Children's health care crisis looms large in Korea

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Gov't urged to set up long-term policies to expand number of pediatric physicians

By Jun Ji-hye

Kim Ji-hye, the mother of a 13-month-old boy, was alarmed to find her son had a fever early Saturday morning.

As the new mother has learned, a fever could have a catastrophic impact on a baby. She rushed him to a nearby children's hospital in Seocho District in Seoul, only to find a long line of parents with their sick kids, 30 minutes before the hospital opened.

"There were more than 25 patients waiting for treatment just 15 minutes after the hospital opened," Kim said. "It was so hard to wait for my son's turn while standing up cradling the crying baby in my arms for more than an hour. I was also scared that my son's condition could worsen while having to wait for a long time to receive treatment."

Similar stories experienced by many other parents with sick children can be spotted easily on online communities amid a deepening shortage of medical facilities for children and pediatric physicians in the country.

The shortage is mainly attributed to a falling birthrate and a growing reluctance among medical students to specialize in pediatrics due to a heavy workload and low pay compared to other popular fields such as plastic surgery.

According to a Statistics Korea report issued, Wednesday, the country's total fertility rate, or the average number of children a woman bears in her lifetime, fell to 0.78 in 2022, which is the lowest level seen since 1970 when the agency began compiling related data.

Korea's fertility rate remained below one for five consecutive years. The country is the only member of the Organization for Economic Co-operation and Development (OECD) with a fertility rate lower than one.

The average total fertility rate of OECD members was 1.59 as of 2020.

While the falling birthrate has led to a reduction in demand for children's health care services, the pediatrics field has also waned in popularity among prospective physicians due to relatively low pay compared to the heavy workload.

According to data tallied by the Korean Pediatric Society, the number of young doctors who applied to be pediatric interns in 2023 stood only at 53 out of the 208 quota, accounting for just 25 percent.

The gap compared to other popular fields of medicine was large, as data tallied last year showed that the application rates of interns in rehabilitation medicine and plastic surgery stood at 202 percent and 180.6 percent, respectively.

What is worse is that the shortage of medical facilities for children and pediatric professionals is expected to worsen, as a falling number of young pediatricians remains a growing burden on those currently in the field, which also makes other prospective physicians reluctant to jump into the field.

Regions outside the Seoul metropolitan area face an even more serious shortage of children's doctors.

According to data provided by Rep. Lee Jong-seong of the ruling People Power Party, 48 out of 53 pediatric interns who were added in 2023 were concentrated in hospitals located in Seoul and surrounding Gyeonggi Province, while the addition to hospitals in 11 other cities and provinces in the country was 0.

The children's health care crisis caused by a shortage of physicians is a trend that started a while ago.

President Yoon Suk Yeol acknowledged that the crisis had been caused by the failure of the government's policies for years.

During his visit to Seoul National University Children's Hospital, Wednesday, the president said, "Doctors should not be blamed for their reluctance to apply for the field of pediatrics, but the government should."

On the same day, the Ministry of Health and Welfare announced a set of measures to improve the children's health care system, vowing to build four more public pediatric health centers to increase the number to 14 and to boost the number of emergency medical services for children to 12 from the current eight.

The ministry also promised to improve compensation for such services and push to improve the work environment for pediatric interns.

"We will try to reduce the workload of pediatric interns," said Lim In-taek, who oversees health care policies at the ministry.

But skepticism is rising over the effectiveness of the government's latest measures as the plans focused only on compensation to facilities and failed to include specific plans on how to increase the number of pediatric physicians in the long term.

Regarding this, a health ministry official said, "We will promptly address the issue with medical circles," falling short of quelling growing concerns over the possible collapse of the children's health care system.

Yim Jun, a professor at the University of Seoul Graduate School of Urban Health, noted that simply increasing compensation would not be very helpful, as the problem lies in the range of medical services in the pediatrics field declining for years due to falling birthrates.

"Long-term policies should be established either to expand public medical services or increase the number of medical schools to nurture pediatric personnel in each region," he said.