Retention rate of physicians in public health administration agencies and their career paths in Japan

Abstract

BackgroundPhysicians who serve as public health specialists at public health centers and health departments in local or central government have significant roles because of their public health expertise. The aim of this study is to analyze the retention and career paths of such specialists in Japan.MethodWe analyzed the data of seven consecutive surveys, spanning 1994 to 2006. We first analyzed the 2006 survey data by sex, age group, and facility type. We then examined the changes over time in the proportion of physicians working in public health administration agencies. We also examined the distribution of the facility types and specialties in which physicians worked both before beginning and after leaving their jobs. These analyses were performed by using physician registration numbers to cross-link data from two consecutive surveys.ResultsThe proportion of physicians working in public health administration agencies was 0.7% in 2006. The actual numbers for each survey ranged between 1,800 and 1,900. The overall rate remaining in public health administration agencies during the two-year survey interval was 72.8% for 1994-1996. The ratio declined to 67.2% for 2004-2006. Among younger physicians with 1-10 years of experience, the retention rate showed a sharp decline, dropping from 72.6% to 50.0%. Many of these physicians came from or left for a hospital position, with the proportion entering academic hospital institutions increasing in recent years. In many cases, physicians left or entered internal medicine clinical practices.ConclusionAt present in Japan, the number of physicians who leave and the number who begin a position are almost the same; thus, some of the problems associated with physicians leaving are yet to become apparent. However, the fact that the retention period is shortening for younger physicians may represent a future problem for ensuring the quality of physicians in public health administration agencies. Possible strategies include: increasing the number of physicians entering positions; reducing the number leaving positions; and creating a system where physicians can easily reenter positions after leaving while also establishing a revolving door type of career development system, involving both public health departments and hospital clinical departments.

Career Paths of Public Health Medicine Specialists in South Africa

“…While some movement between employers is normal and enables people to find work niches, the large proportion who left the public sector, citing job dissatisfaction, and the unidirectional trend in movement out of the public sector, is concerning. These concerns are reflected in a Japanese study, where the retention of younger PH physicians in the public sector dropped from 73% between 1994 and 96 to 50% between 2004 and 6 (62). In the USA, PH professionals who were not satisfied with their work were 3.5 times more likely to consider leaving (22).…”

Factors related to the resignation and migration of physicians in public health administration agencies using nationwide survey data in Japan

“…In Japan, physicians in public health administration agencies (public health physicians: PHP), including public health centers and public health departments in the local or national government, play important roles in public health [ 1 ]. Public health centers operate under the Ministry of Health, Labour and Welfare (MHLW) of Japan, and they perform a wide range of services, such as those involving maternal health, mental health, environmental health, etc.…”

“…Thus, because there are not enough PHPs in Japan, the factors affecting their resignation and migration need to be known. Only one nationwide study has been conducted, which reported that younger people tend to resign more, and many come from hospitals [ 1 ]. The study used data from 1994 to 2004; however, after compulsory postgraduate clinical training was introduced in 2006, the number of medical doctors going to rural areas or basic medical sciences decreased [ 6 ].…”

Distribution and retention trends of physician-scientists in Japan: a longitudinal study

“…Koike et al obtained detailed data with permission from the MHLW and studied the trends in PSs by analyzing the data. They reported that while the number of younger PSs decreased from 1996 to 2008, the total number remained almost unchanged [17]. However, their study was published in 2010 and they did not examine data from 2008, or the measures implemented to nurture or secure PSs such as MD-PhD courses and PS training courses [14].…”