• Journal of Science and Technology Studies
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• 제13권2호
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• pp.71-110
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• 2013

As a patient has recently been recognized as not a passive object but a subject of medical services, various attempts are being made to strengthen the status of a patient. Medical communication which has been led by a doctor so far is being made with a focus on a patient due to sovereignty of a consumer and activation of medical information. The purpose of this paper is to investigate the process to strengthen the status of a patient as a consumer of health care service through a patient association and consumer movement as medical information becomes public. As the patient centered medical service is creating a variety of health care service market using IT technologies, it has contributed to the improvement on asymmetry of medical information. As the expansion of IT fusion health care market is bringing the fundamental change into the traditional relationship between a doctor and a patient, the medical service market is being re-organized. A patient centered medical service such as expansion of mobile health care model led by a patient is being accelerated.

• Journal of Society of Preventive Korean Medicine
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• 제25권2호
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• pp.13-31
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• 2021

Objectives : The objectives of this study are to provide the education of communication skills in the class of theories of Korean medical famous physicians and to survey students' perception of the effect. Methods : The class of theories of Korean medical famous physicians was newly designed and was given to students. The results from the questionnaire survey with second year students at department of Korean medicine were applied to the evaluation of study issues. The scale used for this study was the modified version of 'Beyer-Fetzer's Essential Elements of Communication Skills Assessment Sheet', which was developed by researchers in line with the education of Korean medicine. Results : In six (except for 'opening a conversation') out of seven categories, post-test results were more improved than pretest results. In the category of communication skills (a total of 25 questions), post-test results were higher than pretest results in all items. Among them, 13 items were statistically significant. With regard to the question as to how important the class of communication skills is to raise their professionalism as Korean medicine doctor, post-test result was higher than pretest result. Regarding an appropriate education point of time, there were various points in the entire period of curriculum. The appropriateness of teaching-learning method was positively evaluated. In terms of the content helpful for learning, learner-oriented activities was preferred over teacher-oriented lecturing. Conclusions : The communication skills learned in the class of theories of Korean medical famous physicians were effective. Communications skills should be taught constantly in the entire curriculum in order to raise students' professionalism as Korean medicine doctor. In terms of education method, it is desirable to design a class based on students' various activities, rather than lecturing.

• Journal of Korean Foot and Ankle Society
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• 제8권1호
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• pp.16-21
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• 2004

Purpose: To investigate the characteristics of the patients and therapeutic shoes for diabetic patients. Materials and Methods: Forty two diabetic patients who had their own therapeutic shoes which were prescribed somewhere else were studied from March 2003 to December 2003. There were 27 males and 15 females, and the mean age was 62.1 years (range, 49-72 years). Duration of diabetes was average 14 years (range, $6{\sim}30$ years), all had type 2 diabetes. Sensation was examined with 5.07 nylon monofilament. The route of purchasing the shoes, compliance to the prescribed shoes were investigated by interview. The shape of shoe, stiffness of upper, conformity of insole to the shape of the foot were recorded. In-shoe plantar pressure was measured in 15 patients. Results: Eighteen patients were insensate to the monofilament. Seven patients did not wear the therapeutic shoes, and only 18 of 35 patients were wearing the therapeutic shoes more than 6 hours a day. The shoes of 17 patients were prescribed by medical doctor and the rest were purchased by the recommendation of acquaintances or advertisement. Ulcer recurred in four of five patients to whom the shoe was prescribed by medical doctor and the cause of three recurrences were evident by just observing the foot and shoe. The therapeutic shoes were made from 11 different makers. Eight shoes were adequate for diabetic patients with respect to the material, shape of insole, type of shoe. In-shoe plantar pressure was examined in 15 patients and was less than 300 kPa in all patients. Conclusion: The therapeutic shoes for the diabetic patients need to be prescribed by medical doctor for selective patients with neuropathy or previous history of ulcer and follow-up examination is important to monitor the compliance of the patients and adequacy of the shoes.

• The Journal of Korean Medicine
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• 제34권4호
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• pp.21-31
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• 2013

Objectives: The purpose of this study was to evaluate the efficiency of patient and doctor role-play on participatory clinical clerkship by surveying student's satisfaction and assessing the improvement of skill and consultation ability after conducting a role-play in a Korean dermatology department. Methods: In 2013, 79 seniors participated in the clinical clerkship of the dermatology department at the college of Korean medicine. Two students were randomly selected and paired up. After a brief instruction, one student played the role of doctor and the other took the role of patient. After finishing the $1^{st}$ role-play, they swapped roles and conducted a $2^{nd}$ role-play, using another clinical case. When the two role-plays were completed, the students filled in a questionnaire about their satisfaction with the role-play as clinical clerkship. Also, we compared the scores of the $1^{st}$ role-play with those of the $2^{nd}$ role-play measured by a medical resident to assess improvements of students' skill and interview ability. Results: It appears that students' satisfaction with the role-play was quite high, considering that the overall mean score of the questionnaire was 4.30. According to the result of a t-test on 15 assessment questions, the $2^{nd}$ role-play had a higher mean score than the $1^{st}$ role-play in 12 questions, though this difference was not statistically significant. Conclusions: These results demonstrate that role-play is helpful to improve students' satisfaction and clinical performance ability in clinical clerkship. Further research and continuous development are necessary for better clinical clerkship.

