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Panel debates reducing non-urgent patient visits to cut doctors' overtime

Central Government Building No. 5, which houses the Health, Labor and Welfare Ministry, is seen in this file photo. (Mainichi/Kimi Takeuchi)

TOKYO -- The Ministry of Health, Labor and Welfare has begun discussions aiming to get the public to refrain from making after-hours visits to hospitals and clinics in hopes of curbing doctors' long working hours.

"There are too many cases where doctors have to deal with patients with mild cases who come to see them outside of regular service hours. I want people to be aware of this reality," said Demon Kakka, a celebrity who serves as a member on the ministry's expert panel, after the first meeting convened on Oct. 5. The panel plans to release a summary of opinions by the end of the year.

Under the Medical Practitioners' Act, "No medical practitioner who provides medical treatment shall refuse any request for examination or treatment without just cause." This has made it difficult for doctors to turn down visits after hours. Therefore, in order to implement work-style reform for doctors, it is imperative to trim non-urgent or unnecessary visits by patients.

However, that being said, it is difficult for patients to judge whether their cases are emergencies or not, especially when it comes to the parents of young children. At the panel's meeting, Kyoko Ama, head of a Tokyo-based citizens' group handling pediatric care issues, said, "Unless parental anxiety can be quelled, cutting back on hospital visits would only result in forcing them to persevere." She called for consideration in publicizing the new policy so as not to deprive patients of their right to request necessary treatment.

In the city of Nishiwaki, Hyogo Prefecture, in western Japan, a group of mothers is calling on local residents to refrain from seeing doctors "at their convenience" in order to alleviate burdens on medical staff. The group was set up 10 years ago after the Nishiwaki Municipal Hospital's pediatrics department stopped accepting inpatients in 2007. Naomi Tominaga, 42, head of the group, recalls having to take an hour every day traveling to and from a hospital where her then 3-year-old daughter was hospitalized.

While collecting signatures calling for increasing the number of pediatricians, Tominaga and the others organized study sessions teaching participants how to recognize symptoms on their own. In response to the move, a pediatrician started to work at the hospital, leading its inpatients ward for children to reopen two years later.

The group says that lately, hardly any patients with mild symptoms visit the hospital after hours. "It is important for patients to communicate the specific symptoms that they want to have examined," said Tominaga.

Some patients with chronic conditions, however, have voiced their concern over the ministry's move. Yukiko Mori, 58, who has a connective tissue disease and heads the Japan Patients Association, says it took four years before her disease was properly diagnosed. Until then, she was repeatedly told by doctors that she was not sick.

Noting that patients may be forced to live with suffering and pain if doctors fail to diagnose them, Mori said, "I want the ministry to make sure that patients' judgment will be respected."

(Japanese original by Masahiro Sakai, Medical Welfare News Department)

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