• Journal of Preventive Medicine and Public Health
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• v.15 no.1
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• pp.17-31
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• 1982

A physician assumes toward his patient the obligation to use such reasonable care and skill as is commonly possessed and exercised by physicians in the same general line of practice in the same or similar localities and to use his best judgment at the times. Medical disputes between physicians and patients are, ever more increased in these days as human body, happens to cause a variety of changes in body unlike the function of machine. Such increased trends of medical disputes became a problem in common across the word under the influence of affluent living standard, high consciousness of life value and right by today's people. The aim of this dissertation is oriented to forming a physician's responsibilities in medicalcare accidents arising between physicians and patients. A general physician, for example, has not been negligent merely because, a specialist might have treated the patient with greater skill and knowledge. However, the fact that a physician may have acted to the best of his ability will not avoid legal problems for damages resulting from substandard treatment, that is the degree of care and skill which is to be expected of the ordinary practitioner in his field of practice. The duty of a physician who is, or holds himself out to be, a specialist is greater in the field of his specialty than one who is a general physician. A patient's consent to routine medical procedures is implied from the fact that patient comes to the physician with a medical problem and voluntarily submits to the procedures. For the more serious medical procedures and for major operations, however, it is preferable for the physician to have the patient's consent in writing, to facilitate proof of the consent in the event of a dispute or litigation. Suppose that mistakes on the part of physicians are likely to be blamed in all cases of malpractice. Then it will create a sort of shrinkage in activities of medical treatment. There should be some limitation on excessive application of 'The thing speaks for itself' on mistakes by physicians and availablity of cause and effect. It is a matter of complicity as well as a matter of importance to draw a definite boundary on responsibilities of physician. A series of further research on this particular aspect is strongly urged.

• Journal of Preventive Medicine and Public Health
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• v.26 no.4 s.44
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• pp.661-671
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• 1993

In order to compare the geographical distribution of physician by level of medical care and specialty, a log linear model was applied to the annual registration data of the Korean Medical Association as of the end of December, 1991 which was supplemented from related institutions and adjusted with relevant sources. Those physicians in primary and secondary care institutions were not statistically significantly unevenly distributed by province-level catchment area. There were some differences in physician distribution among big cities, medium and small-sized cities, and counties; however, those physicians for primary care level were equitably distributed between cities and counties. Specialties for secondary care physicians were less evenly distributed in county areas than in city areas, and generalists are distributed more evenly in cities and counties than in big cities. There is a certain limitation due to underregistration in the annual physician registration to the Korean Medical Association; however, the geographical distribution of physicians has been improved quantitatively. It is strongly suggested that specialties and the level of medical care should be considered for further physician manpower studies.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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• pp.161-166
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• 2016

Iranian women are at high risk of low compliance with repeat mammography due to a lack of awareness about breast cancer, negative previous experiences, cultural beliefs, and no regular visits to a physician. Thus research is needed to explore factors associated with repeated mammography participation. Applying the concept of perceived risk as the guiding model, this study aimed to test the fit and strength of the relationship between perceived risk and physician recommendation in explaining repeat mammography. A total of 601 women, aged 50 years and older referred to mammography centers in region 6, were recruited via a convenience sampling method. Using path analysis, family history of breast cancer and other types of cancer were modeled as antecedent perceived risk, and physician recommendation and knowledge were modeled as an antecedent of the number of mammography visits. The model explained 49% of the variance in repeat mammography. The two factors of physician recommendation and breast self-examination had significant direct effects (P < 0.05) on repeat mammography. Perceived risk, knowledge, and family history of breast cancer had significant indirect effects on repeat mammography through physician recommendation. The results of this study provide a background for further research and interventions not only on Iranian women but also on similar cultural groups and immigrants who have been neglected to date in the mammography literature.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10809-10812
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• 2015

