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JKM > Volume 44(2); 2023 > Article
Kim, Chun, Lee, and Leem: The Role and Policy of Korean Medicine Doctor for the Prevention and Management of Infectious Diseases: A Mixed-Methods Approach
Original Article

The Journal of Korean Medicine 2023; 44(2): 45-59.

DOI: https://doi.org/10.13048/jkm.23016

The Role and Policy of Korean Medicine Doctor for the Prevention and Management of Infectious Diseases: A Mixed-Methods Approach

Juchul Kim1, Heasun Chun2, HeeJung Lee3, Jungtae Leem4, 5, *

1Research Institute of Korean Medicine Policy, The Association of Korean Medicine, Seoul, Korea

2Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Gachon University, Seongnam, Korea

3National Agency for Korean innovatice Technologies Development Center for evidence-based practice guidelines of Korean Medicine, Seoul, Korea

4Hanbang Cardio-Renal Syndrome Research Center, School of Korean Medicine, Wonkwang University

5Research Center of Traditional Korean Medicine, College of Korean Medicine, Wonkwang University

Correspondence to: Jungtae Leem, College of Korean Medicine, Wonkwang University, #460 Iksan-daero, Iksan 54538, Republic of Korea, Tel: +82-63-850-6914, E-mail: julcho@naver.com

Received March 13, 2023       Revised April 19, 2023       Accepted May 12, 2023

Abstract

Objectives

This study investigated the role of Korean medicine doctors in the national quarantine system and the status of their duties through questionnaire surveys and in-depth interviews with Korean medicine staff who participated in COVID-19 work.

Methods

We developed a questionnaire survey to investigate the status and perception of Korean medicine doctors’ participation in responding to infectious diseases, and the results were derived by conducting frequency analysis and T-test using SPSS program. The measurement variables of this study were the status of COVID-19 related work participation and perception of Korean medicine doctors’ role in infectious diseases, and the maximum significance level was 0.05.

Results

There were 300 respondents to the survey, and as for the COVID-19 related work, Korean medicine treatment for COVID-19 patients accounted for the most(52.7%), and various preventive and treatment tasks such as epidemiological investigations and specimen collection were conducted.

Conclusion

According to this study, it was confirmed that there are sufficient legal and administrative grounds for Korean medicine doctors to perform specimen collection and epidemiological investigations. Therefore, it is necessary to prepare a policy framework to solidify the status of Korean medicine doctors in national infectious diseases in the future.

Keywords: COVID-19, Infectious Disease, Specimen Collection, Epidemiological Investigation, Korean Medicine

