本音で語る医師の働き方改革

ҩྍۈ຿؀ڥվળϚωδϝϯτγεςϜݚڀձ ୈճγϯϙδ΢Ϝɹ ຊԻͰޠΔҩࢣͷಇ͖ํվֵ $**OD୅දऔక໾౦ژେֶ࢈්ਓՊڭࣨ Ԃాਖ਼थ

7*4*0/ ҆৺ͯ͠࢈ΈҭͯΒΕΔࣾձΛͭ͘Δ

ҭࣇʹؔΘΔ͢΂ͯͷਓΛসإʹ͢Δ .*44*0/

͜ Ͳ ΋ ͱ Ո ଒ ͷ স إ Λ
ͭ ͘Δ ɻ A

࿑ಇ؀ڥվળ͕໨ࢦ͢ͱ͜Ζ ҩྍ҆શ

࢈්ਓՊҩ ౦ ژ େ ֶ େ ֶ Ӄ ެ ऺ
Ӵ ੜ ֶ ೔ ຊ ࢈ Պ ් ਓ Պ ֶ ձ ҩ ྍ վ ֵ ҕ һ ձ ઐ ໳ ҩ ੍ ౓ ҕ һ ձ ະ དྷ ҕ һ ձ ࢈්ਓՊҩ͔Βපࣇอҭͷઐ໳Ո΁

೔ ຊ ࢈ Պ ් ਓ Պ ֶ ձ ҩ
ྍ վ ֵ ҕ һ ձ ઐ ໳ ҩ ੍ ౓ ҕ һ ձ ະ དྷ ҕ һ ձ σ δ λ ϧ ϋ Ϧ ΢ ο υ େ ֶ Ӄ Τ ϯ δ χ Ξ Ϧ ϯ ά σ β Π ϯ Ϗ δ ω ε ٳ ֶ ೔ ຊ খ ࣇ อ ݈ ڠ ձ ޿ ใ ɾ ϗ ʔ Ϝ ϖ ʔ δ ҕ һ ձ පࣇอҭͷઐ໳Ո ࢈්ਓՊҩ͔Βපࣇอҭͷઐ໳Ո΁

ಇ͖ํվֵͷखஈ ҩࢣͷಇ͖ํվֵ ϋʔυ ιϑτ ੍౓ ؀ڥ ΦϖϨʔγϣϯ ୹࣌ؒਖ਼نޏ༻ ؃ޢٳՋ ҭࣇٳՋ
౰௚ɾPODBMMͷਖ਼౰ධՁ Ӄ಺อҭ ࣌ؒอҭ පࣇอҭ Ձ஋؍

w ໌೔͔Βಇ͖ํվֵΛ࣮ߦ͢Δ w ಇ͖ํվֵʹपғΛר͖ࠐΉ ΰʔϧ

࣌ؒ֎࿑ಇΛ·ͣ͸͜ͷϨϕϧ·ͰԼ͛Δʂ ʢ࣮ྫΛݩʹ࡞੒ʣ ա࿑ࢮϥΠϯ ΩʔʹͳΔ਺ࣈ

ᶃॏ఺Խʢू໿Խʣ ᶄมܗ࿑ಇ੍࣌ؒ ᶅ୹࣌ؒۈ຿ऀͷ׆༂ ᶆΦϖϨʔγϣϯͷ޻෉ ᶇՁ஋؍Λม͑Δ ᶈΠΫϘε ᶉঁੑҩࢣͷಇ͖ํͱපࣇอҭ ࣌ؒ֎࿑ಇΛݮΒͨ͢Ίʹඞཁͳ͜ͱ

