Create a system that puts priority on patients’ convenience

What is a “family doctor” and what should they do? Lessons from the novel coronavirus pandemic must be utilized to create a family doctor system that benefits patients.

In general, family doctors are physicians who are familiar to their patients, examining and managing their health on a regular basis. However, there has been no precise definition of the term so far.

The pandemic has exposed the deficiencies of such doctors. The government urged patients with fevers to consult their family doctors, but people were often turned away even from medical institutions that they habitually visited. Many people do not even have a family doctor in the first place.

For that reason, the Health, Labor and Welfare Ministry has proposed a system to legally specify the roles of family doctors. To make it easier for patients to decide which medical institutions to choose, the system would have each municipality post information on its website, including whether a facility can provide medical care on holidays or at night, according to the proposal.

People who wish to have a family doctor would be able to exchange documents with medical institutions to confirm that relationship. However, the proposed system only covers patients deemed by doctors to require ongoing medical management, not people who just visit medical institutions occasionally for the treatment of ailments such as a cold.

This method would neglect people who do not have a specific family doctor. In the case of an outbreak of a new infectious disease, this approach could repeat the dysfunction of family doctors that the nation experienced during the pandemic.

To maintain the quality of family doctors, the National Federation of Health Insurance Societies and other entities have put forward an accreditation system in which a third party examines the functions of medical institutions, and a registration system in which people who want to have family doctors clarify their choice of physician. The aim is to reduce medical costs by avoiding redundant medical care.

In contrast, the Japan Medical Association opposes a family doctor system. It cites concerns that “free access,” which allows people to receive medical care freely at any medical institution, could be restricted, but the association seems to want to prevent competition from heightening among doctors.

In Japan, doctors focus on specific areas, and there are few personnel available to provide comprehensive medical care. There will be challenges in putting a perfect system in place swiftly.

However, it will be difficult to find the right path if all the various parties cling to their respective positions. They should use their wisdom to find the best way forward, putting top priority on convenience for patients.

In Britain, residents are required to register with primary care clinics, and the medical institutions that take care of them are clearly identified. The roles of family doctors are reportedly becoming even more important amid the coronavirus pandemic in Britain. It is important to find a system that fits Japan’s needs, while referring to examples from other countries.

If creating a family doctor system prevents patients from getting the medical care they really need, that represents skewed priorities. Sufficient consideration must also be given to such points.

(From The Yomiuri Shimbun, Dec. 15, 2022)