Deaths from doctor shortage fuel election angst in South Korea

SEOUL – In March 2023, a 17-year-old girl who fell from a building in the South Korean city of Daegu died after her ambulance was turned away by three hospitals that lacked doctors to treat her.

She was among more than 3,750 patients who have died since 2017 after local hospitals refused to provide care, a report by Professor Cheong Yooseok from Dankook University in Cheonan city shows.

The startling statistic from one of Asia’s richest countries has become a major issue in the parliamentary elections taking place on April 10. While the country won acclaim for its low fatality rate during the Covid-19 pandemic, the focus now is on inefficiency, waste and skewed economic incentives in the healthcare system. 

Renowned medical centres in the capital Seoul are overwhelmed by patients, while the rest of the country struggles with a lack of physicians. A six-week-and-counting national walkout by nearly 13,000 residents and interns protesting against a plan to boost medical school enrolment has exacerbated the situation.

Mr Jung Seung-pyo, an esophageal cancer patient who lives on Jeju Island, flew to Seoul National University Bundang Hospital for surgery in June 2023. While he is supposed to have check-ups every four weeks, sometimes it takes several months to get an appointment.

“There’s no doctor at all on this island who can treat esophageal cancer,” Mr Jung said of his hometown, which has a population of almost 700,000 people. “Everything is so concentrated in Seoul.”

South Korea has among the fewest doctors per capita of all developed countries and has not increased the number of medical students in more than two decades, said Mr Gaetan Lafortune, a senior economist at the Organisation for Economic Cooperation and Development. Demographic factors like a rapidly ageing population will exacerbate the scarcity, he said.

South Korean President Yoon Suk-yeol has vowed to address the crisis. He proposed measures, like increasing the number of doctors, that have drawn complaints for being “populist moves” ahead of the election to select the 300-member National Assembly.  

While his conservative People Power Party is in power, he is trying to flip dozens of seats held by his progressive rivals, led by the Democratic Party, to take control of the national legislature. 

The healthcare system is “collapsing”, Mr Yoon said at a public hearing in February. “Now is the golden time to push reforms.” 

Yet the doctors themselves oppose efforts to expand physician supply, arguing that the government’s proposal to increase medical school enrolment by 2,000 spots a year from the current 3,058 does not address the root problem. 

This, they say, is that doctors’ pay in some critical fields covered by the country’s National Health Insurance system is far lower than that for outside specialists, especially those who do cosmetic and aesthetic procedures. The disparity in compensation and infrastructure between Seoul and rural areas also means a dearth of medical workers outside the capital.

“Doctors are disappearing at emergency centres, surgery rooms, delivery rooms and hospitals in smaller cities,” said Prof Cheong in a December report. “Many young doctors gave up becoming fellows at medical colleges and work in the beauty industry.” 

Cosmetic surgery has aggressively taken hold and medical tourism is booming in South Korea. More than eight million foreign patients arrived between 2009 and 2022, many for the beauty industry that offers ubiquitous access to plastic surgery, Botox for US$6 (S$8) per shot and laser skin tightening. 

Meanwhile, essential fields including paediatrics have been hard hit. Only 53 residents applied to fill 205 paediatric slots for 2024, and just eight were outside Seoul and its surroundings, according to the health ministry. For paediatric surgery, two trainee doctors applied for spots outside of the greater Seoul area.