Table 1
Investigation Content
Category
General characteristics
 Sex, Affiliation, Age, Region, Clinical experience
Status of COVID-19 related work participation
 Type of participation, Work of participation, Period of participation, Work satisfaction, Difficulties with work
Strengthening the role of Korean medicine doctors in emerging infectious diseases
 Expertise in the role of Korean medicine doctors(Specimen collection, Prevention, Korean medicine treatment, Management of sequela), Awareness of non-face-to-face Korean medicine treatment, Top priority areas for expanding the role of Korean medicine doctors in the event of emerging infectious diseases in the future, Issues that need to be resolved urgently to strengthen the role of Korean medicine doctors in infectious diseases, What Korean medicine community should prepare to respond to the outbreak of emerging infectious diseases in the future
Table 2
Summary of Interviewee
Affiliation Gender Age Group Performed work
A Public health center·Public health center branch Male 30 Korean Medicine Treatment
B Male 20 Specimen Collection
C Male 20 Epidemiological Investigation
D Male 30 Korean Medicine Treatment
E COVID-19 Korean Medicine Treatment Reception Center Male 50 Korean Medicine Treatment
F Female 30 Korean Medicine Treatment
G Medical Institutions Designated as Infectious Disease Hospital Female 30 Korean Medicine Treatment
Table 3
Demographic Characteristics (N=300)
Classification N(%) Total
Korean Medicine doctor of Public Health Korean Medicine doctor of COVID-19 Korean Medicine treatment reception center
Gender Male 140(78.7) 126(78.7) 266(88.3)
Female 0(0.0) 34(21.3) 34(11.7)
Age Group 20–29 74(52.9) 8(5.0) 82(27.3)
30–39 66(47.1) 26(16.3) 92(30.7)
40–49 0(0.0) 62(38.7) 62(20.7)
50–59 0(0.0) 55(34.4) 55(18.3)
More than 60 0(0.0) 9(5.6) 9(3.0)
Affiliation Korean medicine clinic 0(0.0) 158(98.8) 158(52.7)
Korean medicine hospital 0(0.0) 2(1.2) 2(0.7)
Nursing hospital 9(6.4) 0(0.0) 9(3.0)
Public health center·Public health center branch 131(93.6) 0(0.0) 131(43.7)
Clinical training General practitioner 120(85.7) 129(80.6) 249(83.0)
Specialist 20(14.3) 31(19.4) 51(17.0)
 Korean internal medicine 7(5.0) 8(5.0) 15(5.0)
 Korean acupuncture & moxibustion medicine 4(2.9) 4(2.5) 8(2.7)
 Korean medicine rehabilitation 8(5.7) 2(1.3) 10(3.3)
 Korean medicine obstetrics and gynecology 0(0.0) 4(2.5) 4(1.3)
 Korean medicine neuropsychiatry 0(0.0) 2(1.3) 2(0.7)
 Sasang constitutional medicine 0(0.0) 1(0.6) 1(0.3)
 Korean medicine ophthalmology, otolaryngology & dermatology 0(0.0) 4(2.5) 4(1.3)
 Pediatrics of Korean medicine 1(0.7) 6(3.8) 7(2.3)
Region Seoul 4(2.9) 45(28.1) 49(16.3)
Gyeonggi·Incheon 38(27.1) 47(29.4) 85(28.3)
Daejeon·Chungcheong·Sejong 27(19.3) 11(6.9) 38(12.7)
Gangwon 1(0.7) 6(3.8) 7(2.3)
