Fortunately, I decided to start this series right when I had to use the medical services in Korea, so I’ll just give you a rundown of my experiences over the past two days.
On Monday morning I decided I needed to see a doctor for a follow up to a visit I’d had a couple of months ago (a follow-up that I’d put off because of the virus). I went on line to the hospital site, filled out some information and my desired appointment time, and within two hours had a response from their International Healthcare Center (IHC). I filled out the follow-up information (to include responding to the first of three Covid-19 screenings) and sent it back. Within two more hours I received another email asking if I’d like to see a particular specialist, and within an hour of my “yes” to that I received a phone call from a staff member of the IHC to set up the appointment for 10am Tuesday. This was followed almost immediately with a text message giving me my appointment information and further instructions.
The next day (Tuesday) I arrived at the hospital around 0935, walked through the entrance and up to stand on a set of footprints in front of a screen (smaller than an iPad) and sensors where my body was scanned to see if I had a fever (the machine announced that my temp was “normal”). I was asked by a tech if I had any symptoms (“no”) and was allowed into the hospital.
I went to IHC, received another temperature check, then was given a slip of paper on which was printed a bar code, my name, patient number, and appointment information. I sat down for about 5 minutes and then was taken into a room where they took my vitals. After waiting another 15 minutes, I was shown in to see the doctor. He noted my history, we discussed my symptoms, and addressed two specific issues for which he gave me two separate prescriptions. Then at my request (and because I’d been fasting thinking maybe I could get just this kind of thing done), he ordered lab work, an EKG, and chest x-rays.
And here’s where I think the process gets interesting – namely in its efficiency.
Out from the doctor to nurse one, who checks what he had entered in my record for the day. “Mr. Fraleigh, I see he’s requested a follow up in one month [looks at calendar with me]. How’s August 4th at 10 o’clock?” Fine with me. “You also have some basic lab work, an EKG, and x-rays; as well as two prescriptions. Do you know where to go for that?” I’m not sure exactly so I’m given a map on which she draws the directions and highlights the destinations.
She hands paperwork to the tech next to her for payment. “You have a $45 copay.” Insert my credit card and sign. This will pay for the doctor’s visit, labs, EKG, x-rays, and the prescriptions.
The tech gives me the receipt and a number ticket to pick up my prescriptions at the pharmacy down in the main lobby. She says a few words to the receptionist next to her, who prints out three slips of paper like the one I got when I first arrived – one each for the labs, the EKG, and the x-rays. I take those and the map and head for my first stop on the second floor: the Outpatient Lab.
The Outpatient Lab is a place of controlled chaos. First, a typical Korean jumbled line in front of two screens upon which are written instructions for whether you’re there for blood or urine. Let me take a moment to tell me here that if you’re shy in a Korean “line,” you will never get where you’re going – but you learn. I scan my bar code on the first ticket (for the lab), but it doesn’t read right. With a little help, I find that all I have to do is enter my patient ID number. It spits out a number ticket for reception (along with my name and procedures required). I wait about 3 minutes, my number pops up. I go to reception. I give her my ticket. She asks my name and birthdate. She gives me a specimen bottle and another ticket with a 4-digit number, my ID info, and the number of people waiting in front of me. Since there are 13 people in front of me, she points out a yellow (ha-ha) line on the floor that directs me to the restroom for the urine sample. All easy to follow – put the bottle on the shelf and head back out for the blood draw.
I walk into an open lobby filled with chairs for at least 100 people facing eight windows behind each of which there is a blood tech. There’s a big screen showing what numbers are coming up next – I’m 5562 and they’re on 5557. Within a few minutes my number comes up over a window, I walk up, sit down, give her my ticket. She IDs me (name and birthdate), pulls out three vials, puts on the labels, swabs my arm, then sets the swab on my upper bicep while she finds a vein, ties off my arm, tells me to make a fist, and makes the stick. She fills the three vials and pushes them into a slot to her left front (a hidden conveyer takes the vials back into the lab), pulls out the needle, grabs the swab from my arm and presses it over the hole for a few seconds, then sends me on my way. I spent a total of about 15 minutes at the lab.
Next stop is down the hall at the EKG desk. I check in at reception, show her my ticket for EKG (each of the three places I’m going had slightly different procedures). She takes it, asks my name and birthdate, gives me another ticket on which is printed a three-digit number and my info, points to a door to her right and says “wait outside that door until your number comes up.”
Five minutes later, I’m escorted through the door by a tech who takes me behind one of two curtained areas. ID by name and birthdate. “Take off your shoes and shirt and lie down on this table.” She hooks me up (being sure to tell me it’s cold. I know), runs the test for a minute or two, tells me I’m done. I put on my shoes and shirt and I’m on my way. Maybe 10 minutes at EKG.
