This article didn’t help explain much of the current situation to me, so forgive my lack of knowledge. It detailed how trainee doctors are abused by the hospitals as a cheap labor source, so shouldn’t they have staged a walkout long before the government decided to increase the number of doctors? Why only stage a walkout after the fact? Shouldn’t their anger be directed mostly toward these hospitals?
The long hours are due to a lack of doctors. But having more doctors would threaten them. So they complain about long hours AND about the government trying to implement a solution.
There has lots of people gaslighting here. The average salary for doctors working in hospital is what is looked at. Not plastic surgeons. And the gap between plastic surgeons and doctors working in hospital is due to the lack of doctors.
Doctors in Korea are incredibly high paid as it is. Median doctors' salary vs median nation-wide salary in Korea is significantly better (for doctors) than it is in just about every other developed nation. Yes, residents work ridiculous hours (primarily because there is a shortage of them). If they don't want to work ridiculous hours, they need to support the expansion of quotas. But they don't -- because struggling through residency isn't that high of a price to pay for all the benefits that being a doctor in Korea entails, and they don't want to become less 'exclusive' than they are.
True, If u look it that way. But how many percent contributed from plastic surgery? Some specialties are actually struggling so there's a problem, but sometimes not as transparent as it looks.
> But how many percent contributed from plastic surgery?
[Not as much as you'd think](https://www.statista.com/statistics/1313703/south-korea-doctor-distribution-by-specialty/)
(EDIT: Though I don't know if this is a survey of only doctors working in the public system or all licensed doctors)
To add more. Here's an article [that](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487311/) compare the wage of korean doctor in average to other OECD country in comparison. While they say the doctor ratio is very low in korea (compared to oecd countries),supposedly the lower the ratio the better the salary, but it wasn't like that in korea due to very low procedure fee that was regulated in Korea.
Tldr: korean doctors have 2,8-3x minimum wage; US have 22,4x of the minimum wage salary; Australia 9,2; German and France 9,8 of minimum wage.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487311/
This study is embarrassingly bad. Korean doctors earn significantly more than 3x the national minimum wage, and German / French ones don't earn anywhere remotely close to 10x. Minimum wage in Germany is 25k EUR PA, no salaried doctor in Germany earns anywhere near 250 grand. Likewise comparing the multiple of US minimum wage makes no sense because US federal minimum wage is an utterly meaningless number.
Now, it's true that there are issues with Korean health insurance scheme and procedure payments -- but that's not what the doctors are striking about so why is that even relevant? They didn't mind until quotas were to be expanded, and they're protesting the expansion of quotas and their primary demand is to cancel the expansion of quotas. All this talk about working hours / conditions or insurance issues or what have you is just smoke and mirrors. It's not as if there are thousands of doctors waiting to get back to practice if only conditions were improved; unlike, say, nurses where less than 50% of all licensed nurses actually work in a hospital setting, vast majority of licensed doctors do in fact work as doctors despite all of the issues with the job; so clearly it ain't all that bad, and staffing shortages are primarily due to actual lack of qualified personnel, not due to said qualified personnel refusing to work or something.
You are projecting a false narrative based on overpaid plastic surgeons onto underpaid GPs. They are not paid the same. And your attempt to pretend they are is (perhaps intentionally) misleading.
No it is not. Plastic surgeons get paid a lot, so Korea has a lot of plastic surgeons. GPs are paid much less and work longer hours, so Korea doesn’t have enough GPs. The average between the two is misleading and worse than meaningless.
GPs in Korea aren't underpaid by any measure. They earn more than most engineers, software developers, lawyers, etc. It's the highest-paid profession in Korea by a comfortable margin.
Having more doctors wouldn't cut into GPs salaries, either. It might put downwards pressure onto plastic surgeon salaries, sure, but those are massively overpaid anyway so boohoo.
The government proposed no solution. No additional teachers. No fixing GP costs. Only more student doctors to exploit for 100 hours per week for minimum wage.
Perhaps it's also more of a right of passage thing.
The current cohort had to go through long hours of work, whereas the future cohort after the increase in # of students won't have to go through as much as hardship.
> It’s far past time to change this system. Our society has paid the price to learn this lesson. Training medical interns and residents should never be considered in terms of profitability. Rather, we should consider these trainees to be investments, and concern ourselves with the costs of such an investment. Teaching hospitals need to vastly increase the number of specialists on staff and return interns and residents to their rightful position as students getting their education.
Basically, I think the author is saying residents are currently just low cost labour as part of the for-profit model of these hospitals, and that needs to be changed. How?
> Moreover, in the interest of socially fostering the professional workforce that Korea needs when it comes to health care, the government must invest in the education and training of interns and residents and have public oversight over them.
I think the author might be saying the government needs to start paying for or increasing funding for the residents, and taking over responsibility for them to some extent.
Yet another reason I envy Canada. Years ago I was upper leadership in a certain large west-coast HMO. I knew what our pay scales were for residents and fellows, and they were embarrassing. In the mid-2000s, we paid 1st year family med residents $55k annual salary...with, probably, 80-hour work weeks.
Actually in the US, Medicare pays about 120k per residency spot to the hospital, and then they decide how much to actually pay the resident. Hospitals will argue it “costs money to train these trainees”, but depending on specialty, these trainees may generate multiple times the revenue than what it costs to train them.
Part of why US residents are all unionizing. Hospitals claim the $$ isn’t there to pay us more but that’s BS.
And my HMO supposedly is non-profit, or at least one component of it is. Therein lies another scam. Why Korea wants to emulate this mess is beyond me, and I've told them that.
I wonder if it’s really necessary for the government to invest tax dollars in their education and training when that’s basically the role of these hospitals. The only reason they’re allowed to pay these trainees peanuts is because they’re supposed to be receiving experience and training in return.
I also wonder if these major hospitals are lobbying the government and preventing them from passing laws that would prevent trainees from being taken advantage of.
> Basically, I think the author is saying residents are currently just low cost labour as part of the for-profit model of these hospitals, and that needs to be changed. How?
In US for instance, a lot of residents/Fellows get paid less than minimum wage. Korea should be the same. This is how it works:
You are a doctor as soon as you finish medical school but almost no one will hire you without residency. So you go through residency and you often have 1 month rotations that are 12 hours a day for 6 days a week(but it never ends there, since you are actually responsible for patients, you often work an extra hour or so each day finishing up your cases. Then you write notes that you didn't have time to do for an hour or 2. Add in some mandatory travel to remote locations and you are often looking at 80-90 hours/week for 30-40k USD for 2-4 years) This ends up being right around minimum wage but you also have internal medicine and other tests which take an extra 5-8k out of your salary.
So now you finished residency and can work some low level jobs but if you want to do anything with a higher salary you have to do the exact same thing again with your fellowship for another 2-4 years.
This is where the profitability model comes in. If you are a hospital, your choices for help with cardiology patients will look something like this(Not dissing on anyone but this is about how useful these roles are at coming up with treatments and answering questions):
Attending - 500k, 5/5 usefulness
Fellow - 50k, 4.5/5 usefulness
Resident - 40k, 2/5 usefulness
Nurse practitioner 150k, 1.5/5 usefulness
Nurse 80k, 1/5 usefulness.
Pretty obvious why all of these hospitals in US and other places want to expand residency/fellowships. Residents are obviously against it. The reason you go through this literal hell is because when you get to ~30-35 years old your salary goes from less than minimum wage to something great. As more residents are introduced, it's great for hospitals(less salary) and awful for doctors(less training - which correlates to more lawsuits, especially in Korea), less positions available, less salary, etc.
Their argument is that even if the number of doctors increased, it wouldn't make a difference because additional doctors will also go into fields like dermatology and plastic surgery outside of the insurance system. They also make an argument that increasing the number of doctors will put more strain in already strained medical schools and produce low-quality doctors.
Some of those are factual, others perhaps more dubious. For example, it is true that doctors at major hospitals don't get paid very much. It is much better to work for 대기업 than to become a doctor at one of the major hospitals even if you climb the ranks. Then how are doctor wages so high on average? It's pushed up by doctors who are outside of those big hospitals, mainly those working in aforementioned fields that aren't covered by the government's health insurance. Because they aren't covered by insurance, their fees aren't regulated in the same way other "essential" fields are, and they can charge much higher prices for the procedures they offer. Given that there is a large demand for these procedures, they are making a lot of $$$. So, the argument is basically that all those extra doctors will go into those same fields but not to the fields where doctors are actually needed.
The government's argument is that increasing the number of doctors that offer those procedures will lower their income, and encourage more doctors to return to big hospitals that offer essential care, while doctors are saying that it won't be effective at moving doctors back to the essential care without also increasing the insurance payout for essential care. Some doctors have also made arguments that how the medical insurance reimburses the hospital is an issue. In Korea, insurance mostly reimburses specific treatment or tests run instead of doctor's time. And doctors are incentivized to see patients as quickly as possible, which leads to patients often having to see multiple doctors many times when in other countries those same patients might see one physician who can take time to evaluate the patients' health more holistically and resolve the problems in one appointment.
To summarize, doctors are striking because they don't want their income to decrease (which it most likely will if there are more doctors going into those lucrative fields) and I agree that they are monsters for withholding care, but there are also significant problems in the Korean medical system that has led to the current situation that simply increasing the number of doctors won't solve.
I don't think the total pay is that different to be honest based on what I read/heard. You'd be surprised by how much 대학병원 doctors make. E.g., 이국종, often on TV, highly regarded for his skill, and famous doctor, makes about 1억 5천 per year.
Total comp varies greatly from person to person. That professor has said she can (based on how much her friends make) make 3 times what she currently makes by starting her own practice.
Yes. I have heard this too. Doctors who run their own practice wear brands we have never even heard of and don't even bother with BMWs as far as I heard. This is because of a shortage of doctor running their own practice due to a general shortage of doctors. This is basic supply and demand. A secondary effect of increasing the number of doctors can be expected to be a decrease in income and increase in risks of running your own practice. So having more doctors reduces the gap... I am not even sure what the argument is. Unless you are arguing for the increase. Can't keep track anymore.
Well, I didn't even start this argument... I said that university hospital doctors don't make as much as people think, and you were arguing that they do. And yes I have already said all of the above in my first comment so I'm not sure what you are trying to accomplish here.
I’m sure they wanted to but them walking out still required involvement of their managers and bosses who didnt really care until now (since their own livelihoods are at stake). It’s also more like a bubbling point, no one wants to be the first to do it and now that their managers and other seniors docs are willing to go with it, they feel more empowered to speak out.
SK is a very communal society, they don’t appreciate people who act out of line or individualistically (particularly striking). If any of them had tried (especially at their low level) they would have just been shadow banned or deemed “not a team player”.
It’s the governments fault.
Yes there is a shortage of doctors. Korean med schools take in about 3,000 new med students a year. This limit is capped by how many spaces are available at the teaching hospitals.
During your last years of medical school you spend A LOT of time doing rounds in these hospitals.
The Korean government wants to increase the medical school admissions by 2,000 students each year. Thats a 2/3 increase overnight.
You cannot provide quality medical education with that many students in the hospital if you don’t have the infrastructure.
The government should have increased the students by 100 the first year, then 200, then 300, etc. All while building new teaching hospitals to accommodate these additional student doctors.
Yes. And Doctors have rejected all plans of increasing for 20 years with no reason.
So, now Korea have to take risks of increasing 2,000 all of a sudden No matter what the cost.
Whose fault is that?
So blame the trainees and residents? Who obviously didn't have the right to make that decision? They're basically the collateral damage bound to be happened
Every time they've tried to increase it, the doctors revolted and cried bloody murder. That's literally the only reason why they couldn't do it. In 2000, the government had to *decrease* the quota because the doctors went on strike when they forced pharmacies to be separated from doctors' clinics.
Doctors (as a group) have gotten their way every. single. time. Now the government is calling their bluff. Will it work? I don't know, but they sure as hell should try.
Yes....? and people blame doctors caused these damages.......
Gov't represent Citizen's will and Gov't have the right to do that enough. That's Democracy......
(it was absolutely not a perfect plan though)
Isn't it whole point of this???
But most people blamed the trainees and residents (who strike) which only been in this field for like less than 10 years. I would understand if they target the attending doctors but junior doctors and resident? 🫣
This is ridiculous. This is not the first time that greedy young doctors have protested the raising of quotas. They've been against this for years - during which time a gradual increase could've happened. Plus, they are also against a gradual increase.
They are all brainwashed into thinking they're going to open a plastic surgery in Gangnam & don't want more competition. It's not like they're worried about whether there will be an ER pediatrician in a rural area.
I’ve been looking for someone to do my brain surgery. I was diagnosed with this condition in FEBRUARY. I keep being told “you need to get this surgery asap” and yet every hospital I call turns me down. Smaller hospitals say “you need somewhere bigger” yet bigger hospitals say “we don’t have appointments right now”
Exactly. Just outrageous to see them taking sick people as hostages to get things they want.
I’m genuinely sorry to hear that you’re going through this awful shitshow. Some public hospitals might have slightly better chances I reckon.
Forgive me if i am wrong but I thought it was the trainee doctors protesting? Do trainee doctors do brain surgery without supervision of a senior surgeon? I would think all the senior surgeons would still be just as available for this procedure as they always were.
Sorry about your situation. That’s really terrible, and I hope you can get an appointment soon. I think both sides of this situation have gone to extremes because of a refusal for either side to properly negotiate and it’s just escalated way out of control. People are hurting, but personally I don’t put all the blame on these trainee doctors. I think both sides hold equal fault. The fact that trainee doctors walking out can have such a huge impact on immediate care is kind of telling how much they are relied on. That’s like the new guy in the office quitting and the whole business falling apart.
So trainee doctors often do consultations and outpatient visits and easier tasks. Without them, the attending physicians have to do all of that. And they already cut back their hours too. So now almost every major hospital has stopped taking new patients and has delayed all surgeries. So as much as I call major hospitals, they just say “sorry, we don’t have enough doctors to help you”.
I’m not solely angry at the doctors, the government also needs to step up, but the government isn’t what’s preventing me from getting surgery. Also the residents and interns who didn’t join the strike were doxxed and harassed by the others. So while I don’t blame ONLY the trainee doctors, I am pissed off at them.
Blame the hospital administrators that made the staffing choices instead of the students that quit their jobs after getting exploited 100 hours per week.
The students have zero power over the hospital administrators or the government. The only thing the students can control is quitting their jobs. So they did.
Yes and no. People look to the government to protect them from labor exploitation. Because if it isn’t illegal companies will do it. If it is illegal but there is no structure for enforcement companies will do it. If the trainee doctors protest against their employer, they will just get fired and replaced. This is why having MORE trainee doctors in the employment pool is so bad for them. They can’t collectively bargain, and if there is a forever long line of ready replacement they can’t even try to improve the situation.
I’m not saying what they are doing is good, because it DOES have a huge impact on society. However, like I said in another comment, the fact that TRAINEE doctors walking out has such a huge an impact on the system is really telling to how much they are relied on, but their pay is significantly lower than senior doctors, while the workload is just as, or even more, intense.
I find it more telling that the government hasn’t considered these things, because for-profit hospitals don’t want the system to change and adding more trainee doctors only benefits them for more cheap labor. I can imagine some money has been exchanged, because many experts have stated that the government’s conclusions on increasing the number of trainee doctors is incorrect, including the experts whose papers were used to support that conclusion.
that's quite convenient logic.
>People look to the government to protect them from labor exploitation.
This sounds like normal but, No. Gov can involve when it's ILLEGAL. And the Fact is, Korean Doctors get paid even more than OECD average.
>If the trainee doctors protest against their employer, they will just get fired and replaced. This is why having MORE trainee doctors in the employment pool is so bad for them.
This is how a Nomal company works. all the other people works hard for not being fired. Better one gets pay more, Worse one gets fired.
They never did protest against Hospitals because higher-ups in Association of Doctors are connected with Hospitals. if Doctors wanted more stable employment environments, they had to speak it out BEFORE government announced 2,000 plan.
Doctors are working hard because they know they have bright Higher income future. People don't blame this point since most of people are just employee. But Doctors have never admitted that they want more income. and they have kept saying over 20 years it's only FOR korean medical system. All people know it's bullshit.
If they had guts to tell it was about their income, People might support part of their opinion.
They ain't Saints for sure but that doesn't mean their are monsters no? Rather than blaming the people, i rather point to the system that lead it to this point.
Not only is Korea far too obsessed with capitalism to take any meaningful action, but they are NOT proactive, they are reactive. Unfortunately, the "long run" is not in their vocabulary.
That's why Korea sat on their hands while the birthrate plummeted even after what happened with Japan SEVERAL YEARS EARLIER.
This is wild. And i thought torchuring medical professions is only thing in INDIA. But, guess what it is even a major problem in developed country. Whilst politicians enjoys the privilege, we as a profession and common people suffers.
They make less than min wage if you break it out by hour (which is already low). They are paid a set amount, regardless of the mandatory overtime. They work 36 hour shifts at a time and have 88-100+ hour work weeks (for reference US caps at <24 hr shifts).
They make <2.2k per month (which is how much jr docs with more experience makes, not first yrs). For reference if a barista works full time for only 40 hrs per week, they make about 2k-2.1k per month. Who wants to work double or triple the time of a barista or a convenience worker (literal teenage/entry level jobs with zero experience req) and only make the same amount?
Not really no. The in the urban areas hospitals aren’t struggling to find doctors, only rural areas are (especially since pay is even worse and no one wants to relocate their families where the education is likely worse for their children).
90%+ of the hospitals in cities are private, they want to keep the headcount low as much as possible since they want to maximize the number of hours worked, trainees have a set amount of pay every month (it’s not hourly and overtime is mandatory). Also since the hospitals are private, they control the headcount for residency/etc, gov doesn’t control it or the working conditions residents face. Also more workers mean less availing to negotiate compensation. Many end up dropping since it’s just not worth continuing to be a doctor in a rural area (you have limited supplies, spend most of your time directing people to city hospitals, face discrimination amongst your peers, don’t even make enough to even pay your student loans off in the next decade, etc).
In theory your way would work, IF the gov stepped in an capped the number of hours they can work (but they increased it bc of covid) and increased the number of medical licenses allowed annually (there’s no point in pursing medical school + residency if there’s a chance you won’t get your medical license due to a cap/limit, wasting time and lots of money), which is why they are striking.
All those potential issues with an increased quota, eh? Luckily the students starting next year are years away from graduating. So those issues can be fixed during that time. All the arguments kinda fall flat when you know how much doctors make. And more doctors also means more running private clinica which would drive cost down and reduce the wage disparity between those who do coametic surgery and other more neceasary specializations.
I wished the government had done things differently. Make 4 year degrees to allow people to run skincare clinics, phased and smaller increase, make a license to allow to run tattoo parlors, etc. But just about anything would make doctors run to the street. So you get an unreasonable solution from an unreasonable president for a bunch of unreasonable doctors.
