Doctors take tactical retreat
By Yun Suh-young
An increasing number of doctors are challenging the government over medical fee cuts for seven major operations.
Although they are cautious about halting emergency operations, doctors are threatening to take collective action against the diagnosis related group (DRG) payment system which will be implemented on July 1.
The Korean Medical Association (KMA) denied reports that surgery for appendix removal and cesarean sections would be suspended for a week in early July as part of their protest, saying they were still discussing which operations to boycott.
The denial, however, is seen as a tactical retreat in reaction to the negative public sentiment. Doctors are still maintaining a hard-line position to boycott the surgeries.
The association held a meeting Tuesday with doctors from the four medical service fields in which the new system applies ― surgeons, gynecologists, otolaryngologists, and ophthalmologists ― and decided to refuse to perform some operations that fall under the DRG system.
The doctors, however, made it clear Wednesday that they will continue performing appendix surgery and cesarean sections as they are emergency operations that immediately affect people’s health.
“We are still discussing in which fields to ban operations but we’re definite that we will not give up performing emergency operations such as appendix removal and cesarean sections,” the KMA announced in a statement.
DRG, also known as the fixed-price system, allows patients to pay for hospital services in a bundle. Seven operations ― cataract, tonsil and appendix removal, hernia and hemorrhoid repairs, uterine surgery and cesarean sections ― were covered.
Gynecologists also denied the rumor that they will stop performing operations.
“We are strongly against the unilateral implementation of the DRG system but we will not take the radical method of refusing caesarian sections as that is not appropriate,” the Korean Society of Obstetrics and Gynecology and the Korean Association of Obstetricians and Gynecologists said in a joint statement Wednesday.
Yet they called for the plan to be scrapped.
“The government must withdraw the plan to implement the system as 70 percent of the hospitals are already implementing it. The system should remain as the status quo with doctors participating autonomously. It is not right to force the system upon us,” they added.
The Ministry of Health and Welfare expressed regret about the reaction of doctors.
“It is a pity that some of the medical associations would decide to halt operations ahead of the implementation of the DRG system. It seems inappropriate to tackle a problem this way. The government will prepare ahead of the boycott to prevent any inconvenience to patients,” the ministry announced during an emergency briefing Wednesday.
“The DRG system will be implemented without any changes starting July 1. If the medical industry refuses to do operations, we plan to take legal action.”
Under the DRG system, patients need only to pay 20 percent of the medical fees as fixed hospital fees includes health insurance coverage. It prevents doctors from forcing patients to undergo unnecessary tests, operations and other medical services which was often the case under the current fee-for-service payment system.
Doctors, however, have been protesting the system saying it will lower the quality of medical services. They say fixed prices for medical care will discourage them from providing proper and decent treatment.