Objectives : To determine factors related to peoples' preference for visiting home-doctors when experiencing new health problems.
Method : A questionnaire survey was conducted of people receiving annual health checkups in municipalities in the vicinity of Jichi Medical University Hospital. We surveyed personal characteristics, test equipment, having of a home-doctor, and answers to an assumed scenario (asking about willingness to visit a home-doctor in case of getting certain health problems).
According to the responses to the scenario, we divided the subjects into two groups (a home-doctor group: visiting a home-doctor; and a specialist group: not visiting a home-doctor) and statistically compared the two groups.
Results : In the analytic sample of 1,829, the home-doctor group numbered 1,097 individuals (60%) and the specialist group numbered 732 individuals (40%). The home-doctor group statistically had more home-doctors than the specialist group (adjusted odds ratio, 95% confidence interval: 2.47, 2.00-3.05).
More home-doctors in the home-doctor group had test equipment than home-doctors in the specialist group: Gastrointestinal test equipment (gastroscopy, colonoscopy, or ultrasonography) (adjusted odds ratio, 95% confidence interval: 1.39, 1.06-1.83).
Conclusion : We revealed two factors relating to the preference for visiting home-doctors: First, those people had home-doctors, and, second, the home-doctors had test equipment.

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BACKGROUND: The patient-physician relationship and patient self-management are important in controlling diabetes mellitus. This pilot study assessed the value of patients sharing their stories with physicians.
METHOD: Twelve patients and two physicians participated. Patients told their life stories to a co-medical interviewer, and these were transcribed and summarized in their medical charts. The physicians read the transcripts. The intervention was evaluated by questionnaire and interviews with the patients and physicians. Two coders qualitatively analyzed the interviews. Glycated haemoglobin (HbA1c) and body weight were examined before and six months after the intervention.
RESULTS: 75% of patients felt an improvement in the physician's empathy, advice and ability to share the patient's problems. Physicians reported an improved relationship with 40% of the patients. The patient interview identified: 1) facilitated self-reflection; 2) encouraged self-efficacy; 3) changed perceptions about health-care related behavior; and, 4) difficulties in changing behavior. However, improvement in HbA1c levels and body weight was not significant.
CONCLUSIONS: The patients were satisfied that sharing their stories improved self-reflection and self-efficacy, but found it difficult to adopt healthier options for managing their diabetes. Long-term study of whether improved physician communication skills will enhance outcomes is needed.

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OBJECTIVE: To demonstrate the feasibility of webinars, web-based real time interactive seminars, for geographically distant medical students and their tutors.
METHODS: Six participants from 5 medical schools in Japan were self-selected 3rd to 6th year medical students. A North American medical educator served as their webinar tutor. The students and tutor used home computers to participate in the webinar.
RESULTS AND CONCLUSIONS: A total of twelve webinars were held, 4 with a tutor and 8 without the tutor. Unstructured tutoring formats included symptom-related differential diagnoses, role-play and patient case discussions. We suggest webinar is a feasible technology to supplement the clinical training of medical students at medical universities.

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