ϚΫϩฤ ްੜ࿑ಇলҩࢣͷಇ͖ํվֵʹؔ͢Δݕ౼ձΛத৺ʹ

ಇ͖ํվֵʢҩࢣ൛ʣ w೥͔Βҩࢣʹ͸దԠ w೥࣌ؒ ݄࣌ؒ Ҏ಺ͷ࣌ؒ֎࿑ಇ͕໨ඪ wಛఆͷҩࢣʹ͸೥࣌ؒ ݄࣌ؒ ·Ͱͷ ࣌ؒ֎࿑ಇΛೝΊΔ

ҩࢣͷۈ຿࣌ؒ ްੜ࿑ಇলɹୈճɹҩࢣͷಇ͖ํվֵʹؔ͢Δݕ౼ձɹࢿྉΑΓ Ҏ্ͷۈ຿ҩ͸ա࿑ࢮϥΠϯΛ௒͑ͯಇ͍͍ͯΔ

एखҩࢣͷಇ͖ํ ްੜ࿑ಇলɹୈճɹҩࢣͷಇ͖ํվֵʹؔ͢Δݕ౼ձɹࢿྉΑΓ ଔޙ̏ ʙ̑ ೥໨ͷපӃۈ຿ҩͷिۈ຿࣌ؒͷ۠෼ผׂ߹˞̎ ˞̍ ۈ຿࣌ؒʹ͍ͭͯ͸ɺʮපӃۈ຿ҩͷۈ຿࣮ଶʹؔ͢Δݚڀʯʢฏ੒೥౓ްੜ࿑ಇߦ੓ਪਐௐࠪࣄۀඅʮපӃۈ຿ҩͷۈ຿࣮ଶʹؔ͢Δௐࠪݚڀʯݚڀ൝ʣͷूܭ݁Ռ͔Βɺʮ਍ྍ ֎࣌ؒʯʢڭҭɺݚڀɺֶशɺݚम౳ʣʹ͓͚Δ্࢘౳͔Βͷࢦࣔʢ໧ࣔతͳࢦࣔΛؚΉɻʣ͕ͳ͍࣌ؒʢௐࠪථʹʮࢦࣔແʯΛهೖʣ͕ ˋͰ͋Δ͜ͱΛ౿·͑ɺʮҩࢣͷۈ຿࣮ଶٴͼ ಇ͖ํͷҙ޲౳ʹؔ͢Δௐࠪʯʹ͓͚Δݸථͷ਍ྍ֎࣌ؒΑΓ࡟ݮͨ͠ɻ
˞̎ ݱࡏͷઐ໳ҩ੍౓ʹ͓͚Δઐ߈ҩͷظؒ͸ྟচݚमऴྃޙ̏೥Ҏ্ͱ͞Ε͍ͯΔɻ 6.9% 12.7% 5.2% 1.7% 4.6% 0.0% 5.0% 10.0% 15.0% ि40࣌ؒະຬ ि40Ŗ50࣌ؒ ि50Ŗ60࣌ؒ ि60Ŗ70࣌ؒ ि70Ŗ80࣌ؒ ि80Ŗ90࣌ؒ ि90Ŗ100࣌ؒ ि100࣌ؒҎ্ 5 8.5% 13.9% 24.0% 19.6% 16.0% 10.9% 3.4% 3.8% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% ि40࣌ؒະຬ ि40ʵ50࣌ؒ ि50ʵ60࣌ؒ ि60ʵ70࣌ؒ ि70ʵ80࣌ؒ ि80ʵ90࣌ؒ ि90ʵ100࣌ؒि100࣌ؒҎ্ ˞ʮ ࢦࣔͷͳ͍࣌ؒʯ ͷ࡟ݮޙ

େֶපӃͷҩࢣͷಇ͖ํ ࣌ؒʙ ʹ೔ಇ͘ͱͯ࣌ؒ͠EBZͷ࣌ؒ֎ʢա࿑ࢮϥΠϯͷ̎ഒʣ

ಇ͖ํվֵ࣮ݱ΁ͷ՝୊ ू໿Խ͕ग़དྷ͍ͯͳ͍

7PMVNFPVUDPNFSFMBUJPOTIJQ Birkmeyer JD et al.Surgeon volume and operative mortality in
the United States. N Engl J Med. 2003,27;349(22):2117-27.

ܦࡁࡒ੓ࢾ໰ձٞ ׭ຽͰ̍̏ສපচ࡟ݮΛ ҩྍඅ཈੍Ͱຽؒٞһఏݴ w ೥ʹඞཁͱͳΔපচ਺Λࣔ͢ ʮ஍Ҭҩྍߏ૝ʯΛࡦఆ ˞೥ɿஂմͷੈ୅͕ࡀҎ্΁

िʢ໷ۈ݄ճʣ ʴΦϯίʔϧ݄ճ ݄ Ր ਫ ໦ ۚ ౔ ೔ ࣌ؒ֎࿑ಇ
࣌ؒि ݄ ࣌ؒ ৗۈਓ ஍Ҭप࢈ظ ηϯλʔ" ࣌ ࣌ ࣌ ࣌ ࣌ ࣮ࡍͷ࿑ಇ؀ڥ ࣋ଓՄೳͰͳ͍

࢈්ਓՊͷಛघੑ

ɾएख࢈්ਓՊҩͷ໿ׂ͕ঁੑҩࢣ ɾ࢈Պͷ໷ۈ͸z࢈්ਓՊҩ͚ͩz͕Մೳ ΑΓྑ͍ಇ͖ํվֵ͕ٻΊΒΕΔʂ

ग़య ೔ຊ࢈Պ්ਓՊֶձɹ ೔ຊ࢈්ਓՊҩձ ʮΘ͕ࠃͷ࢈්ਓՊҩྍ ࠶ݐͷͨΊͷۓٸఏݴʯ ฏ੒26೥12݄13೔ ೔ຊ࢈Պ්ਓՊֶձੑผ೥ྸผձһ਺ʢ೥݄ʣ

