J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text HTML] [Full Text PDF] （in Japanese / 860KB） [Members Only]

J.Jpn. Surg. Soc.. 111(4): 209-215, 2010

Feature topic

SURGEONS' HOPE: EXPANDING THE PROFESSIONAL ROLE OF CO-MEDICAL STAFF AND INTRODUCING THE NURSE PRACTITIONER/PHYSICIAN ASSISTANT AND TEAM APPROACH TO THE HEALTHCARE SYSTEM

1) Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Japan
2) Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan
3) Faculty of Clinical Engineering, Fujita Health University School of Health Sciences, Nagoya, Japan
4) Department of Cardiovascular Surgery, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
5) Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan

Tadaaki Maehara1), Hiroshi Nishida2), Takashi Watanabe3), Ryuji Tominaga4), Koichi Tabayashi5)

The healthcare system surrounding surgeons is collapsing due to Japan's policy of limiting health expenditure, market fundamentalism, shortage of healthcare providers, unfavorable working environment for surgeons, increasing risk of malpractice suits, and decreasing number of those who desire to pursue the surgery specialty. In the USA, nonphysician and mid-level clinicians such as nurse practitioners (NPs) and physician assistants (PAs) have been working since the 1960s, and the team approach to medicine which benefits patients is functioning well. One strategy to avoid the collapse of the Japanese surgical healthcare system is introducing the NP/PA system. The division of labor in medicine can provide high-quality, safe healthcare and increase the confidence of the public by contributing to: reduced postoperative complications; increased patient satisfaction; decreased length of postoperative hospital stay; and economic benefits. We have requested that the Ministry of Health, Labor and Welfare establish a Japanese NP/PA system to care for patients more efficiently perioperatively. The ministry has decided to launch a trial profession called "tokutei (specifically qualified) nurse" in February 2010. These nurses will be trained and educated at the Master's degree level and allowed to practice several predetermined skill sets under physician supervision. We hope that all healthcare providers will assist in transforming the tokutei nurse system into a Japanese NP/PA system.

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