Due to the lack of rehabilitation medical service and delivery systems in conventional hospitals, patients had to go from one hospital to another, living a life of “rehabilitation refugee” who become further alienated from the rest of society. Jeesun Lee has broken new grounds in a conventional hospital system by establishing a Community Based Rehabilitation (CBR) service focused on patients with disabilities, especially among children and adolescents, and seeking ways to spread her model through various financial and administrative means.
The New Idea
Jeesun Lee has introduced new paradigms in the medical sector in Korea by broadening the boundaries of rehabilitation medical service and redefining the roles of hospitals and medical workers. Her model provides a seamless web of care for people who need rehabilitation medical services that are connected with the community and responsive to different demographic groups. At Seoul Rehabilitation Hospital, where Jeesun serves as the director, she took more than the role of an average employed doctor and established a customized rehabilitation medical care solution, especially for children and adolescents with disabilities. Children and adolescents with disabilities were also the population group often neglected in the conventional medical care system. Lee noticed that if children acquired a disability, the entire family could break down while providing care for the children. Yet, integrated treatment and care services are scarce. The deficit in convalescent services across the country is primarily due to the lack of national medical subsidies based on the confining perspective of considering rehabilitation medical service as serving the momentary treatment for disabled people. However, patients need both sustainable, holistic treatment and care services for their long-lasting conditions.
To revive the ‘recuperative care’ in the philosophy of the word rehabilitation, Jeesun has shifted the realm of rehabilitation service from the field of treatment for disabled people to the stage of social and community transformation, opening doors for equal opportunities to care and health. At SRH, Lee opened up the first children’s rehabilitation day ward ever in Korea, enabling outpatient treatment instead of hospitalization. This day ward means the inclusion of more patients, including those who could not receive inpatient treatment due to numerous circumstances such as family issues or work. Meanwhile, for those who require hospitalization for treatment, they can regain life balance earlier due to the outpatient service available for continued medical care after the inpatient treatment ends.
Lee also realized the lack of appropriate services for adolescents, catered to their sensitive needs in both physical and psychological states. In response, Lee established a medical team specifically for youth. Her inclusive and responsive models to young patients at SRH have already spread and reflected in the Public Rehabilitation Children’s Hospitals across the country. During the process, Lee has continued to engage in medical research to persuade governmental institutions to take further action and make the expansion a government-based one. As the fruit of her work, she has succeeded in creating a new subsidy for the children’s rehabilitation day ward and having the “convalescence rehabilitation hospital pilot project” by the Ministry of Health and Welfare conducted in partnership with SRH.
While Lee has been able to alleviate some pain points of people in treatment, she has also spotted multiple obstacles in patients’ reintegration to society after the treatment. To help their readjustment, Lee has established various programs focused on helping patients to recover both physical functions and mindsets for their everyday lives. Another unique social reintegration that Lee has built engages multiple stakeholders such as schools, health centers, and local welfare agencies in the local community. Within this program, Lee has formed the coalition among SRH, patients’ families, and schools where medical staff could be directly dispatched to schools to educate and establish guidelines that could reduce discrimination against students with disabilities in the school community. This unprecedented Community-Based Rehabilitation(CBR) model, which bridges the gap between hospitals and local communities, has been approved to be applied to each Provincial Health and Medical Center for People with Disabilities.
There has always been a lack of rehabilitation medical system in Korea, while there are approximately 90,000 minors with disability (under the age of 19) that need rehabilitation medical treatment. Of these minors, over 70,000 have “severe disability.” The ratio of children and adolescents with severe disabilities is far higher than that of adults. The cost of children with disabilities who did not receive the necessary treatment on time, amounts to three times as much, compared to those who have treated at an early age. Moreover, children with disabilities are bound to acquire more complications, which continues to affect the biological and psychological aspects of the patient throughout their lives, hindering them from getting a basic education. Even with such facts, there are only 200 children rehabilitation hospitals out of 30,000 medical institutions nationwide, constituting 0.7%(2017). Children’s rehabilitation is a relatively low-paying field while requiring a long-term one on one treatment with a medical expert. The more the hospital admits such patients, it causes a more profound deficit for hospitals’ operations. Within this context, children with disabilities miss the golden time, which makes their disabilities permanent.
