[The Editors' Verdict]The Path of Medicine Pointed Out by a Pediatric Hospital Director

On a night in December last year, in the middle of winter, a doctor faced a five-month-old infant patient in such critical condition that the baby could barely breathe. The doctor spent a full two hours on the phone, desperately searching for help. Because the hospital did not have an intensive care unit, there was nothing to do except provide emergency care. Looking back, the doctor recalls calling dozens of hospitals. It was only after midnight that the doctor managed to find a tertiary hospital willing to accept the child and arrange the transfer.

"It struck me that an emergency infant patient could lose their life after missing the golden time right here, too." Choi Yongjae, director of Ttuntun Children's Hospital in Uijeongbu, Gyeonggi Province, and president of the Korean Pediatric Hospital Association, had this realization after experiencing that night.

Over the following months, Director Choi gathered about 2 billion KRW of personal funds and other resources to establish a pediatric intensive care unit at the hospital, driven by the accumulation of such "heartbreaking" experiences. The pediatric ICU, which recently began full operation, is equipped with three beds. Determined to do things right, the hospital invested in a wide range of expensive, state-of-the-art equipment.

Emergency medical care is burdensome even for large hospitals. Under current medical regulations, there is no government support available. It is obvious that a small hospital like Ttuntun Children's Hospital would operate its ICU at a loss. Choi described this decision as "an emergency measure to protect our children's lives from the deteriorating treatment environment caused by the collapse of the pediatric medical system," and told this newspaper, "It is far too irresponsible for society to entrust young lives solely to the goodwill of individual doctors."

In our medical market, performing one filler procedure is more profitable than seeing 30 to 40 pediatric patients. According to a survey, only about 35% of pediatricians who closed their practices during the COVID-19 pandemic have continued to work in the field, while the rest have either moved to more lucrative specialties or left the profession entirely. This reflects the state of our pediatric medical system and the reality behind the term "pediatrics open-run," a phrase that is hard to laugh at. Last year, out of 50 university hospitals nationwide, 38 had not a single resident apply to their pediatrics department. The future of pediatric care, as well as its present, is bleak.

Even though the government effectively conceded by freezing next year's medical school admissions as if all medical students had fully returned, the Korean Medical Association (KMA) still mobilized an estimated 25,000 people (according to organizers) to demonstrate in the streets. The government, having linked the essential medical care package?which included some measures to strengthen pediatric care?with the controversial plan to increase medical school admissions by 2,000, ultimately abandoned everything, leaving deep wounds. If the government is incompetent for this, then those who, after extracting the concession of a freeze in admissions, are now demanding that everything?including the essential medical care package?be reset to square one are truly formidable.

It is often said that the government cannot win against doctors. The relentless struggle of that hospital director, pouring water into a bottomless jar, eloquently illustrates the direction the medical system and doctors should take. Yet the medical community does not hesitate to upend the situation, relying on arguments that ordinary people can hardly understand.

Lee Jaemyung, a presidential primary candidate for the Democratic Party, has proposed medical policies such as rationalizing medical school admissions through social consensus and establishing public medical schools. In some respects, the details and intent are similar to those of the current administration, while aspects like public medical schools are even more sensitive and controversial. It is unlikely that the blueprints proposed by other candidates will be readily accepted by the medical community. The KMA's protests appear to be both a threat to seize the advantage in a second or extended round, and a declaration that their standards of reasonableness are entirely different. This is a challenge that demands both determination and wisdom. More than ever, political imagination and leadership?such as a single-issue policy coalition?are urgently needed.