Busan·Ulsan·Gyeongnam 32(22.9) 20(12.5) 52(17.3)
Daegu·Gyeongbuk 12(8.6) 18(11.3) 30(10.0)
Gwangju·Jeolla 26(18.6) 12(7.5) 38(12.7)
Jeju 0(0.0) 1(0.6) 1(0.3)
Table 4
Participation Work Related to COVID-19 (N=300, Multiple Response)
Classification N(%) Total
Korean Medicine doctor of Public Health Korean Medicine doctor of COVID-19 Korean Medicine treatment reception center
Performed work Type 140(46.7) 160(53.3) 300(100.0)
Specimen collection 55(39.3) 5(3.1) 60(14.2)
Epidemiological investigation 65(46.4) 1(0.6) 66(15.6)
Prevention 11(7.9) 147(91.9) 158(37.4)
Korean medicine treatment 16(11.4) 115(71.9) 131(31.0)
Management of sequela 6(4.3) 2(1.3) 8(1.9)
Period Less Than 3 Months 33(23.6) 76(47.5) 109(36.3)
3 Months −1 years 68(48.5) 70(43.7) 138(46.0)
1 years −2 years 32(22.9) 11(6.9) 43(13.3)
2 years −3 years 7(5.0) 3(1.9) 10(3.3)
Table 5
COVID-19 Related Performed Work Diagnosis and Difficulties (N=300, Multiple Response)
Classification N(%) Total
Korean Medicine doctor of Public Health Korean Medicine doctor of COVID-19 Korean Medicine treatment reception center
Areas of work performed best Specimen collection 48(34.3) 4(2.5) 52(17.3)
Epidemiological investigation 72(51.4) 6(3.8) 78(26.0)
Prevention 15(10.7) 9(5.6) 24(8.0)
Korean medicine treatment 53(37.1) 139(86.9) 191(63.7)
Management of sequela 65(45.7) 130(81.6) 194(64.7)
Areas of work that need supplementation Specimen collection 58(41.4) 106(66.3) 164(54.7)
Epidemiological investigation 26(18.6) 44(27.5) 70(23.3)
Prevention 32(22.9) 57(35.6) 89(29.7)
Korean medicine treatment 0(0.0) 0(0.0) 0(0.0)
Management of sequela 48(34.3) 25(15.6) 73(24.3)
Difficulties Lack of academic basis, such as the effectiveness of Korean medicine 14(10.0) 5(3.2) 19(6.3)
Disparagement of Korean medicine due to occupational conflict 50(35.7) 50(31.3) 100(33.3)
Passive cooperation from the government or related organizations 75(53.6) 83(51.9) 158(52.7)
Low public awareness of Korean medicine treatment in COVID-19 41(29.3) 62(38.8) 103(34.3)
Exclusion of medical fees for Korean medicine treatment in COVID-19 (examination, vaccination, treatment, etc.) 52(37.1) 100(62.5) 152(50.7)
Lack of COVID-19 related manuals and educational materials 26(18.6) 8(5.0) 34(11.3)
Lack of internal capabilities of the Korean medicine community related to COVID-19 quarantine 20(14.3) 10(6.3) 30(10.0)
Table 6
Satisfaction with Work Related to COVID-19(N=300)
Variables Korean Medicine Doctor of Public Health Korean Medicine doctor of COVID-19 Korean Medicine treatment reception center t-value (p)
Mean+SD Mean+SD
Performed work 3.21±0.84 3.79±0.67 −5.525
<0.001
Working conditions (Work intensity and environment) 2.96±0.94 3.30±0.72 −2.779
<0.001
Reactions of suspected, confirmed or patient with COVID-19 3.14±0.92 4.36±0.47 −12.138
<0.001

