A meeting of colleagues from Spain and Taiwan

Photo: semFYC journalist receiving Taiwan Association of Family Medicine materials and giving to the Taiwanese President the “Atlas Gráfico de Urgencias” in Taipei. (left to right) Prof Meng-Chih Lee, Dr Brian Chang, Prof Shinn-Jang Hwang, Pere Vilanova (Spain), and rof Steve Shih-Tzu Tsai

The Spanish Society of Family and Community Medicine (semFYC) met with colleagues from the Taiwan Association of Family Medicine (TAFM), in Taipei. These included: Prof Meng-Chih Lee, President of WONCA Asia Pacific Region and Immediate Past President of TAFM; the President of TAFM, Prof Shinn-Jang Hwang; Prof Steve Shih-Tzu Tsai, Chairman of the WONCA Committee of TAFM; and the Honorary Secretary of WONCA APR, Dr Brian Chang.

During the meeting, they explained how Taiwan’s healthcare system and its policy works. Founded in 1986, TAFM joined WONCA in 1988 and since then it has been working to increase the Family Medicine presence in the island.
Taiwan is one of the so-called "Asian dragons", an expression that refers to the Asian countries that lead the continent's economic growth. TAFM is proud to have established an extensive coverage of family medicine throughout Taiwan Island, with nearly 6,000 family doctors who are members of their association. Taiwan is experiencing an exponential growth in the population's predilection for Primary Care and, in that sense, it already has more than 21,000 Primary Care clinics serving a population of 23.5 million. As far as Family Integrated Care plan (or the community healthcare groups) is concerned The Taiwanese healthcare system has universal coverage with a very small co-payment and administrative fee. With an unemployment rate of less than 3%, Taiwanese policy makers are committed to Family and Community Medicine and it is recognized as a specialty. Although people in Taiwan can directly visit medical specialists, they are all advised to consult family doctors first to be referred. if needed. This is increasingly demanded by the population and it is currently preferred by 30% of Taiwanese (a figure that continues to rise).

Photo: Taiwan Association of Family Medicine World Family Doctor Day campaign.

When the Family Medicine specialty was established in Taiwan in 1986, there were only six residency training programs. By the year 2017 it is approaching 70, with more than 150 new (first-year) residents enrolled. The total number of specialists in Family Medicine is around 6,500 -the large majority of them are also members of the Association. TAFM publishes a large number of health promotion materials, including audio-visual materials. One of its most famous campaigns, called "A day in the life of a Family Doctor", explains the typical life of a family doctor. Taiwanese family doctors are also proud to celebrate World Family Doctor Day every year.

Perhaps the two major differences between Taiwanese and Spanish Family Medicine are firstly, the practice of Traditional Chinese Medicine in Primary Care centres, clinics and hospitals, as well as the importance given to Traditional Chinese Medicine by family doctors.

Many of Taiwan's family doctors practice and prescribe treatments based on integrated medicine and evidence-based medicine in order to avoid over diagnosis and excessive medications. Community activity, home visits, organization of events and involvement in the social life of society is a key element of Taiwanese Family Medicine where family doctors dedicate an equivalent part of the time spent in the consultations to these activities.

Another topic of the conversation was Taiwan's collaboration with its neighbour the People's Republic of China - in particular through the Cross-Strait Conference in Family Medicine, consisting of Taiwan, China, Hong Kong and Macau. Family doctors in Taiwan are now leading the implementation of Primary Care and Family Medicine in the most populous country on the planet - and have helped to build a model for improving the quality of general practice and family medicine in urban and rural areas of China.

Photo: Salvador Tranche, President of the Spanish Society of Family and Community Medicine holding the T-shirt of I Love Family Doctor, which is from Taiwan Association of Family Medicine.

On behalf of semFYC, a presentation of new publications "Atlas Emergency Chart" and "Recommendations Do Not Do" were given to the host Association. Both WONCA Asia-Pacific and Taiwanese family physicians showed their interest on the Youth Physician Exchange programs offered by the Vasco da Gama Movement, as well as the work done by the Spanish Doctor Verónica Casado (recently given WONCA Europe’s 5-Star Doctor Award) and the European Union Project KRISTINA whose scientific content is led by the Spanish Society of Family and Community Medicine and that is supported by eight different European countries.

Pere Vilanova
Spanish Society of Family Community Medicine
Journalist. Communication Department