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A person pushes a patient at a university-affiliated hospital in Seoul through a lobby on June 9, 2024. (Yonhap)

The South Korean government will impose treatment orders and closure reporting orders on private clinic physicians who have signaled their intent to go on a collective leave of absence.

It also announced plans to investigate the Korean Medical Association (KMA) for possible violation of the Fair Trade Act.

In a Central Disaster and Safety Countermeasure Headquarters meeting Monday on the collective action by physicians, Jeon Byeong-wang, the director of the Ministry of Health and Welfare health care policy bureau, said the government had “decided to issue treatment orders and closure report orders to private clinic physicians based on the Medical Service Act.”

“We will also conduct a legal examination on whether the Korean Medical Association has violated the Fair Trade Act with its encouragement of illegal collective action,” he added.

The move is being interpreted as a forceful response to avoid health care havoc after the announcement of an indefinite leave of absence starting on June 17 by professors and practicing doctors at Seoul National University medical school and its affiliated teaching hospitals was followed by an announcement that neighborhood clinic physicians were also planning a collective shutdown on June 18.
 
“Violations of orders could result in suspensions, fines and even jail time”

On Monday, the Health and Welfare Ministry said that at its request, individual cities and provinces had issued orders for physicians to continue treating patients on June 18 and to report any clinic closures. The deadline for reporting a closure is Thursday, which is three days before the collective action is scheduled to begin.

If the number of health care institutions reporting plans for closure exceeds a certain percentage, the ministry plans to issue a back-to-work order the day before the collective shutdown. The rate set by the administration is 30%.

On the day of the planned strike on June 18, individual cities and provinces plan to call clinics’ landline numbers to confirm that treatment is taking place. If the actual rate of participation in the collective action exceeds 30%, they will be visiting institutions in person to confirm whether the treatment orders are being violated.

“According to the Medical Service Act, those who violate orders may be subject to suspension of operations for 15 days and suspension of their medical license for up to a year,” Jeon said.

The administration is further examining whether the KMA is in violation of Article 51 of the Fair Trade Act, which states that a business entity or organization of business entities may not unfairly restrict activities by business operators.

This means that the administration intends to examine whether the KMA violated this article by communicating guidelines to its private clinic physician members calling for a strike on June 18. If a violation is confirmed, the first step would be an order for corrective action. Noncompliance with the order could result in up to three years’ imprisonment or fines of up to 200 million won (US$145,200), as well as penalties of up to 1 billion won.

The administration previously played the Fair Trade Act violation card in the case of collective leaves of absence by physicians in 2000 and 2014. In the 2000 case, the Supreme Court recognized “coercion” on the part of the KMA leadership, but the Seoul High Court arrived at a different judgment in 2014. While the strike in the latter case was approved by a vote, the court concluded that the physicians themselves made the decision on whether to close, and there was no punitive action or disadvantageous treatment on the KMA’s part.

Jeon said the ministry would “look at the situation and instruct measures as needed.”
 
Civic groups criticize physicians as KMA “forces shutdown”

The KMA has said that it intends to go ahead with the collective action if there is no reconsideration of or other changes to the administration’s plans for increasing the nationwide medical college admission cap.

“We will be proceeding as originally decided, regardless of what the administration threatens us with,” a KMA official said.

What it will come down to is the rate of participation in the strike. On Sunday, the KMA publicized findings of a poll of 63.3% (70,800) of its active members, of which 73.5%, or 52,015, said they would participate in the collective action. The Korean Society of Emergency Medicine has also stated that it will participate in the shutdown of clinics and a general rally of doctors nationwide organized by the KMA on June 18. 

The government believes that turnout won’t be as high as predicted. According to the Health and Welfare Ministry, during the first round of voluntary collective hiatuses in 2020 (starting Aug. 14), neighborhood clinics participated at a rate of 32.6%, but that dropped to 10.8%, 8.9% and 6.5% participation during the second round of hiatuses on Aug. 26, 27 and 28, respectively. At the same time, high participation by medical school professors could reinforce the collective action’s impact. 

Civic groups have denounced the move by doctors to shutter their clinics. In a statement put out on Monday, the Citizens’ Coalition for Economic Justice wrote, “There is no justification for doctors illegally refusing to treat patients, a move that threatens the safety of patients. This decision must be withdrawn immediately.”

By Son Ji-min, staff reporter

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