[Slate] Why Baek Gang-hyeok's Persuasion on the 'Severe Trauma Center' Falls on Deaf Ears

A Happy Ending Only Possible in a Drama with Fantasy Elements
A Developed-Country-Style System Is Out of the Question in Korea
A Harsh Government Perspective... Hospitals Forced to Be Cautious
Calling, Mission, and Voluntary Sacrifice?Nothing More

The Netflix series 'Severe Trauma Center' exposes the reality of trauma medical care in Korea. The protagonist is Baek Gang-hyeok (Ju Ji-hoon), a surgical specialist who is almost fictional. He boldly establishes a severe trauma center in a Korean university hospital rife with absurdity and irrationality. He struggles to hold the frontline that separates life and death. Despite overwork and lack of sleep, he never puts down his scalpel. He prioritizes the essence of his profession.

The 'Severe Trauma Center' clearly reveals the issues within the trauma medical system of university hospitals.
[Photo by Netflix]

Despite relentless efforts, the flawed system does not improve. Even when the government provides 10 billion won in support under the pretext of operating the severe trauma center, progress remains stagnant. Funds are used for unrelated facilities, resulting in a severe shortage of personnel and equipment. The hospital is indifferent to the increased patient survival rates. Rather, it worries that deficits might widen.

Baek Gang-hyeok overcomes humiliation and disadvantages to nurture a seed of hope. He proves the necessity of the severe trauma center himself and eventually introduces the 'Doctor Helicopter.' This conclusion is possible because the drama incorporates fantasy elements. In Korea, a developed country-style severe trauma medical system is out of the question. Too many people die without receiving timely treatment. It is a relief if they at least die during surgery. Death records do not serve as a measure to improve reality but are merely recorded as the hollow figure of 'preventable mortality.'

Lee Guk-jong, director of the Armed Forces Daejeon Hospital and the inspiration for Baek Gang-hyeok, criticized in his book 'Golden Hour' that "most trauma surgery patients are poor laborers, and policy spotlights do not shine on the underprivileged." "Although some budget and policies were created through the efforts of many who empathize with the importance of trauma surgery, most, like numerous past national projects, vanished in vain. (Omitted) What my team and I confirmed through relentless struggle is that the severe trauma center project is impossible under the current level of transparency in Korean society."

The Severe Trauma Center stands at the heart of public healthcare.
[Photo by Netflix]

The biggest obstacle is money. Structurally, the more patients a severe trauma center treats, the greater the deficit becomes. It is even more unwelcome in private university hospitals, which operate on profit margins of only 1-2% of total sales. The 'Severe Trauma Center' vividly depicts this in episode 4 during a budget meeting at the Korean University Hospital. Director Choi Jo-eun (Kim Eui-sung) and Planning and Coordination Director Hong Jae-hoon (Kim Won-hae) call out the heads of departments running deficits one by one and reprimand them.

"Thoracic surgery, about 342 million won so far." "Thoracic surgery, are you there? Well, compared to last year, you did well." "Yes, Director. Also, obstetrics and gynecology dropped below 100 million won compared to last year." "Professor Ahn, let's work a little harder and turn a profit, okay?"

This is the main reason why Korea's severe trauma centers are not much different from existing emergency medical centers. The related work is at the heart of public healthcare. National budget is absolutely necessary. However, the government's view is harsh. Without understanding the unique nature that cannot be a profitable business, deficits are defined as business failures. Hospitals, which must be cautious, focus more on profitable health checkups and non-reimbursable services.

Professor Lee pointed out, "The hospital wanted to apply for the upcoming 'Severe Trauma Center Project Competition,' but did not provide the support our team needed to endure until then." "Due to a lack of intensive care unit beds, we still had to use acute emergency room beds, and team members endured unbearable on-call schedules and patient burdens to board the helicopter. Everyone worked under extreme adverse conditions but was welcomed by no one. Hospital officials still complained about the helicopter noise and even said we were putting on a show with trivial patients."

Baek Kang-hyuk boldly establishes a severe trauma center in a Korean university hospital rife with absurdity and irrationality.
[Photo by Netflix]

The reality of being treated like unwanted leftovers is clearly reflected in the specialist on-call system at university hospitals. Most are staffed by junior professors or clinical instructors. The top-tier professors focus only on outpatient care for patients who come from afar. This helps improve the hospital's profitability.

It is unreasonable to demand that medical staff fill the resulting medical gaps through sacrifice. Much of Korea's healthcare relies on the private sector, and the state only trains some doctors at national universities. Calling it a calling or mission is just a dream, a voluntary sacrifice. Perhaps that is why Baek Gang-hyeok's answer to the rookie doctor Seo Dong-joo's (Kim Jae-won) question in episode 8 of 'Severe Trauma Center' sounds hollow.

"You're asking what you can do if you go to the trauma center." "You will be able to save lives. Isn't that why we became doctors? Now, the real chance to become a doctor has come."