• Title/Summary/Keyword: 의사의 진료의무

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A Comparative Study on the Satisfaction of Korean and Canadian Primary Care Based on the Survey of Overseas Korean in Canada (캐나다 재외국민 설문조사에 기초한 한국과 캐나다 1차 의료기관 만족도 비교 연구)

  • O, Dongil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.5
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    • pp.565-576
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    • 2020
  • This study compares and analyzes satisfaction with Korean and Canadian primary medical care based on a survey of Koreans living in Canada. Based on data collected from Koreans who live in Canada, a paired sample t-test, analysis of variance (ANOVA), and GLM were used. The main conclusions of this study are as follows. First, overall satisfaction with Korean primary care was high. Second, the results of the analysis were stable, regardless of gender, age, education, and residential area. Third, overall satisfaction with Korean medical care was higher than for medical care in Canada. Fourth, satisfaction was high in terms of treatment skill and technology, and promptness in appointments, but was low in terms of medical expense. Fifth, there was a high level of confidence in physician skills and practices, but there was no significant difference in terms of sufficient counseling and explanations. Finally, the survey found that the tendency to increase medical treatment volume in order to increase a physician's own income was large. As a result of detailed analysis, it was concluded that Korea's primary care is more competitive than in Canada, but the primary medical doctors' patient interview and explanation obligations, and incentives to control income and medical expenses, need to be improved.

Death with Dignity and the Right to Decide (생명권과 자기결정권, 그리고 의사의 진료의무)

  • Yoo, Seung-Ryong
    • The Korean Society of Law and Medicine
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    • v.9 no.2
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    • pp.11-52
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    • 2008
  • Based on foreign examples and past debates, the minimal conditions for passive euthanasia can be suggested as following; (1) The patient is incurable by modem medical practice and his death is impending (less than 6 months), (2) Euthanasia is practiced solely to relieve physical pain of the patient, (3) If the patient can express his will, there should be a clear and sincere request or consent, (4) More than 2 doctors including doctor in charge should consent, (5) Euthanasia should be practiced in ethical way, (6) Patient family should agree(when the patient will is assumed.) It is hard to resolve issues regarding euthanasia based on past rulings and cases without concrete law. As in United States and Germany, clear and objective provisions of euthanasia and definitive method for patient's advanced directive should be legislated to resolve medical conflict and to relieve patient and family from agony. And death with dignity debate will not be able to proceed if it is only substantively approached because of unclear definition of euthanasia and benefit comparison way of thinking. Thus it is important to establish definitive process to decided legislation of euthanasia act and resolving conflicts arising from each step of the process among interested parties exchanging medical/ethical opinions.

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A Survey on the Perception of the Counterplans of Medical Accident and Dispute of Dental Hygienist (의료사고 및 의료분쟁에 대한 치위생사의 인식도 조사)

