A way must be found to get rid of `problem' doctors.

Ashocking case of medical malpractice dates back 25 years ago, and yet the doctors concerned have continued to practice medicine all this time. With their licenses intact, they continued to treat patients.

The case concerns the now-defunct Fujimi Obstetrics and Gynecology Hospital in Tokorozawa, Saitama Prefecture. The scandal surfaced in 1980. But the Ministry of Health, Labor and Welfare has only now decided to impose administrative punishment against the doctors involved: The hospital's former medical director had her doctor's license revoked, and other doctors who used to work there either had their licenses suspended, or received reprimands.

Even though the executive director of the Fujimi hospital was not licensed to practice medicine, he examined patients. Based on his diagnosis, his wife, the hospital director, and other doctors repeatedly removed uteri and ovaries from healthy women who had nothing wrong with them. There were more than 1,000 victims. Criminal charges against them were eventually dropped and they were never prosecuted. That prompted victims to file a civil lawsuit claiming damages, which was finally resolved last summer when the Supreme Court ruled the doctors were liable. The health ministry's latest administrative action stems from the court ruling.

That said, it begs the question: Why did it take so long?

When a doctor botches a medical procedure, no administrative action can be taken unless the health ministry's Medical Ethics Council submits a report. Until now, punitive actions were limited only to cases where doctors were convicted of malpractice in court or the violation involved illicit medical fees. The latest case is the first punitive action to be taken on the basis of a civil lawsuit ruling. It is also the first time for a doctor to lose a license due to malpractice.

A key reason the system has been so lax with doctors is that the health ministry was always careful not to ruffle the feathers of the Japan Medical Association (JMA) when charting medical policies.

But with so many malpractice cases, the existence of ``problem doctors'' with questionable skills and judgment is becoming an issue that is much in the public's mind. It seems the ministry has finally grasped the situation. Officials created a new guideline so that civil court rulings and victims' complaints can form the basis of administrative action. This new rule led to the latest penalties.

Still, we think the health ministry needs to go even further. The Medical Ethics Council, mostly made up of doctors such as Haruo Uematsu, the JMA's president, has no investigative powers of its own. The council is also short of staff. It needs to be revamped so members can solicit reports directly from medical institutions and examine the materials themselves.

Membership to the council also needs to be reviewed. The ministry's Central Social Insurance Medical Council, which was rocked by a bribery scandal last year, is considering including victims of medical accidents as new council members so as to prevent further corruption. We urge the Medical Ethics Council to follow suit by including members who will represent patients. Patients' concerns must be taken more seriously.

We also urge that periodic license renewal become a requirement for doctors, preferably as soon as possible. This is a major flaw in the system in this country. Once a person qualifies as a doctor, there is no review system. A doctor can practice medicine for the rest of his or her life. In the United States, doctors are required to take continued medical education classes and renew their license every few years.

We also have a request for the JMA. If it prides itself on being a group of highly-qualified experts, shouldn't the members be able to cleanse themselves, like the Japan Federation of Bar Associations, and deal with ``problem doctors''?

Uematsu, the JMA president, has announced his intention to reveal the names of ``repeater'' doctors-those who repeatedly cause medical accidents. We urge him to put his words into action.

--The Asahi Shimbun, March 4(IHT/Asahi: March 5,2005)