Satoshi Umemura Meets Inspiring Individuals by Lohas Medical (Part 1 of 2)

Left: Tetsuya Tanimoto

Tetsuya Tanimoto, MD.

Chairman of Accessible Railway Medical Services Tetsuikai Medical Corporation.

Director of Navitas Clinic Kawasaki

In a recent discussion, Dr. Satoshi Umemura, a member of the House of Representatives and an internal medicine physician, engaged with Dr. Tetsuya Tanimoto, Director of Navitas Clinic Kawasaki, to explore strategies for supporting patient autonomy.

Dr. Tetsuya TanimotoDr. Tanimoto graduated from Kyushu University School of Medicine in 1997. He has served at the National Cancer Center Hospital and Tottori University Hospital. From 2007 to 2012, he was a medical reviewer at the Pharmaceuticals and Medical Devices Agency (PMDA). Currently, he is the chairman of the Accessible Railway Medical Services Tetsuikai Medical Corporation and the director of Navitas Clinic Kawasaki.

Dr. Satoshi UmemuraDr. Umemura, a member of the House of Representatives, is also an internal medicine physician and chairman of the Tekijuku Medical Corporation. He graduated from Osaka University School of Medicine in 2001. After serving two terms in the House of Councillors, he transitioned to the House of Representatives in October 2024. He currently serves as the head of the Japan Innovation Party's COVID-19 Countermeasures Headquarters.

Their conversation delved into the importance of continuous professional development for physicians, the role of grassroots study groups in medical education, and the evolving landscape of medical research and practice in Japan. They emphasized the need for flexible and inclusive platforms that allow medical professionals to engage in research and knowledge sharing, regardless of their career stage or practice setting. This dialogue highlights the ongoing efforts to enhance patient care through the empowerment and continuous education of healthcare providers.

Umemura: A few years ago, I had the privilege of being invited to one of your sessions. You host study groups akin to private academies, don’t you?

Tanimoto: Yes, since 2012, I’ve been conducting weekly study sessions for healthcare professionals and medical students. These sessions are offered on a volunteer basis, completely free of charge. We invite various lecturers to provide talks, and when we don’t have a lecture, we often engage in discussions about academic paper writing.

Umemura: What motivated you to start these sessions?

Tanimoto: Initially, it began when medical students and graduate students started gathering at the laboratory of Professor Masahiro Kami, who was then a special appointment professor at the Institute of Medical Science, University of Tokyo (currently the Chairman of the Medical Governance Research Institute). They asked me to help them with writing medical papers, which became the impetus for starting the sessions.

Umemura: After graduating from Kyushu University, you began your training as a physician. During that period, I assume you also gained experience in writing papers. Later, you joined the PMDA (Pharmaceuticals and Medical Devices Agency). How did writing papers fit into your career? Did you also attend graduate school?

Tanimoto: I was briefly enrolled in graduate school, but I found I wasn’t well-suited to basic research. Most of my work has been clinical in nature. I even conducted mouse experiments for about six months, but that was the extent of it.

Umemura: Preference and aptitude certainly play a role in such decisions.

Tanimoto: That’s true. It’s a matter of whether you can dedicate yourself wholeheartedly to basic experiments that don’t involve direct interaction with patients.

Umemura: Given that your focus was on clinical papers, why have you continued writing them even after becoming a private practitioner? Clinical practice alone must keep you very busy.

Tanimoto: Yes, we’re in a particularly busy period right now. Just yesterday, I saw 100 patients, and I was absolutely exhausted. Even in such circumstances, I believe the act of writing papers holds significance because it helps maintain a mindset of continuous learning. Many private practitioners actually want to keep studying. While there are meetings held by Japan Medical Association of private practitioners, they don’t often delve into academic topics, leaving many feeling isolated.

Umemura: That sense of isolation has been a concern of mine for a long time. After all, physicians are professionals, aren’t they?

Tanimoto: Absolutely.

Umemura: When we think of professionals, other examples that come to mind are athletes or singers. Athletes often retire when they can no longer perform at the level they did in their youth. Singers, on the other hand, can adapt their repertoire or style as they age, turning that evolution into a distinctive charm that allows them to continue thriving. But for doctors, it’s natural for their scope of practice to narrow with age. The question is whether that narrowing can truly be considered a “charm” or an asset. Over time, they may drift further from the studies and training they pursued in their youth, with less interaction with younger generations or professionals from other fields, potentially leading to a sense of insular self-importance. That’s why I find your efforts to maintain opportunities for professional development as a physician so fascinating. Would it be correct to say that this is your aim?

