🚨 Second Medical Crisis

Today Korean Social News for Beginners | 2025.11.01

0️⃣ Generic Name Prescription and Korean Medicine X-ray Controversy

📌 Korean Medical Association Warns of 'Second Medical Crisis' Over Generic Name Prescriptions and X-ray Use by Korean Medicine Doctors

💬 The Korean Medical Association has formed a 'National Health Protection Committee' to oppose the government's push for generic name prescriptions and allowing Korean medicine doctors to use X-rays. After the 2024 medical resident mass resignation crisis, there are growing concerns that the medical field, which was finding stability, may face chaos again. While the government is pushing for reforms to stabilize essential medicine supply and improve healthcare access, the medical community sees this as an infringement on prescription rights and a distortion of the healthcare system. The KMA plans to hold a large rally in November and has announced possible collective action, intensifying the conflict between doctors and the government. Issues surrounding expanded medical device use by Korean medicine doctors and reforms to the consignment testing system are also at the center of controversy.

💡 Summary

• The Second Medical Crisis refers to renewed conflict between the medical community and government after the 2024 medical resident crisis.
• The KMA opposes generic name prescriptions and X-ray use by Korean medicine doctors, preparing for collective action.
• Conflict is intensifying between government healthcare reform and the medical community's defense of autonomy.

1️⃣ Definition

The Second Medical Crisis refers to a situation where serious confrontation between the medical community and government occurs again after the 2024 medical resident mass resignation crisis, potentially creating gaps in medical services and threatening citizens' health rights. The term "second" carries a warning about the possibility of the previous crisis repeating.

Currently, the medical community is concerned that a series of government policies—including introducing generic name prescriptions, allowing Korean medicine doctors to use X-rays and other medical devices, and reforming the consignment testing system—will bring chaos to medical practice. With doctors' associations uniting across the medical field to respond, the possibility of large-scale collective action similar to the 2024 medical crisis is being raised.

💡 Why is this important?

• Conflict between the medical community and government directly affects patient care.
• When medical service gaps occur, emergency and critical patients suffer the most.
• Healthcare system reform is an important issue directly connected to citizens' health rights.
• Conflicts between different medical professions can also affect patient safety.

2️⃣ Main Issues and Background of the Conflict

📕 Generic Name Prescription Controversy

• Key features of the generic name prescription system: Main characteristics are as follows:

  • Doctors prescribe using the generic name (e.g., 'acetaminophen' instead of 'Tylenol').
  • Pharmacists can choose from several medicines with the same active ingredient to dispense.
  • The government is pushing for this to solve shortages of specific pharmaceutical products and stabilize essential medicine supply.
  • This system is already implemented in many countries including the UK, Canada, and Australia.

• The medical community's opposition is clear: Main concerns are as follows:

  • They believe doctors' prescription rights are infringed and pharmacists are given excessive authority.
  • Even with the same ingredient, there are differences in formulation, excipients, and bioavailability, making personalized prescriptions difficult.
  • They argue it shakes the foundation of the separation of prescribing and dispensing: "doctors prescribe, pharmacists dispense."
  • When side effects occur from pharmacists' arbitrary substitution, the responsibility becomes unclear.
  • There are concerns that excessive competition among pharmaceutical companies may revive kickback problems.

📕 Korean Medicine Doctor X-ray Use Controversy

• Korean medicine and doctor groups are sharply opposed: Main issues are as follows:

  • Korean medicine practitioners argue that X-ray and other medical device use is necessary for accurate diagnosis.
  • Currently, Korean medicine doctors can only use some devices like ultrasound and thermal diagnostic equipment.
  • A medical law amendment bill has been proposed to parliament to expand the scope of medical device use by Korean medicine doctors.
  • Doctor groups counter that allowing Korean medicine doctors without specialized radiation training to use X-rays threatens patient safety.

• Legal interpretation controversy continues: Main points are as follows:

  • The Constitutional Court previously ruled that restrictions on Korean medicine doctors' medical device use were constitutional.
  • However, the Supreme Court has issued rulings allowing some medical device use, creating confusion.
  • Fundamental differences between Korean medicine and Western medicine, and differences in educational programs are at the core of the controversy.
  • From a patient's perspective, being able to get X-rays at Korean medicine clinics would be convenient, but safety concerns remain.

📕 Consignment Testing System Reform Controversy

• The government's reform direction: Main points are as follows:

  • Currently, hospitals and clinics that outsource specimen testing claim management fees from the health insurance corporation.
  • The reform plan changes this so outsourcing and contracting institutions each directly claim their own costs.
  • The government cites preventing duplicate claims and improving transparency as reasons for reform.
  • The goal is to reduce administrative burden on small and medium medical institutions and increase efficiency.

