South Korea Experts say the reason thousands of resident doctors are on strike is because of profits, which would shrink the income pie if the country had more doctors.
More than 9,000 medical doctors, the core force in caring for and treating critically ill patients, have now left hospitals in protest of a policy of increasing enrollment quotas in medical schools, putting South Korea on the brink of a major medical crisis.
The strikers were protesting against the government’s proposed medical education reform, which calls for an increase in medical school enrolment quotas by 2,000 from 2025. They said the plan to increase the number of medical students would impact the quality of health services, as well as their income and social status. Instead of increasing enrolment quotas, the government should address the income and working conditions of current health workers.
Meanwhile, experts say doctors oppose the expansion plan because many hospitals, mostly private, operate on a profit-oriented structure. In Western countries, public hospitals account for more than 50 percent of medical facilities, according to Jeong Hyoung-sun, a professor of health management at Yonsei University. So doctors welcome the opportunity to have more colleagues, which reduces their workload while keeping their salaries unchanged.
However, in Korea, many doctors run their own clinics. If there are competitors in the future, their income may decrease.
“This is a battle for profits,” the professor said.
Lee Ju-yul, a professor at the Department of Health Management at Namseoul University, pointed to the fee-for-service system as the cause of competition among doctors.
“Under this program, doctors charge separately for each service they perform. But the pie gets smaller if there are more doctors,” Lee said.
According to him, this is why the concept of "three-minute treatment" emerged when doctors only spent three minutes on each patient, in order to increase the number of treatments and gain greater profits.
Medical staff at a hospital in Gwangju, February 2024. Photo: AFP
This is not the first time doctors have protested against plans to expand admission quotas.
In July 2020, the Moon Jae-in administration attempted to increase the number of medical schools, but by a smaller amount of 4,000 students over 10 years, starting in the 2022 academic year. The plan also faced a two-week strike by doctors from August 21 to September 8, at a time when the country was struggling with the Covid-19 pandemic.
But observers say the number of doctors protesting was small, as many were working closely with patients during the pandemic. This drew public sympathy for their hard work and efforts to save lives during uncertain times. The government then backed off plans to increase enrollment quotas as the pandemic escalated.
Public sentiment has shifted. A survey conducted by the Korea Federation of Medical Workers in December 2023 found that nearly 90% of the population supports increasing the number of medical school admissions. That’s up nearly 20% from 2022, according to a report released by Democratic Party Rep. Kim Won-i.
Last week, a doctor’s speech at a protest went viral. She said she would prioritize herself over her patients, in response to the government’s call to put patients first. The speech drew negative comments, with many calling it arrogant and authoritarian.
Currently, South Korea has 2.2 doctors per 1,000 people, much lower than the 3.7 doctors per 1,000 people reported by the Organization for Economic Cooperation and Development. The figure is 4.5 in Germany, 3.2 in France and 2.6 in Japan. Officials say South Korea needs more doctors to prepare for a "super-aging society" where seniors will account for 20% of the population by 2025 and 30% by 2035.
Thuc Linh (According to Korea Herald )
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