Busan Medical Center reinvents itself to regain public trust and stay competitive

Regional medical centers are the last bastion of public healthcare. However, the reality is dire. Despite their dedication to responding to the Covid-19 pandemic, all that remains is debt and distrust. They have even been labeled as “hospitals that no one wants to visit.”

Kim Hui-taek, director of Busan Medical Center, has faced this reality head-on over the past three years. He said that for regional medical centers to survive, “we must change completely.” That also explains why he has been committed to improving the hospital's quality of care, revenue structure, wage system, and organizational culture.

As he concludes his three-year term and leaves Busan Medical Center in August, Director Kim emphasized that “to survive, regional medical centers must be hospitals that are essential to citizens,” in an interview with Korea Biomedical Review.

The starting point is 'medical quality' for public hospitals, true to their name

Director Kim said that regional medical centers must regain the trust of citizens to fulfill their role. And the starting point for that trust is “medical quality.” Patients must be provided with a different experience from their previous hospital visits.

“No one knows the brand power of Busan Medical Center performs as a public medical institution. Unfortunately, public medical institutions are not recognized even when they perform well. However, if we provide good treatment, citizens will return to the hospital. I believe that is the unique brand of Busan Medical Center.”

Busan Medical Center is located in Sajik-dong, Dongnae-gu, Busan, a densely populated urban area with a population of about 50,000. It is an “inner-city medical center” surrounded by general hospitals and clinics. The public hospital is in a structure that cannot avoid competition with private medical institutions in terms of medical standards. That explains why Director Kim has focused on improving medical quality, enhancing services, and strengthening treatment capabilities.

“Now is the time when we must compete not only with other public hospitals but also with private hospitals. Although we receive some support from central and local governments, public medical centers must strive for financial independence. Ultimately, by providing essential medical care well, we can achieve both public interest and profitability.”

Innovating personnel systems is a must to retain excellent workforce

One of the key factors determining medical quality is the quality of the medical staff. However, following the Covid-19 pandemic and the ensuing government-doctor conflict, regional medical centers have faced severe staff shortages and recruitment difficulties. Wages have stagnated, and management conditions are challenging. Lower salaries and poor working conditions, compared to those in private hospitals, are major obstacles to attracting talent.

“We upgraded equipment for treating cerebrovascular diseases, but due to the continuous staff exodus during the Covid-19 pandemic, we couldn’t use it. The government-physician conflict that followed made it difficult to properly treat patients with conditions like cerebral hemorrhage or heart problems. This ultimately led to a weakening of medical functions,” Kim said.

With 25 doctors leaving, a decline in medical functions became inevitable. Director Kim identified the root cause as the hospital’s personnel system and implemented reforms. He also improved the salary structure.

“We invested the time it would have taken to write two or three papers to create a new salary system. We also expanded the annual salary negotiations from once a year to twice a year, in February and August. The principle is to support and nurture personnel who provide quality medical care and generate medical revenue,” Director Kim explained.

The bed occupancy rate, which had hit rock bottom during the Covid-19 pandemic, has also begun to recover. The bed occupancy rate, which was at 40 percent in November last year, rose above 50 percent in July. Medical revenue is also increasing.

Director Kim also sought external changes to capitalize on the hospital's characteristics as an “inner-city medical center.”

He paid attention to even the smallest details to improve accessibility for citizens and raise their awareness of the Busan Medical Center. A crosswalk was installed at the bus stop in front of the medical center, and the hospital used the name “BMC” along with its old name, Busan Public Hospital, to shed the image of an “old public hospital” and restore its identity as an urban medical center. It was a project that began with the mindset of “Let's try everything we can.”

Pushing to build a children's hospital to improve pediatric healthcare delivery

Strategies to differentiate the Busan Medical Center were also devised. Kim, who is a pediatric orthopedic surgeon, continued to see patients while serving as the hospital’s head, performing up to seven pediatric surgeries a day. The number of pediatric rehabilitation patients visiting the medical center also increased.

Currently, Busan Medical Center is constructing a 50-bed children's hospital. The goal is to establish an intermediate hub hospital that can accommodate patients with mild to moderate cases. The hospital also announced plans to collaborate with nearby tertiary hospitals' pediatric units to enhance the regional pediatric medical care system.

“When patients come to Busan Medical Center, there should be an area where they can find a solution to their condition. We already have a cardiovascular center, a gastrointestinal center, a respiratory center, and a rehabilitation center. If we can add pediatric care capabilities, the medical center's competitiveness and recognition will increase,” Kim emphasized.

Becoming a Busan Medical Center that citizens seek out

Director Kim cited “changing the outdated mindset of internal members” as the most difficult challenge over the past three years. He believed that the mindset of “existence itself is the purpose” would make it difficult to be chosen by citizens. He emphasized that citizens need a regional medical center that is “truly necessary.” He believes that a medical center cannot survive simply by maintaining beds, but must be a hospital that citizens choose and trust.

He found the key to the survival of regional medical centers in “trust.” “Twenty-five doctors have joined Busan Medical Center, and our medical capabilities have been strengthened. Our equipment and facilities have also been upgraded to Grade A through a national functional enhancement project. Ultimately, only when citizens trust and visit Busan Medical Center do we have a reason to exist as a public medical center,” Kim said.

Director Kim will conclude his three-year term and leave Busan Medical Center at the end of August. However, he stated that the hospital's innovation is still in its infancy. The direction he proposed for innovation is clear: public hospitals must also demonstrate competence and adopt an attitude that earns the trust of citizens.

“We cannot rely solely on the name ‘public.’ A hospital chosen by citizens is the future of Busan Medical Center,” Kim concluded.