In this preliminary study, we surveyed the physicians at two academic hospitals on their knowledge of and attitudes toward the medical insurance system in Japan. Most of the physicians had not read the "Ministerial Ordinance on Insurance Medical Institutions' and Insurance Medical Doctors' Medical Treatment under Health Insurance." Of the 433 physicians who filled out the questionnaire completely, 34% had either not read or rarely read the "Medical Fee Point List." Most (89.1%) of the physicians knew that there is a stepwise reduction in the hospitalization fee as the length of a patient's hospital stay increases. However, approximately 30% did not know the stipulation of obtaining an informed consent from the patient prior to blood transfusion. As for the right of patients to see their medical care remuneration statements, which was decided by the government in 1997, 26.8% of the physicians did not know this rule. Physicians who had read the "Ministerial Ordinance on Medical Treatment," were more likely to read the "Medical Fee Point List" frequently; were more likely to know the stipulation about diminishing hospitalization fee; were more likely to know that an informed consent must be obtained prior to blood transfusion; and were more likely to know that patients had a right to see their medical care remuneration statements. The longer the clinical experience of the physician, the more likely that the physician had read the "Ministerial Ordinance on Medical Treatment" and know the other stipulations well. In these two academic hospitals, it is important to establish educational seminars for physicians on the guidelines of the medical insurance system so that physicians will become familiar with the medical insurance system quickly.

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An ongoing debate is underway on whether the right to control medical information required for objective evaluations and uncertain information should belong to the physician. In this study, the opinions of practicing physicians were examined. Information appearing on medical records was divided into 10 items, and physicians were asked whether the right to control each item belonged to the patient and/or the physician. More than 60% the physicians answered that both patients and physician have the right to control information such as the diagnosis, examination findings, informed consent, and treatment. All of these items can be categorized as personal data. On the other hand, more than 70% of the physicians believed that only physicians have the right to control information such as the process to reach a diagnosis, subjective patient information, uncertain information and discussion with other physicians. Those physicians who answered that that both patients and physicians have the right to control information such as subjective patient information were more in favor of the disclosure of medical records than the physicians who were against the patient's right to control such information (p<0.05). The results of this study suggest that the right to control medical information on medical records should be considered separately for each chart item. As the network of medical information advances, the right to control medical information will become a topic of increasing importance.