【2】2024日本専門医機構社員総会での日本医学会会長門脇孝氏発言問題を検討

皆さま、こんにちは。
前回は、2024年6月28日に行われた日本専門医機構の社員総会で、日本医学会会長の門脇先生と、日本医師会長の松本先生が、「どうしてこの場でこんなことを言わないといけないの？」という内容を言及したことを記事にしました。
（関連記事日本専門医機構2024/06/28社員総会にて日本医学会会長と日本医師会長が不穏な発言
2024日本専門医機構社員総会での日本医学会会長門脇孝氏発言問題を検討【1】）
今回は、日本専門医機構2024/06/28社員総会における、門脇先生の発言について、法的な問題を検討してみたい第２弾をお届けしたいと思います。

これらの問題については、シリーズで深堀していきたいと思いますので、どうぞよろしくお願いいたします。

日本専門医機構社員総会で行われた門脇孝日本医学会会長の問題発言をおさらい

全文については、
日本専門医機構2024/06/28社員総会にて日本医学会会長と日本医師会長が不穏な発言
をご覧ください。

門脇孝氏の発言の問題点をピックアップ【2】

今回の記事では、以下の部分についての問題点を考えてみたいと思います。

上記発言の法的問題点を検討

「事務局が理事会や委員会、学会との申し送りや説明を適切に行っていないという報告が複数の関係者から私のもとに寄せられました。」について

「事務局が理事会や委員会、学会との申し送りや説明を適切に行っていない」という指摘を100人以上がいる場で公然と発言する場合、特に情報の具体性がないことが大きな問題点です。以下、問題点を考えてみましょう。

1. 具体的な事例や根拠が示されていない
発言の中で、どのような申し送りや説明が不足しているのか、具体的な事例や詳細な状況が提示されていません。問題提起をする際には、いつ、どのような場面で、どのような不備があったのか、具体的な事例や根拠を挙げることが必要です。そうしなければ、単なる噂や感覚的な批判と受け取られてしまい、実質的な解決に繋がらない恐れがあります。

2. 関係者に不必要な混乱を招く
情報の具体性がないまま「申し送りや説明が不適切」とだけ伝えられると、聞いた人々はどの部分が問題なのかを正確に把握できず、誤解や無用な混乱が生じる可能性があります。また、他の部門や関係者にも無関係な疑念が広がり、組織内の士気や信頼が低下する恐れもあります。

3. 問題解決への道筋が不明確
具体的な内容が示されなければ、関係者がどの点を改善すべきかが分かりません。事務局としても、何をどう改善すればよいのかが不明確なため、適切な対応を取ることができません。問題提起を行う際は、詳細な状況や事例を示し、それに基づいて改善策を協議する必要があります。

4. 責任の所在が曖昧になる
具体性のない発言は、誰に責任があるのかが不明瞭になりがちです。申し送りや説明が適切でないという指摘だけでは、事務局全体の責任なのか、一部の担当者によるものなのかが分かりません。責任の範囲や問題の規模を明確にするためには、より詳細な情報が不可欠です。

5. 建設的な議論ができない
情報の具体性が欠けると、建設的な議論が行えません。問題の本質が曖昧なままだと、改善に向けた具体的な行動が話し合われることなく、批判だけが先行してしまいます。具体的なデータや事例が示されることで、初めて問題に対する適切な対策が検討できるようになります。

したがって、100人以上の場で発言する際には、具体的な問題点や詳細な事例を示すことが重要です。情報が不明確なままでは、問題解決につながらず、ただ混乱や不信を招くだけの結果に終わってしまう可能性が高くなります。

このように、「まったく核心に触れずに問題を指摘する」やり方は、「パンチラ」でけむに巻く作戦と言って過言ではないでしょう。

「準備不足のままシステム登録を学会に強要し混乱を招いた」について

日本専門医機構では、専攻研修プログラムの責任者・事務担当者などの情報を、2018年のスタート当初は、各学会からExelの形でもらって、システムに反映していました。
2021年よりシステム更改により、専攻研修プログラム提供側が、専門医機構のシステムに直接登録できるようにしたので、各学会に、今後は自分たちもしくはプログラムを提供する医療機関のほうで登録をお願いしましたそうです。

