Emergency care bottlenecks driven by anesthesiologist shortages, Korean society warns

Delays in transferring critically ill patients to emergency departments -- a phenomenon commonly referred to in Korea as “emergency room shuttling” -- are not caused solely by overcrowding or inefficient patient distribution, but stem from deeper structural weaknesses in essential medical services, a Korean medical society said.

In a statement issued Friday, the Korean Society of Anesthesiologists (KSA) said persistent shortages of anesthesiology and pain medicine physicians are preventing hospitals from accepting emergency patients in a timely manner, creating bottlenecks across the emergency care system.

“The solution begins with normalizing anesthesiology, which is inseparable from emergency medicine,” the society said.

The Korean Society of Anesthesiologists said anesthesiology is the “invisible central axis” of emergency care and called for stronger policy and financial support. (Credit: Getty Images)

According to the KSA, hospitals’ ability to admit emergency patients, perform urgent surgery and provide intensive care depends on securing sufficient numbers of highly trained anesthesiology personnel. Without them, operating rooms and intensive care units cannot function at full capacity, limiting emergency department intake regardless of available beds.

Anesthesiology and pain medicine play a critical role beyond surgical anesthesia, supporting life-saving care in severe trauma, emergency surgery, childbirth, cardiovascular and cerebrovascular emergencies and intensive care, the society said.

However, the sustainability of the specialty is being undermined by inadequate institutional and financial support. The KSA pointed to chronic workforce shortages, insufficient compensation and work structures that require physicians to handle overnight and holiday emergency procedures in addition to regular daytime clinical duties.

The society said undervalued reimbursement systems make it increasingly difficult for hospitals to recruit and retain anesthesiologists, despite the high level of expertise and responsibility required for emergency and critical care anesthesia.

As a result, younger doctors are increasingly avoiding essential medical specialties, further deepening shortages in anesthesiology and emergency care, the KSA said.

Given these conditions, policy responses focused solely on expanding emergency department staffing or improving patient transfer protocols are unlikely to resolve the problem, the society warned.

“The reason critically ill patients cannot be transferred to emergency departments is that downstream care functions—such as operating rooms and intensive care units—are not operating normally,” the KSA said. “Anesthesiology serves as the foundational infrastructure connecting all essential medical services. Without adequate anesthesiology staffing, emergency surgeries are delayed, critical care capacity is reduced, and hospitals are forced to limit emergency patient admissions.”

“Emergency medical care cannot be normalized without normalizing anesthesiology,” the society added, calling for greater recognition of the specialty’s role and for stronger institutional and financial support.