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글로벌 핫 플레이스 강남의 성형외과의사 이야기입니다.
실제 사례를 바탕으로 재구성하였습니다.
원래 제목은 ‘(허상 속의) 의대가 죽어야 나라가 산다’입니다
의대는 미래에도 유망합니다.
그러나 허상을 보고 이뤄지는 진학은
사회병리 현상으로 느꼈습니다.
드라마 속 이상적 의사보다는
현실을 고민하는 의사를 보여주고 싶었습니다.
기름기 걷어낸 핵심만 남은
전문직 자영업 경영을 공유하고 싶었습니다.
미용성형의 밝은 면과 어두운 면이
동시에 공감되어야 하는 시기라고 생각했습니다.

미래플랫폼 윤인모 교수의 신간, 〈의대가 죽어야 나라가 산다〉를 출간

미래플랫폼 출판사는 2월 15일 윤인모 교수(서울성모병원 예방의학교실 외래교수)의 신간, 〈의대가 죽어야 나라가 산다〉를 출간했다.
〈의대가 죽어야 나라가 산다〉는 저자가 경험한 병원의 실제 에피소드와 경영에 직접 참여해 온 저자의 노하우와 철학이 담겨있는 에세이다.
이번 신간은 총 6장으로 구성되어 있다. 마지막장은 한국의료의 미래에 대한 실효성 있는 대안을 제시한다.

마지막 6장의 내용을 잠시 보자면 “ 한국의 의료제도가 출범한 이래로 50년간 변화가 없다.
그러나 현재 제안되는 법안을 관찰해 보면 이러한 변화의 온도가 감지된다.
거의 50년 만에 공급 모델이 바뀌는 경험은 지금까지와는 다른 수준의 갈등과 고통이 수반될 것이다.
아마도 혁신의 가장 큰 장애물은 현재의 제도만이 의료제도라고 익숙해져 있는 사람들일 것이다.
고통도 가장 클 것이다.”라고 저자는 현직 의사가 이야기하는 현재 의료제도의 현실을 과감하게 공개하였다.

이 변화와 고통은 몇 년 후를 위해 의대 입시를 준비하는 학생들에게 돌아갈 확률이 가장 크다.
그렇기 때문에 저자는 허상 속의 의대는 죽어야 한다라는 의미로 책의 제목을 지었다고 한다.
의대생들에게도 본인이 왜 의사가 되고 싶은지 신념과 목적이 명확해야 하지 않을까? 하는 물음표를 함께 던진다.
필수의료의 붕괴를 막기 위해 저자는 ‘사관학교형 의대'라는 모델을 이 책에서 정교하게 보여준다.

제1장 사회-성형외과 진료실의 고민
이런 사회문제로 병원만 어려울까. ··········································1
차라리 내 딸을 고소해 주세요. ·····················································3
부모들의 속앓이 ···················································································3
병원 속여 수술받기 ···············································································4
가정불화 원인 - 중고생 성형 ·································································6
중성반 결성 (중고생 성형 반대모임) ······················································7
성형외과의사가 미성년자 성형을 반대하는 이유 ···································7
해드려요, 말려드려요 ··········································································8
30만 유튜버의 애완용 블로그는 성형외과 갈취용 ························12
갑작스러운 예약 취소 증가 ··································································12
대화를 피하려는 고객 ·········································································17
비로소 밝혀지는 본캐 ·········································································20
이중생활이 들통난 후기 남 ··································································22
학교폭력과 닮은 인터넷 폭력 증가 회로 ·······································25
저 장애인 됐어요 ················································································25
인터넷 폭력 - 플랫폼은 공범죄, 방통위는 방조죄 ································28
외면당하는 성형외과 ···········································································29
학교폭력과 닮은꼴 - 외면속에 증가하는 인터넷 폭력 ···························31
법적 공방 2라운드 ··············································································32
악성 비방자가 원하는 것 - 소기업, 자영업자 매출을 줄여 벌주기 ·········33
검경(檢警)이 방관하는 근본적 이유 ·····················································34
자영업, 소상공인을 위한 제안 ·····························································35

제2장 고객-아! 눈높이 맞추기 어렵네.
오늘도 고객님께 적응 중 ······················································37
만족시킬 고객은 수술받을 사람뿐이 아니다. ································39
쌍꺼풀 1천만 원입니다. .............. 한쪽 눈에… ··························43
묘수 세 번 바둑 필패-정수의 중요성 ···················································43
편견을 깨야 존중이 생긴다 - 코끝보다 높은 모성애 ·····················47
의학은 인문학 - 수술은 진료의 일부일 뿐 ···································50
성형 - 외모의 개선 아니 그 이상의 가치 ······································53
잘 된 성형, 두배된 행복 ······································································53
자신감은 인생의 비타민 ······································································54