ϐϯν͸ νϟϯεʂ

ग़య ೔ܦϝσΟΧϧసࡌɹ ʢ2019/2/4ʣ

࢈Պ්ਓՊֶձ͸ ઌਐతʹٞ࿦ɺఏݴ͍ͯ͠Δ

࢈්ਓՊͷݱঢ়

ҩࢣ਺ͷਪҠ

@தҪ ষਓઌੜʢ೔ຊҩՊେֶʣ ʢҰ෦վมʣ ࢪઃ਺ ෼ṯࢪઃ͸ ݮগ

࣌ؒ֎࿑ಇͰ ࠷΋ΠϯύΫτ͕͋Δͷ͸ l໷ۈͷճ਺z ʮ౰௚ʯͰ͸ͳ͘ʮ໷ۈʯͰ͢ʂ

౰௚ͱ͍͏ͷ͸ ʮ౰൪ΛܾΊͯۈ຿͢Δ͜ͱʯ ͱ͍͏ͷ͕ຊདྷͷҙຯɻ ۀ຿಺༰΍ಇ࣌ؒ͘ଳΛࢦ͢΋ͷͰ͸ͳ͘ɺ ೔௚ɺ॓௚ɺͲͪΒ΋౰௚ͱ͍͑Δɻ ࢀߟɿʮ౰௚ʯͱ͍͏ݴ༿ͷ֬ೝ

॓௚Ͱ͋ͬͯ΋ɺिճ্͕ݶͰ͢ʂ ਍ྍߦҝΛߦΘͳ͍ٳ೔ٴͼ໷ؒۈ຿͕ ࿑ಇج४๏ୈ৚߸ͷ౰௚ʢ॓೔௚ʣۈ຿ ۩ମతʹ͸ɾɾɾ ɾපࣨͷఆ࣌८ճ ɾগ਺ͷױऀͷݕԹɺཁ஫ҙױऀͷఆ࣌ݕ຺ͳͲ ʮ॓௚ʯͷఆٛ

௨ৗۈ຿ɿ೔ۈɺ໷ۈʢ४໷ۈɾਂ໷ۈʣ ౰௚ɹɹɿ೔௚ɺ॓௚ ࢀߟ

໷ۈPS॓௚ ʮ౰௚ʯͱ͍͏ݴ༿ͷ֬ೝ େ੾ͳͷ͸ ͋ͳ͕͍ͨͭ΋ߦͳ͍ͬͯΔʮ౰௚ʯ͸

ਖ਼֬ʹ͸ ʮ໷ۈʯͰ͋Γ ͢΂ͯͷ͕࣌ؒʢ࣌ؒ֎ʣ࿑ಇ࣌ؒʹʂʂ զʑ࢈්ਓՊҩ͕΍͍ͬͯΔͷ͸ʮ॓௚ʯͰ͸ͳ͘ ॳ࢈්ͷฏۉ෼ṯ࣌ؒ͸࣌ؒͰ͋Γ೔ۈଳͰ͸ऴྃ͠ͳ͍ͨΊ ෼ṯΛ΍͍ͬͯͨΒ͢΂ͯz໷ۈzͱߟ͑ͯɺ0,ɻ

࢈්ਓՊҩͷʮ॓௚ʯճ਺͸ଞՊΑΓ΋ଟ͍ @தҪ ষਓઌੜʢ೔ຊҩՊେֶʣ ʢҰ෦վมʣ

ਓ໷ۈ ମ੍ͷ৔߹ ̎ਓ໷ۈମ੍ͷ৔߹໊ @தҪ ষਓઌੜʢ೔ຊҩՊେֶʣ ʢҰ෦վมʣ

൒਺Ҏ্ͷࢪઃ͕े෼ͳৗۈҩࢣΛ֬อͰ͖͍ͯͳ͍ @தҪ ষਓઌੜʢ೔ຊҩՊେֶʣ ʢҰ෦վมʣ

९๏ϥΠϯୡ੒͸ະͩݟ͑ͣ ॓௚ͷճ਺͸΄ͱΜͲݮΒ͍ͤͯͳ͍ @தҪ ষਓઌੜʢ೔ຊҩՊେֶʣ ʢҰ෦վมʣ

࣌ؒ֎࿑ಇΛݮΒ͢ʹ͸ ʮॏ఺Խʯ͕ඞཁʂʂ େֶ͔Β໷ۈͷԠԉΛͯ͠΋Βͬͯ΋ ࠜຊతͳղܾʹͳΒͳ͍ʂʂ ʢେֶۈ຿ͷઌੜ͕݄ճҎԼͳΒྑ͍͕௨ৗ͋Γಘͳ͍ʂʣ

