A Shortage of Medical Doctors Due to Uneven-Distribution in Location and Specialty Needs Interprofessional Collaborative Practice in Health and Social Care in Japan

A shortage of medical doctors has been pointed out in last 20 years in Japan, but it has been more apparent after 2009, when two more years of a new compulsory clinical training added, after six years of medical education and successfully passed the medical licensure examination in Japan. A number of practising doctors per 1,000 population in 2009 was as follows: Norway 4.0, Germany 3.6, OECD 3.1, UK 2.7, USA 2.4, Japan 2.2, Turkey 1.6 and Chile 1.0.　The highest number per 100,000 was 286.2 in Kyoto and the lowest 142.6 in Saitama, in 2009.

Causes of the shortage in Japan were as follows: advancement of medical science,  specialization of health and social care professionals, increase to participate in private practice, increase of woman doctors, longer time to talk with patients, change of patients’ consciousness to right, concentration of doctors to cities, decrease of practicing doctors in pediatrics, and obstetrics.

Meanwhile, average life expectancy has extended as follows: 1921-1925: m 42.06, f 43.20; 1947: m 50.06, f 53.96; 1960: m 65.32, f 70.16 and 2012: m 79.94, f 86.41 (years).   

Various needs of elderly people in health and social care could not be solved by a single profession, such as medical doctors. Many symptoms in health care occurred in the elderly, such as senile dementia, metabolic syndrome, hemiplegia, dysphagia, fragility fracture and dysuria, could be better treated by a team of multiprofessions. Health care outcome such as average and/or healthy life expectancy may not be always correlated with a number of doctors.

In order to improve QOL of service users, a paradigm shift is needed in strengthening competencies of health and social care professionals for interprofessional collaborative practice, to develop a comprehensive health care network in a community, consisting of three community-based powers on health care, welfare and education.