Korean patients visiting large university hospitals used to wait for three hours to see their doctors for three minutes.

That may change gradually, as the government is about to implement a six-month pilot project next month to extend doctors’ consultation time to 15 minutes, according to officials at the Ministry of Health and Welfare.

At stake is how to set the treatment cost to induce longer consultations, they said.

Experts have pointed to the lack of incentives for physicians to spend extra time on patients as the primary reason for the short meeting time. Adding to the problem are Korean patients who flock to large hospitals for consultations out of distrust of their neighborhood clinics.

Doctors for their part have had no choice but to see as many patients as possible rather than improving the quality of care because of the payment system, leaving those who need in-depth care unattended.

That explains why the ministry’s pilot program calls for a tiered payment system where doctors are paid more by their consultation time and quality of treatment instead of the number of patients they meet as has been the case so far, the officials said.

The graded payment system, in particular, will compensate doctors who spend more time with each patient to help physicians make up for losses caused by seeing fewer patients. The ministry hopes to shift the doctors’ focus from making a profit by treating many patients quickly to taking care of severely ill patients in-depth.

Under this system, hospitals will face less pressure to cover costs by treating slight-to-moderately sick patients and focus on those who are critically ill at superior university and government run-hospitals.

Professor Yim Jae-joon of Seoul National University Hospital recently drew public attention by piloting the 15-minute consultations at SNUH, reputed to be the busiest hospital in the nation, without government help.

“We will decide the payment method and system on how much time doctors spent on each severely ill patient, the level of patient satisfaction with treatment time, and the standard of patient compliance with the cost,” a ministry official said.

The pilot project will start in the “superior general hospitals” in Seoul and spread to those in rural areas, for six months. Target patients will be those with serious illnesses particularly in the department of internal medicine and pediatrics where demand for a tiered payment system is high.

The ministry said its primary task is to find the optimal level of the amount in the tiered system, because “too large payment will increase the patient’s burden and too small fees will have little impact,” the official said.

The ministry will prepare a framework for trial runs and unveil a concrete implementation plan next month, he added.

yjc@docdocdoc.co.kr

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