Eleven psychiatrists disciplined at Japanese hospital – fraudulent applications. Newspaper “astounded by the lack of morals”

From The Yomiuri Shimbun [Japan News] (google translate)

We are astounded by the lack of morals of people engaged in medical services at a hospital. It is vital that a thorough investigation is conducted into whether inappropriate medical examinations or treatments were carried out.

At St. Marianna University School of Medicine Hospital in Kawasaki, 11 doctors were recently found to have made fraudulent applications to the Health, Labor and Welfare Ministry to acquire the special status of designated psychiatrist. The health ministry stripped 20 psychiatrists at the hospital, including attending doctors, of the special status. It is believed to be unprecedented for such a large number of doctors to be disciplined for involvement in acquiring the special status by fraudulent means.

There are 14,630 designated psychiatrists working across the country. Through the authority of a prefectural governor or an equivalent official, these psychiatrists are allowed to decide whether mental patients should be “involuntarily hospitalized” to ensure that they do not hurt themselves or others. They are also permitted to decide on “hospitalization for medical protection” for mental patients after receiving consent from the patients’ relatives. As designated psychiatrists have the authority to restrict a patient’s movements, doctors with sufficient knowledge and ample experience in this field are designated by the health minister, on the basis of the Mental Health and Welfare Law. Seeking this status through fraudulent applications is as if the status certification system is not being taken seriously.

To apply for the special status, applicants must have at least three years of working experience as a psychiatrist and to have submitted case reports on at least eight of their patients. The 11 doctors had rewritten the reports of cases treated by senior doctors and submitted them to the ministry as if they themselves had treated the cases. This is abominable.

‘Normal’ practice

What must not be overlooked is that such methods were used so often they had become a normal practice. The hospital has admitted that the transfer of data entered in the reports was carried out by these doctors. The attending doctors also failed in their function of checking such practices. This is indeed a serious problem.

The hospital reportedly became aware of the fraudulent applications of these doctors after the health ministry pointed out striking similarities in the reports. Doctors who obtained the special status fraudulently have decided on involuntary hospitalization of four mental patients and hospitalization for medical protection of about 100 patients.

If doctors made wrong medical judgments to forcibly hospitalize patients, this would constitute a serious human rights problem. Both the Kawasaki city government and the hospital need to delve deeply into the matter to clarify the situation. A designated psychiatrist is eligible for preferential treatment in terms of remuneration for medical services. With the fraudulent acquisition of the special status by these doctors, the hospital received about ¥1.7 million more than it normally would through the treatment of outpatients. Naturally, the hospital has said it will return the money.

With the retraction of the status, the hospital has scaled down treatment in its neuropsychiatric department. As a result, local medical services have been affected.

To prevent a recurrence of fraudulent applications, the health ministry plans to speed up its efforts to make a database of submitted reports in order to determine whether reports have distinct similarities. The ministry will also investigate whether there are similar illicit activities at other hospitals.