[Reporter’s Notebook] Collapse of Regional Healthcare Cannot Be Solved by the Regional Doctor System Alone

"Even after completing mandatory service, most doctors will end up moving to the Seoul metropolitan area by their mid-30s." A pediatrician in his early 40s, currently working at a hospital in Gyeonggi Province, made this comment to a reporter regarding the ongoing controversy over the regional doctor system.

Born and raised in South Gyeongsang Province, he graduated from a medical school in his hometown, obtained his specialist qualification at the affiliated hospital, and worked nearby before moving to his current hospital in his mid-30s. He made this decision after facing challenges such as a sharp decline in population, an aging society, and a significant drop in medical demand, which led to issues related to income and raising children. He said, "Even if the regional doctor system had existed when I entered university, it would not have changed the course of my life."

If a student enters medical school through the regional doctor system at age 19, they will become a doctor at 25 after six years of study. Even after completing mandatory service, they will only be 34. This is typically the time when people have just gotten married or are likely to be planning marriage, making it difficult to expect that the long future they must plan will be based in the region. To achieve the goals of the regional doctor system, what happens after the 10-year mandatory service period is ultimately more important.

The biggest obstacle is the lack of patients in regional areas-in other words, the disappearance of demand. The shuttle buses of large tertiary hospitals, easily seen at Seoul Station and Suseo Station, starkly reveal the reality of regional healthcare, which has already collapsed to a significant extent. The healthcare industry cannot escape the principles of supply and demand and future profitability based on them. The fact that, during the 10-year mandatory service period, doctors go through the stages of intern, resident, and fellow, leaving only 2 to 3 years of actual service in the region as fully qualified doctors, also highlights the limitations of the system.

Despite these constraints, for the regional doctor system to be effective, it is essential to recognize that there are structural problems that cannot be solved by this system alone. At the very least, in key regional areas, it is crucial to offer much more substantial benefits to medical consumers for using local healthcare and to ensure these benefits are tangible. Simply repeating the slogan, "Regional healthcare alone is enough to protect your health," will not fix anything.

In particular, regarding essential regional healthcare, it is urgent to revise the system more proactively and aggressively so that issues such as reimbursement rates, hospital management logic, and legal risks do not hinder doctors. The regional doctor system is just one small piece of the puzzle linked to regional healthcare and, by extension, the entire national healthcare system. It is hoped that the approach will not remain simplistic, assuming that implementing the regional doctor system alone will solve the problems of regional healthcare.