Geographic Maldistribution of Physicians in Japan : Increasing the Number of Generalists is One Solution

Abstract

Despite massive intervention from Japan’s national and local governments, the skewed distribution of physicians remains a serious social problem. This review paper summarizes past literature and proposes a future strategy to deal with this sophisticated issue based on scientific evidence. There are several ways to achieve a more balanced distribution, the most feasible of which is to increase the number of generalists. This increase might be imminent with the establishment of a formal board certification for general practitioners (sougou-shinryou-i) and raising the number of rural subquota (chiikiwaku) entrants to medical school. All the stakeholders should co-operate to take advantage of this great opportunity to increase the number of generalist physicians and solve Japan’s distribution problem.