[Reporter’s Notebook] Essential Medical Departments Stigmatized as 'Trickle-Down Departments'

"The government says they expect a trickle-down effect, but medical staff in essential medical departments ironically say, 'We have become the trickle-down departments.'

[Image source=Yonhap News]

This was said by a medical professional at a forum held on the 23rd on the topic of adjusting medical school quotas. He opposed the increase, stating that the correlation between the essential medical service gap and medical school quotas has not been proven. The government presented the trickle-down effect as one of the rationales for expanding medical school quotas. The idea is that by increasing the quota, the total number of doctors, the 'upper stream,' will increase, which will then lead to an increase in doctors in essential and regional medical services, the 'lower stream.' The medical community questions the government's trickle-down effect. In fact, there is no research that proves a correlation between medical school quotas and essential medical personnel.

How did essential and regional medical services come to bear the stigma of being 'trickle-down departments'? Chronic problems in essential medical departments include excessive workload intensity, reduced profitability due to low medical fees, and exposure to 'judicial risks' such as lawsuits related to medical practices. Because of this, residents who should be heading toward essential and regional medical services have turned away. Another medical professional said, "Medical staff in essential and regional medical services, who care for patients in harsh environments driven solely by the determination to save lives, have suddenly become 'trickle-down doctors' who must wait for the trickle-down effect." This means the roles have been reversed.

The issue of medical personnel, including the increase in medical school quotas, is not only a problem for doctors and the government but requires social consensus. The government as the policymaker, the medical community, and the public as medical service consumers must come up with reasonable measures that satisfy all parties. The current discussion on increasing medical school quotas lacks evidence that it will directly help essential and regional medical services, yet the government seems to be pushing forward based on public opinion supporting the increase. This is also why the medical community strongly opposes the current push for increasing medical school quotas.

If the government has pulled out the medical school quota increase card to solve the gap in essential and regional medical services, it must also present solutions to the low medical fees and treatment issues that the medical community raises. The medical community has argued that the gap in essential and regional medical services is caused by chronic low fees, resulting low profitability, and unstable treatment conditions. Measures to address the low fees and profitability issues in essential and regional medical services are just as important topics to be discussed at the negotiation table as the increase in medical school quotas. Even if backed by public opinion, if the government pushes for expanding medical school quotas using the term 'trickle-down,' it will be difficult to reach social consensus with the medical community. Rather, it will only provoke counterproductive effects, such as encouraging strikes by the medical community.