Dr. Kenji Shibuya, Research Director (right) and Junko Takashima, mother of Dr. Shingo Takashima (left) addressing the press during a December 15th press conference at the Foreign Correspondents’ Club of Japan

Shingo Takashima, a 26-year-old physician, tragically took his own life after consistently working more than 200 hours per month.

Dr. Kenji Shibuya, Research Director, and the bereaved family of Dr. Takashima, comprising his mother and brother—who is also a medical doctor—addressed the critical concerns related to Karoshi Deaths of Young Doctors from Overwork and Power Harassment at a press conference held at the Foreign Correspondents’ Club of Japan on December 15^th. 

“Japan's healthcare system relies on the sacrifices of hospital doctors,” Shibuya stated. 

Shibuya shed light on the challenging working conditions faced by hospital doctors, presenting data from a 2022 survey conducted by the Ministry of Health, Labour and Welfare. Approximately 20% of hospital doctors worked over 80 hours of overtime per month. In another survey conducted by the Japan Medical Association in 2021, 4% of doctors considered committing suicide or death every week or every day. 

In the “Doctors Workstyle Reform” starting from April 2024, one of the policies involved a special exception for annual overtime work hours, with the limit set at 1,860 hours for doctors. Shibuya highlighted that this exception primarily impacts doctors working at university hospitals, and those involved in regional acute care, including emergency hospitals, upon which many private regional hospitals depend for overtime work of these young doctors.

“The ministry and its policies have effectively allowed the status quo to continue, particularly in the context of maintaining regional healthcare. In my opinion, the concept of fulfilling the doctor’s mission in the community and tolerating long-working hours in my opinion are totally separate issues.”

Subsequently, Shibuya and the bereaved family of Dr. Takashima discussed doctor's “Voluntary Self Improvement” and “On Call Duty Permission”. 

“Voluntary Self Improvement,” which includes activities such as studying new treatment methods or new drugs, and preparing for conference presentations, is essential to doctors. However, the distinction between “Work” and “Voluntary Self Improvement” remains unclear.

“On Call Duty Permission” is initially granted to doctors in the case of limited or no patient activity. It is distinguished from regular night duty, but the bereaved family of Dr. Takashima indicates the reality of "On Call Duty Permission” is far from the original principle of it.

The bereaved family appealed to the risks of both are not being recognized in the declared hours of work, serves only to reduce the apparent hours of labor of physicians.

“We may need to rethink about how variable the Japanese health system would be.” Shibuya pointed out the necessity of rethinking from the perspective of how we should support and utilize the healthcare system as patients.

Shibuya, who was the Vice Chair of the Ministry of Health, Labour, and Welfare's “Doctor’s Workstyle Reform Deliberation Committee,” referred to its final report published in 2019. “In the opening sentence of the report, it states, ‘first and foremost, it is essential to share the recognition that our country's health system is being sustained through self-sacrificial, long working hours, and is currently in a critical state.’”

 

“Press Conference: Stop Karoshi Deaths Of Young Doctors From Overwork And Power Harassment” Foreign Correspondents’ Club of Japan
https://www.youtube.com/watch?v=LXZz9KUuesA&t=2877s 

Profile of Research Director Kenji Shibuya
https://www.tkfd.or.jp/en/experts/detail.php?id=653