Enactment of Revised Medical Care Law: Will Legal Revision Lead to Correction of Regional Imbalance of Doctors?

Editorial

16:28 JST, December 17, 2025

Medical institutions and doctors are concentrated in urban areas, and more than a few regional areas are struggling with a shortage of doctors.

In addition, some hospitals have a surplus of inpatient beds due to declining populations in their areas. Meanwhile, the growing number of elderly people who are unable to visit medical institutions is increasing demand for home-based medical care.

As the population ages, the challenges facing medical workplaces continue to grow more complex. It is necessary to closely monitor whether this legal revision will effectively improve these various issues.

The revised Medical Care Law, which incorporated measures to correct the regional imbalance in the number of doctors, has been enacted. They will be implemented in stages starting in spring 2026.

The pillar of the measures to correct the uneven distribution of doctors is to establish restrictions on opening new clinics in areas where they are concentrated and there is an excess of practicing doctors.

Specifically, prefectural governments can request doctors wishing to open a clinic to fulfill roles such as providing home-based care or emergency services, which are lacking in regional areas. This seems to effectively raise the bar for opening a new clinic.

If a doctor does not comply with a municipality’s request, the law allows for the publication of the medical institution’s name and the shortening of its designation period as an insurance-covered medical facility.

The total number of doctors nationwide exceeds 340,000, an increase of 40,000 from about 10 years ago. However, despite this overall increase, their uneven distribution has not been resolved at all. The revision likely took a step toward restrictions on opening new clinics in light of these circumstances.

In addition to such measures, doctors dispatched to areas facing shortages of doctors will be provided with allowances funded by public medical insurance premiums.

How much will these approaches improve the regional imbalance in the number of doctors? Progress must be closely monitored, and if the effects prove insufficient, strengthening of the restrictions should be considered.

The imbalance in the concentration of doctors is not merely a regional issue. Departments with frequent overtime work, such as surgery and obstetrics, are particularly prone to shortages of doctors. Recently, some doctors, immediately after completing their initial training sessions, have been drawn to cosmetic medicine, which offers higher salaries.

Although the recent legal revision partially took measures against the uneven distribution of doctors across clinical departments, such steps cannot be described as sufficient. This situation remains an important issue for future consideration.

The legal revision also included measures to encourage the review of regional health care plans established by prefectures. To improve the efficiency of medical care, a system was established to require medical institutions to report to local governments about which medical institutions have what functions.

The aim is to promote a division of roles among medical institutions, such as acute care, chronic care and home-based care.

It is a major problem for residents in areas with declining populations to lose access to necessary medical care. To sustain regional health care, prefectural governments must take the lead in accelerating the reorganization of health care provision systems.

(From The Yomiuri Shimbun, Dec. 17, 2025)