To the Editor,
The editorial by Oh [
1], “What is the optimal number of physicians for a sustainable healthcare system?” provides crucial insights that are highly relevant to the Philippine healthcare system. In Korea, concerns over physician shortages have led to increased medical school enrollment. However, Oh warns that such strategies, based on studies with varying assumptions, may lead to misleading conclusions. Instead of expanding enrollment, he argues for sustainable healthcare reforms, stronger primary care, and a data-driven approach to determining the ideal number of physicians.
The Philippines faces similar challenges but on a more severe scale. The country has one of the lowest doctor-to-patient ratios in Southeast Asia, with only approximately four doctors per 10,000 people—far below the World Health Organization’s recommended 10 per 10,000 people [
2]. Given these figures, increasing medical school enrollment seems like an obvious solution. However, as Oh [
1] suggests in the Korean context, a simplistic focus on quantity may overlook deeper systemic issues.
A major issue in the Philippines is the maldistribution of physicians. Urban centers such as Metro Manila have an abundance of specialists, while rural areas and far-flung provinces suffer from a severe lack of medical professionals [
3]. Increasing the number of doctors without providing incentives for rural practices may widen this gap. Without structural changes—such as improving healthcare infrastructure in underserved areas, increasing financial incentives for rural doctors, and strengthening the barangay health system—more graduates may still gravitate toward urban hospitals or migrate abroad.
Additionally, the Philippines struggles with a “brain drain” problem, as many Filipino doctors seek better-paying opportunities overseas [
4]. Simply training more doctors will not solve this problem if they continue to leave due to low wages, inadequate facilities, and difficult working conditions. Addressing retention through better compensation, improved working environments, and career development opportunities should be a priority alongside enrollment expansion.
However, some argue that increasing medical school enrollment is essential. Growing populations and aging demographics inevitably require more healthcare services [
5]. Unlike Korea, where physician supply concerns are still debated, the shortage in the Philippines is more evident. Failure to increase the number of doctors could further strain an already overwhelmed system. Moreover, in the long run, a larger physician workforce could help improve accessibility, provided policies ensure equitable distribution.
Ultimately, the Philippine government should adopt a balanced approach. Expanding medical school enrollment can be part of the solution, but only if coupled with systemic reforms—strengthening primary care, incentivizing rural services, improving working conditions, and addressing migration issues. As Oh [
1] highlighted in the Korean context, solving physician shortages requires more than just increasing numbers; it demands a sustainable, well-planned healthcare strategy tailored to the country’s unique challenges.
Notes
References
- 1. Oh SW. What is the optimal number of physicians for a sustainable healthcare system? Korean J Fam Med 2025;46:1-3.
- 2. Macariola AD, Santarin TM, Villaflor FJ, Villaluna LM, Yonzon RS, Fermin JL, et al. Breaking barriers amid the pandemic: the status of telehealth in Southeast Asia and its potential as a mode of healthcare delivery in the Philippines. Front Pharmacol 2021;12:754011.
- 3. Flores EL, Manahan EM, Lacanilao MP, Ladaw IM, Mallillin MM, Mappatao NT, et al. Factors affecting retention in the Philippine National Rural Physician Deployment Program from 2012 to 2019: a mixed methods study. BMC Health Serv Res 2021;21:1201.
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