* Statistically significant with p<.05, Result of paired t-test

Table 7
Tasks to Strengthen the Role of Korean Medicine Doctor in Emerging Infectious Diseases (N=300, Multiple Response)
Classification N(%)
Korean Medicine doctor of Public Health Korean Medicine doctor of COVID-19 Korean Medicine treatment reception center Total
What needs to be resolved urgently to strengthen the role of Korean medicine doctor in emerging infectious diseases. Institutional improvement to guarantee participation of Korean medicine doctor 99(70.7) 115(71.9) 214(71.3)
Application of health insurance fees about performance of the role 74(52.9) 101(63.1) 175(58.3)
Development of Korean medicine technology for performing the role 19(13.6) 9(5.6) 28(9.3)
Education and production of Korean medicine experts to perform the role 29(20.7) 15(9.4) 44(14.7)
Including Korean medicine doctor in major decision-making systems such as Response Advisory Committee on Infectious Disease Crisis 41(29.3) 52(32.5) 93(31.0)
Establishment of Korean medicine department in the Korea Disease Control and Prevention Agency 17(12.1) 28(17.5) 45(15.0)
Areas that should be expanded as a top priority in the role of Korean medicine doctor in the event of emerging infectious disease in the future Diagnostic test using RAT and PCR 54(38.6) 70(43.8) 124(41.3)
Epidemiological investigations such as quarantine of confirmed patients and management of contacts 4(2.9) 2(1.2) 6(2.0)
The use of preventive medical aspects of herbal medicine such as improving immunity 9(6.4) 14(8.7) 23(7.7)
Medical response such as herbal medicine prescription 44(31.4) 63(39.4) 107(35.7)
Management of sequela 29(20.7) 11(6.9) 40(13.3)
What Korean medicine community should prepare to respond to emerging infectious diseases in the future Strengthening capabilities through education on prevention and management of infectious diseases 39(27.9) 50(31.2) 89(29.7)
Promotion of infectious disease-related Korean medicine R&D, Preparation of grounds such as thesis publication 74(52.9) 62(38.8) 136(45.3)
Establishment of public-private partnership system for legal and institutional guarantees for participation of Korean medicine doctor 97(69.3) 117(73.1) 214(71.3)
Active promotion of the role of Korean medicine doctor in infectious diseases 46(62.8) 67(41.9) 113(37.7)
Establishment of a rapid response system and standard manual for disaster crisis management of infectious diseases 24(17.1) 24(15.0) 48(16.0)
Table 8
In-Depth Interview with Korean Medicine Staff on COVID-19
Theme Category In-vivo coding
Work experience in quarantine and medical care 방역과 의료에서의 업무 경험 Specimen collection 검체채취 수행 “확진자가 폭발했던 2020년 2월 인천지역의 선별진료소에 파견되어 검체채취 업무를 간호사, 치과의사와 동일하게 수행하였습니다.”
“한의과 공보의들은 주로 코로나19 확진자 폭증 지역 중심으로 역학조사와 검체채취 업무에 참여하였습니다.”
Activities as an epidemiologist 역학조사관 활동 “제가 근무했던 지역의 역학조사관으로 투입되어 개별 확진자, 확진자와 접촉자 경로파악 및 동선관리 등 감염 위험요소 격리 업무 전담하였습니다.” “2020년 12월부터 2021년 4월까지 경기도 코로나 확진자 수 증가로 인하여 경기도 보건지소에서 역학조사관으로 투입되어 업무를 수행하였으며, 2023년 1월부터는 방역상황이 변경되면서 감염취약시설 위주로 역학조사를 진행하였습니다.”
