Local Medical Associations in

Overview of the Medical Association

JMAJ 50(2): 187–189, 2007

Fukushima 1 Yuzo TAKAYA* Pop. 2.1mil. Area 13,800km2

Aizuwakamatsu City is in the region, the western part of Prefecture. The city is renowned for its Tsurugajo Castle, besieged during the Boshin Civil War in 1868. To the east of the city are magnificent Bandai Mountain Tokyo and Lake, the birthplace of the out- standing medical scientist, Hideyo Noguchi. The natural beauty of the Urabandai area is also noteworthy. The city abounds with cultural assets, such as the historically important remains of Enichiji Temple founded by the great priest, Tokuichi, and Shojoji Temple housing invaluable monthly or semimonthly meetings for continuing Buddhist statues. medical education. Although the Ekiyuukai was “You must not do what you must not do” a voluntary organization, it served as a body to has long been the spirit of Aizu, which strictly decide the activities of the association. governed the acts of young clansmen attending Following the promulgation of the new con- the Nisshinkan school. Adhering to this spirit, stitution of Japan, the Aizuwakamatsu Medical Masayoshi Ito (1913–1994), a statesman from Association was reorganized as a corporate body this area, refused to take office as prime minister, on November 1, 1947 in concert with other medi- when he considered the governing party’s reform cal associations in Japan. policy as useless as “changing the cover of a book without changing the content.” The climate and Aizu Is Closely United culture of the Aizu region as glimpsed here has had considerable influence over the origin and There are four local medical associations in the development of the Aizuwakamatsu Medical Aizu area: Aizuwakamatsu, Kitakata, Ryonuma- Association. gun, and -gun. A liaison council combining these medical associations was set Establishment of the Medical up within this author’s generation. The council Association meets whenever needed to discuss whatever topics necessary. Respecting the opinions of Like most local medical associations in Japan, the neighboring medical associations, the council Aizuwakamatsu Medical Association was first unifies their opinions and communicates them to established on April 4, 1906 under the Medical the prefectural medical association to facilitate Practitioners Law (Law No. 47). Its antecedent, the exchange of information. called the Ekiyuukai, had been formed by doc- tors in Aizuwakamatsu in 1886. The doctors held

*1 Vice President, Fukushima Medical Association, Aizuwakamatsu, Japan ([email protected]). This article is a revised English version of a paper originally published in the Journal of the Japan Medical Association (Vol.134, No.10, 2006, pages 1952–1953).

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and seminars for preschool doctors and preschool Hospital-Clinic, Clinic-Clinic, and teachers are held annually. With the participation Hospital-Hospital Collaboration of schoolmasters, dentists, and pharmacists, these activities are contributing to the improvement of In Aizuwakamatsu City, there are two hospitals the health of children and students. The seminars with more than 1,000 beds, a prefectural hospital of preschool doctors and preschool teachers with 401 beds, and a private hospital with 435 are held to address common problems such as beds (including a psychiatric ward). The age of infection control measures (e.g., when students competition among hospitals has ended, and with infection should refrain from attending each hospital is now offering its own distinctive school and when they may return to school). features, striving to strengthen cooperation with Because of this, a large proportion of preschool clinics to encourage referrals from clinics to teachers attend these meetings, and we have had hospitals and from hospitals to clinics. to limit the number of participants from each The driving force behind this movement is preschool. provided by the presence of Hatsukakai, a group of doctors from all parts of Aizu which was Holiday and Nighttime Emergency formed in January 1983 under the motto of “No Medical Services academic cliques, no seniority. All that counts is personality and specialty.” Starting from a The shortage of pediatricians is a serious prob- membership of eight doctors, this group grad- lem nationwide. An emergency child patient taken ually attracted more and more doctors, not only to the emergency room of a large hospital is not general practitioners but also department chiefs likely to be treated by a specialist pediatrician. and managers of hospitals. Today, 22 years after Although citizens need specialist pediatricians, its establishment, it has as many as 136 members. this need is hard to satisfy. Furthermore, the We are confident that the relationship among concentration of pediatricians in university hos- directly acquainted members has been effective pitals is aggravating the shortage of pediatricians in removing much of the hesitation in writing especially at clinics. Those working in hospitals referral letters. The monthly meeting of general are fatigued from overwork. practitioners and hospital doctors, consisting of The Aizuwakamatsu Medical Association has lectures and presentations followed by a recep- reorganized holiday and nighttime emergency tion, has helped the development of hospital- medical services to include pediatrics, in addition clinic, clinic-clinic, and hospital-hospital collab- to internal medicine and surgery, so that three oration. This group has been instrumental in groups of doctors are available on holidays, al- implementing model projects for hospital-clinic though the number of doctors is still insufficient. collaboration, the family doctor system, and Nighttime emergency centers are staffed with regional health care collaboration promoted by pediatricians on holidays (Sundays and public the Japan Medical Association. Every member holidays) and with doctors trained in pediatrics of the medical associations in Aizu is directly on weekdays. Two years from the introduction of experiencing the importance of hospital-clinic this system, the number of pediatric patients is collaboration and its role in the enrichment of increasing steadily, reflecting the growing aware- community health care. ness among citizens.

The School Doctor and Preschool Promotion of Maternal and Child Health Doctor Committee We have been making efforts to improve social In former days, the assignment of school doctors services and negotiating with relevant authorities was hereditary in the sense that each position to make changes in response to the needs of was handed down from the predecessor to the citizens, such as the in-kind payment of medical successor, but a committee now appoints school benefits for infants, the raising of the age limit to doctors impartially, and the new system has won six, and the direct payment of the Lump Sum the confidence of members. Birth Allowance from the municipal government Meetings of school doctors and nurse teachers to hospitals. While wide-area standardization of

188 JMAJ, March/April 2007 — Vol. 50, No. 2 OVERVIEW OF THE AIZUWAKAMATSU MEDICAL ASSOCIATION

individual (as opposed to mass) vaccination has ing in 1933 was held to commemorate Dr. Hideyo not been implemented on a prefectural basis, we Noguchi, who passed on a few years before. Since are calling for the cooperation of municipalities then, a lecture meeting inviting two distinguished to achieve standardization, at least in the Aizu speakers from various fields has been held every region. year, and is attended by a large audience, of not only practitioners and hospital doctors but also Publication of the Journal of the dentists, pharmacists, and nurses. Aizuwakamatsu Medical Association Conclusion The Journal of the Aizuwakamatsu Medical Association has been issued since April 1965. As The most serious problem at present is related of 2006, 500 journal numbers have been issued to prefectural hospitals, which have become in- without any interruption. Under the motto of dependent corporations under Local Public En- “Written by all, read by all” the journal has been terprise Law and have a tremendous cumulative published by the joint efforts of the four medical deficit. They must be revived through the process associations, and the monthly editorial meetings of closing down and consolidation, and finding a provide wonderful opportunities for interaction. way to survive in the regional community as gen- eral hospitals. All members of the Aizuwakamatsu The Aizu Society of Medicine Medical Association are working together toward the enrichment and development of regional The Aizu Society of Medicine evolved from a health care, striving to be doctors who are loved, study group formed by members of medical asso- trusted, and respected by citizens. ciations in the Aizu region. The first lecture meet-

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