This is my experience with the Taiwan NHI system while I was seeking medical care that ultimately resulted in my Fibromyalgia diagnosis.
Here I am speaking about my time at Taiwan Adventist Hospital. This post is not sponsored or reflects everyone’s visit at Tai-An. Do your research and find what’s best for you.
Fibromyalgia in Taiwan: A Westerner’s guide
1. Get Health Insurance
Taiwan operates under the National Health Insurance act (NHI). This in simple words means socialized health care. After 6 months and a day (for good measure) you will qualify for health insurance. But it’s nothing like the atrocities I have seen of socialized health care in the West.
I don’t have to wait months to see a specialist or pay an arm and a leg in insurance just to find certain things are not being covered. If you are a student on scholarship and you’re only receiving a stipend you’ll never know how much that costs, it’s paid for you. If you’re working you’ll have less than $1000 NTD deducted from your salary for yourself and your employer pays the rest. About $1000 for your dependent(s).
If you have a baby they will be on the mom’s health insurance for 60 days and will qualify for their own at the age of six months. It may be added to a working person’s deductions or a student’s and they will have to pay when they pay their tuition. If you’re self employed you have to go to your local District Administration Center to iron this out. They WILL try to help you no matter how poor their English is. Someone will be out to assist you.
In this situation as with all the others that involve communication in a foreign country patience on your part is KEY! Use google translate, body language, draw pictures, have snapshots and learn a few words to make it easier. If you’re absolutely lucky you can take your Taiwanese friend along. Buy them a drink later to show your gratitude.
Once you get that squared away you will be contacted if anything is required of you. They will find someone who speaks enough English to get the message across to you. Mind your manners and be aware of your tone, ignore any bad grammar as long as it doesn’t interfere with the message. It’s a high stress situation for them as much as it is for you.
2. Find the right healthcare provider
After you’re ready to go to the Doctor, finding the right hospital is important. Since I’ve lived in Taipei for over eight years and in the South of Taiwan for two more years, I have seen many hospitals and I prefer a few things from the moment I enter a hospital.
This will give you a peace of mind and you won’t be nervous or have any negative feelings when entering. If you’re already feeling rotten, a tired dirty building that’s hard to navigate will make you irritable. After visiting a few hospitals on the advice of my mentor I found Taiwan Adventist Hospital
3. Get Directions
Being near a bus stop or MRT station is a huge plus! Here are the directions. Being tired from being sick and having more than ten blocks to a hospital is no bueno. Some of us are on a tight budget and a taxi may not be an option after more than a few visits the costs pile up. In addition, a great advantage is to be able to book appointments online, privately (in English without a Taiwanese friend or work colleague knowing your personal business).
If you prefer male or female, you’ll see pink icons for women and blue icons for males. You can book an appointment even if you’re a first time visitor. Go through this link Pick a department and you’ll find the names, specialty and publications of the Specialist. You can change appointments that were made for you or you made yourself here too. Super convenient.
You may print the document that has your name and information, clinic, your doctor’s name and your number in the queue. You can manage your time and show up on time and avoid a long wait.
3. Look for a healthy building
For me it has to be clean; I don’t like walking into a tired dirty building. I have no confidence in anything that happens after that. It’s just my thing. You may feel differently.
In the same vein of cleanliness are well placed signs for giving directions and people to help you find where’re you’re going is a plus. This place met all my expectations and yes, I have been to quite a few.
In Taipei there’s an especially high chance of finding building molds due to the high humidity. If you suffer from allergies make sure you pay attention to this.
4. Find the Information desk
Good attitude, open to listen and help. Nothing else! The first thing I need to see is the information desk. The women there were very helpful. They called out to me on entering the building and I told them I wanted to make an appointment but I wasn’t sure who I wanted to see.
They walked with me over to a woman and the appointment area and I told her the basic idea. It hurts or I can’t breathe etc. She pulled out a catalog and showed me a few options and I picked the person I wanted to see. She made sure that I wanted to see a specific person or just a specialist in the field to not lose time.
