🚨 Emergency Room Runaround Prevention Law

Today Korean Social News for Beginners | 2025.11.08

0️⃣ Pre-notification Requirements and Specialist Deployment, Medical Community Pushback

📌 "Stop Emergency Room Runarounds"… Medical Community Calls New Bill "Desk-Job Policy That Ignores Reality"

💬 A bill has been proposed to the National Assembly to stop the "emergency room runaround" problem where emergency patients are turned away by multiple hospitals. The bill requires emergency medical facilities to notify the Central Emergency Medical Situation Center in advance when they cannot accept patients, and mandates that regional and local emergency medical centers have at least two emergency medicine specialists on duty 24 hours a day. The purpose is to eliminate the inefficiency of ambulance teams calling hospitals one by one and to ensure quick treatment for emergency patients. However, the medical community, including the Korean Society of Emergency Medicine, is strongly opposing it as "desk-job policy that ignores reality." The medical community warns that with emergency medicine specialists already in short supply nationwide, mandating 24/7 deployment is practically impossible, and placing excessive legal responsibility on emergency medical staff could accelerate the exodus from emergency medicine, ultimately collapsing the emergency medical system.

💡 Summary

• The Emergency Room Runaround Prevention Law requires pre-notification when emergency medical facilities cannot accept patients.
• It mandates 24/7 deployment of two emergency medicine specialists at regional and local emergency medical centers.
• The medical community worries about emergency medical system collapse, calling it excessive regulation that ignores staff shortage reality.

1️⃣ Definition

The Emergency Room Runaround Prevention Law is a bill that requires emergency medical facilities to notify the Central Emergency Medical Situation Center in advance when they cannot accept patients and mandates 24/7 specialist deployment at emergency medical centers, to solve the problem of emergency patients being turned away by multiple hospitals and experiencing treatment delays. The official name is "Partial Amendment to the Emergency Medical Services Act."

"Emergency room runaround" refers to the situation where emergency patients or ambulance teams contact multiple hospitals but are rejected due to lack of beds or medical staff, going from hospital to hospital. During this process, treatment is delayed and the patient's life can be threatened. The bill aims to solve this problem by introducing a pre-notification system and strengthening emergency medical staff deployment.

💡 Why is this important?

• It can protect the golden hour for emergency patients and save lives.
• It can reduce ambulance teams' hospital-searching time and improve emergency medical efficiency.
• It can strengthen cooperation between emergency medical facilities and improve emergency medical care quality.
• If it doesn't consider the reality of medical staff and facilities, it could actually collapse the emergency medical system.

2️⃣ Current Status of Emergency Room Runarounds and Issues with the Bill

📕 Reality of Emergency Room Runarounds

• Cases of emergency patient transfer rejection occur frequently. Key situations include:

  • Cases where critical emergency patients are rejected by multiple hospitals and ultimately die have become a social problem through media coverage.
  • Ambulance teams often need to contact an average of 3-4 hospitals to transfer a patient.
  • Emergency room overcrowding, medical staff shortage, and bed shortage are cited as main causes.
  • Especially during nights and weekends, patient acceptance becomes even more difficult due to lack of on-duty medical staff.

• Regional gaps in emergency medical infrastructure are severe. Key problems include:

  • Large emergency medical centers are concentrated in the capital region and major cities, but rural and farming/fishing areas lack emergency medical infrastructure.
  • While there are regional and local emergency medical centers, many lack sufficient staff and equipment.
  • Even mild cases tend to visit large hospital emergency rooms, pushing out critical emergency patients.
  • The emergency medical delivery system doesn't work properly, making patient classification and appropriate hospital placement difficult.

📕 Main Content of the Bill

• Pre-notification of inability to accept patients is mandated. Key content includes:

  • Emergency medical facilities must notify the Central Emergency Medical Situation Center in advance when they cannot accept patients due to bed shortage, staff absence, etc.
  • The Central Emergency Medical Situation Center shares this information in real-time with ambulance teams so they can quickly transfer patients.
  • Medical facilities can be held responsible for problems arising from failure to provide advance notification.
  • The purpose is to eliminate the inefficiency of ambulance teams calling hospitals one by one and to shorten transfer time.