ところが。これに従わない学会が一部ありました。
内科学会、外科学会、放射線学会などの学会です。

そして、これらの学会は、「今まで通り、機構にエクセルで送るからそっちで登録しろよ」に集約される主張をし、それ以降もずっと同じことを本年2024年まで繰り返しています。

従わない一部学会がある問題点

このような状況が続いている背景には、各学会の文化や運用方針、またはシステムへの移行に対する抵抗感があるのかもしれません。従来のやり方に慣れている関係者にとっては、新しいシステムへの適応が手間と感じられることも理解できる部分はありますが、それでは進歩や効率化の妨げになります。

特に、専門医機構がシステムを更新し、研修プログラム提供側が自ら登録できるようにした背景には、より透明性を高め、効率的に情報を管理し、エラーや遅延を減らすことが狙いだったはずです。それにもかかわらず、一部の学会がこれに応じず旧来の方法を続けることで、結果的には手間や時間を要する非効率な運用が継続してしまっています。

このような抵抗は、デジタル化やシステム改革が進む中で、他の業界でも見られる問題です。しかし、最終的には医療現場や研修制度の全体の向上を目指すためには、こうした旧来の慣習を超えて、新しい仕組みに対応していくことが求められます。長期的に見ると、すべての関係者が協力して効率化に努めることが、医療の質の向上にも寄与するでしょう。

従って、今後はこうした問題に対して対話を深め、適切な移行支援や研修を提供することで、スムーズに新しいシステムに移行できる環境作りが必要不可欠です。

「気にらない」から足を引っ張るという問題点

ルールが変わったのに従わないってどういうことですかね？
しかも、「準備不足のままシステム登録を学会に強要し混乱を招いた」って何なんですかね？

言っておきますが、日本内科学会も初めてコロナ禍で学術集会をWebのみで行ったとき、初日からサーバーダウンでつながりませんでした。
それって、「準備不足」じゃないんですか？
そもそも医療安全の考え方としては、”To err is human.”、つまり、「人間は間違えるものである」ということです。
準備しても完璧なものってありません。
不具合があればその都度是正していけばいいのに、どうしてこうやって「他人や他組織の足をひっぱる」のに使うのでしょうか？
この態度こそが、前近代的であり、建設的な議論や進歩を妨げている要因の一つです。医療安全の本質は、ミスをゼロにすることではなく、ミスが起こる前提でそれにどう対処し、改善策を講じるかにあります。それにもかかわらず、過度に責任追及や非難を強調する態度は、結局は問題の解決を遅らせ、現場のモチベーションを損なう結果につながります。

また、組織としての進化は、失敗から学び、それを共有して同じ過ちを繰り返さない仕組みを構築することにあります。批判ばかりが先行する環境では、失敗を隠す文化が生まれ、本質的な改善の機会が失われるのです。

重要なのは、失敗を恐れるのではなく、オープンに議論し、そこから共に成長していくこと。そのような文化を作り出すことで、初めて真の医療安全が達成されるのではないでしょうか。

「個人情報の漏洩が理事会に報告されるまで時間がかかったり」について

これに関しては、上記の内容が関係していそうです。
直近のプログラムをエクセルで提出したい一部の学会のために、専門医機構では、システム開発会社に「直接、専門医機構のシステムに登録できる形のエクセル」を作成してもらったそうです。
このとき、マクロという、VBA（Visual Basic for Applications）というプログラミング言語を使って、繰り返しの操作や複雑なタスクを記録し、後で簡単に再実行できるようにする、Excelでの作業を自動化するための機能が使用されました。
これについて、実際にデータを使用して確認するために、A学会の前年のデータが使用されたようです。

そして、マクロつきのエクセルが業者から専門医機構に納入されました。
ところが、このとき、業者さんのミスで、A学会のデータが残ったままになっていたのですが、ソートがかかっていて、気づかれないまま、クラウドにアップされ、それを内科学会がダウンロードしました。

