payments from the contracted insurances.

Its International Healthcare Center was launched in February of this year. Says Liao San-San, coordinator, Department of International Health Care: “We are at our initial stage of international services, so patient volume is not significant. Currently, they are from mainland China, Hong Kong and Japan and overseas Chinese from the US. Our target patient markets are the US, Europe and China.”

Speciality centres focus on nephrology, digital imaging and digitally guided surgery, oncology, three-dimensional stereotactic scanning, sleep medicine and 64-slice computed tomography scanning among others. The Dialysis Center is equipped with an online clearance monitor and single-use hollow fibres and caters to patients including overseas patients travelling in Taiwan who are in need of dialysis.

National Taiwan University Hospital (NTUH), Taipei

NTUH established its International Medical Service Center (IMSC) in 2005. It provides services including billing, counselling, doctor referrals, applying and obtaining medical reports, scheduling of appointments, airport pickup, flight reservations and confirmations, arranging local tours and translation. NTUH-IMSC is also the healthcare facility for the American Institute in Taiwan, International SOS and foreign embassies and missions within the country.

Target patient markets are the US, Canada, Europe, Middle East and Asia. Treatments available to international patients include hepatitis, cancer, organ transplant, cardiac catheterisation and open heart surgery, minimally invasive surgery, assisted reproduction, cosmetic surgery, joint replacement and anti-ageing medicine. The cost of assisted reproduction is about US$4,000.

NTUH is Taiwan’s leading hospital in medical education, research and services, with a comprehensive range of specialities and subspecialities. Last year, the hospital received recognition from the Taiwan Joint Commission on Hospital Accreditation. Most of its doctors are able to communicate in English and a number have either studied or trained in the US and/or Europe.


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