• 24/7 specialist deployment is mandated. Key content includes:

  • Regional and local emergency medical centers must have at least two emergency medicine specialists on duty 24 hours a day.
  • This is to ensure emergency patients can receive immediate specialist care whenever they arrive.
  • Currently, many emergency rooms have only on-duty doctors without specialists during nights and weekends, making emergency response difficult.
  • The bill aims to improve emergency medical care quality and ensure patient safety by addressing this.

📕 Medical Community Pushback and Concerns

• Criticism that it's excessive regulation not considering reality is raised. Main objections include:

  • The Korean Society of Emergency Medicine points out that "with emergency medicine specialists in short supply nationwide, 24/7 two-person team deployment is practically impossible."
  • As of 2025, there are only about 1,500 emergency medicine specialists, far too few to deploy sufficiently at all emergency medical centers.
  • Many emergency medical centers have difficulty securing specialists, and especially rural hospitals have even more trouble finding staff.
  • There are concerns that if the bill is implemented, emergency medical centers that cannot meet staffing standards will have their designation cancelled or be forced to stop operations.

• There are also criticisms of placing excessive legal responsibility on emergency medical staff. Key issues include:

  • Due to the nature of emergency situations, mandatory pre-notification is realistically difficult to implement. Emergency room situations change moment by moment, making advance prediction and notification difficult.
  • If medical facilities or staff are held responsible for failing to notify or delayed notification, defensive medicine will increase and the burden on emergency medical staff will intensify.
  • The emergency medical field already faces a situation where many doctors avoid emergency medicine due to heavy workload and legal risks.
  • There are concerns that if the bill is implemented, residency application rates for emergency medicine will drop further, and existing specialists will also leave emergency medicine, ultimately collapsing the emergency medical system.

💡 Main Issues with the Emergency Room Runaround Prevention Law

1. Staff Shortage Reality: Nationwide shortage of emergency medicine specialists makes 24/7 two-person team deployment impossible
2. Difficulty of Pre-notification: Accurate advance prediction and notification realistically difficult due to rapid changes in emergency situations
3. Excessive Legal Responsibility: Concerns about accelerated exodus from emergency medicine due to increased burden on medical staff
4. Regional Medical Collapse Risk: Possibility of rural emergency medical centers stopping operations if they fail to meet staffing standards
5. Root Causes Unresolved: No solutions for emergency room overcrowding and concentration of mild cases

3️⃣ Reasonable Emergency Medical System Improvement Plans

✅ Emergency Medical Staff Expansion Plans

• Policies to increase emergency medicine specialists are needed. Key directions include:

  • Residency positions in emergency medicine should be expanded to increase the number of specialists in the long term.
  • Working conditions in emergency medical fields should be improved and legal protection strengthened to increase the appeal of emergency medicine.
  • Emergency medical fees should be made realistic to encourage hospitals to actively invest in emergency medical care.
  • Emergency medical staff should be deployed primarily in public hospitals, with incentives provided to private hospitals.

• Emergency dedicated nurses and specialized personnel should be utilized. Key measures include:

  • Since specialists alone cannot respond to all emergency situations, the roles of emergency dedicated nurses and nurse practitioners (NP) should be expanded.
  • The scope of work for paramedics should be expanded to strengthen their role in emergency scenes and during transport.
  • A multidisciplinary team approach should be established where specialists, nurses, and paramedics cooperate.
  • Education and training for emergency medical staff should be strengthened to improve expertise.

✅ Emergency Medical System Improvement Tasks

• The emergency patient classification system should be strengthened. Key tasks include:

  • A system that clearly classifies mild and critical patients and places them at appropriate medical facilities should be strengthened.
  • Mild emergency patients should be guided to primary care facilities or night clinics rather than emergency rooms.
  • The triage system should be upgraded so critical emergency patients can receive priority treatment.
  • Citizens should be educated on proper emergency medical use to reduce unnecessary visits to large hospital emergency rooms.

• Regional medical gaps should be resolved. Key directions include:

  • Public hospitals should be expanded in emergency medical underserved areas and additional emergency medical centers should be established.
  • Cooperation networks between regional and local emergency medical centers should be strengthened to appropriately distribute patients.
  • Doctor helicopters and emergency transfer systems should be expanded to quickly transfer critical patients.
  • Telemedicine consultation systems should be introduced to support emergency medical capacity at rural hospitals.

