The need for an independent medical regulatory authority to institutionalize medical professionalism in Korea: a narrative review

Abstract

Purpose: Medical professionalism represents an implicit social contract in which physicians receive clinical autonomy and self-regulatory authority in exchange for professional competence and patient safety. This paper addresses structural gaps in Korea, where licensure, ethics review, and disciplinary functions remain fragmented and lack an independent, statutory self-regulatory authority. This vacuum has produced two parallel crises: hyper-judicialization of medical disputes and the absence of reliable workforce data underlying repeated policy failures, eroding patient trust and straining essential and regional healthcare services.Current concepts: Because self-regulation is severely limited, medical disputes in Korea frequently proceed to civil and criminal litigation rather than internal resolution, with prosecution and conviction rates substantially higher than in Japan or the UK, fueling defensive medicine and physician burnout. Compounding this, the absence of a reliable physician registry has fueled contentious, evidence-poor debates over workforce policy, culminating in the 2024 medical workforce conflict. By contrast, the UK, US, and Canada operate independent regulatory bodies overseeing registration, standards, assessment, and discipline, aligned with WHO workforce governance guidelines.Discussion and conclusion: Korea should separate professional advocacy from public licensure regulation and establish an independent Korean Medical Regulatory Authority, jointly governed by physicians, patients, and public representatives, performing five core functions: self-regulation, promoting patient safety and trust, supporting continuing professional development, maintaining reliable workforce data, and facilitating international licensure cooperation. This authority is intended not to protect physicians' interests, but to serve as public governance infrastructure institutionalizing social accountability, safeguarding patient safety, and securing the long-term sustainability of Korea's healthcare system.