National hospital for firefighters struggles due to lack of funding, staff

It was built to care for firefighters, but Korea’s National Fire Hospital in Eumseong County, North Chungcheong, is struggling to care for anyone at full capacity because it hasn't been able to recruit doctors and pharmacists.

Launched on June 8 as a specialized medical center for firefighters, the hospital is still short of doctors and can operate only about a third of its beds.

The hospital has positions for 48 doctors but had filled only 36 as of Tuesday. It remains short of 12 specialists across departments including gastroenterology, pulmonology, anesthesiology, pediatrics, neurology, general surgery, orthopedics and radiology. It has yet to recruit a nephrologist.

Pharmacists are also in short supply. Only eight of 12 positions have been filled.

The hospital has posted 11 recruitment notices for medical and clinical faculty positions to hire more doctors. Seoul National University Hospital, which operates the facility under contract, has separately posted 10 recruitment notices but has also failed to fill the vacancies.

Some doctors are hired by Seoul National University Hospital and assigned to the National Fire Hospital, and others are dispatched there on a rotating basis.

Nephrology professors from Seoul National University Hospital take turns seeing patients there three times a week. Doctors from its main hospital also provide support once a week in orthopedics, plastic surgery and endocrinology.

“We are short of doctors, but the situation is similar to that of other public medical institutions in suburban areas,” Dr. Kwak Young-ho, director of the National Fire Hospital and an emergency medicine specialist, said.

The staffing shortage has already limited how much of the hospital can actually operate.

The hospital has run just 108 of its 302 beds since opening. As of Tuesday morning, the hospital only had 55 inpatients. It averages about 300 outpatients a day.

Firefighters and police officers account for about 10 percent of patients. Most of the rest are residents of Eumseong and the nearby counties of Jincheon, Goesan and Jeungpyeong.

Despite the hospital being founded to aid emergency response personnel, the share of firefighter and police patients remains relatively low.

Firefighters and police officers injured in the line of duty receive treatment covered at no cost. They pay only part of the cost of services not covered by national health insurance.

Calls for stronger systemic support for emergency response personnel are growing after Gyeonggi Gov. Choo Mi-ae called fire services a “financial drain” during a parliamentary audit earlier this month.

The scrutiny intensified after a firefighter died on Saturday from injuries sustained while battling a large factory fire in Gyeonggi the previous day.

But several factors are making doctor recruitment difficult.

First, the hospital’s location is not easy to reach by public transport. It has no direct KTX or express bus connection. The geographical hurdle also makes it harder for firefighters and police officers from other regions to visit for treatment.

Low pay is another major hurdle. Doctors’ salaries are set through the government budget, resulting in lower pay than in private practice and making it less desirable for doctors.

“The salaries we can offer are lower than those at nearby private hospitals,” Dr. Kwak said. “The severity of the shortage varies by specialty.”

Living conditions are another drawback. The hospital covers the cost of jeonse (lump-sum deposit) housing for doctors, but the doctors themselves still have to pay for utilities.

Limited research opportunities also hurt recruitment, as there is insufficient funding and limited research facilities.

The hospital is running a pilot telemedicine program to improve access for firefighters and police officers from other regions.

But the program has limitations. Patients are required to attend their first appointment in person, which reduces the benefits of remote care. Doctors also cannot prescribe psychotropic drugs remotely to psychiatric patients — including those being treated for post-traumatic stress disorder, or PTSD.

The National Fire Hospital is set to receive 37.7 billion won ($28.3 million) in government funding next year and must generate more than 30 billion won in medical revenue to cover its operating costs.

“The government needs to increase its funding for the hospital so we can bring doctors’ salaries in line with the private sector and build a proper research environment,” Dr. Kwak said.

BY SHIN SUNG-SIK [[email protected]]