--- title: Learning Across Borders – What Korea and Colombia Can Teach Each Other (and the US) description: Explore how healthcare systems in Korea and Colombia can inform practices in the US, enhancing patient care through shared insights and innovative approaches. image: https://www.medicalofficemarketing.org/hubfs/ChatGPT%20Image%20Sep%2030%2c%202026%2c%2004_19_41%20PM.png --- [Skip to content](https://www.medicalofficemarketing.org/blog/learning-across-borders-what-korea-and-colombia-can-teach-each-other-and-the-us#main-content) [![LOGO Design with White Background JPEG](https://www.medicalofficemarketing.org/hubfs/Logos/LOGO%20Design%20with%20White%20Background%20JPEG.jpg)](https://www.medicalofficemarketing.org/) [Medical English Courses](https://www.medicalofficemarketing.org/Medical-English-Courses) [Contact Us](https://www.medicalofficemarketing.org/contact) - [Home](https://www.medicalofficemarketing.org) - [Business Strategy Services](https://www.medicalofficemarketing.org/business-strategy-financial-modeling) Show submenu for Business Strategy Services - [Financial Forecast Modeling](https://www.medicalofficemarketing.org/business-strategy-financial-modeling#modeling) - [Concierge & Private Practice Models](https://www.medicalofficemarketing.org/business-strategy-financial-modeling#private) - [For Regional Anesthesiologists](https://www.medicalofficemarketing.org/business-strategy-financial-modeling#regional) - [Grant & Funding Strategy](https://www.medicalofficemarketing.org/business-strategy-financial-modeling#grants) - [Patient Experience Services](https://www.medicalofficemarketing.org/patient-experience-care-optimization) Show submenu for Patient Experience Services - [Healthcare Consumer Journey Mapping](https://www.medicalofficemarketing.org/patient-experience-care-optimization#mapping) - [Patient Experience Consulting](https://www.medicalofficemarketing.org/patient-experience-care-optimization#consulting) - [About Us](https://www.medicalofficemarketing.org/about-us) - [Blog](https://www.medicalofficemarketing.org/blog) - [Home](https://www.medicalofficemarketing.org) - [Business Strategy Services](https://www.medicalofficemarketing.org/business-strategy-financial-modeling) Show submenu for Business Strategy Services - [Financial Forecast Modeling](https://www.medicalofficemarketing.org/business-strategy-financial-modeling#modeling) - [Concierge & Private Practice Models](https://www.medicalofficemarketing.org/business-strategy-financial-modeling#private) - [For Regional Anesthesiologists](https://www.medicalofficemarketing.org/business-strategy-financial-modeling#regional) - [Grant & Funding Strategy](https://www.medicalofficemarketing.org/business-strategy-financial-modeling#grants) - [Patient Experience Services](https://www.medicalofficemarketing.org/patient-experience-care-optimization) Show submenu for Patient Experience Services - [Healthcare Consumer Journey Mapping](https://www.medicalofficemarketing.org/patient-experience-care-optimization#mapping) - [Patient Experience Consulting](https://www.medicalofficemarketing.org/patient-experience-care-optimization#consulting) - [About Us](https://www.medicalofficemarketing.org/about-us) - [Blog](https://www.medicalofficemarketing.org/blog) ![Hamburger](https://22206477.fs1.hubspotusercontent-na1.net/hubfs/22206477/list-bold-1.svg) ![Close Icon](https://22206477.fs1.hubspotusercontent-na1.net/hubfs/22206477/x-bold-1.svg) # Learning Across Borders – What Korea and Colombia Can Teach Each Other (and the US) [Marion Davis,](https://www.medicalofficemarketing.org/blog/author/marion-davis) 30 September 2026 ![Three clinicians and a patient discuss care around a table with a spine model, medical scans, and nutritious food, beneath a world map and flags of South Korea, Colombia, and the United States.](https://www.medicalofficemarketing.org/hubfs/ChatGPT%20Image%20Sep%2030%2c%202026%2c%2004_19_41%20PM.png) The main reason why I study healthcare systems internationally is because progress rarely comes from assuming any one country has all the answers. Every country’s healthcare system has blind spots and areas where it excels. The challenge, and what I find most interesting, is learning from countries like Colombia, South Korea, and others instead of picking a winner. Earlier in this series, we explored how [South Korea’s regulated private market and price caps](https://www.medicalofficemarketing.org/blog/south-koreas-healthcare-model-what-a-regulated-private-market-gets-right-and-wrong) create expertise in certain specialties through procedural volume. We also examined [Colombia's generalist training model](https://www.medicalofficemarketing.org/blog/colombias-generalist-model-seeing-the-whole-patient) and the country’s emphasis on nutrition as part of whole-patient care. Now it's time to bring it all together. ## What Korea Can Teach the US and Colombia South Korean pain anesthesiologists have retained broad ownership of epidural interventions that many Western systems have lost. Anecdotal evidence from pain physicians in the U.S. suggests that many clinicians haven't performed an epidural blood patch (EBP) since their residency. One practicing anesthesiologist recently described being asked to patch a patient with spontaneous intracranial hypotension and a T3-T9 epidural collection, only to have the group decline because no clinician among them was comfortable performing a thoracic epidural blood patch. This gap in competency has real consequences, as I explored in my post on the [opportunity cost of a private practice physician's failure to diagnose and treat a spinal CSF leak](https://www.medicalofficemarketing.org/blog/the-opportunity-cost-of-a-private-practice-physicians-failure-to-diagnose-and-treat-a-spinal-csf-leak). The