In this article, the author Chang introduces the development of medical environment in Taiwan through four aspects: the establishment of the medical system by the government, the shift from traditional medicine to western medicine, the distribution of medical resources, and finally how the medical profession has affected people’s everyday lives.

The establishing of a governmental system for health administration began in 1912, and through various changes and efforts, became the Department of Health in charge of all medical care, health education, and disease prevention policies nationwide. Since 1954, Public Health Centers and group practice centers were built in each city to provide more close services to local residents and people in remote areas. From the 1970s, the government strived to create a medical network, which included building large hospitals, providing specialized medical and health services, and expanding the reach for medical care. The network brought improvement in medical efficiency, but still wants in more attention to the quality of services in rural areas. The year 1994 is significant in that it marks the passing of the National Health Insurance, bringing equal and affordable medical care to everyone. Though it does solve the problem of uneven distribution of medical resources, the health insurance is like a guardian to their rights for healthcare. The health insurance also resulted in the changing structure of medical system, the aims and expansion of existing medical institutions, and the choice for medical students due to the stress and relative earning for various clinics.

       There has long existed a debate in the effectiveness of traditional versus western medicine. Due to the introduction of western medical practices, traditional medicine faced challenges and doubt. In 1929, it was proposed that traditional medicine be forbidden, which aroused traditional medicine practitioners to team up and fight for their professional rights. With their efforts, traditional medicine was finally legally recognized in 1936. Despite this, in the beginning their profession was still restricted by policies. Gradually traditional medicine became recognized in university and academia, with its own exam and licensing procedure. In recent years, traditional medicine has began to adopt new technologies to assist the diagnosis and curing. On the other hand, western medicine was brought to China by missionaries, and played an important role during the wartime. From 1951, under the U.S. support, the western medical education in Taiwan was established. Though the different cultural and social environment brought disagreements between Taiwanese and U.S. medical personnel, it is doubtless that the U.S. support had a strong influence on Taiwan’s medical system.  

The distribution of medical resources in China and Taiwan has been deeply influenced throughout various periods. Before the introduction of western medicine, traditional and religious doctors in China were the dominant source of medical care. Missionaries in Taiwan also brought doctors to provide free medical services to the local residents in the name of religion. When the Japanese took over Taiwan, they established major medical institutions, and many other private clinics appeared. After the R.O.C. government resituated in Taiwan, the U.S. also provided medical care for sick soldiers. The Taipei Veterans General Hospital was instituted at that time for this cause. As the economic situation improved, the incoming wealth brought increased needs for better medical care. New policies and administrative systems in hospitals were introduced by Dr. Samual Noordhoff to ensure the quality of the medical profession. His efforts brought change to the hospitals such as the Mackay Memorial Hospital and Chang Gung Memorial Hospital. More private hospitals also instituted and expanded. Public hospitals were also challenged with competition. Moreover, in medical personnel, we also see an increase in number of physicians. When the R.O.C. fist took over Taiwan, medical personnel was insufficient. As restrictive standards for medical career was loosened, the medical profession became popularized in the 1950s. since 1980, over 1,400 people gain a doctor’s license each year. Up to now, there are 18.65 doctors for every ten thousand population in 23 different areas of specialization. How to allow this excess of medical resources be distributed evenly has become a main issue of consideration.

Modern medical developments have not only affected the medical profession from within, but also in people’s daily lives. Since the Japanese rule, there has been a practice of sending “Medicine Kits,” which is a home delivery service for drugs. This practice began in more rural areas where medical resources were scarce. They soon became a common form of household medical care for common diseases, and the package distributors became medical consultants. We also see a change in child delivery methods. Early in 1902 policies were established for the training of professional midwives and later birth attendants, which was popularized in the 1950s. However, after the 1970s, most women chose to give birth in hospitals due to the maturing medical system and benefits of health insurance. Finally, with the rapid development of medical technologies and increase of medical institutions gives people more choice of medical care. Yet this new mode distances the relationship between doctor and patient.

This article is Chang’s overview of the hundred years’ development of the medical profession under the administration of the R.O.C. government. Future topics could further discuss the recent development of the role of dentist, nursing, and laboratory medicine within the medical community.