内科学会はこのエクセルファイルに、A学会の「プログラムを提供する病院名、責任者名、担当事務」等が含まれていることに気が付き、ネットで調べて、このデータの氏名や病院名が存在することに気づき、「これはリアルな個人情報だ」、「こんなもの配布するなんてどうなってるんだ」と機構に連絡をしました。

その時点で、専門医機構はそのデータにアクセスできないようにし、ダウンロードしたのは内科学会だけでした。

「プログラムを提供する病院名、責任者名、担当事務」等は個人情報保護法で保護されるべき個人情報なのか

これらが個人情報に該当することは議論の余地はないでしょう。個人情報を取得する場合には、取得目的を特定して、公表または通知または掲示が必要です。

インターネットで公開されている情報は、個人情報保護法で保護されるのか

公知の情報であっても、その利用目的や他の個人情報との照合など取扱いの態様によっては個人の権利利益の侵害につながるおそれがあることから、個人情報保護法では、既に公表されている情報も他の個人情報と区別せず、保護の対象としています。新聞やインターネットなどで既に公表されている個人情報は、個人情報保護法で保護されるのですか。

今回の場合、A学会の「プログラムを提供する病院名、責任者名、担当事務」等が【第三者提供】されたことになるのか

要するに、今回の場合、A学会が提供する「プログラムを提供する病院名、責任者名、担当事務」などの情報は、本来、プログラムを提供する病院側やA学会が専門医機構のシステムに登録するべきところを、専門医機構に「業務委託」をする形で登録を依頼していると形式的に判断されるため、これは個人情報の第三者提供に該当しないと考えられます。

A学会や内科学会はそもそも専門医機構の【外部】つまり【第三者】と言えるのか

これについては、一般社団法人法を管轄する省庁に問い合わせたところ、社員（職員ではなく一般社団法人の構成員）団体に属する者たちが外部なのか内部なのかに関して、法令による明確な規定がないため、判断できないという回答を得ました。
つまり、このケースでは、第三者提供とみなされない可能性が高いということになります。

まとめ

内科学会は、こうした論点を整理することもなく、なぜ、「機構事務局が悪い、ガバナンスがなってない」みたいに騒ぐのでしょうか？
内科は、診断に至る過程やストラテジー（戦略）を非常に重視する診療科です。その理由は、内科が主に体の内側で起こる様々な疾患を扱い、それらの症状がしばしば複雑で多様だからです。

診断に至るストラテジーを重視する理由としては、以下が挙げられます。
1.幅広い疾患を扱う: 内科では、呼吸器、消化器、循環器、内分泌、腎臓など、様々な臓器やシステムに関わる病気を扱います。そのため、患者の症状が多岐にわたることが多く、特定の病気をすぐに特定できない場合が少なくありません。正しい診断に至るためには、症状、検査結果、病歴などを総合的に考慮する必要があります。

2.検査結果の解釈と推論: 内科では、血液検査や画像診断、心電図など多様な検査が行われますが、これらの結果を単に数値として捉えるだけでなく、その背景にある可能性のある疾患を推論し、さらに必要な検査や診断手法を選択します。複雑な検査結果を一つの病気に結びつけるには、しっかりとした推論と分析が不可欠です。

3.症状の因果関係を探る: 患者が訴える症状は、しばしば複数の疾患に関連していることが多いため、その因果関係を探りながら、可能性のある病気をひとつずつ排除していくアプローチが重要です。このようにして最終的な診断に至るプロセスは、まるでパズルを解くような論理的な推論が求められます。

4.治療方針の決定: 正確な診断が行われることによって、最適な治療方針を決定することができるため、診断のストラテジーが非常に重要です。誤った診断が行われると、治療も効果を発揮しないばかりか、患者にとって有害になることもあります。

このように、内科は単に症状や検査結果を機械的に処理するのではなく、患者の全体像を把握し、複雑な要因を分析して診断に至る戦略的なアプローチを必要とする診療科です。そのため、論理的思考や広範な知識をもとに診断を組み立てる能力が重要視されます。

