Disruptions in medical services continue during Chuseok

Health Ministry rolls out guidelines exempting emergency medical workers from responsibility for refusal of treatment

People wait in line in front of an emergency center in Seoul on Tuesday, the day of the Chuseok holiday. (Yonhap)

Disruptions in health care services continued nationwide during the five-day Chuseok holiday, as the medical standoff over the government’s medical school quota hike plan showed no signs of abating.

While there is no official data to assess the scope and size of the disturbances, independent reports emerged of patients being denied admission to multiple emergency care units during the Saturday-Wednesday holiday.

On Saturday, when the nation entered the crest of holiday cheer, a woman whose water broke at 25 weeks of pregnancy in Cheongju, North Chungcheong Province, had to wait in the ambulance for six hours, after being rejected admittance at 75 hospitals, according to the Chungbuk Fire Service Headquarters.

During her wait, which reportedly lasted from 11:25 a.m. until 5:32 p.m. – she was rejected at hospitals nearby and medical institutions in Seoul, Incheon and Gyeonggi Province which cited a lack of neonatal care and the absence of an obstetrician. The woman was later transferred to a nearby women's hospital and is in stable condition while receiving treatment, according to the Health Ministry.

The following day, a 50-something man in Gwangju, South Jeolla Province, suffered a finger amputation but was unable to receive treatment at four medical institutions in the city, according to fire authorities.

The 119 emergency medical service transferred the patient to an orthopedic hospital in Jeonju, North Jeolla Province, some 100 kilometers away, where he could undergo emergency surgery.

In another case Tuesday, which was Chuseok day, a 20-something woman who was at 32 weeks of pregnancy in Gangneung, Gangwon Province, had to be transferred to Wonju, another city in Gangwon, to receive an MRI after experiencing abdominal pains. The transfer occurred after unsuccessful attempts to find a hospital that could examine her in Gangneung or nearby areas, according to reports.

A total of 9,781 medical institutions operated daily during the holiday period, while the emergency medical system prioritized treating patients with severe or life-threatening conditions, according to the Health Ministry on Wednesday. Of the 411 ERs nationwide, 408 emergency departments provided care 24 hours a day during Chuseok.

Despite concerns over hospital emergency rooms and medical services during Chuseok, Prime Minister Han Duck-soo said the country's health care "did not collapse."

"Although the holiday period is ongoing, the emergency medical system is managing to function despite challenging conditions. The number of patients who visited ERs this Chuseok was about 10,000 to 13,000 fewer than last year or this year's Lunar New Year holiday. The number of critical patients was also lower compared to previous years," Han wrote on his official social media.

The Health Ministry said Monday afternoon that it has recently issued new guidelines on legitimate reasons for the refusal of treatment under the Emergency Medical Service Act to 17 provinces and cities in the country, the Korean Medical Association, the Korean Nursing Association and the Korean Hospital Association. The new guidelines hope to streamline emergency departments and make them available for the critically ill or those in urgent need of treatment.

Article 6 of the law stipulates that emergency medical personnel working with an emergency medical institution shall "faithfully perform their duties by providing emergency medical services, so that they can be prepared to treat emergency patients anytime."

However, under the guidelines, the ministry said refusing treatment if violence occurs or is likely to happen in the ER and if a patient or their guardian behaves in an unreasonable or abusive manner are legitimate reasons for medical workers to deny care. The permitted denial of treatment also includes situations where the emergency medical center lacks resources or facilities to provide the necessary care.

In addition, medical personnel will not be held accountable for not admitting patients classified as levels four and five -- or those with mild symptoms or non-urgent situations -- under the five-level Korean Triage and Acuity Scale in emergency rooms.

"The purpose of the guidelines is to protect medical staff from inappropriate assaults or demands for treatment and allow emergency patients to receive necessary treatment promptly," Jung Tong-ryoung, the public health policy director at the Health Ministry, said in a press release.

ER disruptions are part of South Korea’s deepening medical crisis amid a prolonged boycott of junior doctors who are protesting the government’s plan to increase the medical school admission quota.

Last week, the country's largest doctors' group refused to join a proposed four-party consultative body consisting of the government, ruling party, opposition party and medical community, aimed at resolving the monthslong dispute over medical school quotas.

By Park Jun-hee(junheee@heraldcorp.com)