Examining Japanese laypeople's nationality preferences for physicians: a nationwide study

This study aimed to investigate physician nationality preferences of Japanese laypeople and the reasons behind the preferences. We performed a nationwide study in May 2025. The participants were monitors of an internet survey company who responded to closed questions regarding nationality preferences across different physician qualities and clinical scenarios, along with open-ended questions regarding their expectations and concerns about care by foreign national physicians. We analyzed responses to the closed questions by descriptive statistics. We compared responses between individuals with prior experience of seeing a foreign national physician and those without such experiences by chi-square test. For free-text responses, we performed inductive content analysis. Among 2004 respondents, approximately half to two-thirds preferred Japanese physicians. Participants with prior experience of seeing a foreign national physician were significantly less likely to indicate a nationality-concordant preference. In free-text responses, 337 participants provided expectations (360 codes) and 938 provided concerns (982 codes). Among concerns, 723 codes were labelled as a language barrier. Participants expressed expectations of the possible strengths of foreign national physicians. This study clarified the nationality preferences of Japanese laypeople in physician selection. The findings have significant implications, including the necessity of reconsidering medical education strategies, public education, and inclusive policy frameworks.