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Report from the Committee for Improving the Work Environment of Japanese Surgeons: survey on effects of the fee revision for medical services provided by surgeons.

Hanazaki K, Tominaga R, Nio M, Iwanaka T, Okoshi K, Kaneko K, Nagano H, Nishida T, Nishida H, Hoshino K, Maehara T, Masuda M, Matsufuji H, Yanaga K, Tabayashi K, Satomi S, Kokudo N - Surg. Today (2013)

Bottom Line: The main potential causes for the shortage of surgeons in Japan were long hours (72.8 %), excessive emergency surgeries (69.4 %), and high risk of lawsuit (67.7 %).Mean weekly working hours of surgeons in national or public university hospitals and private university hospitals were 96.2 and 85.6, respectively.Approximately 70 % of surgeons were forced to do hardworking tasks, possibly leading to death from overwork.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku, Kochi, 783-8505, Japan, hanazaki@kochi-u.ac.jp.

ABSTRACT

Purpose: The aim of this study was to achieve improvements in the work environment of Japanese surgeons and shortage of surgeons.

Methods: Questionnaires were distributed to selected Japanese surgical Society (JSS) members. Retrospective analysis was conducted comparing the current 2011 survey with previous 2007 survey. To examine the influence of 2010 revision of the fee for medical services performed by surgeons, we distributed a second questionnaire to directors of hospitals and administrators of clerks belonging to official institutes in JSS. Collective data were analyzed retrospectively.

Results: The main potential causes for the shortage of surgeons in Japan were long hours (72.8 %), excessive emergency surgeries (69.4 %), and high risk of lawsuit (67.7 %). Mean weekly working hours of surgeons in national or public university hospitals and private university hospitals were 96.2 and 85.6, respectively. Approximately 70 % of surgeons were forced to do hardworking tasks, possibly leading to death from overwork. Of note, approximately 25 % of surgeons had over time of more than 100 h a week, coinciding to the number of hours that might lead to death from fatigue, described in the Japanese labor law. Although the total medical service fee in hospitals, especially in large-scale hospitals with more than 500 beds, increased markedly after 2010 revision of the fee for medical services performed by surgeons, few hospitals gave perquisites and/or incentives to surgeons.

Conclusion: To prevent and avoid collapse of the surgical specialty in Japan, an improvement in the work environment of surgeons by initiation of the JSS would be required as soon as possible.

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Related in: MedlinePlus

Potential causes of surgeon shortage
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Fig1: Potential causes of surgeon shortage

Mentions: Figure 1 shows potential causes of the shortage of surgeons. The main causes for the shortage were raised as follows: (1) long hours (72.8 %), (2) excessive emergency surgeries (69.4 %), (3) high risk of a lawsuit (67.7 %), (4) too many incidents, and (5) length of time needed to become a specialist surgeon (61.7 %). Nevertheless, most Japanese surgeons continue to work hard in the presence of this high risk of complaints and incidents, and in an underprivileged environment not compatible with the workload. Although these results were essentially similar with those of the previous 2007 results, apprehension of the risk of medical accidents decreased approximately 6 % from 69.1 to 63.2 %.Fig. 1


Report from the Committee for Improving the Work Environment of Japanese Surgeons: survey on effects of the fee revision for medical services provided by surgeons.

Hanazaki K, Tominaga R, Nio M, Iwanaka T, Okoshi K, Kaneko K, Nagano H, Nishida T, Nishida H, Hoshino K, Maehara T, Masuda M, Matsufuji H, Yanaga K, Tabayashi K, Satomi S, Kokudo N - Surg. Today (2013)

Potential causes of surgeon shortage
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3824375&req=5

Fig1: Potential causes of surgeon shortage
Mentions: Figure 1 shows potential causes of the shortage of surgeons. The main causes for the shortage were raised as follows: (1) long hours (72.8 %), (2) excessive emergency surgeries (69.4 %), (3) high risk of a lawsuit (67.7 %), (4) too many incidents, and (5) length of time needed to become a specialist surgeon (61.7 %). Nevertheless, most Japanese surgeons continue to work hard in the presence of this high risk of complaints and incidents, and in an underprivileged environment not compatible with the workload. Although these results were essentially similar with those of the previous 2007 results, apprehension of the risk of medical accidents decreased approximately 6 % from 69.1 to 63.2 %.Fig. 1

Bottom Line: The main potential causes for the shortage of surgeons in Japan were long hours (72.8 %), excessive emergency surgeries (69.4 %), and high risk of lawsuit (67.7 %).Mean weekly working hours of surgeons in national or public university hospitals and private university hospitals were 96.2 and 85.6, respectively.Approximately 70 % of surgeons were forced to do hardworking tasks, possibly leading to death from overwork.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku, Kochi, 783-8505, Japan, hanazaki@kochi-u.ac.jp.

ABSTRACT

Purpose: The aim of this study was to achieve improvements in the work environment of Japanese surgeons and shortage of surgeons.

Methods: Questionnaires were distributed to selected Japanese surgical Society (JSS) members. Retrospective analysis was conducted comparing the current 2011 survey with previous 2007 survey. To examine the influence of 2010 revision of the fee for medical services performed by surgeons, we distributed a second questionnaire to directors of hospitals and administrators of clerks belonging to official institutes in JSS. Collective data were analyzed retrospectively.

Results: The main potential causes for the shortage of surgeons in Japan were long hours (72.8 %), excessive emergency surgeries (69.4 %), and high risk of lawsuit (67.7 %). Mean weekly working hours of surgeons in national or public university hospitals and private university hospitals were 96.2 and 85.6, respectively. Approximately 70 % of surgeons were forced to do hardworking tasks, possibly leading to death from overwork. Of note, approximately 25 % of surgeons had over time of more than 100 h a week, coinciding to the number of hours that might lead to death from fatigue, described in the Japanese labor law. Although the total medical service fee in hospitals, especially in large-scale hospitals with more than 500 beds, increased markedly after 2010 revision of the fee for medical services performed by surgeons, few hospitals gave perquisites and/or incentives to surgeons.

Conclusion: To prevent and avoid collapse of the surgical specialty in Japan, an improvement in the work environment of surgeons by initiation of the JSS would be required as soon as possible.

Show MeSH
Related in: MedlinePlus