제3장 철학-우리 병원 존재 이유
경영은 존재 이유의 실행 ······················································57
미션은 북극성이다. ·····································································59
미션과 비전 ························································································59
why 미션 ···························································································59
미션의 설정 ························································································60
고객보다 고객의 얼굴을 더 잘 아는 병원 ······································62
고객의 얼굴에 대해 미학적 분석이 안되는 경우 ···································62
고객은 자기 얼굴을 잘 알고 있을까 ·····················································62
올바른 상담의 결과 ·············································································63
미션 수행에는 학습이 필요하다 ···························································64
병원의 온도를 변화시켜라
- 차가운 수술 동의서 vs 따뜻한 사후관리 안내문 ·····················66
수술 동의서 - 온도는 영하권 ·······························································66
좋은 담장이 좋은 이웃을 만든다. ························································68
수술 전에는 병원 편 수술 후에는 고객 편 ·····································70
수술 후에는 고객편 ·············································································70
심판말고 소통하라. 관리말고 소통하라. ·············································72
환자 개인의 시그니처 메뉴 - 덧셈보다는 뺄셈으로 찾아라. ··········74
성형외과 산수의 핵심 : 뺄셈 ·······························································74
성형외과 파레토의 법칙 ······································································76

제4장 성형외과-성형외과 사용법
의학(기술, 지식, 자세)과 미학으로 진료한다 ·························77
이벤트 성형 - 호갱 낚시 ······························································79
성형외과 의사 면접을 보자 - Beyond 호갱- ······························82
성형외과의사의 수술 권유기준 - 화룡점정(？龍點睛)을 찾아라 ···85

제5장 직원-고객 그 이상
: 경영학을 현장이라는 압축기에 넣었다.
기름기 빠지고 중요한 것만 남았다 ········································91
경영학 박사 자영업 하다 망하다. ·················································93
가수분해! 책 만으로는 안되더라. ························································93
가수분해가 잘 되면 ·············································································94
CEO의 E-새로운 개념: Entertainment ···································96
직장인의 업무 몰입도 ·········································································96
사장과 직원은 무엇을 교환하는가. ······················································97
유효기간이 지나가는 동기부여 ····························································98
사람을 발전시키는 Key point -흥(興)- ··············································99
신규직원 정착의 핵심- 직장내 착륙할 곳을 마련해 주자. ···········101
100세 시대 누구나 터득해야 하는 삶의 방법은? ························107
시드 머니만큼 시드 피플이 중요하다 ·········································111
정성 들여 교육했는데 사직 - 표정 관리 불능 순간 ·····················113
표정 관리가 안 되는 순간 ··································································113
그래도 다시 교육 ··············································································116
칭찬-질보다 양이다 ··································································117
인간이 저절로 터득하는 천부적인 능력 - 단점 잡아내기 ····················117
침묵은 Gold가 아니고 Cold(싸늘함) ·················································118
직원 빼가서 차린 가게가 오래 못 가는 이유 ·······························120
애벌레 둘이 만난 경우가 최악이다 ····················································120
화성에서 온 사장, 금성에서 온 직원 ··················································121
조직운영 기본 - 자극이 되면 선순환 안심이 되면 악순환 ··········124

제6장 미래-의대가 죽어야 나라가 산다
의대 개혁이 미래 한국의료 개혁 ·········································127
의사들의 걱정 - 한국은 의료계의 베네수엘라가 되는가? ············129
도입글 ······························································································129
의사들의 대화-우리가 아프면 누가 치료해주지? ·······························130
한국의 의료 서비스 공급 모델 ··················································135
한국의료의 모든 부작용의 원인
- 한국의료의 서비스 공급 모델
〈 (저가)보험진료+ (고가)비급여 진료 형태 〉 ························139
의료비 증가율 세계 최고 ···································································139
필수의료 붕괴는 예정된 수순 ····························································140
4차산업 의료도입 후진국 ··································································141
진정한 공공의료는 없다. ···································································142
무늬만 의료전달체계 ········································································142
한국은 대부분 전문의 - 민간의사 100% 국가의 부작용 ····················143
한국 의사 - 부자? (주요국 의사보다 평균 2배 더 벌고)
vs 삶의 질 최저?(5배 일하는 것) ···················································143
주요국과 다르게 한국 의사는 형사재판의 대상이 되고
이에 부작용이 심하게 나타난다. ····················································145
늘어나는 사교육비 낮아지는 출산율 ··················································146
현실을 알게 된 의사의 화학적 변화가 시작되고 있다. ·······················146
한국! 공급 모델의 문제인가 아니면 운영의 실패인가. ················149
한국과 유럽의 명확한 차이 ·······························································149
초기부터 두 가지 축 (민간과 공공)을 분리시켜 제도화한 유럽 ···········149
다른 주요국의 개혁 방향도 두 축으로 분리중 ····································151
한국 의료의 문제점 ···········································································152
개혁의 시기는 이미 늦었다. - 끓는 물속에 개구리 한국의료 ·······153
정책을 위한 정책 - 공공의대 ·····························································153
의과학자 양성을 위한 의대도 예외는 아니다. ····································154
의대 증원 - 수십 년간 논쟁만 지속 중 ···············································155
끓는 물속의 개구리 한국의료 ····························································156
우리에게는 사관학교형 의대가 필요하다. ··································158
필요한 전제조건 ···············································································159
사관학교형 의대를 둘러싼 이해 관계자 ·············································161

제언 ·································································································163

에필로그 ·············································································165

게임에 빠진 남학생과 다르게 여학생은 아이돌에 빠지거나 외모에 집착
하는 경우가 많다. 그러나 아쉽게도 게임중독과 달리 사회에서 심각하게 다
루지 않는다. 하지만 수면 아래에서 앓고 있는 꽤 심각한 사회문제이다. 이
미 중고등학교 방학기간은 새로운 유명 성형외과가 탄생하는 각축장이 되
어 버린 지 오래이다.

