Emergency units at all hospitals in South Korea except for one, on Thursday (Feb 22) were on red alert as more than 8,000 trainee doctors continued their protest against the government’s proposed reforms to boost the country’s healthcare sector. Meanwhile, the doctors have argued that Seoul needs to address existing issues before increasing the number of physicians.
‘Red alert’ in South Korea’s hospitals
As of Thursday, more than 8,400 doctors have joined the walkout – about 64 per cent of the entire resident and intern doctors in the country, reported Reuters citing the health ministry.
Around 300 doctors also took to the streets in the capital city of Seoul near the presidential office to call on the government to scrap its plan.
WATCH | Why are South Korean trainee doctors on strike?
The protests continued a day after South Korea’s government officially ordered thousands of striking doctors to get back to work immediately or face legal action. The walkouts left general hospitals, which heavily rely on trainees for emergency operations and surgeries, paralysed.
Around two-thirds of the country’s young doctors have joined the protests since they began earlier this week raising fears of further disruptions to the medical system if the dispute over the reforms drags on.
About the proposed reforms
The government citing the low number of doctors and the country’s rapidly ageing society proposed several reforms in one of the largest shake-ups to South Korea’s medical training system.
The proposed reforms, announced earlier this month, would raise the number of students admitted to medical schools by 2,000 in the academic year 2025.
The government has sought to fill an expected shortfall of 15,000 doctors projected by 2035, said the health ministry, given that the ageing population would raise the demand for medical services in the future.
Since the medical community is also ageing, more doctors are expected to retire in the upcoming years, said the health ministry.
South Korea, with 2.6 doctors per 1,000 people, is ranked among the lowest in developed countries for its doctor-to-patient ratio, according to data from the Organisation of Economic Cooperation and Development (OECD).
The government’s plan has also sought to increase investment and lift pay for doctors in regional and rural areas to maintain healthcare in those regions.
The government has raised the fees for doctors in paediatrics, obstetrics and emergency medicine since last year, said South Korea’s Prime Minister Han Duck-soo. Seoul also plans to inject over $7.48 billion to further boost these fees.
Specialist doctors in South Korea, as per OECD, are some of the highest paid among developed countries, as opposed to the general practitioners who are comparatively paid less.
South Korea faces a shortage of specialists in certain key areas, such as paediatrics and cardiology which has been attributed to misplaced financial incentives, national health insurance, and the risk of medical lawsuits.
Seoul has acknowledged that doctors in essential services are often subject to malpractice suits and prosecution and plans to introduce new legislation to expand legal protection for doctors.
What have the doctors said?
The doctors have said that universities aren’t ready to offer quality education to that many students, as the government has sought to bring the total to 5,000 students, as per its plan.
The 2,000 additional admissions “is a nonsensical figure,” said the Korea Interns and Residents Association, the body leading the strike, and called the plan a political ploy ahead of a general election in April.
The Korea Medical Association, which represents 140,000 doctors, said it supports the trainee doctors’ walkouts, but is yet to decide if they will join them.
As of Tuesday night, about 8,820 out of the country’s 13,000 trainee doctors have submitted resignations to their hospitals, but none of them have been accepted. Around 7,813 of the doctors have walked off, Vice Health Minister Park Min-soo told reporters, on Wednesday.
South Korea’s medical community argues that there are already sufficient numbers of doctors saying that the real issue is the pay and working conditions.
The medical interns and resident doctors say they are underpaid and overworked and their protests show the flaws in the system. Trainee doctors typically work 80 to 100 hours, five days a week, supporting senior doctors during surgeries and dealing with inpatients.
They say more senior staff needs to be hired to address this issue and not increase the number of trainees.
Young doctors are also concerned that increasing the number of medical students would lead to more competition in the already cut-throat sector; a view which is not particularly popular.
“Opposing the expansion of medical school admissions to ensure greater profitability by reducing competition when they establish their own practices in the future is unlikely to garner public support,” Kim Jae-heon, head of an NGO advocating free medical care told AFP.
Government issues back-to-work order
The government, on Wednesday (Feb 21) issued the back-to-work and accused trainee doctors of putting their rights before the lives of patients. “A collective action taking the lives and safety of the people hostage cannot be justified for whatever reason,” said Safety Minister Lee Sang-min.
Seoul’s medical law allows the government to issue such back-to-work orders if there are grave concerns about public health. If not abided by, striking doctors can face up to three years in prison, $22,480 in fines, and punishment that could lead to them losing their medical licence.
“Everyone is angry and frustrated, so we are all leaving hospitals,” said Park Dan, head of the Korea Interns and Residents Association, adding that he was willing to be arrested if their demands were heard.
Impact on hospitals and patients
The biggest hospitals across South Korea were forced to cancel operations and turn away patients who sought emergency care.
Five major hospitals in the country have cut surgeries by up to 50 per cent to deal with the stoppage of operations, reported news agency Yonhap citing industry sources.
Cancer patients and pregnant women needing C-sections have seen procedures cancelled or delayed, as per local media reports.
Social media and online communities were flooded with posts about people receiving phone calls about delays and cancellations.
“I’m really angry at both the government and the hospital,” wrote a patient with breast cancer whose operation was postponed indefinitely, as per AFP.
She added, “I hate both the government that created this situation and the doctors who pretend not to know that no cause is more important than their patients.”
A poll by Gallup Korea showed that most South Koreans (76 per cent) are in favour of the reforms, amid concerns about an acute shortage of doctors for paediatrics, emergency units and clinics outside the greater Seoul area.
(With inputs from agencies)