Background: Human papillomavirus (HPV) DNA testing is an effective method to screen for precancerous changes in the cervix. Samples from self-collection rather than Pap smear can potentially be used to test for HPV as they are more acceptable and preferred for use in certain settings. The objective of this study was to compare HPV DNA testing from self-collected vaginal swabs and physician-collected cervical swabs. Materials and Methods: A total of 101 self-collected vaginal and physician-collected cervical swabs of known cytology from Thai women were tested by electrochemical DNA chip assay. The specimens were divided into 4 groups: 29 with normal cytology, 14 with atypical squamous cells of undetermined significance (ASCUS), 48 with low-grade squamous intraepithelial lesion (LSIL), and 10 with high-grade squamous intraepithelial lesion (HSIL). Results: Positive detection rates of HPV from self-collected swabs were similar to those from physician-collected swabs. Among specimens with abnormal cytology, HPV was found in 50% of self-collected swabs and 47.2% of physician-collected swabs. In specimens with normal cytology, 17.2% of self-collected swabs and 24.1% of physician-collected swabs were positive for HPV. Concordance was relatively high between results from self-collected and physician-collected samples. The most common HPV genotype detected was HPV 51. Conclusions: HPV DNA testing using self-collected swabs is a feasible alternative to encourage and increase screening for cervical cancer in a population who might otherwise avoid this important preventive examination due to embarrassment, discomfort, and anxiety.

• Journal of Preventive Medicine and Public Health
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• v.25 no.1 s.37
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• pp.73-87
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• 1992

The level of copayment increased in order to stabilize the financial condition of the health insurance on 1986. An important question regarding the policy was whether the increase in the level of copayments reduced the utilization of medical services in the poor selectively. In spite of the importance of the research question, no study has been reported. This study was designed to find out changes in numbers of physician visits, to explain characteristics influencing the difference of utilization before and after the program. Finally the interaction effect between the program and the level of income was examined for the abover question. A total of 10,421 persons from eight institutions was selected as the study sample. Research findings are as follows. 1. The number of physician visits decreased by ten percent as a result of increasing the level of copayment. 2. The decrease was remarkable in some groups such as children, rural area and large family. 3. The most important factor which explained the difference was the number of physician visits before the introduction of the new program. The more numbers of physian visits during the last year were, the more numbers of physian visits decreased after the program. 4. The interaction term between the program and the level of income was statistically significant in the multiple regression model which explained physician visits and its coefficient was negative. It means that an increase in copayment did not reduced the number of physician visits in the poor, selectively. 5. It can be concluded that imposing adequate copayment reduces the use of medical services as well as medical costs without serious damage in access especially for the poor people.

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.411-418
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• 2006

Objectives: The purpose of this study was to determine whether the disabled have worse access to primary care than the non-disabled. Methods: We used the National Disability Registry data and the National Health Insurance data for the calendar year 2003, and we analyzed 807,380 disabled persons who had been registered until December 2001 and we also analyzed 1,614,760 non-disabled persons for nine ambulatory care sensitive conditions (ACSCs). The rates of physician visits and hospitalizations for the patients with ACSCs were compared between the disabled and the nondisabled. Multiple logistic regression analysis was used to evaluate the association between medical care utilization and disability and to assess the association between hospitalization and the number of physician visits while controlling for potential confounders. Results: The numbers of physician visits per 100 patients were $0.78{\sim}0.97$ times lower for the disabled than that for the non-disabled with five of nine ACSCs. The numbers of hospitalizations per 100 patients were $1.16{\sim}1.77$ times higher for the disabled than that for the non-disabled with all the ACSCs. While the ORs of a physician visit for the disabled were significantly lower than that for the non-disabled with all the ACSCs (OR: $0.44{\sim}0.70$), and the ORs of hospitalization for the disabled were significantly higher (OR: $1.16{\sim}1.89$). The lower physician visit group (number of physician visits ${\leq}$1) was more likely to be hospitalized than the higher physician visit group (number of physician visits ${\geq}$2) (OR: $1.69{\sim}19.77$). The effect of the physician visit rate on hospitalization was larger than the effect of disability on hospitalization. Conclusions: The results suggest that the disabled were more likely to be hospitalized for ACSCs due to their lower access to primary care.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.3-46
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• 2017

