Objective: To clarify the scope of practice on rural islands of Okinawa.Patient: A 59-year-old man presented to our clinic with shortness of breath.
He was intubated due to acute respiratory failure caused by severe pneumonia. We could not
transfer him owing to bad weather, and had to continue patient care in the clinic for more
than 24 hours.Discussion: In remote regions, rural physicians may require a broad scope of
practice from primary to tertiary care, in addition to preventive and end-of-life
care.Conclusion: This case illustrates the current state of emergency care and
unique scope of practice on rural islands of Okinawa.