Thu. May 16, 2019 8:30 AM - 10:00 AM Room 1 (1F Main Hall)

Organizer:Michiko Moriyama(Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan)
Chair: Michiko Moriyama(Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan), Akira Matsushita(Family Practice Center of Okayama, Okayama University Medical School, Japan)

The world is affected by the aging population and the National Health Service faces problem with sustainability. In these circumstances, innovative challenges are being conducted in each country and region to build a sustainable health care system. Challenge continues in each municipality towards the development of the integrated community care system in Japan.
In this session, we would like to discuss the challenges of the activities aiming at elderly citizens in social security system in each country, aiming for "Elderly people in the area familiar to the end".



Michiko Moriyama
Professor, Chronic Care & Family Nursing Unit, Graduate School of Biomedical & Health Sciences, Hiroshima University

Michiko MORIYAMA has taught at Hiroshima University since 2002. She graduated from California State University, Fresno （Master’s in Nursing Science（MSN））and obtained a Ph.D in public health from Yamaguchi University. She previously OPrked at Ministry of Health, Labour and Welfare, where she contributed to the development of the National Long-term care insurance system. Prof Moriyama is a clinical nurse specialist in gerontology and is an expert on chronic care and family nursing, has clinical experiences at various nursing fields such as hospitals, the hospice home, the home-visiting nursing station. She has established DPP HEALTH PARTNERS CO., LTD in 2010 to provide chronic disease management programs all over Japan. Prof. Moriyama is a board member of many professional and academic organizations and OPn national and international awards in her field.

Akira Matsushita


Graduated from Yamagata University medical school in 1991.
Kawasaki Medical University General Medicne Training
Michigan State University Hospital, USA Family medicine residency
training in 1996
Kawasaki Medical University, General Medicine Clinical lecturer in 1999
Nagi Family Clinic, Director in 2001

Board certified Family Medicine in USA
Board Member of Japan Primary Care Association
Clinical Professor, Okayama University

Thu. May 16, 2019 10:30 AM - 12:00 PM Room 1 (1F Main Hall)

Organizer:Nobutaka Hirooka(General Internal Medicine, Saitama Medical University, Japan)
Chair: Nobutaka Hirooka(General Internal Medicine, Saitama Medical University, Japan), Shunzo Koizumi(General Internal Medicine, Saitama Medical University, Japan)

Medical generalism in health care system from several countries will be presented. Based on their historic experience of medical generalism in each situation, issues and its potential solution for generalists’ clinical practice will be discussed. Also several important topics of our specialty such as efficient work with specialists and subspecialists in each system, subspecialty training for generalists, research directions will be elaborated. Discussion will take the Asian and Pacific regional issues such as disparity, rapid aging, rurality into considerations. This will create further discussion platform to talk how to enrich our specialty, generalist, in the future.
To achieve this aim of the session, guest speakers who have vast knowledge of generalism in different countries including Singapore, UK, USA, and Japan will be participate as speakers. Active and fruitful participation with audience after the presentation by the guest speakers will also be expected.



Nobutaka Hirooka
Training/practice/services
2016～present Associate Professor, Department of General Internal Medicine, Saitama Medical University
2015～2016 Director, Department of General Internal Medicine, Japan Self-Defense Force Central Hospital
2012～2015 Department of General Medicine, Japan National Defense Medical College
2009～2012 Faculty development fellow, Department of Family Medicine University of Pittsburgh, Pittsburgh, Pennsylvania, USA
2008～2009 Japan Self Defense Force Central Hospital
2006～2008 Office of the US Army Surgeon General, Washington DC, USA
2004～2006 Department of Internal Medicine, National Defense Medical College
2001～2004 Family Medicine resident, University of Pittsburgh Medical Center, Shadyside Hospital, Pittsburgh, Pennsylvania, USA
1999～2001 Internal Medicine Resident, National Defense Medical College
1997～1999 Camp Kumamoto, Japan Ground Self Defense Force
1995～1997 Internship, National Defense Medical College hospital

Medical Education/Training
Medical school Japan National Defense Medical College
Master of Science Clinical Research, University of Pittsburgh
PhD General Medicine, Juntendo School of Medicine



