[Editorial] Shortage of pediatric doctors

A medical conference was held at a hotel in Seoul on Sunday, drawing some 800 participants. But the conference was not a usual one, as the topic focused on “ways to get out of the pediatric department.”

At the conference, participants, including pediatric doctors, listened to lectures on popular medical services such as Botox injections, beauty treatments and tips on handling adult patients with chronic diseases.

The conference reflects the sad reality of South Korea’s distorted medical system. Although the overall medical system and health insurance infrastructure are well established, doctors and medical school students have long held a preference towards certain medical fields and well-connected locations in and around metropolitan areas, moving away from more demanding disciplines and jobs in rural areas.

The country’s lopsided medical system has resulted in a lack of doctors specializing in pediatrics, a field where many of the existing doctors want to quit and shift to more lucrative sectors.

News media outlets often report cases of desperate parents with sick children, scrambling to find emergency rooms, only to be rejected by hospitals because there is no pediatric doctor on duty.

On May 6, a five-year-old boy died helplessly after trying to find emergency care in Seoul. Ambulance workers brought the child to four different hospitals, all of which turned him away, saying they had no beds and that they could not treat him because of the lack of pediatric doctors. At the fifth hospital, the boy was eventually seen to, but was sent home as the parents’ request for hospitalization was denied. But the next day, the child died shortly after being taken to an emergency room.

The hospital where the child was treated reportedly said the number of its pediatric doctors went down from 12 to 3, which made it difficult to run an emergency care service for children.

The drastic shrinking of pediatric departments is affecting a number of hospitals across the nation. Over the past five years, 662 pediatric clinics have closed. Due to the severe shortage, even patients living in Seoul have to wait for three to four hours to see a pediatric doctor. The situation is far worse in rural regions where pediatric doctors are hard to find.

On June 9, a group of pediatric hospitals announced they would shorten their business hours on the weekend and at night, citing the lack of doctors. Such cuts in business hours are inevitable, since pediatric doctors are now required to work for 78 hours per week on average due to the shortage of their peers.

The problem is that a growing number of medical school students are shunning pediatrics. This year, pediatric departments at medical schools filled only 16.6 percent of their available seats, a disheartening shortfall compared with 80 percent in 2019. Even top-notch hospitals are struggling to find enough pediatric doctors.

The main reason for the dire shortage of pediatric doctors lies in the comparatively low salary due to the medical insurance system that sets the treatment and drug prices at low levels compared to other departments. In addition, the pediatrics field does not offer as many treatment options that are not covered by state health insurance as other fields, a longstanding structure which translates to lower income for pediatric doctors.

According to the Health Ministry, the annual income for pediatric doctors stood at 108.75 million won ($85,350) on average as of 2020, less than half of the average income for doctors in general, which was 230 million won.

A positive development is that the government and medical representatives recently held a council to start exploring ways to increase the medical school quota, which has been frozen at 3,058 since 2006.

The government has repeatedly tried to increase the enrollment quota, but failed to do so because the Korea Medical Association, which represents doctors and medical school students, fiercely opposed any increase.

It will take time to negotiate a shift in the enrollment quota. In the short term, health authorities have to implement financial incentives and adjust the health insurance system to help hospitals recruit more pediatric doctors. There should be no more cases in which a child's health and life are put in danger due to the shortage of pediatric doctors.