• 보건행정학회지
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• 제26권3호
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• pp.195-206
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• 2016

Background: Concentration of patients to large hospitals is serious problem in Korea. The purpose of this paper is to propose appropriate policy direction to relieve concentration of patients to large hospitals. It is focused on evaluation of the possibility of family doctor system as a policy alternative to relieve concentration of patients to large hospital by empirically analyzing the effect of usual source of care (USC) on large hospitals medical care use. Methods: Korea Health Panel conducted 2009, 2012, 2013 by KIHASA (Korea Institute for Health and Social Affairs) and NHIS (National Health Insurance Service) was used for analysis. For dependent variables, first, the ratio of the amount of using large hospital to total amount of using medical care, and second, the amount of using large hospital are estimated. Independent variables are having an USC and type of USC. Panel analysis was done with above variables. Results: Main results are as follows. First, having an USC increases using large hospital. Second, having a domestic clinic type USC decreases using large hospital and ratio of using large hospital. Third, the effect of domestic clinic type USC is greater in older group, less income group, worse health status group, not having private insurance group, and having chronic disease group. Conclusion: These results show that family doctor program can be a policy alternative to relieve concentration of patients to large hospital. Nonetheless, primary care system in Korea is unsatisfied. It is recommended to reinforce primary care system and family doctor system to relieve concentration of patients to large hospitals.

• 한국의사학회지
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• 제34권1호
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• pp.31-46
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• 2021

Shin Hong-Gyun and his family have been in medicine for many generations as Korean Medical Doctors (KMDs). In 1919 when Shin Hong-Gyun was participating in an independence movement in Jang-Baek-Hyun, his younger brother Shin Dong-Gyun was killed by Japanese military police forces. This tragic incident triggered Shin Hong-Gyun to establish an army for national independence called , holding 200 young men, to serve in armed struggle against the Japanese Government with Kim Jung-Geon in May, 1920. In March 1933, Shin Hong-Gyun, as a military surgeon, led his men to the Korean Independence Army to fight a battle. Once he became a member of the Korean Independence Army, he, in fact, participated in few battles: Sadohaja, Dong-Kyung-Sung, Deajeonjayeong. Daejeonjayeong was a waypoint that the Japanese military needed to pass through in order to reach the Wangcheong area. Shin Hong-Gyun's independence forces had to endure painful starvation and heavy rain while hiding in ambush for long periods of time until the Japanese military would appear. Due to its summer rainy season, rainwater overflowed into their trenches and was filled up to the waist. Even worse, food stockpiles were low and the Japanese army did not appear for longer time. Shin Hong-Gyun's entire team suffered severe hunger and extreme cold. At this critical moment, Shin Hong-Gyun used his expertise as a KMD to find edible black mushrooms that grow wild in the mountains and use them to feed his men. This event led to the victory of the independence army at the battle of Daejeonjayeong. The purpose of the paper is to inform and highlight the forgotten history of Shin Hong-Gyun who was, both, a Korean Medical Doctor and a military surgeon.

• 대한예방한의학회지
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• 제21권2호
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• pp.45-53
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• 2017

Background and Aim : Lately the age of competition has come among the medical service area. At the same time disputes over the medical practice related to the medical person's territory tend to increase. In part it is due to the increased medical persons but in part it is because the medical practice is not defined clearly in the Medical Service Act for the practice of each medical person. So the legal definition of medical practice will be discussed here. Materials and Method : The cases from the court have been confirmed the difference between the two medical persons regarding the actual events. Legal aspects of medical practice in Korean medicine and the related cases will be reviewed and analysed. Results : The form of medical practice consists of administrating Korean medicine treatment and providing guidance for health based on Korean medicine. For medical doctors the practice includes medical treatment and guidance for health. Circular definition in the Medical Service Act over the medical practice, medical person and medical instruments makes it difficult to understand the whole idea. Therefore, the court has a tendency to decide the medical practice of medical doctor of Korean medicine from the some reliable points which is: 1) it is based on the principle of traditional Korean Medicine, 2) it is practiced by the medical doctor of Korean Medicine, 3) it can do harm to the patient without proper involvement of the medical doctor of Korean Medicine. Now the Act on the promotion of Korean Medicine and Pharmaceuticals makes it include the concept of "scientifically applied and developed" medical practice of Korean Medicine. Conclusions : With the essential change in the Act on the promotion of Korean Medicine and Pharmaceuticals, it is expected that even slight change can be seen in the court cases. However, still the concept of medical practice in the Medical Service Act remains the same. Modernisation of Korean Medicine, enhancement of textbooks and clinical practice training and the effort to amend the law to clearly define the medical practice of Korean Medicine will contribute to the clinical and academic environment. Evidence based Korean Medicine and even the unification of east-west medicine could be considered for the situation.

