Why Is South Korea Govt Taking Legal Action Against Doctors On Strike?

An elderly woman in South Korea died from cardiac arrest in the ambulance after several hospitals denied her entry due to the unavailability of doctors. The 80-year-old woman was taken to seven hospitals in Daejon on February 24 and was eventually admitted to a public university hospital, 67 minutes after she first called for help, where she was pronounced dead on arrival. The government is investigating the case, and has initiated measures to suspend the medical licenses of nearly 12,000 striking doctors, raising concerns about the potential impact on frontline healthcare services. This month-long dispute, originating as a protest against the government's plan to increase the number of trainee doctors, has escalated, leading to surgery cancellations, extended waiting times, and treatment delays, including emergency care.

South Korea's health minister, Cho Kyoo-hong, announced on March 4, 2024, the initiation of legal actions against trainee doctors who persisted in their walkout, protesting government proposals to increase medical school admissions. 

Government's Heavy-Handed Approach

The Ministry of Health has set in motion procedures that could result in the suspension of licenses for 4,900 doctors if they persist in defying orders to return to work. Furthermore, administrative notifications have been dispatched, following earlier warnings that striking doctors might face a three-month suspension—a disciplinary action that could hinder their path to becoming specialists for at least a year.

Since February 20, over 9,000 interns and resident doctors have halted their duties, and over 10,000 have resigned from hundreds of hospitals across South Korea. This has led to a severe lack of medical assistance, a lack of hospital beds, and pressured emergency rooms, proving fatal for patients. The 80-year-old woman's death is the first death linked to the strike so far.

The government had previously issued warnings to the protesting trainee physicians, cautioning them about potential administrative and legal penalties. These repercussions include the suspension of medical licenses, fines, or even jail terms if they failed to resume work by the end of the preceding month. Health Minister Cho Kyoo-hong emphasized the gravity of the situation during a televised briefing, stating, "From today, we plan to conduct on-site inspections to confirm trainee doctors who have not returned, and take action according to the law and principle without exception."

The stakes are high, with Cho urging the protesting doctors to consider the serious impact on their personal career paths. However, he did acknowledge that for those who returned, the government would take into account extenuating circumstances when contemplating any potential action against them.

Reportedly, government officials said they would investigate the death of an elderly woman, which has been widely reported in South Korean media. Surgeries have been postponed, and patients have had to be transferred to other hospitals, according to reports. Lee Hye-ji, a 37-year-old renal dialysis patient, too  highlighted the anxiety over potential scenarios where medical conditions might deteriorate due to the unavailability of doctors. "I would be extremely anxious if I ever needed to undergo kidney transplant surgery, but there are no doctors available," she stated, as reported by Reuters. On February 27, Vice Health Minister Park Min-soo threatened to strip doctors of their practicing licences if they didn't return by the end of the month.

Attempting to mitigate the crisis, the health ministry also announced plans to assign 20 military surgeons and 138 public health doctors to selected hospitals. However, it denies the descent of the country's health services into chaos. Director Chun Byung-wang suggests that returning doctors may avoid punishment, emphasizing the government's commitment to dialogue and a willingness to consider the medical community's opinions.

Escalating Tensions and International Response

Despite the government's warnings, there is little indication of a resolution. Thousands of South Korean doctors, organized by the Korean Medical Association (KMA), held a mass rally on Sunday, defying official calls for the trainee physicians to return to work. The KMA, representing private practitioners, apologized for the inconvenience caused by the walkout but urged the government to reconsider its medical reforms. The association accused authorities of conducting a "witch-hunt" against doctors. The World Medical Association, representing physicians globally, issued a statement strongly condemning the actions of the Korean government, asserting the right of doctors to collective action, including strikes. The association accused the government of attempting to stifle the voices of elected leaders within the Korean Medical Association.

A recent poll by the Yonhap news agency indicates that 84% of respondents support hiring more doctors, while 43% believe that striking physicians should face severe punishments. The Kyunghyang Shinmun newspaper emphasizes the urgency of dialogue, stating, "Doctors and the government are not in a boxing ring; people's patience is wearing thin." The resolution of this crisis hinges on finding common ground through constructive negotiations.

Why Are Doctors Protesting?

The Yoon Suk-yeol government recently announced its plan to expand the nation's yearly medical school admission capacity by 65%. For years, the government has planned to increase the number of doctors as the country is dealing with a rapidly ageing population, which will put an extra burden on the medical system. The enrollment plan is meant to add up to 10,000 doctors by 2035.

However, doctor groups like the Korean Medical Association oppose the expansion as they opine that medical schools can't accommodate the abrupt burden of students. They predict that this would also cause greater competition among doctors, resulting in overtreatment and increasing public medical expenses. 

Another concern is that most of the newly recruited medical students would also likely try to work in high-paying, popular professions like plastic surgery and dermatology, while the long-running shortage of physicians in essential yet low-paying areas like paediatrics, obstetrics, and emergency departments would remain unchanged. 

According to 2022 data from the Organisation for Economic Co-operation and Development (OECD), South Korea's doctors are among the best-paid in the world, showing the average specialist at a public hospital receives nearly $200,000 (Over Rs.1.65 crore) a year. "More doctors mean more competition and reduced income for them... That is why they are against the proposal to increase physician supply," Prof Kwon Soon-man, a public health expert at Seoul National University, told the BBC.

It is to be noted that South Korea has one of the lowest doctor-patient ratios among the 38 countries under the OECD. According to officials, there are only 2.5 doctors per 1,000 people. The country has major shortages in critical specialties such as paediatrics and obstetrics, as well as a lack of physicians in remote areas.

While the government's plan enjoys public support, with approximately 76% of respondents favouring it regardless of political affiliation, critics accuse President Yoon Suk Yeol's administration of insufficient consultation and picking a fight ahead of parliamentary elections in April. This situation echoes past events in 2020, when President Yoon's predecessor, Moon Jae-in, abandoned a similar plan to boost doctor numbers after a strike by trainee doctors coincided with a wave of coronavirus infections.

Despite the government's announcement of pay and condition improvements for trainee medics and a review of continuous 36-hour shifts, the concessions have failed to appease the disgruntled doctors. Calls for negotiation between the two parties are intensifying, with critics arguing that the conservative president, Yoon Suk Yeol, is exploiting medical reforms for political gain ahead of the national assembly elections.