Another prevalent issue is the lack of convalescent medical services that help patients to recover after acute treatment. The two most prominent types of rehabilitation hospitals are 1. acute rehabilitation hospitals treat patients who just had a serious accident; 2. nursing hospitals that merely provide primary care. Since patients who are hospitalized for more than three months damage the finance of the acute hospitals, they try to discharge patients as soon as possible regardless of patients’ condition. On the other hand, since nursing hospitals can charge more for patients with severe disabilities, they do not prioritize the recovery of the patients, which sometimes exacerbates the patients’ conditions into a permanent state. Currently, there is an insufficient number of convalescence hospitals that provide medical services geared towards the holistic recovery of patients. Therefore, there is no continuum of the care nor comprehensive medical delivery system encompassing acute, convalescence, and nursing treatments to aid the full recovery of patients. This deficiency in infrastructure leaves patients to become “rehabilitation refugees” who have to search for hospitals every two to three months due to the limitation of national medical subsidy.
Moreover, there is a lack of an integrated solution, which is vital for helping the patients reintegrate back to their homes, schools, jobs, and local communities successfully. Discharged patients fall in a medical blind spot, as neither the hospital nor the welfare institutions provide effective medical treatment or services that help the patient’s community reintegration. The burden of medical treatment falls all in the hands of the patients and their families. There is a lack of services in the field of community care, which the patients should be receiving as the following: support services for outpatients, home-visit rehabilitation, improving home conditions, and education for schools and workplaces. Thus, patients face significant difficulties in returning to their communities, and this leads to an economic and social loss of 28 trillion Korean won (2015).
To fulfill her mandate of making a hospital that never sends back any patient with the best service and care, Lee fostered a caring community within the hospital that embodies empathy as the foremost step. To build such an empathetic mindset model and culture, Lee nurtured internal book clubs in which hospital staff is encouraged to join and even lead their initiatives in their studies of empathy. In its philosophy, Jeesun laid “servant leadership” at its core, the culture that is to disseminate from medical staff to each other and patients (97.1% positive feedback in customer SRH satisfaction survey for “friendliness,” 2018).
Lee’s recognition of the most critical dent in Korea’s medical care system also played an essential role in cultivating its impact. She noticed that the most vulnerable group, children, and adolescents patients with disabilities are continuously excluded from the existing rehabilitation medical care. Lee pointed out the importance of early intervention for young patients because the young age is crucial not only in the actual physical recovery but also in smooth social reintegration and prevention of future complications. Thus, to provide medical service for children who could not afford hospitalization, Lee opened the first children’s rehabilitation day ward in Korea. Furthermore, to ensure the sustainability and scalability of the program, Lee persuaded the Health Insurance Review & Assessment Service to have this program covered by national insurance. Since then, more than 100 hospitals have visited to study her model, including the government-affiliated National Rehabilitation Center. Similarly, when Lee identified that there was no existing rehabilitation service for adolescents with disabilities, which was the main factor preventing young patients from continuing their education, Lee formed an unprecedented medical team for adolescent patients.
Lee is also very passionate about sharing gained insights and developing an education model for rehabilitation medical care. Through the Education and Research Center within the SRH, she educates about her model and trains students majoring in rehabilitation medicine from 50 universities. Lee is also rigorously publishing research papers, creating manuals, and hosting seminars to influence the rigid medical sector. As a result of her continuous work, she is now an advisor for the government project of the incumbent president – the establishment of Public Children’s Rehabilitation Hospitals throughout the country. SRH’s model is to be reflected in the nine children’s rehabilitation hospitals across the country, which are to be constructed by 2022.
In facilitating support for social readjustment after treatment, Jeesun has launched therapy programs that invite and engage the outside community with medical programs. The first and foremost group Lee engages in is the patients’ families because families are the first community patients return to. These families bridge the patients’ further reintegration into larger communities. Thus, these therapies revolve around rebuilding family bonds via family trips and family-school programs, all coordinated at Support Center within SRH. Lee also connects other communities with the rehabilitation care system. SRH dispatches medical staff to patients’ schools to provide guidelines and foster an inclusive community. With such first-hand care service, Lee has established a very comprehensive and Community Based Rehabilitation (CBR) model that is much needed in the context of the rapidly developed Korean medical system.
Fully aware that a single hospital alone cannot provide adequate CBR rehabilitation medical service to all, Lee also led the rehabilitation consultative group at the precinct level, composed of local hospitals, municipal halls, healthcare centers, welfare centers for disabled persons, and the National Health Insurance Service. With such solidary, Lee was able to provide seamless community care and conserve time and energy in the community reintegration period significantly in comparison to the existing model. With this success, SRH was selected as the Regional Health and Medical Center for People with Disabilities, responsible for managing half of Seoul. Further, Lee’s CBR model will be the paragon for the other 18 Regional Health and Medical Center for People with Disability nationwide. Also, Lee has consulted and affected the convalescent hospital pilot project of the Korean government to weigh more on patients’ social reintegration and holistic recovery.