Tanimoto: That’s exactly my aim. Writing papers as an independent practitioner doesn’t lead to promotions or increased salary, but it offers opportunities for personal growth, the building of professional networks, and the fostering of exchanges between different fields and generations.

Umemura: What kinds of topics do you cover in your papers?

Tanimoto: I don’t have a fixed approach to selecting topics; I’ll take on anything that catches my attention. Sometimes I write opinion pieces or share my perspectives on existing papers. Other times, I work on case reports or collaborate with participants who bring their own data or case studies. I might provide comments or co-author papers with them—it's quite varied.

Umemura: Well, I’m currently in the National Diet.

Tanimoto: That’s right, it’s an entirely different world, isn’t it?

Umemura: Not as different as you might think. In fact, even in the Diet, we sometimes rely on scientific papers. I don’t read them directly myself, but when we need to understand the scientific basis for something or review historical perspectives on a particular issue, we request the help of the National Diet Library. Specialized researchers there read relevant papers and provide us with summaries or abstracts. For example, when determining whether the spread of hepatitis through the reuse of syringes was the government's responsibility or not, it’s clear by today’s medical standards that such practices are completely unacceptable. However, in the 1950s and 1960s, it was common to reuse syringes. The question then becomes whether the government at that time could have reasonably recognized the dangers. This is something that can actually be examined through papers from that era, including those written in Japanese.

Tanimoto: That’s very interesting.

Umemura: Observing how research papers are used, it struck me that while aiming to publish in high-impact journals from university hospitals is undoubtedly important, even single-case reports have intrinsic value simply by being recorded. Just like in the era of papyrus, as long as something is written down, it has the potential to endure. In university hospitals, writing a case report might be dismissed as "hey, don't just let it end as a single case report,” but from the perspective of future generations, such records could hold immense value. They could become treasures not only for the field of medicine but for humanity as a whole.

Tanimoto: As you’ve pointed out, that’s very much part of the significance of our activities. Another thought I have is that, while Japan’s international standing has declined in many respects, the country still has considerable resources and many noteworthy events happening. However, much of this information is recorded only in Japanese. Interestingly, topics like these often attract global interest, and I believe we should share them more broadly with the world. When you look at the world with this perspective, you’ll notice countless untapped topics that haven’t been presented in English. For issues where anyone could write about them, I’ve been publishing papers on such topics.

Umemura: What kinds of topics are those?

Tanimoto: For instance, the death penalty for senior members of the Aum Shinrikyo cult or, more recently, the issue of red yeast rice supplements. That case, where a popular supplement triggered such an incident, is actually cutting-edge globally. Another recent paper I wrote discussed the rise in cosmetic surgeons in Japan, analyzing its connection to the universal healthcare system.

Umemura: That’s fascinating from a sociological perspective.

Tanimoto: Indeed. When I talk to people from other countries, I realize how little they know about Japan. By documenting these events in the form of papers—while, of course, adding original analysis—they often gain acceptance in high-impact journals, which has been a pleasant surprise.

Umemura: When we joined the medical field, we were constantly pushed to aim for high-impact journals. There was always talk like, "He got published there," or, "Don’t just settle for any journal; aim higher." While striving for excellence, it sometimes ended up taking much longer than expected. There were many stories like that back then.

Tanimoto: Absolutely.

Umemura: It’s been almost 25 years since then, and now we hear about the declining number of papers coming out of Japan. From your perspective, how do you see the younger generation today? I feel like I’m sounding old asking this.

Tanimoto: I think the differences among individuals are quite pronounced. Some exceptionally talented students are writing over 100 papers during their academic years—it’s truly impressive.

Umemura: Is that so?

Tanimoto: When I was a student, the internet wasn’t widely available. In fact, I didn’t even know there were journals like The New England Journal of Medicine where research was published until I became a doctor. Nowadays, young people have access to endless medical papers and information online, and those who are motivated can readily absorb that knowledge and publish papers while still in school. The top performers today are on a level I can’t even begin to compete with.

Umemura: That’s remarkable.

Tanimoto: That said, there are likely many who don’t fall into that category. In this digital era, not just in medicine but across all fields, the disparities are becoming quite stark. With AI, for instance, those who actively leverage it and apply it to their work achieve extraordinary results, while those who don’t or can’t adapt face significant challenges.

Umemura: True. It’s become an era where individual passion and motivation can create limitless possibilities. The traditional distinctions between private practitioners, hospital-based physicians, and research doctors might be becoming less relevant.

Tanimoto: I completely agree.

To be continued…

Originally published in Lohas Medical, Winter 2024 (Vol. 171).