Debate between gov't, top medical school leaves chasm unbridged

The government and the nation's top medical school on Thursday could not resolve their differences during a debate on the physician shortage and the direction of medical reform.

Jang Sang-Yoon, left, senior presidential secretary for social policy, shakes hands with Ha Eun-jin, a neurology professor at Seoul National University Hospital, after ending a public debate in central Seoul on Thursday. The person in the center is Kang Hee-gyung, a pediatric professor and head of the emergency response committee representing faculty at Seoul National University's College of Medicine. [YONHAP]

The government and the nation's top medical school on Thursday could not resolve their differences during a debate on the physician shortage and the direction of medical reform.

Senior officers from the presidential office and the Ministry of Health and two medical professors from Seoul National University's (SNU) College of Medicine participated in the public debate, which was held on campus in Jongno District, central Seoul. The debate aimed to establish sustainable and patient-oriented medical infrastructure. Jang Sang-yoon, senior presidential secretary for social policy, stressed that the government's speculation of a physician shortage is “precise” as the government is responsible for managing doctors’ licenses and national health insurance services, with all Korean nationals insured.

The government has cited the need for an additional 10,000 doctors by 2035 to justify its drive to increase student seats in medical schools.

“In a rapidly aging society where many baby boomer doctors are expected to retire soon, the presidential office sees the upcoming 10 years as a golden time to establish sustainable medical infrastructure,” Jang said.

However, Prof. Kang Hee-gyung responded that the country already has “enough available senior doctors.” Kang added that returning senior doctors — with board-certified licenses but no longer serving in their specialties — would solve the physician shortage.

Regarding the validity of the government’s drive to expand enrollment size in medical schools, Kang attributed junior doctors’ collective walkout to distrust prompted by the government’s attitude.

According to Kang, junior doctors believe the government broke its promise not to notify policy changes unilaterally and violated the provision that the government signed four years ago.

The two sides showed different priorities in undertaking medical reform.

While the government said the reform should center on transforming tertiary hospitals into “critically ill patient-oriented” hospitals by preventing patients with mild symptoms from visiting them, Ha Eun-jin, a neurology professor from SNU, said the reform should start from primary and local clinics.

Ha said the current medical system's blind spot is low-priced medical fees for essential care at primary medical institutions, which make community doctors opt to perform non-essential and lucrative treatments.

“Rather than blocking patients from seeking treatment at tertiary hospitals, correcting the compensation scheme should come first so that community doctors can dedicate a considerable amount of time to giving essential health care to their patients," Ha said.

She also highlighted that the national health service’s reserve should remain stable.

“When the fund is deprived, patients should shoulder all costs. If so, those without private health insurance or poor patients cannot receive hospital treatment, even when doctors want to treat them.”

Later in the debate, Ha acknowledged the government’s “courageous” attempt to solve overlooked flaws and issues of sustainability in the nation’s medical system. However, she said its attitude and means were "problematic” and that dialogue between the government and the medical community would resume once trust is rebuilt.

BY LEE SOO-JUNG [lee.soojung1@joongang.co.kr]