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SSouth Korea promotes world-class healthcare infrastructure. Earlier than the pandemic, it had grow to be a busy medical tourism hotspot. In 2019, greater than 90,000 individuals visited the nation for beauty surgical procedure, and the life expectancy of its residents has risen to one of many highest amongst developed nations, in keeping with the Group for Financial Co-operation and Growth.
And but, in July final 12 months, a 37-year-old nurse died of a mind hemorrhage on account of lack of care. She had collapsed whereas on obligation at one in every of Korea’s largest hospitals, however couldn’t obtain crucial remedy as a result of there was no neurosurgeon on name. She was later transferred to a different hospital, the place she was pronounced lifeless.
The nurse’s dying highlighted South Korea’s scarcity of docs specializing in important care. Of the docs the nation has, many as a substitute go for extra profitable fields like cosmetic surgery and dermatology, whereas not sufficient are educated for extra vital specialties like higher-risk surgical procedures, pediatrics and common drugs. With out intervention, the scarcity is sure to worsen, with estimates suggesting that as much as 27,000 docs will likely be wanted by 2035 to fulfill the necessity.
The federal government is contemplating a variety of proposals to deal with this crucial shortcoming, however a brand new proposal has nervous affected person advocates. Well being Minister Cho Kyoo-hong stated at a information convention final week that his company would look at “varied measures to alleviate medical workers.” Korea Occasionstogether with the potential passage of a particular legislation aimed toward lowering the severity of punishments for physicians for medical negligence or medical malpractice.
South Korea’s Well being and Welfare Minister Cho Kyoo-hong addresses the media in Seoul on October 30, 2022.
Andrei Olfert – Sputnik/AP
Based on the ministry, the nation’s stringent accountability necessities imply that many docs are likely to keep away from extra crucial specialties as the chance of eventual monetary smash is excessive. The shortage of legal responsibility safety for medical professionals is a key a part of the “harsh” working circumstances docs face, says Kim Minsung, a postdoctoral researcher in medical ethics and legislation on the College of Hong Kong who has studied South Korea’s healthcare business and regulation.
However civil society teams responded, calling the proposal a “step within the improper path” and saying it will patronize docs as a substitute of addressing sufferers’ wants.
How massive is the scarcity of specialists in South Korea?
There are at the least 130,000 docs in South Korea, however that is not sufficient for his wants. Newest OECD information reveals that South Korea has simply 2.5 docs per 1,000 individuals, or about two-thirds of the OECD common of three.7. This scarcity has manifested itself in an excessive method: In a single case, a hospital needed to cease offering inpatient care for kids for 3 months as a result of it couldn’t make use of pediatricians in non-public observe.
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 colleges within the nation. Docs, preferring the exclusivity of the occupation, and the federal government, which needs extra docs, have been at odds over reforming the quota — a lot in order that in August 2020, junior docs went on strike over a proposed enhance within the licensing cap. Physicians against a rise have argued that the actual drawback lies in low pay and weak infrastructure in rural areas, the place healthcare is most deprived.
And this even supposing docs in South Korea earn 4 instances as a lot as different professionals. The issue is that a lot of them do not specialise in important care. Kim, a College of Hong Kong scholar, says that is as a result of medical college students usually tend to be enticed to coach in fields like beauty surgical procedure, for which charges are much less tightly regulated and are usually a lot larger than for docs. South Korea boasts an almost $four billion cosmetic surgery business that occupies 25% of the worldwide market share, thanks largely to the wonder requirements promoted by the nation’s common and wide-ranging leisure firms.
A pedestrian walks previous billboards for cosmetic surgery clinics in a Seoul subway station in March 2014.
Jung Yeon-je—AFP/Getty Pictures
A specialization in important care, however, will not be so worthwhile and will also be exhausting. 2019, Korea Herald reported that 98% of resident physicians labored over 80 hours per week in 2017 and surgical departments recurrently didn’t fill residency applications. The common age of surgeons is now 53, in keeping with a December report by Korean broadcaster KBS, which additionally stated that with the nation’s falling start price and growing old inhabitants, fewer docs need to work in pediatrics and obstetrics.
Is medical malpractice a giant drawback in South Korea?
A examine by the Korea Medical Affiliation launched in November confirmed that about 750 South Korean docs are accused {of professional} negligence, leading to dying or damage, yearly – or a median of greater than two per day. That’s 14.7 instances larger than the variety of comparable fees in Japan, 580.6 instances larger than within the UK and 26.6 instances larger than in Germany.
However complaints of misconduct should not solely unfounded. Sufferers in South Korea have the bottom notion of their very own well being standing of any OECD nation, and a 2016 examine discovered that, in contrast to many different nations, the general public cares extra concerning the high quality of the well being care system than entry or value. Belief in hospitals and surgeons is especially low, largely on account of suspicions that unskilled workers are mishandling surgical procedures – primarily based on headline-grabbing instances. In 2021, the federal government mandated the set up of surveillance cameras in working rooms the place sufferers are beneath common anesthesia to attempt to curb instances of malpractice.
One other 2019 examine, primarily based on interviews with greater than 3,000 docs in South Korea, discovered that one in three had medical disputes prior to now three years, though 96% of respondents believed that there ought to be a particular legislation on medical accidents required to assist resolve such disputes by way of non-punitive funds quite than legal punishment.
By way of compensation, victims of “medical mishaps” can at the moment declare as much as 30 million gained (US$24,500), with 70% borne by the federal government and 30% by the accountable establishment or physician. The federal government is reportedly contemplating shouldering extra of the associated fee.
On Feb. 2, the Seoul-based Residents’ Coalition for Financial Justice stated in an announcement that enjoyable measures in opposition to medical malpractice will end in docs “enjoyable their obligation of care and instilling worry and suspicion among the many public.” Jung Ho-chul, a world staffer at CCEJ, says the physician scarcity and the misconduct are “unrelated.” If something, the federal government ought to strengthen—not weaken—the legislation that punishes docs who commit malpractice, together with having their medical license revoked. To handle the scarcity, the federal government ought to focus, amongst different issues, on lifting the quota for medical colleges.
However Kim says the present authorized system is overly skewed in favor of sufferers, making a doctor-client relationship the place docs may be afraid to tackle crucial care instances. Kim says docs should not be exempt from malpractice legal responsibility, however that the majority disputes actually ought to be handled in civil courts with extra applicable penalties. In most nations, he says, “legal medical malpractice truly has fewer instances.”
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