Objectives : This survey was accomplished to find out how Korean medical doctors take Ojeok-san prescriptions for low back pain in clinical practice. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. 306 persons having more than 5 years experience were randomly selected from a list of Korean medical doctors. Telephone interviews with them were conducted by the well-trained interviewers between March 21 and April 4 in 2009 and the computerized data were analyzed by STATA 9.0 SE version(Stata Corp, Colleg Station Tex, USA) statistical program. Results : 1. 192 out of 306(65.1%) Korean medical doctors taked Ojeok-san prescriptions for musculoskeletal disorders patients and 183 out of 192(95.3%) Korean medical doctors taked Ojeok-san prescriptions for low back pain treatment. 2. The rate of low back pain patients, '20~30%' was 99 people(33.6%) and the rate of Ojeok-san prescriptions for low back pain treatment, 'below 10%' was 65 people(35.5%). 3. In Ojeok-san effect of low back pain treatment, 'greate effects' 29.5%, 'tolerable effects' 66.7%, 'no effects' 3.8% were selected. In granule extracts effect, 'similar to Original herbs' 9.8%, 'unlike to Original herbs' 90.2% were selected. Conclusions : In our telephone survey, Korean medical doctors taked Ojeok-san prescriptions for low back pain treatment. Further research on this issue is needed.
This study was carried out by using questionnaires with 200 general doctors serving as the director of health subcenter in Kyongsangbuk-do Province as of January 1995. The results are summarized as follows. It was shown that the general characteristics consisted of 53 directors in the lst year(26.5%), 85 in the 2nd year(42.5%) and 62 in the 3rd year(31.0%). The percentage spent on their medical service showed that 73.0% of those directors spent more than 90% on their medical service. Based on their general service attitiude, 0% answered that the director of the health subcenter completes the given duties as the director, and 24.5% did that the director has the sense of responsibility and duty. Multiple answers concerning inconvenience and difficulties of the health subcenter director showed that less monthly salary accounted for 75.5%, no administrative power for 50.0%, insufficient medical instruments for 35.5%, insufficient budget for 30.0%, respect. In conclusion, in order for the health subcenter to meet the function as the primary medical clinic, it is required to arange the plans to inspire the public health doctors' service desire to that they can give the medical service as good as the private primary medical clinics, to convert existing concept of the public health doctors' placement in Myon administrative district into new concept in Gun by breaking from a uniform placement, and to consider an intensive placement according to the relevant projects so that preventive health activities can be planned and carried out.
In this paper, medical books on measles written in the late Joseon dynasty were analyzed to examine Chosonization of recuperation and contraindications of Measles in the Late Joseon Dynasty. It was approached in terms of utilization of Chinese medicine knowledge and utilization of clinical experience in Joseon. Through this study, the following facts were newly discovered. 1) Alcohol was taboo according to Chinese doctors, but in Joseon it was considered good if used properly. 2) Beef was recommended by Chinese medical doctors, but it was taboo in Joseon. 3) Dried fish was a food specially recommended in Joseon literature. 4) Except for diet, the contents of the treatment follow the Chinese literature as it is, or there is no content. In conclusion, Korean medical doctors simply followed Chinese medicine knowledge at the beginning of the 18th century, but in the mid to late 18th century, according to the accumulation of clinical experience in Joseon, they had unique characteristics associated with medicine during the Joseon era.
NHIS claimed for damages to doctors that by doing the treatment breaching medical insurance criteria caused by doctors, NHIS paid for medicine cost to pharmacy; as a result, the doctors caused the tort to NHIS. Following consecutive rulings afterwards, NHIS also argued that the medicine cost violating medical law or medical treatment expense paid to medical organizations are both the tort in civil law. NHIS claimed for all the damages, and the Supreme Court confirmed this judgment. However, within our national health insurance system, the subject of insurance payment is NHIS and the subject of medical treatment expense are also NHIS since the treatment expense is also insurance payment by asking the treatment to medical organizations. Further, national health insurance law is not made to control the violation of medical treatment cases; therefore, the breach of medical law cannot be covered by illegality of tort in civil law regarding NHIS. If that is the case, in the case that if the patients are treated according to treatment criteria via the doctors delegated the doctors' permission by Health and Welfare minister, NHIS acquired the benefits to remove the duty to give treatment payment to doctors in civil law; thus, even though the doctors have breached the medical law, NHIS does not have any damages. The fact that supreme court confirmed the ruling that the treatment is the tort in civil law towards NHIS is the judgment not counting the benefits of insurance payment as the subject but only considering the fact that NHIS paid to the doctors and this ruling have gone against the principle under civil code section 750. If the doctors have breached the medical law, the case should be sanctioned by medical law not national health insurance law, and the ruling of supreme court is assumed that they have confused both with the principle of national health insurance law and civil law.
Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.
