South Korea Proposes Stress-free Medical Malpractice Punishment to Resolve Surgeon Scarcity

South Korea touts world-class well being care infrastructure. Earlier than the pandemic, it had change into a bustling medical tourism hotspot. In 2019, greater than 90,000 folks 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 nations, in keeping 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 a scarcity of care. She had collapsed whereas on obligation at certainly one of Korea’s greatest hospitals, however couldn’t obtain crucial remedy as there have been no neurosurgeons on name. She was later transferred to a distinct hospital, the place she was pronounced lifeless.

The nurse’s loss of life delivered to gentle South Korea’s dearth of physicians specializing in very important care. Of the medical doctors the nation does have, many choose as a substitute for extra profitable fields like cosmetic surgery and dermatology, whereas not sufficient are skilled to carry out extra important specialties, like higher-risk surgical procedures, pediatrics, and normal drugs. With out intervention, the scarcity is certain to worsen, with estimates of as much as 27,000 medical doctors wanted by 2035 to satisfy demand.

The federal government is trying into a variety of proposals to resolve this crucial scarcity, however one current suggestion has fearful affected person advocates. Well being minister Cho Kyoo-hong stated at a press briefing final week that his company will evaluate “varied measures to alleviate the burden of medical professionals,” in keeping with the Korea Instances, together with probably enacting a particular regulation aimed toward decreasing 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 keeping with the ministry, many medical doctors are likely to keep away from extra crucial specialties amid excessive dangers of attainable monetary wreck because of the nation’s stringent requirements for accountability. The shortage 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 business and regulation.

However civic society teams reacted by calling the proposal a “step within the incorrect path,” 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 house to at the very least 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 downside 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. Medical doctors preferring the exclusivity of the occupation 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. Medical doctors opposing a hike have argued that the actual downside is low pay and weak infrastructure in rural areas the place healthcare roles are most disadvantaged.

That is even though medical doctors earn 4 instances the typical wage of different professionals in South Korea. The difficulty is that lots of them are usually not 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 usually a lot increased than they’re for physicians. South Korea boasts a virtually $4 billion cosmetic surgery business that takes up 25% of the worldwide market share, owing largely to the wonder requirements promoted by the nation’s common and far-reaching leisure companies.

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

Jung Yeon-je—AFP/Getty Pictures

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

Is medical malpractice a significant subject in South Korea?

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

However complaints about malpractice are usually not fully unfounded. Sufferers in South Korea have the bottom notion of their very own well being standing of all OECD nations, and a 2016 research discovered that, not like in lots of different nations, the general public is most involved with the standard of the well being care system extra so than entry or value. Religion in hospitals and surgeons is especially low due largely to suspicions—based mostly on instances which have made the information—of unqualified employees mishandling operations. In 2021, the federal government required surveillance cameras be put in in working rooms the place sufferers are underneath normal anesthesia to attempt to stamp down on malpractice instances.

One other research from 2019, based mostly 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 by means of non-criminal funds as a substitute of felony punishment.

By way of compensation, presently, 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 fee.

On Feb. 2, the Seoul-based Residents’ Coalition for Financial Justice stated in a press release that stress-free measures towards medical malpractice will lead medical doctors to loosen up their “obligation of care tasks, inflicting anxiousness and mistrust among the many public.” Jung Ho-chul, a global employees 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 handle the scarcity, he says, the federal government ought to give attention to 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 during which medical doctors may be afraid to take up crucial 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 by means of civil courts with extra acceptable penalties. In most nations, he says, “felony medical malpractice actually has much less instances.”

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