contrast between U.S. clinicians and their South Korean counterparts regarding administering epidural blood patches is striking. Korean publications on epidural blood patches routinely come out of anesthesiology and pain medicine departments, with case reports discussing technically challenging cervical patches and complex patient cases, with some requiring as many as ten attempts at an epidural blood patch before achieving success. South Korean pain medicine is deeply embedded in anesthesiology. Academic pain centers that perform procedures like epidural steroid injections, nerve blocks, and radiofrequency are typically part of anesthesiology departments, rather than being split off into a separate interventional pain specialty. ### What US pain management anesthesiologists could learn South Korean anesthesiologists have demonstrated objective patient success with blood patches for spontaneous intracranial hypovolemia. A [2025 study](https://journals.lww.com/jnsa/fulltext/2025/07000/epidural_blood_patch_for_the_treatment_of.5.aspx) in the Journal of Neurosurgical Anesthesiology found that while a permanent resolution of symptoms was observed in only 29% of individual blood patch attempts, 67% of patients achieved a permanent resolution of symptoms after repeated blood patches. The first-line treatment for spontaneous intracranial hypovolemia (SIH) is a non-targeted epidural blood patch, which should be performed as early as possible. The technique exists. The data exists. The question is whether U.S. practitioners will learn it. For those ready to make the leap, I've written about [how to create a cash-based clinic focused on spinal leak care](https://www.medicalofficemarketing.org/blog/how-to-create-a-cash-based-clinic-focused-on-spinal-leak-care-a-career-move-for-anesthesiologists)—a practical roadmap for anesthesiologists looking to transition to private practice. ## What Colombia Can Teach Korea (and the US) In my experience with Korea’s private healthcare system while living in the country, Korean dermatology excelled at patient interviewing and procedural care, but no one evaluated my nutritional status. No one checked B12, iron, or thyroid function. Meanwhile, I have seen that Colombian dietitians are heavily focused on iron research to address anemia. Iron intake, absorption, and utilization are critical for blood quality for procedures like epidural blood patches. Iron, vitamin B12, folate, and vitamin K all impact blood quality and wound healing. ### What Korean clinicians could learn Korean clinicians can learn the importance of nutritional assessment before performing procedures like epidural blood patches. Blood quality significantly affects the success rates of such procedures. A technically perfect epidural blood patch may fail if the patient's blood doesn't clot properly due to a micronutrient deficiency. Colombian dietitians and generalists may understand this, but many clinicians in other systems like the U.S. and South Korea are not openly demonstrating a more comprehensive approach to spinal leak treatment that considers patients’ nutritional status and blood quality. ### What US PCPs could learn U.S. clinicians can learn about better case management from Colombian generalists, who receive more comprehensive training in medical school. Colombian generalists could teach U.S. PCPs how to recognize symptoms of thyroid dysfunction that don't fit textbook presentations, interpret thyroid labs in context, and use patient narratives as clinical data. **\[Related:** [**Can You Suddenly Have Hypothyroidism? The Overlooked Connection to Spinal CSF Leaks**](https://www.medicalofficemarketing.org/blog/can-you-suddenly-have-hypothyroidism-the-overlooked-connection-to-spinal-csf-leaks)**\]** ## A Better Division of Labor This is where the real opportunity lies. Instead of treating spinal CSF leak care as a turf war between specialties, we should ask: who is best positioned to do what? Radiology's most valuable contribution is on the diagnostic side. The Bern score, a brain MRI-based scoring system developed by a neuroradiology group in Germany and Switzerland, assigns points across six imaging findings to estimate the probability of a spinal CSF leak. A [2025 validation study](https://thejcn.com/pdf/10.3988/jcn.2025.0154) from Seoul National University Hospital found that when using the original cutoff of 3, the Bern score showed high specificity (95.6%) but limited sensitivity (42.2%). Using a revised cutoff of ≥2, the Youden index was highest, with sensitivity of 66.7%, specificity of 84.4%, and accuracy of 75.6%. The study concluded that the Bern score "should not be used alone as a screening tool." [Research](https://pmc.ncbi.nlm.nih.gov/articles/PMC10839534/) has shown that a Bern score of five or higher, combined with a positive non-invasive MR myelogram, is a reasonable basis to proceed directly to an empiric epidural blood patch before resorting to invasive myelography. However, the diagnostic performance of the Bern score improves at lower cutoffs, with one study finding at a cutoff of 4, sensitivity of 85.5% and specificity of 94.6%. A well-trained, high-volume pain anesthesiology workforce, the kind Korea's reimbursement structure has inadvertently cultivated, might be best positioned to deliver the actual epidural treatment for the great majority of ordinary cases, informed by imaging when it exists and supported by routine attention to a patient's coagulation status and nutritional history before the procedure ever begins. Neurosurgery remains essential for the smaller subset of cases that require structural repair such as repairing a dural defect, ligating a