Taiwanese Medicine – a manufacturing approach to health care

Its amazing how well run this place is. Computerized IT systems that allow the doctor to see a patient’s charts, previous diagnoses and office visit notes, imaging and meds all from a smart computer terminal that recognizes and authenticates (via a smart card reader) the user. This as well as the efficiency with which these HMO doctors see their patients results in an average consult time of 10-20 minutes per patient. In some cases, the patients we saw today were in and out in less than 5.

Contrast this with UCSF where the pain management doctor I shadowed sometimes took 30-50 minutes with each patient and you start to see how the bills can add up.

I would be interested to see how a third party public health group rates the care at Chang Gung Hospital in Taiwan. Without much experience to go by, I would say that from what I have seen so far, it is accessible (all Taiwanese are able to go to any hospital), efficient without sacrificing quality, and cost effective for the patient. Maybe the manufacturing mentality that has served Taiwan so well in making semiconductors CAN indeed be applied to health care?

Neurosurgery or Seeing patients?

After two days of observing in both the OR and the outpatient clinic at Chang Gung Hospital in Linkou, I think I have a better idea of what area of medicine I want to pursue. Between spending 3-4 hours
operating on a immobilized BODY that is barely breathing versus seeing and interacting with a living breathing PERSON with real economic, social and medical problems, I prefer the latter. It seems more real to me somehow. The problems and the human contact are aspects of medicine that I like more. Perhaps some area of medicine in which I see patients most of the time and spent 1/4 or 1/5 of my time on procedures may also be good.