South Korean doctors flee paediatrics due to low birth rate, poor pay
Pediatrician Song Jong-geun performs medical treatment at his pediatric clinic in Seoul, South Korea, June 14, 2023. REUTERS/Kim Hong-Ji
On a Friday morning in late June, the waiting room of a children’s hospital on the outskirts of Seoul was packed with dozens of children, many connected to intravenous drips, waiting for hours since 6 a.m. just to see a doctor or secure hospital bed.
“We had to wait about two weeks (to secure a hospital bed), because there was a long waiting list, so we kept getting rejected for about two weeks. I was really scared. My son was sick,” said Lee Bo-mi, the mother of a 3-year-old whose pneumonia still hasn’t dissipated after weeks of treatment.
At the root of the problem facing South Korea is a birth rate that fell to 0.78 in 2022 – that’s the average number of babies expected per woman – combined with the failure of the insurance system to adapt to it, leaving pediatrics starved of resources and doctors shunning a field which they think has no future, seven pediatricians told Reuters.
In May, a five-year-old child in Seoul with acute laryngitis died after being sent home while not being able to find a bed in multiple hospitals. Doctors are concerned such cases will increase.
“Patients are dying. They die while bouncing around multiple emergency rooms, die when it’s not a serious disease, it’s a travesty,” said Choi Yong-jae, M.D., vice president of Korea Children’s Hospital Association.
Paediatricians have blamed the government for lack of appropriate action to fix long-brewing problems and had asked for extra budget to attract more doctors into paediatrics.
South Korea‘s Ministry of Health and Welfare acknowledged “limitations” in the system and said measures were being implemented to address them. The ministry earlier announced measures, such as cancelling major hospitals’ designation as a regional emergency centre if paediatric patients are not properly treated.
Compared with peers, South Korean paediatricians earn little. Among doctors in 23 clinical departments, paediatricians’ income was the lowest, according to Health Insurance Review and Assessment Service data.
Last month, in protest at the government for the lack of support, the Korean Pediatric Association held a “No Kids Zone” seminar to help members leave paediatrics to a better-paying field; roughly 600 out of about 3,000 members flocked to hear lectures on skin beauty procedures such as botox, and adult chronic diseases.
The association said 90 percent of their members have closed their businesses or given up pediatric treatment, further compounded by a sharp drop in the number of patients caused by the historically low birth-rate.
“In foreign countries, the government pays enough to maintain a (children’s) hospital even if you see 20 patients a day. But it’s about $10 per treatment in South Korea, which is not enough to run a (children’s) hospital. So clinics have to see about 80 patients,” said Lim Hyun-taek, M.D., president of the Korean Pediatric Association.
The recruitment rate of paediatrics residents, which was 97.4% in 2013, plummeted to 16.3% in the first half of this year, according to the health ministry. Doctors cite the lack of a future due to the sheer reduction of patients expected.
“The country is spending a huge budget on (trying to counter) the low birthrate. They must divert some of this budget to (paediatric care) so parents feel there is no difficulty with healthcare when they give birth,” said Lee Ju-yul, professor of health administration at Namseoul University.
Parents say fewer paediatricians mean longer wait times for sick babies at children’s hospitals, creating a vicious cycle that makes the country not conducive to having babies.
Kim Eun-ji, whose son is already four months old, is hesitant about having a second child due to the current healthcare system.
“If I have a second child, there will be fewer children’s hospitals and fewer doctors than now, so it will be difficult to go the hospital,” said Kim, while waiting with her son at a children’s hospital in Seoul.
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