*NQBDUPGIPTQJUBMDPOTPMJEBUJPOGPSTVSHFSZ Number of cases Quality For young surgeon Surgical opportunity
Experience; various cases Burden (per one surgeon) Training environment for Professional medical staff Flexibility for absentee maternity / childcare family caregiver / sickness Impact of hospital consolidation for surgery Small team Big team @ཱੴ ࣮ઌੜʢ੟ྴ඿দපӃ ৺ଁ݂؅֎Պʣ

มܗ࿑ಇ੍࣌ؒ

࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ൟ๩೔ มܗ࿑ಇ࣌ؒੑʹΑͬͯ ࿑ಇ࣌ؒΛൟ๩೔ʹ ഑෼Ͱ͖Δ
݄ Ր ਫ ໦ ۚ มܗ࿑ಇ੍࣌ؒ

࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ൟ๩೔ มܗ࿑ಇ࣌ؒੑʹΑͬͯ ࿑ಇ࣌ؒΛൟ๩೔ʹ
഑෼Ͱ͖Δ ݄ Ր ਫ ໦ ۚ ๏ఆ࿑ಇ࣌ؒ ࣌ؒ ͷ·· มܗ࿑ಇ੍࣌ؒ

݄ Ր ਫ ໦ ۚ ౔ ೔ ࣌ؒ֎࿑ಇ ࣌ؒ ࣌
࣌ ࣌ ࣌ ࣌ มܗ࿑ಇ੍࣌ؒ

ʢCFGPSFʣ ݄ Ր ਫ ໦ ۚ ౔ ೔ ࣌ؒ֎࿑ಇ ࣌ؒ
ʢ݄࣌ؒʣ ໷ۈ೔ ࣌ ࣌ ࣌ ࣌ ࣌ มܗ࿑ಇ੍࣌ؒ

ʢBGUFSʣ ݄ Ր ਫ ໦ ۚ ౔ ೔ ࣌ؒ֎࿑ಇ ࣌ؒ
ʢ݄࣌ؒʣ ໷ۈ೔ ࣌ ࣌ ࣌ ࣌ ࣌ ࣌ؒ֎࿑ಇ ࣌ؒ ʢ݄࣌ؒʣ มܗ࿑ಇ੍࣌ؒ

݄ Ր ਫ ໦ ۚ ౔ ೔ िʢ໷ۈ݄ճʣ ʴΦϯίʔϧ݄ճ ৗۈ̔ਓ
஍Ҭप࢈ظ ηϯλʔ" ࣌ ࣌ ࣌ ࣌ ࣌ ʢ࠶ܝʣ஍Ҭप࢈ظηϯλʔ"Ͱͷ໷ۈिճମ੍ ࣌ؒ֎࿑ಇ ࣌ؒ ݄ ࣌ؒ

݄ Ր ਫ ໦ ۚ ౔ ೔ िʢ໷ۈ݄ճʣ ʴΦϯίʔϧ݄ճ ৗۈ̔ਓ
I ºճ 㲈I ஍Ҭप࢈ظ ηϯλʔ" ࣌ ࣌ ࣌ ࣌ ࣌ ࣌ؒ֎࿑ಇ ࣌ؒ ݄ ࣌ؒ ஍Ҭप࢈ظηϯλʔ"Ͱͷ໷ۈिճମ੍

݄ Ր ਫ ໦ ۚ ౔ ೔ िʢ౰௚݄ճʣ ʴΦϯίʔϧ݄ճ ৗۈ̔ਓ
࣌ؒ֎࿑ಇ ࣌ؒ ݄ ࣌ؒ ࣌ ࣌ ࣌ ࣌ ࣌ ஍Ҭप࢈ظ ηϯλʔ" I ºճ 㲈I ౰௚໌͚ؼ୐ʢมܗ࿑ಇ੍࣌ؒʣ

݄ Ր ਫ ໦ ۚ ౔ ೔ िʢ౰௚݄ճʣ ʴΦϯίʔϧ݄ճ ৗۈ̔ਓ
࣌ؒ֎࿑ಇ ࣌ؒ ݄ ࣌ؒ ࣌ ࣌ ࣌ ࣌ ࣌ ୡ੒ʂ ஍Ҭप࢈ظ ηϯλʔ" I ºճ 㲈I ͞Βʹ࣌ؒ֎࿑ಇΛݮΒ͢౒ྗΛͯ͠

