icine: O ed pe M n l A a r c e c e n s e s Takahashi et al., Gen Med (Los Angeles) 2016, 4:2 G General Medicine: Open Access DOI: 10.4172/2327-5146.1000232 ISSN: 2327-5146 Research Article Open access A Questionnaire Survey in Ehime Prefecture, Japan Revealed the Residents’ Preferences for Community Medicine and Medical Education Toshiaki Takahashi1*, Onishi Sachiko1, Kiyonori Takada1 and Naoto Kobayashi2 1Ehime University Hospital, Community Medical Support Center Shitsukawa, Toon, Ehime, Japan 2Ehime University School of Medicine, Medical Education Center Shitsukawa, Toon, Ehime, Japan *Corresponding author: Takahashi T, Ehime University Hospital, Community Medical Support Center, Shitsukawa, Toon, Ehime, Japan 791-0295, Tel: 089-960-5990; Fax: 089-960-5759; E-mail: [email protected] Rec date: March 17, 2016; Acc date: April 12, 2016; Pub date: April 18, 2016 Copyright: © 2016 Takahashi T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background: The lack of physicians in any given community results in very serious and ongoing deficiencies in medical service, and is a matter of considerable urgency for certain communities in Japan. Methods: We surveyed 2812 people by questionnaire regarding community medicine in Ehime Prefecture, Japan. Results and Conclusion: Those surveyed reported inadequate numbers of physicians in the areas of gynecology, pediatrics, internal medicine, neurosurgery, and other medical specialties. Regarding a question about the desired characteristics of a community physician, more than 50% of respondents indicated a desire for a physician who treats patients gently and kindly, can provide total care, and has extensive medical knowledge, while 15% expressed a preference for a physician with strong training in a particular field of medicine. In order to attract young physicians to the community, the majority of respondents were in favor of establishing a community hospital system that would accept those with excellent postgraduate medical training. Based on these results, it is possible to improve the medical education curriculum and to make an adequate regional policy to attract young physicians to community hospitals. Keywords: Community medicine; Questionnaire; Medical student; an important issue not only for rural regions with population declines Lack of physicians but also for Japan as a whole [2,3,4]. This supply-side decision-making often takes precedence over the demand-side realities, for instance Introduction community residents’ desires for safe and adequate medical care. Previous studies have only conducted questionnaire surveys among In many communities, especially those with smaller populations, community residents at the city or town level [5]. the insufficient number of physicians has become a significant problem. It is very difficult to maintain the function of medical Ikai reported questionnaire survey regarding the concern and facilities such as proper primary care and emergency first aid in the interest of community medicine, and eagerness of citizen’s movement rural area. Then, the progressive breakdown of community medicine for improvement of community medicine in 990 peoples of Takahama systems has occurred, jeopardize residents’ safety and security, and rural town (population of 11,500), Japan [5]. However, we could not potentially lead to community collapse. identify any studies performed at the prefecture level (in prefectures with a population of one million or more). Based on the national census, Ehime Prefecture had a population of 1,431,493 as of October 1, 2010, making it the 26th largest prefecture in The goal of the present study was to assess the current lack of Japan. Its proportion of residents aged 65 years and older was 26.6%, physicians in each region of Ehime Prefecture by administering a the 10th highest rate in Japan and above the country’s average (23%). questionnaire survey about community medicine to all residents of the The number of physicians per 100,000 residents was 244.7 for Ehime prefecture. The number of respondents from each region was Prefecture as a whole, which was slightly larger than the national determined by multiplying each community’s population by a certain average (230.4 per 100,000). The majority of physicians worked in percentage. Matsuyama City (308.5), the capital of Ehime prefecture, while the We hope our findings will contribute to a more efficient distribution values in the prefecture’s other cities and towns were all below the of physicians following discussion among administrating agencies, national average [1]. major hospitals, and community universities, as well as the medical In Ehime Prefecture, especially