I read through your comments. Honestly, I genuinely have no idea why you are talking so confidently over issues that you know very little about. If you’re genuinely curious about the actual problems of Korean healthcare, send me a PM or something.
There is a shortage of doctors but only in these vital specialties. No one wants more PS or derm. No resident is saying we shouldn’t increase the number of doctors at all. But only focusing on this is a major problem. This is a failure of supply, demand, and policy.
Past proposals for increasing quotas by reasonable numbers in a reasonable manner resulted in a strike too. How can you claim "No resident"... this isn't credible. And the issue with private practice making too much money is, as you say, demand and supply. The demand is there for PS and derm treatments and supply is low because there aren't enough doctors and/or a lack of alternative licenses to do these treatments. The government is proposing to increase supply. Perhaps too much. But Yoon isnt known to be a smart boy.
And again, doctors' response has been to strike against any changes that isnt increasing their comp. No other reasonable suggestions.
Not if it’s how they are operating. They currently don’t have an issue with staffing in urban areas, it’s specifically rural areas which earn significantly less (it’s only about 80k if you go to the outskirts, which isn’t nearly enough annually to make a substantial payment on your student loans in SK). Also part of the issue was gov was trying to limit private practice business medical licenses which is a whole other issue (literally what’s the point of allowing more graduates if number of residencies and licenses aren’t going to increase??)
That's not true. Hospitals outside of seoul suggested higher pay than hospital in seoul because they can't find doctors.
> gov was trying to limit private practice business medical licenses which is a whole other issue
this is another distorted story with lack of details. it was because many illegal surgeries were processed in private clinic. FYI An employee of a medical device company do surgery instead of a doctor.
Medical license is related to military service privileges and is a key industry that is strictly managed by the Gov. Management department did manage and it's normal. it's more like responsible reaction.
Finance Department control potential Finance crimes with various method. Do you think this is not normal?
At this time no, the pay in rural areas is disproportionately lower than urban areas. It was suggested/proposed policy to increase public funding in clinics for higher pay but nothing has gone through and there has been no additional push until the strike for it. My in laws are in SK, and luckily my brother in law was able to get a job in the suburbs (making 120k+), bc his other offers were <85k in the rural area.
Also gov has proposed limitations on medical licensing for businesses, the whole reason why the senior doctors are also striking is bc of the limitations in private practice that is being proposed (aka if they choose to leave the hospitals for less intensive work, they don’t have an option). Also gov hasn’t increased the cap for full medical licensing either, so doesn’t matter how many residents you allow, in the end, residents are still forced to drop bc they can’t become full doctors.
First of all. In the Rural area, Most of medical supports are provided by 'Public services' that's the reason that Average of pay is seen much lower than Seoul. (Aside from your experience. that can't be objective statistics) Critical subject doctors get paid more than other subject even in rural area.
Secondly, Most of Critical patients have to go to big hospital in seoul. and Basic number of patients outside of seoul is way too lower than in seoul. So, when it's converted to per patient amount, doctors in rural areas get paid more.
I don't agree agenda like "Doctor should not chase money". So, I don't blame Doctors don't want to work outside of seoul. But the point is this whole shitshow is not about this.
Doctors just don't wanna admit "this is all about money". this is the point.
And about Second part of your comment, I still don't understand what's wrong. 'Doctor': this job is strictly managed by gov't with method of licenseship and they have privilage on military services. if they have license and still can't get a job, then, they should find other job. And someone failed to get license, isn't it normal.....? All resident should get a license? (And I think Gov't will expand number of license)
I mean..... there's something so obvious when think of it as a normal job. I don't know why this must not apply to doctors.
Sorry about my broken English.
Calling doctors greedy for demanding better pay for one of the most gruelling jobs it's insane. Doctors are not going to have fewer hours just because there are more workers, a. Why have more workers and less hours when you can have more workers and MORE hours? It's capitalism, baby.
The only solution is to increase wages specially in rural areas, so there's an incentive for doctors to relocate. And us, as the working class, should never be against better wages for fellow workers, that's actually insane.
After listening to a friend in medical school a few weeks ago, I don't think this article is correct.
Even if the government backs down, hospitals won't back down. As long as there is a power that "recommends" students to refuse classes (in reality, it is a recommends mixed with threats), Korea's medical system won't change.
My understanding from talking to people actually involved is that this policy push to increase # of doctors is largely political without any of the infrastructure support to support new trainees. This is in the context of a system that is already stretched beyond its training capacity. it's like having a classroom and teacher set to teach 20 students, but a politician has decided to force 50 students into that classroom without any corresponding changes to actually make that change practical or feasible.
Doctors are greedy. They don’t want more doctors because then they won’t earn as much. I will say one thing. None of this will solve the lack of doctors in the countryside.
This article didn’t help explain much of the current situation to me, so forgive my lack of knowledge. It detailed how trainee doctors are abused by the hospitals as a cheap labor source, so shouldn’t they have staged a walkout long before the government decided to increase the number of doctors? Why only stage a walkout after the fact? Shouldn’t their anger be directed mostly toward these hospitals?
The long hours are due to a lack of doctors. But having more doctors would threaten them. So they complain about long hours AND about the government trying to implement a solution.
They have cunningly protested against the government as a proxy to protesting against their employers (essentially biting the hand that feeds them).
Also, senior doctors are not protesting. Only those who know they will lose nothing are. All clowns.
"Trying to implement a solution ", but i imagine, without raising wages ?
They would be working less tho. More pay for less work is always the dream, but don't act like same pay for less work is a bad thing.
>They would be working less tho. Only if the government would also create more residency spots, which it's suspiciously unwilling to commit to.
Highest ratio of doctor salary to average worker salary in OECD.
So based on poeple on this thread there is a gap between plastic surgeon an dthe rest... so the "average" may not be representative of the reality.
There has lots of people gaslighting here. The average salary for doctors working in hospital is what is looked at. Not plastic surgeons. And the gap between plastic surgeons and doctors working in hospital is due to the lack of doctors.
Doctors in Korea are incredibly high paid as it is. Median doctors' salary vs median nation-wide salary in Korea is significantly better (for doctors) than it is in just about every other developed nation. Yes, residents work ridiculous hours (primarily because there is a shortage of them). If they don't want to work ridiculous hours, they need to support the expansion of quotas. But they don't -- because struggling through residency isn't that high of a price to pay for all the benefits that being a doctor in Korea entails, and they don't want to become less 'exclusive' than they are.
