• Journal of Korean Neurosurgical Society
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• 제67권4호
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• pp.385-396
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• 2024

Previously, we reported the concept of a cloud-based telemedicine platform for patients with intracerebral hemorrhage (ICH) at local emergency rooms in rural and medically underserved areas in Gangwon state by combining artificial intelligence and remote consultation with a neurosurgeon. Developing a telemedicine ICH treatment protocol exclusively for doctors with less ICH expertise working in emergency rooms should be part of establishing this system. Difficulties arise in providing appropriate early treatment for ICH in rural and underserved areas before the patient is transferred to a nearby hub hospital with stroke specialists. This has been an unmet medical need for decades. The available reporting ICH guidelines are realistically applicable in university hospitals with a well-equipped infrastructure. However, it is very difficult for doctors inexperienced with ICH treatment to appropriately select and deliver ICH treatment based on the guidelines. To address these issues, we developed an ICH telemedicine protocol. Neurosurgeons from four university hospitals in Gangwon state first wrote the guidelines, and professors with extensive ICH expertise across the country revised them. Guidelines and recommendations for ICH management were described as simply as possible to allow more doctors to use them easily. We hope that our effort in developing the telemedicine protocols will ultimately improve the quality of ICH treatment in local emergency rooms in rural and underserved areas in Gangwon state.

• Korean Journal of Acupuncture
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• 제24권3호
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• pp.67-79
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• 2007

Objectives : The Purposes of this study were to investigate payment system for oriental medical treatment as supplier of medical services, and to estimate reasonable levels of medical fee. Methods : This study made these following results by reviewing the answers which were given by 172 Korea traditional doctors from March 1 to April 15, 2006. Results : General satisfaction of payment system for oriental health insurance was $2.17{\pm}1.01$ $(mean{\pm}SD)$ on a 1-7 scale (median 4) as very low level. Reasonable medical fees which were answered by 172 Korea traditional doctor are higher than present fees, thus Korea traditional doctors think that present fees should be increased. And according to the survey, current insurance fees have a problem of disparity between each treatment fee. Conclusions : According to results of this study, current fees of oriental medical treatment are not rational. And this problem leads to distortion of medical treatment. Additional studies in thls field are needed.

• 의료법학
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• 제16권2호
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• pp.131-157
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• 2015

국민건강보험공단은 의사가 요양급여기준을 위반하여 처방을 함으로써 국민건강보험공단이 약국에 약제비를 지급하게 된 것은 의사가 국민건강보험공단에 대해 민사상 불법행위를 한 것이라고 주장하며 손해배상청구를 하였다. 대법원이 이를 인정하는 판결이 잇따르자, 국민건강보험공단은 의사들이 의료법을 위반하여 진료를 하여 약국에 지급하게 된 약제비나 해당 의료기관에 지급하게 된 요양급여비용에 대해서도 모두 국민건강보험공단에 대한 민법상 불법행위라고 주장하며 손해배상을 청구하였으며, 대법원은 이를 모두 인정하였다. 그러나 우리나라 국민건강보험제도에서 보험급여의 주체는 국민건강보험공단이며, 환자가 의료기관에 진료를 요청하여 의료기관이 행하는 요양급여 역시 보험급여이므로 이러한 요양급여를 행하는 주체 역시 국민건강보험공단이다. 그리고 국민건강보험법은 의사의 의료법위반행위를 규제하기 위해 만든 법이 아니므로 의사의 의료법 위반행위를 국민건강보험공단에 대한 민법상 불법행위책임에서의 위법성으로 포섭할 수 없다. 그렇다면 환자가 보건복지부장관으로부터 부여 받은 면허를 가진 의사에 의해 요양급여기준에 맞는 진료를 받은 경우에는 국민건강보험공단은 민법상 환자에게 요양급여를 해 줄 의무를 면하는 이득을 얻었으므로 설사 해당 의사가 진료를 하는 과정에 의료법을 위반한 행위를 하였더라도 국민건강보험공단으로서는 손해가 없다. 대법원이 의료법위반으로 진료를 한 행위를 모두 국민건강보험공단에 대한 민법상 불법행위책임으로 인정하는 것은 국민건강보험공단이 보험급여의 주체로서 보험급여를 해 줄 의무를 면하였다는 이득은 고려하지 않고, 오로지 의사에게 요양급여비용을 지급하였다는 측면만을 고려한 것으로서 민법 제750조의 법리에 어긋난다. 의사가 의료법을 위반하였다면 의료법에 따라 제재를 받을 일이지, 국민건강보험법으로 규율할 일이 아니며, 대법원이 위와 같이 판결한 것은 국민건강보험법의 법리와 민법의 법리를 혼동한 탓으로 생각된다.