Shunzo Koizumi

Graduated from Kyoto University in 1971, he served general surgical residency in U.S. from 1975 to 1980 (first year at Youngstown Hospital Association, Ohio; second through fifth years, at St. Vincent’s Medical Center, Bridgeport, Connecticut, a Yale affiliated program) and Board Certified in 1981. Since 1980, he OPrked at Tenri Hospital in Nara both as a general surgeon and co-director of residency program. In 1994, he was appointed as the Professor and Chairman of the Department of General Medicine, Saga University Hospital. In 2011, he inherited current practice.
He is a Fellow of American College of Surgeons, a member of Society of General Internal Medicine (SGIM), an Affiliate Fellow of American College of Physicians, a Board Member of Japanese Society for Quality and Safety in Healthcare, Senior Advisor to Japan Primary Care Association and an Honorary Member of Japan Society for Medical Education. He represents “Choosing Wisely Japan” since 2016.

Thu. May 16, 2019 3:30 PM - 5:00 PM Room 1 (1F Main Hall)

Organizer: Christopher Dowrick(Department of Health Scieneces, University of Liverpool, UK)
Chair: Christopher Dowrick(Department of Health Scieneces, University of Liverpool, UK), Ryuki Kassai(Department of Community and Family Medicine, Fukushima Medical University, Japan)

Common mental health problems such as depression are now the leading cause of disability worldwide. Yet there is a substantial treatment gap: less than one-quarter of those who would benefit from evidence-based interventions actually receive them. The integration of mental health and primary care is an international priority, and family medicine is well placed to provide effective patient care close to home. Family doctors have recently identified mental health issues as their most pressing educational need.
This symposium, presented by leaders of the WONCA Working Party for Mental Health, will provide up-to-date information on key challenges and opportunities for the delivery of primary mental health care in the Asia-Pacific region.
We will begin by describing the core competencies needed by family doctors to deliver high quality primary mental health care, using case examples to explain how they can work in daily clinical practice.
Then we will give the first international conference presentation of a Train the Trainers in Depression Course for family doctors in Japan, organised by WONCA and EACH (Internaional Association for Communication in Healthcare). This course is an excellent example of how to enable family doctors to increase their knowledge, skills and confidence in managing common mental health problems in primary care.



Christopher Dowrick
Christopher Dowrick is Professor of Primary Medical Care in the University of Liverpool, a general practitioner in Aintree Park Group Practice, and Professorial Research Fellow in the University of Melbourne in Australia. He is Chair of the OPrld Organisation of Family Doctors (OPNCA) OPrking party for mental health, and a technical adviser to the OPrld Health Organisation’s mhGAP programme.
His research portfolio covers common mental health problems in primary care, with a focus on depression and medically unexplained symptoms. He critiques contemporary emphases on unitary diagnostic categories and medically-oriented interventions, and highlights the need for socially-oriented perspectives. He is currently exploring the concept of self in primary care encounters and developing mental health care for marginalised communities, including asylum seekers and refugees.
He has published five books and over 250 research papers. Through OPNCA he has produced a series of guidance documents on primary mental health care for family doctors.



Ryuki Kassai
Dr Kassai is a founding Professor and Chair of the Department of Community and Family Medicine at Fukushima Medical University, Fukushima, Japan. He is a member of the Board of Directors of the Japan Primary Care Association and acts as Senior Advisor of its International Committee. He graduated from Hokkaido University School of Medicine, Sapporo, and completed a residency training in family medicine at the University of British Columbia, Vancouver, British Columbia, Canada. In 1996 he founded the Hokkaido Centre for Family Medicine (HCFM) and started the first formal family medicine training program in Japan. After having made the HCFM a successful model of Japanese residency program, Dr Kassai moved to Fukushima to found the first medical school department of community-based family medicine in Japan at Fukushima Medical University in 2006. He is a Vice Chair of the Organizing Committee, and Chair of the Scientific Program Committee of WONCA APR 2019 Kyoto.

