Koreans are being turned away from emergency rooms, sent to small hospitals unable to treat them

Posted on : 2024-02-23 17:57 KST Modified on : 2024-02-23 17:57 KST
Those seeking care at emergency rooms are being redirected to smaller general hospitals and local medical centers, many of which are ill-equipped to perform the types of treatments suddenly required of them
Patients in wheelchairs are helped into cars outside of a university hospital in Seoul on Feb. 21, 2024. (Shin So-young/The Hankyoreh)
Patients in wheelchairs are helped into cars outside of a university hospital in Seoul on Feb. 21, 2024. (Shin So-young/The Hankyoreh)

On Thursday, 51-year-old Seoulite Park Yeong-hee rushed to Severance Hospital’s emergency room with her mother, who was suffering from sudden severe abdominal pain and bleeding.
Yet upon her arrival, she was informed that only cancer patients who had been receiving prior treatment were being seen. She consequently set off with her mother to the emergency room at Dongshin Hospital, a nearby hospital equipped with 200 beds.
“The doctor she saw at a hospital in our neighborhood advised that we go to a bigger hospital since there was a cyst on my mother’s ovary and that her stomach was full of something, so we went to Severance only to not even be seen by a doctor,” Park told the Hankyoreh. 
“Normally, they’d treat patients with symptoms as severe as these, but since they only have one doctor in charge of around 20 to 30 patients, they said they lack the resources,” she added.
As such, they went to Dongshin Hospital’s emergency room, but there they were only able to run a CT scan and nothing more.
“Even if they caught the cyst, the hospital said they’re unable to do anything about it. I don’t know what we’re supposed to do at this point,” Park said, exasperated.
The emergency rooms at major hospitals in Seoul are facing considerable disruptions in care after thousands of medical interns and residents left their workstations in opposition to the government’s plans to raise the cap on admissions at South Korean medical schools by 2,000 per year for the next five years.
Patients who are unable to receive treatment at university hospitals are heading to general hospitals, which are required to have 100 or more hospital beds and operate more than seven or eight departments. 
However, there are concerns that a prolonged clash between the government and doctors will only hurt patients, as the government has neglected support for general hospitals and local public medical centers, which act as bridges between smaller local clinics and larger hospitals.
According to the emergency medical care portal site operated by the National Emergency Medical Center, as of 3 pm on Thursday, 114 out of 409 emergency health care centers nationwide posted notifications that understaffing was preventing them from accepting patients seeking treatment for eye or pediatric conditions, among others. Such notifications are passed on to paramedics tasked with transporting patients.
The disruptions in urgent care are mainly happening at large hospitals, showing that the higher the proportion of medical interns and residents in a hospital’s workforce, the greater the impact of the en masse resignations.

In particular, Severance Hospital — known to have a greater percentage of interns and residents on staff than other major hospitals — has halted emergency procedures for 10 conditions, including emergency ophthalmic surgery, emergency endoscopies, and gastric obstruction in newborns and infants. Kyung Hee University Medical Center has also said that it can no longer provide emergency care in its plastic surgery, pediatrics and urology departments. 

The majority of these hospitals cite a lack of staff as the reason for turning away patients seeking urgent or emergency care. Konkuk University Medical Center has said that “the absence of interns and residents in the pediatrics department has made it difficult to accept some pediatric patients with severe symptoms,” and asked that the public contact the hospital before transporting patients, including those experiencing severe respiratory failure.

The government has put forth measures in which major hospitals facing staffing shortages are to focus on critical and emergency surgeries, and send patients in stable condition to hospitals in the surrounding area. However, there are concerns that this measure will be untenable if there continues to be disruptions in care at major hospitals. 

While hospital fellows and attending physicians are rotating to fill in for residents and interns in the emergency rooms of major hospitals, the longer that these trainee doctors are out of office, the more fatigued their replacements will become, inevitably exacerbating the interruptions in care. 

Moreover, general hospitals and public medical centers run by local governments have a harder time treating critical or emergency patients who had once been seen by major hospitals. 

“For patients that once were directed to major hospitals to now be dispersed, general hospitals and local public medical centers need to have the capacity to provide basic surgeries in a variety of areas, excepting critical conditions like cancer or trauma,” said Jeong Hyeong-jun, the head of policy at the Association of Physicians for Humanism. 

“The reality is that, over time, these types of hospitals have seen a decline in their capacity to provide such care, and more patients are flocking to major hospitals,” he added. 

By Cheon Ho-sung, staff reporter; Goh Gyoung-ju, staff reporter; Lim Jae-hee, staff reporter

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