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Yoshifumi Nakashima
Toru Yoshikawa
Michiko Kido
Yoshiharu Aizawa
Kichiro Matsumoto


Background: The April 2019 amendment of the Labor Standards Act in Japan led to a current ongoing work style reform. The amendment set the monthly overtime cap at 100 hours, but physicians are exempt for the next five years. The work style reform for physicians aims to ensure both their health and well-being and to provide appropriate community medicine. From April 2024, the maximum overtime permitted for physicians will be 100 hours a month and 960 hours a year. Community medicine hospitals, however, will have a different time limit and their physicians will be allowed to work up to 100 hours a month and 1,860 hours a year overtime. Junior/senior residents can also apply for exemption by registering for accredited training programs. Exempt physicians are required to comply with additional measures to ensure their good health and well-being.
Objectives: This paper proposes promotion strategies for work style reform for physicians in Japan.
Method: The Japan Medical Association Physicians’ Work Style Reform Committee developed proposals using the Delphi methods.
Results: To manage physicians’ work time, an objective understanding of real work conditions, a review of employment agreements, active use of occupational health teams, task shifting, support for female physicians, and KAIZEN (a Japanese business philosophy) activities are important. The roles fulfilled by occupational health physicians, hospital directors, supervisors, physicians, patients, and community medicine systems are summarized from the perspective of comprehensive management.
Conclusions: The Japanese health care system defines the work style of Japanese physicians. However, physicians as highly specialized professionals can more or less choose any workplace. A physician being aware of their characteristics and independently choosing their own work style would give meaning to an appropriate work–life balance. True work style reform should aim for this.

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