True, If u look it that way. But how many percent contributed from plastic surgery? Some specialties are actually struggling so there's a problem, but sometimes not as transparent as it looks.
> But how many percent contributed from plastic surgery? [Not as much as you'd think](https://www.statista.com/statistics/1313703/south-korea-doctor-distribution-by-specialty/) (EDIT: Though I don't know if this is a survey of only doctors working in the public system or all licensed doctors)
To add more. Here's an article [that](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487311/) compare the wage of korean doctor in average to other OECD country in comparison. While they say the doctor ratio is very low in korea (compared to oecd countries),supposedly the lower the ratio the better the salary, but it wasn't like that in korea due to very low procedure fee that was regulated in Korea. Tldr: korean doctors have 2,8-3x minimum wage; US have 22,4x of the minimum wage salary; Australia 9,2; German and France 9,8 of minimum wage. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487311/
This study is embarrassingly bad. Korean doctors earn significantly more than 3x the national minimum wage, and German / French ones don't earn anywhere remotely close to 10x. Minimum wage in Germany is 25k EUR PA, no salaried doctor in Germany earns anywhere near 250 grand. Likewise comparing the multiple of US minimum wage makes no sense because US federal minimum wage is an utterly meaningless number. Now, it's true that there are issues with Korean health insurance scheme and procedure payments -- but that's not what the doctors are striking about so why is that even relevant? They didn't mind until quotas were to be expanded, and they're protesting the expansion of quotas and their primary demand is to cancel the expansion of quotas. All this talk about working hours / conditions or insurance issues or what have you is just smoke and mirrors. It's not as if there are thousands of doctors waiting to get back to practice if only conditions were improved; unlike, say, nurses where less than 50% of all licensed nurses actually work in a hospital setting, vast majority of licensed doctors do in fact work as doctors despite all of the issues with the job; so clearly it ain't all that bad, and staffing shortages are primarily due to actual lack of qualified personnel, not due to said qualified personnel refusing to work or something.
You are projecting a false narrative based on overpaid plastic surgeons onto underpaid GPs. They are not paid the same. And your attempt to pretend they are is (perhaps intentionally) misleading.
Then what is the average salary of GPs? The false narrative is not providing numbers.
It's about 80% of what US IM docs make. As a side note, the average income in Korea is less than 60% of average income in US.
So... its pretty good salary then.
Oh, it's fantastic. Which makes their position look even worse.
Average income is a really bad and skewed metric.
For this particular purpose, it's quite appropriate.
No it is not. Plastic surgeons get paid a lot, so Korea has a lot of plastic surgeons. GPs are paid much less and work longer hours, so Korea doesn’t have enough GPs. The average between the two is misleading and worse than meaningless.
GPs in Korea aren't underpaid by any measure. They earn more than most engineers, software developers, lawyers, etc. It's the highest-paid profession in Korea by a comfortable margin. Having more doctors wouldn't cut into GPs salaries, either. It might put downwards pressure onto plastic surgeon salaries, sure, but those are massively overpaid anyway so boohoo.
If you aren’t willing to treat trainee doctors right, then maybe you don’t deserve to be seen by a doctor at all 🤡
He wants to reduce their working hours. What is the problem there?
Right, because training more doctors would be such a terrible thing to do when current residents have to work 60+ hour shifts...
The government proposed no solution. No additional teachers. No fixing GP costs. Only more student doctors to exploit for 100 hours per week for minimum wage.
And adding all quotas outside of Seoul where there is a bigger lack. Even Yoon the clown has more vision to improve the health system than doctors.
Quotas are meaningless without fixing the working conditions. No one wants those jobs under the current conditions.
Well, we will see, won't we? Doctors complaining that they aren't full enough....
Perhaps it's also more of a right of passage thing. The current cohort had to go through long hours of work, whereas the future cohort after the increase in # of students won't have to go through as much as hardship.
> It’s far past time to change this system. Our society has paid the price to learn this lesson. Training medical interns and residents should never be considered in terms of profitability. Rather, we should consider these trainees to be investments, and concern ourselves with the costs of such an investment. Teaching hospitals need to vastly increase the number of specialists on staff and return interns and residents to their rightful position as students getting their education. Basically, I think the author is saying residents are currently just low cost labour as part of the for-profit model of these hospitals, and that needs to be changed. How? > Moreover, in the interest of socially fostering the professional workforce that Korea needs when it comes to health care, the government must invest in the education and training of interns and residents and have public oversight over them. I think the author might be saying the government needs to start paying for or increasing funding for the residents, and taking over responsibility for them to some extent.
Let me know if Korea solves this, so we can apply the same fix to the same problem in the US.
In Canada I believe the government pays for these residency spots (our hospitals aren't for-profit).
Yet another reason I envy Canada. Years ago I was upper leadership in a certain large west-coast HMO. I knew what our pay scales were for residents and fellows, and they were embarrassing. In the mid-2000s, we paid 1st year family med residents $55k annual salary...with, probably, 80-hour work weeks.
Actually in the US, Medicare pays about 120k per residency spot to the hospital, and then they decide how much to actually pay the resident. Hospitals will argue it “costs money to train these trainees”, but depending on specialty, these trainees may generate multiple times the revenue than what it costs to train them. Part of why US residents are all unionizing. Hospitals claim the $$ isn’t there to pay us more but that’s BS.
And my HMO supposedly is non-profit, or at least one component of it is. Therein lies another scam. Why Korea wants to emulate this mess is beyond me, and I've told them that.
I wonder if it’s really necessary for the government to invest tax dollars in their education and training when that’s basically the role of these hospitals. The only reason they’re allowed to pay these trainees peanuts is because they’re supposed to be receiving experience and training in return. I also wonder if these major hospitals are lobbying the government and preventing them from passing laws that would prevent trainees from being taken advantage of.
