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
The aim of this study was to achieve improvements in the work environment of Japanese surgeons and shortage of surgeons.
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.
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.
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.
- Tominaga R, Nagino M, Kaneko K, Nagano H, Nishida T, Nishida H, Hoshino K, Maehara T, Masuda M, Matsufuji H, Yanaga K, Tabayashi K. Survey for Japanese surgeon’s work environment and the response of hospital administrators to the increased income of medical service fee by surgeons-report from the committee for the improvements in work environment of Japanese surgeons. J Jpn Surg Soc. 2012;113(2):226–40 (in Japanese).
- Nishida H, Satomi S, Endo H, Tabayashi K, Kanematsu T, Tominaga R, Maehara M, Ito M, Miyazaki M, Kaneko K, Shirai Y, Tsuchiya R, Nagano H, Hoshino K, Yanaga K. Importance of expanded role of non-physician healthcare provider in surgical practice: from analysis results of work contents obtained from workweek-time study of JSS members. J Jpn Surg Soc. 2010;111(4):251–7 (in Japanese).
- Endo H. How long do surgeons work a week? J Jpn Surg Soc. 2010;111(4):258–67 (in Japanese).
- Monden M. Changing society, evolving surgery. Surg Today. 2008;38:195–205. CrossRef
- Sheldon GF. The evolving surgeon shortage in the health reform era. J Gastrointest Surg. 2011;15:1104–11. CrossRef
- Turan S, Konan A. Self-regulated learning strategies used in surgical clerkship and relationship with clinical achievement. J Surg Educ. 2012;69:218–25. CrossRef
- Harder F. I would like to be a surgeon, but. Ann Surg. 2002;236:699–702. CrossRef
- Nasuda TJ, Day SH, Amis ES Jr. The new recommendation on duty hours from the ACGME Task Force. N Engl J Med. 2010;363(2):e3(1–6).
- Dawson D, Reid K. Fatigue, alcohol and performance impairment. Nature. 1997;388:235. CrossRef
- Gaba DM, Howard SK. Fatigue among clinicians and the safety patients. N Engl J Med. 2002;347(16):1249–55. CrossRef
- McCormick F, Kadzielski J, Landrigan CP, Evans B, Herndon JH, Bubash HE. Surgeon fatigue: a prospective analysis of the incidence, risk, and intervals of predicted fatigue-related impairment in residents. Arch Surg. 2012;147(5):430–5. CrossRef
- Hanazaki K. Pre- and post-graduate education for academic surgeon. J Jpn Surg Soc. 2010;111(Suppl 3):7–8 (in Japanese).
- 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
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Volume 43, Issue 11 , pp 1209-1218
- Cover Date
- Print ISSN
- Online ISSN
- Springer Japan
- Additional Links
- Shortage of surgeons
- Work environment of surgeons
- Medical service fee
- Incentive of surgeons
- Collapse of surgery
- Industry Sectors
- Kazuhiro Hanazaki (1)
- Ryuji Tominaga (1)
- Masaki Nio (1)
- Tadashi Iwanaka (1)
- Kae Okoshi (1)
- Koichi Kaneko (1)
- Hiroaki Nagano (1)
- Takahiro Nishida (1)
- Hiroshi Nishida (1)
- Ken Hoshino (1)
- Tadaaki Maehara (1)
- Munetaka Masuda (1)
- Hiroshi Matsufuji (1)
- Katsuhiko Yanaga (1)
- Koichi Tabayashi (1)
- Susumu Satomi (1)
- Norihiro Kokudo (1)
- Author Affiliations
- 1. Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku, Kochi, 783-8505, Japan