• 대한한의학원전학회지
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• 제30권2호
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• pp.59-81
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• 2017

Objectives : This paper studies the pulse diagnosis as found in Youksimanpil, which is a series of medical charts containing 150 diagnosis records of Yi Suki, a doctor who was active in Joseon during the 17-18th centuries. Through this effort, the paper aims to shed light on how pulse was utilized in the Korean medicine, and in process tries to reveal the essence of Korean medicine's treatment method. Methods : 60 charts where pulse method was used are selected in Youksimanpil and a table is created with them. Figures are drawn to explain four steps of pulse-sensing from the simple method to highly advanced method. Charts are presented with the corresponding original texts and their translations. With these efforts, the paper attempts to reveal the broad understanding of the doctor of Joseon period who consistently kept to the most basic principle of pulse diagnosis. Results : The efficiency of pulse diagnosis depends on the unity and simplicity in diagnosis and prescription. There were continued efforts between the doctors in Joseon to collect and compare the experiences they gained from clinical practices in order to organize their findings and form a system. These are: (1) individual pulse, (2) patternized pulse, (3) balance between left and right pulses, (4) balance between pulse and body, and (5) the doctor's extemporaneous diagnosis. In that efforts, they protect the principle of holistic diagnosis, which is one of Korean medicine's core principles. Conclusions : Thanks to the existence of medical charts that presents in detail how the texts of Donguibogam were applied in real clinical practices, today we can see Korean medicine's highly advanced synergy between textual knowledge and clinical experiences as recorded in the form of charts.

• 의학교육논단
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• 제24권2호
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• pp.77-78
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• 2022

• Archives of Plastic Surgery
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• 제36권3호
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• pp.262-268
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• 2009

Purpose: Recently medical dispute about plastic surgery is increasing rapidly as result of growing surgery itself due to high interest in appearance and advertisement of plastic surgery. So we want to find a way to prevent similar medical accident by making better solution of plastic surgery through case analysis of medical dispute. Method: 161 cases about plastic surgery asked for aid at Korea Consumer Agency and 41 cases judged at the court was surveyed and gender, location and kind of hospital, goal and kind of operation, making operation agreement or not, kind of damage, result of process, result of lawsuit was studied from 2004.1.1. to 2006.12.31. Result: Medical doctor have to explain about symptoms of disease, method of treatment, possibility of complication, prognosis to patients before therapy so they can make decision if they take operation by doctor or not. On this survey, among the patients who underwent re - operation or had complication, 88.1%(96 from 109 cases) of them didn't get enough explanation about possibility of complication before surgery They brought lawsuit insisting they would not undergo operation if they got enough explanation about possibility of complication and result of operation before surgery. Conclusion: It is advisable that doctor must observe the duty of explanation before surgery and respect the right to decide of patient, make operation agreement and put down concrete progress note and store the pre and post operative photo to avoid medical accident. It is also needed to have guideline of therapy, Code of ethics, organization which deals with medical dispute, reconsideration of law to control that.

• 한방안이비인후피부과학회지
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• 제19권2호
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• pp.168-179
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• 2006

Background and Aim : As the aged society is coming, people pay attention to it and the government is also increasing subsidy into the welfare of the aged. As a branch of social welfare, community welfare is familiar and close to local residents. We could open up a new field in community welfare for oriental medicine and oriental medical doctor(OMD). Materials and Method : Analyzing the worts of community welfare center, we tried to find ways for OMDs to take part in there. We focused m community care and home care service of community welfare center and community health center. Result : Free oriental medical services are offered in many places, but a lot of them are temporary and hard to continue due to financial problem and lack of specialist. Local residents want to know about oriental medicine but few OMDs are willing to participate, thereforen, unqualified lectures of such as hand acupuncture, moxibustion, meridian massage prevail among them. This leads to illegal oriental medical services in the name of volunteer medical work. Conclusion The system is needed that local OMD association take part in community welfare of oriental medical service and care with community welfare center and community health center. Local volunteer medical services and researches of medical policy can help increase the chance for OMDs to go into social welfare system of the aged.