૯߹प࢈ظηϯλʔ " ࣮ࡍͷέʔεΛ౿·͑ͯ

໷ۈ͸໷͚ͩ ೔ۈ͸࣌ʹؼ୐ มܗೋަ୅ۈ຿੍౓ʢมܗ࿑ಇ੍࣌ؒͷҰͭʣ @໦ށ ಓࢠઌੜʢ೔ຊ੺ेࣈࣾҩྍηϯλʔʣ

೔தͷਓһෆ଍ ผࢪઃͰ͸ ᶃ໷ۈ ᶄ॓௚ ᶅ॓௚ ʔ̏ਓ ʔ̍ਓ ަ୅ۈ຿੍౓ͷσϝϦοτ @໦ށ ಓࢠઌੜʢ೔ຊ੺ेࣈࣾҩྍηϯλʔʣ

lઈରʹzඞཁͳͷ͸ ୹࣌ؒۈ຿ҩࢣͷ׆༂ʂʂ ʢ೛৷ɾग़࢈հޢຊਓͷපؾͳͲʣ ೔தͷ਍ྍͷ࣭Λҡ࣋͢ΔͨΊʹ

ࢪઃू໿Խɾ୹࣌ؒۈ຿ऀͷ׆༻ɾॊೈͳಇ͖ํͷબ୒ࢶ ୹࣌ؒۈ຿ऀ͸ϑϧʹಇ͚ͳ͍ɹɹ ϚΠφεͷଘࡏͰ͸ͳ͘ ૊৫ʹߩݙ͢Δϓϥεͷਓࡐ ඇৗۈͰ͸ͳ͘ৗۈͱ͠ কདྷ͸ϑϧλΠϜͱͯ͠׆༻Λ มܗ࿑ಇ੍࣌ؒͰ͸ɺ೔ۈ͚ͩͷઌੜʹॿ͚ΒΕΔ @໦ށ ಓࢠઌੜʢ೔ຊ੺ेࣈࣾҩྍηϯλʔʣ

@໦ށ ಓࢠઌੜʢ೔ຊ੺ेࣈࣾҩྍηϯλʔʣ มܗ࿑ಇ੍࣌ؒ ҩྍͷඪ४Խ

࿑ಇ؀ڥվળ͕໨ࢦ͢ͱ͜Ζ ҩྍ҆શ

ҩྍऀ͕ෆ޾ʹͳͬͯ͸͍͚ͳ͍ ҩࢣ΋ਓؒͰ͢

ҩྍऀ͕ෆ޾ʹͳͬͯ͸͍͚ͳ͍ ҩࢣ΋ਓؒͰ͢ ҩྍऀ͕݈߁Ͱ͋Δ͜ͱ ਓΛٹ͏ʹ͸ɺ·ͣࣗ෼͕݈߁Ͱͳ͚Ε͹ͳΒͳ͍ɻ ͦ͏Ͱͳ͍ͱɺ൑அΛޡΔɺελοϑ͕໎͏ɻ Ո଒͕৺഑͢Δɻࣗ෼Λ੹ΊΔɻ ΋͠΋Ωϛ͕ٹٸҩʹͳΔͷͳΒ ·ͣࣗ෼ͷ͜ͱΛ࠷༏ઌʹߟ͑ͯཉ͍͠ɻ ͦΕΛඇ೉͢Δਓ͕͍ΔͳΒ͹ɺ ࢲ͕ͨͪҾ͖ड͚Δɻ
ߴྸԽ͸ਐΉɻҩࢣ͸଍Γͳ͍ɻ ͔ͩΒͦ͜ٹٸҩ͕݈߁Ͱ͋Δ͜ͱɻ ͜Ε͸ٛ຿ͩɻ ɹ೔ຊٹٸҩֶձ

⼼臓⾎管外科学会雑誌 2012年,41巻2号, 63-66 • Young surgeons decreasing → Increased burden
on mid-career surgeons • Questionnaire Survey of doctors changed their career from CVS. (N=56) • CVS experience (mean) 15.4 year • Certified CVS 65%, experience of research/work abroad 32% “ Survey of Doctors Who Changed Their Clinical Specialty from Cardiac Surgery ” ҩྍऀ͕ෆ޾ʹͳͬͯ͸͍͚ͳ͍ ͢΂ͯͷ਍ྍՊͰ࣮ݱ͞ΕΔ΂͖ @ཱੴ ࣮ઌੜʢ੟ྴ඿দපӃ ৺ଁ݂؅֎Պʣ