Fri. May 17, 2019 8:30 AM - 10:00 AM Room 1 (1F Main Hall)

Organizer:Shunzo Koizumi(Shichijo Clinic, Kyoto, Japan)
Chair: Shunzo Koizumi(Shichijo Clinic, Japan), Tadao Okada('Department of Family Medicine, Tessyoukai Kameda Family Clinic Tateyama, Japan)

In recent years, overuse of healthcare has been recognized as one of the major drivers of increasing healthcare costs and as an urgent priority for healthcare quality and patient safety in developed countries. There have been a number of attempts to address this issue by health care profession and the public. Notably, the Preventing Overdiagnosis Conferences, launched in 2013 and convened every year have led this awareness internationally. Similarly, “Too Much Medicine” by the BMJ, “Less Is More” by JAMA and “Right Care” by the Lown Institute/the Lancet are among the most influential in campaigns against overuse. The “Choosing Wisely” campaign, launched in 2012 by American Board of Internal Medicine Foundation, advocates for shared decision making in choosing care best-suited for each patient. Proposed by over 80 medical societies and supported by evidence, the “Top Five List” of procedures to be re-considered has been the cornerstone of the international success of this campaign. In order to implement these recommendations within the current healthcare environment which includes heightened public expectations of medical technologies, clinicians should embrace the professional ethical code outlined in the “Medical Professionalism in the New Millennium - a Physician Charter” (2002). In this session, international efforts to counter the healthcare overuse will be reviewed.



Shunzo Koizumi
Graduated from Kyoto University in 1971, he served general surgical residency in U.S. from 1975 to 1980 (first year at Youngstown Hospital Association, Ohio; second through fifth years, at St. Vincent’s Medical Center, Bridgeport, Connecticut, a Yale affiliated program) and Board Certified in 1981. Since 1980, he OPrked at Tenri Hospital in Nara both as a general surgeon and co-director of residency program. In 1994, he was appointed as the Professor and Chairman of the Department of General Medicine, Saga University Hospital. In 2011, he inherited current practice.
He is a Fellow of American College of Surgeons, a member of Society of General Internal Medicine (SGIM), an Affiliate Fellow of American College of Physicians, a Board Member of Japanese Society for Quality and Safety in Healthcare, Senior Advisor to Japan Primary Care Association and an Honorary Member of Japan Society for Medical Education. He represents “Choosing Wisely Japan” since 2016.



Tadao Okada
Tadao Okada, MD, MPH, DABFM, FAAFP, JPCACFP, JSMECMES
Diplomat, American Board of Family Medicine (DABFM)
Master of Public Health (MPH)
Fellow, American Academy of Family Physicians (FAAFP)
Japan Primary Care Association certified family physician (JPCACFP)
Japanese Society of Medical Education Certified Medical Education
Specialist（JSMECMES）
Director and Chief, Tessyoukai Kameda Family Clinic Tateyama

Dr. Okada is a family physician devoted in clinical practice,
residency teaching and research who nurtured over 40 residents for 18
years. He is also an established faculty developer who personally
trained more than 120 young faculty spread throughout Japan. He holds
board certification in family medicine both in Japan and the U.S. He
has served as General Secretary for
OPNCA Asia Pacific Regional Executive Committee. He also has several
appointments as clinical/visiting professor at prestigious medical
schools.

Fri. May 17, 2019 1:30 PM - 3:00 PM Room 1 (1F Main Hall)

Organizer: Masako Ii(School of International and Public Policy, Hitotsubashi University, Japan)
Chair: Masako Ii(School of International and Public Policy, Hitotsubashi University, Japan), Ryota Nakamura(Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Japan)

Non-communicable diseases (NCDs) kill 41 million people annually, representing 71% of all deaths. Unhealthy diets, smoking, and physical inactivity increase the risk of NCDs. Most NCDs are preventable and manageable if appropriate screening and care are provided through the continuous monitoring of (potential) patients. Primary care is therefore critical, and investing more in primary care may be the most cost-effective approach for reducing NCD mortality and its societal burdens. There exit no health systems that have enough resources to afford all healthcare interventions regardless of price. We must therefore consider the costs and effectiveness of each medical intervention to achieve health systems that are catch-all and sustainable, especially in this era of fiscal decline. Health technology assessments (HTAs) are increasingly used internationally to help determine “best-buy” interventions and clinical guidelines. This session invites national experts in HTA from four Asia-Pacific countries (Indonesia, Japan, South Korea, and Thailand). Each speaker will discuss the roles and challenges of HTA policies for preventing and treating NCDs at the primary care level in their country. A panel discussion with all speakers will follow to share experiences and idea


