2018 Volume 45 Issue 3 Pages 472-476
There has been increased demand for team medicine through collaboration of physicians and non-physician healthcare professionals (non-physicians) to promote (1) higher quality of medical care, (2) reduced burden on physicians, (3) improved medical safety, and (4) reduced medical expenses. The Ministry of Health, Labor and Welfare has adopted various renewal plans designating the specific roles of non-physicians that can be carried out under the current healthcare system.
It can be said that the heath evaluation is a common area for conducting team medicine as interprofessional collaboration. In primary preventive health evaluations (disease prevention, enlightenment of health, health promotion), especially for examinees with ‘mibyou’, guidance in dietary education (nutritional guidance), physical education (exercise therapy), and intellectual education (motivation, behavior change, stress management, sleep guidance) is of great importance, and this will become a crucial role for non-physicians. Furthermore, in examinees with metabolic syndrome, providing effective suggestions for prescription drugs and recognizing its side effects can also be expected to become the role of pharmacists and nurses. In particular, clinical reasoning (medical interview and physical assessment) may be required in some situations to recognize side effects in those who undergo drug therapy.
However, despite such attempts to expand the current role of non-physicians, Article 17 of the Medical Practitioners’ Act, which limits medical practice by non-physicians, has raised various differences in opinion regarding the extent to which non-physicians can deliver such explanations, guidance and suggest prescription drugs; therefore, a consensus has yet to be obtained. Additionally, efforts must be made to obtain sufficient understanding and consent from examinees.
Future reforms to the educational program (graduation curriculum, national licensing exam, post-graduate training and lifelong education system) to help non-physicians acquire more sophisticated knowledge, skills and attitudes, in addition to changes in legislation, are essential in promoting role expansion of non-physicians in health evaluations.