• The medical community points out practical problems: Main concerns are as follows:

  • They believe administrative work for outsourcing institutions will actually increase, making it difficult to focus on treatment.
  • Small clinics worry about worsening management as testing management fee income decreases.
  • From patients' perspective, confirming test results and consultations may become more complicated.
  • There are strong complaints about one-sided implementation without sufficient discussion on timing and methods.

💡 Key Issues in Medical-Government Conflict

1. Prescription Rights and Separation of Prescribing/Dispensing: Does generic name prescription infringe on doctors' inherent authority?
2. Inter-professional Conflict: Clarity of work boundaries between Korean medicine doctors and doctors
3. Patient Safety: Impact of system changes on medical safety
4. Medical Community Autonomy: Government-led reform vs. medical community input
5. Legitimacy of Collective Action: Impact of medical professionals' collective action on patients

3️⃣ Comparing 2024 Medical Crisis with Current Situation

✅ Development of 2024 Medical Resident Crisis

• Medical school enrollment increase policy was the trigger: Main developments are as follows:

  • In early 2024, the government announced plans to increase medical school enrollment by 2,000 students.
  • The medical community opposed, saying strengthening essential medical support should come before increasing doctor numbers.
  • From February, medical residents began submitting mass resignation letters and leaving hospitals.
  • Medical service gaps occurred as emergency rooms and intensive care units in major hospitals faced disruptions.
  • The situation prolonged as negotiations between the government and KMA broke down.

• It caused significant damage to medical practice and citizens: Main impacts are as follows:

  • Emergency and critical patient treatment was delayed or transferred to other hospitals.
  • Surgery schedules were canceled or postponed, causing patient inconvenience.
  • Professors' workload greatly increased due to residents refusing to participate in treatment.
  • There was significant social criticism that the medical community's collective action threatened patients' right to life.
  • The government issued return-to-work orders, but their effectiveness was limited.

✅ Characteristics and Differences of Current Conflict

• Issues have become more diverse and complex: Main features are as follows:

  • Multiple policies are simultaneously controversial, not a single issue (medical school enrollment).
  • A wider range of medical professionals including private practitioners, professors, and Korean medicine doctors are involved, not just residents.
  • Inter-professional conflicts (doctors vs. Korean medicine doctors, doctors vs. pharmacists) are also emerging.
  • A pan-medical committee has been formed to prepare organized and systematic responses.

• Both government and medical community have hardline positions: Main aspects are as follows:

  • The government maintains its policy push, saying medical reform is inevitable.
  • The KMA is warning of stronger collective action, learning from the 2024 crisis.
  • Public opinion questions both concerns about medical service gaps and the validity of government policies.
  • The atmosphere is intensifying toward confrontation and conflict rather than dialogue and compromise.

4️⃣ Related Terms Explained

🔎 Generic Name Prescription

• Generic name prescription is a system of prescribing by active ingredient.
  • Generic name prescription is a system where doctors write prescriptions using the generic name (active ingredient) instead of brand names. For example, prescribing 'acetaminophen' instead of 'Tylenol', or 'acetylsalicylic acid' instead of 'aspirin'. Pharmacists can select an appropriate product from several medicines with the same ingredient to dispense.
  • Benefits of this system include: First, substitute dispensing becomes possible when specific products are in short supply, improving supply stability. Second, pharmacists can choose cheaper generic medicines, reducing medication costs. Third, it can reduce excessive competition among pharmaceutical companies and promote quality-focused competition. Fourth, it is an internationally standardized prescription method.
  • However, medical community concerns are significant. Even with the same ingredient, there can be differences in formulation, excipients, and bioavailability, leading to different patient responses. There may be reasons why a doctor prescribed a specific product, but pharmacist substitution risks changing treatment effectiveness. Also, when side effects occur, responsibility becomes unclear, and the distinction between prescription and dispensing rights—the principle of separation of prescribing and dispensing—becomes ambiguous.

🔎 Separation of Prescribing and Dispensing

• Separation of prescribing and dispensing is a system that clearly divides roles between doctors and pharmacists.
  • Separation of prescribing and dispensing is a system where doctors examine patients and prescribe, while pharmacists dispense according to prescriptions and provide medication guidance. It has been fully implemented since July 2000. The main purpose is to prevent drug misuse and abuse and improve patient safety.
  • The basic principle is summarized as "doctors diagnose and prescribe, pharmacists dispense and provide medication guidance." Through this, doctors and pharmacists can each exercise their expertise to provide safer and more effective medical services to patients. It also serves as a dual safety mechanism to check duplicate medication and drug interactions.
  • The core of the generic name prescription controversy is related to this principle. The medical community worries that if pharmacists can choose medicines, it goes beyond dispensing rights to effectively intervening in prescriptions, shaking the foundation of separation. Conversely, pharmacist associations argue that choosing within the same ingredient is within the scope of professional dispensing and not an infringement of prescription rights. This debate is also about distributing authority between professions within the medical field.

