制度として確立していない「かかりつけ医」
何なんでしょうか、この厚生労働省のポスターは？
悪魔を名乗る方が、白衣を着てこんな宣伝をしていいのでしょうか？
彼は、「上手な医療のかかり方大使」なのだそうです。
彼は、実生活では、中学の同級生のかかりつけ医がいて、「定期健診を、悪魔のくせに、体は人間の体を借りているので、まあやっている」そうです。
しかし、普段健康で、病気にかからない人には、かかりつけ医なんかいないと思います。
日本医師会が２０２０年７月に行った「第7回 日本の医療に関する意識調査」によると、「かかりつけ医がいると回答した人の割合は全体の55・2％で過去の調査から大きな変化が見られなかった」ということです。
そのようにかかりつけ医を持っていない人でも、「あの病気」に感染してしまった人が大勢いたでしょう。
２０２１年夏の第５波などに、症状が悪化しても医療を受けられず、自宅療養中に亡くなった人たちがいたことです。電話で医師らとつながることもできず、まさに医療からこぼれ落ちた患者がいた。働き盛りの世代も多く含まれます。（中略）
保健所が、感染者の健康観察や入院をすべきかの判断までを担い、流行時には破綻していました。これらは本来、かかりつけ医が担うべき業務です。
かかりつけ医は法律で定められたものではありません。診察を受ける側にとっては、どこのスーパーで買い物をするか、という程度のものでしかないのです。かかりつけ医を持っていると思う人も、「片思い」なのかもしれません。
日本ではどこの病院でも、健康保険証を持っていけば診てもらえる「フリーアクセス」のルールがあり、医者にとっても、患者にとっても仕組みとして定着しています。でも、『あの病気』のような感染拡大が今後も起きることを想定した対策が必要です。
近年の医療制度改革で「かかりつけ医」がキーワードになっている。コロナ禍でも入院医療が逼迫する中、身近なかかりつけ医の役割がクローズアップされた。
かかりつけ医には制度的な規定がなく、その意味は曖昧だ。日本の医療の特徴であるフリーアクセスを阻害しかねない面があり、制度化が避けられてきた。
高齢化による疾病構造の変化で、患者の健康問題全般に一貫して対応するプライマリーケアの重要性が増している。かかりつけ医が中核となって適時適切な医療につなぐ体制が求められる。
かかりつけ医の普及には、患者が医師を登録する制度の導入も選択肢だ。担い手となる人材の質・量を確保するため、研修や認定の仕組みも工夫する必要がある。
健康保険制度は国によって異なり、一長一短あります。それについて書くと長くなるので、改めて投稿します。
このnoteで「かかりつけ医」を検索すると、よいかかりつけ医を見つけられるかどうかは、運次第のようです。その点では、デーモン閣下は恵まれています。悪魔が恵まれていいのかどうかわかりませんが。
"Primary care doctor" that has not been established as a system in Japan
What is this poster of the Ministry of Health, Labor and Welfare?
Can a person who claims to be the devil, wearing a white coat, advertise like this?
He is said to be an "ambassador of good medical care".
He says that in real life, he has a primary care doctor who was a classmate of his in junior high school, and "I do regular checkups, well, I do them because I am a demon and I owe my body to a human body". However, people who are usually healthy and do not get sick do not have a primary care doctor.
According to the "7th Survey on Attitudes toward Medical Care in Japan" conducted by the Japan Medical Association in July 2020, "The percentage of respondents who said they have a primary care doctor was 55.2% of all respondents, and There was no significant change from past surveys".
Many people who did not have a primary care doctor as such would have contracted "that disease".
When the fifth wave arrived in the summer of 2021, there were people who died while recovering at home because they could not get medical care even as their symptoms worsened. There were patients who were unable to connect with doctors and others by phone, and who were truly spilling over from medical care. Many of them were in their prime working years. （omitted) The public health department was responsible for monitoring the health of infected patients and even deciding whether they should be hospitalized, which was failing during the epidemic. These are duties that should be performed by primary care doctors.
The primary care doctor system is not stipulated by law. For the person being examined, it's just a matter of where to shop. Even those who think they have a primary care doctor may in fact have a "one-sided" love affair.
In Japan, there is a "free access" rule that allows patients to be examined at any hospital as long as they bring their health insurance card, and this has become a well-established system for both doctors and patients. However, it is necessary to take measures in anticipation of the spread of infection like "that disease" in the future.
With the recent reform of the medical system, "primary care doctor" has become a keyword. The role of a primary care doctor was highlighted while hospitalization was tight even in the spread of "that disease". Primary care
doctors have no institutional provisions and their position is ambiguous. Institutionalization has been avoided because it may hinder free access, which is a characteristic of Japanese medical care. Changes in the disease structure due to the aging of people are increasing the importance of primary care, which consistently addresses patient health problems in general. A system is required in which the primary care doctor plays a central role in providing timely and appropriate medical care. In order to popularize family doctors, it is also an option to introduce a system in which patients register their doctors. In order to secure the quality and quantity of human resources who will be the leaders, it is necessary to devise a training and certification system.
Health insurance systems vary from country to country, and each has its advantages and disadvantages. It would be a long post to write about it, so I will post it later.
If you search for "primary care doctor" in this note, it seems that it depends on your luck whether you can find a good primary care doctor. In that respect, "His Excellency Demon Kakka" is blessed. I don't know if the devil can be blessed.
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