The Market for Pediatric Surgeons in Japan : A Recommendation for the Appropriate Allocation of Qualified Pediatric Surgeons and Facilities

Abstract

Purpose The Japanese Society of Pediatric Surgeons (JSPS) has endeavored to increase authorized pediatric surgeons and facilities for nationwide recognition of pediatric surgical subspecialty. However, there has been a lack of assessment of current markets for pediatric surgery or the outcome of pediatric surgeons' employment research. This paper recommends an appropriate allocation of qualified pediatric surgeons and facilities in Japan to meet the current market demand. Methods Based on the clinical performance in the pediatric surgical department of Saitama Municipal Hospital, the workload required for a pediatric surgeon to adequately meet the budget balance in the Japanese Health Insurance System was calculated. The rate of pediatric surgical patients among the pediatric population was calculated by dividing the whole pediatric population by the number of hospitalized pediatric surgical patients registered in annual reports of the Certifying Committee of the JSPS. According to the calculated data, the size of the workforce market for pediatric surgeons was estimated. Results An income of 91,558,000 yen/doctor/yr is required to adequately meet the hospital budget balance. A pediatric surgeon should have 220 hospitalized patients, conduct 164 operations and have 2,750 outpatients per year to earn this amount. Numbers of pediatric population were calculated at 484 per hospitalized patient and 626 per patient needed operation. The estimated pediatric surgical market to keep with the pediatric population was 188 pediatric surgeons and 50 facilities nationwide. The modest market for pediatric surgical manpower in each administrative division of Japan was also recommended based on pediatric populations in each district using a regionalization map. Conclusions The current supply of pediatric surgeons and facilities has exceeded the demand Leaders of the JSPS need to give serious consideration to workforce adjustment in order to maintain the highest quality of pediatric surgical care in the context of the current and future market. Construction of a novel common nationwide system is mandatory.