CSF-venous fistula, or removing an offending osteophyte. Dietitians and primary care physicians can ensure patients are nutritionally optimized before procedures, improving blood quality and potentially reducing failure rates. This division of labor makes clinical and economic sense. None of these specialties needs to own the entire pathway to contribute meaningfully. As I've argued in my post on [bridging the gap: a profitable approach to spinal leak care for anesthesiologists](https://www.medicalofficemarketing.org/blog/bridging-the-gap-a-profitable-approach-to-spinal-leak-care-for-anesthesiologists), anesthesiologists are uniquely positioned to lead in this space. ## What the US Can Learn from Both The U.S. system has created a strange situation. The 2023 multidisciplinary consensus guideline for spontaneous intracranial hypovolemia (SIH) explicitly recommends non-targeted epidural blood patching as the primary, first-line intervention for a broad segment of patients before initiating invasive leak localization. Yet U.S. patients frequently describe being routed through costly, invasive diagnostic procedures before receiving a simple blood patch. This is typically all conducted by radiology in the U.S. and in other Western countries. Meanwhile, U.S. pain anesthesiologists, who could be performing these patches, have been pulled toward the lucrative chronic pain market. From 2000 to 2020, the number of Medicare beneficiaries receiving spinal interventional pain management techniques increased significantly, with epidural steroid injections becoming one of the most commonly performed procedures. In my experience, these pain anesthesiologists often play word gymnastics when I challenge them on their blood patch knowledge, such as claiming that they *can* complete blood patches but that they simply *don’t* because there is no need. Coming from an education background, I am well aware that skills that are never practiced since learning them 15 years before are typically not retained and should likely not be considered a current skill. Meanwhile, a radiology nurse has reported to me that patients were regularly coming into the radiology department where she worked and receiving improperly performed blood patches by radiology after a dural puncture during an epidural steroid injection at a pain management clinic because the anesthesiologists there did not know how to complete a blood patch. Korea's regulated pricing didn't create the same financial incentive to specialize away from blood patches. Colombia's generalist training didn't create the same siloed approach to care. Each system has preserved something the U.S. has lost. ## The Takeaway Rather than asking which country has the best healthcare, I ask different questions: - How are physicians trained? - Who can enter these professions? - How much socioeconomic distance exists between clinicians and their patients? - What happens when a system rewards volume over prestige—or nutrition over procedures? These questions matter because a clinician's background shapes their perspective, their assumptions, and how they listen to a patient's story. No single nation holds the monopoly on superior healthcare. Excellent healthcare systems are forged by drawing on international perspectives. ## Join a Global Community of Clinicians The clinicians who will thrive in the next decade will be the ones who build bridges across borders, learn from colleagues in other countries, and position themselves to serve patients wherever they are. - **Discover the opportunity**: My free introductory webinar, [*The US Wellness Market: An Opportunity for International Clinicians*](https://www.eventbrite.com/e/the-us-wellness-market-an-opportunity-for-international-clinicians-tickets-1995467671522), is the starting point. No cost. No commitment. Just a clear-eyed look at what the U.S. market offers, and what it takes to enter it. - **Get the roadmap**: My paid workshop, [*Building Your Cross-Border Business in the US Wellness Market*](https://www.eventbrite.com/e/workshop-building-your-cross-border-business-in-the-us-wellness-market-tickets-1995468238217), transforms insight into action. 90 minutes of practical, step-by-step guidance on building a practice that serves U.S. patients from abroad. - **Speak the language of your patients**: My [Medical English courses](https://www.eventbrite.com/e/medical-english-for-healthcare-professionals-module-1-tickets-1996342312597) are designed for clinicians who want to build confidence in their English while learning the vocabulary and communication strategies that actually matter in clinical practice. Start with subjects that interest you most, with zero long-term commitment required. ## What's Next? This three-part series has explored what South Korea and Colombia can teach us about healthcare, and what these countries can learn from each other. But we're just scratching the surface. There’s more to come if you're a clinician interested in cross-border practice, an administrator looking to expand your network, or a patient seeking care across borders. I'm building a community of clinicians who want to learn from each other, share expertise, and build practices that serve patients wherever they are. Sign up for our [Newsletter](https://www.medicalofficemarketing.org/subscribe) to receive updates on future articles, webinars, courses, and networking opportunities. You can also [contact us](https://www.medicalofficemarketing.org/contact) for more information. You can help improve your country’s healthcare system by learning from what other countries excel at. Obtain a competitive advantage by addressing hidden markets in healthcare. 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