Essential medical collapse… Firework, low number, high risk and avoidance

A nurse came to the emergency room of Asan Hospital in Seoul on the 24th of last month.
He complained of severe headaches as a hospital.
A wide range of cerebral hemorrhage occurred and first aid was in progress, but surgical treatment …

A nurse came to the emergency room of Asan Hospital in Seoul on the 24th of last month. He complained of severe headaches as a hospital. A wide range of cerebral hemorrhage occurred and first aid was in progress, but surgical treatment was not performed. It was because of the absence of a professor in charge of surgical surgery. The nurse was later transferred to Seoul National University Hospital for surgery, but died six days later. Since then, Seoul Asan Hospital staff became known to the world with the incident in the office of the office.

Seoul Asan Hospital is classified as a big five hospital and is a senior general hospital where emergency patients are constantly transported. It is concerned that Korea’s essential medical system is collapsing over the fact that the treatment of a member of the original has not been done.

In some cases, a medical school garden increases are needed to solve the lack of doctors, but it is difficult to see as a fundamental solution. A number of experts say that if you only increase the number of intentions that are discharged without improving the chronic ills of our medical system, avoiding a certain medical system, the rich and poor phenomenon of popularity and avoidance cannot be improved.

Shin Hyun-young, a member of the Democratic Party, said, It is shocking that even Seoul Asan Hospital has a neurosurgery care system for cerebral hemorrhage emergency surgery. It’s a clear signal that a red light has entered the Korean doctor training system.

** ■ Supported by the major

The death of a nurse in Asan Hospital in Seoul shows how the reality is. Nevertheless, the problem of lack of doctors in charge of medical care has been continuously raised. According to the recruitment rate of professional subjects by Shin Hyun-young, submitted by the Ministry of Health and Welfare, ▲ 37.9% of thoracic surgery ▲ 76.1% for surgery ▲ 80.4% of obstetrics and gynecology. In particular, for pediatric adolescents, it was significantly lowered from 101.0%in 2018 to 28.1%this year.

In the last five years, the total amount of recruitment rate of the essential medical departments was found to be 57.7% of thoracic surgery, 67.3% of pediatric adolescents, and 79.0%. Given this, it is realistic to see a thoracic surgeon’s recruitment system as a collapse. The number of thoracic surgeons was reduced every year, only 20 last year. The recruitment rate of 20 thoracic surgeons a year has not changed in the last 10 years.

The bigger problem is that even after acquiring a specialist in the medical department, it is also intensifying to change to other medical departments. According to the 2016 national doctor’s survey, thoracic surgery 40.7%, surgery 12.8%, obstetrics and gynecology 10.6%, and 4.3% of emergency medicine.

The reason for avoiding the essential medical department is due to the lack of appropriate compensation for the hard work. First of all, emergency surgery, such as cerebrovascular disease, is characterized by a large number of emergency situations. For this reason, specialists and fellows with the relevant should be on an emergency waiting for one year. Nevertheless, there are few manpower themselves, so much of the number of people should be alternated and take a daily job. The Korean Medical Association explained that there are not many cases where a separate pay fee is not paid if the patient does not occur.

It is also one of the reasons for avoiding the risk of requiring emergency and high treatment difficulty due to essential medical treatment and characteristics. This is because it increases the possibility of medical accidents compared to other medical care.

According to a survey of thoracic surgeons commissioned by Gallup by the Korean Cardiovascular Surgery Society in 2019, thoracic surgeons worked 63.5 hours a week. I worked an average of 12.7 hours a day, and most of them worked on weekends, and the average number of duty days without an average holiday was 5.1 days. Waiting outside the hospital was 10.8 days a month. 51.7%of thoracic surgeons at the senior general hospitals and general hospitals are expected to burn out, and the possibility of patient risk is 93.7%.

Low medical prices are also pointed out as problems. For example, the cost of surgery related to brain disease is around 20% compared to Japan. Currently, the cost of medical water in Korea and the relative value score system will be set. However, as mentioned earlier, the medical community is common point that the medical price is too low considering the difficulty and risks.

For reference, the hourly labor cost of thoracic surgeon was 75,000 won per hour, which is 20%of the surgery fee of 1.5 million won.

In most cases, patient treatment is performed in the intensive care unit after thoracic surgery. The intensive care unit thoracic surgeon is in charge of treatment. The problem is that during the treatment of intensive care unit, there is an intensive care management fee for intensive care professional, but the thoracic surgeon management fee of thoracic surgeon who treats the intensive care unit after surgery is not calculated. Therefore, the thoracic surgeon is operated as a structure in which the patient is treated with a minimum wage level and treats the patient.

In relation to this, the Korean Stroke Middle School said, We must solve the problems of chronic reservoirs and lack of human resources.

■ It takes a significant time to get a fundamental solution

The government is also aware of this situation. President Yoon Seok-yeol promised to introduce the so-called essential medical national responsibility system in January, when he was a presidential candidate. At the time, President Yoon said, We will establish a separate public policy price. It will introduce the number of public policy prices in the treatment facility of severe trauma centers, delivery rooms, newborns, and senile diseases.

The Ministry of Health and Welfare also operated a essential medical council where the medical community participated, and recently established a dedicated organization for essential medical support. Lee Ki-il, the second vice minister of the Ministry of Welfare, said, We will expand the required medical personnel and related infrastructure.

An official from a medical community said, The problem of collapse of the essential medical department is not yesterday, today’s work, and is not limited to essential medical departments. It will take a considerable time until.

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