• 한국콘텐츠학회논문지
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• 제13권2호
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• pp.331-340
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• 2013

최근 의과대학과 의료서비스 산업에서 환자-의사 커뮤니케이션에 관한 논의가 활발히 이루어지고 있다. 환자-의사 커뮤니케이션이란 '진료면담'에서 환자와 의사간의 쌍방향 의사소통으로써, 환자와 의사 양자에게 모두 긍정적인 효과를 가져다주는 것으로 알려져 있다. 이 연구에서는 의사의 커뮤니케이션 스킬을 향상시켜 환자와 의사간의 의사소통을 원활히 할 수 있는 방안으로 코칭기법을 접목한 의사코칭 모델을 개발하였다. 모델 개발 방법은 문헌검토를 통해 초안을 개발하였고, 전문가 자문과 의사평가를 통해 수정 보완하였다. 연구 결과, 의사코칭 모델을 총 5단계로 구성하였다. 첫째, '관계 형성'으로 의사가 코칭에 대한 기대나 관심을 가지도록 한다. 둘째, '변화 주제 인식'으로 환자와의 커뮤니케이션에서 의사의 문제점과 장점을 파악하여 코칭의 방향을 설정한다. 셋째, '관점의 획득'으로 의사가 환자의 관점에서 생각할 수 있도록 유도한다. 넷째, '문제 해결 및 의사소통 역량 강화'로서 의사의 커뮤니케이션 스킬 개선사항을 세부항목으로 제시한다. 다섯째, '목표 설정 및 지원'으로 개선 사항 목표를 설정하고 장점을 유지 강화할 수 있는 실천 방안을 합의한다. 개발된 의사코칭 모델은 환자-의사 커뮤니케이션 개선을 위해 의사들을 대상으로 코칭기법을 처음으로 적용했다는데 가장 큰 의의가 있다. 향후 의료서비스 현장에서 활용될 경우, 의사들의 커뮤니케이션 스킬 향상과 환자 공감적 능력 향상에 효과가 있을 것으로 판단된다. 이를 통해 환자들의 진료만족도를 높이는데 기여할 것이다.

• 한국의사학회지
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• 제26권1호
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• pp.87-96
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• 2013

This study confirmed that a doctor named Lee, Seok-gan whose name has been widely known but whose real identity has remained unclear, was an active Confucian doctor in the 16th century. In addition, through the newly discovered "Daeyakbu" among his family line, writings, and relics that have been handed down in a family, this study looked into his medical philosophy and medicine culture. The author of "Ieseokgangyeongheombang"(Medical Book by Lee, Seok-gan(李石澗), Seok-gan is the same person as an active famous doctor Lee, Seok-gan(李碩幹, 1509-1574) in the 16th century. Such a fact can be confirmed through "Samuiilheombang", "Sauigyeongheombang" and the newly opened "Ieseokgangyeongheombang". Lee, Seok-gan was born in the 4th ruling year of king Jungjong (1509) and was active as a doctor until the 7th ruling year of king Seonjo(1547); his first name is Jungim with the pen name-Chodang, and he used a doctor name of 'Seokgan.' He was known as a divine doctor, and there have been left lots of anecdotes in relation with Lee, Seok-gan. Legend has it that Seokgan went to China to give treatment to the empress, and a heavenly peach pattern drinking cup and a house, which the emperor bestowed on Seokgan in return for his great services, still have remained up to the present. Usually, Seokgan interacted with Toegye Lee Hwang and his literary persons, and with his excellent medical skills, Seokgan once gave treatment to Toegye at the time of his death free of charge. His medical skills have been handed down in his family, and his descendant Lee, Ui-tae(around 1700) compiled a medical book titled "Gyeongheombangwhipyeon(經驗方彙編)". Out of Lee, Seok-gan's keepsakes which were donated to Sosu museums by his descendant family, 4 sorts of 'Gwabu'(writings of fruit trees) including "Daeyakbu" were discovered. It's rare to find a literary work left by a medical figure like this, so these discoveries have a deep meaning even from a medicine culture level. Particularly, "Daeyakbu" includes the typical "Uigukron". The "Uigukron", which develops its story by contrasting politics with medicine, has a unique writing style as one of the representative explanatory methods of scholars' position during the Joseon Dynasty; in addition, the distinctive feature of "Uigukron" is that it was created in the form of 'Gabu' other than a prose.

