Those trained in other areas learn on the fly
Kim is an obstetrician running his own hospital in Gyeonggi Province. He is currently considering opening a new clinic in Gangnam, southern Seoul, for plastic surgery. "For the past 20 years, I have delivered babies, but I cannot afford to pay employees these days," he complained. "I will learn how to perform plastic surgery from friends before opening my new clinic." Things are not as good as they used to be for many doctors in South Korea, as they face greater difficulty in making ends meet, forcing many of them to give up their practice and open new, small-sized neighborhood clinics. According to the Health Insurance Review Agency, the number of obstetrics hospitals that converted into general clinics rose to 304 as of the end of June from 131 at the end of the year 2003. The number of surgical hospitals that changed into general clinics also increased to 1,014 as of the end of June from 915 at the end of December 2003. Overall, the number of general clinics surged to 4,569, accounting for 17.8 percent of all hospitals operating in South Korea.By law, doctors can open general clinics and give up practicing in their areas of specialty. Though changing practices is not illegal, it may pose a threat to patients as it means a possible drop in quality of care. "A doctor specializing in a certain area knows better than any others about that [particular area]. But in other areas, he or she is more liable to make mistakes," noted Kim Chang-bo, an official at the Health Right Network. Kim, who is considering opening a new hospital in Gangnam, confirms these concerns: "I learned how to perform plastic surgeries from other doctors practicing in the neighborhood," he said. "I am able to see patients with light diseases by resorting to basic medical knowledge." Asked if he were less effective in treating patients with complicated symptoms than internists in that specialization, however, he made no comment that would assuage public concerns. Lim, a plastic surgeon, said, "It is a well-known fact that [those untrained as] plastic surgeons are practicing in the field... Why would they bother to take official courses to do plastic surgery if they can do [the operations] with just a little training?" Some experts pointed out that the new trend is a waste of medical resources. "Do we need to nurture doctors by investing years of money and time if a doctor specializing in some areas sees only patients that have come down with a cold?" said Yoon Tae-ho, a medical professor at Pusan National University. Behind the trend of doctors giving up their specialities lie the government’s myopic policies, the nation’s low birth rate, and an aging population. Making things worse is the fact that doctors tend to practice in more profitable areas, rather than providing an even spread of health care services for the public good. "The government should be held accountable for the current situation, as it has failed to provide appropriate measures to ensure [matching] supply and demand of medical resources," said Cho Hong-joon, a medical professor at Ulsan University. "For the sake of patients’ health, the system should be overhauled to properly educate doctors at general clinics. We also need to review the system for doctors’ specialization."
