Is there such a shortage of doctors in Korea?
Not all departments are short of doctors
According to the data of the Organization for Economic Cooperation and Development in 20 17 years, there are 2.3 doctors per 1000 people in South Korea, far below the average of 3.4 in OECD countries. Park Linghou, Minister of Health and Welfare of South Korea, previously revealed that Seoul has three doctors for every 65,438+10,000 people, while another economic center, Gyeongsangbuk-do, has only 1.4 doctors.
To this end, the Korean government recently launched a plan to expand the enrollment of medical students, that is, in the next 10 year, the enrollment quota of 3,058 medical schools will be increased by about 400 students each year, and at the same time, low-income students such as epidemiology and medical students who volunteer to engage in public health work in rural areas will be rewarded to better cope with public health emergencies.
However, as soon as the plan was announced, the Korean medical circle instantly "exploded the pot" and went on a large-scale strike.
Song Jingying, a professor of surgery at St. Mary's Hospital who opposes the Korean government's plan, believes that the Korean government has not accurately grasped the shortage of doctors. "More precisely, what South Korea lacks is not all doctors, but general surgeons and cardiothoracic surgeons."
According to Korean media reports, after completing medical education and training, most medical students and clinical interns in Korea are willing to study surgical skills in depth, even if they are interested in surgery, instead of becoming general surgeons.
On the one hand, general surgery is not popular in the Korean medical circle itself.
A medical student at Seoul National University School of Medicine said that in their medical school, the most sought-after fields are dermatology, plastic surgery, radiology, rehabilitation medicine and orthopedics, while cardiothoracic surgery and general surgery are the least popular fields.
A survey of more than1.20,000 medical students conducted by the School of Medicine of Seoul National University found that internal medicine, psychiatry, pediatrics and plastic surgery were the first choices for medical students after graduation, and medical students who graduated from undergraduate courses were more inclined to choose non-clinical practice fields.
Park Ji-hyun, chairman of the Emergency Countermeasures Committee of the Korean Intern Association, said that it is often difficult for specialists, including general surgeons, to find suitable hospitals. Unrealistic medical expenses in hospitals make hospitals unable to make ends meet, which leads many interns to choose other departments outside medical insurance coverage, such as dermatology and plastic surgery.
On the other hand, the income of general surgeons is lower than that of plastic surgeons.
Under the reimbursement system of medical insurance in Korea, more patient operations mean greater economic losses for hospitals.
If surgical services are not covered by medical insurance, such as plastic surgery, hospitals and doctors have higher incomes.
For example, Song Jingying said that gastrectomy requires at least one surgeon, an anesthesiologist and a nurse. However, compared with the labor and operation expenses, the medical insurance reimbursement for gastrectomy is too low, equivalent to 100 of the operation expenses, while the hospital only gets 70 won, which is not included in the labor expenses. No hospital is willing to do such a low-profit "business".
Song Jingying said that this is the reason why hospitals cannot make profits through critically ill patients, and it is also an important reason why Korean medical students and interns are unwilling to become general surgeons. "Unless the reimbursement for surgical medical insurance is improved, specialists will rarely choose general surgery in the future."
Song Jingying believes that this "distorted system" in South Korea is gradually reducing the number of large hospitals that can provide services for critically ill patients.
Even the expansion of enrollment will hardly work.
Song Jingying said that he raised this issue long ago and stressed that if he got proper reimbursement, the operation department would attract more doctors, but nothing changed. "The government did not even discuss the issue of reimbursement, but only focused on increasing the number of doctors."
Now, the Korean authorities are also dealing with the problems faced by the public health department in the same way, but in Song Jingying's view, more doctors can't bring a better public health system, what is needed is a perfect infrastructure.
Like public health, increasing the number of general surgeons also requires strengthening the infrastructure construction of hospitals. Song Jingying believes that general surgeons often don't choose hospitals that lack infrastructure such as operating rooms and surgical equipment. "They prefer hospitals where patients are willing to undergo surgery."
"Small hospitals or provincial medical institutions are mostly under-equipped. Therefore, surgeons in these hospitals only perform simple operations and even go to outpatient clinics. In rural areas, seriously ill patients who need surgery are more willing to go to big hospitals in Seoul. Even if the government arranges more doctors in public hospitals, patients will' avoid' public medical institutions if there is not enough infrastructure. " Song Jingying said.
In addition, the Korean government's plan to expand the enrollment quota of medical schools and establish public medical schools may not work.
Song Jingying said that although South Korea urgently needs general surgeons, it will take more than 15 years to fill the vacancy by increasing the enrollment of medical schools and establishing public medical schools. Take becoming a surgeon as an example. "After graduating from a 6-year medical school, you must spend five years on internship and residency training, and then two years on specialist training, while male doctors need to serve in the military for three years."
He believes that the Korean government's plan cannot attract more medical students to choose surgery. "No matter how many doctors are added, the number of general surgeons in Korea will not increase unless the reimbursement system that more operations mean more economic losses is changed."
Song Jingying revealed that students and interns in Korean medical colleges have no confidence in the prospects of general surgeons because the reimbursement for general surgeons is very low.
References:
1. Korean medical review: "Why don't medical students want to be surgeons?"
2. Reuters: Korean medical students oppose the government's medical reform plan.
3.NCBI: Factors related to Korean medical students' major choice: an inter-departmental survey