The Expansion Project of the NCKU Medical Center
                                                                                
Dear members of our Medical Center and alumni:
     Many of our faculty members have expressed to me their concerns
regarding the Expansion Project (擴建計畫) that we are currently
contemplating for our Medical Center.  Specifically, they have cast
doubt whether we can carry such an enormous budgetary burden under
the current medical care system in which the global containment of
payment (總和給付) is being applied.  They also wonder whether we
have the effective strategic plan to direct various clinical services,
 in particular, the Cancer Center, Ambulatory Care Center, Intensive
 Care Unit, and the Emergency Department when the project is completed.
     Before responding to these critical issues, I would like to make
it clear to you all that this Expansion Project is not merely confined
to the affiliated Hospital (附設醫院), it actually, to a significant
extent, encompasses the entire Medical Center including certain
departments of basic science in the College of Medicine (醫學院) as
 well as the Division of Clinical Research (DCR) of the National
Health Research Institute (NHRI) (國家衛生研究院臨床醫學研究組).
The NHRI has so planned that 50% of DCR's research facilities and
personnel will be housed at the NCKU Medical Sciences Campus
(醫學科學校園) while the remaining 50% at the NHRI home base
currently being built at the southern region of Shin- Tsu City (竹南).
     Conceptually, the inclusion of the NHRI's DCR in this Expansion
 Project is well justified inasmuch as the DCR's building purportedly
 would accommodate quite a few of our faculty from the Department of
Medical Technology (醫技系/所), Department of Microbiology and Immunology
 (微免所), and the Division of Infectious Diseases (ID) (感染科) for the
 purpose of collaborating studies between NHRI and our Medical Center.
 The cost of constructing the NHRI's DCR building within the NCKU Medical
 Sciences Campus is approximated to be NT$200,000,000 (二億) which has
 been donated by the Uni-President Enterprise Corporate (統一集團).  The
 long-term goal of the NHRI's DCR is to optimize related national
resources and to become the ID research center for the nation and the
south-eastern region of Asia.  In the wake of recent SARS outbreak and
 in light of Tainan Army Hospital (台南國軍醫院) having been renovated
 as one of the two national ID centers chosen, the role of NHRI's DCR
and our Medical Center in the battle against ID can not be overemphasized.
  I hope you also come to realize that the success of NHRI's DCR is also
 apt to elevate our Medical Center's research in the field of ID to a
new horizon!
     The original Expansion Project with an estimated cost of
NT$1,800,000,000 (新台幣十八億) was designed to have a 12-floor building
 containing the Cancer Center, Outpatient Clinic, Ambulatory Care Center,
 basic science research units and allied health sciences (e.g., the
public and environmental health).  From a budgetary standpoint, it is my
 understanding that NT$500,000,000 (五億) will be supplemented by the
Ministry of Education (教育部), NT$300,000,000 (三億) by our University
 (NCKU), and the remaining NT$1,000,000,000 (十億) to be defrayed by our
 hospital cash reserves (approximately NT$500,000,000五億) and yearly
surplus and bank loans, among which NT$300,000,000三億is allocated as
moving expenses for the Outpatient Clinic.  Looking only at these numbers,
 I very much agree with your concern about our fiscal responsibility that
 would incur for expanding our Medical Center.  Nevertheless, when we
 analyze our current financial situation along with the predicted
lackluster trend, we unfortunately have to admit that we are likely to
 run out of the profit sharing plan (績效獎金) regardless of whether we
 proceed with (in 7 years) or without (in 10 years) this Expansion Project.
  In other words, over the past several years, like it or not, we have
 never been under sound financial management.  Thus, it is imperative
 that we act now to overhaul our fiscal planning.  However, as we look
 at our counterparts in the vicinity, the Chi Mei Medical Center
 (奇美醫學中心) and the Kaohsiung Medical University (高雄醫學大學),
 and other medical centers in the nortthern and middle parts of our
country, such as Chung Kung Medical University (長庚醫學大學), Taipei
 Medical University (台北醫學大學), Chinese Medical College (中國醫藥學院)
 and Chung Shang Medical University (中山醫學大學), we also have to agree
 that we are losing our national status in competition with these medical
 institutions if we abandon our Expansion Project.  In my previous letter
 to you, dated March 21, 2003, I expressed my admiration for the
University of Mississippi Medical Center (UMC) on account of its evolution
 and development from a small to a medium-sized medical center with
excellence in both clinical services and academic achievements.  Hope
 this would be our turn!
     By now, I hope it is apparent to you all that there are compelling
 reasons why we ought to proceed with the Expansion Project so as to
