J.Jpn. Surg. Soc.. 127(5): 476-484, 2026

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Feature topic

BACKGROUND AND FUTURE OUTLOOK OF THE 2026 REVISION OF MEDICAL REIMBURSEMENT FEES AIMED AT IMPROVING SURGEONS’ WORKING CONDITIONS

In the recently finalized 2026 revision of medical reimbursement fees, measures aimed at improving the working conditions of surgeons were finally incorporated. The newly introduced “Regional Medical Care Support and the Special Surgical Care Add-on” represents groundbreaking measures that for the first time provide a base salary increase for physicians in specific specialties and offer direct incentives to surgeons who perform long, highly complex operations. At the same time, these add-ons are not merely financial adjustments; they form part of a comprehensive policy package that includes the promotion of work-style reform, consolidation of medical services and regional role-sharing in anticipation of population decline, aging, and workforce shortages expected around 2040. This package may indicate what acute-care hub hospitals should look like in the near future. To increase the number of surgeons, we must advance both improved compensation based on these new add-ons and the realization of better work–life balance as two inseparable pillars. This article reviews the series of initiatives undertaken by the Japan Society of Gastroenterological Surgery which led to the inclusion of surgeon-focused improvements in the current revision and outlines the fundamental principles underlying our approach to enhancing surgeons’ working conditions.

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