• The Korean Society of Law and Medicine
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• 제15권2호
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• pp.285-316
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• 2014

As the number of medical disputes regarding nurses has increased after medical disputes have increase, there is a need for a study on it. However, the legal relationship between nurses and patients has not yet been analyzed. Recently, the role and function of nurses are expanded according to the development of the science of nursing; moreover their activity and limitation of responsibility are also expanded. For this reason, the medical disputes regarding nurses have been increasing. However, the majority of these kind of dispute are just passed over because their practice is usually considered to be a mere action to assist doctor's role. In addition, nurse practice is not a secondary action of doctor's role, but forms part of a medical treatment. Of course, nurses handle many secondary tasks after doctors finish their medical treatment. But this is only part of the whole tasks of nurses. Furthermore, the general details of their medical treatment are not different from those of doctors because they also belong to the medical service personnel. Considering these features of nurse and the medical condition in South Korea, their task is becoming increasingly developed and specialized and they are also establishing their own field. With this stream of times, there is a growing interest in enacting a Nursing Practice Act, in other words, the independent law on nurse for the sake of patient safety and national health promotion. Then, their responsibility will distinctly be expanded as much more. That is, the time that nurses practice their medical care by following doctors' order and also pass over their responsibility to doctors is closed. Thus, this study examines the features and responsibilities of nursing practice, and discusses an institutional framework to efficiently cope with the legal disputes between nurses and patients. It aims to throw light on the decision making on nurse-patient disputes in future.

• Journal of the Architectural Institute of Korea Planning & Design
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• 제36권3호
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• pp.31-38
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• 2020

The purpose of this study is to compare between professionalism in medical field(doctor) and architectural design field(architect) in Korea through synchronic and diachronic analysis, with basic requirement of expertise and systemicity, attitude requirement of the publicness, and structural requirement of exclusiveness and autonomy. The medical professionalism adapted by Korean government in the early period of modernization evolved from Western's professional expertise is highly divided as economy grew and society changed. In comparison, architecture was divided into architecture, urbanism, landscape, and interior architecture. Additionally, architectural field was subdivided with architectural design, engineering, construction, structure, and facilities, but architectural design focused on generalized education and practice system. From the systematical point of view, architectural design field has changed profoundly from architectural engineering as 5 year undergraduate educational system was introduced with Korean architectural accreditation. The publicness is approved through health service in medical field and safety and the public domain in architectural design field, but in reality the professionals are viewed as economic interest groups. Hence, the professionalism in both fields is required to reinforce ideology and ethics, and to practice concrete measures for publicness. Compared with the unified organization of medical field, architectural design professionalism faces various difficulties in unifying the organization, such as internal competition caused by tightened architect's requirements, along with external problems from architectural design permission demands of construction companies. In medical and architectural design professionalism, with the appearance of consumerism and stricter governmental regulations, the autonomy is weakened. From the result of comparative analysis, Korean medical field became extremely subdivided and specialized in each department, therefore integration of each disease and establishment of centers are proposed as solutions. By contrast, the reinforcement of expertise in architectural design professionalism might be necessary to strengthen autonomy caused by governmental restriction, and to form architectural culture and secure public architecture.

• The Korean Society of Law and Medicine
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• 제20권1호
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• pp.163-201
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• 2019

Doctor has the duty of an inter-hospital transfer, known as inter-facility or secondary transfer, when the diagnostic and therapeutic facilities required for a patient are not available at the given hospital. Also, the decision to transfer the patient to an another facility is rely on whether ill patient is the benefits of care, including clinical and non-clinical reasons, available at the another facility against the potential risks. Crucial point to note is that issues about 'inter-hospital transfer' is limited to questions occurred in the course of transfer between emergency medicals (facilities). 'emergency medical (facility)' is specified by Medical Law, article 3 and the duty of an inter-hospital transfer includes any possible adverse events, medical or technical, during the transfer. Because each medical facility has an different ability to care for a patient in an emergency condition, coordination between the referring and receiving hospitals' emergency medicals would be important to ensure prompt transfer to the definitive destination avoiding delay at an emergency. Simultaneously, transfer of documents about the transfer process, medical record and investigation reports are important materials for maintaining continuity of medical care. Although the duty of an inter-hospital transfer is recognized as one of duty of doctor and more often than not it occurs, there is constant legal conflict between a doctor and a patient related to the duty of the inter-hospital transfer. Therefore, we need clear and specific legal standard about the inter-hospital transfer. This paper attempts to review the Supreme Court's cases associated to the inter-hospital transfer and to compare opinion of the cases with guideline for an inter-hospital transfer already given. Furthermore, this article is intended to broaden our horizons of understanding the duty of an inter-hospital transfer and I wish this article helps to resolve the settlement and case dealt with the duty of inter-hospital transfer.

