Will the 'Macperan Ruling' Increase the Closure Rate on the 18th? "Adding Fuel to the Fire"

KMA "Macperan Prison Sentence Provokes Private Clinic Doctors' Resentment"
Government Expects 'Tempest in a Teapot' Due to Low Suspension Reporting Rate

The Korean Medical Association (KMA) will begin a full-scale strike on the morning of the 18th. Centered around private practitioners, major medical school professors including those from the 'Big 5' are joining this collective strike, and the government plans to respond with administrative sanctions. The key factor that will determine whether the medical community and the government, who have been confronting each other head-on, will ultimately clash or step aside is the strike rate. The government announced that if the strike rate exceeds 30% on that day, it will issue an order to resume work and take action against non-compliance.

According to the government's strike notification order, 1,463 medical institutions reported to their local health centers on the 13th that they would strike, which is only 4% of the total 36,371 primary medical institutions subject to notification. The government believes that due to the low notification rate, the KMA's full-scale strike is likely to end as a 'storm in a teacup.'

However, the medical community anticipates that the actual number of striking medical institutions may be much higher, as resentment against the government among private practitioners has been rising since the Changwon District Court's sentencing of a physician prescribing Macperan on the 30th of last month. The Changwon District Court sentenced the attending physician to 10 months in prison with a two-year probation for professional negligence causing injury after prescribing the antiemetic 'Macperan' to a Parkinson's disease patient, which worsened the patient's condition.

The Ministry of Health and Welfare stated, "Professional negligence causing injury or death does not constitute grounds for license revocation under Article 65, Paragraph 1, Subparagraph 1 of the Medical Service Act," but the medical community strongly opposed this. KMA President Lim Hyun-taek expressed outrage toward the judge who issued the ruling, saying, "Is this woman in her right mind?" The Korean Parkinson's Disease and Movement Disorders Society stated, "This is enough to demoralize medical staff. We are concerned it will lead to further avoidance of essential medical care."

In the context of escalating medical-government conflicts, this court decision may provoke private practitioners and increase strike participation rates. A KMA official said, "The resentment in private practice over the Macperan ruling is extremely high," adding, "Participation rates will be higher than during the 2020 public medical school opposition strike, and many private practitioners plan to close their clinics after morning hours to attend the nationwide doctors' rally held at 2 p.m. in Yeouido, Seoul." In a survey conducted by the KMA from the 4th to the 8th asking members about collective strike participation, 63.3% voted, and among them, 73.5% said they would participate in the KMA's collective action.

Hwang Gyu-seok, President of the Seoul Medical Association, said, "Anger has been growing due to the government's continuous pressure and orders, and the Macperan ruling poured fuel on the fire," adding, "Participation rates are expected to be much higher than the 2020 rally, which exceeded 30%." Kim Taek-woo, President of the National Association of Metropolitan and Provincial Medical Associations, also said, "Since the Macperan ruling, more private practitioners have decided to strike and attend the Yeouido rally," and added, "Each of these rulings restricts medical practice and blatantly shows how the government and judiciary handle the entire medical system of the Republic of Korea."

An anonymous president of another regional medical association said, "There has been a change in atmosphere due to the Macperan case. Many more private practitioners are expected to participate in the strike than the 4% notification rate." He added, "Many private practitioners cannot strike all day but plan to see urgent patients in the morning and strike in the afternoon." A private practitioner in Jung-gu, Seoul, said, "I plan to see patients only in the morning on the 18th to attend the KMA rally in Yeouido in the afternoon."

During the KMA's total strike against the public medical school initiative in 2020, 11,025 out of 33,836 clinic-level medical institutions nationwide participated, resulting in a strike rate of 32.6% on the first day (August 14). It remains to be seen whether the strike rate among private practitioners on the 18th will reach the government's threshold of 30% for issuing an order to resume work. Reflecting on the 2020 KMA total strike, the strike rate rapidly declined during the second collective strike period (August 26?28) to 10.8%, 8.9%, and 6.5%, respectively. The government is most concerned about 'disruptions to medical services,' and if the strike rate remains in the single digits, it is unlikely to issue additional administrative orders.

However, if the strike rate exceeds 30% on that day, the government plans to issue an order to resume work and impose administrative sanctions on institutions that do not comply. A Ministry of Health and Welfare official stated, "Non-compliance with the order to resume work may result in a 15-day suspension of operations and suspension of medical license qualifications for up to one year, as well as imprisonment for up to three years or a fine of up to 30 million won." In response, a medical community official protested, saying, "Is the government planning to collectively suspend private practitioners who receive patients amid the clinical gaps in university hospitals?"