What is the profession of a physician?

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What is the profession of a physician?

 
Kang Hye-ryun
The author is an emeritus professor of Ewha Womans University and a member of the National Education Commission.

What does the profession of physician stand for in the 21st Century Korea? Educator Abraham Flexner, credited for shaping medical education in America in the 1900s, said the profession is “not just a program for building knowledge and skills in its recipients. […] It is also an experience which creates attitudes and expectations.” He argued that medical education should have a foothold in universities. He emphasized that physicians should be “culturally experienced” and possess humanistic skills to serve social good.

The mass resignation and walkout of trainee doctors beckons a reflection on the profession they worked hard to enter. Many wish to believe their actions stem from individual deviations. But they were following a well-organized collective action plan — deleting medical records and prescriptions, changing the password to the electronic files — upon handing in their resignations. And in blocking and hampering the treatment of patients, they have gone too far.

“Rent” refers to payments received in exchange for the temporary use of a good or property. Since land and labor are both intrinsic to productivity, the concept of “economic rent” can be applied to the money a worker receives. Suppose that I earn just 300 won ($0.23) per month in a work different from my job as a university professor, which pays 1,000 won. The difference of 700 won would be my economic rent, or extra money for choosing the career as a professor.

The proportion of an individual’s earnings for which economic rent accounts varies by profession. The greater the scarcity of the job, the larger the economic rent and income.

Popular musicians, professional athletes, doctors and lawyers are illustrative examples. Entertainers earn fame and money through their extraordinary individual talent. But the way licensed medical and law practitioners gain the advantage is different. They owe their higher economic rent to the government’s cap on enrollment in medical and law schools, which creates artificial scarcity in those fields. The fields, in turn, vehemently oppose moves to increase the supply of medical and legal professionals.

According to the National Tax Service, medical professionals’ annual income averaged 269 million won in 2021, up 55.5 percent from 173 million won in 2014 when the agency began tallying profession-specific income. The annual income of lawyers during the same period rose just 12.7 percent from 102 million won to 115 million won. The income gap between medical doctors and law practitioners widened by 150 million won with doctors earning 2.5 times more than lawyers did over the past seven-year period.

Korean doctors are the highest paid among developed countries with their annual income averaging at $192,749 in 2020, according to OECD data from 2023. Specialty doctors who opened their own clinics earn 6.8 times more than average salaried worker in Korea did, showing the widest gap among OECD members.

The relatively high income of Korean doctors appears to pertain to their numbers. Korea has 2.6 doctors per 1,000 people, far below the OECD average of 3.7 per 1,000.

The income of lawyers stagnated after law schools were institutionalized in 2009. The number of licensed lawyers, after graduating from law schools that numbered 1,500 in the early period, has risen to 1,700.

The number of lawyers registered with the Korean Bar Association has jumped to 30,000 from 10,000 in 2010. Lawyer groups also have been lobbying to cap the issuance of licenses at 1,200, but the Justice Ministry determines the successful candidates within more than 75 percent of the annual law school enrollment of 2,000.

A former head of the Korean Medical Association recently proclaimed online that the government cannot beat its doctors. The comment implies that medical practitioners are an elite group is above the rest. That bravado has shone through in doctors’ collective action against many government moves that they oppose, including the division of medicine, introduction of telemedicine and medical school quota increase during Covid-19.

I personally want to see the scarcity in the medical profession eased and the quota increased for medical schools across the country. I hope the waning popularity of medical schools can funnel more of the highest brainpower to tech and science field for the balanced advancement of the country. I hope to see physicians relinquish some of their rents from their privileged profession to earn respect and appreciation from the people.

Translation by the Korea JoongAng Daily staff.
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