Dream a little dream of Unions
Physicians working and labor rights protection issues in Taiwan.
The medical profession is highly esteemed in Taiwanese society. However, doctors do not receive adequate protection under the Labor Standards Act. They often face overwork, imbalanced contracts, and occupational illnesses without workers' compensation. An incident from 2009 illustrates the severity of this problem when a doctor died from long working hours. The Ministry of Health and Welfare's Residency working hours guideline allows resident physicians to work 28 consecutive hours and 80 hours a week, which surpasses the regulation of the Labor Standards Act. This leads to an elevated risk of coronary artery disease and stroke among doctors.
Employed doctors often sign one-year unequal contracts with medical institutions. These contracts feature high default liquidated damages and arbitrary employment terms. If a doctor terminates their contract prematurely, they might be liable for nearly 800 hours of salary. Under these contracts, they often cannot voice against workplace conditions. Additionally, occupational injuries, like the aforementioned, are not covered under the Labor Standards Act. This leaves doctors to engage in protracted legal battles.
The establishment story of the union.
Founded in September 2017, our organization has achieved several milestones in just a year and a half. We have challenged long-standing hospital practices of "guarantee" fees, ensured maternity and marriage leave for doctors in Taipei City, and closely overseen the government's adherence to the labor standards acts. In 2019, the government responded to societal pressure and included a fraction of doctors under the Act. However, only resident physicians without military or governmental roles were incorporated. This represents less than 10% of all doctors in Taiwan. To address this, we have launched a campaign for legislative reform to safeguard the contractual terms and working rights of the remaining doctors by enacting special laws.
The Doctors Union faces several challenges. First, there exists a risk of free-riding, as Taiwanese people heavily rely on legal measures to enhance working conditions. Second, doctors, by virtue of their professional status, possess greater opportunities and bargaining power than other workers. After enduring initial hardships as juniors, most can expect improved life circumstances. In this context, even when faced with dissatisfaction, they often remain silent, choosing not to rally for change collectively. Third, Taiwan's healthcare insurance system, managed by the government as a single-payer, emphasizes accessibility and affordability of healthcare but also encourages competition among medical service providers. This causes doctors to direct their grievances to the healthcare system rather than their employers.
Furthermore, the mandated doctors’ association holds a pivotal and representative role in policymaking, and their stances do not always align with employed doctors and the union. Lastly, the legal requirement for craft unions in Taiwan presents another challenge. While having members nationwide, our organization is nominally city-based, which might impede our efficacy in addressing cross-city labor issues. At present, The Taipei Doctors Union has around 400 members, including 80 medical students.