🔎 Medical Resident

• A medical resident is a doctor in training to obtain specialist qualifications.
  • A medical resident refers to a doctor who, after obtaining a medical license, receives specialized education and treatment at a training hospital to obtain specialist qualifications. They go through 1 year of internship and 3-4 years of residency, during which they serve as important medical personnel in hospitals. Korea has about 13,000 medical residents.
  • Medical residents play a key role in hospital medical systems. They directly care for patients in emergency rooms, intensive care units, and wards, and participate in surgeries and procedures under professor supervision. Especially in major hospitals, dependence is so high that normal treatment is difficult without residents. Night and weekend on-call duties are mainly handled by residents.
  • The 2024 medical resident mass resignation crisis showed how much impact their collective action has on the medical system. When residents left hospitals, emergency rooms and intensive care units faced disruptions, and scheduled surgeries were canceled, causing patient harm. The government issued return-to-work orders, viewing residents as special workers, but the medical community countered that improving poor training conditions should come first. This conflict raised the need to reconsider the overall medical personnel structure and training system.

🔎 Essential Medical Services

• Essential medical services are healthcare services absolutely necessary for citizens' lives and health.
  • Essential medical services refer to medical fields such as emergency care, severe trauma, childbirth, pediatrics, and cardiovascular care that are absolutely necessary to protect citizens' lives and health but are avoided due to low profitability. It is also at the core of medical imbalance problems between regions and medical specialties.
  • Korea's essential medical services situation is serious. Surgery, obstetrics and gynecology, and pediatrics have become specialties that medical students avoid, and regional small and medium hospitals find it difficult to maintain these departments. Emergency rooms suffer from chronic staff shortages, and areas without obstetrics clinics capable of childbirth are increasing. Unfortunately, cases occur where critical patients die while being transported long distances.
  • The government pushed for increasing medical school enrollment under the pretext of resolving the essential medical services crisis, but the medical community argued that strengthening essential medical support should come before increasing doctor numbers. They say fee increases, reducing medical malpractice burden, and improving working conditions are needed. The essential medical services problem is a complex task requiring structural reform of the overall medical system, not simply a matter of doctor numbers.

5️⃣ Frequently Asked Questions (FAQ)

Q: How will generic name prescriptions affect patients?

A: There are medication cost savings, but personalized prescriptions may be limited.

• The biggest advantage of generic name prescriptions is reducing medication cost burden. Pharmacists can choose cheaper generic medicines with the same ingredient, reducing patients' out-of-pocket expenses. Also, even if a specific product faces shortages, substitute dispensing with other products becomes possible, improving medicine supply stability. When getting explanations at pharmacies, discussing by generic name makes it easier to compare various products.
• However, there are concerns. If a doctor prescribed a specific product considering the patient's condition, pharmacist substitution may change effectiveness. Even with the same ingredient, differences in formulation (tablets, capsules, etc.) or excipients can lead to different absorption rates or side effect possibilities. If problems occur, it may become unclear whether to hold doctors or pharmacists responsible. Therefore, when introducing generic name prescriptions, clear guidelines and responsibility systems for patient safety must be established together.

Q: Is it really dangerous if Korean medicine doctors use X-rays?

A: Without proper education and safety measures, it can be dangerous for patient safety.

• The core of the Korean medicine doctor X-ray use controversy is education and safety. X-rays are medical devices using radiation, and misuse risks radiation exposure to both patients and medical staff. Also, accurately interpreting captured images requires specialized medical knowledge. Currently, medical schools provide sufficient education in radiology, but Korean medicine school curricula do not include such content.
• Korean medicine practitioners argue that X-rays are needed to improve diagnostic accuracy. For example, when treating spinal or joint diseases, having X-ray findings enables more accurate diagnosis. However, doctor groups oppose allowing X-ray use without radiation safety education as endangering patients. Possible solutions include making radiation-related education mandatory for Korean medicine doctors, or strengthening collaborative medical systems where hospitals are referred when X-rays are needed.

Q: How should the general public prepare if the medical crisis recurs?

A: Get chronic disease prescriptions in advance and check emergency preparedness information.

• When a medical crisis occurs, major hospital emergency rooms and intensive care units are affected first. However, most local clinics and pharmacies operate normally, so there's no need to worry excessively. Still, those who regularly take medicine for chronic diseases should get prescriptions in advance before running out. Also, if you have a regular hospital, check emergency contact information and treatment availability in advance.
• Preparing for emergencies is also important. 119 ambulances operate normally, but some major hospital emergency rooms may operate on a reduced scale, so the Emergency Medical Information Center (1339) can guide you to hospitals available for treatment. Minor illnesses can use on-call medical institutions operating at night or on weekends. Above all, prevention is best, so pay attention to health management in daily life and detect diseases early through regular checkups. Citizens should also pay attention and watch as the government and medical community resolve conflicts through dialogue.

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