Amanda Howe visits Taiwan and the TAFM Action Plan

Report from Prof Howe regarding her visit to Taipei, Chinese Taipei, Asia Pacific Region, July 8-11 2016.

Occasion: Taiwan Association of Family Medicine (TAFM) National Conference and 30th Anniversary.

Funder: TAFM.

Activities: keynote at conference, press conference, young doctor presentations and panel, clinic visit to Taichung Hospital, and meeting with 12 residents there.

Rationale for attendance: to acknowledge important work of the TAFM over many years: and to establish relationship with Prof Meng Chih Lee who is President of TAFM and will be Asia Pacific President from November 2016. Conference also attended by Prof. Donald Li and Dr Gene Tsoi (Hong Kong) and colleagues from Shanghai, Beijing, and Shenzhen as China Mainland delegation invited by the TAFM.

Support for members and family doctors – this was well attended (2000+), had a real buzz, and as far as I could tell from a national programme was what family doctors wanted. Run on a Sunday, with mainly clinical topics, doctors had come from all over the country to attend. There was a prominent but professional exhibitors space, which included some non-pharmacological stands such as kiwi fruit promoters and complementary therapies (which are part of the Taiwanese insurance package.) The local organisers would be best placed to give objective evaluation. The celebratory atmosphere of the event led me to describe it to friends as ‘like going to a wedding or a party’: I think this emphasis on years of effort and evidence of success will have boosted morale.

Profile of family doctors in Chinese Taipei
– there were a number of non – family doctors, leads from some collaborating countries, a large and well attended press conference, a wonderful historical photomontage of the TAFM, and an interest in international speakers. In my research about the meeting, I found a number of published articles about the development of FM in Chinese Taipei, showing objective evidence of outputs over the three decades.

Health care system
- Chinese Taipei has a strong health system where family medicine is already playing a major role. From reviewing the literature before this visit I remembered that Chinese Taipei introduced a National Health Insurance (NHRI) model more than 20 years ago, which continues to fulfil the government’s commitment to universal health coverage, and has proved both popular and cost effective [1]. They also have a well established national training for family residents, which again has existed for 30 years, and was written up by Meng Chih Lee and colleagues more than 10 years ago [2]. Recently the NHRI has considered incentivisation of registration of the population with a family doctor, which is great news.

The TAIWAN Action Plan

Dr Donald Li (WONCA Treasurer) and Dr Meng-Chih Lee (TAFM) report that during a press conference attended by Prof Amanda Howe, the Taiwan Association of Family Medicine made the following declaration:

Vision: Establishing a person-centered, system-based integrated health care system to meet the needs of an aged society.

Goal: Building Chinese Taipei into the world paradigm of “Every family a family doctor” by 2020.

The TAIWAN Action Plan

T: Developing a uniquely Taiwanese family physicians system fully capable of delivering quality person-centered, family-based, and community-oriented healthcare services;

A: Enhancing Accountability of care and empowering citizens to enhance self-care;

I: Providing Integrated people-centered health services and enforcing bi-directional referral to ensure coordination and continuity between the three tiers of health care;

W: Providing family physicians with payment incentives to support reasonable increase in national health expenditure, thereby building up a World leading model of sustainability;

A: Upgrading the ability of family physicians in providing preventive health care to reinforce Assurance of quality care;

N: Constructing Networks of community health support by recruiting and training volunteers for health education, and self-care.

[1] Tai-Yin Wu, Azeem Majeed, Ken N Kuo. An overview of the healthcare system in Taiwan London J Prim Care (Abingdon). 2010:3(2):115–119. PMCID: PMC3960712.
[2] Shiuan-Chih CHEN, Chi-Hua YEN, Chun-Chieh CHEN, Wei-Ya WU, Ming-Chih CHOU, W. BELL, E. Y. T. YEN, Meng-Chih LEE. Outpatient teaching in family medicine residency training programs in Chinese Taipei. Asia Pacific Family Medicine 2004;4: 1-5