  • Oh, Jin-Ho;Kwon, Jeong-Seung;Ahn, Hyoung-Joon;Kang, Jin-Kyu;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.32 no.1
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    • pp.9-33
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    • 2007
  • In the field of dentistry, there existed relatively few emergency patients or patients who need intensive care and thus had low medical dispute rates. However, these days, there is a general tendency of increased medical disputes. Although many medical disputes are caused by medical accidents of the dentists, because dental assistants are also lawfully involved in practicing dentistry, there is a possibility of medical disputes or medical accidents caused by dental assistants. Therefore, the role of the dental assistants cannot be ignored. This study consists of a survey given to dental hygienists currently working in general hospitals, dental hospitals and private dental clinics. Following is the results of the analysis of 275 respondents' backgrounds, medical disputes rates including patients' complaints, their understanding of medical regulations and their general understanding of overall dental practice and medical disputes. 1. 251 of 274(91.6%) respondents doubted the risk of medical accident and dispute. 2. 81(29.5%) dental hygienist experienced complaint from patients. They have been working in the private dental clinic, the rate of this experience was high. 3. 349 case of 1805(19.3%) the complaints by patients, highest percentage among its category, were those regarding dental fees and poor service. 4. 129 case of 1805(7.1%) patients' complaints, highest percentage among it's subcategory, were those regarding the absence of explanations of precautions or request of agreements before dental treatment. 5. 252 of 267 (94.4%) dental hygienists chart after a scaling treatment. However, only 55(20.7%) dental hygienists chart the fact of explaining the precautions. 6. 6(2.2%) dental hygienists do not inspect patients' medical history, if patients don't mention it. 7. 104 of 274(38.0%) dental hygienists responded to be capable of administering first aid treatment. 8. 115(41.8%) dental hygienists have a first aid kit and equipment. 9. In case of medical dispute, 268(97.8%) dental hygienists respond that, charting plays a big role in resolving the dispute. 10. In case of medical dispute, 272(93.3%) dental hygienists respond that, explanation and agreement before treatment have an important role in settlement of dispute 11. Only 160(58.4%) dental hygienists responded correct answer that the duration of keeping medical records is 10 years. 12. 124(45.3%) respondents thought that it is legal for a dental hygienist to take a panoramic dental X-ray, 71(25.9%) respondents thought that it is legal practice cervical resin treatment by dental hygienist, and 37(13.5%) respondents thought that it is legal extract primary teeth by dental hygienist. 13. 24(18.76%) respondents thought that it doesn't matter to tell patient's state to others 14. 272(99.27%) responded that receiving education for the prevention of medical disputes was needed and of them, 61.0% thought it was urgent. 15. 186(64.2%) has never had classes regarding the prevention of medical disputes while in school and 212(77.4%) has not had the same type of classes after graduating from school. 16. 256(93.4%) responded that there will be even more of an increased number of medical disputes. Among them, 83.3% of respondents though that due to the increased opportunity of acquiring information through the internet and mass media. The study shows that 29.5 percentage of dental hygienists have experienced the medical disputes and complaints and they are lack of recognition of medical regulations and dental hygienist's official duty. So, there is a big potential of the percentage to increase. Therefore, the correct understanding of explaining precautions and requesting agreement before dental treatments and performing them are mandatory. Moreover, classes regarding the prevention and counterplans of medical disputes need to be widely offered.

Medicolegal Problems in Pediatric Area (소아과 영역에서 의료분쟁)

  • Kwon, Soo Jeong;Jang, Ji Young;Kim, Nam Su;Yum, Myung Kul;Seol, In Joon;Jung, Ku Won
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.813-819
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    • 2005
  • Purpose : Medicolegal problems start when the patient asserts the mistake of doctor and doctor does not accept it. The purpose of this study is to assess the actual condition of medicolegal problems and to provide solutions of medicolegal problems in the pediatric field. Methods : There is not official statistical data about medicolegal problems in our country. We gathered data of legal insurance program of Korean Medical Association(KMA) and court cases and other fragmentary data. Results : Between 1981 and 1995, of total 2,338 cases reported to legal problem insurance program of KMA, most common ones were 748 cases of obstetrics and gynecology. Pediatric case was ranked at the 5th, 74 cases(3.1%). According to analysis of 41 medicolegal cases' after 1990, maltreatment of patient had the highest incidence of 14 cases, injection and medication were related to 12 cases, misdiagnosis was 9 cases, patient management were related to 4 cases, and others were 2 cases. The trial result of the medicolegal cases was that 31 cases were compensated, and 8 cases were defeated, and 2 cases were still in the process. Conclusion : The aspect of medical legal problem has the tendency of radicalism and systematization. This brings an economic destitution in the patient and gives damage to a doctor. In order to reduce medicolegal problem, doctor should offer a duty of explanation and efforts to his best to satisfy patient and endeavor to make an intimate doctor-patient relationship.

