My Experiences with (Government) Medicine in Korea

[Nick M]

Pre-reading for why government healthcare is an outrage: http://www.bdt.com/pages/Peikoff.html

Over the past month I have had need of medical treatment in Korea, and while I believe I will eventually heal completely, I have been absolutely alarmed and disgusted by the blatantly obvious degree of professional atrophy I have observed across 3 different hospitals where I have been a customer. Of course this decay in the standards of medical practice (relative to America) stems from the disgusting philosophy (and political-philosophy) which is prevalent here, but it doesn't make it any less infuriating to be a victim of those ideas at this time when I am most physically vulnerable, and linguistically impotent.

I suffered two fractures in my fibula on April 19th (from an impact-type injury while playing soccer) one of which was sightly displaced. I eventually underwent a titanium plate-fixation surgery on May 3rd at Seoul National University Hospital (SNUH), supposedly the best in Korea. (On a side note, I believe the rubberized artificial turf playing surface was absolutely a factor which contributed to my injury, but that's hardly the most important example of compromised standards I've encountered here). After the initial ER visit, my research of how to proceed with treatment involved going to 3 hospitals, and getting 3 local opinions on how to proceed. I also was able to email xrays and get additional opinions from an orthopedist uncle of mine back in America.

What I observed every step of the way with the doctors in Korea, was indignation and offense at the idea of being questioned, of even general inquiries like “what's gong on with my body? Why?” and “How long will this last?” Psychologically, doctors here operate under the premise of “this care is mine to mete out and yours to receive at my pleasure. If there's something about your treatment that you don't understand, don't worry about it, don't you trust that I'm doing my job?” After hearing in my first consultation with orthopedist #1 that he recommended surgery, this doctor was genuinely offended that I felt the need for further consultation and a second opinion. Not “har har, ok, but you're wasting your time, he's going to say the same thing as me...” but he was actually, sincerely, affronted that I was questioning his expertise or even “authority” to decide how to proceed.

It was even less reassuring that orthopedist #2 came to an entirely opposite conclusion from #1, saying “surgery is unnecessary” and that he did not recommend it. This left me about a week after my accident with a slowly healing, crooked fibula. Unsatisfied to literally lie there and take it, I got in touch with SNU Hospital which was listed on the American embassy website. SNU Hospital has a much greater reputation that either of the first two hospitals, but what really sold me was the fact that I was able to be connected to a polite, knowledgeable nurse-receptionist who spoke to me in fluent English. Later she even accompanied me to the first consultation. Throughout all of this, my wonderful girlfriend has been acting as driver and interpreter, but the language skills exhibited by (some of) the staff at SNU Hospital was a large part of my decision to receive surgery under their care.

However, the alarming ideas I've described above were still present in at this hospital. Take a number (like at the DMV) and wait in line to be called for your turn at a blood-letting (sampling) station. Take a number and wait to be called for your time with an xray technician. Take a number and wait to be called for an “electro cardiogram.” (Also as an aside, never in the three hospitals where I was xrayed did I ever see a lead apron to protect my balls from xrays. In America, I've always been told to wear one, even when doing xray at the dentist).

Most every encounter I had with medical professionals was rushed, and I found myself repeatedly asking nurses to “slow down, please. Take your time” when inserting IV needles, or taking blood samples, or dressing my incision, it was amazing, and alarming to see the frenetic pace at which they worked. I wanted to say “I know there are 200 more patients you need to see. I don't care about them. Please, slow the fuck down, and do your job the best you can, I'm not going to grade your performance by actions-per-minute.”

There were other alarming instances, such as the process of removing post-operative drainage tube from the incision, which happened in my hospital bed at SNU Hospital. Korea is a country that doesn't understand the idea of privacy. I'm not saying that “it's a different style,” I'm saying they literally do not understand the meaning of the concept. People that are accustomed to the feeling of each other's flesh on one another as they ride the subway. As this tube was being removed from my wound (which was a pretty painful procedure, that had me sweating and gritting my teeth), the curtain around my bed was left open, and strangers (other ambling patients, and their visitors) were stopping to gawk and even point their rotten fingers alarmingly close to my wet and dripping incision as a doctor is performing this procedure on my lower leg with his ungloved-hands. It never occurred to anyone else that there was anything remotely objectionable happening. It was not a lack of technology, it was a lack of ideas, a lack of patience; a low standard accepted by default due to scarcity of time and ability.

What has prompted me to write this anecdote is less the disgusting medical practices I witnessed, but the disgusting psychology. Today, two weeks after surgery, I returned to the first hospital, and to orthopedist #1 to have the stitches and staple in my incision removed. I felt it would be ok to go to this nearby hospital for this relatively minor procedure, despite believing that SNU Hospital is more reputable. I also stood to save about $50 by choosing this hospital over SNU Hospital's more expensive consultation fees. I met with the first doctor I had seen after the accident, and was absolute astounded by the infantile temper-tantrum psychology exhibited by this SURGEON.

This man does not speak much English, but while talking at my partner, who was there to translate, the things he found it most important to say were “you paid too much, your incision is too big, you should have come to me, I would have done it better.” His demeanor was not at all helpful, nor concerned about my treatment, it was positively surly and pouting. He then proceeded to take out my stitches and staple; I'm not a doctor, but by all my past American experiences (and simple “how to take out sutures” research on the internet) he did it carelessly, and incorrectly. He did not wear gloves, he did not wash or disinfect his hands in front of me, he did not disinfect the staple-remover or the forceps, he did not disinfect the stitches or wound before pulling the (possibly bacteria laden!) sutures through my skin. I'm pretty sure you don't pass med school doing it that way, and everything I've read on the internet says you're doing it wrong. After the stitches were removed, he made one pass over the incision with disinfectant, and bandaged me up. He didn't do it well, but he did it fast!

It is this situation, of knowing there is a better way, and being powerless to choose it, that is the inevitable result of government regulation of industry. Any industry. Education, medicine, energy, anything. I also understand that the disgusting psychology exhibited this doctor is an INEVITABILITY of government coercion of professionals, and it is all the more grave the more specialized, and difficult the work that needs to be performed. I witnessed, at more than one hospital, people with amazingly specialized skills, people who should rightfully take pride (and care) in their work, reduced to psychological parity with your average DMV worker. I was furious at being the victim of these bad ideas, and also angry at myself for being too paralyzed with fear to say “Yo doc, you're doing wrong. Please use disinfectant.”

I have reached a milestone in my post-operation recovery, and am at a point where I can do nothing but wish. I wish that the consequences of my injury, and treatment, are not very severe. I am also confronted by the ironic reality that had this injury occurred in America, as an uninsured person, treatment would likely have been many times more expensive. For many people, prohibitively so (making orthopedist #2's non-surgical recommendation much more subjectively appealing). The final cost of my surgery and treatment in Korea (across the 3 hospitals I visited) will probably be around $3700. I don't really have a way to estimate what the cost would have been in America, but I bet it would have stung more financially, and that the care I received would have been higher quality. Whether or not the care would have been a better *value,* I suppose I will learn as complications in my recovery arise, or don't.