Is medical void not culpable?

The Korean government issued a "serious" level warning in public health and medical emergency for the first time in history when medical residents and interns collectively resigned. The Korean Medical Association warned of an impending medical catastrophe. Despite nearly two months passing since the onset of the medical "vacuum," Korean society remains surprisingly calm and quiet.

Several patients have tragically died since then while seeking emergency rooms for treatment. Last Tuesday, a patient in their fifties in Busan, suffering from cardiovascular disease, passed away after being turned away by over 10 emergency rooms. In March, a three-year-old girl who fell into a ditch and a woman in her seventies who was struck by a utility pole, both from North Chungcheong Province, succumbed to their injuries after being denied transfer by every medical center they approached. A month prior in Daejeon, an octogenarian who suffered cardiac arrest also met a fatal end after being refused transfer to an emergency room. These are just a few cases that have been covered and reported in newspapers.

The grieving families openly expressed their resentment, contending that the shortage of medical trainees exacerbated the difficulty of accessing emergency room care. Then, something astonishing occurred. Both the government and the medical community, previously locked in fierce disagreement, issued a jointly stated that the deaths cannot solely be attributed to the absence of medical trainees. While the government pledged to investigate whether the shortage of medical trainees impacted the situation, no official findings have been released thus far. The medical community maintains that the patients were beyond salvation even if they had been admitted to the emergency room. Both the government and physicians assert that the deaths were inevitable, leaving the patients with no recourse for argument.

It is debatable to classify provincial metropolitan cities such as Busan and Daejeon as medically underserved areas. However, it is undeniable that provincial regions are susceptible to shortages in emergency medical services. Some argue that small-to-medium-sized hospitals in provincial areas, initially less staffed with medical trainees, may be less impacted by such absences than hospitals in metropolitan areas. It is imperative that we thoroughly investigate these tragic deaths and ensure they are not linked to the shortage of medical residents and interns.

Emergency rooms (ERs) are the areas where medical trainees are most needed, as they can work overtime at lower labor costs. It is possible that the absence of medical trainees exacerbated the workload at provincial hospital ERs. Alternatively, it could be that ERs in metropolitan area hospitals, often the last hope for emergency patients, decreased their capacity, limiting their ability to accommodate more patients. Both the government and the medical community maintain that these tragedies were inevitable, dismissing any other potential explanations or possibilities.

Patients and their families hold different perspectives from those of the government or the medical community. On Monday, Kim Seong-ju, the head of the Korea Cancer Patients Rights Council, received a distressing phone call from a patient suffering from chronic kidney failure. The provincial mid-sized hospital where the patient was admitted requested a transfer to a larger hospital due to blood dialysis complications. However, the larger hospital, where the patient was receiving treatment, refused admission to the emergency room, citing the absence of medical trainees. The caller was nearly in tears, describing how one hospital asked them to leave while the other refused to accept them, leaving the patient nowhere to turn.

Kim is inundated with calls reporting that surgeries are being postponed due to the absence of medical trainees, making admission impossible. The statistics corroborate the experiences and testimonies of these patients thus far. According to the National Fire Agency, the number of cases rejected for transfer by 911 ambulances has skyrocketed to 2.5 times the usual rate.

In an attempt to evade responsibility for the medical treatment vacuum, the government is unwilling to admit that the medical system is in jeopardy. Conversely, the medical community insists that emergency rooms are functioning adequately and safely, likely to avoid drawing attention to the necessity of increasing medical student quotas. Once, Korea proudly touted its world-class medical treatment, but now it reluctantly acknowledges that people frequently perish in Korea while searching for emergency rooms to admit them.

Patients are pleading for assistance while the government and doctors are embroiled in a power struggle over trivial numbers. Medical trainees have filed lawsuits against the Vice Minister of Public Health and Welfare. Still, patients and their families cannot afford to take legal action against doctors, as they are hesitant to dispute those who hold the lives of themselves or their loved ones in their hands. For patients grappling with illnesses, participating in protests would be challenging. Moreover, those patients who missed critical opportunities and subsequently perished remain voiceless.

President Yoon Suk Yeol's announcement that the government will persist with medical reform was met with a chilly reception from the medical community. Patients and their families, who had hoped for a significant resolution, were likely disappointed once again. Both the government, unilaterally advocating for an increase in medical school quotas, and the medical community, advocating for the outright cancellation of the quota increase plan, assert that their actions are aimed at saving patients. Should today's patients be sacrificed for the sake of tomorrow's? While the big players engage in their battles, our vulnerable ones—the patients—cannot even raise their voices, let alone engage in dialogue. This is precisely why the absence of medical trainees and the shortage of medical services are not receiving adequate attention.