A Study on Recent Discussions ahout the Pysician's Explanation in Medical Litigation (의료소송에서 의사의 설명에 대한 최신 지견)

  • Baek, Kyounghee
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.37-63
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    • 2023
  • In medical litigation, there are various cases where a doctor's 'explanation' of a patient becomes problematic. Medical explanations and guidance are required from the doctor, starting from the beginning of diagnosis, through treatment processes such as surgery, when hospitalization is necessary for treatment, during hospitalization, upon discharge, and after discharge. Furthermore, notification from the doctor or medical institution may be requested regarding the economic costs that will be incurred due to medical treatment. South Korea's judiciary has been developing legal principles regarding such doctor's explanations by distinguishing between explanations for obtaining consent for medical treatment and medical explanations related to guidance on patient treatment methods, taking into account related laws such as the stage of treatment and the Medical Service Act. Additionally, the Constitutional Court recently ruled on the non-benefit cost notification system linked to the explanation of economic costs. However, holding a doctor accountable solely because the doctor's explanation was insufficient has aspects that do not correspond to the actual situation in clinical reality, and may have a reflexive disadvantage that results in a decline in legal rights. Therefore, the doctor's explanation needs to be examined from both perspectives: guaranteeing the patient's right to self-determination and protecting his or her right to decision.

Besteht die Pflicht des Arztes, den Patienten ${\ddot{u}}$ber einen eigenen Behandlungsfehler zu informieren? (의사에게 치료상의 과오를 설명할 의무가 있는가?)

  • Kim, Min Joong
    • The Korean Society of Law and Medicine
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    • v.15 no.2
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    • pp.165-194
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    • 2014
  • Der Vertrag zwischen dem Arzt und seinem Patienten wird als Auftrag im Sinne des ${\S}680$ KBGB qualifiziert. Dem Arzt erwachsen innerhalb dieses Behandlungsvertrages zahlreiche Pflichten, von denen ein gro${\ss}$er Teil durch Richterrecht geschaffen wurde. Den Arzt treffen z.B. Behandlungspflicht, Informationspflicht ${\ddot{u}}$ber die Behandlung, Aufkl${\ddot{a}}$rungspflicht ${\ddot{u}}$ber einwilligungspflichtige Umst$\ddot{a}$nde, Dokumentationspflicht, Schweigepflicht. Der Arzt ist nach Rechtsprechung und Literatur verpflichtet, den Patienten ${\ddot{u}}$ber s${\ddot{a}}$mtliche f${\ddot{u}}$r die Einwilligung wesentlichen Umst${\ddot{a}}$nde aufzukl${\ddot{a}}$ren, insbesondere ${\ddot{u}}$ber Art, Umfang, Durchf${\ddot{u}}$hrung, zu erwartende Folgen und spezifische Risiken der Ma${\ss}$nahme, die Notwendigkeit, Dringlichkeit und Eignung der Ma${\ss}$nahme zur Diagnose oder zur Therapie und uber die Erfolgsaussichten der Ma${\ss}$nahme im Hinblick auf die Diagnose oder Therapie. Mu${\ss}$ der Arzt den Patienten auf einen eigenen Behandlungsfehler hinweisen, wenn f$\ddot{u}$r ihnen Umst${\ddot{a}}$nde erkennbar sind, die die Annahme eines Behandlungsfehlers begr${\ddot{u}}$nden. Allgemeine Offenbarungspflichr bei ${\ddot{a}}$rztlichen Behandlungsfehlern wird bisher nicht diskutiert. Nach derzietigem Recht besteht keine allgemeine Offenbarungspflicht des Arztes, den Patienten unaufgefordert ${\ddot{u}}$ber einen eigenen Behandlungsfehler hinzuweisen. Aber wie im ${\S}630c$ BGB, sind f${\ddot{u}}$r den Behandelnden Umst${\ddot{a}}$nde erkennbar, die die Annahme eines Behandlungsfehlers begr${\ddot{u}}$nden, hat er den Patienten ${\ddot{u}}$ber diese auf Nachfrage oder zur Abwendung gesundheitlicher Gefahren zu informieren.