ところが。内科学会は今回、「個人情報漏洩やー！！！どないしてくれるんじゃ(*｀Д´)ノ！！！」みたいに騒ぎ立てております。

それを耳にして、門脇孝先生がこのように発言したのでしょうが。門脇先生は内科専門医なのに、こうした論点を一度も考えたことがないのでしょうか？内科医としての腕に疑問が生じますね！
そのようなかたが、日本医学会会長とは恐れ入ります。

門脇氏の発言のほかの問題点については

順次書いていこうと思います。
この問題は、日本の医学のアカデミアの最高峰であるはずの、日本医学会連合会長が関係しているので、前回同様、英語をつけておきます。
もうね。世界中の人に見てもらったほうがいいんですよ。
どうせ日本人なんてガイアツでしか変われないのですから。
内容に問題がある、英文が間違っている、情報提供などありましたら、ぜひ、コメント欄からお知らせください！

Examining the issue of the comments made by Takashi Kadowaki, President of the Japan Medical Association, at the 2024 Japan Medical Specialty Board General Meeting [2]
2024.09.24

Issues related to the 2024 Japan Medical Specialty Organization General Meeting

Hello everyone.
In the previous article, we reported on the content of the comments made by Dr. Kadowaki, President of the Japan Medical Association, and Dr. Matsumoto, President of the Japan Medical Association, at the general meeting of the Japan Medical Specialty Board on June 28th, 2024, which included the words “Why do I have to say this here?
(Related article: Japan Medical Specialty Board 2024/06/28 General Meeting: Unrestful Remarks by the President of the Japan Medical Association and the President of the Japan Medical Association
2024 Japan Medical Specialty Board General Meeting: Examining the Remarks of the President of the Japan Medical Association, Takashi Kadowaki [1])
In this article, we would like to look at the second part of our examination of the legal issues surrounding the comments made by Dr. Kadowaki at the 2024/06/28 general meeting of the Japan Medical Specialty Board.
We will be looking at these issues in depth in a series of articles, so please look forward to them.
Review of the problematic comments made by Dr. Kadowaki, President of the Japan Medical Association, at the general meeting of the Japan Medical Specialty Board
For the all,
please see
Japan Medical Association President and Japan Medical Association President’s Unrestful Remarks at the Japan Medical Specialty Board General Meeting on 28/06/2024
.
Issues with the comments made by Takashi Kadowaki 2
In this article, I would like to consider the issues with the following parts
I have received reports from several people involved that the secretariat has not been properly communicating with the board of directors, committees, and academic societies. There are many problems, such as forcing academic societies to register with the system without adequate preparation, causing confusion, and the fact that it took a long time for the leak of personal information to be reported to the board of directors.
Examining the legal issues in the above statement
Regarding the statement “I have received reports from multiple people involved that the secretariat is not properly communicating with the board of directors, committees, and the academic society.”
When making a public statement in front of more than 100 people that the secretariat is “not properly communicating with the board of directors, committees, and the academic society,” the main problem is that there is a lack of concrete information. Let’s consider the issues below.
1. No specific examples or evidence are given
The speaker does not give any specific examples or details of the situation to show what kind of information or explanation is lacking. When raising an issue, it is necessary to give specific examples and evidence of when and in what situations the problem occurred. Otherwise, it may be taken as mere gossip or a subjective criticism, and there is a risk that it will not lead to a substantive solution.
2. Causing unnecessary confusion among those involved
If you simply tell people that “the handover of information and explanations are inadequate” without providing any specifics, those who hear this will not be able to accurately grasp which parts are the problem, and there is a possibility that misunderstandings and unnecessary confusion will arise. In addition, there is a risk that suspicion will spread to other departments and those involved, and morale and trust within the organization will decline.
3. The path to solving the problem is unclear
If you don’t give specific details, those involved won’t know what points they need to improve. The secretariat will also be unable to take appropriate action, as they won’t know what or how to improve. When raising an issue, you need to show detailed circumstances and examples, and discuss improvement measures based on this.
4. The location of responsibility becomes unclear
Statements that lack specifics tend to make it unclear who is responsible. If you only point out that the handover or explanation is inadequate, it is not clear whether the entire secretariat is to blame or whether it is the fault of a particular person in charge. In order to clarify the scope of responsibility and the scale of the problem, more detailed information is essential.
5. Unable to have a constructive discussion
If the information is not specific enough, it will be impossible to have a constructive discussion. If the true nature of the problem remains vague, criticism will be the only thing discussed, without any concrete action being taken to improve the situation. Only when specific data and examples are presented will it be possible to consider appropriate measures to deal with the problem.
