Current situations and issues in respiratory medicine in Japan

Hiroshi Kimura, Hirohisa Toga, Mutsuo Yamaya, Michiaki Mishima, Toshihiro Nukiwa, Shoji Kudo

Research output: Contribution to journalArticlepeer-review


The essence of the current shortage of physicians in Japan is not just a shortage in the absolute number. It is also a shortage of physicians in particular fields of medicine, as well as an uneven geographic distribution of hospital-employed physicians. The Future Planning Committee of Japanese Respiratory Society conducted a survey to determine the actual status and issues pertaining to the practice of respiratory medicine in 2007-2008, as part of an effort to seek appropriate measures to increase the number of respiratory physicians. For this survey, 3,000 hospitals were randomly sampled from nationwide that had a department of internal medicine, then, 1,232 (41.1%) hospitals that returned the questionnaire were subjected to analysis. The national average number of physicians per 10 beds was 0.83 for internists, 0.50 for respiratory physicians, and 0.21 for physicians specialized in respiratory diseases. Among all prefectures of Japan, there were 3.9-fold and 6.1-fold differences for internists and respiratory specialists, respectively. Even amongst large hospitals with 300 beds or more, the self-containment level, which indicates the extent to which the diagnosis and treatment of diseases can be completed within a particular hospital, was low for the treatment of acute respiratory failure, chemotherapy of lung cancer, and diagnosis and treatment of intractable diseases such as pulmonary circulatory disease in rural areas with a population of less than 50,000. This suggests a qualitative disparity in the practice of respiratory medicine among different areas of Japan. On the other hand, the survey also indicated that physicians not specialized in respiratory diseases have to deal with intractable respiratory diseases like acute respiratory failure or interstitial pneumonia in rural areas, suggesting possible disadvantages to patients in rural areas who are in need of respiratory medicine. In order to promote equality in medical practice in Japan, it is urgent to foster respiratory physicians and specialists and distribute them appropriately.

Original languageEnglish
Pages (from-to)178-184
Number of pages7
JournalJapan Medical Association Journal
Issue number3
Publication statusPublished - 2010 May


  • Equalization of healthcare
  • Regional disparity
  • Respiratory specialists
  • Shortage of physicians

ASJC Scopus subject areas

  • Medicine(all)


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