TAIPEI (Taiwan News) — Emergency room (ER) congestion has become a persistent issue in Taiwan’s healthcare system, making it increasingly difficult for hospitals to retain and recruit ER doctors.

Lou Pei-jen (婁培人), deputy director of National Taiwan University Hospital (NTUH), said that filling ER residency positions has become more challenging, with many slots only being filled during second and third rounds of recruitment. Most ER departments are struggling with staff shortages, often relying on middle-aged doctors who remain committed to the field, UDN reported.

Chung Kong (鍾孔), director of the Taiwan Society of Emergency Medicine, said young doctors are leaving ER positions at high rates due to heavy workloads, a shortage of nurses, and unfair distribution of health insurance benefits. Many former ER doctors transition to primary care clinics or start their own businesses, opting for better hours and higher earnings.

Lou acknowledged that recruiting ER doctors is becoming increasingly difficult. While NTUH has managed to fill its target number of ER residents, the number of applicants has plummeted compared to previous years when a single recruitment round was sufficient.

The shortage of ER residents across Taiwan means specialist nurses are being asked to share more responsibilities, further complicating scheduling. Beyond ERs, pediatrics and other departments are also struggling with similar staffing challenges.

Lou noted that each attending physician in the ER used to care for 20-30 patients on average, but now must handle 30-40 patients or more. At NTUH, even if patients are temporarily kept in the ER, their medical condition can be quite complicated, adding to the stress on doctors.

Chung emphasized that ER departments rely on teamwork, and nursing shortages are exacerbating doctor fatigue and stress. To improve conditions, he suggested increasing contributions to the National Health Insurance system. However, he acknowledged that raising premiums could face public resistance, leaving government subsidies as the only alternative.

Lou also pointed out that private hospitals are now offering higher salaries than public hospitals to attract young doctors. However, public hospitals lack the flexibility to adjust salaries competitively, further complicating recruitment efforts.