May 22, 2024

(Bloomberg) — Lee Kyung-ja’s sister is caught in the middle of a labor dispute between South Korean doctors and the government, and her life is at risk.

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“This walkout is driving me mad,” said Lee, a 70-year-old visitor to a local hospital in Cheongju, thinking of her sister who has been trying to schedule an appointment for a cancer prognosis. “Doctors deal with life and death, so they should stay with the patients even as they protest.”

Trainee doctors, who play key roles in providing emergency care and surgeries, walked off the job more than three weeks ago to protest a government plan to increase enrollment at medical schools by 2,000 spots a year from the current 3,058. President Yoon Suk Yeol’s administration is standing by the plan and finding funding for those who have stayed at their posts.

As the labor action drags on, people seeking health care have been putting off procedures, trying telemedicine and going to local clinics instead of emergency rooms. The government has allowed nurses to take on more tasks in providing health care, opened up emergency rooms in military hospitals to the public and is deploying some of its doctors serving in the military to civilian facilities.

This has helped keep the health-care system running, albeit precariously, and left people on edge about putting aside care now that could cause irreparable harm later.

Lee takes care of her 62-year-old sister, who found out a few months ago that she had late-stage cancer causing pain in her pelvis. Despite several scans at Chungbuk National University Hospital, the biggest in the city, her sister has failed to schedule a surgery let alone determine the exact type of cancer, even as the skin from her waist to thigh turns dark. Lee blamed the walkout.

More than 90% of the country’s 13,000 trainee doctors, who are similar to medical residents, have defied a government deadline to return to work by the start of March, according to Yonhap News. The walkout has led to about a 50% reduction in surgeries and decreased staffing levels at emergency rooms, the government said.

The Health and Welfare Ministry has said the government will inject 188.2 billion won ($143.1 million) a month into national health insurance finances to increase compensation during the walkout for doctors at emergency centers and those who look after patients in intensive care units.

Lee Geon-joo, head of the Korea Lung Cancer Patient Association, and a stage-four lung cancer patient, said people in the group have told him that crucial care is still being dispensed, but he feels they are being held hostage by doctors worried about how their earning power would be affected if more people entered the profession.

“You don’t call someone a doctor if they don’t look after their patients,” Lee Geon-joo said.

Doctors leading the protest contend the enrollment plan won’t fix fundamental problems such as a shortage of physicians in vital fields, a concentration of doctors in urban areas and an array of legal risks

In the meantime, procedures to check for illnesses such as endoscopies are being postponed or called off for now, which can lead to problems later on, said Kim Sung-ju, head of the Korean Cancer Patients Rights Council. Many in the group are worried about treatment and have tried to steer clear of politics when they see medical professionals, so as not to endanger their future care, he said.

The number of medical school seats, set by the government as a way to keep control of the number of doctors, has not risen for nearly three decades. Yoon argues more doctors have to be added to provide care in the rapidly aging nation, and polling shows the public supports the plan. The previous government tried to raise the quota in 2020 but backed down after about a month-long walkout that took place during the coronavirus pandemic.

The impact of the latest walkout has been most acute in emergency rooms at bigger general hospitals where trainee doctors once made up more than one third of staff. As these rooms shutter, burdens on smaller hospitals are growing, including Hana Hospital in Cheongju, about three hours’ drive from Seoul.

Emergency staff at Hana said they are finding it’s common to skip meals as they pick up a greater flow of patients who would have gone to larger hospitals that have been hit harder by the walkout. In recent days, three patients, including two with cardiac arrest, were brought in at once, sending the emergency room into chaos and raising questions about how sustainable the situation was.

Yoon’s approval rating has shot up to 39% in a weekly tracking poll by Gallup Korea — its highest since July of last year — as he has taken a tough stand in the dispute. That could help his conservative People Power Party in April elections for parliament in places like Cheongju, seen as a bellwether swing area.

“It’s a race against time,” said Lee Yong-bok, who handles administration at Hana. “We’re stretched thin, and more resources funneled into emergency operations means more delays for other general patients.”

Sung Si-yoon, who operates a street cart selling fried buns and fish cakes, wants doctors and the government to reach a deal and focus more on economic issues.

“People like us are trying to avoid doing stupid things that would land us in a hospital,” she said. “But we first need to survive on the street and I’ll vote for whoever helps with that.”

–With assistance from Emily Yamamoto and Jenny Lee.

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