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Current state of integrated care: Interview with a family physician in South Korea

Posted By Jeehee Sung, Wednesday, November 15, 2017

In 2007, my education in marriage and family therapy (MFT) in the US began. After a year of course work, my clinical experience as a MFT intern started at the University of California San Diego Family Medicine Residency, which had well-established integrated care. For me, it was a novel and exciting experience working as a mental health provider in a medical setting. I was amazed by the service the collaborative care clinic provided and somewhat envious of patients who came to the clinic, thinking of Koreans who did not have such service. 

After 10 years of studying and practicing in the field, I became curious about whether there has been any movement toward integrated care in Korean medicine. I decided to make this one of my projects and applied for CFHA mentorship program. I was paired up with a mentor, Dr. Laurie Ivey, who is Director of Behavioral Health at the Swedish Family Medicine Residency in Colorado. With her guidance, I started to search ways to get familiar with the family medicine field in Korea.  I tried to broaden my professional network in medicine there, which, of course, was/is quite challenging. I tried to join one of the major family medicine organizations in Korea-- the Korean Academy of Family Medicine, but it was a physician-only organization. I tried to find Korean physicians through the CFHA listserve and other physicians’ organizations, but still no luck. Both in Korean and English, I looked for articles that discussed the concept of integrated care or collaborative care (there is no established terminology to identify this model in Korea). Unfortunately, there was a dearth of literature on this subject.  

I still wanted to pursue my curiosity about integrated care in Korea, so I took a different route in approaching the family medicine field. I shared my interest with one of my friends who recently finished medical school in family medicine in Korea. Surprisingly, through her, I was introduced to a great family medicine doctor, Dr. Jong-Sung Kim. 

During my stay in Korea in the summer of 2017, I met with Dr. Kim, Chairman of family medicine at Chungnam National University Hospital. Chungnam National University Hospital is located in Daejeon, the fifth-largest metropolis in South Korea. Daejeon has a population of over 1.53 million and serves as a hub of transportation. Before serving his current position, he was the head of an alcohol treatment center in Daejeon, where individuals and their family members are treated from an integrated approach. Despite being in an integrated center, he shared that one of the main struggles he experiences is uncertainty and unwillingness on the part of the psychiatrists with whom he works, toward the integrated approach to treatment.  He stated this is particularly challenging for the psychiatrists that are new to his team because integration is a new concept for them. He said that it has taken him almost three years to help the psychiatrists open up and be fully on board with him.

Dr. Kim is a well-known family physician and holds a strong family-centered perspective. While he was making me a cup of tea, I looked around his book shelf. I was impressed by so many family therapy books on the shelf. He shared that he taught genogram, family dynamics, and family interview to family physicians in Korea during the Korean Academy of Family Medicine conference twice every year-- spring and fall. When I asked how much interest he noticed on this subject among Korean family physicians, he said, “not much.” His assumption was they were so busy with medically related topics that the family factor was a non-priority to them. He also said that family physicians were aware of the benefit of the integrated treatment, but the priority was still to protect their high-bar field and a system that is provider-centered, not patient-centered. 

Through this experience, I learned that unfortunately the medicine field in Korea is a quite private and non-inclusive community. However, when you keep trying using various approaches, the door can open. I also learned that family medicine in Korea has much work to do in the future in order to create a successfully integrated system. Finding answers will take time, effort, and people who are interested in this subject. If you happen to know any Korean family physician, please let me know. It would be greatly appreciated! 

Jeehee Sung, Ph.D., is an assistant professor in Marriage and Family Therapy Program at Mercy College in New York. She is a licensed marriage and family therapist and American Association for Marriage and Family Therapy approved supervisor.

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Randall Reitz says...
Posted Saturday, December 2, 2017

This is a wonderful contribution to the global growth of our field. You have started your role as an ambassador for collaborative care within your country of origin. In the process you demonstrated persistence, initiative, and a collaborative spirit. It is connections like the ones you created that plant seeds for the flowering of collaborative care in new areas. I'm very pleased that this effort was part of your ECP fellowship with CFHA and your great mentorship experience with Laurie Ivey.

I commend you both,
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