It's been six weeks since thousands of medical interns and interns retired from South Korean hospitals, and dissatisfaction is mounting.
Patients have filed more than 2,000 complaints about surgeries and other treatments being postponed, canceled or denied, according to the country's health ministry. Hospitals closed wards and laid off staff. Nurses took on duties normally performed by doctors, and military doctors were dispatched to health centers.
Much of the anger over the disruption has been directed at President Yoon Seok-yeol, who has not backed away from his proposal to significantly expand medical school admissions to address the doctor shortage. Young doctors who rose against the plan in February say it will not solve problems in the health care system.
However, despite the high status of doctors in South Korea's class society, there are many people who resent them. Critics accuse it of trying to protect elite status and income by keeping the number of doctors low.
“Doctors are one of the richest and most powerful groups in South Korea,” said Lee Chun-hee, 26, an office worker living in Seoul. “They need to be humble.”
South Korea has fewer doctors per 1,000 people than most developed countries, at 2.6 doctors per 1,000 people, compared to an average of 3.7 for countries in the Organization for Economic Co-operation and Development. According to a survey, most Koreans would like to enroll more medical students to address this issue. In one recent poll, 43% of respondents said doctors who quit their jobs (currently 12,000) should face legal action.
For some doctors, the messages from patients are surprising.
“When they get sick and come to us for treatment, they seek us out with gratitude. But when it comes to public policy and big social issues, the public believes doctors are compromising.” “It seems like they're hoping for that,” said Dr. Kim Dae-jun, a professor of endocrinology and metabolism at Ajou University Hospital in Suwon.
“There are two sides to the public's feelings toward doctors,'' Dr. Kim said. “While they are admired and respected, they are also objects of envy and anger.”
Doctors have prestige everywhere, but that's especially true in South Korea. Ki Bon-go, a sociology professor at Kookmin University in Seoul, believes the cause is a strong belief in educational hierarchy. Many talented students choose medicine over finance or other corporate careers, partly because of its higher social status, but also because it is thought to provide financial security in the long run. There is also.
“When people hear the word 'doctor', they think you were the first in your class since high school,” Professor Cai said. “And they are highly respected because they undergo rigorous training to become doctors.”
Dr. Kim, who earned his license in 1993, remembers a time when top performers were more likely to enter fields such as engineering, where high-paying jobs at major companies were guaranteed. But after the Asian financial crisis of the late 1990s, when thousands of businesses were forced out of business, he began to think health care might be a better option.
“Becoming a doctor was considered a more stable path,” Dr. Kim said.
Medical care in South Korea is relatively cheap, subsidized by the government, and easily accessible, allowing patients to “shop for medical supplies,” said Dr. Seo Young-joo, an internal medicine specialist at St. Vincent Hospital near Seoul. 33) says. put it. Doctors say this creates something like a star system, where patients seek out highly rated doctors from top schools.
“A lot of people come to big hospitals looking for these big-name doctors,” Dr. Seo said.
Retired young “trainees” say their situations are very different. They work grueling shifts that pay less than minimum wage considering the long hours. But some Koreans are skeptical, saying that a five-year stint as an intern or intern will lead to a lucrative and comfortable career. residents.
Chosun Ilbo said in an editorial, “There is no other explanation for why doctors oppose increasing the number of doctors other than to make more money at the expense of patients.''
This is not the first time doctors have pushed back against attempts to expand medical school enrollment. A strike broke out in the summer of 2020 after then-President Moon Jae-in proposed a more modest increase. Faced with a strained medical system in the midst of the coronavirus pandemic, the government retreated.
However, Professor Kye said that once such episodes shake public trust in doctors in South Korea, it tends to recover quickly.
“While there may be current hostility toward physicians, our culture of seeking treatment from respected physicians and long-standing perceptions of physicians are unlikely to change,” he says. A 2021 survey, a year after the last strike, found that around 60% of the public thought the health system had handled the pandemic well.
Yoon Jeong-min (54), who underwent foot surgery in October, was scheduled to undergo a re-examination last month. He said the surgery was postponed to mid-April because of the strike, but the Seoul hospital where he was treated could not guarantee it would not be postponed again.
But he blames the government more than doctors for the conflict. “I am being harmed by the administration's political show,” he said. He said the number of medical school admissions should increase, albeit gradually.
President Yoon's plan calls for increasing the number of students admitted to medical schools from about 3,000 to about 5,000 a year starting next year. It also plans to spend 10 trillion won ($7.5 billion) over the next five years to improve health services, especially in rural areas that the government says are underserved.
Doctors, along with other government critics, say the plan was hastily put together to win votes in this month's parliamentary elections. Doctors say the shortage will do little to alleviate the shortage because it is concentrated in certain specialties, such as emergency medicine.
Civil society groups are calling on doctors and the government to end the conflict. “Will we end this abnormal situation only if patients die because they cannot receive treatment as scheduled?” the Korean Patients Federation said in a statement last week.
In a televised speech this week, Yun defended his plan, saying the “minimum” needed was to increase the number of medical students by 2,000 a year. But he also called on the doctors to submit a counterproposal and requested a meeting. Major doctors' bodies welcomed the offer but said any consultations must be “meaningful”.
Dr. Kim, a professor at Asia University Hospital, said that whatever the outcome of the conflict, the country's attitude towards his profession is unlikely to change. “People may be angry at doctors right now, but they will still want their children to become doctors,” he says.