Assessment #3

The Sociocultural Effects on Orthopedic Surgeries in Taiwan

Vedika Bakre

ISM I

Mr. Walters

September 28, 2018

Chiu, Shin-Lin, et al. "The sociocultural effects on orthopedic surgeries in Taiwan." ​PLoS ONE​, vol. 13,

no. 3, 2018, p. e0195183. ​Academic OneFile​,

http://link.galegroup.com/apps/doc/A532722834/AONE?u=j043905002&sid=AONE&xid=51519

108. Accessed 27 Sept. 2018.

When people are thinking about surgical techniques and procedure, the cultural identity and

protocols of a country don’t usually come to mind. In countries like America where there are people from

every corner of the world, this situation is much less irrelevant than countries like Taiwan, India, or China

where a majority of the population shares a common background. In this paper, the author analyzes the

effect of different holidays and cultural experiences on the surgical patterns of the region.

Chiu focuses on a variety of situations that could prompt an increase or decrease in the amount of

elective surgery options such as lunar calendar events (Chinese New Year, the Dragon Boat Festival, the

Ghost Month, and the Moon Festival), disparity between the rural and urban regions of Taiwan, and

disparity between genders. Chiu and a team of researchers looked into the amount of surgeries by going

through the National Health Insurance Research Database (NHIRD) and specifically through the

Longitudinal Health Insurance Database (LHID), a subset of NHIRD. By specifically examining the data

for Taiwan’s longitude, Chiu’s team was able to gather a set a data that would assist them in drawing
conclusions that show the correlation between the surgeries performed and the culture of a group of

people.

Traditionally most Taiwanese avoid elective surgeries during Chinese New Year because it is

seen as unfortunate to begin the new year with an illness especially when deliberately brought upon

oneself as in a majority of orthopedic surgeries that can wait for another month or two. Secondly, the

Ghost Month in Taiwan is considered as the time of year where the gates of hell are opened and ghosts

spend the month out of hell, looking for souls to replace them in the underworld. Because of this belief,

citizens avoid activities that could be potentially dangerous including surgery which can result in

weakness, a compromised immune system, or, worst of all, death.

The results of the study can best be summarized as a notable difference between months where

there is a religious holiday compared to those where there isn’t a religious occasion. Additionally, there

was also a larger drop in the female patients of elective surgeries. When further looked into, it was

discovered that a possible root of this fluctuation is the fact that women are expected to do all the chores

and preparations leading up to the main ceremony. Conversely, when Chiu studied emergent studies, it

was found that the lunar months had not significant impact on the frequency that these particular surgeries

were performed.

My takeaways from this study that could apply to my future are making sure to take into

consideration what types of surgeries to prepare for if I ever work in a specific cultural enclave or in

another country. In addition, this study opened a whole new perspective in orthopedic surgery because I

never really thought about cultural effects on medicine in the sense of the time of year impacting whether

patients opted to partake in surgery. An additional scenario where a study such as this could open

people’s eyes to new avenues for orthopedic surgery is for Jehovah’s Witnesses that believe in not taking

in other blood products. This is a cultural application that differs from the Taiwan example because the
Jehovah’s Witnesses don’t accept blood all year round, so surgeons will have to find a way to help them

in emergent cases where hanging another bag of blood isn’t an option.

This can apply to my future because if I ever decide to practice surgery in another country or a

culturally concentrated enclave, I will be sure to study on what practices that I will need to perfect during

specific times of a year or cultural beliefs that affect forms of surgery that I will have to do.