• 동의생리병리학회지
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• 제32권2호
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• pp.126-133
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• 2018

The aim of this survey is to investigate the current state of pattern identification, treatment and management on chronic fatigue in the Korean medicine. From May 25, 2017 to June 7, we distributed contents of questionnaires to 17,992 Korean medical doctors via e-mail, and then received answers from 329 people. The surveys were conducted by a specialized research organizations. Researchers were blinded to the participant's personally identifiable information or whether they participated in the investigation. In Korea, almost Korean medicine doctors (94.5%) used pattern identification in the treatment of chronic fatigue patients. The main diagnostic methods were visceral (38.5%), qi-blood-fluid-humor (32.3%), and sasang constitutional pattern identification (14.3%). The high-frequent therapy were herbal medicine (37.0%), acupuncture (27.9%), moxibustion (11.7%), and cupping (8.6%). The primary goals of treatment were Improvement and relaxation of stress condition (18.1%), improvement of quality of life (13.1%), increase of functional vitality (34.0%), and fatigue management (23.3%). The key factors affecting treatment outcomes were the patient's aggressiveness in treatment (23.5%) and his/her lifestyle and environment(22.7%). This study was a pioneering research for chronic fatigue on the aspect of medical service provider in the Korean medicine. We hope that this study can be used as a basis for developing a more appropriate and reasonable practice guidelines for chronic fatigue.

• 의학교육논단
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• 제16권1호
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• pp.50-54
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• 2014

It is becoming increasingly important for medical doctors to have a thorough understanding of human genetics and the ethical, legal, and social implications of genetic testing, counseling, and treatment. As genetic engineering and technology evolves, medical doctors will find themselves called in to counsel patients about a rapidly increasing number of diseases for which genetic testing and treatments are available. Medical doctors will need to master a new set of principles and clinical skills. A lack of knowledge about these issues and problems may lead to serious, lifelong or even fatal negative effects on patients. Medical genetics has moved from the study of rare conditions to the illumination of disorders that impact the entire spectrum of medical practice. This study demonstrates several areas in which medical genetics is clearly an important tool in medical practice and the necessity of establishing new curriculum for clinical genetic education in Korea. Medical students nearing graduation may lack genetic knowledge that is essential for daily practice because genetics has little or no place in clinical teaching. Medical schools should make extensive curriculum changes to increase students' awareness of clinical genetics and its ethical implications. The medical school curriculum will need creative new approaches to keeping up with the rapid pace of evolution of clinical genetics.

• Journal of Preventive Medicine and Public Health
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• 제35권3호
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• pp.236-244
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• 2002

Objective : To empirically investigate the relationship of internal and external customer satisfactions, service quality, and customer loyalty in medical services. Methods : This essay proposes an integrated model to explain the causality of internal and external customer satisfactions, service quality, and customer loyalty. To this end, a structural model was developed, consisting of the following factors: internal and external customer satisfactions, service quality, and customer loyalty. The study included 214 sets of data, with 107 sets being collected for both out-patients and in-patients. The data were analyzed using AMOS 4.0. Results : We found the greater the internal customer satisfaction, the greater the out-patient quality of service quality. Secondly, the greater the service quality, the greater the external customer satisfaction of both in- and out-patients. The service quality of doctors, compared to that of the nurses, had a greater effect on external customer satisfaction. Thirdly, the service quality of doctors and nurses affected both internal and external customer satisfactions, which ultimately affected the customer loyalty. Finally the greater the external customer satisfaction, the greater the customer loyalty. Conclusion : This Study confirms the positive relationship among the internal and external customer satisfactions, service quality, and customer loyalty, which proves the doctors quality of service is the primary factor for external satisfaction, and customer loyalty relating to medical services.

