The concept of medical professionalism as for self-employed physicians in Korea

ABSTRACT

Medical professionalism in Korea is underdeveloped because of a strong state that has been in place for the past one hundred years. If the government actively controls policies and regulates the professional associations under state corporatism, deterioration of professionalism is inevitable. The current medical insurance in Korea is unified as a monopsony, but it is not the 'bipartite corporatism' between the government and the medical profession such as the National Health Services (NHS) in Britain. All insurance matters related to a physician's practice, including standards of treatment and the physician's reimbursement, are handled by the government. Therefore, the authority of medical expertise is subordinate to the authority of the government agency, and physicians are forced to follow the goals and policies that are set by the government. Physicians' professional ethics are the core of their occupational control. The declaration of "Codes of Ethics" by the Korean Medical Association, before it was revised in April 2006, defined a "sincere fulfillment in practicing medicine" as a full duty of the physician's life. If this declaration was intended to be interpreted literally, all physicians in Korea could be asked to pursue identical lives with the same goals as their professional life as a physician. If it was not intended to be interpreted literally, then physicians may develop their own ethical approaches according to their individual perspectives on life. The former case is an unethical form of state control while; the latter case would make legitimate occupational regulation impossible. The ideal of medical service is an institutional attribute of an occupation and not a duty of an individual's life. Therefore, it should be possible for physicians to work under an occupational control that requires specific standards for the members of the profession and embodies their professional values.