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Legal Interest in Damages Regarding Loss of Treatment Chance (치료기회상실로 인한 손해배상에 있어서 피침해법익)

  • Eom, Bokhyun
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.83-139
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    • 2019
  • Recognition of liability for damages due to medical malpractice has been developed largely on the basis of two paths. First is the case where there is an error in a physician's medical practice and this infringes upon the legal interests of life and body, and the compensation for monetary and non-monetary damages incurred from such infringement on life and body becomes an issue. Second is the case where there is a breach of a physician's duty of explanation that results in a infringement on the patient's right of autonomous decision, and the compensation for non-monetary damages incurred from such infringement becomes an issue. However, even if there is a medical error, since it is difficult to prove the causation between the medical error of a physician and the infringement upon legal interests, the physician's responsibility for damage compensation is denied in some cases. Consider, for example, a case where a patient is already in the final stage of cancer and has a very low possibility of a complete recovery even if proper treatment is received from the physician. Here, it is not appropriate to refuse recognition of any damage compensation based on the reason that the possibility of the patient dying is very high even in the absence of a medical error. This is so because, at minimum, non-monetary damage such as psychological suffering is incurred due to the physician's medical error. In such a case, our courts recognize on an exceptional basis consolation money compensation for losing the chance to receive proper treatment. However, since the theoretical system has not been established in minutiae, what comes under the benefit and protection of the law is not clearly explicated. The recent discourse on compensating for damages incurred by patients, even when the causation between the physician's medical error and infringement upon the legal interests of life and body is denied, by establishing a new legal interest is based on the "legal principle of loss of opportunity for treatment." On what should be the substance of the new legal interest, treatment possibility argument, expectation infringement argument, considerable degree of survival possibility infringement argument and loss of opportunity for treatment argument are being put forth. It is reasonable to see the substance of this protected legal interest as "the benefit of receiving treatment appropriate to the medical standard" according to the loss of opportunity for treatment argument. The above benefit to the patient is a value inherent to human dignity that should not be infringed upon or obstructed by anyone, and at the same time, it is a basic desire regarding life and a benefit worthy of protection by law. In this regard, "the benefit of receiving treatment appropriate to the medical standard" can be made concrete as one of the general personal rights related to psychological legal interest.

The Effect of Line Office Manager's Leadership Styles on the Employee's Job Esteem and Organization Behavior (계선조직 관리자의 리더십 스타일이 직원의 직업존중감 및 조직행위에 미치는 영향)

  • Kim, Woon-Shin
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2017.01a
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    • pp.93-96
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    • 2017
  • 본 연구는 의료서비스를 생산 제공하는 병원조직의 계선조직 관리자의 리더십 스타일이 부하직원들의 직업존중감과 조직행동에 미치는 영향을 분석하고자 한다. 본 연구에서 사용할 관리자의 리더십 스타일은 헤이컨설팅 그룹에서 제시한 6가지 리더십 스타일인 지시명령형, 비전제시형, 관계중시형, 집단운영형, 규범형, 육성형 리더십스타일을 사용하고자 한다. 각 리더십 스타일이 직원들의 직업존중감, 즉 부서 내에서의 커뮤니케이션 수준, 직무몰입, 직무만족, 자기비전 자각 및 이직의사 등 조직행동에 어떤 영향을 미치는지 알아보고자 한다. 또한 관리자의 리더십 스타일과 직업존중감에 따른 조직행동, 즉 직무만족, 조직충성도, 자기계발의지, 이직의도 등에 대해서도 분석하고자 한다. 연구표본으로는 사립대학교병원 1개, 국립대학교병원 1개, 500병상 이상 규모의 종합병원 1개이며, 조사 및 분석에 활용할 개선조직은 진료행정부서인 원무과(부), 진료지원부서인 의무기록실(팀), 의료기사, 간호과(부)이다. 연구의 결과를 통해서 직원들이 가장 선호하는 관리자의 리더십 스타일을 도출함과 동시에 각 리더십스타일의 장단점을 통하여 직원들의 직업존중감 확대와 생산적인 조직행동이 조직성과로 이어질 수 있는 방안을 제시하고자 한다.