Non-face-to-face Korean medicine treatment project at public health centers 보건소에서의 비대면 한의약 진료사업 “대한한의사협회 코로나19 한의진료접수센터의 진료지침과 운영가이드를 참고하여 보건소에 코로나19 환자에 대한 한의진료 사업을 직접 제안하였으며, 3개월간 운영하였습니다.”
“보건소에서 코로나19 감염증상 및 후유증상 비대면 한의약 진료사업을 통해 코로나 환자 100명에게 한약을 처방하였고 사업 종료 후 환자들에게 설문조사 결과, 참가자 중 과반인 56명(65.1%)이 건강 회복에 ‘매우 도움이 됐다’, 21명(24.4%)이 ‘도움이 됐다’고 응답해 전반적으로 큰 도움을 받은 것으로 나타났으며, 또한 한의약 진료사업에 만족한 환자는 84명(97.6%)이었습니다.” “2022년 5월 11일부터 9월 14일까지 코로나19 재택치료자 624명을 대상으로 보건소에서 비대면 한의진료(탕약과 보험급여 한약제제)를 실시하였습니다.”
Korean medicine treatment and management of sequela at Korean medicine clinic 한의원에서의 한의치료 및 후유증 관리 및 후유증 관리 “양약을 먹고 있던 환자들을 대상으로 한의진료 시행 시 발열, 오한, 인후통 등에서 호전 되어 진료에 만족한 환자들이 대부분이었으며, 한의원에서 자체적으로 시행한 설문조사에서 25명 중 24명이 앞으로도 다른 질병에서도 한의진료를 받고 싶다고 하였습니다.”
“의과에서 코로나19 경증환자에게 제공되었던 타이레놀, 아세트아미노펜 등의 해열제와 동등한 치료 효과를 내는 연교패독산, 형개연교산 등을 한의원에 방문한코로나 19 경증·무증상· 후유증 환자군에 처방하였고 환자들의 만족도가 높았습니다.”
ifficulties experienced as a Korean medicine staff 한의의료진으로 겪은 어려움 Organizational opposition of the Korean Medical Association 대한의사협회의 조직적 반대 “대한의사협회에서 한의사 검체채취가 불법이라는 항의 공문을 각 지역 보건소로 발송하여 한의과 공보의는 배제되는 경우가 많았습니다.”
“생활치료센터 백신접종 업무에는 의과 공보의만 투입되는 경우가 많았는데 이는 대한의사협회의 반대로 한의과 공보의는 주로 역학조사나 검체채취 보조적인 행정업무를 수행하게 되었습니다.”
“초기 코로나19 검사 오더 입력 및 검체채취 업무(의사직 공통 업무로 의사, 한의사, 치과의사 해당)를 수행하였으나 약 한달 뒤에, 한의사가 충분히 수행할 수 있는 업무임에도 불구하고 대한의사협회의 반대로 업무에서 배제되었습니다.”
Restricting Korean medicine doctor on RAT RAT에 한의사 제한 “의료는 기본적으로 진단과 치료를 포함하는 것으로 일반 국민들도 스스로 할 수 있는 자가진단키트와 비슷한 코로나 전문가용 신속항원검사(RAT)에 한의사는 제한되었습니다. 또 현장에서는 인력난으로 유전자증폭(PCR)검사를 간호사, 요양보호사, 공무원 등이 수행하는데 의료인인 한의사는 할 수가 없었습니다.”
“역학조사, 검체채취 등에 한의과 공보의를 제외하고 치과공보의만 투입하는 경우가 많았으며, 한의과 공보의는 코로나19 관련 업무에 배제하는 경우가 대다수였습니다.”
“한의사는 법적으로 감염병 대처에 참여할 책임과 의무가 있고 코로나19에 대처할 역량과 능력이 충분함에도 검체채취, 역학조사에 한의사는 배제되었습니다.”
Cancellation of the dispatch of Korean medicine public health doctor 한의과 공보의 파견 취소 “국립중앙의료원에 코로나19 신규 병상 의료인 배치에 대해 한의과 공보의 파견이 결정되었으나 대한의사협회 반발로 의과 공보의만 투입되었다는 결정을 통보받았습니다.”
“코로나 초기 대구지역에 파견을 지원하였으나 대한의사협회의 반대로 무산되었습니다.”
Failure of collaborative Treatment 협진진료 무산 “코로나19 초기에 검체채취 업무를 수행하였으나 이후 의과의 반발로 업무에서 제외되었고 코로나19 입원환자에 대한 협진진료도 시행되지 않았습니다.”
“감염병전문병원 지정 의료기관임에도 불구하고 협진진료는 할 수 없었습니다.”
Proposal to strengthen national response to infectious diseases 국가 감염병 대응 강화를 위한 제안 Ensuring the patient's choice of treatment 환자의 진료 선택권 보장 “국민들에게 한의치료 효과에 대한 홍보를 통해 신종감염병 발생 시 한의진료가 가능하다는 인식을 심어줄 수 있어야 하며, 환자의 진료 선택권을 보장해야 합니다.”
“감염병 확산 저지를 위해 한의사, 의사 모두 진단과 치료에 참여시켜 환자의 진료 선택권을 확대해야 합니다.”
Quick initial response 신속한 초기대응 “감염병은 전파력이 높아 신속성이 최우선으로 유증상자를 빨리 한의원에서도 진단하고 신고할 수 있도록 해야 하며, 격리 혹은 치료 등을 신속하게 결정해야 국가적으로도 감염병 전파를 차단하는데 도움이 된다는 사실을 간과하면 안 됩니다.”
“코로나19처럼 전파력이 높은 감염병 위기 앞에서는 한의와 양의를 결코 차별해선 안 되며, 초기에 가용 가능한 모든 자원을 총동원해야만 합니다.”
Support for Korean medicine staff and compensation for medical fee 한의의료진 지원 및 수가 보상 “한의의료진의 8 들코로나 환자 치료에 대한 수가지급 등에 대해 능동적 관심 필요하며 감염병 치료에 있어 초기단계부터 후유증 관리까지 협진이 이루어질 수 있어야 합니다.”
“코로나19 재택치료자들에 대한 한의치료의 본인부담금 지원 및 한의과 별도 수가 신설이 필요합니다.”
“코로나19 경증·재택치료· 백신 후유증 환자에 대한 한의진료 제도화를 통해 수가보상체계가 마련되어야 합니다.”
Participation in government consultative organization 정부협의체 참여 “한의 감염병 전문가를 육성하여 국가 주도의 감염병 전문가회의(예, 국가 감염병 위기대응 자문위원회)등에 참여할 수 있도록 해야 합니다.”
“보건복지부, 질병관리청 등 보건의료 관련 중앙행정기관에 감염병 관련 협의체에 한의사 참여를 요청해야 합니다”

