This study is designed to find out some intra-clinic factors affecting the content of practice provided by primary care physicians in Korea, and proposed factors in this study are characteristcs of each private clinc --- physician-related variables(age, sex, specialty), bfed-related variables for inpatient care, laboratory-related variables for precise diagnosis. We have tried to estimate the difference of disease entities cared by each primary care physician according to above factors by analyzin gdisease data claimed during one month(April, 1992) to National Federation of Medical Insurance. The diagnosis codes by ICD-9 in the research disease data were reclassified to 'diagnosis clusters' by virtue of clinical similarities for effective analyses. We have converted frequent-tsing ICD-9 codes to 86 diagnosis clusters, which incorporated 97.4 percents of all ambulatory visits to private clinics. This result means proposed diagnosis-cluster method is effective tool for analysis of the content of ambulatory medical care carried out by primary care physicians. Comparisons and analyses of multiple diagnosis-clusters made on the basis of presented factors were done and the results were as follows; - Major factors affecting the difference between diagnosis-cluster pattern by each variables were phyusician's age, sex, specialty and bed counts of each private clinic for inpatient care and the size of laboratories of each clinic. - Middle aged(30th to 40th) group physicians are providing more comprehensive care than 20th or above 50th aged groups. Male physicians are more adequate for comprehensive care than female physicians, because woman-doctors are providing narrow-spectrum care. The content of practice of obstetricians and gynecologists shows much difference from primary medical practice, and they cannot be included in primary care physician, this study suggested. Pediatricians are also providing short-spectum acre, and nearly all visits to pediatricians were incorporated only 2-3 diagnosis-clusters. General surgeons' practices are very similar to general practioners' or family physicians' practices, the means they are providing primary care rather than special surgical care. And small number of beds(under 5 beds) and only basic(2-3 sorts of)diagnostic apparatuses are sufficient for primary physicians' clinic to carry out primary care. In conclusion, to reinforce primary care department in Korea, there must be support with health policy to expand office-based primary care practice-- with small number of beds for inpatient care and only basic laboratories-- provided by general practitioner of family physician.
Objectives: This study examined the degree of professional autonomy of nurses as perceived by nurses and doctors, as well as the relation between professional autonomy, job satisfaction, and turnover intention of nurses. Methods: A questionnaire survey was conducted with 292 nurses and 121 physicians working in 10 small- and medium-sized hospitals with located in G Metropolitan City. Results: The difference in the level of nurses' professional autonomy as perceived by nurses and physicians was found to be significantly higher in nurses than in physicians. Professional autonomy and job satisfaction were significantly and positively correlated; professional autonomy and turnover intention were significantly and negatively correlated; and job satisfaction and turnover intention were also significantly and negatively correlated. Conclusions: Various efforts to increase nurses' professional autonomy and the development of effective workforce management programs to prevent turnover should be actively conducted to address the problems of small- and medium-sized hospitals facing a shortage of nurses.
Western medicine was first introduced to Korea by Christian missionaries and then by the Japanese in the late 19th century without its historical, philosophical, cultural, social, political, and economic values being communicated. Specifically, during the Japanese colonial era, only ideologically 'degenerated' medicine was taught to Koreans and the main orthodox stream of medicine was inaccessible. Hence, Korean medical education not only focuses on basic and clinical medicine, but also inherited hierarchical discrimination and structural violence. After Korea's liberation from Japan and the Korean war, the Korean medical education system was predominantly influenced by Americans and the Western medical education system was adopted by Korea beginning in the 1980s. During this time, ethical problems arose in Korean medical society and highlighted a need for medical humanities education to address them. For Korean medical students who are notably lacking humanistic and social culture, medical humanities education should be emphasized in the curriculum. In the Fourth Industrial Revolution, human physicians may only be distinguishable from robot physicians by ethical consciousness; consequentially, the Korean government should invest more of its public funds to develop and establish a medical humanities program in medical colleges. Such an improved medical education system in Korea is expected to foster talented physicians who are also respectable people.
