Although about 10,000 residents left the group last February and have not returned, it was confirmed on the 23rd that the average number of inpatient patients in large hospitals has recently recovered to 70-90% of the level before the strike. The analysis is that this is the result of the government’s recent legalization of over 10,000 ‘PA (Physician Assistant) nurses’ to fill the gap in the specialty that has left, and at the same time, ‘crisis patients’ who can no longer postpone surgery are beginning to flock. Patient groups said, “Recently, the number of complaints complaining of pain due to delayed surgery and hospitalization has decreased significantly.”
According to the Ministry of Health and Welfare, the average number of hospitalized patients at 47 general hospitals across the country at the beginning of last month was 63% of the level before the resident group left. Afterwards, from the 15th to the 19th of this month, the figure rose to 70% of what it was before the strike. The number of patients hospitalized in general hospitals with more than 100 beds (including tertiary general hospitals) also increased by about 6% from 83,549 to 88,279 during the same period. This is 92% of the level before the group of majors left. This means that the patient capacity of large hospitals, which had drastically reduced the number of surgical and hospitalization patients by 30 to 50 percent due to a shortage of doctors, has increased noticeably even though residents have not returned. However, the so-called ‘Big 5 hospitals’ in charge of intensive care remain at around 60%. This is because the ratio of medical residents at these hospitals was particularly high, at about half.
The government and medical community cite the introduction of PA nurses as the main reason for the increase in patients hospitalized in large hospitals. According to the Ministry of Health and Welfare, as of the 12th, 11,388 PA nurses are working at 387 general hospitals nationwide, including high-level general hospitals. PA nurses who have assisted in surgeries have been on the border between illegal and legal. According to medical law, patient treatment and treatment must, in principle, be performed by a doctor. Nurses can only perform some auxiliary tasks under doctor’s orders. However, due to a shortage of doctors in large hospitals, PA nurses often took over the work of residents, such as arterial blood collection, blood tests, and electrocardiogram examinations.
Accordingly, in order to fill the gap in medical residents, the government allowed PA nurses at the end of February to perform some doctor duties (administration of emergency medication, blood collection, etc.) until residents return. A government official said, “PA nurses have become quite established in the field of non-emergency surgeries and hospitalizations.”
As the situation improves somewhat, the number of emergency patients and critically ill ‘crisis patients’ whose surgeries have been postponed is increasing. Hospitals are also moving forward with surgeries that were postponed at the beginning of the strike. Person A, who was diagnosed with breast cancer at the end of February, was originally scheduled to undergo surgery at a general hospital in Gangnam on the 9th of next month. However, on the 18th, I received a call from the hospital saying, “The surgery can be postponed to the 24th of this month.” Mr. A said, “I am thankful that I was able to receive surgery quickly.”
Recently, there has been a clear movement of full-time doctors (specialists specializing in specialties) from large hospitals to return. When residents left en masse at the end of February, the proportion of 2,741 full-time doctors at 100 large hospitals who had contracts to continue working at the hospital was in the low 30% range. However, as of the 19th, the full-time contract rate rose to 55.9%. The contract rate of the ‘Big 5’, which are very large hospitals, reached 58.1%. The prevailing observation is that full-time doctors who sympathized with the departure of residents are returning one after another as the strike continues.
It is said that some medical residents are also returning. Officials at large hospitals said, “The majority of residents are in the position of ‘I will take a year off even if I face legal punishment,’ but there are also quite a few residents who feel burdened by taking more time off.” After the 30th of this month, when each university confirms the number of medical school students for next year, the increase in medical school numbers is confirmed and cannot be reversed. The burden on the government will increase, but residents and medical students will also have nothing to gain. After the medical school quota is confirmed, there is a possibility that the number of residents who are unable to rest due to personal reasons will increase.
Amid these changes in the field, some are concerned that medical groups are still refusing to engage in dialogue with the government, demanding only ‘abolishment of the number of medical schools.’ If the medical strike is prolonged while empty-handed, some residents and medical students may begin to return, and the possibility that there will be cracks in the ‘unified structure’ of the medical community cannot be ruled out. “Although it is imperfect, large hospitals can operate at a certain level, and only the striking doctors may be in a lonely position, receiving public criticism” (Professor at Severance Hospital).
