[The Editors' Verdict] "Appropriate" Telemedicine vs. "Indiscriminate" Telemedicine

The weight loss drug Wegovy, dubbed the "dream obesity drug," has exposed the side effects of telemedicine (non-face-to-face medical care). As soon as it was released, indiscriminate prescriptions poured in through telemedicine platforms. The telemedicine issues triggered by this drug even became a topic at the National Assembly audit. In response to the audit, Cho Kyu-hong, Minister of Health and Welfare, stated, "We will consider excluding obesity drugs from telemedicine," but the loopholes in telemedicine cannot be patched up temporarily by simply adding or removing a single medication.

Telemedicine has been gradually recognized since the 1990s. The United States included telemedicine in Medicare for the elderly in 1997. Japan also recognized telemedicine in the same year and fully permitted it in 2015. Australia, which began promoting telemedicine in 1996, officially implemented it in 2001, just five years later. Only South Korea remains stuck in pilot projects for 36 years since 1988 due to strong opposition from the medical community. There is no longer any justification to reject telemedicine.

The government is currently pushing for the legalization of telemedicine, and it is hoped that the system will be refined in the process. The weaknesses (safety issues) identified through pilot projects should be resolved, and the strengths (convenience) should be enhanced as the law is enacted.

There are two safety issues. One is insufficient diagnosis due to non-face-to-face consultations (a problem pointed out by doctors), and the other is overprescription causing misuse, like with Wegovy (a problem caused by doctors). The former can be supplemented by granting doctors the right to switch to face-to-face consultations. Doctors should have the authority to convert telemedicine cases to in-person visits based on their judgment, and medical accidents resulting from patients not following this should be exempt from liability. The latter should be addressed by strengthening supervision by health authorities. Utilizing the reporting system for non-reimbursed prescriptions could help crack down on medical institutions that overprescribe via telemedicine.

Increasing convenience is the responsibility of healthcare service providers, but one key policy should be pursued by the government: allowing non-face-to-face sales of pharmaceuticals (delivery by courier). The pharmaceutical sector is united in opposing courier delivery. Their stated reason is the risk of misdelivery and deterioration of medicines, but the real concern is the decrease in fees for medication guidance and pharmacy management received from health insurance based on pharmacy visits, as well as the decline in sales of health supplements and other recommended products to visitors.

The Japanese precedent is instructive. In 2020, the Japanese government amended the Pharmacists Act to allow courier delivery of pharmaceuticals. Although Japanese pharmacists opposed this, the government found a compromise by introducing online medication guidance fees.

Concerns from the medical community that telemedicine will deal a direct blow to local clinics seem exaggerated. South Korea has 1.24 doctors per square kilometer (3rd among OECD countries). On average, you can meet a doctor by walking just 1 km in any direction from anywhere in the country. Clinics are densely packed right outside your door.

Generally, telemedicine is used only by those who have no other choice. According to a paper by the Korea Institute for Health and Social Affairs, telemedicine usage in Japan was almost nonexistent before COVID-19. In the U.S., telemedicine accounted for only 0.2% of health insurance claims before COVID-19. Both countries have seen slight increases since then.

Therefore, the pharmaceutical sector in South Korea should provide more convenient telemedicine services, and the government should manage safety. Then telemedicine will appropriately establish itself as a complementary measure to address the gaps in our healthcare supply system, which, despite having the world's best medical accessibility, still experiences inefficiencies.