I got squared away and got my number and turned around to find someone waiting to take me upstairs to get my vitals checked. Once I got upstairs there was a row of machines to take my blood pressure and heart rate, then a scale to record my weight. All this info was logged into my health insurance card that was placed in the machine I sat in front of.
This is the same story for visiting the eye specialists. Once you visit the doctor he will know your temperature, body weight, blood pressure and heart rate before they even see your face. If you want to do this in private you may do so in some of the clinics you go to but you’ll have to write it down. Don’t worry there are pencils and paper there to use. The nurse will record it before you see the Doctor to save time.
5. Learn who are the Specialists on board
A wide range of specialists will give you a buffet of options to look at the specific problem with an extra special set of eyes. I get to the room and sit in front of the Specialist. For every appointment with every specialist I see there I get the feeling that they were just meeting me.
They listened to my story, asked many questions and took their time to examine me if they had to. Most of the time in any hospital I have gone to they would search images and medicine doses and show me on the computer screen and we would sit side by side chatting and discussing.
I have never ever in all the time I have been here, and any hospital I have been to, felt rushed, not listened to or not taken seriously. EVER!
6. English service/Foreigner friendly
Most Specialists will be comfortable in English, but not all the staff are willing to try with you. At Tai-An they seem to focus on making their environment very foreigner friendly and most signage is translated in english. Including prescription meds.
7. Find out who treats fibromyalgia
If you think you may have fibromyalgia the best person to see is YUN-CHEN TOH, she’s a very popular rheumatologist there. If you’re having trouble booking her, see a family doctor or endocrinologist and ask them to do it for you. It’s a double visit but the task will get done.
The time when I did my follow up visit with her I was number 83. I was sure I would get a ten minute visit and be out the door but she sat there, spoke with me as if I were the first and only patient she had that day. I was totally grateful and super impressed at her stamina and care she took to attend to me.
There are also other Doctors that will take a look at your condition HSIN-YING LIN, a family doctor that sees cases of chronic illnesses. I continue to see her and I am quite satisfied with her on my team. I notice that at this hospital every Specialist I see is just like the rheumatologist. I am thankful to have found this hospital.
Not sure if I should mention this but on more than one occasion, if i didn’t need a prescription or just went to get a few questions answered they told the nurse to let me go without a charge especially if they could not help me.
8. Understand your labs
Of course whenever you’re presenting with non-specific symptoms you need to get a pile of labs done. If you’d like, you can schedule your lab to be able to see your doctor the following week or you can make an appointment after you’ve had all your labs done.
In my case many of my lab request forms were good for three months or others were good up to the end of the year. It’s made easy for you to make the date for whenever is convenient for you.
I usually go to the labs to ask any questions I have and they are very ready to tell me what I need to do to prepare for the labs and how to collect the specimen I need from home.
9. Confidently handle your prescriptions
After diagnosis here comes the medicine. You’re still in control here. Sometimes I refuse meds and try to work it out with natural remedies or I ask what kind of medicine it is and what it’s for. I reserve the other questions for later. I also ask for generic preparations if possible to bring down the already low costs.
I pay and then go to the pharmacy where through the magic of technology already has had my prescription and has it prepared in a basket waiting for me. I already have a number on my prescription copy and line up when it’s called which doesn’t even matter because I’ll get served anyway.
They explain to me briefly what I need to take and how much if it’s not clear there’s a window with a chair in front where I can sit with a pharmacist and they will explain to me all aspects of the medicine including side effects and how to use the applicators or pumps. (with one handy for demo) I don’t ever feel confused when I leave that window.
I walk out of the hospital feeling in control of my treatment and up to speed with what’s going on with me or my child. If I’m at home and I get confused about anything I can call and have someone speak with me over the phone. If I miss an appointment or the specialist has cancelled they call me and rescheduled.
It’s very hard to be ignored there.
Of course there are naturopaths around and I will make appointments with a few of them and come back to report on a different post. Stay tuned…
Things to do
1. Collect your records
you’ve been to to either open your report(s) or offer you an official hospital stamped and sealed printed copy for insurance purposes; there’s 10 NTD charge or for CDs might be the same or more. Point being, it’s dirt cheap.