학생은 어머니 주민등록증과 신용카드를 훔쳤다. 전화 확인을 대비해
가짜 부모 역할 대역도 준비했다. 부모 대역에게 선불폰을 만들어 주고 어
머니 주민번호 등 개인 인적 사항을 미리 알려주었다. 그렇게 우리는 학생
고객의 치밀한 거짓말에 속았다.
자녀가 수술 사실을 알게 된 부모는 우리를 고소하겠다고 변호사를 통
해 연락해 왔다. 그러나 부모 측의 협박도 별로 화가 나지 않았다. 부모가
이해가 되었기 때문이다. 얼마뒤 우린 흥분이 진정된 후 학생 어머니와 만
나서 차근히 지난 일을 설명하였다. 녹음한 것도 들려주었다. 이를 확인한
어머니도 놀란 것은 예상했던 일이다.

병원 속여 수술받기 중에서


개인이 SNS를 통해 수많은 콘텐츠를 만들고 개인을 브랜딩 하며 대중의
공감을 얻어내고 이것이 크게 성공하면 하나의 1인 미디어가 되어 그 영향
력과 파급력은 커져 흔히 말하는 파워 인플루언서가 된다. 그리고 곧 권력
이 되었다. 하지만 대중에 큰 영향을 주는 만큼 그 권력을 남용하는 것에 대
한 사회가 제도적, 문화적으로 준비가 아직은 덜 되어 있는 듯하다. 누구나
접근 가능한 개인 미디어 권력은 어지간한 기업 하나 무너뜨리기에 충분한
상황이다. 그러나 검증받지 않는 권력의 잘못된 사용에 대해서도 규모가 작
은 소기업은 홀로 대응해야 하는 가혹한 시대가 왔다. 이 시기에 상대적으
로 사각지대에 놓인 소기업 보호를 위해서 대책이 필요하다.

제1장 사회-성형외과 진료실 고민 중에서


1900년 전후에는 산업혁명의 시기였다. 이에 유럽의 국가는 의료복지
재원을 마련할 수 있었다. 심지어는 독일의 비스마르크는 노동조합에 정부
도 돈을 지원하겠다고 하였으나 노동조합이 이를 거절할 정도였다. 이들 국

가는 1910­30년 사이에 GDP의 3­5% 가 복지 재정으로 투입이 가능했다.
(오늘날은 약 20% 정도가 되어야 선진복지국가라고 한다.)
이러한 재원을 가지고 두 가지 시스템을 견고하게 만들어 간다. 하나는
공공의료비중이 70% 전후인 시스템을 만든다. 다른 하나는 앞에서 이야기
한 공공의료를 보완해 줄 민간 의료 시스템을 만든다.
유사시에는 공공의료의 니드가 증가한다. 이를 대비해 예비 2중대가 필
요한데 이를 항상 유지하려면 비용이 많이 소요된다. 이에 평소에는 “ 의료
의 수요를 일부 제공하고 돈을 벌어가서 하드웨어와 소프트웨어를 유지하
고 있어 다만 급하면 정부가 빌려다 쓸 수 있게 해줘.” 이것이 바로 민간 의
료시스템을 유지하는 이유이다. 민간 의료 시스템은 평소에는 공공의료 범
위를 초과하는 서비스를 원하는 국민에게 제공하고 수익을 올린다. 그러나
공공의료의 필요성이 갑자기 증폭하는 재난사태 때에는 공공의료 역할을
같이 한다. 이 이상의 민간의료는 정부의 관심사가 아니다. 그러나 일정수
준 이상을 올리면 의료시스템이 영향을 받는다. 이에 각국의 상황에 따라서
이러한 숫자는 조절한다.
결국 공공과 민간 의료는 둘 다 국가에 필요한 존재이고, 모든 의사는
국가에 자산이었다. 따라서 의사 교육 시 학비도 지원하고 의료기관 설립도
지원한다. 공공과 민간 의료의 비율은 7: 3 정도인 것은 아마도 이 비율은 정
부가 복지를 유지하는데 가장 효율적 비율이 아닌가 생각이 된다. 민간이 더
늘어나지 않는 이유는 지면상 줄인다. 물론 불편하고, 비합리적인 부분도 있
다. 그러나 한국보다는 이 나라들의 제도가 지속가능성이 더 높아 보인다.
즉, 분리를 통해서 지속 가능한 의료를 운영하고 있다.

제6장 미래-의대가 죽어야 나라가 산다 의대 개혁이 미래 한국의료 개혁 중에서