ҩྍऀ͕ෆ޾ʹͳͬͯ͸͍͚ͳ͍ ࣗݾ٘ਜ਼Λڧ͍ͯ΋ɺͨͩڈΔͷΈ It should have been a hard-working career in
cardiovascular surgery… However, 77% of them do not regret quitting their CVS career. Only one person regrets it. Free comments ü There is a lot of self-sacrificing work, but the salary is not rewarding their contribution. ü Cardiac surgery cannot be performed operation in early stage, has a lot of miscellaneous work, and difficult to think the future career. ü Too Difficult to update Certified CVS. ⼼臓⾎管外科学会雑誌 2012年,41巻2号, 63-66 @ཱੴ ࣮ઌੜʢ੟ྴ඿দපӃ ৺ଁ݂؅֎Պʣ

w ҩྍΛఏڙ͢ΔපӃΛͰ͖Δ͚ͩॏ఺Խʢू໿Խʣ w ໷ۈ໌͚͸ؼ୐͢Δมܗ࿑ಇ੍࣌ؒ w ݱ৔Λٹ͏୹࣌ؒۈ຿ҩࢣͷ׆༂ தؒ·ͱΊ

ࣲాҁࢠઌੜʢ࢈්ਓՊҩʣ ಇ͖ํվֵͷ࣮ફฤ

@ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ͋ͳͨͷ৬৔ͷ࢒ۀΛݮΒ͢ͷํ๏ ໌೔͔ΒͰ͖Δ΋ͷͭ පঢ়આ໌ͷ࣌ؒͷܝࣔ ࣌ؒ֎ʹओ࣏ҩΛݺͼग़͞ͳ͍ ৘ใڞ༗πʔϧͷಋೖɹ ޮՌ͕େ͖͍΋ͷͭ ΧϯϑΝϨϯεΛ࿑ಇ࣌ؒ಺ʹ ओ࣏ҩ੍ͷఫഇ
౰௚໌͚ͷ൒ٳ ಇ͖΍͘͢͢Δͭ ౰௚ଳͷਃ͠ૹΓɹ ҩྍࣄ຿ɾΞγελϯτͷಋೖ ฏ೔ͷ༗ٳಋೖ Ұ൪େࣄͳ΋ͷ̍ͭ ·͕ͪͬͨࢥ͍ࠐΈΛࣺͯΑ͏ ɹɹᶃ࢒ۀʹඞཁѱʁ ɹɹᶄશһ͕ಉ͡Α͏ʹಇ͔ͳ͍ͱ͍͚ͳ͍ʁɹɹ !ࣲాҁࢠʢཎ઒ΩϦετڭපӃ࢈්ਓՊʣ ࣌ؒ֎࿑ಇΛݮΒͨ͢Ίʹඞཁͳ͜ͱ ʮ࣌ؒ֎࿑ಇ࣌ؒɹ ɹ࢈්ਓՊʯ ɹͰݕࡧʂʂ ˡϦϯΫ͸ ͪ͜Β

࢒ۀΛ΁Β͢ʹ͸ ·͕ͪͬͨࢥ͍ࠐΈΛࣺͯΑ͏ w ࢒ۀʹඞཁѱʁ w શһ͕ಉ͡Α͏ʹಇ͔ͳ͍ͱ͍͚ͳ͍ʁɹɹ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ

೥લ ɾओ࣏ҩ੍ ɾ౰௚ཌ೔͸௨ৗۀ຿ ɾฏ೔௨ৗۀ຿ ɾΧϯϑΝ͸ۀ຿ޙ͔Β @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ

ݱࡏ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ɾ࣌ؒ֎ͷݺͼग़͠ແ͠ ɾ౰௚೔͸೔ۈແ͠ ɾ݄ճฏ೔ٳΈ ɾΧϯϑΝ͸࣌ؒ಺ͷΈ

໌೔͔ΒͰ͖Δ΋ͷͭ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ පঢ়આ໌ͷ࣌ؒͷܝࣔ ࣌ؒ֎ʹओ࣏ҩΛݺͼग़͞ͳ͍ ৘ใڞ༗πʔϧͷಋೖɹ

ޮՌ͕େ͖͍΋ͷͭ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ΧϯϑΝϨϯεΛ࿑ಇ࣌ؒ಺ʹ ओ࣏ҩ੍ͷఫഇ ౰௚໌͚ͷ൒ٳ

ಇ͖΍͘͢͢Δͭ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ ౰௚ଳͷਃ͠ૹΓɹ ҩྍࣄ຿ɾΞγελϯτͷಋೖ ฏ೔ͷ༗ٳಋೖ

