Written by Jeonghwa Lee, Choonjae Lee, Published by Korea Institute of Oriental Medicine
A. TKM doctor
TKM doctors (Euisaeng at the time) were intentionally ignored and discriminated against under the Japanese colonial rule. It is not difficult to assume that the Japanese wanted to suppress the development of Joseon’s self-reliant and pragmatic medicine as part of its oppressive policy. It was only after the independence that the need for TKM doctors was acknowledged.
In 1953, TKM doctor license system was belatedly institutionalized. Today there are 11 TKM colleges (6 year course: 2 year preparatory course and 4 year regular course) and one special TKM graduate school (establishing in 2008). Around 700 to 800 TKM college graduates pass the state-administered exam and become TKM doctors every year. People who received TKM education in foreign countries is not acknowledged so those who had TKM education overseas are not qualified to take the exam and required to receive TKM education in Korean TKM colleges.
Those who pass the exam will receive TKM doctor license, and are allowed to take additional training courses in TKM hospitals at will or to open a TKM clinic anywhere in Korea. TKM doctors are different from Oriental herbalists (who sell herbal materials or can practice in a limited area prescribing herbal medicine) or Oriental pharmacist (as opposed to Western pharmacist, Oriental pharmacist deals with differential diagnosis, numerical production, and prescription of herbal medicine).
B. Medical Departments of TKM clinic
Anyone who finishes the 2-year preparatory and 4-year regular courses in one of 11 TKM colleges and passes a TKM doctor’s exam administered by the state receives TKM doctor license and is allowed to practice at a TKM clinic.
Medical departments of TKM clinic include internal department, women’s department, pediatrics, neuropsychiatry, acupuncture and moxibustion, ENT / Skin department, rehabilitation department, and sasang (four-constitution) department.
Currently TKM treatments such as acupuncture, moxibustion, or cupping are covered by health insurance. New treatment practices are being added to existing ones, and health insurance coverage of TKM practices is becoming wider.
The term TKM hospital is used when the size of the hospital is bigger than a TKM clinic and the number of its employees and sickbeds exceeds a certain mark.
C. TKM health insurance and various insurance plans
TKM had traditionally taken the center stage in Korea’s medical system. However, TKM had to go through sever suppression during the Japanese colonial rule, however. Japan encouraged the development of western medicine while stifling TKM. As a result, TKM had to give way to western medicine in the Korean medical system even after the independence.
The Law of Public Health enacted in 1952 divided the Korean medical system into two categories: TKM and western medicine. Meanwhile TKM was regarded as unscientific and old-fashioned and considered mere dietary supplements, which further delayed the development of TKM. The result was marginalization of TKM in the national health care.
A decreasing number of people used TKM clinics since they became confused on the choice between TKM clinics and western clinics when they were ill. TKM health insurance was first introduced on a pilot basis to acupuncture, moxibustion, cupping, and other 63 practices in Chungju and Chungwon gun in North Chungcheong Province from December 1, 1984 to January 30, 1986. The TKM health insurance has been expanded nationwide since February 1, 1987. As of 2002, the TKM health insurance covers basic medical examination fees (consultation and hospital charges), inspection fees (skin resistance check, pulse check, meridian and collateral function test, etc.), and medical treatment fees (acupuncture, moxibustion, cupping, enema, bath, and general treatments), medication, prescription and compounding (56 treatments composed of 68 powered Oriental medicinal stuff).
The number of people using TKM health insurance has been on the rise over the past 20 years since its implementation. However, TKM health insurance still accounts for only 4.6 percent of the total number of medical examinations and 4.3% of total amount of examination fees (as of 2003). These figures indicate the still limited use of TKM health insurance. In order to improve these unrealistic medical charges, the TKM health insurance should be expanded with a variety of TKM treatment insurance.
Meanwhile, TKM Industrial Accident Compensation Insurance was introduced on March 13, 1996 to 32 TKM sanatoriums across the nation with the same coverage with health insurance. Currently, any TKM medical institutions which meet the standards set by the government can be certified as TKM institutions covered by Industrial Accident Compensation Insurance and join the industrial accident compensation insurance.
D. Medical Aid Work by TKM Doctors
1. Domestic Medical Aid
The Association of Korean Oriental Medicine (AKOM, henceforth) and its affiliated agencies and members have continued to provide medical services to marginalized people with limited access to medical care, and are now taking care of the underprivileged all across the nation. These efforts will continue until every Korean enjoys proper medical care. Among many medical services, TKM colleges across the nation and the AKOM systematically organize and implement summer/winter medical services every year to provide balanced medical services to residents in obscure regions. Around 15,000 people in 25 regions or so are enjoying the medical service every year. In addition, the AKOM and its affiliated city and provincial branches are delivering much-needed medical services to around 200,000 people every year.
2. Overseas Medical Service
Established in July, 1998, Korean Oriental Medical Service Team Abroad (KOMSTA, henceforth) has started its activities against all odds due to unfavorable conditions at home and abroad. It conducted its first overseas medical service in Vietnam for seven days starting July 20, 1998 right after its establishment. It was established as a corporate sole under the AKOM in December in the same year. KOMSTA has since conducted medical services in many countries around the world such as Cambodia, Mongolia, and Kazakhstan.
The purposes of establishment are 1) to achieve the humanitarian purpose via TKM aid works; 2) to promote the efficacy of TKM by adopting TKM’s pragmatic treatments and popular herbal medicines; 3) to improve the national image by delivering TKM, the national cultural products to all around the world. As of 2004, KOMSTA has around 750 members, among whom is the majority of TKM doctors, including western medical doctors, nurses, and honorary members comprised of professors and media reporters.
KOMSTA provides medical services four to eight times a year. Among the regions KOMSTA has visited so far are four middle Asian countries including Nepal, and Sakhalin, Russia and Yonbyun, China, places where many ethnic Koreans live, and also countries with poor medical environment such as Ethiopia, Vietnam, Cambodia, and Laos.
In addition, TKM hospitals were set up in Kazakhstan, Uzbekistan, Cambodia, Mongolia, and Karakalpastan for the promotion of TKM in those regions. TKM doctors dispatched abroad in their capacity as state-dispatching doctor or international cooperation doctor are actively engaged in aid activities. As part of the government-backed projects, there are on-going plans to establish TKM hospitals in Sri Lanka and Ethiopia. Also, there are continuous requests for TKM doctors from many countries such as Laos.
TKM services can help promote the efficacy of TKM via its pragmatic treatments and wide clinical adaptations of herbal medicines, spread TKM practices across the globe, and improve Korea’s image on the international stage, thereby strengthening Korea’s relations with other nations