Taiwanese hospital culture - odd features

Right, just having my first TW hospital experience, guess I should have read some threads here first, cause it was a bit of an eyeopener.

As it was, while 85% was good (specialists, tech, speed, friendliness etc), some details were rather shocking coming from a European p.o.v.

Like, room bathrooms do not even have the bare minimum of towels, soap or toilet paper!?

How can that represent any savings at all, at least the latter two represent absolutely miniscule savings and are totally inefficient not to provide, not to mention not very hygenic which is supposedly a thing hospitals should go for. Whats next, bring your own bedding, pillow, wheel chair?

Also, and I suppose a result of a more traditionalist and less individualist culture, you are supposed to have a family caretaker around. Nurses are used to this and offload their work to family helpers.

However, this has plenty of possibly disastrous effects. Helpers are not professionals. Your undermine the whole point of specialised expertise by outsourcing to family member of variable competence.

Who bears responsibility if accidents happen? Would imagine there could be tons of issues and lawsuits. What if patient A suffered brain damage due to nurse B didnt make sure X, while granny C forgot to X?

Just in my room, a granny nearly choked her handicapped, largely unconscious grandson to death by pouring liquid into his mouth without elevating the upper body. Luckily, the nurse who was interviewing me noticed just in time. How many accidents must happen due to this system?

Again, 85% a good service, it is just very interesting to experience different ways of organising systems and trying to understand why these choices were made.

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What I don’t understand is why doctors prescribe antibiotics for viruses here…

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Sorry to hear about your experiences.

This is indeed a frustrating aspect of Taiwan. You hear government bureaucrats and their cronies about pandemic prevention, yet simple soap and towel are an afterthought because “it’s a waste”.

Usually this is the result of a very high patient-mnurse ratio, not due to cultural norms. The implementation of the NHI system is notorious for leading to crowded hospitals, like it’s the holiday shopping season or something.

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Patient happy → good patient reviews & referrals → $$$.

Yeah, clearly you will have overcrowded hospitals if every patient effectively is a +1. Which makes for even worse pandemic times.

I think the amount of medication here is generally shockingly high.

Here’s what my friend was prescribed for his cold and coughing:

  1. Cephalexin 500mg - Antibiotic
  2. Acetaminophen 500mg - Ibuprofen (painkiller)
  3. Dextromethrol 15mg - Morphin / Cough suppressant
  4. Ambroxol 30mg - slime dissolving
  5. Fexofenadine 60mg - anti allergic
  6. Famotidine 20mg - stomach acid reduction

He did not know what all the medication actually does. I googled and added the effect of the medication. Asking him why so much medication, he just told me it’s normal around here because people want to get healthy again very fast.

Now that really leaves me wondering what kind of medicine doctors prescribe when someone is really ill. Will people just take like 20-30 different pills multiple times per day? :thinking:

Hope you’re doing better now. What was your experience about medication?

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I was shocked at first. But I was even more shocked at how bloody effective it was for a flu.

I took the meds and goddamn I felt almost normal

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Medication was pretty spot on, no issue.

Perhaps at the clinic before I realised hospitalisation was necessary, the medicine choice was a bit too shotgunny, but then again better safe than sorry in this case.

Anyway out tomorrow it seems, all good, particularly considering the maximum bad timing of having to go to a hospital.

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I want some of these

Yeah I imagine that would be a shock. It takes some getting used to

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Anyone with experience of hospitals in South Korea, Japan, China, Philippines - are these issues the same there?

The worst is the “workflow” of doing anything in the hospital. Imagine needing a vaccine for your kid.

Turn up for the appointment on 10F. Beep your card in the machine. Go to side room for them to measure weight, height etc. Then wait until your number. This is all ok. Finally see the doctor who writes the prescription. Then you need to go wait outside the room again until they give back the NHI card. Then go down to cashier on 1F to pay for the appointment and vaccine. Then go to the pharmacy in B2 to collect the vaccine. Then take it back up to 10F to finally have the injection.

It’s a huge faff overall.

Also, the obsession with doing everything in hospitals is a bit crazy. If you just need the same routine prescription for blood pressure or cholesterol meds, you still need proper outpatient appointment every 3 months. The whole thing usually takes 2-3 hours. In the UK, once you’re on a stable repeat prescription like that, they’ll see you every few years. You just pick up repeat prescriptions at the pharmacy.

Now with Covid, I hope it prompts change. Because what’s the point of doctors seeing so many people just to fill routine prescriptions?

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They love the NHI money. In fact many clinics are worse, ‘here is 3 days worth of meds, see you soon’
The hospital usually gives me 2 weeks or even a months worth so I don’t have to schlep to a clinic every 3 days

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I bet they will give you more if you asked. It might have just been an oversight by the cleaning staff.

Caregivers who stay overnight do have to bring their own bedding and pillow or rent from the hospital based on my limited experience (one hospital).

That’s one aspect that I hate about Taiwan’s system, but I guess it keeps the inpatient care affordable (if the caregiver doesn’t have to take time off from work to take care of the patient). For those who can afford it, they can hire a professional helper for 2500 NT-3500NT/day(24H). Most Taiwanese I know have private insurances that cover their hospital stays in addition to NHI.

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I recommend to use https://myhealthbank.nhi.gov.tw
There you can see all the medications and description in English.

You can sign up with a card reader and your NHI card or get a password from a NHI office near you.

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Is it really in English? I’ve been using the app but I didn’t think it was, and I couldn’t see an obvious option to change it…

Korea is the same

if it is not a chronic disease, 3-7 days sound reasonable.

For medicine one thing to note is that Taiwan uses very little combination drugs . So when you take Nyquil in USA you are taking three medicines in Taiwan:

Acetaminophen 325 mg - fever reducer
Dextromethorphan HBr - Cough suppressant
Phenylephrine HCl - Nasal decongestant

Overall most drugs used here are a generation old though my pharmacist friend calls a lot of these new versions just a way to make more money for the drugs companies as the active ingredients are just the same. The patient just saves some work taking one pill instead of three.

I do agree that there is an overuse of antibiotics here.

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Its chronic but not an emergency type issue. Small clinics always want to give me a few days medication. 7 days is still a waste of time for non urgent, chronic cases. Hospital usually gives me enough for the month, saves me time, saves NHI cash, and there is nothing the doctor can tell me in 7 days that he cant tell me in 30. I guess for some cases, a shorter duration is needed for some patients.

I had been in Taiwan barely a year and developed a serious case of pneumonia which required a hospital stay. I was amazed that so many of my students, coworkers, and friends visited me and brought me food every day. I thought it was just a cultural thing, then later learned that was the only way I was going to get food. Very different than in the US.

Yep I myself have supplemental insurance, one reason being that I’m a single guy and don’t have family to care for me should I require a hospital stay.

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