࢒ۀΛݮΒ͢ʹ͸ ·͕ͪͬͨࢥ͍ࠐΈΛࣺͯΑ͏ ࢒ۀʹඞཁѱʁ શһ͕ಉ͡Α͏ʹಇ͔ͳ͍ͱ͍͚ͳ͍ʁɹɹ @ࣲా ҁࢠઌੜʢཎ઒ΩϦετڭපӃʣ

ঁੑҩࢣͷಇ͖ํվֵ

ঁੑҩࢣͷਪҠ

ঁੑҩࢣͷׂ߹

ঁੑҩࢣͷबۀ཰

ҭࣇ΍௕͍߆ଋ࣌ؒͷͨΊৗۈΛ཭ΕΔ ಇ͖੝Γͷҩࢣ͕গͳ͘ͳ͍ ୀ৬ཧ༝

൒਺Ҏ্͕ʮຊ౰͸ৗۈͱͯ͠ಇ͖͍ͨʯ ؀ڥΛ੔͑ͯ׆༂ͯ͠΋Β͏ʹ͸ɾɾɾ ৗۈ෮ؼͷر๬

ঁੑҩࢣ͕ಇ͖΍͍͢৬৔ͮ͘Γ 平成20年度厚⽣労働科学研究補助⾦（厚⽣労働科学特別研究事業）病院勤務医等の勤務環境改善に関する研究「⼥性医師就労⽀援事例の収集・検討」より ঁੑҩࢣͷΈͳΒͣ શͯͷۈ຿ҩΛର৅ͱͨ͠ ۈ຿؀ڥͷݟ௚͠ ͪ͜Β͔Β֬ೝͰ͖·͢

೥ൃץ ˏཱੴ ࣮ઌੜ ʢ੟ྴ඿দපӃ ৺ଁ݂؅֎Պʣ

To Know 上司との定期⾯談 Ø ⾯談時の質問は雛形を学会が⽤意 Ø 実施率を学会に報告 Ø 罰則は設けないが、賞与を設ける

To Adjust Ø イクボスの腕の⾒せどころ Ø 個々の価値観を満⾜できるように Ø 全員が70点をとれるように上司が業務調整

ෆެฏײ

To Evaluate 職場満⾜度アンケートを実施 Ø 上位10病院は表彰 Ø Top10の部⻑のコラムをHPで連載 Ø 上位病院に奨励⾦を授与

Ӄ಺อҭͱ͸

Ӄ಺อҭͷݱঢ়

Ӄ಺อҭͰͷఏҊ ࣌ؒอҭ ༵೔Λݻఆ͢Δ͜ͱͰ ɹϦεΫΛܰݮ

ࢠڙͷٸප࣌ͷ ࢓ࣄͷௐ੔ ެӹࡒஂ๏ਓ஍ํܦࡁ૯߹ݚڀॴɹঁੑͷ࢓ࣄͱࢠҭͯʹؔ͢Δௐࠪ ʢ೥݄ʣ Λݩʹ࡞੒
ಇ͓͘฼͞Μ͕࠷΋ࠔΔ͜ͱ ೥ؒղܾͰ͖͍ͯͳ͍՝୊ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE

පࣇ ʢʹܰ঱ͷࢠͲ΋ʣ อҭԂ͸༬͔ͬͯ͘Εͳ͍ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE පࣇอҭ

පࣇอҭ පࣇͷҰ࣌༬͔Γࢪઃ έΞͱอҭΛߦ͏ පࣇอҭࢪઃ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE

පࣇอҭ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ҩྍػؔซઃ อҭԂซઃ
୯ಠܕɾͦͷଞ ग़యɿ ʮපࣇɾපޙࣇอҭͷ࣮ଶ೺Ѳͱ࣭޲্ʹؔ͢Δݚڀʯ ʢฏ੒25೥౓ްੜ࿑ಇՊֶݚڀඅิॿۚʣ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE පࣇอҭ

පࣇอҭ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ՝୊ɿར༻཰͕௿͍ ར༻཰ ग़యɿ ʮපࣇɾපޙࣇอҭͷ࣮ଶ೺Ѳͱ࣭޲্ʹؔ͢Δݚڀʯ ʢฏ੒25೥౓ްੜ࿑ಇՊֶݚڀඅิॿۚʣ

࢖͍ͮΒ͍ ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ར༻཰͕௿͍ཧ༝͸ʜ ग़యɿ ʮපࣇɾපޙࣇอҭͷ࣮ଶ೺Ѳͱ࣭޲্ʹؔ͢Δݚڀʯ ʢฏ੒25೥౓ްੜ࿑ಇՊֶݚڀඅิॿۚʣ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ࢖͍ͮΒ͍පࣇอҭͷϑϩʔ ࢠͲ΋ ൃ঱ ༧໿ ਍࡯ ೖࣨ
อҭ ܾࡁ ࣄલ ొ࿥

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ͔͋ͣΔͪ͜ΌΜ පࣇอҭͷར༻Λ εϚϗͰ γϯϓϧʹɻ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ΦϯϥΠϯ໰਍ -*/& ࢖͍΍͍͢ ࢴ͕ͳ͘ ͳͬͯϥΫ ࣌ؒ༧໿
͏Ε͍͠ ࣄલͷ ৘ใೖྗ ॿ͔Δ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ͔͋ͣΔͪ͜ΌΜͷϏδωεϞσϧ ϏδωεϞσϧಛڐ ʢಛڐୈ߸ʣ ར༻ऀ ແྉ පࣇอҭࣨ
ར༻ྉ ࢢ۠ொଜ ར༻ྉ ັྗ͋Δ ֗ͮ͘Γ΁