in mountainous and island areas, associations of the prefecture, counties, and cities. We also solicited there has been significant population decline. In addition, the fact that community residents’ opinions about their expectations regarding the residents are aging has contributed to the decline of local communities. medical students who would be the future providers of their medical Furthermore, there are many medically underserved areas and thus the care, and about measures to attract young physicians to their enhancement of community medicine is an urgent issue. The communities to promote the development and reconstruction of appropriate distribution of a limited number of physicians has become community medicine. Gen Med (Los Angeles) Volume 4 • Issue 2 • 1000232 ISSN:2327-5146 GMO,Open access journal Citation: Toshiaki Takahashi, Onishi Sachiko, Kiyonori Takada, Naoto Kobayashi (2016) A Questionnaire Survey in Ehime Prefecture, Japan Revealed the Residents’ Preferences for Community Medicine and Medical Education. Gen Med (Los Angeles) 4: 232. doi: 10.4172/2327-5146.1000232 Page 2 of 8 Materials and Methods (11) Expectations regarding the medical students who constitute the future of community medicine (up to three multiple-choice answers, We conducted an anonymous questionnaire survey of 3371 including “Other,” which allowed for free response) (i) Doctors who residents from all areas in Ehime Prefecture regarding their attitudes are familiar with state of the art medical technologies (ii) Doctors who towards their community medical care and physicians. The number of can provide general care based on broad knowledge (iii) Doctors with subjects in each region was determined based on the region’s strong training in a particular field of medicine (iv) Doctors who are population (a total of 20 cities and towns): 1034 people (0.2% of all rooted in the community (v) Doctors who are empathetic with patients residents) for Matsuyama City (which has a total of 516,803 residents (vi) Doctors who have excellent medical technique (e.g. surgical as of July 1st, 2012), and 2697 people (0.3% of the overall number of technique) residents) for cities other than Matsuyama City (which have a total of 899,283 residents as of July 1st, 2012). The numbers of questionnaires (12) Measures to be taken to attract young physicians to the sent to each region were: Ainan Town, 70; Ikata Town, 31; Imabari respondent’s community (any number of multiple-choice answers, City, 491; Iyo City, 113; Kamijima Town, 22; Kihoku Town, 34; including “Other,” which allowed for free response) (i) Inviting medical Kumakogen Town, 28; Masaki Town, 90; Matsuno Town, 13; students to local festivals or events (ii) Launching the city or town’s Matsuyama City, 1034; Niihama City, 362; Ohzu City, 138; Saijo City, own scholarship fund to attract students to the community (iii) 334; Seiyo City, 123; Shikokuchuo City, 267; Tobe Town, 65; Toon City, Encouraging local high school students to go to the local university’s 105; Uchiko Town, 53; Uwajima City, 246; Yawatahama City, 112 (total school of medicine (iv) Increasing the salary of young physicians 3,731), listed in alphabetical order within the prefecture. working at local hospitals (v) Establishing hospital systems that accept trainees A lower percentage of subjects were enrolled from Matsuyama City than other locations because, as it has been reported, urban areas have (The answer choices for questions (8), (9), and (10) were based on relatively more physicians and more adequate medical care than rural the classification of specializations provided by the Japan Medical areas [1]. In early September 2012, we sent the above-mentioned Association) numbers of questionnaires to the Division of Health and Medical Care This study was conducted under the Ehime Prefecture’s Project on of each city and town, and asked them to distribute and recover the Doctor Training and Career Support 2012, and approved by the sheets during relevant occasions such as events they hosted in their Community Medicine Promotion Committee of Ehime University regions so that the participants could voluntarily respond to the Hospital. Informed consent to participate in the study was obtained questionnaires. They were also asked to send the collected from participants. The study was approved by the Ethics Committee of questionnaires to the Community Medicine Support Center at Ehime Ehime University Graduate School of Medicine and conducted in University Hospital using collect on delivery parcels by the beginning accordance with the Helsinki declaration. of November 2012. The survey items included in the questionnaire were as follows: