Incheon doctor warns telemedicine is leaving marginalized regions behind

As the framework for institutionalizing telemedicine takes shape, concerns within the medical community are growing that it is drifting further away from its original intent.

Critics argue that by focusing on “smart and wearable” technologies and prioritizing convenience and efficiency, accessibility is being increasingly sacrificed. From the perspective of regions with medical blind spots, this irony is even more pronounced.

Meeting with journalists last Thursday, Dr. Ham Jeong-sik, president of the Incheon Physicians’ Association and director of Dajunghan Internal Medicine, also raised the same issue while explaining the current state of medical care in the Incheon area.

In the Incheon area, there are medical blind spots centered around the Five West Sea Islands, where residents rely on medical services provided by hospital ships operated by local governments. The Five West Sea Islands refers to the five islands in the West Sea -- Yeonpyeongdo, Baengnyeongdo, Daecheongdo, Socheongdo and Soyeonpyeongdo -- that are close to North Korea. B y ferry is the only way to reach any of the five islands.

Recently, a patient with a cerebrovascular disease on Socheong Island, one of the five Islands, died due to delays in diagnosis and transportation.

“Therefore, it is impossible to deny the necessity of telemedicine in this region," Ham acknowledged.

The problem is the “lack of accessibility to telehealth.” Island areas have a high proportion of elderly households. Many residents struggle to use smartphones or video calls, let alone telemedicine applications or platforms. Their children live in other regions, and securing caregiving personnel is also challenging.

Asking these individuals to self-diagnose using wearable devices, access telemedicine platforms via smartphone apps, and accurately describe their symptoms to request necessary treatment without any assistance is an “unrealistic demand.” This is why doctors in the Incheon region are appealing for telephone consultations (rather than video calls) to be permitted.

Dr. Ham believes that village community centers or health clinics should be designated as “telemedicine hubs,” with a system in place that allows nursing and care staff to relay patient conditions and information.

However, telemedicine-related policies require medical institutions to install video consultation equipment and discuss the distribution of wearable devices.

Ham pointed out that telemedicine platforms are becoming a channel for “conveniently prescribing cosmetic, obesity, and hair loss treatments.” In reality, those who need telemedicine cannot even access it.

This irony is also evident in the controversy over the establishment of a public medical school, which has reignited with the inauguration of the Lee Jae Myung administration.

Incheon, along with South Jeolla Province and North Gyeongsang Province, is included in the regions where the president has promised to establish new medical schools. Incheon is a large city that forms part of the capital region, along with Seoul and Gyeonggi Province. It has three tertiary general hospitals, and university hospitals are competing to establish branch hospitals. However, when the topic turns to medical schools, Incheon is labeled a “city with weak medical infrastructure.” Nothing illustrates this better than local patients traveling to Seoul.

“Compared to patients from other regions who have to take the KTX bullet train for an entire day, patients in the Incheon area can reach Seoul in just a few dozen minutes by subway. Therefore, even patients with severe illnesses who could be adequately treated at tertiary hospitals in Incheon end up seeking care at larger hospitals in Seoul,” Ham pointed out.

In this way, a large city with a population of 3 million is considered a “provincial or rural area” when compared to Seoul. Some refer to Incheon as a medically alienated region. However, from the perspective of the local medical community, it is the regional medical system that is being “estranged by patients.”

Incheon is a dual-natured city, considered both part of the capital region and a provincial area. As a result, it is becoming a region marginalized both by the institution and patients,” Ham said. “As seen in Incheon's case, the government should reflect on whether the current direction of medical system development, including telemedicine, is growing abnormally by focusing solely on convenience.”