Reshaping Tertiary Hospitals: A New Era of Critical Care

If you've ever visited a tertiary hospital (especially referred to as the Big 5 hospitals in Seoul, Korea), you’ve probably noticed the overcrowded outpatient clinics and general wards. Many patients seek treatment at these top-tier hospitals, even for conditions that could be managed at secondary and regional hospitals. This has led to an overburdened system, where emergency rooms are frequently at full capacity, inpatient beds are occupied by non-critical cases, and doctors are stretched thin trying to manage excessive patient loads, distorting the healthcare system by exacerbating disparities between urban and rural medical services. Patients in regional areas often struggle to access specialized care, while major hospitals in Seoul face overwhelming demand, making it harder for patients with severe illnesses to get timely treatment.

To address this, the government is rolling out the Tertiary Hospital Structural Reform Pilot Program—a plan designed to help these hospitals focus on critical care while improving medical training for residents.

 

Why Is This Reform Necessary?

Currently, many tertiary hospitals are handling a large number of non-severe cases, which could be treated elsewhere. This creates long wait times for critical patients and puts intense pressure on medical staff, especially residents who handle much of the workload.

With this new initiative, tertiary hospitals will gradually reduce their general inpatient beds and shift their focus to treating severe, emergency, and rare diseases. But reducing beds alone isn’t enough. The program also introduces financial incentives, rewarding hospitals that prioritize critical care over lower-acuity cases. This means hospitals will be encouraged—not just required—to make this transition.

This policy also comes in response to mass resignations of medical residents following the government’s decision to increase medical school admissions by 2,000 students. While this reform aims to improve patient care and restructure the hospital system, it is closely tied to the ongoing conflict between the government and the medical community. I'll discuss this in more detail in a future post.

 

What Will Change?

✔ More Focus on Critical Patients

• Hospitals will increase the proportion of severe cases they treat (target: 50% → 70%).
• Additional support for emergency care, cardiovascular, trauma, high-risk childbirth, and pediatric critical care.

✔ Better Referral & Transfer Systems

• Stronger collaborative networks between tertiary hospitals and regional hospitals.
• Enhanced fast-track systems for referred patients, ensuring that those who need specialized care get it faster.

✔ Rebalancing Hospital Bed Allocation

• Reduction of general inpatient beds by 5–15%, depending on the hospital’s location.
• Expansion of ICU and critical care units to accommodate more high-acuity cases.

✔ Support for Doctors & Residents

• Medical residents will benefit from a more structured and high-quality training environment, rather than being overworked with routine cases.
• The introduction of team-based care models (specialists + support nurses) to distribute workload more effectively.

 

What Does This Mean for Patients?

For those needing high-level treatment, this is great news! If you or a loved one is facing a severe illness, access to specialized care should improve as hospitals streamline their services to focus on what they do best—treating complex conditions.

However, for those with milder illnesses, tertiary hospitals may gradually limit access, redirecting patients to regional and secondary hospitals. The good news? This could lead to shorter wait times and more personalized care at local hospitals, as they take on a bigger role in the healthcare system.

 

Final Thoughts

This reform isn’t just about cutting beds—it’s about building a more efficient, patient-centered healthcare system where critical patients receive priority treatment and doctors can work in a more sustainable environment. While change can be challenging, this shift is a step toward a smarter, more responsive healthcare system that benefits patients, doctors, and the entire medical ecosystem.

What do you think about this reform? Will it help improve our healthcare system? Let’s discuss in the comments below! 🚑💙