Care for the underprivileged firstDebate about telemedicine services began in 2002. The medical service law was revised then to restrict telemedicine technology applications to information sharing and video conferencing among doctors via the Internet. If health care and treatment is extended to patients via the web, illicit consulting, prescriptions and care over cyberspace could become rampant and cause legal disputes over medical bills and questionable treatment.
The government’s proposed electronic health care service program is more problematic. Although it has not officially unveiled the bill, the program includes remote e-health care for patients with chronic illnesses and those requiring post-surgical care, according to media reports. The bill also permits first-time patients to apply for clinical service without visiting hospitals and could trigger ceaseless and unnecessary rivalries among large hospitals and local clinics over certain patients.
Telemedicine technology that can help improve access to medical services to people living in faraway areas are widely performed in large-scale countries like the United States and Canada, and island countries like Finland that suffer distance barriers. They are optional and supplementary in countries with restricted and lesser accessibility to hospital care and treatment. But South Korea boasts one of the highest accessibility to doctors among the member countries of the Organization of Economic Cooperation and Development. The number of doctors per square kilometer of land is 0.98, compared with 0.01 in Canada, 0.06 in Norway, 0.08 in the United States and 0.75 in Japan. What use are remote medical services in a country where there are doctors around every corner?
The government argues the program will be helpful to senior patients who cannot move well, first-time patients in distant rural areas and patients with chronic diseases. But the guidelines for defining those people is ambiguous. The eligible patients are mostly the underprivileged, who require face-to-face treatment for precise check-ups, prescriptions, care and recovery. Instead of studying remote medical services, health authorities should try to improve the medical system to offer better services to underprivileged patients. Clinics in the region would be best qualified to provide optimal care for these patients.
If telemedicine services are provided, patients will prefer large, well-known hospital brands due to a general lack of information on medical and hospital services. Large and well-funded hospitals should focus primarily on research for critical diseases but could turn attention to profit-making through cost-saving electronic long-distance services. Local clinics and hospitals in provincial areas will be hurt. Long-distance health care that aimed to reinforce accessibility to medical services will only aggravate the imbalance in medical care, hike health care costs and worsen financial deficits in the public health insurance scheme.
In principle, doctors welcome widespread use of monitoring and consultation through telecommunications and IT technologies. But remote medical programs will do more harm than good in upgrading health care. Some argue that the electronic medical device industry will be vitalized by the legalization of remote health care system for patients. But there are just a few industries that will benefit. This is because patients will always prefer face-to-face treatment over talking to doctors on a computer screen. The medical value from long-distance diagnosis can never replace direct examination.
We hope the government will come up with a better cutting-edge medical service program that could best satisfy its goal, technologies, security and financial effects, the interests of patients and medical suppliers.
Translation by the Korea JoongAng Daily staff.
*The author is a spokesman for the Korea Medical Association.
By Song Hyung-kon