Physician's Duty of Information is classified into three categories by legal function: 'Duty of Information to Report' to fulfill the patient's right to know; 'Duty of Information to Guide' patient's convalescing and staying healthy; 'Duty of Information to Contribute' to patient's self-determination. We classify the physician's duty of information because the legal effect from the breach of duty varies accordingly. The legal effect is focused on damage compensation responsibility for breach of duty. When a physician violates 'Duty of Information to Report', he subjects himself to liability of compensation for infringing on the patient's 'Right to Know'. When a physician violates 'Duty of Information to Guide', she subjects herself to liability for general medical malpractice. Finally, when a physician violates 'Duty of Information to Contribute', the physician is basically liable for violation of the patient's 'Right to Self- Determination' which refers to infringement on freedom of choice. However, in the case of situation that patient's refusal to the medical treatment would be presumed, the physician bears all liability for the patient's damage which includes both of property and mental damage.

• Journal of muscle and joint health
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• v.23 no.2
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• pp.105-113
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• 2016

Purpose: The purpose of this study was to investigate the effect of Situation-Background-Assessment-Recommendation (SBAR) reports on communication clarity and nurse-physician collaborative relationships. Methods: SBAR forms in one group were measured at baseline, at 2 weeks, and at 4 weeks postintervention. The subjects were 30 nurses who worked in a general ward of a general hospital in B city, Korea. A 45-minute SBAR education was provided to all subjects. Data was collected between September to October 2015. The collected data was analyzed using a repeated measure ANOVA. Results: After SBAR reports, levels of nurse's communication clarity and nurse-physician collaborative relationships were significantly higher than levels before SBAR reports. Conclusion: SBAR reports improved the communication clarity and nurse-physician collaborative relationships. It is recommended to use a lot of SBAR in clinical practice.

• Health Policy and Management
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• v.17 no.2
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• pp.18-32
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• 2007

The purpose of this study was a quantitative analysis for the influence of physician's assistants on national health insurance revenue and number of patients in clinic. The data was derived from the Korean national health insurance. That was complete enumeration. Dependent variables were measured by national health insurance revenue and number of patients. Independent variables were reported physician's assistants that the number of nurse, nurse-aid, technologist of clinical laboratory, physical therapist and radiologist in clinic. Confounding variables were classified by demand(region, number of inhabitants, number of clinics, number of bed per a hundred thousand persons) and supply(sex and age of representative, number of bed, subjective of medical treatment). On the multiple regression analyses, the physician's assistants that nurse, nurse-aid, technologist of clinical laboratory and physical therapist were statistically significant for outputs. But radiologist was statistically significant only for number of patient.

• Korean Medical Education Review
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• v.14 no.1
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• pp.1-6
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• 2012

The idea that medicine itself imposes certain obligations upon the physician probably originated in Greece. It is Socrates in the fifth century BC who first discussed medical professionalism. Socrates said that no physician should seek the advantage of the physician but of the patient. For the physician was a ruler of bodies and not a money-maker. However, it is Hippocrates, the contemporary of Socrates and the Father of Medicine, who founded medical professionalism education and professional medical ethics. The professional spirit of Greek physicians is summed up in the magic phrase 'love of humanity.' In Epidemics I, Hippocrates expressed hope that physicians would help patients, or at least do them no harm. He also said, "Life is short; Art is long" in The Aphorisms. Here he described the reflective philosopher and the practiced physician. At once he sang the shortness of human life and the extent of the medical arts. Moreover, he made students swear by the gods that "I will keep pure and holy both my life and my art." The Oath can serve as a coherent starting point and organizing framework for medical professionalism education and professional medical ethics. We need to have an opportunity to employ this fascinating text in teaching medical professionalism and medical ethics. In this article, the author asserts that the Hippocratic Aphorism (Life is short; Art is long) and The Oath, the most famous work of the entire Hippocratic collection, should be used for medical professionalism education.