Best medical practice: the case of Japan

'Best medical practice' can be given three different definitions. Definition A, by the medical profession, emphasizes the maintenance of technical standards in diagnosis and treatment. Definition B, by the essentially healthy general population, emphasizes preventive measures and the reassurance of the healthy status. Definition C, by the chronically sick and disabled, emphasizes rehabilitation and nursing care. Although each has its inherent weakness, each could be said to be describing an essential but distinct aspect of comprehensive health care which can be utilized to legitimize each party's claim for priority in the allocation of resources. Thus, the relative weight that is given to the three definitions of 'best medical practice' in society as a whole appears to be ultimately dependent on the social and cultural conditions unique to each country. In the case of Japan, Definition B has become the most dominant: it has resulted in the health care demands of the essentially healthy general population being well taken care of without excessive allocation to high technology medicine. However, a combination of demographic, technological and social changes will necessitate a different emphasis in the future.