Rural Doctors’ Satisfaction in Japan: A Nationwide Survey

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Abstract
The purpose of this paper was to discover to what degree Japanese rural doctors are satisfied with various aspects of their jobs and lives, and to find out whether they intend to continue their rural careers. Nationwide postal survey. Public clinics or hospitals in municipalities that are authorised as 'rural' by the national government. A total of 4896 doctors working for public clinics or hospitals. Self-evaluation questionnaires were mailed. The rural doctors were asked to evaluate their satisfaction with 19 items related to their job conditions and 10 items concerning life conditions, using a four-point scale. They also were asked to evaluate their intent to stay in rural practice until retirement. The response rate was 64%. Overall, rural doctors were satisfied with both their work and life conditions. However, only 27% of respondents hoped to continue rural practice beyond the usual age of retirement. Among job-related items, continuing medical education and interactions with municipal governments were rated as least satisfactory. Among lifestyle-related items, duration of holidays and workload were unsatisfactory. Subgroup analysis revealed male doctors showed greater intent to stay in rural practice. Doctors aged > 50 years were more satisfied with most aspects of their job and lifestyle than younger doctors. A strong correlation was found between the degree of intent to stay and several items such as interactions with municipal government, human interactions salary and job fulfillment. Strategies, based on the results of this survey, should be implemented. Particularly in Japan, positive interaction between doctors and municipal governments is crucial. Though rural doctors in Japan in general were satisfied with their lifestyle and work conditions, they have low intentions to stay in rural areas. Among the various factors that can cause this dissociation between satisfaction and intention to stay, doctors' interactions with municipal governments play a pivotal role.