South Korea doctor crisis: Urgent lessons for U.S. healthcare

SEOUL, SOUTH KOREA — South Korea’s major doctor strike in early 2024 exposed deep vulnerabilities in its healthcare system—issues that echo challenges in the United States and offer urgent lessons for American policymakers, as highlighted in a recent analysis published in the Health Affairs Journal.

Physician shortages threaten South Korea, U.S.

South Korea’s doctor-to-patient ratio is among the lowest in the Organization for Economic Co-operation and Development (OECD), with a projected shortfall of 15,000 physicians by 2035. 

Sarah Kim, James Patrick Waters, and Young Ki Hong wrote in their article that striking workers criticized the government’s recommendation to expand medical school enrollment annually by 2000 seats because they believed this would devalue medical education and disregard existing healthcare needs in rural areas.

The U.S. faces a comparable crunch; the Association of American Medical Colleges (AMCC) projections show a deficit of 13,500 to 86,000 doctors by 2036. 

Medical school enrollments have grown by 33% since 2002, but residency programs have not expanded accordingly, which could lead to a shortage of up to 124,000 physicians by 2034.

Like South Korea, the U.S. must pair workforce growth with expanded training capacity and retention incentives.

Rural care deserts widen as specialists dominate

In South Korea, Seoul boasts 4.7 doctors per 1,000 people—double rural regions’ rates. Pediatric and essential care units are especially strained, with up to 20% of teaching hospitals lacking residents. 

The government pledged $725 million to bolster rural care, but doctors demand deeper reforms, like better pay for primary services over lucrative specialties. The U.S. mirrors this divide: urban areas gained up to 10 physicians per 100,000 people from 2010–2017, while rural counties lost 3.1. 

With 70% of U.S. doctors in specialties versus 25–50% in other nations, primary care faces a compensation gap of 36-48%, fueling shortages. 

South Korea’s push for rural incentives and pay parity offers a model for U.S. policymakers to integrate and avoid future challenges in the industry.

Fee-for-service models fuel burnout: unions rise in response

South Korea’s fee-for-service system drives grueling workloads, with doctors logging some of the highest patient loads globally. 

Striking physicians argue expanding schools won’t help without addressing burnout—a lesson resonating in the U.S., where 42.5% of residents reported burnout in 2023 amid similar payment pressures.

Kim, Waters, and Hong stressed that unionization is surging among U.S. trainees, with the Committee of Interns and Residents (CIR) doubling its ranks since 2019 to 33,000. Like South Korea’s strikers, U.S. unions now demand better pay, hours, and protections—signaling a brewing labor reckoning. 

Without reforms to reduce administrative burdens and shift toward value-based care, both nations risk worsening physician flight.

Lessons from South Korea’s doctor strike

The strike of South Korean doctors over a planned medical school expansion highlights risks the U.S. could soon face—escalating physician shortages, rural care deserts, and systemic challenges. 

With America already projecting a deficit of up to 124,000 doctors by 2034, the crisis underscores the need for proactive reforms: expanding residency slots, incentivizing primary care and addressing unsustainable workloads before U.S. health care reaches a similar breaking point.

Failure to act could deepen disparities and trigger disruptive labor unrest, as seen in South Korea’s overwhelmed hospitals.