Q ";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE Ͱ΋ʜ ͔͋ͣΔͪ͜ΌΜͷϏδωεϞσϧ පࣇอҭͬͯ χονͩΑͶʁ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE පࣇอҭ͸ӈݞ্͕Γ Ͱ΋ʜ )
) ࢪઃ਺ ར༻ਓ਺ ࢪઃ )೥ݟࠐΈ ສਓ )೥ ར༻཰ͷ Ξοϓͳ͠

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ްੜ࿑ಇলͷ਺஋໨ඪ ) ) ར༻ਓ਺
ສਓ ) ഒ ສਓ

";6,"36,0$)"/ $POOFDUFE*OEVTUSJFT *ODPSQPSBUFE ) ) ສਓ )
ഒҎ্ ສਓ ڻ͖ͷજࡏχʔζ ར༻ਓ਺ ສਓ

ᶃॏ఺Խʢू໿Խʣ ᶄมܗ࿑ಇ੍࣌ؒ ᶅ୹࣌ؒۈ຿ऀͷ׆༂ ᶆΦϖϨʔγϣϯͷ޻෉ ᶇՁ஋؍Λม͑Δ ᶈΠΫϘε ᶉঁੑҩࢣͷಇ͖ํͱපࣇอҭ ࣌ؒ֎࿑ಇΛݮΒͨ͢Ίʹඞཁͳ͜ͱ

w ໌೔͔Βಇ͖ํվֵΛ࣮ߦ͢Δ w ಇ͖ํվֵʹपғΛר͖ࠐΉ ࠓ͕มΘΔ࣌Ͱ͢ʂ ΰʔϧ

l4VDDFTTJTOPUpOBM GBJMVSFJTOPUGBUBM JUJTUIFDPVSBHFUPDPOUJOVFUIBUDPVOUTz ੒ޭ͸ΞΨΓͰ͸ͳ͘ɺࣦഊ͸க໋తͰ͸ͳ͍ɻ େ੾ͳͷ͸ଓ͚Δ༐ؾͩ

ࠓճ͸وॏͳ৔Λ࡞͍͍ͬͯͨͩͨ໦ށಓࢠ෦௕ʢ೔ຊ੺ेࣈҩྍηϯλʔʣɺஸೡʹରԠ͍ͨͩ ͍ͨࣄ຿ہͷਫ໺͞Μʹਂ͘ײँ͍ͨ͠·͢ɻ ·ͨɺ͜ͷ෼໺Ͱͣͬͱਚྗ͞Ε͖ͯͨதҪষਓڭतʢ೔ຊҩՊେֶ࢈්ਓՊʣɺएखͰ͋ΔΘͨ ͠Λ͍ͭ΋Թ͔͘ࢦಋͩ͘͞Δւ໺৴໵ڭतʢ๺ཬେֶ࢈්ਓՊʣΛ͸͡Ίͱͨ͠ҩྍվֵҕһձ ͷઌੜํɺوॏͳ͝ҙݟ΍εϥΠυͷఏڙΛ௖ଷͨ͠খদ޺জઌੜʢௗऔେֶ࢈්ਓՊɺݩएखҕ һձҕһ௕ʣɺత৔༏հઌੜʢܚጯେֶ࢈්ਓՊɺएखҕһձҕһ௕ʣɺࣲాҁࢠઌੜʢཎ઒ΩϦ ετڭපӃ࢈්ਓՊʣɺશࠃͷ෼ṯࢪઃʹ͓͚Δಇ͖ํվֵௐࠪΛڞʹղੳɾݕ౼ͨ͠ླ໦ਅઌੜ ʢُా૯߹පӃʣɺॏݟେհઌੜʢ౦ژେֶେֶӃྟচӸֶڭࣨʣɺখ໺݈ଠ࿠ઌੜʢ੟࿏ՃපӃ ࢈්ਓՊʣɺߔޱതॏ͞Μʢגࣜձࣾ".**ʣʹਂ͘ײँ͍ͨ͠·͢ɻ ࠷ޙʹɺࣾձىۀՈͱͯ͠ͷಇ͖ํΛԠԉͯͩ͘͠͞Δ౻Ҫ஌ߦڭतɺେਢլয়ڭतɺ౦ژେֶ࢈
්ਓՊڭࣨͷઌੜํʹ͸͍ͭ΋ਂ͘ײँ͓ͯ͠Γ·͢ɻ ँࣙ

本音で語る医師の働き方改革

本音で語る医師の働き方改革

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