Suggestion: Develop an effective plan to legalize the profession of chiropractic.
Taiwan generally seeks to be a faithful member of the international community and rightfully complains when not given a proper opportunity to do so. Yet for many years Taiwan has been one of very few countries in the world that has made no arrangement to provide a legal status for the profession of chiropractic, even though it is recognized in nearly all jurisdictions as a valuable contributor to the healthcare system. The World Health Organization, whose World Health Assembly Taiwan aspires to join as an observer, has long recognized and supported chiropractic as a form of alternative medicine.
Following Indonesia’s recent establishment of a mechanism to legalize chiropractic, Taiwan is in even narrower company in keeping the profession in limbo. After years of study abroad and receiving licenses from the United States and other developed countries, the chiropractic doctors who have returned to Taiwan are obliged to accept strict constraints on their professional activity. If no longer harassed by the authorities as happened in the past, they are still unable to advertise, maintain websites, or otherwise publicize their services – and as recent events have shown, they must live with the constant risk that their right to practice will be challenged by the health authorities on questionable grounds.
Despite a previous understanding with the authorities that foreign-licensed chiropractors would be accepted as “backbone-soothers” as long as they did not make any therapeutic claims, in recent weeks two chiropractors have been charged by health inspectors with practicing medicine without a license.
In Indonesia, in contrast, chiropractic is now acknowledged by regulation as part of the Allied Health/Complementary Health System, despite longstanding opposition from the local medical associations. Indonesia citizens who have graduated from accredited foreign chiropractic colleges and passed an Indonesian qualifying exam are allowed to practice legally under the title of doctor of chiropractic. They are allowed to make diagnoses, claim therapeutic effects for the treatment, and advertise their practice.
In Taiwan, in contrast, scant progress has been made in finding a way to legitimize the chiropractic profession. In fact, the topic is the longest unresolved White Paper issue, having appeared in every edition since 2006. Although the National Development Council has made a concerted effort in recent years to find a solution, after numerous meetings the same obstacle has remained: insistence by the Ministry of Health and Welfare that chiropractic cannot be considered as a healthcare discipline if it is not taught at any domestic medical colleges or universities.
The catch is that no educational institution is willing to offer such courses if there is no guarantee that their students can become licensed professionals after graduation. In Indonesia, where that assurance now exists, a chiropractic school has been established and its students are now in their second semester.
The barriers to chiropractic in Taiwan are especially unfortunate considering the rapid aging of the Taiwan population and the tremendous financial strains that is bound to impose on the National Health Insurance system in the coming years. Chiropractic has been proven in numerous studies to be safe and effective in treating many of the aches and pains that affect the elderly, including low-back pain, neck pain, headaches, and other neuromusculoskeletal ailments. Since chiropractic treatment involves neither surgery nor medication, it is a highly cost-effective approach that could bring substantial savings to Taiwan’s National Health Insurance program.
For the benefit of Taiwan’s patients and healthcare system, the chiropractic doctor members of AmCham Taipei urge the government to continue to seek a breakthrough to enable chiropractic to operate as a normal profession. Indonesia’s example is evidence that with sufficient will, a way can be found.