Patient Hostage Strike, Ineffective Government... "Now We Must Break the Vicious Cycle"

2000 Medical Separation Strike Demanded 10% Reduction in Medical School Quotas
Doctors' Group Overturned Medical Policy
Medical Crisis Reoccurs After 4 Years

Experts Urge Healthcare Supply System Reform
Including Expansion of Public Medical Institutions Despite Doctors' Collective Action

A medical crisis has erupted again after four years due to the submission of resignation letters and hospital departures by residents protesting the increase in medical school quotas.

As of 10 p.m. on the 20th, the second day since residents began submitting resignation letters, the Ministry of Health and Welfare announced on the 21st that 8,816 residents, accounting for 71% of residents at 100 major training hospitals, had submitted their resignation letters. The number of residents who left their workplaces was 7,813, representing 63% of the total. Consequently, surgeries and outpatient services at major general hospitals have been reduced, and patient care has begun to be postponed one after another. As of 6 p.m. that day, the 'Physician Collective Action Damage Report and Support Center' had received 58 reports of damages such as indefinite surgery postponements and unilateral cancellations of medical appointments.

[Image source=Yonhap News]

This is the fourth time since 2000 that the medical community has halted the healthcare system through refusal to provide medical services. No other country in the world, except South Korea, has seen its doctors repeatedly engage in collective work stoppages every few years over medical policies such as physician supply.

In 2000, the medical community staged a strike opposing the introduction of the separation of prescribing and dispensing drugs, achieving demands such as a 10% reduction in medical school quotas and an increase in medical fees. The government's forecast of a shortage of 15,000 doctors by 2035 originated from the quota reduction obtained through that strike. Subsequently, the government's attempts to introduce telemedicine in 2014 and to increase medical school quotas and establish public medical schools in 2020 were also thwarted by collective medical strikes and resident general strikes, respectively. Each time the medical community took collective action, the government conceded to prevent prolonged medical service gaps. Knowing this 'Achilles' heel' of the government well, doctors have once again used the impact of medical service gaps to engage in collective action by submitting resignation letters.

However, experts point out that the government should not yield to the doctors' collective action this time. Professor Jeong Hyeong-seon of Yonsei University (Health Administration) said, "If the government bends its will again due to doctors' collective action, it will be impossible to implement any policy opposed by the medical community in the future," adding, "Even if some patients suffer damage, if the government firmly shows it will not back down and the public accepts this, the medical community will recognize that they cannot win through collective action going forward." This implies that if residents' collective resignation leads to illegal acts, license suspensions, revocations, and criminal penalties should be enforced according to principles.

On the 20th, the outpatient waiting area of a large hospital in Seoul appeared quiet as residents of the Big 5 hospitals stopped working at 6 a.m. Photo by Jinhyung Kang aymsdream@

Along with this, there are opinions that the government should reorganize the medical supply system to maintain the national healthcare system if the medical community engages in collective action again in the future. Expanding public healthcare such as local medical centers and public health centers is a representative measure. Jeong Hyeong-jun, Policy Chairman of the Health and Medical Organizations Federation (specialist in rehabilitation medicine), said, "To prevent repeated collective actions by doctors, public healthcare supply must be expanded," adding, "If the government delays this citing financial burdens, it will be swayed every time the medical community takes collective action." Jeon Jin-han, Policy Director of the Health and Medical Organizations Federation, also said, "Without increasing public medical institutions, it is difficult to find ways to prevent collective actions by medical associations."

South Korea's healthcare system is based on the 'Mandatory Designation System' requiring all private medical institutions to accept National Health Insurance patients, effectively outsourcing almost all public healthcare to the private sector. Due to this system, the proportion of public healthcare in South Korea ranks among the lowest in the OECD countries. According to the '2021 OECD Health Statistics,' South Korea's public healthcare proportion by number of medical institutions is 5.2%, far below the UK (100%), Canada (99.0%), as well as the US (23.9%) and Japan (22.8%). By number of hospital beds, it is 8.8%, also lower than the UK (100%), France (61.6%), Japan (27.6%), and the US (21.3%).

There is also a view that the training hospital care system, which relies on residents, should be improved. Jeong Un-yong, representative of the Busan-Gyeongnam branch of the Association of Physicians for Humanism (A Physician's Association), said, "The repeated collective actions by residents occur because hospitals prioritize profit generation over specialist-centered care," adding, "The government should guide general hospitals to change their care system to be specialist-centered."

There were also calls for the government to operate communication channels with the medical community more effectively. Professor Koo Jeong-woo of Sungkyunkwan University (Sociology) said, "The government and the medical community should actively operate ongoing communication channels to prevent conflicts from worsening, and the medical community should also continuously communicate with the public to convey their claims."

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