• 의료법학
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• 제15권2호
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• pp.227-251
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• 2014

In current law, the premium medical treatment system gives patients the right of choice between normal medical treatment service and premium medical treatment service. Only the doctors having a career more than a certain period of time fixed in the law are eligible for providing the premium medical treatment service. So, the premium medical treatment system is highly related to the patients' right to know and the right of self-determination. The system is also relevant to the so-called 'economic explanation' notion because patients should pay additional fee when they want to use this system. Meanwhile, the situation as follows is problematic as to this system. Although a patient applied for using the premium medical treatment system and the patient also chose his or her own doctor specifically, another doctor who was not selected as premium doctor could make a medical accident. Then, is the another doctor liable for damages because the accident was a medical malpractice or a breach of medical contract? In this study, we are going to examine the problems related with the premium medical treatment system. First, we examine the current law related to the system. Second, we look into the economic explanation duty and its application to the premium medical treatment system. Finally, we examine a real judgment case about a medical practice against the premium medical treatment system and we propose our solution to this case.

• 의료법학
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• 제5권1호
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• pp.622-660
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• 2004

Medical services aren't done by doctors only but by different medical personnels. If any medical accident takes place, to what extent doctors, nurses and other personnels should respectively be liable for that should be determined. And when an employed doctor does any illegal medical act, his or her employer also should be responsible for that as a user. If a medical accident occurs, the victim or patient usually claims against the employer of the doctor sho causes the accident for compensation. And those who assist medical treatment, including nurses, should be liable for their own acts, but in case their doctor doesn't give any appropriate directions, the doctor should shoulder the liability. This indicates that nurses are also professional medical personnels, and that they should share the liability as well. There are lots of different medical personnels, but doctors and nurses are the pivot of team treatment, and nurses should also take responsibility for their services. Doctors and nurses are equal, as they are in pursuit of the same, namely, helping patients recover their health. Only their roles are different. If they respect each other and see each other as being responsible for their own roles, they will be able to consult together. Medical information on patients and nursing information should be shared by both of them, and patients should be provided accurate treatment and nursing services. If those who offer nursing services are unaware of required information due to conflicts with doctors, it might result in threatening the safety of patients. And in case any important information isn't properly conveyed between them, it might trigger a medical accident. Sophisticated and complex medical science requires medical personnels to be professional, and nurses as well as doctors need to be an expert. The fact treatment-related accidents take place often indicates that treatment is basically attended with danger. Furthermore, patients respond to all sorts of investigation and medicine in a different manner. They should be professional and knowledgeable to predict how they might respond and prevent any possible hazardous situations, and they are expected to have more knowledge in the future. Nonetheless, there aren't yet enough studies on the legal liability of nurses, and this study is expected to pave the way for future research on nurse liability against medical accidents.

• 대한한방소아과학회지
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• 제31권4호
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• pp.71-77
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• 2017

Objectives This study aims to build the baseline data for school health care program by analyzing the questionnaires about satisfaction regarding Oriental Medical Doctor's (Korean Medicine) student health and wellness program. Methods The association of Korean medicine doctor in Sung-nam city conducted Oriental Medical Doctor's student health and wellness program for 12 middle schools and 8 high schools in Sung-nam from August to December, 2015. The participating Oriental Medical Doctor visited each school for 8 times during 5 months period, and conducted health consultations, health education classes and Korean medicine treatment for the school students and school employees. Teachers and administrators from the participating schools answered the self-reported satisfaction questionnaires and the satisfaction questionnaires results were analyzed. Results 85 people responded the program satisfaction questionnaires; 69% responders were very satisfied and 28% were satisfied about the program specifically about the student's health check-ups, informatory brochures for the parents, good participation enrollment process. Responders were pleased about doctor's consultations regarding 'Advising students about their general health', 'Ways to cure sick students fast', 'Providing students with useful information about health', and 'Teaching students how to manage their health in a good shape'. 92.94% of participants agreed to the needs of the school health and wellness program. Conclusions One of the fundamental national health policies is to provide students opportunities to maintain their good health. We have developed a successful pilot program called, "Oriental Medical Doctor's student health and wellness program". We got positive feedback from the participating school teachers regarding our program. Further studies based on this study are needed to show the benefit of the program to broaden its use.

• 동의신경정신과학회지
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• 제24권1호
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• pp.109-122
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• 2013

Objectives : To research the needed Buddhistic ethical beliefs and psychotherapy from representative medical records of oriental medicine. Methods : The baseline data this research used is Myeong-Ui-Lyu-An, Sok-Myeong-Ui-Lyu-An, Ui-Bu-Jeol-Lok and from the variety of medical records; we extracted 22 medical records that refer to Buddhist thoughts. The sequence of medical records is determined by analyzing the contents of all medical records and grouping them by their categories. Results : The representative ethical mind that a doctor needs is the 'mercy thought' from Buddhism. This way, the doctor has 'pity' on patients and expects no reward for what he had done. 'Spells and religious beliefs developed into medical treatment procedures by Buddhism and oriental medicine psychotherapy. Using the belief that everything is made of the mind, which is the point of the 'Hwa-Eum' theory and the realization that the psychotic factors have a big role in the occurrence and progress of sicknesses, we emphasized supportive psychotherapy or more specifically, the suggestive therapy. 'Anguish' is an important point in the occurrence and progress of illnesses. To solve this, we used 'Zen family's 'Zen self-discipline' and ascetic life from Buddhism. According to Buddhism, a human's metal conflict and love or malingering from obsession is the cause of all mind illnesses. To heal these, a doctor must have an insight of the patient's mind more than the symptoms. Conclusions : Buddhistic thoughts suggested clearly the mentality necessary for oriental medical psychotherapist and medical ethics for a doctor.

