With the mindset of saving trauma patients, many become trauma specialists, but half of them leave the trauma center once they start working on-site. An environment must be created where young doctors who committed to dedicating themselves to patients can feel a sense of fulfillment. I am worried that if there is no change now, the system for managing critically injured trauma patients, which has accumulated over the past 10 years, may regress.
On the morning of 4th, at Korea University Guro Hospital in Guro-gu, Seoul, Oh Jong-geon, president of the Korean Trauma Society, said this regarding the recently raised issue of the shortage of trauma specialist personnel. He is a professor of orthopedics at Korea University Guro Hospital and the director of the training center for critical trauma specialists. Oh noted, "Currently, the domestic trauma patient management system is at a crossroads: whether to move forward or regress, and revolutionary support for trauma medicine is needed."
Oh is a renowned expert in the fields of traumatic fractures and osteomyelitis and a key figure in establishing the foundation of trauma education in the country. He has served as the director of the critical trauma specialist training center, the first of its kind in the country established at Korea University Guro Hospital in 2014, for 11 years. The critical trauma specialist training center is an educational institution that can produce trauma experts in conjunction with regional trauma centers.
The critical trauma specialist training center at Korea University Guro Hospital has trained over 20 trauma specialists, sending them to regional trauma centers nationwide. How many of them are currently working at regional trauma centers? Oh responded, "I haven't detailed the statistics, but probably only about half remain in the field."
This is confirmed by statistics. Since 2011, there have been a total of 371 trauma specialists recognized by the Korean Trauma Society. According to Han Ji-ah, a member of the National Assembly's Health and Welfare Committee, as of the end of January this year, there are 188 dedicated specialists working at regional trauma centers across the country. This means that more than half of the trauma specialists in the country are seeing general patients rather than trauma patients.
Looking into the details, there are even more serious issues in some fields. According to statistics from the Trauma Society, the estimated number of trauma specialists among orthopedic surgeons is 76. According to Oh, there are only about 10 orthopedic trauma specialists working at regional trauma centers nationwide.
The Trauma Society has improved various systems to develop the domestic trauma patient management system. In the past, only specialists in three areas—surgery, orthopedics, and thoracic surgery—could pursue a subspecialty in trauma medicine, but it has recently been restructured to allow all specialists to specialize in trauma.
This is important because not only the surgeon but also those who support the surgery and care for patients after surgery are essential for saving critically injured trauma patients. Oh stated, "Due to the popularity of the critical trauma drama, many are becoming interested in the specialty of trauma surgery, but collaboration with various departments such as radiology, anesthesia and pain medicine, and plastic surgery is essential for trauma surgery."
Nonetheless, the number of trauma subspecialists produced each year is decreasing. While specialists are leaving the field, the output of follow-up personnel is also continuously decreasing, causing most regional trauma centers to suffer from staffing shortages. Among the 17 regional trauma centers nationwide, 9 have less than 10 dedicated specialists. Oh expressed concern that, "The achievements accumulated over more than a decade since the regional trauma center project began may collapse due to personnel attrition," and emphasized that "radical support measures need to be established immediately."
He pointed out that improving medical expenses related to the treatment of trauma patients is urgent. Medical expenses are the costs paid for medical actions, mostly covered by the National Health Insurance. Oh mentioned that due to the extremely low medical fees for surgeries on trauma patients, hospitals lack the capacity to invest in regional trauma centers. He stated, "Trauma surgeries cannot be completed easily within 1 to 2 hours as depicted in dramas. They take 2 to 3 times longer than general surgeries, yet the fees are low, making it impossible to avoid deficits."
Responding to medical lawsuits is also an urgent issue. Trauma subspecialists face high risks of medical lawsuits. Oh posed the question, "Doctors operate with the intent of saving patients each time, but not every surgery can be successful; if, in such situations, the burden of going to prison for failing to treat patients falls solely on the individual doctor, who would want to stay in the field?"
He argued that if the treatment conditions for trauma subspecialists are improved, the domestic trauma patient management system could advance to the next stage. He stated that while the domestic trauma patient management system has focused on reducing the 'preventable mortality rate,' more effort should now be made to ensure that trauma patients recover well and return to society.
Oh emphasized, "The most rewarding moment while caring for trauma patients is seeing them recover their health and return to society and daily life," adding, "It is time to seriously contemplate how to restore the bodily functions of trauma patients and reintegrate them into society."