A shortage of paediatricians in South Korea is leaving hospitals unable to fill posts while raising risks for children’s health, doctors have said, claiming that the shortage is both a result of the world’s lowest birthrate and increasingly a factor behind it.
The number of paediatric clinics and hospitals in the capital, Seoul, has fallen by 12.5% over the five years to 2022, to just 456. Over the same period, the number of psychiatry clinics increased by 76.8%, while anaesthesiology centres saw a 41.2% rise, according to the Seoul Institute, a public administration thinktank.
At the root of the problem is a birthrate that fell to 0.78 in 2022 combined with the failure of the insurance system to adapt to it, leaving paediatrics starved of resources and doctors shunning a field they think has no future, seven paediatricians told the Reuters news agency.
The Ministry of Health and Welfare acknowledged “limitations” in the system and said measures were being implemented to address them.
According to ministry data, hospitals were only able to secure the services of 16.3% of the paediatricians they sought in the first half of this year, down from 97.4% in 2013.
For parents, the shortage can mean long waits for treatment for sick children.
“We had to wait two weeks,” said Lee Bo-mi, a 35-year-old mother with a sick 3-year-old boy, at the Healthy Children’s hospital in Seoul. “I was really scared. It felt like the sky was falling.”
Dr Song Dae-jin at Korea University Guro hospital said he worried that staff shortages could soon cripple his team’s ability to provide emergency care.
“At this rate, we won’t be able to last the year,” Song said. “It’s not a big deal if mild diseases are not seen for a day or two but the consequences of not seeing serious diseases or emergency patients in a timely manner can be devastating.”
In May, a five-year-old boy with a respiratory infection died after failing to find a hospital bed, provoking a public outcry.
“Patients dying while bouncing around multiple emergency rooms, dying when it’s not a serious disease, it’s a travesty,” said Dr Choi Yong-jae, vice-president of the Korea Children’s hospital Association.
Doctors say the low fee problem is particular to paediatrics as the insurance system hasn’t been revised to reflect fewer child patients. When more babies were growing up, paediatricians could sustain a low price, high volume model but that doesn’t apply now.
“In foreign countries, the government pays enough to maintain the hospital even if you see 20 patients a day,” said Dr Lim Hyun-taek, president of Korean Pediatric Association, who said fees had not been raised significantly for 30 years.
“But it’s about $10 per treatment in Korea so clinics have to see about 80 patients a day.”
By comparison, it costs about US$225 for an initial standard consultation with an Australian paediatrician, while observation at Nationwide Children’s hospital in the US costs $208 an hour, according to its website.
The health ministry said measures had been introduced this year on fees and insurance compensation to supplement “limitations”. It said it had proposed more state-backed centres and requirements for major hospitals to maintain emergency paediatric treatment.
“We understand that there are opinions from doctors saying it is not enough to cope with difficulties in the field. The government plans to steadily implement and continue to supplement the announced measures,” it said.
Data from the Health Insurance Review and Assessment Service shows paediatricians are South Korea’s lowest paid doctors, making 57% less than the average doctors salary.
Some Hospitals have responded to the shortage by cutting services.
Sowha hospital, South Korea’s oldest children’s hospital, recently suspended Saturday afternoon and Sunday treatment for the first time in 77 years due to a lack of staff.
Other hospitals have reduced night-time treatment and shut children’s emergency rooms.
The situation is so alarming that some couples say it is adding to their doubts about having babies despite government efforts to reverse the sliding birthrate with billions of dollars a year on childcare subsidies.
“I’m worried,” said Kim Eun-ji, the 34-year-old mother of a baby boy, referring to the prospect of a second child.
“If the number of children’s hospitals decreases and the number of doctors falls, it’s going to be difficult to get children treated.
