Physician-turned-politician works to bring doctors to rural Japan

MIYAZAKI – Tomonori Kiyoyama, 34, was once a promising, elite physician. A graduate of the prestigious University of Tokyo’s medical school, he also studied in the United States. But he turned to politics five years ago and is now using that platform to try to attract more doctors to his hometown in Miyazaki.

What motivated the second-term Miyazaki Prefectural Assembly member was an online article he read in 2009, while in New York studying infectious diseases, about a shortage of doctors in less-populated areas in the prefecture.

Recognizing that deliberations on the issue in the prefectural assembly lacked a key perspective — how to make intern programs in the prefecture attractive to young doctors — he immediately decided to come home.

His wife, Chiharu, remembers Kiyoyama saying: “There are people who cannot receive treatment due to the absence of doctors,” and “the problem should be addressed before the treatment of infectious diseases.”

Kiyoyama’s decision was initially met with skepticism because he had no political background. But he was determined.

After returning, he bought books on “how to run for an election” and helped an acquaintance run for mayor in order to get first-hand experience.

In April 2011 Kiyoyama ran for a prefectural assembly seat, stressing his youth and background as a physician in a grass-roots election campaign supported by his friends and volunteers. He garnered the largest number of votes in his electoral district.

He has since pursued his goal and has recently seen signs of improvement.

During an assembly session last November, Kiyoyama made inquiries about the government’s target for soliciting intern applications from doctors in training.

The prefectural government’s goal had been to attract 96 interns for the year beginning this month. But it only received applications from just over half the target, so in November it lowered the number to 62.

Behind the reduced goal was a change in the system in medical training and education.

In the past, interns were trained at hospitals run by the universities they graduated from and those hospitals sent them to sparsely populated communities to support regional health care.

But the system was changed in 2004 and as interns are now allowed to choose where they want to receive training, many choose big cities over country practice.

Believing that hospitals with advanced educational programs attract more doctors in training, Kiyoyama urged the prefectural government to take measures to make the prefecture-run hospitals more attractive and called for raising the target to at least 90 interns in the coming years.

Measures to have interns stay after the completion of training were also needed, Kiyoyama said.

Replying to Kiyoyama’s proposals during the November assembly session, a senior government official in charge of the issue said the prefectural office would work out “attractive” training programs.

“Awareness (of intern programs) is changing,” Kiyoyama said.

Kiyoyama, whose parents ran a noodle restaurant in Miyazaki, dreamed of being a doctor since childhood. He wanted to take care of his grandmother, who looked after him on behalf of his busy parents.

He achieved this goal, attending to his grandmother until she died three years ago at age 94.

While working as a prefectural assembly member, Kiyoyama continues to work at a local hospital on weekends and sometimes provides on-the-spot training sessions for medical students.

Kiyoyama said he cannot turn his back on people who do not have enough access to medical care due to the shortage of doctors. He became a member of the assembly because “there is only so much I can do as a physician.”