참고문헌

1. Kate EJ, Patel NG, Levy MA, Storeygard A, Deborah Balk, Gittleman JL, Daszak P. 2008; Global trends in emerging infectious diseases. Nature. 451:21. 990–993. https://doi.org/10.1038/nature06536


2. Kim JK, Han DH. 2020; COVID-19 and Smell Loss. Korean Journal of Otorhinolaryngology-Head and Neck Surgery. 63:11. 491–6. https://doi.org/10.3342/kjorl-hns.2020.01039


3. CoronaBoard. [cited 2023 May 2] Available from: URL: https://coronaboard.com/global/ko/


4. Welfare, M. o. H. a. 2009. A Study on Response Analysis of Covid-19 in 2020. Ministry of Health and Welfare.


5. The Association of Korean Medicine. The government announced that it would discuss treatment with the Korean medicine community, welcomed the oriental medicine community, and presented three proposals, including the establishment of a support system for oriental medicine treatment. [cited 2020 April 14] Available from: URL: https://https://comm.akom.org/bbs/board.php?bo_table=akom_notice&wr_id=694&page=38


6. Among epidemiological investigators in Gyeonggi-do, many of the Korean Medicine doctors. [cited 2023 February 22] Available from: URL: http://www.mjmedi.com/news/articleView.html?idxno=51193


7. Voluntary medical support despite the exclusion of corona quarantine in the Korean Medicine doctors bulletin. [cited 2023 February 22] Available from: URL: https://www.medipana.com/article/view.php?page=1&sch_menu=1&sch_gubun=261093&news_idx=266374


8. K-MEDICINE 2020 International Online Conference. [cited 2022 December 17] Available from: URL: https://www.youtube.com/watch?v=H1dvOs10G4c


9. Wolcott HF. 1991; Making A Study “More Ethnographic”. Journal of Contemporary Ethnography. 19:1. 44–72. https://doi.org/10.1177/089124190019001003


10. Ministry of Health and Welfare. ‘impossible → possible’ to collect samples from Korean Medicine doctors. [cited 2020 November 13] Available from: URL: https://www.dailymedi.com/news/news_view.php?wr_id=862730


11. Why were Korean Medicine and public health doctors excluded from responding to COVID-19? [cited 2022 April 24] Available from: URL: http://www.ohmynews.com/NWS_Web/View/at_pg.aspx?CNTN_CD=A0002827961


12. Kang BS, Lee JT, Chu HM, Youn BY. 2022; Prevention and management of adverse events following COVID-19 vaccination using traditional Korean medicine: An online survey of public health doctors. World Journal of C Clinical Cases. 10:28. 10053–10065. https://doi.org/10.12998/wjcc.v10.i28.10053
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13. Jeon CH, Leem JT, Chi GY, Choi GM, Kim HJ. 2022; Effect of Non-contact Korean Medical Treatment for Patients Recovering at Home with Positive Coronavirus Disease 2019 Diagnostic Test Results at a Local Public Health Center. Journal of Physiology & Pathology in Korean Medicine. 36:4. 130–137. https://doi.org/10.15188/kjopp.2022.08.36.4.130


14. Infectious disease cycles are getting shorter. [cited 2020 April 13] Available from: URL: https://www.hidoc.co.kr/healthstory/news/C0000686961


15. The new infectious disease outbreak cycle will be shortened to less than three years. [cited 2020 May 19] Available from: URL: https://www.hani.co.kr/arti/society/environment/945497.html


16. Choi WS. 2020; Understanding the Complementary Relation between Duty Ethicsand Virtue Ethics for Medical Practitioners. The Korea Journal of Medical Ethics. 23:1. 39–56. https://doi.org/10.35301/ksme.2020.23.1.39
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