Objective : The aim of this study was to survey the present utilization of pattern identification(PI) in the clinical field among Korean Medicine Doctors. Method : This survey was conducted from Oct. 1 to Oct. 31, 2014 by face-to-face interview using structured questionnaire. The subjects were 400 korean medicine doctors who worked in hospitals or clinics. The questionnaire consisted of two sections - a demographics section(i.e., sex, age, clinical experience, place of work, residence and so on) and the main research section(i.e., the PI utilization rate, the utilization of PI systems, the utilization of PI in the clinical domain and in the treatment domain, the correlation between utilization PI and so on). Results : This study revealed that subjects used the PI to 66.7% of their patients on average. The utilization rate of PI in patients was significantly higher for female physicians than for male physicians, for physicians worked in clinics than for physicians who worked in hospitals and for physicians with more than 10 years clinical experience than for physicians with less than 10 years clinical experience. In the utilization of PI systems, Visceral PI was most as 92.0%. There were significant difference on the PI utilization rate according to utilization of Meridian and Collateral PI, Triple Energizer PI, Defense, Qi, Nutrient and Blood PI, Six-Meridian PI and Six Excesses PI. As a result of analysing the PI utilization rate by clinical domain and in the treatment domain, the Treatment and the Drug Treatment showed the highest values. Among utilized PI systems, the correlation coefficients between Defense, Qi, Nutrient and Blood PI and Triple Energizer PI showed the highest value, but the correlation coefficients between Sasang Constitutional Medicine with the each PI showed substantially lower value. Conclusion : The results of this study demonstrate that usage of PI was higher than usage of U code(in KCD) usage in clinical field. we suggested that additional studies on using PI and developing more appropriate standardized tool should be conducted to widen scope of PI's utilization.
The rate of human milk feeding has been decreasing despite the diverse efforts of many physicians and nurses, as well as numerous professional organizations and various international health institutions. The number of physicians and nurses who can provide proper guidance for human milk feeding and offer appropriate knowledge and techniques to allow the most beneficial and convenient manner of breastfeeding is quite deficient. It is suggested that physicians and nurses be trained to teach and educate about the medical importance of human milk feeding to lactating mothers. This can be accomplished through systemic changes in medical education and clinical practice. However, the curricula of medical schools in Korea do not provide enough education and training to effect an increase in human milk feeding. The author strongly recommends that the educational objectives for medical schools and resident training offer more education and training concerning so that they are well aware of breastfeeding basics and techniques, and have ability to solve lactation-associated clinical problems.
Patients transported from fire sites may exhibit various injury patterns. Major trauma, skin burn, inhalation burn, and carbon monoxide poisoning are typical injuries. However, most physicians may be unfamiliar that cyanide poisoning can frequently occur due to combustion. Cyanide poisoning is highly significant owing to high mortality and the existence of antidotes. I present a 35-year-old man who was transported from a burning building and suffered severe metabolic acidosis despite no major bleeding as well as mild carbon monoxide poisoning. I suspected cyanide poisoning and administered the antidote; subsequently, the patient showed improvement. The next day, sudden airway obstruction developed, and emergency endotracheal intubation was performed. The inhalation damage was detected only in the lower airway tract and not in the upper airway. Physicians should be aware of cyanide poisoning and inhalation burn to avoid missing treatment opportunities.
Objectives: The purpose of this study is to find a way to effectively introduce accreditation for ambulatory health care organization by identifying the physicians' attitude for accreditation and characteristics that affect thei r attitude. Methods: A web survey was conducted from February 15 to March 4, 2011 for 183 physicians who work in ambulatory health care organizations throughout the nation. Self-reported questionnaire was used for this study. SPSS WIN(version 12.0) was utilized for statistical analysis. Results: Physician's attitude towards accreditation for ambulatory health care organization was positive(25.7%), moderate(39.3%), and negative(35.0%). Clinics that practice as a group or which treat more patients per day showed more positive attitude(p<0.05). The result of ordinal regression analysis indicates the groups with daily patients over 100 showed 36.3 times more positive attitude than the one under 75(p<0.05). Conclusion: The accreditation for ambulatory health care organization has not been throughly discussed yet. Many physicians did not have knowledge about accreditation. Clinics that see more patients per day had more positive attitude for accreditation. It indicates the cost may play important role in voluntary participation in accreditation.