• 한국임상약학회지
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• 제16권2호
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• pp.139-146
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• 2006

Objectives: Bio-equivalence(BE) test is important not only to ensure the quality of generic drugs, but also to promote drug substitution under the separation of prescribing and dispensing practice(SPD). This study was intended to investigate the perception of consumers, doctors, and pharmacists on the confidence of bio-equivalence(BE) assured drugs. Methods: Nation-wide telephone interview survey was conducted for 1,018 consumers, 800 doctors, and 806 pharmacists from September to October in 2003. Descriptive analysis and ${\chi}^2$ analysis were conducted. Results: Even though people showed higher confidence level for the Bioequivalent drugs compared with Bio-inequivalent drugs, the confidence was generally low. Among those asked about the therapeutic substitutability of original drugs by BE versions, 95.78% of pharmacists responded "positive", while only 39.33% of consumers and 31.13% of doctors said so. The elderly, the less educated, who takes chronic disease medicine, pays high cost of prescription drugs, and are in the low income responded less aware of that. Also most consumers got information such as effect of drugs from either media or doctors. Conclusions: In order for people to believe that BE drugs and original drugs are equivalent, we need to strengthen health education, and to clarify any misunderstanding. It is also necessary for the national policy to provide accurate information about drugs to the public.

• 대한한방내과학회지
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• 제39권4호
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• pp.686-698
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• 2018

Objectives: The aim of this study was to report the current status of the Korean traditional medicine side effects described in domestic western medical journals in the past 10 years. Methods: We searched for domestic western medical papers about Korean traditional medicine side effects cases from January 1, 2008, to August 31, 2017. Results: Thirty papers were selected from 31 studies. The number of papers of side effects caused by acupuncture was 21 (70%), by herbal medication was 7 (23%) and by thread lifting was 2 (7%). The number of papers of side effects caused by Korean medical doctors was 20 (66.8%), by non-medical persons including patients was 2 (6.6%), by herbal pharmacists was 1 (3.3%), by multiple practitioners, including Korean medical doctors, was 1 (3.3%), and by unknown persons was 6 (20%). Reported side effects were mostly mild, except for death and severe side effects. Conclusions: Studies of Korean traditional medicine side effects are short, and in-depth studies of stability are needed. These studies will improve the safety of the Korean traditional medicine.

• Korean Journal of Acupuncture
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• 제26권2호
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• pp.1-13
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• 2009

Objective: Optical Coherence Tomography (OCT) has emerged as an important optical imaging modality in non-invasive medical diagnostics. Hence, the aim of this study is to measure the similarity of the diagnosis by a traditional method using doctor's hand for feeling of pulse and by the non-contact/non-invasive pulse analyzing system using OCT on Chon(寸), Kwan(關), Chuk(尺). Method: Four korean medical doctors and the non-contact/non-invasive pulse analyzing system using OCT have measured the rapidity, the dimension, and the power of pulse waves of 25 volunteers. First, four korean medical doctors measured pulse waves of volunteers. During measuring, four doctors were separated from each other and so were volunteers. And then, the pulse waves of volunteers were measured by OCT. This was performed on the right Chon(寸), Kwan(關), Chuk(尺). Results: The study showed that the traditional method and the OCT based method had the 88% matches on the values of the slow and rapid pulse condition (遲數), 64% matches on the values of the small and big pulse condition(微細弱緩大[洪]), and 72% matches on the values of the weak and strong pulse condition(虛實). Conclusions: Based on the high similarities of the measurements of two approaches, we suggest that the OCT based pulse diagnosis method is useful for compensating the traditional method for the pulse diagnosis.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1999년도 제51차 추계 학술대회 연제집
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• pp.349-350
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• 1999