South Korea Proposes Relaxing Medical Malpractice Punishment to Solve Surgeon Shortage


South Korea touts world-class well being care infrastructure. Earlier than the pandemic, it had turn into 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 international locations, in accordance with the Group for Financial Cooperation and Growth.

And but, in July final 12 months, a 37-year-old nurse died of a mind hemorrhage due to an absence of care. She had collapsed whereas on obligation at considered one of Korea’s largest hospitals, however couldn’t obtain important therapy as there have been no neurosurgeons on name. She was later transferred to a unique hospital, the place she was pronounced lifeless.

The nurse’s dying dropped at mild South Korea’s dearth of physicians specializing in very important care. Of the medical doctors the nation does have, many decide as a substitute 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 common medication. With out intervention, the scarcity is sure to worsen, with estimates of as much as 27,000 medical doctors wanted by 2035 to fulfill demand.

The federal government is wanting into a variety of proposals to resolve this important scarcity, however one latest suggestion has nervous affected person advocates. Well being minister Cho Kyoo-hong stated at a press briefing final week that his company will evaluation “numerous measures to alleviate the burden of medical professionals,” in accordance with the Korea Instances, together with probably enacting a particular regulation geared toward lowering the severity of punishment medical doctors 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.

Andrei Olfert—Sputnik/AP

In line with the ministry, many medical doctors are inclined to keep away from extra important specialties amid excessive dangers of attainable monetary smash because of the nation’s stringent requirements for accountability. The dearth of legal responsibility protections for medical professionals is a key part of the “harsh” working situations dealing with medical doctors, 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 trade and regulation.

However civic society teams reacted by calling the proposal a “step within the unsuitable route,” criticizing it for patronizing medical doctors as a substitute of catering to sufferers’ wants.

How dangerous is South Korea’s specialised physician scarcity?

South Korea is dwelling to no less than 130,000 medical doctors, however that isn’t sufficient for its wants. Newest OECD information present that South Korea has simply 2.5 medical 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 a single occasion, a hospital needed to cease providing inpatient care for youngsters for 3 months as a result of it couldn’t rent resident pediatricians.

The provision 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 desires there to be extra medical doctors are repeatedly at odds over reforming the quota—a lot in order that in August 2020, medical doctors in coaching staged a walkout amid a proposed enhance 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 medical doctors earn 4 instances the common wage of different professionals in South Korea. The problem is that lots of them aren’t 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 sometimes a lot larger than they’re for physicians. South Korea boasts a virtually $4 billion cosmetic surgery trade that takes up 25% of the worldwide market share, owing largely to the wonder requirements promoted by the nation’s fashionable and far-reaching leisure companies.

A pedestrian walks past advertisements for plastic surgery clinics at a subway station in Seoul in March 2014. (Jung Yeon-je—AFP/Getty Images)

A pedestrian walks previous ads for cosmetic surgery clinics at a subway station in Seoul in March 2014.

Jung Yeon-je—AFP/Getty Photographs

Specializing in very important care, alternatively, is just not as worthwhile, and could be exhausting, too. In 2019, Korea Herald reported that 98% of residents labored over 80 hours per week in 2017, and surgery-related departments recurrently fail to refill slots for residency packages. The typical age of surgeons is now 53 years previous, in accordance with a December report from Korean broadcaster KBS, which additionally says that because the nation’s fertility fee declines and its inhabitants ages, fewer medical doctors need to work in pediatrics and obstetrics.

Is medical malpractice a significant challenge in South Korea?

A November examine from the Korea Medical Affiliation launched in November confirmed that some 750 South Korean medical doctors yearly—or a mean of greater than two per day—are criminally charged with skilled negligence leading to dying or damage. That’s 14.7 instances larger than the variety of comparable indictments in Japan, 580.6 instances larger than within the UK, and 26.6 instances larger than in Germany.

However complaints about malpractice aren’t utterly unfounded. Sufferers in South Korea have the bottom notion of their very own well being standing of all OECD international locations, and a 2016 examine discovered that, in contrast to in lots of different international locations, 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 workers mishandling operations. In 2021, the federal government required surveillance cameras be put in in working rooms the place sufferers are below common anesthesia to attempt to stamp down on malpractice instances.

One other examine from 2019, primarily based on interviews with greater than 3,000 medical doctors in South Korea, discovered that one in each three had medical disputes previously three years, although 96% of the respondents believed a particular regulation on medical accidents was wanted to assist resolve such disputes via non-criminal funds as a substitute of felony punishment.

By way of 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 associated fee.

On Feb. 2, the Seoul-based Residents’ Coalition for Financial Justice stated in a press release that stress-free measures in opposition to medical malpractice will lead medical doctors to calm down their “obligation of care obligations, inflicting anxiousness and mistrust among the many public.” Jung Ho-chul, a world workers member for CCEJ, says the physician scarcity and malpractice are “unrelated.” If something, the federal government ought to strengthen—not weaken—the regulation penalizing medical doctors who commit malpractice, together with taking away their medical licenses. To deal with the scarcity, he says, the federal government ought to concentrate on lifting the medical college 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 medical doctors could be afraid to take up important care instances. Kim says that medical doctors shouldn’t be free from legal responsibility for malpractice however that almost all of disputes ought to actually be dealt with via civil courts with extra applicable penalties. In most international locations, he says, “felony medical malpractice actually has much less instances.”

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