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

Kazuhiro Hanazaki, Ryuji Tominaga, Masaki Nio, Tadashi Iwanaka, Kae Okoshi, Koichi Kaneko, Hiroaki Nagano, Takahiro Nishida, Hiroshi Nishida, Ken Hoshino, Tadaaki Maehara, Munetaka Masuda, Hiroshi Matsufuji, Katsuhiko Yanaga, Koichi Tabayashi, Susumu Satomi, Norihiro Kokudo

Research output: Contribution to journalArticle

7 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1209-1218
Number of pages10
JournalSurgery Today
Volume43
Issue number11
DOIs
Publication statusPublished - 2013 Nov
Externally publishedYes

Fingerprint

Fee-for-Service Plans
Japan
Surgeons
Surveys and Questionnaires
Surgical Specialties
Hospital Administrators
Private Hospitals
Public Hospitals
Fatigue
Motivation
Emergencies

Keywords

  • Collapse of surgery
  • Incentive of surgeons
  • Medical service fee
  • Shortage of surgeons
  • Work environment of surgeons

ASJC Scopus subject areas

  • Surgery

Cite this

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, Kazuhiro; Tominaga, Ryuji; Nio, Masaki; Iwanaka, Tadashi; Okoshi, Kae; Kaneko, Koichi; Nagano, Hiroaki; Nishida, Takahiro; Nishida, Hiroshi; Hoshino, Ken; Maehara, Tadaaki; Masuda, Munetaka; Matsufuji, Hiroshi; Yanaga, Katsuhiko; Tabayashi, Koichi; Satomi, Susumu; Kokudo, Norihiro.

In: Surgery Today, Vol. 43, No. 11, 11.2013, p. 1209-1218.

Research output: Contribution to journalArticle

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 2013, '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', Surgery Today, vol. 43, no. 11, pp. 1209-1218. https://doi.org/10.1007/s00595-013-0691-5
Hanazaki, Kazuhiro ; Tominaga, Ryuji ; Nio, Masaki ; Iwanaka, Tadashi ; Okoshi, Kae ; Kaneko, Koichi ; Nagano, Hiroaki ; Nishida, Takahiro ; Nishida, Hiroshi ; Hoshino, Ken ; Maehara, Tadaaki ; Masuda, Munetaka ; Matsufuji, Hiroshi ; Yanaga, Katsuhiko ; Tabayashi, Koichi ; Satomi, Susumu ; Kokudo, Norihiro. / 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. In: Surgery Today. 2013 ; Vol. 43, No. 11. pp. 1209-1218.
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AU - Iwanaka, Tadashi

AU - Okoshi, Kae

AU - Kaneko, Koichi

AU - Nagano, Hiroaki

AU - Nishida, Takahiro

AU - Nishida, Hiroshi

AU - Hoshino, Ken

AU - Maehara, Tadaaki

AU - Masuda, Munetaka

AU - Matsufuji, Hiroshi

AU - Yanaga, Katsuhiko

AU - Tabayashi, Koichi

AU - Satomi, Susumu

AU - Kokudo, Norihiro

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N2 - 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.

AB - 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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