I had an acquaintance who was a doctor at one of the so-called “big five” hospitals, and he worked in a department that was quite favored by medical students.
He told me one day that there were children who were born with congenital degeneration of certain body parts, and that he had honed his surgical skills to regenerate them, but he was never given the opportunity to operate on them. He was frustrated that all of these patients were going to the top doctors in his field and not to him, but whenever he saw them and their parents, he would try his best to make “eye contact” and get the opportunity to operate on them.
I was really impressed with him – he seemed like a “real doctor” who worked at a big hospital, in a popular department, and had a deep thirst for medicine.
When I saw him again a few months later, I asked him if he’d gotten the opportunity to do surgery. His answer was surprising: He told me that he and a colleague had opened a neighborhood practice. I was shocked, but also saddened by how eager he was to use his surgical skills. I didn’t ask him about the specifics, but I’m sure he had a lot on his mind. I also thought that there must be a strong force in the medical world that led him to this path.
Today’s story is about the world of doctors. We’re joined by reporter Hyangmi Kim, who covers the Ministry of Health and Welfare and the medical community.
The World of Doctors: Warning Signs
- Lately, I’ve been seeing signs that something is going wrong in the medical system.
- Hit-and-runs in the ER: Stories of people meeting tragic outcomes at the hospital, or even on the road, after struggling to find the right place to go have become unforgettable.
*A nurse at Asan Medical Center in Seoul who collapsed on duty in August 2022, a middle school student who fell from a building in Daegu in March 2023, and a 70-year-old who was hit by a car in Yongin, Gyeonggi Province in May 2023.
- Pediatric open run: Parents line up outside the pediatric department before dawn. The term “open run” was coined after the practice of waiting in front of a department store to catch a rare new product.
*In some places, pediatricians have been forced to close weekend clinics because they don’t have enough doctors, and facilities have been built but never opened.
- Ransom for doctors: Local hospitals can’t get doctors to come no matter how much they pay them.
*Sancheong-gun in Gyeongnam Province was looking for an internal medicine specialist with an annual salary of 360 million won, and was able to hire a doctor in his 60s within six months.
- When I see news like this, it’s clear that there’s something wrong with the healthcare system – doctors aren’t where they should be.
Emergency room hit-and-runs, pediatric open runs, and skyrocketing physician salaries in rural areas make me feel like doctors aren’t where they should be.
Graphic design: Kyuyeon Kim, Designer
For today’s topic, I drew a picture that I’d like to share with you… A room with people pouring out of it, cryptic words like ‘internal oxygen’, ‘Jae Young Jung’, and ‘Pian Sung’, and intricate circuits twisting between rooms and rooms… In the distance, the word “DOCTOR” is revealed. I wanted to express that the problems in the medical world that we will look at today cannot be solved with a simple or piecemeal solution. Maybe the complexity of the problem makes it difficult to be interested in it, but I think it is a problem that cannot be ignored because people’s lives are at stake. Let’s take a look at it slowly one by one.
- What’s happening in the world of doctors
If we look at what’s happening in the medical world right now스포츠토토, we can predict that this problem is only going to get worse.
First of all, there is a big difference in the popularity of each specialty. When medical students choose a specialty, they are gravitating towards Pian Sung (dermatology, ophthalmology, plastic surgery) and Jae Young Jung (psychiatry, radiology, rehabilitation), while neglecting internal medicine, surgery, obstetrics, gynecology, and pediatrics.
The current phenomenon of (in)external medicine is well illustrated by the choice of doctors. If you look at the recruitment rate of specialties from 2018 to 2022, pediatrics plummeted from 101% to 94% to 74% to 38% to 28%, and the recruitment rate of cardiothoracic surgery, which is often seen in dramas, is only 48% to 64% for 5 years.
This is true even if we look at our own neighborhood physicians. In the 10 years from 2013 to 2023, the number of internal medicine, psychiatry, orthopedics, anesthesiology, pain medicine, and otolaryngology doctors increased by 517 and 1279, respectively, while the number of pediatricians and gynecologists decreased by 53 and 78, respectively, while the total number of local doctors increased by 1.2. The number of doctors could decrease even more in the future as the recruitment rate of specialties is currently falling.
There is also a large regional disparity. In the provinces, especially in rural areas, the problem is more severe than in hospitals in urban centers. The continued decline in public health doctors* is largely due to the increasing proportion of women among medical students, shorter military service, and more doctors graduating from medical schools who have already completed their military service.
*Public health physician: a doctor who works in rural health centers or public hospitals instead of serving in the military.
If you look at the number of doctors per 100,000 people, Seoul has 305, but Gyeongsangbuk-do has 126, Chungcheongnam-do 137, Jeonnam-do 143, Ulsan 148, and Gyeongnam-do 156. These regions are more than twice as difficult to find a doctor as Seoul, simply based on numbers, not geography.
The tendency for doctors to go into private practice, where they can make more money than salaried doctors (who are paid by general hospitals), is further exacerbating the imbalance in the medical field. It is not uncommon for medical students to go into private practice, such as dermatology, where they can earn a high income without specialty qualifications.
- Solutions outside the world of doctors
This is why some people are looking outside the medical world for solutions. Civil society organizations Citizens for Economic Justice and the Healthcare Workers Union offer two alternatives. The first is the introduction of public medical schools by region, and the second is the introduction of special-purpose medical schools, where doctors are trained to work only in certain regions and only in certain medical specialties.
There are role models for these alternatives. Japan, a country that started experiencing declining birthrates and ruralization 20-30 years ahead of us. Japan has a regional quota system for medical schools and an autonomous university system.