Clipping Board » Medical Affairs and Administration ─ Medical system, pharmaceuticals, and medical community-related reports
November 1, 2010, China Times
By Huang Tianru, Zhang Cuifen, Qiu Liying / Taipei Report
The implementation of a one-month ban on designated physician fees has stirred up the medical community! A senior hospital executive revealed that these fees account for nearly half of a renowned doctor's income. Prohibiting them effectively encourages under-the-table red envelopes (bribes). Without the "transparent" option of designated physician fees, patients are left scrambling to inquire about a doctor's "price" and worrying about when and how to offer payment, making them even more uneasy.
For a long time, the Department of Health has "technically" allowed hospitals and doctors to decide whether to charge designated physician fees. For example, in Hsinchu City, scheduling a cesarean section could cost NT$10,000 to NT$30,000; in Taichung City and Nantou County, choosing a specific surgeon could add 30% to the standard health insurance payment; while in Taichung County, Changhua County, and Nantou County, selecting a preferred outpatient doctor could incur an additional fee ranging from NT$250 to NT$1,000.
In Taipei City, the rules around designated physician fees were ambiguous. Several high-end private hospitals, such as Shu-Tien, Hong-En, and Chung Shan, previously had institutional policies allowing such charges. Fees varied from a few thousand to NT$50,000–60,000, depending on the doctor's reputation. For instance, a celebrity-favored obstetrician might charge NT$60,000 for a single cesarean delivery. The Department of Health's sudden ban has slashed the monthly income of top doctors—previously averaging NT$300,000–400,000—by half, leaving many resentful but silent.
Designated physician fees also represented a significant revenue stream for hospitals. Some hospitals charged NT$8,000 per surgery, pocketing the money first before distributing it based on the doctor's "performance." Others allowed doctors to collect NT$6,000–20,000, with the hospital taking a fixed 20% cut as a management fee. The ban has angered hospitals, as it reverts to an era where doctors rely on under-the-table red envelopes, leaving hospitals out of the profit loop.
Ms. Li, who requires gynecological surgery, shared her frustration: "It's incredibly hard to get an appointment with a renowned doctor at a major hospital. After finally securing one, I was told the surgery would take over three months to schedule. I can’t help but wonder if it’s because I didn’t offer a red envelope." She is now privately inquiring about how to "gift" her way to a faster slot.
Three years ago, Ms. Lin gave birth via cesarean at a public hospital. While no designated physician fee was charged, she had already planned to give a red envelope as thanks for the doctor's attentive care—and to ensure a "neat incision." To avoid the sensitivity of cash, she opted for luxury-brand wallets and cardholders worth over NT$10,000, along with a thank-you note, discreetly placing them under the doctor’s desk during a consultation. The cost, she noted, was comparable to designated physician fees at other hospitals.
Will the ban on designated physician fees revive the culture of red envelopes? Shih Chung-liang, Director of the Department of Medical Affairs at the Department of Health, argues that allowing such fees as part of a "celebrity doctor's" income would exacerbate the trend of "medicine for the wealthy," leaving poorer patients unable to access top-tier care. Meanwhile, less lucrative specialties, such as those treating rare diseases, would struggle financially—creating an unfair system for both patients and doctors.
Source: http:/ / life. chinatimes. com/ 2……0302+112010110100053,00. html
Ban on Designating Doctors: is the Red Envelope Culture Making A Comeback?
By Huang Tianru, Zhang Cuifen, Qiu Liying / Taipei Report
The implementation of a one-month ban on designated physician fees has stirred up the medical community! A senior hospital executive revealed that these fees account for nearly half of a renowned doctor's income. Prohibiting them effectively encourages under-the-table red envelopes (bribes). Without the "transparent" option of designated physician fees, patients are left scrambling to inquire about a doctor's "price" and worrying about when and how to offer payment, making them even more uneasy.
For a long time, the Department of Health has "technically" allowed hospitals and doctors to decide whether to charge designated physician fees. For example, in Hsinchu City, scheduling a cesarean section could cost NT$10,000 to NT$30,000; in Taichung City and Nantou County, choosing a specific surgeon could add 30% to the standard health insurance payment; while in Taichung County, Changhua County, and Nantou County, selecting a preferred outpatient doctor could incur an additional fee ranging from NT$250 to NT$1,000.
In Taipei City, the rules around designated physician fees were ambiguous. Several high-end private hospitals, such as Shu-Tien, Hong-En, and Chung Shan, previously had institutional policies allowing such charges. Fees varied from a few thousand to NT$50,000–60,000, depending on the doctor's reputation. For instance, a celebrity-favored obstetrician might charge NT$60,000 for a single cesarean delivery. The Department of Health's sudden ban has slashed the monthly income of top doctors—previously averaging NT$300,000–400,000—by half, leaving many resentful but silent.
Designated physician fees also represented a significant revenue stream for hospitals. Some hospitals charged NT$8,000 per surgery, pocketing the money first before distributing it based on the doctor's "performance." Others allowed doctors to collect NT$6,000–20,000, with the hospital taking a fixed 20% cut as a management fee. The ban has angered hospitals, as it reverts to an era where doctors rely on under-the-table red envelopes, leaving hospitals out of the profit loop.
Ms. Li, who requires gynecological surgery, shared her frustration: "It's incredibly hard to get an appointment with a renowned doctor at a major hospital. After finally securing one, I was told the surgery would take over three months to schedule. I can’t help but wonder if it’s because I didn’t offer a red envelope." She is now privately inquiring about how to "gift" her way to a faster slot.
Three years ago, Ms. Lin gave birth via cesarean at a public hospital. While no designated physician fee was charged, she had already planned to give a red envelope as thanks for the doctor's attentive care—and to ensure a "neat incision." To avoid the sensitivity of cash, she opted for luxury-brand wallets and cardholders worth over NT$10,000, along with a thank-you note, discreetly placing them under the doctor’s desk during a consultation. The cost, she noted, was comparable to designated physician fees at other hospitals.
Will the ban on designated physician fees revive the culture of red envelopes? Shih Chung-liang, Director of the Department of Medical Affairs at the Department of Health, argues that allowing such fees as part of a "celebrity doctor's" income would exacerbate the trend of "medicine for the wealthy," leaving poorer patients unable to access top-tier care. Meanwhile, less lucrative specialties, such as those treating rare diseases, would struggle financially—creating an unfair system for both patients and doctors.
Source: http:/ / life. chinatimes. com/ 2……0302+112010110100053,00. html