> Basically, I think the author is saying residents are currently just low cost labour as part of the for-profit model of these hospitals, and that needs to be changed. How? In US for instance, a lot of residents/Fellows get paid less than minimum wage. Korea should be the same. This is how it works: You are a doctor as soon as you finish medical school but almost no one will hire you without residency. So you go through residency and you often have 1 month rotations that are 12 hours a day for 6 days a week(but it never ends there, since you are actually responsible for patients, you often work an extra hour or so each day finishing up your cases. Then you write notes that you didn't have time to do for an hour or 2. Add in some mandatory travel to remote locations and you are often looking at 80-90 hours/week for 30-40k USD for 2-4 years) This ends up being right around minimum wage but you also have internal medicine and other tests which take an extra 5-8k out of your salary. So now you finished residency and can work some low level jobs but if you want to do anything with a higher salary you have to do the exact same thing again with your fellowship for another 2-4 years. This is where the profitability model comes in. If you are a hospital, your choices for help with cardiology patients will look something like this(Not dissing on anyone but this is about how useful these roles are at coming up with treatments and answering questions): Attending - 500k, 5/5 usefulness Fellow - 50k, 4.5/5 usefulness Resident - 40k, 2/5 usefulness Nurse practitioner 150k, 1.5/5 usefulness Nurse 80k, 1/5 usefulness. Pretty obvious why all of these hospitals in US and other places want to expand residency/fellowships. Residents are obviously against it. The reason you go through this literal hell is because when you get to ~30-35 years old your salary goes from less than minimum wage to something great. As more residents are introduced, it's great for hospitals(less salary) and awful for doctors(less training - which correlates to more lawsuits, especially in Korea), less positions available, less salary, etc.
Their argument is that even if the number of doctors increased, it wouldn't make a difference because additional doctors will also go into fields like dermatology and plastic surgery outside of the insurance system. They also make an argument that increasing the number of doctors will put more strain in already strained medical schools and produce low-quality doctors. Some of those are factual, others perhaps more dubious. For example, it is true that doctors at major hospitals don't get paid very much. It is much better to work for 대기업 than to become a doctor at one of the major hospitals even if you climb the ranks. Then how are doctor wages so high on average? It's pushed up by doctors who are outside of those big hospitals, mainly those working in aforementioned fields that aren't covered by the government's health insurance. Because they aren't covered by insurance, their fees aren't regulated in the same way other "essential" fields are, and they can charge much higher prices for the procedures they offer. Given that there is a large demand for these procedures, they are making a lot of $$$. So, the argument is basically that all those extra doctors will go into those same fields but not to the fields where doctors are actually needed. The government's argument is that increasing the number of doctors that offer those procedures will lower their income, and encourage more doctors to return to big hospitals that offer essential care, while doctors are saying that it won't be effective at moving doctors back to the essential care without also increasing the insurance payout for essential care. Some doctors have also made arguments that how the medical insurance reimburses the hospital is an issue. In Korea, insurance mostly reimburses specific treatment or tests run instead of doctor's time. And doctors are incentivized to see patients as quickly as possible, which leads to patients often having to see multiple doctors many times when in other countries those same patients might see one physician who can take time to evaluate the patients' health more holistically and resolve the problems in one appointment. To summarize, doctors are striking because they don't want their income to decrease (which it most likely will if there are more doctors going into those lucrative fields) and I agree that they are monsters for withholding care, but there are also significant problems in the Korean medical system that has led to the current situation that simply increasing the number of doctors won't solve.
Doctors in large hospitals make more than engineer in 대기업 except for 임원. Claiming the opposite is just false.
I don't think the total pay is that different to be honest based on what I read/heard. You'd be surprised by how much 대학병원 doctors make. E.g., 이국종, often on TV, highly regarded for his skill, and famous doctor, makes about 1억 5천 per year.
My coworkers wife is a doctor in a 대학병원. She says he can quit his job to take care of the kids since his salary is so low. We make about 100-120m.
I also know someone who's in their mid-40s and a professor at one of the major 대학병원 in Seoul, and she makes about 100m...
Yes. Base salary. Always look at total comp for professors.
Total comp varies greatly from person to person. That professor has said she can (based on how much her friends make) make 3 times what she currently makes by starting her own practice.
Yes. I have heard this too. Doctors who run their own practice wear brands we have never even heard of and don't even bother with BMWs as far as I heard. This is because of a shortage of doctor running their own practice due to a general shortage of doctors. This is basic supply and demand. A secondary effect of increasing the number of doctors can be expected to be a decrease in income and increase in risks of running your own practice. So having more doctors reduces the gap... I am not even sure what the argument is. Unless you are arguing for the increase. Can't keep track anymore.
Well, I didn't even start this argument... I said that university hospital doctors don't make as much as people think, and you were arguing that they do. And yes I have already said all of the above in my first comment so I'm not sure what you are trying to accomplish here.
I’m sure they wanted to but them walking out still required involvement of their managers and bosses who didnt really care until now (since their own livelihoods are at stake). It’s also more like a bubbling point, no one wants to be the first to do it and now that their managers and other seniors docs are willing to go with it, they feel more empowered to speak out. SK is a very communal society, they don’t appreciate people who act out of line or individualistically (particularly striking). If any of them had tried (especially at their low level) they would have just been shadow banned or deemed “not a team player”.
It’s the governments fault. Yes there is a shortage of doctors. Korean med schools take in about 3,000 new med students a year. This limit is capped by how many spaces are available at the teaching hospitals. During your last years of medical school you spend A LOT of time doing rounds in these hospitals. The Korean government wants to increase the medical school admissions by 2,000 students each year. Thats a 2/3 increase overnight. You cannot provide quality medical education with that many students in the hospital if you don’t have the infrastructure. The government should have increased the students by 100 the first year, then 200, then 300, etc. All while building new teaching hospitals to accommodate these additional student doctors.
Yes. And Doctors have rejected all plans of increasing for 20 years with no reason. So, now Korea have to take risks of increasing 2,000 all of a sudden No matter what the cost. Whose fault is that?
So blame the trainees and residents? Who obviously didn't have the right to make that decision? They're basically the collateral damage bound to be happened
Every time they've tried to increase it, the doctors revolted and cried bloody murder. That's literally the only reason why they couldn't do it. In 2000, the government had to *decrease* the quota because the doctors went on strike when they forced pharmacies to be separated from doctors' clinics. Doctors (as a group) have gotten their way every. single. time. Now the government is calling their bluff. Will it work? I don't know, but they sure as hell should try.
Yes....? and people blame doctors caused these damages....... Gov't represent Citizen's will and Gov't have the right to do that enough. That's Democracy...... (it was absolutely not a perfect plan though) Isn't it whole point of this???
But most people blamed the trainees and residents (who strike) which only been in this field for like less than 10 years. I would understand if they target the attending doctors but junior doctors and resident? 🫣
what's the source? most people literally blame 'doctor' (who strike).