Therefore, when speaking in a group of 100 or more people, it is important to present specific problems and detailed examples. If the information is unclear, it will not lead to a solution to the problem, and there is a high possibility that it will only end up causing confusion and mistrust.
In this way, it is not an exaggeration to say that the method of “pointing out the problem without touching the core at all” is a strategy of confusing people with “panchira”.
Regarding “causing confusion by forcing the academic society to register the system without sufficient preparation”
At the Japan Medical Specialty Board, information such as the names of the people in charge of the training programs and administrative staff was initially received from each academic society in Excel format at the start of the system in 2018, and this was reflected in the system.
From 2021, due to a renewal of the system, the providers of the training programs were able to register directly in the Japan Medical Specialty Board system, so the Board asked each academic society to register either themselves or through the medical institutions providing the programs.
However, there were some academic societies that did not comply with this.
These included the Japanese Society of Internal Medicine, the Japanese Society of Surgery, and the Japanese Society of Radiology.
These societies made the argument that they would continue to send the data to the JSME in Excel format as before, and asked the JSME to register it for them. They have continued to do the same thing ever since, and this year, in 2024, they are still repeating the same thing.
The problem with the fact that some societies are not complying
The reason for this situation continuing may be due to the culture and operational policies of each society, or their resistance to the transition to the new system. For those involved who are used to the old way of doing things, it is understandable that adapting to the new system may seem like a hassle, but this will hinder progress and efficiency.
In particular, the aim of the system update by the specialist medical organization and the ability for training program providers to register themselves was to increase transparency, manage information more efficiently, and reduce errors and delays. Nevertheless, some academic societies have not responded to this and are continuing with their old methods, and as a result, inefficient operations that require time and effort are continuing.
This kind of resistance is a problem that can be seen in other industries as well, as digitization and system reform progress. However, in order to ultimately improve the medical frontline and the training system as a whole, it is necessary to move beyond these old customs and adapt to new systems. In the long term, the cooperation of all parties involved in striving for efficiency will also contribute to improving the quality of medical care.
Therefore, it is essential to create an environment in which we can smoothly transition to the new system by deepening dialogue on these issues and providing appropriate transition support and training.
The problem of dragging your feet because you don’t like it
What do you mean by not following the rules when they’ve changed?
And what do you mean by “forcing the academic society to register on the system without adequate preparation, causing confusion”?
I should mention that when the Japanese Society of Internal Medicine held its first academic conference online only due to the coronavirus pandemic, the server went down on the first day and it was impossible to connect.
Isn’t that “poor preparation”?
The basic idea of medical safety is that “to err is human.” In other words, “humans make mistakes.”
There is nothing that is perfect, even if you prepare for it.
If there are any problems, why not just fix them as they arise? Why do we use them to “pull the legs of others and other organizations” like this?
This attitude is pre-modern and is one of the factors that prevents constructive discussion and progress. The essence of medical safety is not to reduce mistakes to zero, but to deal with them on the premise that mistakes will occur and to take measures to improve them. Nevertheless, an attitude that emphasizes excessive blame and criticism will ultimately delay the resolution of problems and result in a loss of motivation in the workplace.
In addition, organizational evolution lies in learning from mistakes and building a system that shares this information to prevent the same mistakes from being made again. In an environment where criticism is the only thing that prevails, a culture of hiding mistakes will be born, and opportunities for essential improvement will be lost.
What is important is not to be afraid of failure, but to openly discuss it and grow together from it. I think that true medical safety can only be achieved by creating such a culture.
Regarding “it took a long time before the leak of personal information was reported to the board of directors”
This seems to be related to the above content.
For some academic societies that wanted to submit their most recent programs in Excel, the Japan Medical Specialty Board had a system development company create “Excel that can be directly registered in the Japan Medical Specialty Board system”.