• The Korean Society of Law and Medicine
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• 제14권2호
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• pp.217-260
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• 2013

In connection to the civil liability of the medical malpractice, plaintiff and courts are solving the medical disputes with theory of the liability based on tort law. because contract law does not enact the right of claim of solatium and a plaintiff's lawyer and courts hesitate to use contract law. Medical treatment of doctor is main debt in medical contract and its in-complete performance gives rise to the violations of human's life, body and health. Consequently a breach of medical contract leads to violations of person-al rights. These violations spring from liability of contract as well as tort and damages from them are recognized based on medical contract law. A duty of explanation of doctor is a independent and appendant debt to the treatment debt. However its breach provokes violations of human's life, body and health as well as a right self-determination. Therefore consolation money claim should be recognized. In case of the violation of patient's life, body and health, patient's family al-so can demand consolation money due to the violation of their's own mental pain. However in case of the violation of only patient's self-determination without informed concent, they can not demand it by reason of the violation of patient's self-determination. But by reason of the violation of patient's life, body and health that were recognized by proximate causal relation between violation of duty of explanation and abd execution, they can do.

• Korea Journal of Hospital Management
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• 제2권1호
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• pp.65-79
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• 1997

This study aims to measure in-patients' willingness to choose the same hospital, and to define the related factors. The willingness was measured by the fact whether in-patients would return to the same hospital for their future hospitalization and can be said as the essence of ascertaining patients' satisfaction. Data was collected from 236 patients hospitalized in two hospitals selected according to its superiority, one being superior in medical technique, the other being superior in facility and equipment. To enhance the comparability between the two hospitals, the department and the diagnosis were matched, and structured questionnaires were self-fill-up. The main findings are as follows. Hospitals were analyzed by their superiority : medical services, facility and equipment. In case of hospitals with superior medical services, the willingness was proportional to positive doctor-patient relationship, to satisfaction with the medical level, and to the acknowledgement of utility in cure. In case of hospitals with superior facility and equipment, the willingness was proportional to the satisfactory state of overall facility. Two types of hospitals were combined and analyzed. The willingness for choosing hospitals with superior medical services was stronger than that for choosing the other hospitals. The satisfaction with overall facility, satisfaction with medical level, acknowledgement of utility in cure, positive doctor-patient relationship, and better consultation produced higher willingness to choose the same hospital. The willingness for the option shows to what degree the hospital suffices patients' expectation. Patients' understanding views were obviously influential. The satisfaction level for medical aspect was more influential than the level for non-medical aspect.

• Health Policy and Management
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• 제10권1호
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• pp.31-56
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• 2000

A purpose of this study is to study on Rene Descartes's mind-body theory in medical aspect. Though Rene Descartes was not so much a doctor as a philosopher, he had health and medical science at heart. When he came into the world in 1596, he was in poor health. Therefore, he suffered from his bad health. Descartes's ideas absolutely colored Western thought for three hundred years, especially, his mind-body theory, mechanistic life-view, and reductionism had important effect on medical study and science of public health. As a rule, we know that his mind-body theory was applicable to mind-body dualism, and his mind-body dualism was connected with biomedical model of medicine. But by this study, his mind-body theory was not only mind-body dualism but also mind-body monoism. And he asserted mind-body interaction too. In other words, he advocated mind-body dualism in scientific aspect, but he knew mind-body monoism from his experence. He confessed this fact to Princess Elizabeth of Bohemia, he wrote mind-body interaction in $\boxDr$Discours de la methode$\boxUl$, $\boxDr$Meditationes de prima philosophia$\boxUl$, and $\boxDr$Traite des passions de 1'ame$\boxUl$ etc. However, only mind-body dualism of his mind-body theories was written in our medical text book, morever mental realm was excluded from the persuit of learning Descartes advocated a mechanistic world-view and mechanistic life-view, he regarded human body as a machine part. And a paticent corresponds to a troubled machine, a doctor deserves a repairman. But this point of view made holistic understanding of man impossible. Descartes divide the whole into basic building blocks, we named the approach Reductionism. Reductionism led to ontological concept in medical science, bacteriology established 'specific cause-specific disease-specific therapy'. We examined medical influence of Descartes's thought, we need to draw out a philosophic basis of medical science and science of public health by a close study of his records.