Medical professional conflicts and health care policy in South Korea

Abstract

The purpose of the thesis is to explore the characteristics of the system of medical professions and its changes in terms of the conflicts existing among the medical professions in South Korea since the 1990s, in the light mainly of Abbott's theory of the professional system (Abbott, 1988). Four cases of conflict were examined and analysed: the conflict between oriental medicine and pharmacy over preparing oriental medicines; the one between western medicine and pharmacy over the separation system; the one between western medicine and oriental medicine over unification; and the one among the three medical professions over the National Health Insurance. This study used primary data from interviewing members, particularly elites, of the three medical professions, the government, the press and civic groups. The data included active and dynamic inside information about individual medical professions and conflicts.

With the conflicts, the situations of the medical professional system has changed: pharmacy kept and even strengthened its position in the professional system; oriental medicine also found opportunities to develop its professionalism and fortify its position in health care; and western medicine faced its weakening influence in the medical professional system. In addition to a change in the influence of individual medical professions, the features of the conflicts have changed. The former two open conflicts were undertaken in a strong and violent way, using strikes and street demonstrations. However, in the latter two conflicts, professions attempted academic and logical strategies to control their situations.

Through the four medical conflicts, more complex causes and situations have been uncovered in the medical professional system and health care in Korea.

The conflicts have developed from professional jurisdictional ones into economic and political ones. Applying Abbott's factors to the Korean cases, the following points are outstanding: salient organisational development of individual professions; inconsistency between the influence of a dominant profession and the actual result of conflict; more dynamic and fundamental influences of political, economic, social and cultural factors; and the influence of the government's mismanagement.