[Inside Chodong] Essential Medical Services in Crisis, Remote Consultations Still a Long Way to Go

Shortage of Pediatric and Emergency Medical Staff
Medical Policy Stalled by Profit Disputes
Urgent Need for Decisions to Protect Public Health

[Image source=Yonhap News]

Seoul Sohwa Children's Hospital, which had been operating during weekday nights and holidays, stopped Saturday afternoon, Sunday, and public holiday consultations starting last weekend. This was due to a shortage of staff after one doctor recently resigned. Families raising young children in nearby Yongsan, Mapo, and Seodaemun districts were flooded with concerns about "which hospital to go to if a child suddenly falls ill." On internet mom cafes, parents exchanged various experiences about which general hospital emergency rooms accept young children when local pediatric clinics are closed and whether they need to travel as far as Gangnam if no other options are available. The conclusion from dozens of comments was a lament and sigh: "There is no hospital that accepts sick children, so how can they encourage childbirth?" and "If this is the reality of a children's hospital in the heart of Seoul, how much worse must it be in the provinces?"

With Sohwa Children's Hospital ceasing holiday consultations, the number of "Moonlight Children's Hospitals" in Seoul where pediatric patients with mild symptoms can receive outpatient care instead of emergency room visits during late weekday hours or holidays has decreased from four to three. Nationwide, including Seoul, there are now only 37 Moonlight Children's Hospitals. Earlier in February, the government announced the "Pediatric Medical System Improvement Plan," promising to increase the number of Moonlight Children's Hospitals to 100 nationwide and to support improvements in their numbers and operating costs for night and holiday consultations. However, the reality is moving in the opposite direction.

Although temporarily allowed during the COVID-19 period, telemedicine has continued as a pilot project, but for parents raising children, it is almost useless. For pediatric patients under 18, initial consultations during night and holiday hours are permitted, but actual prescription of medication is prohibited. Since children are sick enough to need medicine, parents seek hospitals, and if none are open, they try to get telemedicine consultations. But if only consultations are possible without prescriptions, what use is it? Moreover, telemedicine costs 30% more than regular in-person visits. The medical community argues that accurate diagnosis and prescription are difficult through video calls alone and claims, "The harm from misdiagnosis will outweigh the benefits patients gain from telemedicine." However, during the COVID-19 'severe' phase when telemedicine was allowed, among 37.86 million telemedicine cases, no misdiagnosis incidents were reported.

Although we have entered the endemic era (periodic outbreaks of infectious diseases), our medical field is overwhelmed by multiple severe problems erupting simultaneously, leaving us unsure where to start. These include the shortage of essential medical personnel leading to the issue of increasing medical school admissions, the collapse of regional and emergency medical systems, the pediatric crisis, controversies over the enactment of the Nursing Act and legalization of physician assistants (PA), and the institutionalization of telemedicine. Meanwhile, a 5-year-old child suffering from high fever was sent home due to lack of hospital beds and later died, and a teenager severely injured in a fall died in an ambulance after being transferred between hospitals.

To solve these problems, our society cannot simply demand unconditional sacrifice from medical staff or decide on bold fee increases regardless of health insurance finances. However, in South Korea, which prides itself as a medical powerhouse, the fact that a significant portion of the public views doctors as a vested interest group and that medical consumers cannot receive timely care is due to misguided medical policies and insufficient government roles. Although it is difficult to resolve all confusion and conflicts at once, it is now time to find swift and definite solutions and make decisions. The health and lives of the public are already beginning to be threatened, and no further sacrifices should be made.