[Reporter’s Notebook] Will Increasing the Number of Doctors Revive Essential Medical Care?

At the 'Medical Issues Council' meeting held on the 26th of last month, Cho Kyu-hong, Minister of Health and Welfare (fourth from the left), Lee Pil-su, President of the Korean Medical Association (fifth from the left), and others are taking a commemorative photo. The Medical Issues Council discusses medical sector issues such as support measures for essential medical services.
[Photo by Ministry of Health and Welfare]

[Asia Economy Reporter Lee Gwan-ju] The 2018 study by the Industry-Academic Cooperation Foundation of the University of Seoul titled ‘Research on the Establishment Plan for the National Public Medical University (Graduate School)’ is regarded as the most in-depth research on the establishment of a public medical school. The report, spanning a total of 226 pages, covers the entire process of how to establish and operate a public medical school?from student selection, faculty recruitment, curriculum, facilities, to post-graduation management.

However, even this report explicitly states that 'training institutions and specialty choices guarantee the individual autonomy of doctors.' This is because unilaterally assigning specialties could infringe on the constitutional freedom to choose one’s profession. Even in a public medical school, a doctor cannot be forced to specialize in pediatrics or emergency medicine.

Voices that regard the establishment of public medical schools and the increase of medical school quotas as a 'panacea' for the crisis of essential medical care collapse are emerging. The simple logic is that since there is a shortage of doctors, the number must be increased. However, even if medical school quotas are increased immediately, it will only be reflected in reality at least 10 years later. Since it is difficult to force specialties even in public medical schools, there is no guarantee that increasing medical school quotas will expand the currently lacking fields such as pediatrics and obstetrics and gynecology. Rather, it might only produce more doctors in popular specialties like plastic surgery, ophthalmology, and dermatology.

Let’s look at the nursing workforce policy where quotas were previously increased. The nursing department quota, which was around 10,000 in the mid-2000s, increased to the 20,000 range in the mid-2010s and has maintained around 20,000 since then. However, problems such as regional workforce imbalance and ward staffing shortages remain unchanged. Although there are 250,000 licensed nurses, it is estimated that 120,000 are 'dormant license' nurses who are not actually working. This is the result of increasing quotas without addressing the root causes of workforce shortages.

The failure of nursing workforce policy is strong evidence that simply increasing manpower cannot be a solution. The 'golden time' to resolve the essential medical care crisis is running out. Choosing only easy methods out of impatience can only be a temporary fix. The underlying problems must be confronted and resolved. It is now more important to first understand why doctors avoid essential medical care and prepare alternatives.

Kwanju Lee, Biohealth Department Reporter