Too Many Doctors
An internal medicine and respiratory clinic that opened in fall 2000 in Omiya, Saitama Prefecture--25 kilometers northwest of downtown Tokyo--has a director who entered the medical profession after working as the manager of a family restaurant. Before opening the clinic, 36-year-old Fuminori Yasutomi made a thorough study of the local market, personally visiting doctors in the neighborhood. He eventually opted for a location that had few rivals. Staff members were instructed to maintain a courteous, helpful attitude, and they went through rehearsals before welcoming their first patients. Borrowing a principle from the service industry that anyone kept waiting for more than 15 minutes starts getting anxious, the clinic informs patients of the expected waiting time when it is particularly busy.

"Medical care is a service industry, too," maintains Yasutomi, who thinks of patients as "customers." "Competition is intense, and gone are the days when you could expect people to show up just by opening your doors."

When 40-year-old Yoshiyuki Kawano was looking to launch an internal medicine and cardiovascular clinic in Yokohama, also in the fall of 2000, he turned to a consulting firm for advice. The company directed him to a physician who had just closed his infirmary. Kawano now rents the premises from the retired doctor; having also purchased the existing equipment and materials, Kawano was able to cut the cost of opening a new facility to less than half of what it would normally take, even when leasing equipment.

"I was also able to inherit the patients who frequented the old clinic," Kawano says happily, "and to maintain ties with the area hospitals to which I can refer seriously ill patients."

Both of these cases are responses to the intensifying competition for patients in the greater Tokyo area, caused primarily by the rapid increase in the number of clinics. There have been around a thousand new clinics a year since 1990, or 12,000 new facilities over the past decade, according to the Ministry of Health, Labor, and Welfare. The total figure as of July 2000 stood at around 93,000.

The biggest factor behind the rise has been a surplus of doctors. The ministry estimates that the nation needed 244,000 physicians in 2000, but there were already 260,000 in 1998, and the number has continued to rise since then.

Building an Electronic Database
Hospitals are being compelled not only to improve patient services but also to strengthen their administrative systems to prevent medical mishaps. In fiscal 2001 (April 2001 to March 2002) the International Medical Center of Japan will become the first medical institution to apply point-of-sale technology to the medical field. Long used by convenience stores, POS systems enable retailers to manage sales data of products and outlets and analyze purchasing trends.

The medical center's system, which it developed on its own, uses leading-edge technology to integrate the various electronic systems--such as those for medical records and diagnosis--that have been developed individually and introduced in a piecemeal manner.

Specifically, the doctor or nurse will use a terminal similar to a palm-sized computer when giving medicine, injections, intravenous drips, or blood transfusions, registering the act by reading the bar code on the patient's wristband and the bag or box of medicine.

This will mean that information about what treatment has been given to which patient by which doctor or nurse will be recorded without fail in the center's host computer. This system will help prevent mishaps, as the terminal will sound an alarm if, for example, the wrong drug is administered.

Also, because the system will effectively become a database of various treatments and their effects, it could help doctors find effective cures without having to implement clinical tests, which require a great deal of time and money. In addition, it promises to make administrative work more efficient, as the distribution of medical supplies and equipment become automated.

In order to protect the privacy of patients, those who are able to access information will be restricted to system engineers and the doctors directly in charge of particular patients. Once the experiment gets firmly on track, the center plans to offer its technology to other national hospitals in Japan.

Copyright (c) 2001 Japan Information Network. Edited by Japan Echo Inc. based on domestic Japanese news sources. Articles presented here are offered for reference purposes and do not necessarily represent the policy or views of the Japanese Government.