Masako Ii

Professor, Asian Public Policy Program, School of International and Public Policy, Hitotsubashi University
She received Ph.D. in Economics from University of Wisconsin, Madison in 1993. Prior to joining Hitotsubashi University, Professor Ii was as an associate professor at the Faculty of Economics, Yokohama National University. She also OPrked as a consultant at the OPrld Bank, Inter-America Development Bank and the Ministry of Planning of the Government of Bolivia. Her fields of specialization are health economics, public economics and development economics. Her recent publication is “Are Japanese People Satisfied with Their Health Care System and Services? Empirical Evidence from Survey Data,” (with B Niu) Health Policy in 2019.
She is currently on the editorial board of Financial Review, issued by the Policy Research Institute, the Japanese Ministry of Finance.
She is a member of Science Council of Japan; Tax Commission, Cabinet Office; the Board of Governors, NHK, Japan Broadcasting Corporation



Ryota Nakamura
Ryota is an associate professor at Hitotsubashi University. He is an applied microeconomist specialising in health. He holds a BA and an MA in Economics from Kyoto University and a PhD in Economics from the University of York. Prior to joining Hitotsubashi in 2016, he held positions at the University of East Anglia and the University of York. His research interests include empirical investigations of health-related behavior and also of healthcare system to inform national and international health policies, using a wide range of research methods including micro-econometric analysis of observational data, economic experiment, and research evidence synthesis.

Contact
Hitotsubashi Institute for Advanced Study
Hitotsubashi University
2-1 Naka Kunitachi Tokyo 186-8601 Japan
Tel: +81 (0)42580 8660
Fax: +81 (0)42580 8605
Email: ryota.nakamura@r.hit-u.ac.jp

Academic positions
Oct 2016 - Associate Professor, Hitotsubashi Institute for Advanced Study, Hitotsubashi University
Sep 2014 - Visiting Associate Professor, Institute of Statistical Mathematics
Sep 2014 - Sep 2016 Research Fellow, Centre for Health Economics, University of York
May 2014 - Jun 2014 Short Term Consultant, OPrld Bank
Jun 2011 - Aug 2014 Research Associate / Senior Research Associate, Norwich Medical School, University of East Anglia
Jun 2011 - May 2013 Research Associate, School of Economics, University of East Anglia

Education
Oct 2007 - Jun 2011 PhD in Economics, Department of Economics and Related Studies, University of York
Apr 2005 - Mar 2007 MA in Economics, Graduate School of Economics, Kyoto University
Apr 2001 - Mar 2005 BA in Economics, Faculty of Economics, Kyoto University

Research area
Health Economics, Health Policy, Public Health

Fri. May 17, 2019 3:30 PM - 5:00 PM Room 1 (1F Main Hall)

Organizer:Christiaan van Weel(Department Primary and Community Care, Radboud University Nijmegen, the Netherlands/Department Health Services Research and Policy, Australian National University, Australia)
Chair: Chris van Weel(Department Primary and Community Care, Radboud University Nijmegen, the Netherlands/Department Health Services Research and Policy, Australian National University, Australia), Felicity Goodyear-Smith(Department of General Practice and Primary Health Care, University of Auckland, New Zealand)

Since 2013, the WONCA Working Party on Research has organized comparisons between WONCA Member Organizations of the status of primary health care and the policy to implement health systems reforms, in their country. These presentations were standardized through the use of an 11 slides’ power-point template – ‘the panel method’ and aimed to present, critically appraise and compare countries. The WONCA Asia Pacific region organized two highly successful comparisons that provided important insights in the regional status of family medicine and primary health care.
Built on this success, the WONCA Working Party on Research proposes more in-depth comparisons between countries, of the role, structure, organization, training and performance of primary health care. The aim of this Workshop is to review the experiences with the panel method, and explore how its findings can inform policy makers. Presentations will explore recent primary health care innovations in Hong Kong, Taiwan and Thailand, the importance of empirical primary health care data for health-economists and how the International Classification of Primary Care (ICPC) in its current revision to ICPC-3 can support comparisons.
Based on the Workshop findings, future comparative studies – in the region and/or at a WONCA global level – can be planned.

Chris van Weel
Chris van Weel graduated (Leiden University) 1973, full time FP in the Ommoord community health centre in Rotterdam 1973- 1985. PhD Erasmus University, Rotterdam, 1981 on a practice based study of prevention.
From 1985 – 2012 professor of family medicine Radboud University Nijmegen, and head of department. Since 2013 affiliated with the Australian National University, as professor of primary health care research, currently in an honorary appointment.
President of WONCA 2007 – 2010, after serving as chair of the WONCA WP research 1984 – 1998, and European president 1998 - 2001.
Research focusses on primary care morbidity, multi-morbidity, long-term outcome of chronic illness, using the Nijmegen Continuous Morbidity Registration family practices network.