✅ Establishing Liability Exemption Provisions for Medical Staff

• The legal burden on emergency medical staff should be eased. Key measures include:
  • Liability exemption provisions should be applied to medical staff who did their best with good intentions in emergency situations to exempt them from excessive legal responsibility.
  • Good Samaritan Law provisions should be strengthened in the Emergency Medical Services Act to protect medical staff who provided emergency treatment.
  • It should be clearly stipulated that medical staff will not be criminally punished for unavoidable results during emergency medical care.
  • The medical accident mediation system should be activated to encourage dispute resolution through mediation rather than court litigation.

4️⃣ Related Terms Explained

🔎 Emergency Medical Services Act

• The Emergency Medical Services Act is the basic law to ensure prompt and appropriate treatment for emergency patients.
  • The Emergency Medical Services Act is a law enacted to protect the lives and health of emergency patients and to efficiently operate the emergency medical system. It stipulates the designation and operation of emergency medical facilities, responsibilities and duties of emergency medical workers, operating standards for ambulance teams, the role of the Central Emergency Medical Center, etc.
  • Key content of this law includes: First, emergency medical facilities are designated by categories including regional emergency medical centers, local emergency medical centers, and local emergency medical facilities. Second, emergency medical facilities cannot refuse treatment of emergency patients without legitimate reasons. Third, the Central Emergency Medical Center and regional emergency medical information centers are operated to manage emergency medical information. Fourth, emergency medical workers must provide the best treatment to emergency patients.
  • The Emergency Room Runaround Prevention Law proposed this time is an amendment to this law, adding mandatory pre-notification of inability to accept and mandatory 24/7 specialist deployment. Violations can result in fines or penalties, and in serious cases, emergency medical facility designation can be cancelled.

🔎 Pre-notification System for Inability to Accept

• The pre-notification system for inability to accept is a system where emergency medical facilities notify in advance when they cannot accept patients.
  • The pre-notification system for inability to accept refers to a system where emergency medical facilities notify the Central Emergency Medical Situation Center in advance when they cannot accept patients due to reasons such as bed shortage, staff absence, or equipment failure. This information is shared in real-time with ambulance teams so they can immediately transfer patients to facilities that can accept them.
  • The purpose of this system is to eliminate the inefficient process of ambulance teams calling multiple hospitals one by one, and to protect the golden hour for emergency patients. Through advance notification, ambulance teams can quickly identify hospitals that can accept patients and shorten transfer time.
  • However, the medical community raises questions about the practical applicability of this system. First, emergency room situations change moment by moment, making advance prediction difficult. Second, holding medical facilities responsible for failing to notify is an excessive burden. Third, following notification procedures during emergency situations could delay actual patient treatment. Fourth, considerable costs are required for building and maintaining the real-time information system. Therefore, it is pointed out that sufficient pilot operation and field opinion gathering are needed before introducing the system.

🔎 Mandatory Emergency Medicine Specialist Duty

• Mandatory emergency medicine specialist duty is a provision requiring 24/7 specialist deployment at emergency medical centers.
  • Mandatory emergency medicine specialist duty refers to a bill provision requiring regional and local emergency medical centers to have at least two emergency medicine specialists on duty 24 hours a day. This is a measure to ensure emergency patients can receive immediate and professional care from specialists whenever they arrive.
  • Currently, many emergency medical centers have only on-duty doctors without resident specialists during nights and weekends. On-duty doctors are often not emergency medicine specialists, so emergency response capability may be lower. The bill aims to build a 24/7 specialist system to address this.
  • However, the medical community strongly refutes the feasibility of this provision. First, as of 2025, South Korea has only about 1,500 emergency medicine specialists, far too few to deploy 24/7 in two-person teams at all emergency medical centers nationwide. Second, due to heavy workload and legal risks, residency application rates for emergency medicine are low, and existing specialists are also leaving. Third, especially rural and small/medium city hospitals have great difficulty finding emergency medicine specialists. Fourth, if the bill is implemented, emergency medical centers that cannot meet staffing standards will have their designation cancelled or be forced to stop operations, potentially increasing emergency medical blind spots. Therefore, concerns are raised that strengthening obligations without expanding staff could cause field collapse.

