• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.105-138
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• 2017

This is case comments of several representative legal cases regarding self- determination right of patient. In a case in which an intoxicated patient attempted suicide refusing treatment, the Supreme Court ruled that the medical team's respect for the patient's decision was an act of malpractice, and that in particular medical situations (medical emergencies) the physician's duty to preserve life supersedes the patient's rights to autonomy. Afterwards, at the request of the patient's family, and considering the patient's condition (irrecoverable death stage, etc.) consistent with a persistent vegetative state, the Supreme Court deduced the patient's intention and decide to withdraw life-sustaining treatment. More recently, regarding patients who refuse blood transfusions or other necessary treatment due to religious beliefs, the Supreme Court established a standard of judgment that can be seen as conferring equal value to the physician's duty to respect patient autonomy and to preserve life. An empirical study of legal precedent with regard to cases in which the physician's duty to preserve life conflicts with the patient's autonomy, grounded in respect for human dignity, can reveal how the Court's perspective has reflected the role of the patient as a decision-making subject and ways of respecting autonomy in Korean society, and how the Court's stance has changed alongside changing societal beliefs. The Court has shifted from judging the right to life as the foremost value and prioritizing this over the patient's autonomy, to beginning to at least consider the patient's formally stated or deducible wishes when withholding or withdrawing treatment, and to considering exercises of self determination right based on religious belief or certain other justifications with informed refusal. This will have a substantial impact on medical community going forward, and provide implicit and explicit guidance for physicians who are practicing medicine within this environment.

• Health Policy and Management
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• v.11 no.1
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• pp.62-86
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• 2001

This study purports to Investigate the determinant of job satisfaction and the organizational commitment of medical insurance review nurses working at Korean hospitals. The independent variables contain three groups of determinants: organizational characteristics variables(job autonomy, work unit control, role variety, role ambiguity, role conflict, workload, resource inadequacy, coworker support, supervisor support, distributive justice, promotional chances, job security, and job hazard), environmental variables(job opportunity, spouse support, and parent support), and psychological variables (met expectation, work involvement, positive affectivity, and negative affectivity). The sample used in this study consisted of 445 medical insurance review nurses from 89 hospitals nationwide. Data were collected with self-administered questionnaires and analyzed using multiple regression analysis. The results of the study are as follows : 1) the following variables, listed in order of size, have significant effects on job satisfaction : role ambiguity(－), distributive justice(＋), work involvement(＋), role variety(＋), met expectation(＋), negative affectivity(－), job autonomy(＋), and positive affectivity(＋). 2) the following variables, listed in order of size, have significant effects on organizational commitment: met expectation(＋), work involvement(.＋), distributive justice(＋), job security(＋), role variety(＋), positive affectivity(＋), negative affectivity(－), resource inadequacy(＋), and tenure(－). 3) the variance of job satisfaction and organizational commitment explained by the variables used in the study are 30.0% and 39.1% respectively. 4) In comparison to the results of other studies on the determinants of job satisfaction and organizational commitment of clinical nursing staff working at hospitals, the results of this study indicate that three variables of distributive justice, work involvement, and role variety are especially important for improving the level of job satisfaction and organizational commitment of medical insurance review nurses.

• Health Policy and Management
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• v.29 no.4
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• pp.394-398
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• 2019

Education on the physician continues with undergraduate medical education, graduate medical education, and continuous medical education. The countries such as the United States, Japan, the United Kingdom, German, and others are required to undergo training in the clinical field for 2 years after completing the national medical examination, and to become doctors after passing the clinical practice license test. Korea can obtain a medical license and become a clinical doctor at the same time if it passes written and practical tests after completing 6 years of undergraduate medical education or 4 years of graduate school. About 90% of medical school graduates replace clinical practice with 4-5 years of training to acquire professional qualifications, but this is an option for individual doctors rather than an extension of the licensing system under law. The medical professional qualification system is implemented by the Ministry of Health and Welfare on the regulation. In fact, under the supervision of the government, the Korean Hospital Association, the Korean Medical Association, and the Korean Academy of Medical Sciences progress most procedures. After training and becoming a specialist, the only thing that is given to a specialist is the right to mark him or her as a specialist in marking a medical institution and advertising. The government's guidelines for professional training are too restrictive, such as the recruitment method of residents, annual training courses of residents, dispatch rule of the residents, and the quota of residents of training hospitals. Although professional training systems are operated in the United States, the United Kingdom, France, and Germany, most of them are organized and operated by public professional organizations and widely recognize the autonomy of academic institutions and hospitals. Korea should also introduce a compulsory education system after graduating from medical education and organize and initiate by autonomic public professional organization that meets global standards.

