Why is there a shortage of medical doctors in the Japanese healthcare market?

Japan is already commonly known as a rapidly aging country. According to life expectancy at birth from OECD health data 2014, Japanese men live up to 80.5 years old while women live up to 86.8 years old on average. Contributions in the national health insurance system of Japan only serve as further proof of this.

I would like to direct attention to the supply side of the health care market by referring to significant contents of chapter 5 of Yoshida, A.(2009) and why one certain misconception occurs. The impression that many people have regarding the shortage of medical doctors can be extremely serious when in fact, the number of medical doctors has been increasing to about 311,000 in 2014 (The Survey of Physicians, Dentists, and Pharmacists by The Ministry of Health, Labour and Welfare). Fairly recently, “Tohoku Medical and Pharmaceutical University” was founded as a medical school in 2016, and “International University of Health and Welfare” consecutively in 2017.

Regardless, we still call it a shortage of medical doctors through media every time a shocking news like “taraimawashi” occurs. The fact is that a “maldistribution” of medical doctors certainly exists, but it is not as simple as most may think. One of the underlying reasons behind this maldistribution is indirectly caused by current medical law. According to the law, medical doctors have the freedom to put up clinics as long as the clinic itself does not have any beds (This does not necessarily mean, however, that there are areas without any hospitals. We should keep in mind that Japan has various types of hospitals and each prefecture has at least one medical school and one hospital since the 1970’s). This is merely a “geographical” bias.

Another underlying cause of “maldistribution” comes from the viewpoint of specialty as Yoshida (2009) explains. He describes this as a “bias of specialties” caused by gender differences. As a rule of thumb, residents have free rein on choosing their specialties during medical training. As such, female residents tend to select “Dermatology” or “Ophthalmology” and so on, while men tend to choose among specialties such as “Orthopedics” and “Cardiac surgery”.

Yoshida, A. (2009) , What problems exist in the Japanese healthcare market? (in Japanese), NTT Publisher.