🔎 Emergency Medical System Improvement Tasks

• Emergency medical system improvement requires a comprehensive approach to solve the root causes of emergency room runarounds.
  • Emergency medical system improvement means comprehensive improvement beyond simply strengthening legal regulations, including expanding emergency medical infrastructure, training personnel, strengthening patient classification systems, and strengthening regional cooperation. Experts point out that the root causes of emergency room runarounds are the concentration of mild cases at large hospitals and the lack of medical infrastructure in underserved areas.
  • Major improvement tasks include: First, the triage system should be upgraded to place patients at appropriate medical facilities according to severity. Second, mild patients should be guided to use primary care facilities or night clinics rather than emergency rooms. Third, public hospitals and emergency medical centers should be expanded in emergency medical underserved areas. Fourth, cooperation networks between regional and local emergency medical centers should be strengthened to appropriately distribute patients. Fifth, emergency medical fees should be made realistic to provide incentives for hospitals to invest in emergency medical care. Sixth, working conditions for emergency medical staff should be improved and legal protection strengthened to prevent staff exodus.
  • Simply strengthening obligations and responsibilities without such comprehensive improvements can bring field pushback and actually weaken the emergency medical system. Therefore, the government should invest sufficient budget and personnel and consult with the medical community to prepare feasible improvement plans. Citizens should also learn proper emergency medical use methods and create a culture of primarily using primary care facilities for mild illnesses.

5️⃣ Frequently Asked Questions (FAQ)

Q: What are the main causes of emergency room runarounds?

A: Main causes include emergency room overcrowding, medical staff shortage, bed shortage, and regional medical gaps.

• The causes of emergency room runarounds are complex. First, emergency room overcrowding is the biggest problem. As mild cases also prefer large hospital emergency rooms, emergency rooms become saturated and critical emergency patients get pushed out. Second, medical staff is insufficient. Especially during nights and weekends, only on-duty medical staff work, making it difficult to accept patients. Third, there's a bed shortage problem. After receiving emergency room treatment, if patients need hospitalization but there are no general ward beds, they must wait in the emergency room, preventing acceptance of new emergency patients. Fourth, regional medical gaps are serious. Rural and farming/fishing areas lack emergency medical infrastructure itself, often requiring patient transfer to distant large hospitals.
• These problems are difficult to solve with legal regulations alone. A comprehensive approach is needed including expanding emergency medical infrastructure, training personnel, improving patient classification systems, and changing public awareness. In particular, a culture where mild cases primarily use primary care facilities must be established to resolve emergency room overcrowding.

Q: How can I get treated quickly when using the emergency room?

A: It's important to choose the appropriate medical facility according to severity and accurately explain the emergency situation.

• Methods for effectively using the emergency room include: First, assess severity. If life is at risk or there's critical trauma, call 119 to go to a large hospital emergency room. However, for mild conditions (cold, mild stomach pain, minor injuries, etc.), it's better to first use a primary care facility or night clinic. Second, explain symptoms accurately and in detail to 119 paramedics. Paramedics evaluate the patient's condition and choose an appropriate hospital. Third, calling the Central Emergency Medical Center (1339) provides emergency consultation and guidance to nearby emergency medical facilities. Fourth, upon arriving at the emergency room, you'll receive triage, and since critical patients receive priority treatment, waiting time may be long for mild cases.
• Also, if you organize information about yourself and your family's medical history, medications being taken, and allergy information in advance, you can quickly provide information to medical staff in emergency situations, helping treatment. It's also good to always carry your health insurance card and ID.

Q: If the Emergency Room Runaround Prevention Law passes, how will it affect citizens?

A: Positively, shortened transfer time is expected, but negatively, there are concerns about emergency medical system weakening.

• If the bill passes, theoretically, emergency patient transfer time will be shortened and the possibility of protecting the golden hour will increase. Ambulance teams can identify hospitals' acceptance availability in real-time and quickly transfer patients. Also, with 24/7 specialist deployment, emergency patients can always receive professional care.
• However, as the medical community worries, realistic problems may occur. First, if emergency medical centers that cannot meet staffing standards stop operations, emergency medical blind spots may actually increase. Especially, rural area residents may have to travel farther distances. Second, if the burden on emergency medical staff intensifies and the exodus from emergency medicine accelerates, emergency medical staff shortage may worsen in the long term. Third, if the pre-notification system doesn't work properly, only confusion may increase.
• Therefore, regardless of whether the bill passes, efforts to comprehensively improve the emergency medical system are needed, and citizens should also create a culture of properly using emergency medical services.

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