You can start collecting the reports and have a folder but with the age of technology you can simply ask them to open your file so another doctor may be able to view it. I have asked for unofficial copies of blood work and other labs from the doctor’s office with no extra charge and no resistance.
2. Write down all your symptoms
and record when it started and describe the pain briefly using pictures, numbers and figures. Use our printables here to make that easier for you to record and your Doctor to understand. Write down medications and supplements you’re taking and ingredients list and generic names. It helps with making the visit more efficient.
This was THE key for me getting diagnosed. Imagine being a doctor and having a conversation like this: Where does it hurt? –Everywhere. When did this start? Long time now. What did you take? -A white pill, forgot the name… NEXT!
3. Make the time to see the Doctor
Don’t go there rushing and demanding to be seen. Good ole’ the customer is always right mentality seldom works here in Taiwan especially coming from Westerners.
You’re not entitled to be seen because you pay more insurance, you have the privilege and right to be seen. Wait your turn. When the nurse comes out give your insurance card to her. Other people are more impatient and will knock on the door.
Wait your turn; being foreign makes it stick out a bit more than if a local does it. No idea why but it does. If you’re lucky as I have been in the past if someone misses their turn I get bumped up and I’m in and out quicker than I expected
4. Be polite
Be quiet and listen to the Doctor once they are speaking. Unless he asks don’t discuss another doctor’s treatment, But Doctor so-and-so wasn’t doing that…or wasn’t giving me this. You’ll get a chance to ask questions or let them know you have after they are done and before they start prescribing. Being polite in Asia is viewed the same way as being an assertive “go-getter” person in the West.
It’s your health and you’re in charge. If you want to see another Doctor to do a follow-up in the same hospital ask them to make an appointment there for you.
5. Ask specific questions
that are clear and are directed to your illness, cause and treatment. Save the questions about medicine reactions and interactions for the pharmacist unless you’re there because of medicine adjustment.
6. Watch your tone and mannerism
As westerners we tend to speak with our hands a lot and come off as dominant and aggressive or overly assertive sometimes. Sit with your hands in your lap and speak slowly and softly. No handshakes required.
English might not be their first language and the Doctors may feel uncomfortable if you’re filling up the room with your gestures and raised voice. Along with remember that feeling ill for a long period of time will undoubtedly make you grumpy and more sensitive than usual so watch your behavior.
7. Wear a mask!
They’re my doctor and a bunch of other people’s doctor too.
8. Don’t complain
Make direct requests. Understand that they may or may not be met. Be mentally prepared. Too cold? Sit somewhere else, Too crowded? Go wait at the door. Long wait? Walk around the hospital or sit in the restaurant and have a snack to kill time.
Don’t accept medicine if you don’t think it will help and you’re not intending to take it. It keeps the cost of Health Insurance Stable and makes these prescriptions for persons that will really use them.
The point is you’re foreign already, you look different and speak differently the minute you open your mouth anxiety levels rise because someone will need to speak with you in English. Make sure it’s necessary.
Conclusion
Your experience does not have to be horrific or frustrating. Finding the right place starts with doing your research and talking to friends and co-workers. Get your health insurance, find the right hospital and make sure it’s easy to find. Make sure you’re comfortable in the building and you’re able to find the information you need. They will help you find the specialists who offer English service and are able to treat Fibromyalgia. Take a walk to the labs and make sure you understand how you’re supposed to prepare for them. After you get diagnosed and get medication the pharmacists should be available to help you.
In addition to that there’s a part you need to play also. Make sure your health records are available to view by your new doctor. When you get there make sure you’re prepared by having your symptoms written down, having enough time, patience and humility to go through the entire process.
Ask specific questions about your conditions and make sure you’re wearing a mask in this close encounter.
Protect the NHI. It’s here for all of us
After you have been diagnosed, there are some steps to take to make the transformation from searching to now knowing.
If you’re in Taiwan and you are willing to share your experience please contact us. We’d love to hear from you.
