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Jan 27, 2017 - wileyonlinelibrary.com/journal/jgf2 ... In Japan, leaders in medical field gathered and took initiative in ... and Family Medicine published by John Wiley & Sons Australia, Ltd on behalf of Japan Primary Care Association.
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Received: 10 November 2016    Accepted: 27 January 2017 DOI: 10.1002/jgf2.96

LETTER TO THE EDITOR

Dawn of Choosing Wisely Japan Student Committee On October 15th, 2016, Choosing Wisely Japan kickoff seminar

those who were not basically familiar with medicine just a few years

was held in Suidobashi, Tokyo, Japan. Choosing Wisely is a global

ago, can see to some extent this activity from a citizen point of view.

campaign aiming reduction in overdiagnosis and overtreatment.

Therefore, students would potentially be the interpreters of the public

In Japan, leaders in medical field gathered and took initiative in

and serve to bridge doctors and citizens.

launching Choosing Wisely Japan, raising awareness of Choosing

Choosing Wisely Canada, one of the most enthusiastic organiza-

Wisely in Japan. At the same time, we, a group of interested medi-

tions of Choosing Wisely International, launched STARS (Students and

cal students, started Choosing Wisely Japan Student Committee,

Trainees Advocating for Resource Stewardship) last year and published

and learning how to practice high-­value care through initiating

Choosing Wisely lists associated with medical education “Six Things

student-­led conversations on Choosing Wisely. We found three

Medical Students and Trainees Should Question,” encouraging them

standpoints explaining the significance of student’s engagement

to think twice when ordering tests and procedures. STARS hosted

in this campaign.

“Leadership summit” for medical student leaders from across Canada. Participants brought ideas shared back to their own schools and began

FUTURE—AS A DOCTOR IN FUTURE

local campaigns. Choosing Wisely Japan Student Committee started monthly case conferences mainly in Osaka Medical College. Members en-

Yasuhisa Shiozaki, Minister of Health, Labour and Welfare in Japan,

gaged in publication of their perspectives, translation of Choosing

developed “JAPAN VISION: HEALTH CARE 2035,” the long-­term

Wisely lists into Japanese, and gave several presentations in con-

vision of healthcare system with a focus of the year 2035. In this

ferences of different academic societies. In the following year, we

document, it is emphasized that Japan’s healthcare system was in a

are planning to establish relationships with oversea campaigns, in-

period of transition, from evidence-­based medicine to value-­based

cluding STARS.

one. Doctors in future need to focus more on patient’s value than

Choosing Wisely is not a goal but just a starting point for our learn-

ever. Choosing Wisely surely offers us a clue to learning patient’s

ing. With Choosing Wisely, we would make a greater contribution to

value.1,2

future of health care in Japan (Figure 1).

PRESENT—AS A MEMBER IN MEDICAL TEAM Clinical clerkship in Japan has been traditionally observation based, but these days, transition to more participatory is required. In this setting, medical students will be expected to be more engaged in medical practice and decision making of diagnosis, testing, and treatments. Medical students themselves need to know well about how to practice high-­value care.

PAST—AS A CITIZ EN In promoting this movement, earning public understanding is vital. Messages of Choosing Wisely, however, can be easily misunderstood and mistakenly regarded as a campaign pursing reduction in medical expenditure or denying modern medicine. Medical students, as

F I G U R E   1   Members of Choosing Wisely Japan Student Committee and Professor Levinson

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2017 The Authors. Journal of General and Family Medicine published by John Wiley & Sons Australia, Ltd on behalf of Japan Primary Care Association. J Gen Fam Med. 2017;1–2.

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LETTER TO THE EDITOR

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CO NFLI C T OF I NTE RE ST

REFERENCES

The authors have stated explicitly that there are no conflicts of inter-

1. Miyata H, Ezoe S, Hori M, et al. Japan’s vision for health care in 2035. Lancet. 2015;385:2549–50. 2. Choosing Wisely Canada. Medical Students and Trainees. Available from ht t p : // w w w. c h o o s i n g w i s e l yc a n a d a . o rg /re co m m e n d at i o n s / medical-students-and-trainees/

est in connection with this article. Mano Soshi1 Kotaro Maeda MD1 Sho Isoda MD2 Keiko Tsukamoto3 1

Osaka Medical College Faculty of Medicine, Osaka, Japan 2

Shiga University of Medical Science, Shiga, Japan

3

Tokai University School of Medicine, Kanagawa, Japan