At this time, a function called “macro” was used, which is a programming language called VBA (Visual Basic for Applications) that records repetitive operations and complex tasks so that they can be easily re-executed later, to automate work in Excel.
To check this using actual data, it seems that data from the year before the A conference was used.
Then, Excel with macros was delivered from the vendor to the specialist medical organization.
However, at this time, due to a mistake by the vendor, the data from the A conference was still left in the file, but it had been sorted, so it was uploaded to the cloud without being noticed, and the internal medicine conference downloaded it.
The Internal Medicine Association noticed that this Excel file contained information such as the names of the hospitals providing the programs, the names of the people in charge, and the names of the people in charge of the administrative work, etc., and after checking online, they realized that the names and hospital names in this data existed, and contacted the organization, saying, “This is real personal information,” and “How can they distribute something like this?”
At that point, the specialist medical organization made the data inaccessible, and only the internal medicine association was able to download it.
Are the names of the hospitals that provide the program, the names of the people in charge, and the names of the people in charge of the administration, etc. personal information that should be protected by the Personal Information Protection Law?
There is no room for debate that these fall under the category of personal information. When acquiring personal information, the purpose of acquisition must be specified, and it must be made public, notified, or posted.
Is information published on the internet protected by the Personal Information Protection Law?
Even if the information is already public knowledge, there is a risk that it could lead to a violation of an individual’s rights and interests, depending on how it is handled, such as its purpose of use or collation with other personal information. The Personal Information Protection Law therefore protects information that has already been made public, without distinguishing it from other personal information. Is personal information that has already been made public in newspapers or on the internet protected by the Personal Information Protection Law?
In this case, does it mean that the “names of the hospitals providing the program, the names of the people in charge, and the administrative staff in charge” of the A Society were provided to a third party?
2-2-1-1 The concept of “provider
If the case falls under either (1) Provision by the Individual Themself or (2) Provision on Behalf of the Individual Themself, the obligation to confirm and record the information does not apply, as it is not effectively provided by the “provider”. With regard to the provision of information by a third party, i.e. the act of “providing” information from the “provider” to the “recipient”, the applicability of each element is judged in light of the purpose of the obligation to confirm and record the information.
Specifically, the following concepts listed in “2-2-1-1: The concept of ‘provider’” to “2-2-1-3: The concept of ‘provision’” may be applicable, but each category is not mutually exclusive and there may be cases where they overlap. In addition, in light of the purpose of the obligation to confirm and record, there is no exclusion of other cases where the obligation is not practically applicable.
– Omitted –
[Cases that fall under provision by the individual]
Example: When acquiring the profile of the poster and the content of the post on a social networking service
Provision on behalf of the individual
When a business handling personal information provides personal data of an individual to a third party based on a commission from the individual, the business handling personal information is providing the personal data “on behalf of the individual”.
Therefore, in this case, neither the provider nor the recipient is subject to the obligation to confirm or record the provision of personal data to a third party.
Whether or not a business operator handling personal information can be considered to be providing personal data based on a commission from the individual in question will be determined by considering the content of the commission, the content of the personal data to be provided, and the personal information handling business operator to which the data is provided, etc., as a whole, and from the perspective of whether or not the individual in question can specifically identify the provision in question.
In addition, when receiving a commission to provide personal data from the individual, it is possible that the personal data of someone other than the “individual” may be included in the personal data.
Source: Guidelines on the Act on the Protection of Personal Information (Verification and Recording Obligations when Providing Personal Information to a Third Party)
In other words, when a business handling personal information commissions all or part of the handling of personal data to a third party within the scope necessary to achieve the purpose of use, if the personal data is provided
