After hearing the stories of medical students, teachers, and professors, I feel like running away. Why was I asked to give a presentation from the perspective of a Seoul Depei Dane? Let me tell you in advance that I will be expressing opposing opinions. I have no choice but to say things that may upset you. First of all, in the picture, you can see a young Jo Dong-chan. When I was in the operating room, the patient covered in sheets is a patient with chronic subdural hematoma. If we talk about the perspective of the people, if we talk about the perspective asked of me by the people, I thought it would be the perspective of this patient lying down. And now, as it will be shown on the slides I have prepared later, I am considering whether to talk about why the perspective of the patient lying down is important. There have been many reports on the medical crisis for the past two months, and there have been times when there were reports that were so upsetting in the medical field.

A month ago, more than I expected, the voices of the medical community are being highlighted in the news. Now, people are nodding, thinking about what arguments the medical community is making, and realizing that some of the government's policies are wrong. It's not about simply looking at the numbers. The number of neurologists is three times higher than the OECD average. Therefore, it was reported that increasing the numbers that we think are insufficient is not the ultimate goal. Also, although the ratio of residents to specialists in pediatrics is decreasing now, compared to the past 10 years, it has increased by 21% per 100,000 people. Some pediatricians come and go, and some start from the age of 15.

Some people have been counting from the age of 18, so roughly speaking, the number of medical students has doubled. The birth rate has decreased, but now, compared to 10 years ago, there is more talk about opening new medical schools. Actually, it seems that the public is more aware of this. In Korea, the number of doctors is among the lowest in OECD countries, along with Japan. However, when looking at the growth rate of doctors, there is a significant difference. In the chart on the right, the dashed line represents Korea, which is the highest. Although I haven't reported this on the main news, there have been times when it was covered, and there are certainly people who are aware of these issues. Some argue that if the number of doctors increases, the national medical expenses will also increase, but there are those who disagree with this statement. One of them was actually a medical school professor, and I confirmed it right away.

I just came from Japan, so you know, there was a time when we increased the number of doctors in Japan, and as a result, the medical expenses for patients increased. In fact, this is not a concept from the 1970s; it was announced in 2015 and is still being applied today. Therefore, there are still grounds to say that increasing the number of healthcare providers does not necessarily lead to an increase in national medical expenses. Of course, it's not easy to say this is the absolute truth based on just one paper. In 2024, Yale University tracked from 1970 to 2018, a total of 48 years, and found that areas with a shortage of doctors did not have an impact on the mortality rate, and the density of doctors did not improve much. So, in the United States, the number of doctors has continued to increase for 50 years, and as a result, it continues to increase per capita. These are the points that are being discussed. Therefore, in fact, there are various grounds not only domestically but also internationally.

Looking at it comprehensively, it is clear that simply numbers alone cannot solve the problems. Many issues arise from this, and in my opinion, it has been covered more than my expectations. Therefore, I believe that many people are aware of these issues. So, I asked the citizens. However, I had no way to ask the citizens directly, so I had to ask acquaintances and people I know. The target group does not include doctors but rather parents or children without doctors. Where have I seen this a lot? For example, at Seoul National University's Presidential Committee on Balanced National Development, we conducted a similar survey to improve our country's public services. However, we included siblings of doctors in the survey as well because I wanted to make a slight comparison. The survey method was sent via KakaoTalk, and anonymity was guaranteed. Nevertheless, there were quite a few non-responses. Those who responded were guaranteed anonymity, but those who did not respond were also guaranteed anonymity.

Because they didn't guarantee it, the Beijing correspondent is curious about why Kwon Ran, the reporter, is responding. Our program Ppoyan Geotap that I host, PD Hong Hyejin, did not provide an answer. We did not inquire about gender, education, and other personal information. Now, from now on, um, what I just said, unlike Professor Kang Gu, I am not an expert, and I have made many mistakes. So, what I do the most is, I'm not confident in saying what is right even now. I have made too many mistakes. Therefore, there is a high possibility that the information I provide now may be incorrect, so I hope you listen carefully. I am a mother of a two-year-old. From the perspective of a mother raising a two-year-old, I am more negative about the medical field. I recently visited a math institute, and the math teacher there said there won't be many in the future because eight out of ten places are closing down.

It seems that out of ten places, eight are actually closed. But is it because of the consumers? Consumers are still frequenting the remaining two places. And most of the people in the country do not watch the news diligently. They read the overall atmosphere and message. I would like to emphasize this part a bit. So, rather than fact-checking one by one in a logical manner, people read the overall atmosphere and message. I agree with this part. Of course, I agree with this, but I could be wrong. Next, I am a person who had their medical appointment canceled at a university hospital. I also received a text message today saying that the medical examination I had scheduled at the university hospital was canceled. I once again felt how precious every second is for those in a medical crisis.

I see the reality of a dysfunctional politics. I criticized politics first. This person must be a journalist. When it comes to dysfunctional politics, just by doing this roughly, I can guess who it is. However, medical professionals should also consider if resigning is the best option. Like dysfunctional politics, it makes me think of medical professionals who are failing, leaving aside the lives of patients. This is what I'm conveying. Next, I'm attending a graduate school for interpretation, and as it prolongs, it seems that fatigue is increasing. It seems that the public is feeling high levels of fatigue on this matter. Our journalists are also sensing these circumstances because the news sources are continuously decreasing. It's a very important issue, but the reduction of news sources is necessary. What is necessary is to hear the unpleasant news. Government and medical briefings are always seen. Medical briefings that we all see.

