Frontier medical sciences versus geriatrics

摘要

The Ministry of Health, Labor and Welfare of Japan has been changing medical system very rapidly with limitations on hospital stays of 2 weeks, emergency department preparedness, decreases in hospitals for long-term medical treatment and cutting medical costs. Doctors in hospitals have to care only for acute patients and are forced to increase the turnover of beds in order to increase the income of the hospital. Veteran doctors claim it is hard work to keep a high turnover of beds and increased night duty for emergency patients and some of them are leaving hospitals due to burnout. New training systems for postgraduate doctors accelerated the uneven distribution of young doctors among all hospitals in Japan, which also accelerated the work of veteran doctors. It is quite efficient to discharge patients immediately after curing the disease but doctors complain of a loss of accomplishment because of the unknown prognosis of the patients. After discharge from the hospital, most young patients can rapidly recover their daily activity but most older patients are far below their former daily activity before they got sick because of multi-organ diseases. Older patients, after discharge from the hospital, are taken care of by outpatient departments, rehabilitation departments or the disease becomes chronic.