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A Study on the Repeat Tests for Diagnosis at a Tertiary Hospital in Taegu City (3차진료기관(3次診療機關)과 환자의뢰기관간(患者依賴機關間)의 중복검사(重複檢査))

  • Park, Jae-Yong;Kim, Gui-Young
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.3 s.43
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    • pp.457-468
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    • 1993
  • This study was conducted to investigate the repeat test rate for diagnosis at a tertiary hospital for the outpatients who were referred themselves to the hospital by the clinics and other medical facilities. The study population consisted of 498 patients who visited outpatient department of internal medicine, general surgery, orthopedic surgery and neurosurgery in the hospital between March 16 and April 11, 1992. This study was surveyed by the questionnaire about the tests for diagnosis at first level medical facilities, and then, was investigated by the medical record about the tests for diagnosis at a tertiary hospital. The proportion of test among the patients who utilized the first level medical facilities was 20.9% for the X-ray test, 10.6% for the urinalysis, 9.0% for the electrocardiogram, 3.4% for the computer tomogram and 6.4% for the ultrasonogram. At the tertiary hospital, the X-ray test was 45.2%, the liver function test was 24.1%, the urinalysis was 19.1%, and the electrocardiogram was 15.7%. The proportion of patients who possessed results of test for diagnosis at the first level medical facilities was 76.5% for the computer tomogram, and 31.3% for the ultrasonogram. As the repeat test rate between the first level medical facilities and the tertiary hospital, the thyroid function test was the first rank as 71.4%, the second rank was the routine CBC as 67.9%, and the third rank was the X-ray test as 64.4%. But among the patients that brought the result for tests at the first level medical facilities, the repeat test rate was as follow : the routine CBC was 75.0%, the liver function test was 72.1%, and the computer tomogram was 15.4%.

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Dental Service System and Oral Health Providers in Correctional Institutions (구금시설의 치과진료체계 및 구강보건의료인력 현황 조사)

  • Kang, Jung-Yun;Kim, Young-Hyun;Oh, Kyung-Sun;Jo, Yeon-Suk;Lee, Min-Sun;Kim, Nam-Hee
    • Journal of dental hygiene science
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    • v.9 no.5
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    • pp.507-511
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    • 2009
  • The purpose of this study is to analyze the dental service system in correctional institutions and 10 find the factors for improving inmates' oral health. This study is comprised of document review, telephone and questionnaire survey. The subjects of questionnaire survey are public health dentists and doctors in correctional institutions. They responded to questionnaire and the survey was collected from previous research and selected information about the dental service system. The findings of the study were as follow : Documentary survey 1. According to 2004's study, there are 42 dental offices in 46 all correctional institutions. 2. Criminals who took an health examination occupied 69.0% when committed to a jail in 2002's study. Majorities of them(81.5%) responded that they didn't take any oral examination. Telephone & Questionnaire survey 1. Full-time public health dentists are 26 in 2009. There is no correctional institution having oral health providers in 26 correctional institutions surveyed. 2 About 10 patients use the dental services in a day. Part-time dentists visit 4 times a month as average in 80% of institutions. 40% of institutions responded dental treatments can't be progressed conveniently because of the lack of oral health providers. 3. 80% of respondents answered that it is hard to cure prisoners, and that's because they are forbidden to get out of the institutions. 4. Only 20% of correctional institutions offered the oral hygiene instructions. There is no regular oral hygiene education for all inmates. 5. They need to increase the number of oral health providers.

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