The purpose of this study was to evaluate the difference in perception of clinical nutrition service (CNS) between doctors and dietitians working in hospitals in Busan and the Gyeongnam area. Research was performed through questionnaires (from November to December 2011) at over 100 beds. 73.3% of dietitians were aware of the Nutrition Support Team (NST), while only 15.6% of doctors were aware of it. Due to heavy work and lack of medical staff, doctors didn't participate in NST, although most of them recognized the necessity of NST. 61.7% of dietitians screened and managed malnourished patients, whereas only 29.8% of doctors did. The main reason dietitians didn't treat malnourished patients was the absence of a treatment system in the hospital. Less than 50% of dietitians participated in the doctor's round to malnourished patients. As for why dietitians didn't participate in doctor's rounds, 71% of doctors chose understaffed dietitians and 38.1% of dietitians chose the doctors' unawareness of the importance of the dietitian in doctor's rounds. For the lower rate of nutrition counseling in provincial regions, compared to the capital region, 46.8% of doctors cited a lack of connection between doctors and clinical dietitians, while 43.3% of dietitians cited the lack of doctors' awareness on the importance of nutrition counseling. Although 87.3% of the doctors and 91.6% of the dietitians answered that CNS is important for treatment, the perception of onsite performance status on CNS was found to be low in both groups. 48.9% of doctors and 50.0% of dietitians regarded dietitians in the hospital as personnel in charge of food services, rather a member of the medical team. To improve the awareness of the importance of the CNS, and the image of clinical dietitians, 31.2% of doctors answered "to introduce a professional dietitian license for each disease" and 26.7% of dietitians answered "to change the system in the hospital". Most subjects found that a separation of clinical nutrition services from the food service part is needed. These results suggest that it is important to narrow the difference in perceptions of clinical nutrition services between doctors and dietitians for an organized clinical nutrition management of patients in hospitals in Busan and the Gyeongnam area.
Objectives : Moxibustion therapy is one of the most popular oriental treatments in Korea. In this study, we operate the in-depth interview for use of moxibustion therapy in Korea. Methods : Survey questions were developed based on consensus of acupuncture professors. The list of the Korean medical doctors with experiences more than 10 years is provided by the Association of the Korean Oriental Medicine. The in-depth interview was conducted in 30 Korean medical doctors who answered in the previous telephone survey that they use moxibustion therapy for more than 30 % of patients everyday. Interview survey with them were conducted by the well-trained interviewers of Korea Institute of Oriental Medicine in medical researcher from 22th May to 28th June 2007. Results : Korean medical doctors prefer to use the moxibustion with moxa stick (83.9%). The most common treatment disease was musculo-skeletal disorder (28.9%), gynecology (14.1%), digestive disorder (28.6%). The most common treatment area was the abdomen (35.3%), back (22.5%), lower extremity (15.8%) and upper extremity (16.9%). Indirect moxibustion’s was as frequent as 73.5% of moxibustion method. The most common instrument for treating was mini-moxa of manufactured goods (39.3%). Most Korean medical doctors (48.8%) took up the position that bring symptom relief following good treatment area. 'High preferences of patients' (32.7%) was one of moxibustion strong points but 'Lots of smell and smoke' (54.7%)' was a weak points. The most common side effects was the 'slight burn' (34.9%), 'skin rash' (22.5%), 'skin pruritus' (23.8%) Conclusions : This survey provides unique insight into the perception of the Korea medical doctor at moxibustion therapy. Future research needs to provide more in-depth insight into doctor views of the experience.
Since the year 2000, lung cancer has become the leading cause of cancer death in South Korea as in many other parts of the world. The current multidisciplinary approach for lung cancer includes a wide range of modalities, not only surgery, radiotherapy, medical drug therapy but also pain control, as well as social and psychological support. Therefore, thoracic surgeons, radiologists, nuclear medicine specialists, anesthetists, psychologist, nurses and social workers as well as medical doctors care for lung cancer patients. Sharing a common treatment protocol and optimal communication are vital aspects of shared care both from a medical and cost-effectiveness point of view. We developed a shared electronic medical record (SEMR) for treating patients with lung cancer in a university hospital to facilitate the sharing protocols and communications between doctors involved in a lung cancer clinic. A SEMR system was developed within a order communication system(OCS) for a lung cancer clinic. The records of radiological, laboratory and pathological studies as well as the records of surgery, chemotherapy, and radiotherapy were stored and presented to all doctors who treat the same patient. Every doctor was allowed to change his/her own records. They could review other doctor s records but could not alter them. With the SEMR, it was expected that the time to complete the medical records for one patient could be reduced because it was easy to review all the data from the other doctors who share the same patient. In addition, the confidence of the doctors who share a common treatment protocol would be higher. Therefore, a shared electronic medical record is expected to improve the quality of patient care.
Stroke patients need regular medical treatments and rehabilitation training from their doctors. However, severe aftereffects caused by stroke allow them minimum activities, which make it difficult for them to visit doctor. Recently, electric brain stimulation treatment has been found to be better way compared to conventional ones and many are interested in using this method for the treatment of stroke. In this study, we have developed a remote medical treatment system using wireless electric brain stimulator that can help the stroke patients to get a treatment without visiting their doctors. The developed remote medical treatment system connects the doctors to the brain stimulator implanted in the patients via the internet and ZigBee communication built in the brain stimulator. Also, the system receives personal information of the connected patients and cumulates the total records of electric stimulation therapy in a database. Doctors can easily access the information for better treatment planning with the help of graphical visualization tools and management software. The developed remote medical treatment system can be applied to the electric stimulation treatments for other brain diseases with a minor change.
Doctors and patients for the purpose of healing and treatment of disease through the contract will make a relationship. Doctors perform the medical practice for the state and illness of patient. Given that the patient did not cooperate in the doctor's medical practice, it is difficult to achieve the goal of disease healing. If the patient don't cooperate the medical care, and it is linked with a doctor's medical malpractice, patient's violation of obligation in medical cooperation is considered with negligence on the part of patients. However, this negligence should be limited to obvious cases that the patient's behavior is unreasonable although the doctor provides medical information to patients and induced the patient's response. Also, patient's violation of obligation in medical cooperation must result in adjusting the indemnification via a setoff of fault except the cases having causal relationship between doctor's fault and malpractice.
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