Looming healthcare crisis

The Korea Times

The Korea Times

Opinion

Fri, December 1, 2023 | 02:50

Editorial

Looming healthcare crisis

Posted : 2023-02-01 17:11

Updated : 2023-02-12 09:46

Doctors should agree to raising medical school enrollment quotas

Medical doctors comprise one of the most complex and elusive groups in Korea.

Medical schools suck up all the best talents. They are so popular that even college students who entered the nation's three most prestigious universities quit to move to medical schools.

Becoming a doctor is never easy. Medical residents must work 78 hours weekly, sleeping four hours a day. These trainee doctors are so stressed out due to the murderous workload and other reasons that cause more than half to consider dropping out, with nearly two in 10 thinking of suicide once.

Still, they will never share their work with others. Physicians vehemently oppose the invasion of their territory by traditional medicine practitioners, nurses, or even tattooists, all in the name of "protecting people's lives and promoting public health." However, the most popular departments among residents are dermatology, cosmetic surgery and psychiatry, instead of thoracic or brain surgery.

Existing doctors are even reluctant to share their work with more would-be physicians, opposing an increase in the medical student enrollment quota.

As a result, the admission quota has been fixed at 3,058 for the past 18 years. In 2020, the Moon Jae-in administration tried to increase it by 400 more, but then backed off after encountering fierce opposition from the medical community. Trainee doctors walked out en masse during the COVID-19 crisis and boycotted state exams for doctor licenses. The government yielded, agreeing to revisit the issue after the pandemic stabilizes.

Now that COVID-19 has weakened, the Yoon Suk Yeol administration seems set to tackle the matter and rightly so. Last week, Minister of Health and Welfare Cho Kyu-hong tackled the issue with the head of the Korean Medical Association (KMA), the largest doctors' group with about 130,000 members, to discuss the matter. It is also uncommon, in Korea or elsewhere, for a cabinet minister to have weekly meetings with a vocational group's representative to make policies.

However, the association's position remains unchanged from two years ago. A KMA spokesperson reiterated claims that the government must first "rectify structural problems" by, for instance, allowing increases in medical fees for "essential but unpopular" departments, such as OB-GYN and pediatrics. The group maintains that the government can remedy the extreme imbalance in healthcare services between urban and rural areas and between different medical departments with more sophisticated policies instead of increasing the number of doctors and medical schools.

Various statistics say otherwise, however.

In 2020, the number of physicians, excluding traditional medicine practitioners, stood at 2.5 per 1,000 people, some two-thirds of the OECD average of 3.7 and the lowest after only Mexico's 2.4. The figure was 16 in a central Seoul district and 0.16 in a rural county in southeastern Korea. A recent study also showed that, at this pace, Korea will face a doctor shortage of 27,000 by 2035.

The healthcare crisis has already begun. A pediatrics department at a large hospital in Incheon suspended accepting patients after one of two remaining trainee pediatricians left. In a recent and very unfortunate case, a nurse who suffered a stroke at one of the big five hospitals, had to be transferred to another institution as its two brain surgeons were not available at the time and she died.

Still, nothing seems to change the adamant stance of doctors. They say even if the government increases their number, the void at unpopular ― and unprofitable ― departments will remain the same because medical residents have "freedom to choose a vocation." About the government's idea of setting up public medical schools in provinces and nurturing regional doctors, they say "few will remain there after their mandatory period of service ends." In Japan, however, a similar system has taken root as more regional doctors decided to settle in their respective regional areas.

Korea has a relatively excellent healthcare service thanks partly to competent and dedicated physicians. It would, however, be far better than now if doctors drop their collective selfishness a little for the benefit of all. Lawyers, another elite group, did so a few decades ago, and Koreans now enjoy legal services far more quickly and at a cheaper price.