Korean Doctors Warn New Law Could Cripple Emergency Medical system
A recently enacted law intended to address “emergency room hit and run” cases is facing fierce opposition from Korean emergency physicians,who fear it will overwhelm hospitals and ultimately compromise patient care. Teh legislation, formally an amendment to the Emergency Medical Services Act, has sparked a national debate over resource allocation, legal liability, and the appropriate use of emergency medical services.
The controversy centers on a change removing the requirement for 119 emergency services to confirm emergency room capacity before transporting patients. Under the new rules, hospitals are only required to notify a central center if they cannot accommodate a patient. Critics argue this effectively mandates “forced acceptance” of patients, nonetheless of available resources or staffing levels.
On Thursday, the Korean Association of Emergency Physicians (KAEP) held a press conference at the Korean Medical Association in Seoul to voice their concerns. “Even though accepting patients is a medical practice that requires professional judgment, they are trying to unconditionally force [accepting emergency room patients] for the sake of administrative convenience,” a representative from the KAEP stated.
The government approved the amendment at a Cabinet meeting on April 4th, aiming to streamline the process and ensure patients receive timely care. The revised law also requires emergency medical institutions to publicly disclose their staffing and capacity via a national network. However,the KAEP contends that similar measures implemented in the past have proven ineffective and that the current approach fails to address the root causes of emergency room congestion.
The Bottleneck Isn’t at the Hospital Doors
According to Lee Hyeong-min, president of the KAEP, the government is misdiagnosing the core problem. “the current bottleneck appears to be where 119 comes to the hospital, but in reality, the bottleneck is between emergency care and final care,” he explained. This refers to the difficulty in transitioning patients from initial emergency stabilization to definitive treatment and long-term care.
A significant factor contributing to this bottleneck is the legal risk faced by emergency medical staff regarding the outcome of final treatment. Physicians are hesitant to accept patients when they fear potential liability for complications arising from care beyond the scope of emergency stabilization.This creates a situation where emergency rooms are perceived as “not accepting patients that it can accept,” despite their willingness to provide initial life-saving interventions.
Priorities for a Sustainable System
The KAEP has outlined three key priorities for resolving the crisis: reducing legal risks for emergency physicians, alleviating overcrowding in emergency rooms, and improving infrastructure for final treatment, particularly in underserved areas.
Specifically, the association advocates for protecting emergency medical staff from legal repercussions in the absence of negligence, discouraging patients with minor ailments from utilizing emergency rooms at tertiary hospitals, and bolstering resources for comprehensive, follow-up care.
“we need a ‘barrier’ that can voluntarily reduce the use of emergency rooms by mildly ill patients,” Chairman Lee emphasized. He also noted that approximately half of patients transported by 119 present with non-emergency conditions,highlighting the need for better triage and a renewed focus on ensuring that 119 services are reserved for genuine emergencies.
Furthermore,Lee underscored the limitations of tertiary hospitals in providing definitive treatment. “We cannot always provide [definitive treatment] because we do not have the capacity to provide [definitive treatment] at tertiary hospitals with the ability to provide final treatment,” he stated, adding that expanding emergency room capacity is contingent upon investing in broader healthcare infrastructure.
The debate underscores a critical challenge facing healthcare systems globally: balancing access to emergency care with the sustainable allocation of resources and the protection of medical professionals. The outcome of this situation in Korea will likely serve as a case study for other nations grappling with similar issues.
