Korean doctors spent an average of 4.2 minutes per patient in 2014, compared with the average of 26 minutes for U.S. doctors, indicating why it is difficult in this country to build a doctor-patient relationship.
It is a small surprise then trust in healthcare professionals is deemed low in Korea, ranked 20th out of 29 countries. “Patients question whether the doctor is treating me for my health or his living,” said Lee Sang-mu, a researcher at Health Insurance Review and Assessment Service.
This is less than desirable at a time when patient-based treatment is the buzzword in global medical communities. Doctors are moving from disease-based treatment to patient-based treatment, founded on scientific evidence.
A case in point is the U.K.’s National Institute for Health Research (NIHR), a research organization that is patient-oriented. The research group finds clinical studies that would benefit the patient directly, according to Professor Tom Walley, director of NIHR.
“It is tax-funded, not insurance-funded like the Korean system,” Walley said while speaking at the annual conference of the National Evidence-based Healthcare Collaboration Agency (NECA), held at Kyobo Building in Gwanghwamun, Seoul, Friday. “Because it is tax-funded, we have a responsibility to the public.”
|Professor Tom Walley, director of the U.K. National Institute for Health Research, talks about patient-oriented healthcare, during a conference in Seoul Friday.|
Walley said NIHR’s services are equally disseminated throughout the country so unlike Koreans, people in the U.K. go to a clinic near them, instead of traveling far distances.
“Of course, there are problems with our system– it is under constant stress, and we do not have enough hospital beds at certain times, mainly because the government does not provide the money,” he said. “However, the NHIR is a “need-led, science-added” organization where the patient is involved in every step of the trial, from patient involvement as co-applications, setting the question, evaluating the importance of the issue, and interpreting and disseminating the results.”
Walley stressed that his organization’s research benefits the patients, and does not have the objecting of advancing the frontiers of science. In other words, NHIR focus on what patients need, citing the example of “tranexamic acid,” an off-patent drug for preventing death by blood loss.
“We focus on areas that other bodies, such as pharmaceutical companies, have no interest in, such as off-patent drugs,” the professor said. “Our research found that tranexamic acid, which costs almost nothing, reduced chances of dying by blood loss by 10 percent, which is an incredible finding.”
However, like other all research all around the world, not all studies have positive results. “NIHR publishes 98 percent of its studies, meaning we publish researches that have even negative results,” Walley said.
Korea set up National Health Clinical Research Program (NHCR) in August 2015, aimed to replicate NIHR by investing $25 million. Their purpose is to strengthen evidence-based health care system by upgrading government-initiated clinical research, practical use of research evidence, and strong coordination of national clinic research.
However, trust is a big issue in Korean medicine.
Professor Michael Calnan who teaches at the University of Kent stressed the importance of trust in healthcare.
“U.K.’s National Institute for Health and Care Excellence published results that NICE committee members, who approve or disqualify expensive medication, faced uncertainty in the decision-making process when rationing them,” he said. “Drug makers have profit motives, patients have health motives, and clinical experts’ have other motives that influence interpersonal trust levels with committee members. Committee members are swayed in the decision process by people and emotion, making the process far from neutral.”
Professor Calnan reemphasized the importance of trust within healthcare. “Trust can make or break medicine,” he said.
Commenting on the development of Korea’s NHCR, Professor Wallen said, “It’s too early to say - it would take five to 10 years for progress.”
Stressing the need to make persistent, long-term efforts and funding for the NHCR for its success, Walley said, “Leadership is key to get these kinds of organization started.”
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