Hiroki Nogawa

The current shortage and future surplus of doctors: a projection of the future growth of the Japanese medical workforce

BackgroundStarting in the late 1980s, the Japanese government decreased the number of students accepted into medical school each year in order to reduce healthcare spending. The result of this policy is a serious shortage of doctors in Japan today, which has become a social problem in recent years. In an attempt to solve this problem, the Japanese government decided in 2007 to increase the medical student quota from 7625 to 8848. Furthermore, the Democratic Party of Japan (DPJ), Japans ruling party after the 2009 election, promised in their manifesto to increase the medical student quota to 1.5 times what it was in 2007, in order to raise the number of medical doctors to more than 3.0 per 1000 persons. It should be noted, however, that this rapid increase in the medical student quota may bring about a serious doctor surplus in the future, especially because the population of Japan is decreasing.The purpose of this research is to project the future growth of the Japanese medical doctor workforce from 2008 to 2050 and to forecast whether the proposed additional increase in the student quota will cause a doctor surplus.MethodsSimulation modeling of the Japanese medical workforce.ResultsEven if the additional increase in the medical student quota promised by the DPJ fails, the number of practitioners is projected to increase from 286 699 (2.25 per 1000 persons) in 2008 to 365 533 (over the national numerical goal of 3.0 per 1000) in 2024. The number of practitioners per 1000 persons is projected to further increase to 3.10 in 2025, to 3.71 in 2035, and to 4.69 in 2050. If the additional increase in the medical student quota promised by the DPJ is realized, the total workforce is projected to rise to 392 331 (3.29 per 1000 persons) in 2025, 464 296 (4.20 per 1,000 persons) in 2035, and 545 230 (5.73 per 1000 persons) in 2050.ConclusionsThe plan to increase the medical student quota will bring about a serious doctor surplus in the long run.

Qualitative and quantitative assessment of video transmitted by DVTS (digital video transport system) in surgical telemedicine.

Real-time video pictures can be transmitted inexpensively via a broadband connection using the DVTS (digital video transport system). However, the degradation of video pictures transmitted by DVTS has not been sufficiently evaluated. We examined the application of DVTS to remote consultation by using images of laparoscopic and endoscopic surgeries. A subjective assessment by the double stimulus continuous quality scale (DSCQS) method of the transmitted video pictures was carried out by eight doctors. Three of the four video recordings were assessed as being transmitted with no degradation in quality. None of the doctors noticed any degradation in the images due to encryption by the VPN (virtual private network) system. We also used an automatic picture quality assessment system to make an objective assessment of the same images. The objective DSCQS values were similar to the subjective ones. We conclude that although the quality of video pictures transmitted by the DVTS was slightly reduced, they were useful for clinical purposes. Encryption with a VPN did not degrade image quality.

UDP Large-Payload Capability Detection for DNSSEC

Domain Name System (DNS) is a major target for the network security attacks due to the weak authentication. A security extension DNSSEC has been proposed to introduce the public-key authentication, but it is still on the deployment phase. DNSSEC assumes IP fragmentation allowance for exchange of its messages over UDP large payloads. IP fragments are often blocked on network packet filters for administrative reasons, and the blockage may prevent fast exchange of DNSSEC messages. In this paper, we propose a scheme to detect the UDP large-payload transfer capability between two DNSSEC hosts. The proposed detection scheme does not require new protocol elements of DNS and DNSSEC, so it is applicable by solely modifying the application software and configuration. The scheme allows faster capability detection to probe the end-to-end communication capability between two DNS hosts by transferring a large UDP DNS message. The DNS software can choose the maximum transmission unit (MTU) on the application level using the probed detection results. Implementation test results show that the proposed scheme shortens the detection and transition time on fragment-blocked transports.

A Short Introduction to MedicoMusik

In this short note, we are going to outline our idea of MedicoMusik , which means our integrated view and methodology towards a scientific and evidence-proved investigation of effective music to human health. On this theme, we are now preparing a book that describes the full perspective of MedicoMusik , and we strongly recommend interested users to examine our book to be published soon.