75% of pediatric hospitals report doctor shortages as police raid deepens avoidance fears

Growing backlash from the medical community over a police search and seizure at Ajou University Hospital's pediatric emergency room has raised fears that an already severe shortage of pediatric specialists will worsen. Doctors warn that if incidents like this repeat — following the earlier case in which medical staff at Ewha Womans University Mokdong Hospital were detained over a newborn death and later acquitted — the staffing crisis in essential pediatric care will accelerate.

According to a survey by the Korean Pediatric Hospital Association conducted from Sept. 29 to Sunday among 71 member hospitals nationwide, 74.6 percent — 53 hospitals — said they lacked the specialists needed to maintain their services. Only 25.4 percent, or 18 hospitals, said their specialist numbers were sufficient.

"We believe that after the Ewha Womans University Mokdong Hospital newborn death case — in which medical staff were detained and later acquitted — residents began avoiding pediatrics, and that has translated into difficulty hiring specialists," Association President Choi Yong-jae said. "I am worried that the search and seizure at the pediatric emergency center last month will accelerate that trend."

The most commonly cited reason for difficulty filling specialist positions was a lack of applicants, named by 86.8 percent of respondents. Avoidance of night, holiday and inpatient duties (71.7 percent) and high labor costs (58.5 percent) were also major factors. Among hospitals that attempted to hire specialists over the past three years, 72.1 percent said the process took more than six months or that they had still not secured the staff they needed.

The staffing shortage is translating directly into gaps in care. Some 60.6 percent of hospitals said they had reduced or suspended services at some point over the past three years due to a lack of specialists. More than half — 52.1 percent — said that if current staffing conditions continued, they could sustain their existing services for less than four years.

Of the 313 full-time specialists working at these hospitals, the largest age group was those in their 40s (34.5 percent), followed by those in their 50s (31.6 percent), 60s (16.6 percent), 30s (16.0 percent) and 70s or older (1.3 percent). The association noted that the youngest cohort — specialists in their 30s — was smaller than those in their 60s, making generational renewal difficult.

Among the chief directors of the surveyed hospitals, 43.7 percent said they worked more than 52 hours a week. Of those, 96.8 percent cited the need to maintain night, holiday and inpatient services as the reason.

When asked whether their hospital had reduced or suspended services due to a specialist shortage at any point in the past three years — with multiple answers allowed — 60.6 percent said yes. Among those, the most common measure was reducing or halting night-time services, cited by 33.8 percent.

Asked how long they could sustain current services — including night, holiday and inpatient care — if staffing and hiring conditions remained unchanged, more than half, 52.1 percent, said less than four years.

Among 49 written responses — with multiple answers allowed — on what respondents wanted from the government and the association to address the staffing crisis, improvements to medical fee schedules under the national health insurance system were the most frequently requested, cited in 35 responses. Other requests included financial support for labor costs and staffing (8 responses), expanding the pipeline of residents and specialists (7 responses), and establishing legal protections for medical staff (5 responses).

"Pediatric hospitals are barely holding on," Choi said. "If the government delays any further in putting institutional safeguards and support measures in place, essential pediatric care in the regions will soon cease to function."

Police executed a search and seizure warrant at Ajou University Hospital's pediatric emergency medical center on Sept. 30 in connection with the death of a child patient. The investigation followed the death of a child who had been receiving treatment at the hospital, developed cyanosis and was transferred to the pediatric emergency center, where the patient died despite emergency treatment.

The Korean Society of Pediatric Emergency Medicine, the Korean Medical Association and other medical groups responded with strong opposition. They argued that conducting a forced investigation in an emergency room — where medical staff are fighting to save lives — risks disrupting patient care. They particularly said it was excessive to carry out a physical search and seizure in the emergency room when medical records were already accessible through the electronic medical record system.

NGP (Nextgen Pediatrics), a group of young pediatric physicians, also issued a statement Saturday raising concerns about the criminal liability burden on medical staff. The group said it was unreasonable to ask young doctors to remain in essential medical fields when treatment outcomes for critically ill and emergency patients could lead to investigation and punishment, and urged improvements to how such investigations are conducted.

However, police maintained that the search and seizure did not infringe on patients' right to treatment. The Gyeonggi Nambu Provincial Police Agency said the warrant was executed in a treatment room with no patients present, and that officers waited about four hours before entering spaces where patients were present, taking care not to disrupt care.

As the controversy grew, the government moved to improve investigative procedures. Health and Welfare Minister Jeong Eun-kyeong told the National Assembly's health and welfare committee during a national audit Wednesday that her ministry had held a working-level meeting with the Korean National Police Agency and would draw up search and seizure guidelines reflecting the medical community's concerns.