the medical system; a first visit

Well, I can now report on the Taiwan hospital system. No, don’t panic (she said, in large friendly letters); in this country all the doctors are kept in hospitals so even if you have a hangnail that’s where you go. As it happens I didn’t have a hangnail, but that’s not too far off anatomically. I’ve been having some pain in my left foot, at first at the base of the big toe and moving to sort of the middle of the metatarsals. It’s been hurting for a while now, but first I was waiting to see if it would get better on its own, then it seems like a waste to go see a Dutch doctor right before we left since in case treatment was required I’d need to see a Taiwan doctor anyhow, and then I was waiting for our health insurance here to kick in. By this weekend, though, it was hurting enough that I’d begun to limp, so I decided not to wait any longer. I was worrying that it might be a bunion because I do have a bump at the side of the base of my big toe, and according to the internet reading I’d done, those just keep getting worse until you need surgery.

When I asked our HR manager for the list of Englishspeaking doctors she says she has, she sent me the link to the National Taiwan University hospital instead. (According to one website for expats, this is the “jewel in the crown of health care providers in Taiwan”.) I’m not sure why; it may just be because she didn’t have a podiatrist / orthopedist on the list. I was worried about whether they’d speak English there, though. So I called the Taipei Community Center, which despite the name caters to the expat community here rather than to Taipei as a whole. The British woman I spoke to there suggested that since I didn’t have insurance yet anyway it might be better to go to a private clinic rather than to a public hospital, and gave me the numbers of several. I selected Shin Kong because she’d said it had something to do with orthopedics. There is a Shin Kong Orthopedic Sports Medicine Institute, but I’m not sure if I ended up there or in the regular Orthopedic section of the hospital (or possibly they’re the same and the Orthopedic Institute is just one section of the hospital). When I called, they transferred me to someone who spoke English, and I was able to get an appointment for the very next morning (first difference from the US!). They don’t give you an appointment time, just the number in which you’ll be seen. I was number 34, and when I asked the apointment person, he recommended showing up around 10:30.

I took a cab to the hospital, walked in through the crowds at the entrance, and walked across a huge and crowded lobby not unlike one at a high-end US hospital. There were lots of people walking around with bandages or on crutches, a few in wheelchairs, and in one case a woman shuffling along with (presumably) her husband holding an IV bag above her, its drip line snaking down to her arm. Across the lobby opposite the doors I saw a big desk with a big sign saying INFORMATION (and what was presumably the same in Chinese), so I went there and a nice lady in a bright yellow staff vest took me down to the registration desk and then to the waiting room for the Orthopedics offices.

I was waiting for number 34 on room 28; I’d gotten there early, just in case and they were on number 9. The nurse popped out of the office door frequently to show people in or out and updated the number, and it moved up to number 13 fairly rapidly. Then the process stalled; people who had been in earlier came back, the nurse was out talking to people in the waiting room, and people seemed to go in even when the number hadn’t changed. Most patients were accompanied by 2 or 3 family members. At one point the number went up to 16, then a few minutes later blinked back to 15. I was sitting on the far end of the row nearest the door, the only Westerner in the room, the nurse figured out I was for her room because I was watching her and the door. After spending some time with the people on the near end of my row, she came over to talk to me; fortunately she spoke some English. Then she asked me to fill out a family history form, which I’d have been happy to do except it was entirely in Chinese. I think she was a little taken aback, not having thought the matter through. But she gamely translated the questions as best she could (a native Mandarin speaker with heavily-accented English takes some serious decoding when she’s using words like “hypertension”). It has to be difficult – anyone speaking a Romance language or one with technical vocabulary borrowed from Latin can make a good stab at what the (usually Latin-based) English word should be, but from Chinese I don’t think you can do that. For some odd reason, she didn’t write down any of my answers.

A few numbers later, she called me in. (Actually, she called me “Miss Paula”.) The number above the door was now up to 19, so I hope I was being brought in early just because I’d gotten there early and not because she was jumping me ahead of others. The doctor spoke pretty good English and seemed as competent as any I’d get in the US. The best part about him being in the hospital was that he was able to send me right upstairs for an X-ray (they promptly sent me back down to the cashier to pay for it first) and then have the X-rays delivered a few minutes later. The hall by the radiology room was lined with people on gurneys, some with bandages or IVs, many with family keeping them company. It was right next to the ER, so they may have been waiting to be seen – apparently here you get to lay down while waiting for the ER. The X-ray tech just stretched out and positioned my leg; he didn’t put a lead blanket over me, though he did leave the room himself, closing a heavy metal door behind him. (I don’t expect those few roentgens in my foot did any harm, either, but US X-rays always seem to use the blankets.) He took two images, then sent me back down.

I only had to wait for another 10-15 minutes before they called me back in. (“Miss Paula!”) The doctor showed me that the bones are intact. (I do have a bunion, and was surprised how canted the bone is for my big toe, but he said it was just a minor one, no problem at the moment.) He gave his opinion that the pain was due to a strained ligament, and told me not to wear high heels, stand on my toes, or do sports that put pressure on that part of my foot. Then he wrote a prescription for an analgesic/anti-inflammatory, and told me I could pick it up upstairs. I stpoped back at the cashier’s desk to pay for the pills; the total for visit, X-ray, and medicine was NT$1147. Even at today’s abysmal rate for the US dollar, that comes out to a whopping US$35.

My foot should be better in a few weeks, and the pills should cut the pain for the next week. (They do seem to work, and without making me groggy or giddy or queasy.) I think if either of us get the kind of illness that leaves you feeling generally awful, as opposed to just aching, I might want to find one of the smaller private clinics. They don’t take national health insurance when we get it, but I can afford these rates – or else turn our bills in through Ted’s US insurance. On the other hand, though this hospital was big and noisy and busy, I think the care I got was very good. And I’m pretty relieved that my foot will get better on its own.

One Response to “the medical system; a first visit”

  1. marsha Says:

    I’m glad your medical visit went so well. Hope your foot is fine very soon.

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