On June 27 2017, at Waseda University, Professor Toshihide Awatani from the Department of Family Medicine at Kochi Medical School lectured on community medicine, a field which he has been devoted to for many years to support local communities. This lecture was organized by Waseda’s TGU Center for Positive/Empirical Analyses of Political Economy.
Professor Awatani passed the national medical licensing exam in 1990, and at the age of 27, he was appointed Director of Matsubara Clinic (now known as Yusuhara Hospital), which appeared in the famous novel “The White Tower” by Toyoko Yamazaki. Since then, as a physician, an educator, and a researcher, Professor Awatani has been dedicated to building the integrated community care system (ICCS) for local communities. The ICCS, which bring public health, medical care, and social services together, are now considered the core of health care and long-term care policies in the nation today. However, Professor Awatani’s efforts to construct the ICCS, which look ahead at the upcoming super-aging society, was pretty much pioneering in 1990s, since population aging in Kochi Prefecture had been progressing 20 years in advance compared to the rest of Japan. Hence, there is a lot to learn from his work.
In the lecture, Professor Awatani said that the ICCS should be designed together with local residents and be part of community development. Moreover, he believes that local residents should be fully aware and take advantage of the medical services available to them, which could be great lessons and training to physicians in the community. Under the beliefs, Professor Awatani has comprehensively supported the biological, the daily, and the whole lives of people. Instead of a model where medical staff intervenes only when patients are diagnosed, the kind of relationship Professor Awatani and medical staff members who are his former students are focusing on a life-support model that provides healthcare for its local residents holistically. Professor Awatani refers to this as having a lens of different magnification. A 400x lens can find the cause of the disease, but it is unable to examine the patient’s entire physical and psychological status. When lowering the magnification to 40x, a patient’s entire condition will become clear. For example, physicians may find that a patient is an elderly person with dementia, aspiration pneumonia, and knee osteoarthritis. By further lowering the magnification to 4x, the patient’s background, including family members, communities, and cultures surrounding the patient, will become visible. Professor Awatani explained that this will help understand the medical institution’s accessibility, comprehensiveness, continuity, coordination, and accountability.
Lastly, Professor Awatani mentioned specific examples of his interactions with local residents, sometimes smiling and sometimes tearing up. Although he expressed his resentment towards not being able to make significant changes in the medical field at present, Professor Awatani’s lecture provided scientific evidence on how to support Japan’s super-aging society.