South Korea touts world-class health care infrastructure. Earlier than the pandemic, it had turn out to be a bustling medical tourism hotspot. In 2019, greater than 90,000 individuals visited the nation to avail themselves of beauty surgical procedure there, and its personal residents have seen life expectancy shoot as much as among the many highest of developed nations, in line with the Organization for Economic Cooperation and Development.
And but, in July final yr, a 37-year-old nurse died of a mind hemorrhage due to an absence of care. She had collapsed whereas on obligation at one among Korea’s largest hospitals, however couldn’t obtain important therapy as there have been no neurosurgeons on name. She was later transferred to a distinct hospital, the place she was pronounced lifeless.
The nurse’s demise delivered to gentle South Korea’s dearth of physicians specializing in very important care. Of the docs the nation does have, many decide as an alternative for extra profitable fields like cosmetic surgery and dermatology, whereas not sufficient are educated to carry out extra important specialties, like higher-risk surgical procedures, pediatrics, and basic medication. With out intervention, the scarcity is certain to worsen, with estimates of as much as 27,000 docs wanted by 2035 to fulfill demand.
The federal government is wanting into a spread of proposals to resolve this important scarcity, however one latest suggestion has fearful affected person advocates. Well being minister Cho Kyoo-hong stated at a press briefing final week that his company will overview “varied measures to alleviate the burden of medical professionals,” in line with the Korea Times, together with presumably enacting a particular regulation aimed toward decreasing the severity of punishment docs face for medical negligence or malpractice.
South Korea’s Minister of Well being and Welfare Cho Kyoo-hong speaks to the media in Seoul on Oct. 30, 2022.
In accordance with the ministry, many docs are likely to keep away from extra important specialties amid excessive dangers of attainable monetary destroy because of the nation’s stringent requirements for accountability. The dearth of legal responsibility protections for medical professionals is a key element of the “harsh” working situations dealing with docs, says Kim Minsung, a postdoctoral fellow in medical ethics and regulation on the College of Hong Kong who has studied South Korea’s well being care business and regulation.
However civic society teams reacted by calling the proposal a “step in the wrong direction,” criticizing it for patronizing docs as an alternative of catering to sufferers’ wants.
How unhealthy is South Korea’s specialised physician scarcity?
South Korea is dwelling to a minimum of 130,000 docs, however that isn’t sufficient for its wants. Newest OECD information present that South Korea has simply 2.5 doctors per 1,000 inhabitants, or about two-thirds of the OECD common of three.7. This shortage has manifested itself in excessive methods: in one instance, a hospital needed to cease providing inpatient care for youngsters for 3 months as a result of it couldn’t rent resident pediatricians.
The availability drawback begins early, on the college stage: since 2006, the federal government has had an annual admission restrict of three,058 college students for 40 medical faculties within the nation. Docs preferring the exclusivity of the career and the federal government that wishes there to be extra docs are repeatedly at odds over reforming the quota—a lot in order that in August 2020, docs in coaching staged a walkout amid a proposed improve of the admission cap. Docs opposing a hike have argued that the true drawback is low pay and weak infrastructure in rural areas the place healthcare roles are most disadvantaged.
That is although docs earn four times the common wage of different professionals in South Korea. The problem is that lots of them should not specializing in very important care. Kim, the College of Hong Kong scholar, says that’s as a result of aspiring medical professionals are extra enticed to coach in fields like beauty surgical procedure, for which charges are much less strictly regulated and usually a lot greater than they’re for physicians. South Korea boasts an almost $4 billion cosmetic surgery business that takes up 25% of the worldwide market share, owing largely to the sweetness requirements promoted by the nation’s common and far-reaching leisure companies.
A pedestrian walks previous commercials for cosmetic surgery clinics at a subway station in Seoul in March 2014.
Jung Yeon-je—AFP/Getty Pictures
Specializing in very important care, however, shouldn’t be as worthwhile, and could be exhausting, too. In 2019, Korea Herald reported that 98% of residents labored over 80 hours every week in 2017, and surgery-related departments usually fail to refill slots for residency applications. The typical age of surgeons is now 53 years previous, in line with a December report from Korean broadcaster KBS, which additionally says that because the nation’s fertility price declines and its inhabitants ages, fewer docs wish to work in pediatrics and obstetrics.
Is medical malpractice a significant difficulty in South Korea?
A November examine from the Korea Medical Association launched in November confirmed that some 750 South Korean docs yearly—or a median of greater than two per day—are criminally charged with skilled negligence leading to demise or damage. That’s 14.7 occasions greater than the variety of related indictments in Japan, 580.6 occasions greater than within the UK, and 26.6 occasions greater than in Germany.
However complaints about malpractice should not fully unfounded. Sufferers in South Korea have the lowest perception of their very own well being standing of all OECD nations, and a 2016 study discovered that, in contrast to in lots of different nations, the general public is most involved with the standard of the well being care system extra so than entry or price. Religion in hospitals and surgeons is especially low due largely to suspicions—primarily based on instances which have made the information—of unqualified employees mishandling operations. In 2021, the federal government required surveillance cameras be put in in working rooms the place sufferers are below basic anesthesia to attempt to stamp down on malpractice instances.
One other study from 2019, primarily based on interviews with greater than 3,000 docs in South Korea, discovered that one in each three had medical disputes prior to now three years, although 96% of the respondents believed a particular regulation on medical accidents was wanted to assist resolve such disputes by means of non-criminal funds as an alternative of legal punishment.
When it comes to compensation, at present, victims of “medical mishaps” are allowed to assert as much as 30 million gained ($24,500), with 70% shouldered by the federal government and 30% by the establishment or physician accountable. The federal government is reportedly contemplating shouldering extra of the price.
On Feb. 2, the Seoul-based Residents’ Coalition for Financial Justice stated in a press release that enjoyable measures towards medical malpractice will lead docs to calm down their “obligation of care obligations, inflicting nervousness and mistrust among the many public.” Jung Ho-chul, a world employees member for CCEJ, says the physician scarcity and malpractice are “unrelated.” If something, the federal government ought to strengthen—not weaken—the regulation penalizing docs who commit malpractice, together with taking away their medical licenses. To handle the scarcity, he says, the federal government ought to deal with lifting the medical faculty quota, amongst different issues.
However Kim says the present authorized system is excessively skewed in favor of sufferers, which creates a doctor-client relationship wherein docs could be afraid to take up important care instances. Kim says that docs shouldn’t be free from legal responsibility for malpractice however that almost all of disputes ought to actually be dealt with by means of civil courts with extra applicable penalties. In most nations, he says, “legal medical malpractice actually has much less instances.”
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