This study was conducted to follow the patient referral system operated from the primary health care facilities to the hospital in a rural area of Korea. The subject for this study was sampled from a community health development project carried out by the Korea University in Yeoju Kun, Kyonggi Province. The data of referred patients from primary health care facilities were collected during the period from January 1989 to December 1989. The data was sorted out by a computer system using Database package. The results of this study were summarized as follows: 1. Characteristics of the referred patients were: males $32.0\%$. and females $68.0\%$. The more elderly of the patients visited to the hospital after having been referred there by CHPs or public physicians, $25.9\%$ has been to hospital on at least one previous occasion as against $74.1\%$ for whom it was there first visit. 2. The majority of patients who were referred to a hospital where: medicine $44.3\%$ and orthopedics$16.4\%$, major diseases were : diseases of digestive system $(21.3\%)$ ; symptoms and ill defined conditions $(17.3\%)$ ; diseases of the muscular skeletal system and connective tissue$(14.2\%)$. chronic illness was $82.0\%$ and acute illlness was $18.0\%$. 3. From Community health practitioners more patients referred than the public physicians. Categoris of diseases of the referred patients were different between community health practitioners and public physicians. Due to the. respective differences between the medical restrictions put on the nursing staffs at the community health practitioners and public physicians. From this study it was recommended to define the reason of differences between ~he two groups in futher study. Study as to 1) why one group should be referring more for hospital treatment than the other. And 2) why the two agencies should be referring different diseases.
Background: Cancer genetics have gained public attention dramatically. Everyday physicians and nurses use the knowledge of cancer genetics in their practices. Despite the importance of the knowledge of the health care providers on cancer genetics, there is a paucity of literature investigating the levels of knowledge about cancer genetics among health care providers. Purpose: This study aimed to describe the Korean physicians' current knowledge level about hereditary breast and ovarian cancer (HBOC). Method: This nation-wide survey used a 15-item questionnaire which is modified from the Breast Cancer Genetic Counseling Knowledge Questionnaire originally developed by Erblich et al.(2005). One hundred and forty-four physicians participated in this survey from October 1, 2006 to March 31, 2007. Result: Physicians' knowledge level about hereditary breast cancer was 11.94 (S.D=2.46). Physicians with short-term careers (less than one year), the position of Intern, or who were involved in breast or ovarian cancer care demonstrated the highest knowledge about HBOC. Conclusion: Genetic courses in medical education seemed to contribute to the high level of physicians' genetic knowledge. Also, nursing discipline needs to incorporate genetics or genetic counseling courses into the formal educational curriculum in order to deliver up to date cancer care services which are sensitive to ever-changing cancer genetic information.
Lee, Sanghoon;Song, Jae Yun;Ku, Seung Yup;Kim, Sun Haeng;Kim, Tak
Clinical and Experimental Reproductive Medicine
/
제39권2호
/
pp.46-51
/
2012
Fertility preservation (FP) is an effort to retain the fertility of cancer patients, and as an emerging discipline, it plays a central role in cancer care. Because of improvement in diagnostic and therapeutic strategies, an increasingly large number of patients are surviving with cancer. FP specialists should make an effort to spread the significance of FP among reproductive women with cancer and provide appropriate education both for associated physicians and for cancer patients who wish to preserve their fertility. Physicians who take part in the initial diagnosis and management of cancer should consider the importance of early referral of young cancer patients to FP specialists and take care of those patients by providing timely information and appropriate counseling. Individualized treatment strategies should be delivered depending on the patient's situation with appropriate team approach.
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