• 의료법학
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• 제24권3호
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• pp.125-153
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• 2023

대법원 2022. 12. 22. 선고 2016도21314 전원합의체 판결은 한의사의 진단용 의료기기 사용이 면허된 것 이외의 의료행위에 해당하는지를 판단하는 새로운 기준을 제시하고, 이 기준에 따라 한의사의 초음파 사용을 무면허 의료행위가 아니라고 판단하였다. 대법원 2023. 8. 18. 선고 2016두51405 판결은 새로운 판단기준을 적용하여 뇌파계를 파킨슨병과 치매 진단에 사용한 행위가 한의사로서 면허된 것 이외의 의료행위에 해당하지 않는다고 판단한 첫 번째 사안이다. 대법원은 판례변경을 통해 의료기기 사용에 서양 의학적 지식과 기술이 필요하지 않아야 한다는 종전 기준을 폐기하였지만, 진단용 의료기기를 사용한 한의사의 서양 의학적 진단행위를 진단의 보조수단으로 볼 것인지는 불투명한 상태였다. 이에 대법원은 뇌파계를 활용하여 파킨슨병과 치매, 즉 서양 의학적 진단을 한 한의사의 행위를 면허된 것 이외의 의료행위가 아니라고 판단함으로써 진단의 보조수단이 가지는 의미를 명확히 정리하였다. 이외에도 대상 판결은 뇌파계의 개발, 제작 원리와 뇌파계 검사 결과의 자동 추출 및 자동 판독 여부 또한 판단기준에서 배제함으로써 한방의료행위의 의미가 수범자인 한의사의 관점에서 명확하고 엄격하게 해석되어야 한다는 죄형법정주의 관점을 더욱 투철하게 적용하고 진단용 의료기기가 한의학적 의료행위 원리와 관련 없음이 명백한 경우가 아닌 한 형사처벌 대상에서 제외됨을 분명히 하였다.

• 의료법학
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• 제8권1호
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• pp.215-234
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• 2007

The mission of the doctors is to take care of human life, body and health through the medical behaviors such as diagnosis and treatment. Under this job propensity, the doctors have care duty to take the best actions required to prevent the risk according to the patients' specific disease status. Such care duty of the doctor may be evaluated based on the medical behavior level at the medical institution and clinical medical study field. Such medical level should be understood in the normative level, considering the treatment environment, condition and specialty of the behavior, because it means the medical common sense known and acknowledged to the normal doctors. While the criminal suit requires the evidence for no doubt conviction, the civil suit requires more eased different standard. The results between the criminal and civil sentence may be different, because the confirmed former case may lead to long-term imprisonment and even death penalty, while the latter case puts only monetary penalty on the defeated party.

• 산업공학
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• 제21권4호
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• pp.394-402
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• 2008

The objective of this paper is to design segmentation algorithm for applying the breast ultrasound image to CAD(Computer Aided Diagnosis). This study is conducted after understanding limits, used algorithm and demands of CAD system by interviewing with a medical doctor and analyzing related works based on a general CAD framework that is consisted of five step-establishment of plan, analysis of needs, design, implementation and test & maintenance. Detection function of CAD is accomplished by Canny algorithm and arithmetic operations for segmentation. In addition to, long computing time is solved by extracting ROI (Region Of Interests) and applying segmentation technical methods based morphology algorithm. Overall course of study is conducted by verification of medical doctor. And validity and verification are satisfied by medical doctor's confirmation. Moreover, manual segmentation of related works, restrictions on the number of tumor and dependency of image resolution etc. was solved. This study is utilized as a support system aided doctors' subjective diagnosis even though a lot of future studies is needed for entire application of CAD system.