• Health Policy and Management
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• v.11 no.3
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• pp.1-30
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• 2001

This study was conducted to evaluate the effectiveness of team system at university hospitals in Korea. Data were collected from administrative and medical support workers at 4 university hospitals through the self-administered questionnaires and analyzed using frequency analysis, t-test, and oneway ANOVA. The results of this study are as follows. First, teams with higher team management characteristics show higher level of quality of work life and performance effectiveness. Second, teams which consist of members with variety background and skills show higher level of quality of work life and performance effectiveness. Third, team which have the higher autonomy, technology variety, job significance, and feedback show higher team effectiveness. Fourth, team which have team leaders with higher leadership score show higher level of quality of work life and performance effectiveness. Fifth, there are differences in team effectiveness in terms of sicio- demographic variables such as average age, position, and tenure of team members, length of team system, and team size. Sixth, the job autonomy of team members and the leadership of team managers have significant effects on the quality of work life variables. Seventh, the leadership of team leaders, job autonomy of members, and individual contact between team managers and members have significant effects on the team performance variables. In conclusion, in order to increase the effectiveness of team system in university hospitals, it is required to consider the characteristics of team management, diversity of team members, the autonomy of team members, the leadership of team manager, and the socio-demographic factors of team members.

• 대한예방의학회:학술대회논문집
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• 2001.10a
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• pp.371-372
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• 2001

• Journal of Korean Critical Care Nursing
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• v.8 no.1
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• pp.25-40
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• 2015

Purpose: The purpose of the study was to identify the frequency and importance of task performance and the perceived competence to perform of the emergency nurse practitioners (ENPs) certified in Korea. Method: This cross-sectional study was conducted with 41 ENPs certified by March 2012. The questionnaire to identify frequency, importance, autonomy, and perceived competence to perform 131 typical ENP task elements was developed on the basis of the standardized role of an ENP defined by the Korean Accreditation Board of Nursing Education. The data were analyzed using descriptive statistics. Results: The professional nursing practice showed the highest scores for performance frequency, task importance, autonomy, and perceived competence to perform as compared to other job categories. Clinical decision making was the most frequently performed duty. Data collection was the duty with highest levels of importance, autonomy, and perceived competence for the ENPs. However, the ENPs reported that research was the duty with the lowest levels of frequency, importance, autonomy, and perceived competence Conclusion: ENPs in Korea perform various tasks. In order to improve their position in the field, it is necessary to clarify their job description and enhance their competence to perform evidencebased professional nursing practices.

• Health Policy and Management
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• v.18 no.1
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• pp.63-84
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• 2008

The aim of this study was to analyze the correlation between professional autonomy and ideology among Korean physicians and to investigate how these factors affect job satisfaction like social status satisfaction and economic reward satisfaction. This study utilized a self-administered questionnaire survey and collected data nationwide between July and August, 2003. 211 responses were used for final analysis. SPSS 12.0 was used for a chi-square test, one-way ANOVA, Pearson correlation analysis, independent t-test and hierarchical multiple regression analysis. The results of this study were as follows. First, many variables of ideological factor were related to job satisfaction. Second, physicians expecting the change of political influence has patient-centered attitude. Third, there were many relationships between professional autonomy and ideology variables. Fourth, physicians expecting the change of political influence and customer-centered healthcare system showed more job satisfaction. In conclusion, professional autonomy is related to ideology, and in order to enhance job satisfaction, ideological factor needs more development. In addition, market-oriented healthcare system would contribute to enhance the job satisfaction of physicians expecting the change of political influence and customer-centered healthcare system.