Last but not least, Lee is preparing to build a new hospital as a national role model for the caring community and advanced global CBR model. Lee is also continuously fostering a unique ecosystem that can help society to embrace people with disabilities via a new collaboration model redesigning the realm of rehabilitation services into public social welfare. Seven years ago, when she became the director of SRH, Lee has forged an innovative strategy that can engage various partners, such as the government, to partake in establishing and sustaining a new hospital, called New Hospital. With full approval and support from Angel’s Havens, Lee has named the New Hospital project, “The Miracle Project,” of which a new Board will be formed for its new governance, financing, and functions. Jeesun envisions New Hospital to continue to play the central role of identifying and providing for the needs of the people with rehabilitative care, including a population of senior citizens in addition to many children with disabilities. In addition to the fundamentals, New Hospital is expected to encompass four additional essential functions : 1) R&D Center to not only pioneer but also to accumulate knowledge and experiences as public resources 2) Education and Training Center fostering the next generation of caregivers 3) New Model of “Silvertown” and 4) International Collaboration Center all of which are based on core insights established in Seoul Rehabilitation Hospital. Her vision in New Hospital is building an excellent global foundation for healthcare that genuinely exists for the service of the people with a universality that enables greater equity, inclusion, and vitality for all.
To achieve this goal, Lee set up a unique core Miracle Project Leading Group, composed of diverse experts such as CEOs of corporate, social entrepreneurs, lawyers, and professional marketers; patients and their families; and medical staff of SRH. By doing so, Lee was able to design an unprecedented strategy to build a new medical center. Unlike the traditional model that unilaterally requests service or funds to the government, Lee initiated a movement by raising funds from the public. Lee aims to further enhance the sustainability and public nature of New Hospital by planning to establish a third legal entity, a converged model of administration that represents partnerships of the public sector and actual citizens. This integrated model of a hospital operating system is unprecedented, quite different from that of social welfare foundation like SRH and general hospitals. Through this new model, Jeesun is naturally drawing the participation and cooperation of stakeholders in various fields for building and providing health care for the public interest. Furthermore, Lee has created a movement to raise awareness about disabilities and change the mindset of the general public. With the team of 80 media experts and SRH’s contents archiving staff, Lee creates media content and campaigns. For example, Lee began the 1% project inviting 100 corporates to donate 1% of their profit. In less than a year, she has received a 10 billion Korean Won donation agreement. With such effort combined, Lee is making society caring and inclusive towards the most vulnerable.
Lee had suffered pernicious anemia throughout her childhood and had to skip schools when she was hospitalized. Even after her condition has been improved, such experience made her deeply empathize with people with illness and disability. Also, the medical condition of her family member not only enhanced her empathetic skills but also impacted her decision to become a doctor.
In 1988 after finishing her medical studies in rehabilitation medicine, Jeesun Lee joined founding Seoul Rehabilitation Hospital, which is under a social welfare foundation, Angels’ Haven. She had two mandates from the chairman of the foundation: 1. Never send back patients, even those who can not afford the care. 2. Make the best rehabilitation hospital in the world. To achieve this mission, Lee had been working tirelessly, seeing patients first hand as the first doctor of the hospital while running it. She was the only medical doctor among the founding members, and in 2013, she finally became the director of the hospital.
Lee deeply empathized with patients, especially children, and their families, who can not easily access the care within the existing medical system, thus experiencing the breakdown of the family. Lee believed that medical institutions and society should be able to embrace the most vulnerable group in our society. Hence, she has pioneered developing medical programs such as the rehabilitation day ward for children with disabilities. Furthermore, she created a Community Based Rehabilitation model that brings the local community into medical care. Lee is also planning to disseminate such a model and change the societal framework through Miracle Project involving the private, governmental, and public sectors.
Meanwhile, after visiting Uzbekistan in 2000 for medial support, Lee realized that it takes one medical expert personnel to begin building a rehabilitation medical infrastructure in marginalized regions such as Africa and Arab countries. Therefore, Lee is dispatching medical personnel of SRH to provide medical training and spread her rehabilitation model and system abroad. By partnering with KOICA(Korea International Cooperation Agency) and a social welfare organization, Lee was able to utilize its international network to provide 54 trainings across 10 countries.