[News Terms] The Nonexistent(?) 'PA Nurse' in Korea

[Asia Economy Reporter Kim Jong-hwa] Although 'PA nurses' do not officially exist in Korea, they are indispensable nurses in some university hospitals and other institutions.

In the United States, 'PA (Physician Assistant)' refers to 'physician assistant nurses' who assist doctors, and it is a promising occupation. It was established in 1961 in the U.S. to create a 'group that can assist doctors' when there was a shortage of primary care physicians.

To become a PA nurse in the U.S., one must obtain a license and complete related education. According to statistics from the U.S. Department of Health and Human Services (HHS), the number of PA nurses in the U.S. increased from 43,500 in 2003 to 95,583 in 2013, and it is expected to exceed 127,800 by 2025.

Participants are shouting slogans at the nationwide nurses' rally urging the enactment of the Nursing Act held near the National Assembly in Yeouido, Seoul last year. Photo by Moon Honam munonam@

However, PA nurses cannot be employed in Korea. This is because PA does not exist in the classification of 'medical personnel' under current law. Article 2 of the Medical Service Act limits 'medical personnel' to doctors, dentists, oriental medicine doctors, midwives, and nurses licensed by the Minister of Health and Welfare. Therefore, PA, who are not medical personnel, performing doctors' duties is 'illegal.' Nevertheless, many PAs are already playing roles such as assisting in operating rooms, assisting in examinations and procedures, specimen requests, and emergency support.

As of 2021, there are 457,849 nurses in Korea, and it is estimated that about 10,000 of them work as PA nurses. In some tertiary hospitals, more than 100 PAs may work in one place. According to the 'PA operation status at national university hospitals over the past five years (2015-2019)' submitted by Kwon Chil-seung, a member of the National Assembly Health and Welfare Committee from the Democratic Party of Korea, the number of 'PA nurses' at national university hospitals increased by 64% over five years, from 592 in 2015 to 972 in 2019.

Recently, the controversy over PA nurses, a long-standing issue in the medical community, has surged to the surface as the director of Samsung Seoul Hospital was booked by the police on charges of hiring PA nurses (suspected violation of the Medical Service Act). Despite the habitual use of PA nurses in medical settings due to a shortage of doctors, which may violate the Medical Service Act, the medical community opposes the enactment of the Nursing Act that expands the scope of nurses' duties, arguing that it may infringe on doctors' domains.

The Korean Nurses Association appeals, "PA nurses themselves are illegal in Korea, so illegality must be strictly eradicated," adding, "Hospitals assign tasks, so even if they do not want PAs, they have no choice but to accept them."

Especially in less preferred departments such as surgery and thoracic surgery, where residents are always in short supply, dependence on PA nurses is higher. The health of the public is threatened by the power struggle among various interest groups, including tertiary hospitals that urgently need PA nurses and organizations such as the Korean Medical Association and the Korean Nurses Association that refuse to acknowledge the existence of PA nurses.