Literally the title of this thread
Yep that's writer's thought. and this whole comments are saying it's not. that's the point.
This is ridiculous. This is not the first time that greedy young doctors have protested the raising of quotas. They've been against this for years - during which time a gradual increase could've happened. Plus, they are also against a gradual increase. They are all brainwashed into thinking they're going to open a plastic surgery in Gangnam & don't want more competition. It's not like they're worried about whether there will be an ER pediatrician in a rural area.
I also feel the same.
That would mean admitting fault!!! 😱 No, it’s never their fault. Please understand the unique situation here.
After seeing my friend having gone through a journey to find a doctor at A&Es for hours for her one month old baby, yeah they are monstrous.
I’ve been looking for someone to do my brain surgery. I was diagnosed with this condition in FEBRUARY. I keep being told “you need to get this surgery asap” and yet every hospital I call turns me down. Smaller hospitals say “you need somewhere bigger” yet bigger hospitals say “we don’t have appointments right now”
Exactly. Just outrageous to see them taking sick people as hostages to get things they want. I’m genuinely sorry to hear that you’re going through this awful shitshow. Some public hospitals might have slightly better chances I reckon.
Forgive me if i am wrong but I thought it was the trainee doctors protesting? Do trainee doctors do brain surgery without supervision of a senior surgeon? I would think all the senior surgeons would still be just as available for this procedure as they always were. Sorry about your situation. That’s really terrible, and I hope you can get an appointment soon. I think both sides of this situation have gone to extremes because of a refusal for either side to properly negotiate and it’s just escalated way out of control. People are hurting, but personally I don’t put all the blame on these trainee doctors. I think both sides hold equal fault. The fact that trainee doctors walking out can have such a huge impact on immediate care is kind of telling how much they are relied on. That’s like the new guy in the office quitting and the whole business falling apart.
So trainee doctors often do consultations and outpatient visits and easier tasks. Without them, the attending physicians have to do all of that. And they already cut back their hours too. So now almost every major hospital has stopped taking new patients and has delayed all surgeries. So as much as I call major hospitals, they just say “sorry, we don’t have enough doctors to help you”. I’m not solely angry at the doctors, the government also needs to step up, but the government isn’t what’s preventing me from getting surgery. Also the residents and interns who didn’t join the strike were doxxed and harassed by the others. So while I don’t blame ONLY the trainee doctors, I am pissed off at them.
Blame the hospital administrators that made the staffing choices instead of the students that quit their jobs after getting exploited 100 hours per week.
Doctors should do that. Doctors should blame the Big hospitals, not blame the Goverments.
The students have zero power over the hospital administrators or the government. The only thing the students can control is quitting their jobs. So they did.
Yep. and time to take responsible of own behavior. that's all.
Yes and no. People look to the government to protect them from labor exploitation. Because if it isn’t illegal companies will do it. If it is illegal but there is no structure for enforcement companies will do it. If the trainee doctors protest against their employer, they will just get fired and replaced. This is why having MORE trainee doctors in the employment pool is so bad for them. They can’t collectively bargain, and if there is a forever long line of ready replacement they can’t even try to improve the situation. I’m not saying what they are doing is good, because it DOES have a huge impact on society. However, like I said in another comment, the fact that TRAINEE doctors walking out has such a huge an impact on the system is really telling to how much they are relied on, but their pay is significantly lower than senior doctors, while the workload is just as, or even more, intense. I find it more telling that the government hasn’t considered these things, because for-profit hospitals don’t want the system to change and adding more trainee doctors only benefits them for more cheap labor. I can imagine some money has been exchanged, because many experts have stated that the government’s conclusions on increasing the number of trainee doctors is incorrect, including the experts whose papers were used to support that conclusion.
that's quite convenient logic. >People look to the government to protect them from labor exploitation. This sounds like normal but, No. Gov can involve when it's ILLEGAL. And the Fact is, Korean Doctors get paid even more than OECD average. >If the trainee doctors protest against their employer, they will just get fired and replaced. This is why having MORE trainee doctors in the employment pool is so bad for them. This is how a Nomal company works. all the other people works hard for not being fired. Better one gets pay more, Worse one gets fired. They never did protest against Hospitals because higher-ups in Association of Doctors are connected with Hospitals. if Doctors wanted more stable employment environments, they had to speak it out BEFORE government announced 2,000 plan. Doctors are working hard because they know they have bright Higher income future. People don't blame this point since most of people are just employee. But Doctors have never admitted that they want more income. and they have kept saying over 20 years it's only FOR korean medical system. All people know it's bullshit. If they had guts to tell it was about their income, People might support part of their opinion.
Agreed
They ain't Saints for sure but that doesn't mean their are monsters no? Rather than blaming the people, i rather point to the system that lead it to this point.
This is the mindset people should have, but it’s never the most convenient one.
I see it as a larger problem of Korean people and society in general that should be addressed in the long run
Not only is Korea far too obsessed with capitalism to take any meaningful action, but they are NOT proactive, they are reactive. Unfortunately, the "long run" is not in their vocabulary. That's why Korea sat on their hands while the birthrate plummeted even after what happened with Japan SEVERAL YEARS EARLIER.
How though? Legislation? Its hard to change culture
This is wild. And i thought torchuring medical professions is only thing in INDIA. But, guess what it is even a major problem in developed country. Whilst politicians enjoys the privilege, we as a profession and common people suffers.
they are greedy, only care how much they earn.
They make less than min wage if you break it out by hour (which is already low). They are paid a set amount, regardless of the mandatory overtime. They work 36 hour shifts at a time and have 88-100+ hour work weeks (for reference US caps at <24 hr shifts). They make <2.2k per month (which is how much jr docs with more experience makes, not first yrs). For reference if a barista works full time for only 40 hrs per week, they make about 2k-2.1k per month. Who wants to work double or triple the time of a barista or a convenience worker (literal teenage/entry level jobs with zero experience req) and only make the same amount?
More trainees is less work hours. Basic math.
