Punishment for Doctors in 'Emergency Room Roundabout'?..."Many Will Leave to Private Clinics for Non-Covered Procedures"

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Regarding the case of a teenager who died last March in Daegu after failing to find an emergency room, A, a resident in the Department of Emergency Medicine at Daegu Fatima Hospital, is currently under police investigation as a suspect. He is accused of violating Article 48-2 of the Emergency Medical Service Act, which states that "emergency medical care cannot be refused without justifiable reasons." At the time, A assessed that the teenager who later died was not in a severe condition upon first arrival at Daegu Fatima Hospital and recommended transfer to another hospital as psychiatric treatment seemed necessary. The medical community is concerned that the police investigation of an emergency medicine resident could lead to the abandonment of essential medical services spreading even to emergency rooms.

In the emergency medicine departments of tertiary hospitals, patients visiting the emergency room are triaged into five levels according to the Korean Triage and Acuity Scale (KTAS), and the roles of coordinating with other necessary medical specialties and defining the scope of work are carried out. If the emergency room is overcrowded or if there is no attending physician from an essential department available for immediate treatment, patients must be transferred. Emergency rooms are overwhelmed with patients suffering from chronic and mild illnesses, while the number of attending physicians in essential departments for patients requiring surgery is decreasing. This has increased the need to transfer critically ill patients whose lives are at risk. An emergency medicine specialist said, "Currently, most regional emergency medical centers are facing this problem," adding, "The endless cycling of patients in emergency rooms is a result of the lack of an emergency transfer system, not the fault of individual doctors."

At the B Regional Emergency Medical Center in the metropolitan area, 50% of patients visiting the emergency room require treatment from other departments. A representative of this center stated, "Due to the avoidance of essential departments, other specialties are losing their functionality, leading to an increasing number of requests for patient transfers from the emergency room," and warned, "If individuals are repeatedly held responsible in such situations, it could lead to avoidance of emergency medical care altogether." Although the application rate for emergency medicine residency this year was 85% (134 out of 158), which is below full capacity, it is still higher than that of other less favored departments such as pediatrics (26%). However, if doctors are penalized for the cycling of patients in emergency rooms, the number of applicants could sharply decline.

On the 3rd, the Korean Medical Association, the Korean Society of Emergency Medicine, the Korean Association of Emergency Medicine, and the Korean Intern Resident Association held a press conference, arguing that to prevent the recurrence of emergency room cycling, the following are necessary: ▲ enactment of a special law for handling essential medical accidents ▲ establishment of emergency medical infrastructure and adequate compensation ▲ restraint in the use of emergency rooms by mild patients ▲ and incorporation of opinions from medical field practitioners.

There is also a forecast that if the structural problems of emergency medical care are attributed to individual responsibility, emergency medicine specialists may leave for private practice, causing adverse effects. Professor Kim Ho-jung of the Department of Emergency Medicine at Soonchunhyang University Bucheon Hospital said, "There are emergency medicine doctors who, after enduring the tough work of performing cardiopulmonary resuscitation daily in the emergency intensive care unit, move to private practice where they perform less demanding non-reimbursed procedures and even receive higher reimbursements, finding satisfaction," adding, "If punishments extend to residents, even the existing emergency medicine specialists will leave."

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