Down the escalator to radiology, where I see more screens. I step up and enter my patient ID number and it spits out two tickets. I walk over to a nearby room and show the tech my tickets. He asks me if I’m wearing a t-shirt under my shirt (I am) so he tells me to step into a changing room, take off my outer shirt and put it into a locker (with an electronic key fob that I can take with me – there’s a pile of gowns there in case I wasn’t wearing a t-shirt). I come out and he tells me to sit outside again for a couple of minutes. He brings me back into the room a few minutes later, has me drop my stuff in a basket and stand in front of the machine. Positions me for two shots (chest then side). I’m done. Put on my shirt and head out to the pharmacy. Time in x-ray? Maybe 15 minutes.
I walk out to the front lobby (the location of the pharmacy). There are several windows, three of which are specifically for picking up prescriptions. Of course the number of my ticket is already displayed for pickup. I walk up to the window, hand her my ticket, she grabs my meds from a cart full next to her, explains them to me, offers a bag (I don’t need one), and I’m on my way to the coffee shop for a café mocha and pastries to go. I head out to the parking garage, enter my car license number on a screen (I owe 4,500 won) followed by my patient ID number (now my parking is free), go to my car, and drive out. The gate opens automatically for me and I’m on my way home.
My appointment was at 10. I got to the IHC by about 0945. I’m done and out of the hospital by about 1120. A doctor’s visit, paperwork, follow-up scheduling, payment, then three procedures for which I was not even scheduled when I walked in (all three of which were being done by dozens of people at the same time), all within about an hour and a half.
And that’s what I like about Korea. The medical system is fast, efficient, and helpful. You are treated like cattle, but as cattle you are shuffled efficiently through the system and then you’re done. You don’t need to make friends with the tech taking your blood. Who cares if you’re giving your name and birthdate to a stranger in a room surrounded by 100 people? HIPAA? Pffft. Nobody cares. Sit out in the lobby in your t-shirt? Pffft. I wasn’t the only one. Nobody cares. You’re in, you’re out. You can do this on your insurance, and Koreans all get a full physical every two years that includes major procedures like a colonoscopy, endoscopy, and mammogram if needed [Quick side story about this: Some years back when I went to the hospital for one of these checkups, the doctor asked if I’d like an endoscopy. I said, sure, I can probably get back here in a couple of weeks for one of those. “How’s 1 o’clock?” Yeah.]
I’m sure like every system, there are problems – I’ve never experienced it as a Korean, and Korean people are notoriously polite and helpful to us foreigners so my experiences have been positive all around (my wife has been through it at another hospital that she prefers and has no complaints). The bottom line is that you get your medical care done and it’s not some big, complicated production. You’re in, you’re out. I didn’t have to fill out any forms and I didn’t write anything more than my signature on the billing screen and punched in my patient ID a couple of times. If they catch something, they make it easy enough that it’s handled. I mean, who wants to go through all the hoops just to see a doctor? I think it’s enough of a pain that some people actually end up dying because of it. Make it fast and easy enough that you can make it a regular part of people’s lives and I bet they’ll catch things early enough to cure a few more.
Does it matter? Maybe. South Korea ranks 11th in the world in life expectancy. The US is 46th. Koreans live nearly 4½ years longer than Americans on average. To be clear, there are a lot of other factors involved, but honestly, availability and efficiency of health care has to be a contributor. When I feel sick, my wife immediately thinks “go to the doctor…and while you’re there, have them check x, y, and z.” That response is engrained in her and it’s a product of the ease and availability of health care to which she’s accustomed [slight disclaimer though – going to perhaps one of the best hospitals in the country as I do is a lot easier when you live in a country this size].
Obviously, it’s not a direct comparison. There are interesting quirks, like family members taking care of you while you’re hospitalized and the fact that you seldom get a private room (four to six in a room is about standard it seems, but if the insurance covers it, single or double occupancy rooms can be had I’m sure). My doctor yesterday cryptically told me “there are different objectives” when comparing US and Korean health care (I’ll have to ask him what he meant when I get my follow up). In any case, Korean health care works well enough to keep Koreans alive longer than Americans, or at least after adjusting for things like diet and violence (Korea’s murder rate is 201st in the world at 0.60 per 100,000 while the US is 94th at 4.96 – a topic for another post I’m sure), keeps them in the general ball park among developed countries. And again, much more efficiently.
So, when it comes to health care, I’m pretty sure Korea’s got a winner.