• 디지털콘텐츠학회 논문지
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• 제4권1호
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• pp.57-66
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• 2003

본 논문에서는 인터넷 기반에서의 3자(환자, 의사, 약사)간의 상호대화형 원격진료 시스템 구현으로서, 효율적인 진료와 빠른 처리를 위한 전자진료차트 및 자료처리에 관한 내용을 제시하고 있다. 즉, 고가형 시스템, 비호환성 등 기존 원격진료시스템의 문제점을 해결한 저가형이면서, 누구나 참여할 수 있는 웹상에서의 시공간을 초월한 on-line 및 off-line 겸용모드의 지능형 원격진료시스템이다. 데이터베이스는 IIS 4.0 웹서버상에서 ASP와 SQL을 연동한 구현하여 효율적인 자료처리를 위한 시스템 통합과 환자와 의사간의 on-line 상담, 그리고 off-line상에서의 진료와 환자가 지정한 약사로의 처방전 전송 및 조제, 그리고 진료데이터의 저장 및 검색으로 인한 반영구적인 진료데이터저장, 환자 및 의사의 본 진료데이터를 이용한 보다 정확한 진료 및 처방등이 가능하다.

• 의료법학
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• 제15권1호
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• pp.59-80
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• 2014

The Medical Affairs Law regulates that Medical Doctor and Korean Medical Doctor(KMD) can practice in the boundary of each licence. But there is no clear provision to explain what practice in the boundary of MD's permitted region and what is KMD's. Moreover practice over the boundary of licence could be punished as a violation of the Law. KMD's use of medical devices have been objects of legal conflicts in the field. Because there is no clear provision in the Law, judical precedents have played the role as practical and final regulations. In this study, analyses on some judical precedents could show some rationales whether an issued KMD's use of medical devices is in the boundary of license. The courts considered the theories based on the practice, the level of required specialty and education, and the probability of danger to a patient. The judical precedents should be reviewed more precisely in the respects that it is adaptable in "the written law system"and it is desirable to divide boundaries between MD's and KMD's.

• 대한한의학회지
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• 제20권2호
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• pp.27-36
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• 1999

This study was performed to investigate the supply and demand of the oriental medical doctor(OMD) based on the supply and demand analysis of OMD up to the year 1997. The baseline projection and demographic methods were considered to examine the supply of OMD. On the contrary, for the demand analysis, two different approaches were conducted with the nonlinear regression model. The findings of this study indicate that the OMD will be oversupplied before the year 2012 with decreasing rate. However, when we consider the demand of OMD in the future. it is anticipated that the demand of oriental medicine will be increased rapidly with two major aspects. The first is the expansion of insurance benefits. The second is the increasing number of adult diseases because of the aging of the population structure. Therefore, the effective cooperation system and mutual exchange between western and oriental medicine is required for the future. Also. it is necessary to make the oriental medicine of the pharmaceutical services in more scientific way for the appropriate policy of the demand and supply of OMD. For the future study, the students who study abroad, especially China should be considered. These students will be the key element for the future supply of OMD.

• 대한지역사회영양학회지
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• 제16권6호
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• pp.627-635
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• 2011

The prevalence of Atopic Dermatitis (AD), a non-infective chronic inflammatory skin disease, is increasing worldwide. Avoiding the allergen is the basic principle in the treatment of AD. However, when the allergen is food, excessive restriction can lead to nutrition deficiency. The objective of the study was to examine the status of the dietary restriction and compare the caregiver's restriction practice with doctor's recommendation in Korean children with AD. A total of 158 children diagnosed with Atopic Dermatitis were recruited for this study. Information about foods that aggravate AD symptoms and food restriction were collected from the mothers of 158 children aged 6 month-5 year with AD using questionnaires. Food restriction recommendation by doctor was collected through medical chart. McNemar and Margianl homogeneity tests were used to detect a relationship between food restriction recommended by doctor and current practice by mother. There were significant proportion differences of food restriction for each food between by doctor and mother. We found 75.9% of children were avoiding eggs although only 61.4% were recommended for egg restriction by a doctor. Children with restriction of more than 4 kinds of food were 53.2% compared to 13.3% by doctor. Excessive restrictors tended to be younger and diagnosed at younger age. The caregivers of excessive restrictors had trends of "being older" and "having higher income". Avoidance of common foods in children without food allergy could result in malnutrition or impaired growth. Nutrition education is needed for sound practice and nutrition care in children with Atopic Dermatitis as well as interactive communication between caregivers and experts.