The Four Characters 'Jikjeopjinchal' in the Medical Law, Core of the Telemedicine Conflict

Deadlock Lasting Over 10 Years... Key Is Legal Amendment
Ruling Party Considers Alternative Terms for 'Non-Face-to-Face Medical Care'... Amendment in Mind
Medical Community "Clear Limits Compared to In-Person Diagnosis, Such as Misdiagnosis"

[Asia Economy Reporter Cho Hyun-ui] As the government and some ruling party members push for the introduction of telemedicine, the long-standing Pandora's box of conflicts with the medical community has reopened. The background is the increased necessity for non-face-to-face medical consultations triggered by the COVID-19 pandemic, but considering the ongoing telemedicine conflicts over the past decade, social controversy is inevitable. While the Korea Medical Association, a key stakeholder, expresses deep-seated rejection of 'telemedicine,' some within the ruling party are attempting a direct breakthrough by using the alternative term 'non-face-to-face medical care.'

◆Telemedicine, the key is 'legal amendment'= The movement to promote telemedicine began during the Lee Myung-bak administration in 2010. The government has knocked on the National Assembly's door for over ten years to introduce telemedicine between doctors and patients but has repeatedly failed due to opposition from the medical community. The core of the conflict surrounding telemedicine lies in amending the Medical Service Act. The current law stipulates 'direct examination' (face-to-face consultation) between doctors and patients as the principle. According to Article 17, Paragraph 1 of the Medical Service Act, only the doctor who performs the face-to-face consultation or examination can issue medical certificates, examination reports, or proof documents. In South Korea, telemedicine is only allowed in the form of a doctor consulting another doctor in a different region since the 2002 amendment of the Medical Service Act, but telemedicine between doctors and patients, which the ruling party is expected to push in the 21st National Assembly, remains illegal.

Unlike South Korea, there are few legal obstacles to introducing telemedicine overseas. The United States, which allowed telemedicine early on, has never legally stipulated the principle of face-to-face consultation. Telemedicine in the U.S., which began in the 1990s, has become popular enough to account for one in six medical consultations. Last year, the related market size reached $2.4 billion (approximately 2.95 trillion KRW).

Even in countries with relevant laws, telemedicine has become normalized after amendments. These countries took the first step by allowing telemedicine in a limited way. Japan conducted a pilot project for residents in remote islands in 1997 and fully allowed telemedicine for follow-up patients after revising the Ministry of Health, Labour and Welfare notification in 2015. Remote dispensing at pharmacies is also possible.

France allowed telemedicine between doctors and patients in the 2010 related law. France is the only European country that explicitly specifies the scope of telemedicine provision in legal form. To provide medical services, the doctor's certification, patient identification, and the doctor's access to the patient's medical information must be guaranteed. Also, contracts with central or local health authorities can only be made if certain effectiveness is judged.

The government's use of the term 'non-face-to-face medical care' instead of telemedicine is interpreted as a consideration for amending the Medical Service Act. Since face-to-face consultation is the principle under current law, this part must be amended to introduce telemedicine. Additionally, emphasizing the necessity is efficient given the increased importance of non-face-to-face care due to COVID-19.

◆"A situation like the 2014 collective strike"= The Korea Medical Association is opposing the government's move, even mentioning 'extreme struggle.' The medical community strongly opposed every time a Medical Service Act amendment bill was submitted to the National Assembly in 2010, 2014, and 2016, holding large-scale rallies in front of the National Assembly. The most intense conflict was the collective strike during the Park Geun-hye administration's push for telemedicine in 2014. At that time, former KMA President Roh Hwan-gyu was prosecuted by the prosecution following a complaint by the Fair Trade Commission, and the related trial is still ongoing.

The medical community perceives the ruling party's telemedicine promotion movement as a serious situation similar to 2014. Regarding KMA President Choi Dae-jib's statement the day before that 'if telemedicine is forced, we will engage in extreme struggle,' a KMA official said, "It is too early to discuss how to fight at this point, but we see it as a situation similar to that time."

The biggest reason the medical community opposes telemedicine is the risk of medical accidents such as misdiagnosis. Kim Dae-ha, KMA Director of Public Relations, said, "South Korea is one of the countries with the best medical accessibility in the world," adding, "There is a system in place to book consultations with specialists and receive related tests when necessary, so there is no need to introduce non-face-to-face consultations, which clearly have limitations compared to face-to-face consultations."

This content was produced with the assistance of AI translation services.