Thursday, February 04, 2016

reasons not to like Korean health care

My left middle finger continues to swell, albeit slowly. Perhaps the witches' brew of garlic, honey, and cayenne that I concocted last night did some good. Hard to tell.

Samsung Seoul Hospital is located right up the street from where I live, so I decided to give the place a call to make an appointment with one of the hospital's several clinics. Conversation was difficult, given my middling Korean, and I got transferred twice before finally talking with a lady who was willing to set up an appointment. Near the end of our conversation, after having told me what time to come to the clinic (I didn't get to choose a time), the lady said I needed to bring along a "referral letter" from my boss. Huh? I told her I had an insurance card, but she said something about how referral letters were the standard, and how sometimes it was unclear whether insurance would cover a given procedure. I wasn't clear on how one thing related to the other, but I realized I was stuck in the typically Korean valley of We Cannot Color Outside the Box—a common problem in this country. If all the hospital has is round holes, and I come as a square peg, the only recourse is for me to round out my corners to fit: the hospital (or whatever institution) makes no changes of its own. As with kamikaze pilots, there is never to be any deviation from the plan.

Ideally, with clinics, you should just be able to walk on in with no previous appointment. It could be that this is, in fact, how it works at smaller Korean clinics that aren't affiliated with hospitals. I looked for such clinics during my lunchtime walk today, but saw nothing but Chinese-medicine facilities. No, thanks.

Won't be surprised if I leave tomorrow's appointment missing a finger.

UPDATE: my boss tells me there's an internal-med clinic inside our building. Just walk on in, no fuss, no muss, and they accept your insurance card without asking you for any bullshit "referral letter." So I'll be going there in the morning and, very likely, canceling my afternoon appointment with the bureaucratic nightmare that is Samsung Seoul Hospital.



Charles said...

Yeah, you should definitely just go to a 내과. 종합병원 are always going to be a bureaucratic hassle (although I've never been asked for a referral letter, so that's a bit weird).

Also--and I know we've had this conversation before--but it seems to me here that your beef is not so much with Korea's health care system itself as it is with Korea's bureaucratic culture. This is most evident at big hospitals, but smaller clinics are usually (at least in my experience) much better. I just often get the impression that you factor in a lot of environmental factors when evaluating the Korean health care system, and that leads to a very negative outlook. I know you can quote horror stories, but my own experience has been overwhelmingly positive, so every post like this leaves me confused. How could our experiences be so different? Is it just luck?

Kevin Kim said...

Partly luck, yes, but not just environmental factors, either. The local hospital that I went to when I was living in Hayang was filthy, for example, and the equipment in that place was run-down and outdated-looking. One of my coworkers down at Daegu Catholic talked about how one nurse (at the same hospital) spilled part of his blood sample all over his paperwork after she'd removed some of his blood. Korean hospitals have never inspired trust in me.

The only decent medical recommendation/referral I've ever gotten has been from Sperwer, when he recommended his dentist to me—a lady in the Banpo neighborhood who worked on Koreans and expats, mainly French folks. She was professional and gave quality care, although you may remember my tale of the 90-minute wisdom-tooth extraction—a procedure that my Korean colleagues told me normally takes 10-15 minutes.

A hospital is a system of systems, and part of the hospital experience is the bureaucracy. Not to say that it's all roses in the US: Mom's cancer care required a ton of annoying paperwork, and the record-keeping was pretty shitty. (One of the few things I give Dad credit for is his management of that paperwork. He caught a ton of errors made by the hospitals and clinics Mom attended.) But this doesn't excuse Korean hospitals for adding unnecessary layers of difficulty to fairly straightforward procedures.

When I do finally get very sick, I hope I'm in the States and well insured.

Surprises Aplenty said...

Your Korean is far better than mine but is it possible that the nurse was asking for a referral from a clinic? You know, in the way that a General Practitioner would refer a person with a serious/unusual injury to a specialist. That is the only way a referral makes sense to me.