The Japan Medical Association (JMA) warned 27 doctors between fiscal 2013 and 2016 over repeated medical blunders or inappropriate medical practices, it has been learned.
The JMA identified the 27 doctors after examining treatment processes and other details of cases in which large amounts of benefits of medical accident insurance were paid. The revelation for the first time shed light on the situation of repeated medical malpractice by the same medical practitioners as civil suits over such blunders seldom uncover the repetition of mistakes in the treatment of different patients.
Attention has been focused on so-called "repeaters," or medical practitioners who repeat blunders, since around 1999 -- when serious medical accidents occurred one after another. In December 2016, it surfaced that six serious incidents, including three fatal cases, had occurred at an ob-gyn clinic in Ehime Prefecture since 2005, prompting the prefectural government to inspect the institution.
However, the central government has no system to uncover "repeaters." It is impossible to grasp the situation even by utilizing a medical accident investigation system, used to report unexpected deaths of patients at medical institutions to a third-party organization, which was launched in October 2015.
Of some 310,000 doctors across the country, approximately 120,000 have taken out insurance policies to cover compensation for medical blunders, which are run jointly by the JMA and private insurance companies.
These insurance policies cover compensation paid to victims of medical mishaps and their families. If a doctor makes an insurance claim, the JMA investigates the details of the treatment and decides whether an insurance benefit can be paid.
Since August 2013, the JMA has used the insurance system to improve the ethical levels and quality of its member doctors. The association's guidance and improvement panel comprised of lawyers recognize doctors who repeat medical accidents, for which they are held responsible, as "repeaters."
Between August 2013 and March 2016, 19 member doctors were recognized as repeaters, according to the JMA. At a regular representative assembly on June 25, the JMA reported that eight members were recognized as such in fiscal 2016 that ended in March 2017. However, the JMA has stopped short of disclosing the names of the repeaters or the details of the blunders concerned.
Local chapters of the JMA provide guidance, recommendations to improve practices or strict warnings, in the order of severity, to doctors recognized as repeaters.
The Tokyo Medical Association provided guidance to doctors involved in three cases. Specifically, senior officials at the association questioned those involved in these cases over the details of the accidents and took measures such as having the doctors submit written pledges not to perform high-risk surgeries in the future.
The health ministry's medical ethics council examines doctors reported by the ministry twice a year. However, most doctors subject to investigation are involved in criminal cases not directly connected to medical malpractice, such as false medical fee claims.
The ministry council decided in 2002 to punish those responsible for medical accidents in cases where the doctors clearly failed to exercise due care, even when doctors were not criminally charged. But since there has only been one case involving warnings for repeated medical errors, some point out that the rule has become a dead letter.