Korean doctors experience low self-satisfaction and burnout, as they cannot secure adequate treatment time due to low reimbursement, a report said. It called for raising medical fees to realistic levels and creating an environment that guarantees sufficient medical consultation.
The Research Institute for Healthcare Policy under the Korean Medical Association released the “Report on the analysis of doctor’s treatment time” on Wednesday. Based on the Korean Physician Survey (KPS) and OECD data, the report compared and analyzed the relationship between medical fees and the treatment environment.
According to KPS 2022, Korean doctors treated 39.7 first-time patients and 125.25 returning patients on average per week. The average treatment time was 11.81 minutes for first-time patients and 6.43 minutes for returning ones.
In the case of first-time patients, interviews accounted for the largest share of time (39.42 percent), followed by a physical checkup (23.2 percent) and writing medical records, and making prescriptions (13.72 percent). Time for consultation and education stood at 2.91 minutes, accounting for only 23.67 percent of total treatment time (11.81 minutes).
For returning patients, the share of consultation and education was slightly higher than first-timers, with 27.64 percent. Of the treatment time of 6.43 minutes, they spent 1.8 minutes on consultation and education. The shares of interviews and physical checkups were 35.05 percent and 22.49 percent.
As the number of patients per doctor increased, the treatment time decreased for first-time and returning patients. On the other hand, the longer the treatment time, the greater the doctors’ treatment satisfaction. Notably, increases in counseling and training raised treatment satisfaction and reduced doctors’ burnout. Moreover, the number of patients and the examination time were closely correlated with the level of medical fees. And this trend has been confirmed worldwide.
After analyzing OECD Health Statistics and other data, researchers confirmed that countries with low medical fees showed the largest number of per capita hospital visits and the largest number of patients a doctor must meet. And the shorter the treatment time, the higher the number of per capita hospital visits and patients one doctor has to see.
Low medical fees fixated on ‘3-minute treatment,’ producing violent patients
The researchers pointed out that doctors must increase the number of treatments due to low medical fees, curtailing treatment time per patient. In 2019, Korea had the largest number of patients per doctor in the OECD, with an average of 6,989 patients per year. It was more than three times higher than the OECD average of 2,122.
Therefore, Korea must create an environment for sufficient treatment by guaranteeing reasonable medical fees, the report said. In the short term, it called for lifting the in-depth treatment support, now in the pilot project stage, to a realistic level and expanding the targets of chronic disease management to surgical departments. It also maintained that additional fees be given to the treatment of patients who need more treatment time, including children, pregnant women, the elderly, and the physically challenged.
In the long run, it suggested introducing a system that differentially pays medical fees according to treatment time. To do this, they need to find the appropriate level of fees patients are willing to pay and doctors satisfactorily accept.
“Consultation is the most basic medical act in treatment. However, Korea has very low consulting fees, forcing doctors to adopt a ‘quick sales for low profit’ pattern, fixating ‘three-minute’ consulting, and deepening the distortion of the treatment system,” said Woo Bong-shik, the director of the institute. “That deepens distrust between doctors and patients, leading to the vicious circle of violence at consulting rooms.”
Woo added that he hoped the nation would create a desirable treatment environment where doctors can have sufficient time to provide treatment that can even care for patients’ minds and receive an optimal level of fees.