Pediatricians are already in short supply... Concerns that "search and seizure fallout will wipe out specialists"

As concerns mount that the police search and seizure of the pediatric emergency center at Ajou University Hospital on the 30th of last month will trigger a mass exodus of pediatricians, it was revealed that three out of four national pediatric and adolescent hospitals responsible for secondary care already face a shortage of physicians.

On the 10th, the Korea Pediatric and Adolescent Hospital Association held an "Emergency Press Conference on Medical Workforce Status at Pediatric and Adolescent Hospitals" at the Westin Seoul Parnas in Samsung-dong, Seoul, revealing that 74.6% responded that current staffing is "insufficient" compared to the number of pediatric specialists needed to maintain current care levels, three times the 25.4% who said it was "sufficient."

This survey analyzed responses from 71 hospitals (22 in the metropolitan area, 12 in Chungcheong region, 22 in Yeongnam region, and 15 in Honam region) out of approximately 120 national pediatric and adolescent hospitals that participated in the survey conducted by the association from September 29 to October 4.

When asked about "reasons for being unable to fill physician positions" (multiple responses allowed), among the 53rd hospitals that answered "insufficient," the most common response was "lack of applicants" at 86.8%. This was followed by "applicants are reluctant to work nights, holidays, or inpatient shifts" (71.7%) and "difficult to afford salaries demanded by applicants" (58.5%).

95.8% (68 hospitals) had attempted to recruit pediatric specialists within the last three years. Among these, only 19 hospitals (27.9%) succeeded in hiring within six months. 27.9% took between six months and one year, 11.8% took more than one year, and a staggering 32.4% have yet to hire anyone. Thus, 72.1% of hospitals that attempted recruitment either took more than six months or still have not filled the position.

57.7% of hospitals reported that salaries per pediatric specialist had risen by more than 30% over the past five years. In particular, 33.8% saw increases of 30-50%, and 19.7% saw increases of 50-100%. Even 4.2% reported salary hikes exceeding 100%. Conversely, only 36.6% saw increases of 10-30%, and just 5.6% reported salaries remaining similar or decreasing.

The average weekly working hours (including on-call duties) for employed specialists were most commonly 40-52 hours at 52.1%, followed by less than 40 hours at 36.6%, and 53-60 hours at 11.3%.

For Ban Myeon (CEO) chief physicians, 43.7% worked more than 52 hours a week (26.8% for 53-60 hours, 7% for 61-70 hours, and 9.9% for over 70 hours). Compared to the 11.3% of employed physicians working over 52 hours, this suggests that Gong Baek-eul (CEO) chief physicians are directly filling gaps left by unfilled recruitment positions.

In fact, when asked about reasons (multiple responses allowed) among the 31st hospitals where staff work more than 52 hours, "to maintain night, holiday, and inpatient care" was cited by 96.8%, while "staff shortages due to inability to hire specialists" was cited by 64.5%.

60.6% (43 hospitals) reported having reduced or halted care due to specialist shortages within the last three years (multiple responses allowed). The most common reduction was in night care at 33.8%, followed by shortened outpatient hours at 29.6%, reduced or halted holiday care at 28.2%, reduced inpatient beds at 23.9%, and returning designation or abandoning applications for Moonlight Children's Hospitals at 7.0%. One hospital had completely stopped inpatient care.

If current staffing and recruitment conditions continue, the period during which current care (including night, holiday, and inpatient services) can be maintained was most commonly cited as less than two years at 28.2%, followed by less than two to four years at 23.9%. Thus, 52.1% of responding hospitals believe they cannot maintain current care levels within four years. Other responses included less than four to six years at 15.5%, less than six to ten years at 7%, more than ten years at 2.8%, and "difficult to judge" at 22.5%.

The age distribution of the 313th full-time pediatric specialists at responding hospitals was: 34.5% in their 40s, 31.6% in their 50s, 16.6% in their 60s, 16.0% in their 30s, and 1.3% aged 70 or older. There are fewer specialists in their 30s (50) than those aged 60 or older (56). Among chief physicians, the distribution was: 38.0% in their 50s, 29.6% in their 40s, 28.2% in their 60s, 2.8% aged 70 or older, and 1.4% in their 30s, with those aged 60 or older accounting for 31%.

The number of pediatric specialists, including chief physicians, was most commonly 4-6 at 49.3%, followed by 7-9 at 25.4%, 1-3 at 14.1%, and 10 or more at 11.3%.

Based on this survey, the association requested the government to: △provide separate compensation for pediatric and adolescent hospitals maintaining night, holiday, and inpatient care; △establish legal safeguards against medical malpractice incidents occurring during pediatric treatment; and △set nursing staff standards and provide support reflecting the nursing needs of pediatric wards.

Choi Yong-jae, Chairman of the Korea Pediatric and Adolescent Hospital Association, stated, "I believe that the avoidance of pediatrics by residents following the infant death incident at Ewha Womons University Mokdong Hospital has led to recruitment difficulties for specialists at pediatric and adolescent hospitals," adding, "We are concerned that this trend may accelerate further due to the search and seizure of the pediatric emergency center in September."

He continued, "Pediatric and adolescent hospitals are struggling to fulfill their role and responsibility as the backbone of pediatric healthcare, but as this survey shows, reality is not easy," warning, "If the government delays any further in establishing institutional safeguards and support measures, regional essential pediatric care will soon lose its function."

Han Dong-kyun, Academic Director (Director of Mirae Children's Hospital in Nam-gu, Gwangju), who attended the event, said, "It is difficult to hire not only pediatric specialists but also nurses due to burdens such as complaints from guardians; this is the current state of medical institutional investors in pediatrics," adding, "Given numerous difficulties including accumulated fatigue among existing medical staff and management pressure from rising labor costs, we earnestly hope the government will take active steps to protect regional essential pediatric care."