hankyoreh

Doctors walk down the hallway at a hospital in Seoul. (Yonhap)

One day before the Thursday deadline set by the South Korean government for interns and residents to return to work, a small number had gone back to their jobs, while the vast majority carried on with their collective action protesting a planned increase in the nationwide medical college admission cap.

As the standoff between the administration and physician groups has dragged on, third- and fourth-year interns and residents are poised to begin departing hospitals once their contracts expire, while the remaining staff members have complained of mounting fatigue.

Park Min-soo, the second vice minister of health and welfare, proposed meeting with interns and residents on Thursday for a dialogue.

On Wednesday, the administration continued applying pressure tactics against the interns and residents. Ministry of Health and Welfare (MOHW) employees visited the homes or representatives at different teaching hospitals to hand-deliver back-to-work orders.

While the orders had previously been sent by post and text message, the ministry began delivering them in person in order to make thorough preparations for judicial procedures. Interns and residents had previously dodged the orders by turning off their cell phones and other means.

According to the Administrative Procedures Act, orders may be delivered to a fellow resident or other proxy in the event that the deliverer is unable to meet with the recipient at the location. If these deliveries are refused, deliverers may record that fact on a receipt confirmation document and leave the document at the delivery location.

The administration has continued to apply hard-line tactics following its filing of complaints against five Korea Medical Association officials the day before, including emergency committee chairperson Kim Taek-woo.

On Wednesday, Park sent a text message to interns and residents proposing a dialogue.

Emphasizing that “any and all interns and residents may participate,” he told the recipients that the matter was “separate from the collective action” and that he hoped they would “take part in the dialogue without concerns.”

“Obviously, we also welcome participation in an individual capacity,” he added.

No major changes occurred with the collective action by interns and residents. The Health Ministry reported Wednesday that a total of 9,937 had submitted resignations at 99 major teaching hospitals nationwide as of Tuesday. The number was up by 28 from 9,909 the day before.

Out of that total, 8,992 interns and residents have left their hospitals. A total of 9,267 at 100 teaching hospitals have received back-to-work orders.

But only a portion of them have actually returned to the job, including seven at Chonnam National University Hospital and six at Chungbuk National University Hospital.

The administration has emphasized the significance of even a portion of the interns and residents returning. But when contacted by the Hankyoreh, sources with the interns and residents said there was no movement to return.

As it girds for a long battle, the administration has come out with emergency supplementary measures for medical treatment.

“We can’t rule out the possibility that physician groups will continue their collective action through the general election in April and after,” a Health Ministry official said.

The plan is to first offset physician shortages at national university hospitals and other medical centers with public health physicians and military surgeons, while providing financial support for cases where tertiary hospitals take on additional medical staff or where current faculty members and specialists assume duties.

The medical fee system is also to be adjusted so that tertiary hospitals can focus on treating patients with severe symptoms, while other hospitals are responsible for treatment of those with mild to moderate symptoms.

Another plan under consideration would grant secondary hospitals exclusive rights to request treatment at tertiary hospitals. Under this system, national health insurance funds and other sources would be used to make up for the difference in profits at tertiary hospitals due to declining patient numbers.

Additionally, there are plans to encourage public health centers to extend their weekday treatment hours and provide a maximum of treatment on weekends and holidays.

The Ministry of Health and Welfare expressed confidence that it could fill the health care void.

“The health care system can be sufficiently sustained even if [the interns and residents] don’t return for several months,” a ministry official asserted.

“If anything, this could be an opportunity to address issues with the health care delivery system,” they suggested.

But some have raised doubts over how effective the administration’s measures will actually be, as the physicians currently working face growing fatigue and additional departures are expected.

As of Friday, third- and fourth-year interns and residents who have completed training will be leaving their hospitals, while some specialists who are working on one-year contracts have indicated plans to join in the collective action.

Also, some secondary hospitals are ill-equipped to process the influx of patients coming from major hospitals due to their less robust treatment environments. The risk of patients shying away is a very real concern.

“Even if university hospital emergency rooms operate around the clock the way the government is planning, the emergency treatment won’t mean anything if final treatment is not provided,” said Lee Hyung-min, a professor of emergency medicine at Hallym University Sacred Heart Hospital.

“There’s a danger of some secondary hospitals reaching capacity in their intensive care units,” he warned.

By Cheon Ho-sung, staff reporter; Lim Jae-hee, staff reporter; Kim Yoon-ju, staff reporter; Kim Yong-hee, Gwangju correspondent

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