Tago Masaki, Hirata Risa, Shikino Kiyoshi, Watari Takashi, Takahashi Hiromizu, Nishi Tomoyo, Sasaki Yosuke, Shimizu Taro
Department of General Medicine, Saga University Hospital, Saga, Japan.
Department of Community-Oriented Medical Education, Chiba University Graduate School of Medicine, Chiba, Japan.
Int J Gen Med. 2025 Sep 1;18:5033-5038. doi: 10.2147/IJGM.S540846. eCollection 2025.
General medicine physicians in Japan play diverse roles depending on their work environments; however, there is no clear definition. In the United States, the establishment of a definition for "hospitalists" has contributed to the accumulation of evidence. To develop research in general medicine and build evidence in Japan, there is an urgent need to establish a systematic classification method for general medicine physicians.
Based on discussions with six hospital-based general medicine physicians with over 10 years of experience at an academic conference in 2024 and a literature review, we proposed a classification method for general medicine physicians.
The proposed classification method was based on four indicators: physician maldistribution index, inpatient care contribution index (the contribution of one general medicine physician to inpatient care across all beds in the hospital), clinical content (home medical care, outpatient care, emergency response, inpatients management, and critical inpatients management), and education (medical students, clinical residents, and senior residents). These indicators were established by considering physician characteristics, target population, social environment, and hospital environment, enabling an objective evaluation of factors contributing to the practice of general medicine physicians.
This classification method may serve as a foundation for research that makes it easier to understand the characteristics of general medicine physicians under study and allows for the comparison of roles according to regional characteristics and hospital size. Future validation and continuous improvement of this classification method are expected to advance the accumulation of evidence related to general medicine physicians. In this paper, we present a proposal for a classification method; future validation of this classification is necessary.
日本的普通内科医生根据其工作环境发挥着不同的作用；然而，目前尚无明确的定义。在美国，“医院医生”定义的确定促进了证据的积累。为了在日本开展普通内科研究并积累证据，迫切需要建立一种系统的普通内科医生分类方法。
基于2024年在一次学术会议上与六位具有超过10年经验的医院普通内科医生的讨论以及文献综述，我们提出了一种普通内科医生分类方法。
所提出的分类方法基于四个指标：医生分布不均指数、住院护理贡献指数（一名普通内科医生对医院所有病床住院护理的贡献）、临床内容（家庭医疗护理、门诊护理、应急响应、住院患者管理和重症住院患者管理）以及教育（医学生、临床住院医师和高级住院医师）。这些指标是通过考虑医生特征、目标人群、社会环境和医院环境而确定的，能够对影响普通内科医生执业的因素进行客观评估。
这种分类方法可为研究提供基础，有助于更轻松地了解所研究的普通内科医生的特征，并允许根据地区特征和医院规模比较其角色。预计未来对该分类方法的验证和持续改进将推动与普通内科医生相关的证据积累。在本文中，我们提出了一种分类方法建议；未来有必要对该分类进行验证。
