As burned-out senior doctors resign, emergency rooms feel the pinch

The recent resignation of senior doctors has crippled emergency rooms nationwide even further, aggravating the medical vacuum that has persisted since the country's junior doctors’ began their walkout in February.

Medical staff carry an urgent patient on a bed at an entrance to an emergency room at Ajou University Hospital in Suwon, Gyeonggi, on Wednesday. [YONHAP]

The recent resignation of senior doctors has crippled emergency rooms nationwide even further, aggravating the medical vacuum that has persisted since the country's junior doctors’ began their walkout in February.

At noon Tuesday, only one doctor was on duty at an emergency room in Kangwon National University Hospital in Gangwon. A status board showed that the doctor was caring for nine patients simultaneously.

The hospital had five emergency medicine specialists until last month. However, two resigned recently, leaving only three doctors in the emergency room.

“Providing round-the-clock medical services with five people was arduous,” one doctor at Kangwon National University Hospital told the JoongAng Ilbo on Tuesday. The doctor said covering night shifts with only three doctors was “impossible.”

Since Monday, the hospital has suspended emergency room operations for adult patients during evening and night hours — from 6 p.m. to 9 a.m.

A notice informs visitors and patients of a medical service suspension at the emergency room at Kangwon University Hospital in Gangwon. The suspension began on Monday. [JOONGANG ILBO]

Such an indefinite shutdown is unprecedented.

“Although the hospital opened job slots to recruit emergency medical specialists 16 times in the last two years because the emergency room has been shorthanded for years, no doctors applied for the position,” a hospital employee said.

On Tuesday, an emergency room at Ajou University Hospital, which functions as a regional emergency medical center in southern Gyeonggi, also informed incoming patients and visitors of a temporary service suspension.

Three emergency medical specialists quit last month, prompting the hospital to limit its services.

For 24 hours, beginning every 7 a.m. Thursday, the emergency room accepts only patients in a state of cardiac arrest who are 16 or older. Likewise, its children's emergency room has been admitting only the most critically ill pediatric patients on Wednesdays and Saturdays.

“The decision is to reduce the workload on doctors without shutting down the entire service,” an official from Ajou University Hospital said.

Ajou University Hospital used to have 14 emergency specialists, but three left, and four more have stated their intent to resign.

“Although it is not the worst scenario as the service downsizing only affects one day a week, it still worried us a lot,” a wife and a guardian of a cancer patient said. She said her husband occasionally visits the emergency room whenever his health worsens.

A patient walks by closed doors as Konkuk University Chungju Hospital in North Chungcheong on Sunday. The hospital closed its emergency room on weekends and at night due to short-staffing. [YONHAP]

The emergency room at Konkuk University Chungju Hospital in North Chungcheong has been treating patients only from 9 a.m. to 9 p.m. on weekdays since Monday. Overnight emergency medical services are unavailable.

Earlier, all seven emergency specialist doctors submitted their resignations. The hospital narrowly avoided a complete shutdown after it dissuaded two doctors from resigning.

The change in hours of service also reduced the number of emergency patients. On Aug. 26, 80 patients were admitted. In contrast, it had admitted only 24 patients between Monday and 5 p.m. Tuesday.

A 45-year-old surnamed Kim, who was in the emergency room at Konkuk University Chungju Hospital, said discontinuing nighttime services there was “nonsense” because many serious accidents happen at night.

Several ambulances are parked in front of am emergency room at Ewha Womans University Mokdong Hospital in western Seoul on Wednesday. [YONHAP]

Although Health Minister Cho Kyoo-hong said Tuesday that the current situation did not constitute a “crisis with emergency patient care on the verge of collapse,” reporters from the JoongAng Ilbo said it is analogous to a “calm before the storm.”

The Ministry of Health and Welfare said doctors at 180 regional and local medical centers nationwide decreased to 73.4 percent compared to last December. As of Aug. 26, some 1,587 doctors have remained at their posts in emergency rooms.

The JoongAng Ilbo reported that the number of active doctors in emergency rooms dropped sharply after 525 junior doctors who were in training at emergency rooms resigned.

Since then, the remaining doctors and emergency medical specialists have taken extra shifts. Fatigued doctors who have reached their limit are now considering resigning.

A medical professor at a Seoul-based regional emergency medical center explained that exhausted doctors are “knackered after their dedicated service during the protracted medical void.” The professor said the exhausted doctors stayed at hospitals because of “their sense of duty” when their colleagues and juniors left.

An increasing number of urgent patients in ambulances are roving from one emergency room to another, seeking one that will admit them.

This year, 3,597 patients who arrived at an emergency room had been sent to other emergency rooms as of Aug. 20, according to a data set provided by the National Fire Agency to the Rebuilding Korea Party’s lawmaker Kim Sun-min. Among them, 1,433 patients were rejected because of an absence of emergency medicine specialists.

Rep. Kim pointed out that so-called “emergency room-hopping would increase around 20 to 30 percent this year” because of the ongoing situation.

Another emergency medicine professor at Pusan National University Hospital said the hospital has been “rejecting more patients who would have been admitted if it were not the medical vacuum.”

Another emergency medicine professor working in a tertiary hospital in the greater Seoul area expressed "concern over the medical staff’s possible burnout" after the Chuseok holiday, which comes later this month, noting that the period is a peak season when patients flock to emergency rooms.

BY SPECIAL REPORTING TEAM [lee.soojung1@joongang.co.kr]