Founder EU Erasmus programme ‘Primary Health Care’ for primary care attachments and research electives to medical students from 15 countries.

Co-founder (1995) the Netherlands School of Primary Care Research (CaRe), currently member of its Board of Governors.



Felicity Goodyear-Smith
Felicity Goodyear-Smith is a professor of general practice and primary health care at the University of Auckland, New Zealand. She is currently the Chair of the wonca working Party on Research. In this role she instigated panels at wonca conferences whereby primary health care systems are presented and compared, enabling cross-national lessons to be learned both at the meetings and through subsequent peer-reviewed publications. She is passionate about primary care research and has co-edited two books on behalf of wonca: International Perspectives on Primary Care Research and How to do Primary Care Research, both published by Taylor and Francis.

Sat. May 18, 2019 8:45 AM - 10:15 AM Room 2 (2F Room A)

Organizer:Tomio Suzuki(General Medicine, Osaka Medical College), Kentaro Asakura(Daifuku Clinic, Japan)
Chair: Tesshu Kusaba(The Hokkaido Centre for Family Medicine, Japan), Amanda Howe(Norwich Medical School, Univeristy of East Anglia, UK)

WONCA has declared the importance of Young Doctors Movement to promote the implementation of UHC: Universal Health Coverage that WHO already has put forward and the education for bringing up younger family doctors. On the other hand, Japan has just introduced the new education and certification system designed by Japanese Medical Specialty Board, expecting younger generations to have their own career as family doctors/general practitioners to care the patients, the community, and the nation.
In this session, firstly, we want to discuss why we emphasize YDM for our academic activities. The campaign of YDM has expanded gradually so far. Secondly, leaders of YDM from the Asia-Pacific Region and other regions will make a brief presentation of their own viewpoints regarding the situations of their own countries, why they commit to YDM, and the challenges of nowadays. These presentations will be expected to trigger our ideas and motivations, and give awareness of the importance of thinking globally and having action plans for achieving UHC. We also expect the ex-chair of WONCA, Amanda Howe to listen to the voice of younger generations and give us brilliant advice for the future.



Tesshu Kusaba
1999 M.D. Kyoto University School of Medicine, Kyoto, Japan
1999-2001 Junior Resident, Nikko Memorial Hospital, Muroran, Japan
2001-2003 Senior Resident in Family Practice, Hokkaido Centre for Family Medicine,
Caress Alliance, Muroran, Japan
2003-2006 Motowanishi Satellite clinic, Hokkaido Centre for Family Medicine
2006- Director and chair, Hokkaido Centre for Family Medicine
2019- President, Japan Primary Care Association

License and Certification
Japan Primary Care Association certified family physician
International member of Royal college of general practice

Public Work:
Executive vice president, Japan Primary Care Association
Executive council member, WONCA Asia Pacific Region
Member, Regional Medical Council of Hokkaido prefecture
Adjunct lecturer, Kyoto University School of Medicine

Publication and translation
T.Kusaba, et al. “The Essence of Family medicine”, Kai shorin, Tokyo, 2011.
T.Kusaba, et al. “Family Medicine”, Person shobou, Tokyo, 2013.
T.Kusaba, et al. “Inner Consultation” , Kai shorin, Tokyo, 2014.
T.Kusaba, et al. “Training for General practitioner”, Nakayama shoten, Tokyo, 2016.



Amanda Howe
Amanda Howe is a practising family doctor, an academic professor, and a national and international leader in family medicine. Since 2001, she has been Professor of Primary Care at the Norwich Medical School, University of East Anglia, where she was part of the founding team for a new medical programme. She has particular expertise in the teaching and learning of professionalism and patient safety; in the models and effectiveness of involving family medicine in community based medical education; and in resilience and doctors’ wellbeing. She also has clinical research interests in primary care mental health, the contribution of patients to health care, and in early interventions for risk factors. She served from 2009 – 2015 as an Officer of the Royal College of General Practitioners, previously chairing their research committee and the U.K. Society for Academic Primary Care. She is Immediate Past President of the World Organization of Family Doctors, having served as President from 2016-2018.