Taiwan Chiropractic Faces Long Road to Legalization

UNCLAS SECTION 01 OF 02 TAIPEI 000374

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TAGS: ETRD ECON PREL PGOV TW

SUBJECT: Taiwan Chiropractic Faces Long Road to Legalization

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Summary
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1. (SBU) Taiwan does not recognize chiropractic as a legitimate
medical practice, and chiropractors operate in a legal gray area.
Taiwan Department of Health (DOH) authorities recommend that
chiropractors establish a chiropractic school or course of study in
Taiwan as an intermediate step to full legalization. Local
chiropractic doctors, however, worry that even if the Taiwan medical
community came to accept chiropractic's clinical merits, Taiwan's
powerful doctors' associations would pressure the authorities to
allow only licensed medical doctors to perform chiropractic.
Chiropractors, therefore, continue to ask the authorities to both
lift the DOH ban on chiropractic, and pass a Chiropractic Physician
Law containing examination and licensing provisions. End summary.

Background
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2. (U) The Taiwan authorities, unlike the World Health Organization
(WHO) and most countries in East Asia, do not recognize chiropractic
as a legitimate and distinct medical practice. Chiropractic
doctors, therefore, may not advertise as such, nor may they
advertise the efficacy of their treatments. Due to chiropractics'
uncertain status in Taiwan, legitimate chiropractic doctors are
frequent targets of raids by law enforcement officers, and often
receive fines from the medical authorities based on complaints by
dissatisfied customers.


3. (U) In 2006, a group of Taiwan legislators sought to enact a
WHO-consistent Chiropractic Law, modeled on a similar Hong Kong law,
that would have permitted chiropractors trained and licensed in the
United States or another advanced country to practice legally in
Taiwan. The Legislative Yuan (LY),however, did not pass the bill,
due mostly to strong opposition from medical doctors and hospital
industry associations.

DOH: Tough Road Ahead
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4. (SBU) Economic Chief recently met with Department of Health (DOH)
Vice Minister Chen Tzay-jinn to urge Taiwan to ease regulations on
chiropractic. Chen suggested Taiwan's chiropractors, in order to
gain official recognition, first introduce chiropractic techniques
to the medical community and the Taiwan public by establishing a
chiropractic school or course of study in a university. He said he
knows of several schools interested in introducing chiropractic
techniques into physical therapy curricula. Chen said chiropractors
could build on this exposure by creating a certification process for
domestic chiropractic doctors, and then working with the DOH and LY
to establish an examination and licensing process.


5. (SBU) Chen recognizes this path to recognition is long and
difficult, and offered alternatives to formal permission. For
example, chiropractors could hold seminars or workshops for local
medical associations or patients' groups in order to build up
broader public acceptance of and demand for chiropractic, which
could lead lawmakers to push for its legalization. In addition,
Chen said chiropractors can operate more openly by advertising their
techniques as "non-medical" or "alternative" physical services.

Taiwan-based Chiropractors Call for Legal Fix
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6. (SBU) Local chiropractors, however, want chiropractic to be
recognized as a legitimate and distinct medical practice, not a
non-medical service or a sub-branch of modernmedicine. Albert Lee
and Mark Griffin, who represent the chiropractic industry in the
Taipei American Chamber of Commerce (AmCham),recently told econoff

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chiropractic doctors worry that even if they prove the legitimacy of
chiropractic by successfully establishing a chiropractic school or
department in Taiwan, Taiwan's influential doctors' associations
would convince the authorities to allow only licensed medical
doctors to perform chiropractic. VM Chen's longer path to full
recognition would, in their view, continue to marginalize
chiropractic doctors. Lee and Griffin also worry that without legal
recognition, chiropractic doctors will have no effective defense
against lawsuits brought by unhappy patients, or "harassment" by
police.


7. (SBU) According to Lee and Griffin, the only fix acceptable to
the chiropractic industry in Taiwan would be for the authorities to
lift legal barriers to chiropractic services, and establish a
certification and licensing process. Specifically, they want the DOH
to amend an October 15, 2003 Executive Order in order to allow
doctors of chiropractic who have graduated from Council on
Chiropractic Education-accredited chiropractic colleges to perform
chiropractic in Taiwan, and the LY to pass a Chiropractic Physician
Law containing examination and licensing provisions.

Comment
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8. (SBU) According to AmCham estimates, legitimizing chiropractic in
Taiwan could lead to millions of dollars in annual U.S. equipment
and education exports. We will continue to advocate for DOH to
amend its 2003 Executive Order banning chiropractic doctors from
practicing in Taiwan, and recognize chiropractic as a legitimate and
distinct medical practice. We think the most effective way to
achieve this goal would be within the context of bilateral Trade and
Investment Framework Agreement (TIFA) talks. End Comment.

YOUNG