POINT OF VIEW/ Masami Kitano: Require doctors to renew their medical licenses

Fears of a breakdown of the nation's health-care system are rising, with critics questioning the overall quality of medical services.

As someone in clinical practice with long experience working in both Japan and the United States, I wish to propose a system that would require doctors to renew their medical licenses on a regular basis.

Such a system would improve the quality of medical treatment through the efforts of doctors working at self-improvement.

In Japan, once a doctor graduates from medical school and passes a national qualifying examination, he or she is set to work for life. That is, unless one commits a serious transgression, such as misconduct that warrants administrative punishment. There is no requirement for doctors to renew their licenses.

Few countries allow such a state of affairs, especially among industrialized nations.

In the United States, medical licenses are good for life, too. However, doctors are required by law to renew their licenses at regular intervals. The systems differ by state. For example, in California, the interval is two years, while Texas requires doctors to renew their licenses every year.

While doctors do not have to pass paper tests to renew their licenses, they are required to attend medical seminars, lectures or similar educational programs.

In California, doctors must submit a certificate to the state board that shows they underwent a Continuing Medical Education (CME) program of 25 hours or more to have their licenses renewed. Various programs are available so that even busy doctors in private practice can meet the requirement.

For example, they can attend hour-long lunchtime lectures organized by community hospitals on a weekly basis. Such lectures typically focus on the latest developments in treatment of the new strain of swine flu, AIDS and metabolic syndrome as well as updates on advanced medicine for obesity, diabetics, pneumonia, cancer and other diseases.

The lectures are also open to nurses, social workers and pharmacists in addition to practicing physicians. Doctors are allowed to substitute in part attendance at such re-education programs with attendance at seminars hosted by medical societies, presentations at medical societies and enrollment in authorized CME courses featured in medical journals.

On their medical license renewal forms, doctors must list their practice of specialty, board certifications, foreign language skills and whether they have a financial interest in a health-related facility. Such information allows the state medical board to understand the situation facing doctors in their jurisdiction.

Being aware of a shortage or surplus of doctors in certain areas can help medical administrators more efficiently run their hospitals and advise practitioners.

In Japan, too, such institutions as medical societies, doctors' associations and medical schools offer lifelong education programs for doctors.

However, since these programs are optional, it is up to doctors to enroll in them. In other words, it is a doctor's willingness to keep his or her skills up to date that ensures that medical care is improved.

Unfortunately, the lack of such efforts by some doctors has led to a gap in the quality of medical services and wider regional disparities.

Globally, advances in medicine and medical services are directly affecting people's health and lives.

It is crucial for administrative authorities to keep tabs on the situation facing doctors, including imbalances in their distribution in terms of areas of specialty and by region, and take steps to rectify such problems.

Doctors in turn must keep abreast of the latest medical treatments in order to prevent malpractice, enhance quality of medical care and offer patient-oriented services.

I believe that a medical license renewal system would solve all these issues. Doctors shouldn't wait for the government to introduce it, however; they should take action on their own

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The author is a doctor specializing in neurosurgery and neurology.(IHT/Asahi: December 17,2009)