So, in the medical field, some people seem to get annoyed after watching the Ministry of Health and Welfare briefing. It must be acknowledged that there are definitely people who get annoyed after watching the briefing in the medical field. And it's frustrating that these important issues seem to receive relatively less attention. This person felt surprised even though they have nothing to do with the medical field. So, I was really surprised. So, how important the current medical crisis is to our people is something we all know. And I also mentioned one more thing. Even if one side bends the argument of the other side to produce the desired result, it seems impossible to gain people's support. People do not want a situation where one side is heavily favored. And they say that the people think the same way. It would be good if both sides could focus a little more on what is really needed by whom and who is right or wrong in this issue.

I left, and this is what I have grasped at the moment. But it's a bit too negative. Excluding those with a medical background among the parents and children, I asked siblings who are doctors. Because now, although parents and children are a bit like that, siblings become like others when they grow up. So, at first, it was frustratingly vague, but now I get the impression that the medical field is the same. For example, it was mentioned that the representative of the medical device industry did not participate in recent medical association discussions. From the perspective of the medical device industry, it was a situation where they did not participate too much. But from the perspective of the general public, it seems like, why isn't the medical field doing this here? That's what people think. It's not that each logical argument has sunk in, but the overall atmosphere is like, why isn't the medical field doing this here? My sister is over there, but I do it like this. Both should maturely go beyond their own positions.

I negotiated with a focus on resolving the issue through my perspective, but the problem is that I asked my acquaintance without statistical significance. And what I mean is that there was no one who spoke more positively than this. To be frank, I think there might be, even though there are journalists in Korea, it became a sensational article that Korean doctors earn the most money among O countries. Of course, I also realized this recently. When you look at the OECD doctor's income in this way, the methods vary significantly by country, so it needs to be adjusted a lot. Therefore, it is a serious mistake for someone teaching at a medical school to announce it without such detailed adjustments. Even if this data is a bit misleading, we need to know the order. The medical expenses paid by our citizens compared to GDP in our country are lower than the OECD average. In 2023, the Ministry of Health and Welfare provided the OECD Health.

In data as well, the average is lower. So, we pay less for medical expenses. The quality of medical care for the people is well known. In fact, it is much more important to question how much the citizens are paying for medical expenses than to ask how much doctors earn. When the subject of the question is the citizens, discussions on answers for the citizens can be made, which is why it is much more crucial. If the medical expenses paid by the citizens are high but the medical services they receive are low, what comfort would it be for doctors to earn less? On the contrary, if the medical expenses paid by the citizens are low and the medical services received by the citizens are good, why would there be any jealousy about doctors having high incomes? The order is citizens, the medical expenses paid by citizens, and then the income earned by citizens should be considered. It is correct to evaluate doctor's income as part of medical services when that is not fulfilled.

It should be the third step, but we went to the first step. Where did this good article come out? For example, SBS. I'm sorry, but it's company policy that you have to subscribe. Please log in and subscribe. Could you please do that for me? I have received permission from the company to advertise this. You need to log in. You only need to do it once. At times like this, what is the essence of the people? It's the concept of the veil of ignorance. The government says it's for the people, and even doctors say they are one of the people. It's true that public officials are also one of the people. So, what should we do to truly understand the will of the people at times like this? I have also received this. It's not my justice, it's the veil of ignorance. Because it's not a veil, we should discard all the various classes and statuses outside the world and discuss in a state where we all let go of our social status. Only then can we truly understand the will of the people, who are the weakest in society.

Decisions are made based on a rational and just definition that reflects the rights of individuals. Anyone of us could become a patient with chronic subdural hematoma as I have shown before. Therefore, we need to take the position that our decisions are made with this in mind. In this process, the biggest victim of the current medical crisis is the patient. There is no room for choice, and right now, we are the only victims. Who is the victim? Who represents us? It's too difficult. During the time of COVID-19, there were many excess deaths. But non-COVID-19 deaths were around 20,000 more in five months. That's more than COVID-19 deaths. The intensive care units were weak. Why did emergency critical care stop at that time of COVID-19 infection? What about us now? Emergency critical care has dramatically decreased, and non-COVID-19 excess deaths are increasing. This is how our patients are being affected.

I think the most memorable thing for me now is when my major went on strike. They went on strike and then they said they would go see COVID-19 patients, so I went to the hospital. So, as usual, when they see patients, we will film from behind. The patient was wearing an artificial trachea and removing it. When I removed it earlier, the patient coughed and tried to stop it, but it was so funny that I burst out laughing. You have to cough hard. When the patient coughed like that, many people laughed like that. And what the people want is for you to laugh like this. So, I really like this. Movies actually do everything for me as if it were fate. When we solve a problem or resolve a conflict, I think we need to recognize the opponent as the most minimal and the target of negotiation. The person on the left is KKK.

So, the person on the left was the leader who was against black people, and on the right was me, the leader of a black movement group, the person I dislike the most, hate, and really want to hit and kill, somehow could be the person I need to face the problem with, I think I should acknowledge that. This effect has been proven in a paper. In the 1970s, black and white people lived separately, but after 46 years in 2016, many places where black and white people live have merged. So, what we expect from the government is, currently, in the medical field, regardless of the specialties and the Medical Association, once we unite our intentions, the government should acknowledge it. As a representative of the medical field, and in fact, if the medical field does not fit well as a negotiating body for the medical reform that the government has limited, then I think the medical field should first say, Let's reject this negotiation proposal, so let's discuss it together. So, anyway, now.

Gumin doesn't have the leisure to judge right from wrong. In fact, what the people send me, whether it's a text or an email, it's like in the judgment of Solomon, where two mothers fight over a baby, I really don't know who the real mother is. It seems like I'm putting too much burden on the staff because it's the voice of the people, but still, if it's the voice of the people wishing for everyone to come back to the hospital, I think I should deliver it as well. I will end here.

2024.04.30 심포지엄 조동찬

2024.04.30 심포지엄 조동찬

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