Related Experiment Video
Updated: May 29, 2025
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Scope of practice of Japanese primary care physicians and its associated factors: a cross-sectional study
Tomoya Higuchi1,2, Mieko Nakamura3, Toshiyuki Ojima2
1Department of Family and Community Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan tomoyah@hama-med.ac.jp.
Objective:
The scope of practice (SOP) of primary care physicians (PCPs) has been narrowing, with declining comprehensiveness leading to fragmented care. Identifying SOP-associated factors can help improve comprehensiveness. This study aimed to describe the SOP of PCPs working in clinics and to identify SOP-associated factors.
Design:
A cross-sectional study using a self-administered questionnaire.
Setting:
Shizuoka, Japan.
Participants:
PCPs working in clinics offering internal medicine.
Main Outcome Measures:
The total number of services provided, covering 109 items, was categorised into 8 clinical areas, 78 clinical activities and 23 procedures.
Results:
Questionnaires were mailed to 1191 clinics, and 389 valid responses were included in the analysis. Of the 389 physicians, 254 (65.3%) were internal medicine specialists, and 382 (98.2%) worked in their own private clinics. The mean number of services provided was 60.4±17.4. Clinical activities were provided less frequently in the areas of paediatric and adolescent care, women's health, home healthcare, palliative care and mental health. Physician-related factors were more significantly associated with SOP than practice or environmental factors. Preference for broad practice was the strongest factor associated with a broader SOP, followed by completion of the Japan Medical Association (JMA) primary care training programme and rotational training experience. Additionally, younger physician age, rural practice experience, surgical specialisation, a larger number of physicians in the clinic, higher patient volume and a more rural setting were associated with broader SOP.
Conclusion:
Physician preference regarding SOP, completion of the JMA primary care training programme and rotational training are key factors influencing SOP. These findings suggest that postgraduate clinical training with a broad scope not limited to internal medicine and continuing medical education after establishing a private clinic, particularly for physicians who prefer broad practice, may be important in expanding the SOP of PCPs.
Related Concept Videos
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
01:18Factors Affecting Illness
For instance, risk factors are connected to illness,...
01:11Secondary Healthcare System
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:29Assessment of the Gastrointestinal System II: Health Perception Pattern
Health Perception Patterns
Health perception patterns offer valuable insights into a patient's lifestyle habits and how they may impact their GI health. These patterns include:
01:30Preventive Healthcare Services