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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

Participation in surgical procedures after sleep-in, night duty
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Fig4: Participation in surgical procedures after sleep-in, night duty

Mentions: Figure 2 shows the mean working hours per week. In 2011, it was 77.1 h, a decrease of about 4 h, compared to the 81.1 h reported in the 2007 survey. As shown in Fig. 3, a comparison of working hours by hospital type, surgeons affiliated with national and public university hospitals had the greatest mean number of weekly working hours at 99.6 h/week, and those affiliated with private university hospitals came in second at a mean of 90. 4 h/week. The mean number of weekly working hours for surgeons affiliated with prefectural, municipal or public welfare hospitals was more than 70 h/week. In a comparison of age groupings, surgeons under 30 and 40 years of age had the longest workweek, a mean of 92.2 h. Mean number of days in a month of sleep-in duty and on-call duty were 2.3 and 2.2 days, respectively. Seriously, almost surgeons performed not only routine work but also elective surgery on the day after night duty even though they were apprehensive of the risk of accidents due to the influences of night duty (Fig. 4).Fig. 2


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)

Participation in surgical procedures after sleep-in, night duty
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig4: Participation in surgical procedures after sleep-in, night duty
Mentions: Figure 2 shows the mean working hours per week. In 2011, it was 77.1 h, a decrease of about 4 h, compared to the 81.1 h reported in the 2007 survey. As shown in Fig. 3, a comparison of working hours by hospital type, surgeons affiliated with national and public university hospitals had the greatest mean number of weekly working hours at 99.6 h/week, and those affiliated with private university hospitals came in second at a mean of 90. 4 h/week. The mean number of weekly working hours for surgeons affiliated with prefectural, municipal or public welfare hospitals was more than 70 h/week. In a comparison of age groupings, surgeons under 30 and 40 years of age had the longest workweek, a mean of 92.2 h. Mean number of days in a month of sleep-in duty and on-call duty were 2.3 and 2.2 days, respectively. Seriously, almost surgeons performed not only routine work but also elective surgery on the day after night duty even though they were apprehensive of the risk of accidents due to the influences of night duty (Fig. 4).Fig. 2

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