Can I lose my unpaid doctor? Direct hit on the heavyweights of the medical community August 7 at 16:37

The problem of “unpaid doctors” where salary is not paid even after medical treatment at a university hospital. Nearly a year after I started the interview, I finally met a medical scientist. “What do you think about unpaid physicians?” When asked, the answer returned was surprising. (Social Department reporter Sayaka Kobayashi)

I applied for coverage to the top of the unpaid doctor “White Tower”

In June, the Ministry of Education, Culture, Sports, Science and Technology announced the survey results of unpaid doctors. First recognized the existence of 2191 unpaid doctors.

I have been covering this theme for almost a year, and I was a little relieved that “the country has finally moved”, but my anxiety never disappeared. This is because there was no confirmation that each university hospital really wanted to change the treatment of unpaid doctors.

That is why the people who wanted to hear the story were the top of the “white giant tower”. Therefore, I asked for the interview at the “National Medical Director Hospital Directors Meeting”. Most people have never heard of it, but in fact, it is a very prestigious organization where medical directors from all over the country gather.

When I applied for coverage while thinking "I would be honestly refused", I got a phone call to my smartphone. If this organization's heavyweights are 30 minutes between meetings, time can be taken.

If I didn't miss this machine in 30 minutes, I headed to the designated Yamagata University School of Medicine.

Amazing answer!

It was Mr. Takamasa Kayama, a neurosurgeon, who appeared before me when I was sent to the director's office.

She wore a white coat and had a gentle expression, but her career was overwhelming. As an authority on brain tumors, he has served as the director of the National Cancer Center and chairman of the National Hospital Directors' Conference. Currently he is a member of the Yamagata University School of Medicine.

I cut out the opening “What do you think about unpaid doctors?”

Mr. Kayama's response was amazing.

“Surely I wasn't doing at National University, so I was surprised to see this result. In local areas, people won't come unless they are treated well, so it's natural that Yamagata University is unpaid.

I never thought I would get this answer from the top of the medical office. Many unpaid doctors interviewed have not even been able to speak for years in the pyramid structure of the medical office.

I also covered the thoughts of those people, so I lost my word for this unexpected answer for a moment.

"I don't have a university hospital anymore"

I reconsidered and asked how many universities actually accept unpaid doctors.

“Traditionally, hospital director teachers may find it difficult or hesitant to pay salaries to unpaid doctors.”
“As a major premise, university hospitals are economically difficult. Advanced medical care such as that performed at university hospitals costs money. However, in the first place, medical fees in Japan are determined at official prices. Even if only advanced surgery is performed, only a certain amount of medical fees can be obtained, and it is a mechanism that is not so big. ''

Certainly, unlike general hospitals, university hospitals have functions such as education and medical research as well as medical care. Even if expensive drugs and medical devices are used for cutting-edge medical care, the income is limited and the company is in a difficult business situation.

On the other hand, he pointed out with his own experiences that unpaid doctors are still in the background of the traditional practice that continues in the medical community.

“The university hospital has long been a place where I couldn't live even if I worked hard. I became a doctor and my salary from the university was about 50,000 to 100,000 yen per month until the early 30s. I became a formal assistant in the middle and finally got a regular salary, but it was still not high, and even after I became a professor, I continued to work on Mondays, Tuesdays, Tuesdays, Wednesdays, and Thursdays. The day I took my daughter to an amusement park, I was called for emergency surgery and left my wife and child to return to the hospital by car. ”Does not mention the salary from the university of the protagonist, Gozen Zenzen.

Using the masterpiece of Toyoko Yamazaki, who made the medical office so famous, he complained that there was a misunderstanding.

Don't think of the way we ’ve gone

However, I think that the doctor's income was still high, right?
If there was a problem, why did it not change so far?

“It was good in the past. The level of consumption was different now and I wasn't very worried about the future. It was common to think of“ Samurai do n’t eat, Takamine Eda, ”“ Poverty is precious. ” The doctors at the university hospital were able to live with the so-called “giving,” so that each time they answered “Yes, how much”, they got surgery and received thanks from the patients, the wedding matchmaker, and the trouble of writing the papers of young doctors. Many people came from wealthy families. ”

However, I declined that this former spirit theory was the limit.

“First of all, the situation where young people are placed is different from the past. The number of students in the medical school has increased, and the number of students who have advanced from families of various economic conditions has increased. Some of us were sending out 100,000 yen, and we can't do it alone with Noblesse Oblige.

The doctor is gone ...

Furthermore, the reason why Mr. Kayama thinks that improvement of unpaid doctors is necessary is to “protect human rights”.

“It's a basic right to be paid for labor. Doctors are no exception. Because of self-study,“ You do n’t have technology, so you ’re free ”. No matter how much he says, a person with a doctor's license does a medical practice, and as a result, the hospital has a medical fee, and the same doctor goes to the other hospital and works part-time. There is a salary paid for the same medical practice, which is contradictory. "

The more you seem to ask questions, the more likely you are to understand. However, when I dared to confirm why I was able to exhale my honest thoughts, I appealed with a serious expression.

“If you keep it, the younger generation will leave the university hospital. Now, the name hospital is popular. However, research and education in advanced medicine can only be done in a university with good environment. The system will be broken. Eventually, the quality of medical care will not be maintained and patients will be affected. "

Do what you can do first, and then the national discussion

I felt that it was of great significance that the heavyweights of the medical community claimed that young doctors and even the future of the medical community should “change now”. However, as Mr. Kayama pointed out, I finally wondered if I could pay my salary amid the severe management of university hospitals.

“At Yamagata University I belong to, as a result of various ingenuity, I paid up labor costs and gave me the first“ Doctor's Fee ”in Japan. Naturally, there are no unpaid doctors, although the management of university hospitals is certainly difficult, but there is still a profit of about 5% from the profit breakpoint of medical practice. I think it ’s possible to pay for it.

Mr. Kayama said that he can pay his salary. However, after making all possible efforts, I made such a recommendation.

“I think there are too many doctors in universities where it is difficult to pay the full amount to all doctors. Many universities with unpaid doctors are urban universities. These universities employ only the number of people who can pay. In other cases, however, doctors should go to areas where there is a shortage of doctors, but if labor costs are still insufficient, it is necessary to seek discussions including the public. It is also true that the patient is less burdensome, and it will be necessary to present the costs and benefits of each medical treatment in a visible way. "

Mr. Kayama responded to the interview for two hours, saying that “there may be criticism from the medical community”, but the schedule was greatly exceeded. The words convey a strong sense of crisis to the current medical world.

How did you feel about it? I will continue this interview in the future. Please send your opinions and impressions here. The address is: http://www3.nhk.or.jp/newspost/form.html
Please write "Non Physician Issue" in the post.

Social Department reporter Sayaka Kobayashi