A future estimate of physician distribution in hospitals and clinics in Japan.
OBJECTIVES
To make future estimates of physician distributions in hospitals and clinics to better understand the impact of recent health policy changes in post graduate clinical education, and to discuss possible policy implications.


METHODS
Analyze National Surveys Data conducted from 1972 to 2004. Multistate Life Table was used to make future estimations of numbers of physicians in hospitals and clinics.


RESULTS
A typical Japanese physician's career would start from academic hospitals, and move through non-academic hospitals to clinics. After the introduction of the new post-graduate clinical training system in 2004, more medical school graduates started their careers at non-academic hospitals. Recently, the flow of physicians from academic hospitals to non-academic hospitals has been declining while the flow from academic hospitals to clinics has slightly increased. We also observed a shift of physicians from hospitals to clinics. From the data we estimated that the number of physicians working at clinics will be almost equal to those at non-academic hospitals in 2016, for the first time in 30 years.


CONCLUSIONS
It is important to discuss the appropriate sharing of roles, responsibilities, and cooperation among medical facilities in line with the observed changes of career paths and physician distributions.