Doctors are in short supply in many provincial districts where the number of hospitals has been on the decline since 2000.

A new intern clinical training system introduced in fiscal 2004 is believed to be partly responsible for the uneven distribution of doctors in the country.

As of the end of 2008, half of all physicians were in urban areas with a population topping 300,000.

According to the Health, Labor and Welfare Ministry, which carries out a survey on medical practitioners every two years, the number of doctors in Japan totaled 286,699 at the end of 2008.

This represented a 3.2 percent increase from 2006. On the other hand, the number of hospitals totaled 8,794, marking a decrease of nearly 500 from the year 2000.

Meanwhile, the Organization for Economic Cooperation and Development said Japan had 2.1 doctors per 1,000 people in terms of its population in 2007, ranking 27th among the 30 OECD member countries. The average score among OECD states was 3.1.

The new training system opened the door for interns to choose hospitals where they want to receive professional guidance. As a result, interns have become concentrated in big cities.

Faced with a shortage of manpower, universities recalled doctors they had earlier dispatched to local hospitals.

Medical experts said it may be necessary to review career trajectories and have doctors work in provincial areas for a fixed period if they want to become a hospital director or administrator.

The health ministry’s study group on public health and medical care in depopulated districts called in March for the creation of a regime to recognize doctors who complete their medical care in remote areas and physicians who go back and forth between big hospitals in cities and regional hospitals and clinics to improve their skills.

Some have proposed dialogue over the utilization of non-Japanese physicians. There have been cases of foreign doctors who have been allowed to engage in medical care in Japan under the guidance of Japanese physicians as part of their training.

Educational institutions such as Iwate Medical University in Iwate Prefecture have a track record of accepting doctors from other countries. There are also human resources companies that introduce non-Japanese doctors.

Foreign physicians, however, are limited to working for two years in hospitals designated by the health ministry.

Yoshito Sengoku, minister in charge of national strategies, said the medical system should be revised to allow skilled foreign doctors to do more in Japan.

Health minister Akira Nagatsuma reacted prudently to Sengoku’s remark, saying that it is “necessary to put the point at issue in order.”

A revision of laws has made it possible for prefectural governments to issue bonds not only to construct hospitals but also to increase the salaries of the physicians working in them. There are also possibilities for regional governing bodies to introduce helicopters for use in emergencies and cooperation with local universities and medical institutions.

Young doctors at Togane Hospital in Togane, Chiba Prefecture, hold a meeting every month with regular people in a show of solidarity with the local community. People seek doctors’ advice on how to stay healthy and at the same time learn how hard doctors work.

A nonprofit organization to promote local medical care handles the meetings. Group leader Harue Fujimoto said that “when there is mutual respect, doctors think of themselves as being there for residents, and come to feel that they don’t want to leave the area.”

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