As artificial intelligence, or AI, and Photoshop technology become increasingly sophisticated, cases of forged doctor and pharmacist licenses, which are often displayed on the walls of medical institutions and pharmacies, continue to occur. Patients need to exercise caution.
According to data submitted by the Health Insurance Review and Assessment Service to the office of Kim Gyo Heung, a lawmaker of the Democratic Party of Korea and a member of the National Assembly Health and Welfare Committee, the number of cases in which unqualified individuals performed medical procedures without a license and then claimed reimbursement costs from 2022 through July this year reached 57,097, with the amount totaling 1.78165 billion won. In this way, the National Health Insurance Service recovers amounts improperly claimed by medical institutions, pharmacies and other healthcare providers.
A representative case involved a fake doctor who treated patients at a Korean medicine hospital in Dalseo-gu, Daegu, from 2021 to 2024 after forging a medical license. The man stole the license of another doctor who had worked with him at a hospital in the past and forged it as his own by compositing his identification photo onto it. After being hired by a Korean medicine hospital with the forged license and performing medical procedures, he improperly claimed 595 million won from HIRA.
At a pharmacy in Guro-gu, Seoul, a family member of a retired pharmacist was caught after stealing the pharmacist's license and compounding and selling medicines. The fake pharmacist improperly claimed more than 140 million won in healthcare reimbursement costs over seven months.
Patients can verify the authenticity of doctors' and pharmacists' licenses only indirectly. This is because a database containing license information is not publicly available for the protection of personal information. However, the total number of doctors reported by a medical institution to HIRA, the number of specialists by medical department, and the number of pharmacists reported by a pharmacy to HIRA can be checked by the general public, allowing them to infer whether the information is authentic. The information can be viewed by searching for a medical institution or pharmacy under ‘Health Insurance Review and Assessment Service website → Medical Information → Find a Hospital or Pharmacy.’
According to data submitted by the Health Insurance Review and Assessment Service to the office of Kim Gyo Heung, a lawmaker of the Democratic Party of Korea and a member of the National Assembly Health and Welfare Committee, the number of cases in which unqualified individuals performed medical procedures without a license and then claimed reimbursement costs from 2022 through July this year reached 57,097, with the amount totaling 1.78165 billion won. In this way, the National Health Insurance Service recovers amounts improperly claimed by medical institutions, pharmacies and other healthcare providers.
A representative case involved a fake doctor who treated patients at a Korean medicine hospital in Dalseo-gu, Daegu, from 2021 to 2024 after forging a medical license. The man stole the license of another doctor who had worked with him at a hospital in the past and forged it as his own by compositing his identification photo onto it. After being hired by a Korean medicine hospital with the forged license and performing medical procedures, he improperly claimed 595 million won from HIRA.
At a pharmacy in Guro-gu, Seoul, a family member of a retired pharmacist was caught after stealing the pharmacist's license and compounding and selling medicines. The fake pharmacist improperly claimed more than 140 million won in healthcare reimbursement costs over seven months.
Patients can verify the authenticity of doctors' and pharmacists' licenses only indirectly. This is because a database containing license information is not publicly available for the protection of personal information. However, the total number of doctors reported by a medical institution to HIRA, the number of specialists by medical department, and the number of pharmacists reported by a pharmacy to HIRA can be checked by the general public, allowing them to infer whether the information is authentic. The information can be viewed by searching for a medical institution or pharmacy under ‘Health Insurance Review and Assessment Service website → Medical Information → Find a Hospital or Pharmacy.’
If medical professionals want to verify the authenticity of another medical professional's license when hiring them, they can use the ‘Ministry of Health and Welfare License Civil Affairs Information’ website. They should check whether the license and qualification information registered in the Ministry of Health and Welfare's license management information system matches the information provided by the job applicant.
Kim Gyo Heung said, “Medical practice by an unqualified person goes beyond a simple violation of the Medical Service Act and threatens the lives and safety of the public. Through thorough investigations, we must eradicate unlicensed medical practice and guarantee patients' right to receive medical treatment safely.”