Even if the information is already public knowledge, there is a risk that it could lead to a violation of an individual’s rights and interests depending on how it is handled, such as the purpose of use or collation with other personal information, so the Personal Information Protection Law protects even information that has already been made public, without distinguishing it from other personal information. Is personal information that has already been made public in newspapers or on the internet protected by the Personal Information Protection Law?
In short, in this case, the information provided by the A Society, such as the names of the hospitals providing the program, the names of the people in charge, and the administrative staff in charge, is formally judged to be information that should be registered by the hospitals providing the program or the A Society in the system of the Specialist Medical Organization, but instead they are requesting that the Specialist Medical Organization register it as a form of “outsourcing”, so it is not considered to be a case of providing personal information to a third party.
Can the A Society and the Internal Medicine Society be considered to be [external] to the Specialist Medical Organization, or [third parties]?
When we asked the ministry in charge of the general incorporated association law about this, we received a response that it was impossible to determine whether the people belonging to the organization (members of the general incorporated association, not employees) were external or internal, as there were no clear regulations in the law.
In other words, in this case, there is a high possibility that it will not be considered to be a third party provision.
Summary
Without sorting out these issues, why is the Japanese Society of Internal Medicine making such a fuss, saying things like “the JSOI secretariat is at fault, and there is no governance”?
Internal medicine is a medical specialty that places great importance on the process and strategy of diagnosis. The reason for this is that internal medicine deals mainly with various diseases that occur inside the body, and the symptoms of these diseases are often complex and diverse.
The following are some of the reasons why internal medicine places such importance on diagnostic strategies.
1. It deals with a wide range of diseases: Internal medicine deals with diseases that affect various organs and systems, such as the respiratory, digestive, circulatory, endocrine, and renal systems. As a result, patients often have a wide range of symptoms, and it is not always possible to immediately identify a specific disease. In order to reach a correct diagnosis, it is necessary to consider the symptoms, test results, and medical history as a whole.
2. Interpretation and inference of test results: In internal medicine, various tests are carried out, such as blood tests, imaging diagnosis, and electrocardiograms, but it is not enough to simply look at the results as numbers. It is also necessary to infer the possible diseases behind these results, and then select the necessary tests and diagnostic methods. In order to link complex test results to a single disease, it is essential to have a solid basis for inference and analysis.
3. Exploring the causal relationship between symptoms: Since the symptoms that patients complain of are often related to multiple diseases, it is important to eliminate possible diseases one by one while exploring the causal relationship. The process of reaching a final diagnosis in this way requires logical inference, like solving a puzzle.
4. Determining the treatment plan: The strategy for diagnosis is extremely important, because an accurate diagnosis allows the most appropriate treatment plan to be determined. If a wrong diagnosis is made, not only will the treatment be ineffective, but it may even be harmful to the patient.
As you can see, internal medicine is not simply a matter of mechanically processing symptoms and test results, but rather a medical specialty that requires a strategic approach to diagnosis, based on an understanding of the patient’s overall picture and an analysis of the complex factors involved. For this reason, the ability to construct a diagnosis based on logical thinking and extensive knowledge is considered to be of great importance.
However, the Japanese Society of Internal Medicine has been making a lot of noise recently, saying things like “What are you going to do about the personal information leaks! .
I think that Dr. Takashi Kadowaki made this comment after hearing about this. Dr. Kadowaki is a specialist in internal medicine, but has he never considered these issues before? I have to question his ability as a doctor!
I’m surprised that someone like him is the president of the Japan Medical Association.
I’ll write about the other issues with Dr. Kadowaki’s comments
in due course.
As this issue involves the president of The Japanese Medical Science Federation, which is supposed to be the highest peak of Japanese medical academia, I will add English to the article as I did last time.
You know, it would be better if people from all over the world could see this.
After all, Japanese people can only change if they are exposed to foreign cultures.
If you find any problems with the content, any mistakes in the English, or any information you would like to provide, please let us know in the comments section!