Large university hospitals have shown strong enthusiasm toward the government’s pilot program to extend doctors’ consultation time to 15 minutes from the usual three minutes, to improve their quality of medical care.

Officials from as many as 36 large hospitals attended the Ministry of Health and Welfare’s briefing on the “Pilot Project for In-depth Consultation at Tertiary Hospitals,” held at the Seoul office of the Health Insurance Review & Assessment Service on Sept. 21.

Higher-than-expected demand from the large hospitals prompted the ministry to consider increasing the number of participating hospitals for the pilot project from the initial plan of four.

The government’s program aims to improve the current medical service system where physicians are paid more for their consultation time and quality of care, instead of the number of patients they see. It devised the program based on exemplary cases, such as Seoul National University Hospital’s consultation system.

For severely ill patients and those with a rare disease, doctors can offer in-depth consultation for 15 minutes under the program.

Even state-run university hospitals, including SNUH, suffer chronic problems of doctors seeing patients for a too short amount of time. About 1,000 outpatients visit them per day, which translates into 20 patients per day for a physician to see. A patient’s consultation time with a doctor is usually between 3.8 and 8 minutes, on average.

To resolve the overcrowding issue at large hospitals, the government plans to implement the pilot project from November, which would guarantee a certain amount of medical payments for doctors. The program will allow large hospitals to reduce the number of outpatients and focus more on medical care for inpatients, government officials said.

However, the “15-minute consultation” program applies to only severely ill patients, patients with a rare disease or those with difficulty in diagnosis or treatment. Also, patients subject to the program are mainly those transferred to tertiary hospitals for in-depth treatment at the request of primary and secondary institutions.

The ministry said it would give as much autonomy as possible to participating hospitals, as the pilot program aims to set the definition of “in-depth consultation,” categorizing its types and setting the treatment cost. The government will select pilot hospitals after reviewing how hospitals choose patients for detailed consultation and checking what kind of service they provide.

The participating hospitals, to be selected later by the ministry, will also be able to refer patients back to the primary medical institution, in case the treatment at the tertiary hospital is completed.

“Although the program is for severely ill patients and patients with rare disease, who received the initial diagnosis at a tertiary hospital, we need to develop protocol on what kind of service the participating hospitals should provide,” said Cho Ja-jin, an official at the Ministry of Health and Welfare’s Health Insurance Benefits Division.

“The ‘15-minute consultation’ does not necessarily limit the time to 15 minutes. Some say it is still short for children. So, we will develop a medical payment model, after we find some solutions to differentiate the cost by the amount of consultation time, the types of patients and quality of care,” he added.

Thirteen doctors at SNUH currently are offering in-depth consultation as part of the hospital’s system. Except for surgery-related departments, departments, including pediatrics and internal medicine, established additional in-depth consultation sessions to offer such care on a designated day.

If a patient visits SNUH with a treatment request from the primary hospital, SNUH’s consultation support team makes a reservation for an in-depth consultation. The consultation time and the content are recorded separately. Its web-based treatment request system allows the patient to be transferred back to previous hospitals on completion of the treatment. They record all the procedures to make it easy to see the status of the entire in-depth consultations and how treatments are proceeding.

At the briefing, the ministry took SNUH’s case as a good example but stressed that other hospitals do not have to copy their system.

The ministry urged hospital officials to actively participate in the pilot program, saying it might increase the number of participating hospitals to meet the demand.

The ministry plans to recruit participating hospitals from Sept. 27 to Oct. 13 and select the final participants sometime around Oct. 20. Depending on the demand, it can seek additional participants later, officials said.

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