Nakayasu Anna, Kido Michiko, Katoh Keiichi, Homma Yukio
Department of Obstetrics and Gynecology, Japanese Red Cross Medical Center, Tokyo, Japan.
Department of Anesthesiology, Japanese Red Cross Medical Center, Tokyo, Japan.
JMA J. 2020 Apr 15;3(2):118-124. doi: 10.31662/jmaj.2019-0013. Epub 2020 Apr 7.
The paucity and maldistribution of physicians among various specialties are key issues facing the Japanese health care system. Studies have shown that young physicians place more emphasis on work-life balance while selecting their specialty and that they prefer controllable lifestyle (CL) specialties over noncontrollable lifestyle (NCL) specialties. As this may be a cause of maldistribution, we investigated the relationship between views on work-life balance and specialty selection among young physicians in Japan.
An online questionnaire was sent to 1451 residents (postgraduate years 1-5) at 60 Japanese Red Cross hospitals across Japan.
In all, 226 physicians responded (response rate: 15%), with 21% in CL and 74% in NCL specialties. When compared with NCL specialties, CL specialties had less overtime (43% vs. 16%, = 0.001), considered life to be more important than work (26% vs. 15%, = 0.018), and were more likely to give precedence to work-life balance over medical interest while choosing their specialty (49% vs. 30%, < 0.001). Furthermore, physicians were more likely to change their choice of specialty, contrary to their professional interest, because of social reasons (49% vs. 26%, = 0.007).
Our study suggests that young physicians in CL specialties have better working hours and place more emphasis on work-life balance while choosing their specialty compared with those in NCL specialties. The increase in the number of physicians in CL specialties is likely attributable to the growing preference for an optimal work-life balance among young physicians; this seems to have increased the maldistribution of physicians among various specialties. Institutional mechanisms to support the lifestyle of physicians (especially in NCL specialties) are required to provide a balanced medical service in Japan.
各专业医生数量不足及分布不均是日本医疗体系面临的关键问题。研究表明，年轻医生在选择专业时更注重工作与生活的平衡，且相较于不可控生活方式（NCL）专业，他们更喜欢可控生活方式（CL）专业。由于这可能是分布不均的一个原因，我们调查了日本年轻医生对工作与生活平衡的看法与专业选择之间的关系。
向日本全国60家日本红十字医院的1451名住院医师（研究生1至5年级）发送了在线调查问卷。
共有226名医生回复（回复率：15%），其中21%从事CL专业，74%从事NCL专业。与NCL专业相比，CL专业的加班时间更少（43%对16%，P = 0.001），认为生活比工作更重要的比例更高（26%对15%，P = 0.018），并且在选择专业时更倾向于将工作与生活的平衡置于医学兴趣之上（49%对30%，P < 0.001）。此外，由于社会原因，医生更有可能违背自己的职业兴趣改变专业选择（49%对26%，P = 0.007）。
我们的研究表明，与NCL专业的年轻医生相比，CL专业的年轻医生工作时间更好，在选择专业时更注重工作与生活的平衡。CL专业医生数量的增加可能归因于年轻医生对最佳工作与生活平衡的偏好增加；这似乎加剧了各专业医生分布不均情况。在日本，需要建立支持医生生活方式的制度机制（尤其是在NCL专业），以提供均衡的医疗服务。
