Abstract
Risk management has become an important issue in Japanese healthcare. This development can be explained by reasons that are internal and external to healthcare. First of all, medical malpractice litigation is increasing in Japan because American liberalism is spreading and the patients' rights movement is developing. Secondly, quality of care has become an important goal in both academic medicine and public policy. But risk management in Japan is not working well because many physicians are not familiar with the method of risk management. They also lack legal support and economic incentives that are needed in a system of risk management. The development of a good system of risk management will depend on adequate legal support, proper economic incentives, and a teaching program aimed at physicians. The role of a good system of risk management is not only to prevent medical litigation, but also to ensure high quality healthcare. To achieve the goal of high quality care, the focus must shift from narrow system of risk management to a broad system of peer review and medical audit.