• Physical Therapy Korea
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• v.30 no.2
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• pp.87-91
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• 2023

Most advanced countries that are members of the World Physiotherapy have established a 4-year education system or specialized graduate school system for physical therapists based on national standards. They have also expanded their laws and systems to provide physical therapists with the autonomy and independence to offer services in their clinics. However, compared with developed countries in North America and Europe, there are issues with the autonomy and independence of physical therapists in Korea related to national regulations. Social status and recognition of the profession are also lagging. Korea is expected to become a super-aged society by 2025. To reduce the financial burden of healthcare and welfare on the government, it is necessary to extend the time spent by older adults on independent activities and minimize their time spent using medical services. To achieve this goal and maximize the active life of older adults, a plan to efficiently use licensed physical therapists in the country should be prepared. Korea should increase the license utilization rate of physical therapists to reduce waste at the national level and increase the professional hope of the younger generations of physical therapists. To create a healthcare policy focusing on the use of physical therapy personnel, similar to that in advanced countries, it is necessary to unify educational systems and produce excellent physical therapists. Providing professional autonomy can help physical therapists develop a sense of job satisfaction. Outstanding talent will choose physical therapy as a profession if they can see hope for their future careers, and if physical therapy services in Korea are similar to those delivered in advanced countries, physical therapy in Korea can develop into a healthcare service that people desire.

• Korea Journal of Hospital Management
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• v.17 no.4
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• pp.1-20
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• 2012

The purpose of this study is to find out the job satisfaction of the korean medical clinic workers, and understand the factors that affect the satisfaction thereby increasing the efficiency of human resource management and providing the basic data to establish the management strategy. We visited 50 korean medical clinics which were chosen randomly from the korean medical clinics in the city of Changwon, Gyungnam. First, we explained the purpose of the study and survey contents to the surveyees, then distributed the Questionnaire and collected them. The data analysis was done statistically using the SPSS WIN IBM 20.0 program. The results were as follows: Professional career, interpersonal relationship, work autonomy, and overall job satisfaction showed significant differences depending on ages. While satisfaction of interpersonal relationship showed significant difference depending on final education. Depending on marriage status, while married persons showed significantly high satisfaction on professional career, interpersonal relationship, work autonomy, administration, and overall job satisfaction, there is no significant difference on income satisfaction. The number of years worked in the current clinic showed significant difference on administration satisfaction. Also, daytime working hours showed significant difference on administration and overall job satisfaction. The work area showed significant difference on overall job satisfaction. The income level showed significant differences on professional career, administration, and overall job satisfaction. From this study, it was confirmed that demographic characteristics and work environment factors showed significant differences on overall job satisfaction of workers in korean medical clinics. Therefore, in order to facilitate efficient manpower utilization and organization efficiency maximization, and motivation of human resources, a detailed plan should be developed to improve working environment and take demographic characteristics into consideration.

• Journal of Korean society of Dental Hygiene
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• v.18 no.6
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• pp.891-902
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• 2018

Objectives: The purpose of this study was to propose contents of a curriculum and training program for dental hygienists as medical professionals by surveying the opinions of clinical dental hygienists and dental hygiene professors. Methods: The subjects were 192 clinical dental hygienists and 193 dental hygiene professors. They answered questionnaires that consisted of grading each task based on its importance: a) for dental hygiene students to learn, b) to perform autonomously in clinical practice, and c) the expectancy of the task to change when dental hygienists become medical professionals. Data analysis was performed using an independent sample T test to capture differences between clinical dental hygienists and dental hygiene professors. The terms in the answers of open-ended questionnaires were extracted. We used R 3.5.0, R Recommender, and Wordcloud software packages. Results: Calculus removal had the highest scores for dental hygiene students to learn and expectancy to change when dental hygienists become medical professionals. Physiotherapy of temporomandibular disorders (TMD), planning, performing, and assessment of community oral health programs had the lowest scores in autonomy in clinical practice. The dental hygiene professors gave higher scores in most of the tasks for dental hygiene students to learn, autonomy in clinical practice, and expectancy to change, than did clinical dental hygienists. Cardiopulmonary resuscitation (CPR), job ethics, and communication were the most frequently mentioned terms in the training as medical professionals program contents. Conclusions: In the future, it will be necessary to study the curriculum to improve the proficiency of dental hygienists as medical professionals.