Profit-driven hospitals overschedule doctors

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Profit-driven hospitals overschedule doctors

A 38-year-old female patient from Yeongdeungpo District, western Seoul, didn’t seem satisfied with the doctor she had just seen when the JoongAng Ilbo met her at a university hospital in Seoul on March 27.

The woman, surnamed Park, visited the obstetrics clinic to receive test results after being told she could have uterine cancer two weeks earlier.

Park told the JoongAng Ilbo that she waited for more than an hour to see her physician, and once in the clinic room, he simply said that she did not have cancer and declined to answer questions. After just about one minute, the doctor gestured to the nurse, who escorted Park out.

“I may have to come back here again for further examinations, so I can’t complain,” Park said.

The doctor who saw Park had 152 patients that day from 9 a.m. to 3:30 p.m. To make sure that all scheduled patients could be seen, nurses put the medical records of each patient on computer monitors. After one or two minutes and a glance at the screen, the doctor moved on to the next appointment.

This type of situation is common at hospitals across the country as they welcome more and more outpatients because they generate more revenue.

At a separate location on April 2, the JoongAng Ilbo visited a cancer specialist at a major university hospital.

The oncologist saw a total of 153 patients during the day, and he asked aloud, “Should I treat each patient in 30 seconds?” For the first few dozen patients, the doctor spent nearly five minutes on each case. But as he got behind schedule, he soon spent less than a minute with each patient.

Money is the leading cause behind doctors’ crowded schedules.

Outpatients typically undergo more expensive tests compared to inpatients, making them more financially attractive to major hospitals.

This incentive structure has led to what some call “conveyor-belt treatment,” and it has become increasingly common at university hospitals in particular since they treat a high number of outpatients.

Some doctors at such hospitals have nearly 200 patients to cover each day.

“Close communication between patients and doctors is very important,” said Yu Seung-hum, chairman of the Korea Medical Assistance Foundation. “Today’s medical consultations are not conducted properly.”

Patients aren’t the only ones with complaints; doctors are worried, too.

“I wish I could spend at least 10 or 20 minutes with each patient, but doing so would jeopardize the hospital,” said an oncologist at a Seoul university hospital.

Doctors say that the problem is fueled by treatment fees that do not change based on the amount of time spent with a patient.

“Raising medical fees at major hospitals so that those with minor illnesses will be more likely to go to smaller local or specialized hospitals could be one option,” said an official at the Ministry of Health and Welfare.

Well-known hospitals are often more crowded than their lesser-known counterparts because patients feel their practitioners are more reliable.

“Patients flock to major hospitals because there is no way of knowing which doctors are qualified ones,” said Prof. Yoon Seok-jun of the department of preventive medicine at Korea University College of Medicine.

“Evaluating medical performance, disclosing service quality to the public and charging medical fees accordingly could help clear the backlog [at major hospitals].”

By Shin Sung-sik, Jang Joo-young [jkkang2@joongang.co.kr]

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