maintain and enhance our national status.  As we ponder on the future of
 our Medical Center, we simply cannot continue on keeping the status quo
and current comforts as it would bring us down from the national scene to
 become a local medical organization.  I have full understanding that to
complete this Expansion Project and to maintain the new facility in
optimal functions are financially a daunting job.  Therefore, after
deliberate discussion with many faculty members, we have come up with
several ideas and strategies.  The following describes a few of these
thoughts:
1.        As we have finally selected Professor Jyh-Hong Chen (陳志鴻教授)
 to be the new hospital superintendent, all factions should unite together
 and have more in common than in dispute to strive jointly for the future
advancement of our Medical Center.  Professor Chen and deputy-superintendents
 Professor Chyi-Her Lin (林其和) and Professor Sen-Tien Tsai (蔡森田) all
 share the same vision of the future development of our Medical Center and
 all are eager in shaping up this wonderful community.  They have promised
 to be fiscally responsible in managing the affiliated hospital and socially
 progressive in seeking financial support as outlined below.
2.        We need to form an ad hoc Committee to set forth a strategic plan
 for better management of our finance.  Ideally, we should not use up our
hospital reserves and should avoid making loans from commercial banks.
Instead, we should aggressively campaign for donations from various sources,
 especially entrepreneurs who are graduates from our College of Engineering
 (工學院)(NCKU).  Meanwhile, we should consider the feasibility of making
 a loan through our own University, albeit it may be a wishful thinking.
  More importantly, all of us should pull out all the stops to drum up
supports inside and outside our Medical Campus such as refashioning of
 practice policies and outreach programs.
3.        Equally urgent is to assemble another ad hoc Committee for future
physical planning.  We need to appropriately place and manage the Cancer
 Center, Ambulatory Care Center and basic science departments, and to
renovate the research building and the main hospital proper, e.g., our
 research space, dialysis unit, intensive care unit, emergency room, etc..
 As for the Cancer Center which is the primary focus of our Expansion
Project, we need to obtain experiences of other medical centers such as
 Ho Shin Cancer Center (和信癌症中心) and the world renowned M.D.
Anderson Cancer Center.
4.        We should proactively work with social elites including
 political heavy weights such as legislators (立法委員) and government
 officials, specifically lobbying for progressively increasing governmental
 support as we continue to play the role of a national university medical
 center (國立大學醫學中心) where the importance of medical education and
medical research is no less than that of patient care.
5.        To continue our educational reform, we should place the emphasis
 on quality resident training (住院醫師的培育) in tandem with the ongoing
faculty development (教師的培育及成長) program.  Our aim is to nurture all
 residents to become excellent assistant teachers (助教) who, in turn,
would provide quality teaching for medical students (i.e., interns and
clerks).  Our aim is to establish a first rate medical educational program
 in the nation.
6.        Besides maintaining a solid foundation in research, we need to
 achieve clinical excellence by cultivating visiting staff (主治醫師) and
 junior faculty members and by recruiting superlative junior and/or well
 established senior faculty from other medical centers, in the country and
 overseas.  Concurrently, we should encourage more of our junior faculty
 to go abroad for advancing their research and/or clinical skills.  These
 policies are similarly applicable to the allied health sciences within the
 Medical Sciences Campus.
     Thus, we have a great mission with myriad of challenges in front of us.
  Along with the expansion of our physical structure, we have to facilitate
 our faculty development and to continue the process of reforming medical
 education while promoting quality research and better patient care.  I am
 confident that these guiding principles in shaping our Medical Center will
 enrich the opportunities for our faculty, trainees (residents and
postgraduates), and students alike for years to come, and will eventually
make NCKU Medical Center a respectable medical institution, nationally and
 internationally!
     I earnestly invite your constructive comments and recommendations for
 all aspects we have undertaken to better this community as much as I look
 forward to your joining our march toward the next 20 years of the NCKU
 Medical Center!
                                                                                
     Best wishes and enjoy the rest of summer!
                                                          
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