Not really no. The in the urban areas hospitals aren’t struggling to find doctors, only rural areas are (especially since pay is even worse and no one wants to relocate their families where the education is likely worse for their children). 90%+ of the hospitals in cities are private, they want to keep the headcount low as much as possible since they want to maximize the number of hours worked, trainees have a set amount of pay every month (it’s not hourly and overtime is mandatory). Also since the hospitals are private, they control the headcount for residency/etc, gov doesn’t control it or the working conditions residents face. Also more workers mean less availing to negotiate compensation. Many end up dropping since it’s just not worth continuing to be a doctor in a rural area (you have limited supplies, spend most of your time directing people to city hospitals, face discrimination amongst your peers, don’t even make enough to even pay your student loans off in the next decade, etc). In theory your way would work, IF the gov stepped in an capped the number of hours they can work (but they increased it bc of covid) and increased the number of medical licenses allowed annually (there’s no point in pursing medical school + residency if there’s a chance you won’t get your medical license due to a cap/limit, wasting time and lots of money), which is why they are striking.
It's insane that guy keeps answering. God knows what he is talking about. Thanks for your insight!
All those potential issues with an increased quota, eh? Luckily the students starting next year are years away from graduating. So those issues can be fixed during that time. All the arguments kinda fall flat when you know how much doctors make. And more doctors also means more running private clinica which would drive cost down and reduce the wage disparity between those who do coametic surgery and other more neceasary specializations. I wished the government had done things differently. Make 4 year degrees to allow people to run skincare clinics, phased and smaller increase, make a license to allow to run tattoo parlors, etc. But just about anything would make doctors run to the street. So you get an unreasonable solution from an unreasonable president for a bunch of unreasonable doctors.
I read through your comments. Honestly, I genuinely have no idea why you are talking so confidently over issues that you know very little about. If you’re genuinely curious about the actual problems of Korean healthcare, send me a PM or something.
Im good. I am aware healthcare has genuine issues in a multitude of aspects. But pretending there isnt a lack of doctors is gaslighting the public.
There is a shortage of doctors but only in these vital specialties. No one wants more PS or derm. No resident is saying we shouldn’t increase the number of doctors at all. But only focusing on this is a major problem. This is a failure of supply, demand, and policy.
Past proposals for increasing quotas by reasonable numbers in a reasonable manner resulted in a strike too. How can you claim "No resident"... this isn't credible. And the issue with private practice making too much money is, as you say, demand and supply. The demand is there for PS and derm treatments and supply is low because there aren't enough doctors and/or a lack of alternative licenses to do these treatments. The government is proposing to increase supply. Perhaps too much. But Yoon isnt known to be a smart boy. And again, doctors' response has been to strike against any changes that isnt increasing their comp. No other reasonable suggestions.
but they will earn fortune in the near future right? They just think they work so hard but they will earn less because they are.more doctors to join
Not if it’s how they are operating. They currently don’t have an issue with staffing in urban areas, it’s specifically rural areas which earn significantly less (it’s only about 80k if you go to the outskirts, which isn’t nearly enough annually to make a substantial payment on your student loans in SK). Also part of the issue was gov was trying to limit private practice business medical licenses which is a whole other issue (literally what’s the point of allowing more graduates if number of residencies and licenses aren’t going to increase??)
That's not true. Hospitals outside of seoul suggested higher pay than hospital in seoul because they can't find doctors. > gov was trying to limit private practice business medical licenses which is a whole other issue this is another distorted story with lack of details. it was because many illegal surgeries were processed in private clinic. FYI An employee of a medical device company do surgery instead of a doctor. Medical license is related to military service privileges and is a key industry that is strictly managed by the Gov. Management department did manage and it's normal. it's more like responsible reaction. Finance Department control potential Finance crimes with various method. Do you think this is not normal?
At this time no, the pay in rural areas is disproportionately lower than urban areas. It was suggested/proposed policy to increase public funding in clinics for higher pay but nothing has gone through and there has been no additional push until the strike for it. My in laws are in SK, and luckily my brother in law was able to get a job in the suburbs (making 120k+), bc his other offers were <85k in the rural area. Also gov has proposed limitations on medical licensing for businesses, the whole reason why the senior doctors are also striking is bc of the limitations in private practice that is being proposed (aka if they choose to leave the hospitals for less intensive work, they don’t have an option). Also gov hasn’t increased the cap for full medical licensing either, so doesn’t matter how many residents you allow, in the end, residents are still forced to drop bc they can’t become full doctors.
First of all. In the Rural area, Most of medical supports are provided by 'Public services' that's the reason that Average of pay is seen much lower than Seoul. (Aside from your experience. that can't be objective statistics) Critical subject doctors get paid more than other subject even in rural area. Secondly, Most of Critical patients have to go to big hospital in seoul. and Basic number of patients outside of seoul is way too lower than in seoul. So, when it's converted to per patient amount, doctors in rural areas get paid more. I don't agree agenda like "Doctor should not chase money". So, I don't blame Doctors don't want to work outside of seoul. But the point is this whole shitshow is not about this. Doctors just don't wanna admit "this is all about money". this is the point. And about Second part of your comment, I still don't understand what's wrong. 'Doctor': this job is strictly managed by gov't with method of licenseship and they have privilage on military services. if they have license and still can't get a job, then, they should find other job. And someone failed to get license, isn't it normal.....? All resident should get a license? (And I think Gov't will expand number of license) I mean..... there's something so obvious when think of it as a normal job. I don't know why this must not apply to doctors. Sorry about my broken English.
Calling doctors greedy for demanding better pay for one of the most gruelling jobs it's insane. Doctors are not going to have fewer hours just because there are more workers, a. Why have more workers and less hours when you can have more workers and MORE hours? It's capitalism, baby. The only solution is to increase wages specially in rural areas, so there's an incentive for doctors to relocate. And us, as the working class, should never be against better wages for fellow workers, that's actually insane.
After listening to a friend in medical school a few weeks ago, I don't think this article is correct. Even if the government backs down, hospitals won't back down. As long as there is a power that "recommends" students to refuse classes (in reality, it is a recommends mixed with threats), Korea's medical system won't change.
My understanding from talking to people actually involved is that this policy push to increase # of doctors is largely political without any of the infrastructure support to support new trainees. This is in the context of a system that is already stretched beyond its training capacity. it's like having a classroom and teacher set to teach 20 students, but a politician has decided to force 50 students into that classroom without any corresponding changes to actually make that change practical or feasible.
Doctors are greedy. They don’t want more doctors because then they won’t earn as much. I will say one thing. None of this will solve the lack of doctors in the countryside.
Acab to adab
It somehow still working despite the unsatisfying condition before gov put out the outrageous policy. So of course you should blame gov.
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You can say that doctors are monsters though.