Patient satisfaction is a key indicator of healthcare quality. While physician-related factors are well studied, less is known about how non-physician staff contribute to satisfaction in primary care. This study examined the association between patient satisfaction and multidisciplinary staff involvement in a Japanese primary care clinic.
We conducted a secondary analysis of patient satisfaction survey data collected from 2019 to 2022. The primary outcome was overall satisfaction with the visit, dichotomized as “highly satisfied” versus “less than highly satisfied.” Modified Poisson regression with robust standard errors estimated prevalence ratios (PRs) and 95% confidence intervals (CIs). Multivariable models included satisfaction with non-physician staff, patient demographics, and physician-related satisfaction via principal component analysis. Sensitivity analyses included consultation duration and access to care.
Among 1415 patients, higher satisfaction with the demeanor of nursing staff (PR 2.06, 95% CI 1.39–3.05) and waiting time care (PR 1.43, 95% CI 1.33–1.54) were significantly associated with greater overall satisfaction. Receptionist demeanor also showed a modest but significant association (PR 1.30, 95% CI 1.05–1.61). In the sensitivity analysis, these associations persisted for nursing staff (PR 1.64, 95% CI 1.20–2.24) and waiting time care (PR 1.08, 95% CI 1.02–1.14), while the receptionist association was attenuated (PR 1.15, 95% CI 0.97–1.35).
Beyond physician-related factors, nursing staff demeanor and waiting time care were found to be associated with patient satisfaction. These findings support the importance of multidisciplinary contributions to patient-centered care in primary care clinics.
Neisseria meningitidis can cause invasive meningococcal disease (IMD). Individuals with primary complement deficiencies are at a higher risk of developing IMD. However, cases of IMD associated with complement deficiency have rarely been reported in Japan. In this case, a 35-year-old Japanese man presented with fever and a spreading skin rash. Blood culture identified N. meningitidis serogroup B. The patient was treated with antibiotics and fully recovered. Genetic analysis revealed a deficiency in complement component 7. This case highlights that IMD can occur in young, otherwise healthy individuals, some of whom may have underlying complement deficiency.
Japan's 2022 Model Core Curriculum (MCC) recommends community-based clinical clerkships spanning at least three consecutive weeks to foster generalism competency, although empirical evidence supporting this guidance remains limited.
We used an explanatory sequential mixed-methods design. Fifth-year Chiba University medical students (n = 112) completed a three-week community-based clinical clerkship from September to November 2024. Self-assessed attainment of the 18 MCC generalism learning objectives was measured pre- and post-clerkship. Daily reflection sheets (n = 1680) were deductively coded to analyze the learning processes using content analysis.
Mean self-assessment scores increased significantly for all the objectives (p < 0.001), with effect sizes ranging from small (d = 0.37) to very large (d = 1.40). Content analysis of the reflection sheets yielded 539 reflection codes across 16 objectives, with all the students contributing. The most frequently coded objectives were “primary care at home” (106 codes from 58 students), “geriatric stage” (79 codes from 44 students), “primary care in the community” (64 codes from 42 students), and “end-of-life care” (62 codes from 43 students).
A three-week community-based clinical clerkship produced significant self-assessed gains across all 18 generalism learning objectives and generated 539 reflection-based learning units, including 16 objectives, confirming that students actively engaged with the full breadth of generalism in practice. These findings should be interpreted as indicating perceived growth rather than objective competence, given the reliance on self-assessments, and exposure opportunities varied across clerkship sites. Further multi-site studies are needed to clarify whether 3 weeks is the optimal duration.
The Japan Primary Care Association (JPCA) was established in 2010 through the merger of three academic societies: the Japanese Medical Society of Primary Care, the Japanese Academy of Family Medicine, and the Japanese Society of General Medicine. This article reviews the historical development of these predecessor organizations, the context and process of their unification, and the evolution of JPCA. Over the past 15 years, JPCA has promoted clinical practice, education, and research while enhancing inter-professional collaboration and certification systems for physicians, nurses, and pharmacists. Its proactive response to disasters, involvement during the COVID-19 pandemic, and participation in healthcare policies reflect its dedication to addressing Japan's changing healthcare landscape. As the leading academic organization for primary care in Japan, JPCA continues to foster integrated community-based care and aims to strengthen its presence both nationally and internationally in the advancing field of primary care.
Jolt accentuation of headache (JAH) is well-described as a highly sensitive indicator for detecting meningitis. However, its effectiveness in identifying herpes zoster (HZ)-associated meningitis remains unclear.
This study aims to evaluate the sensitivity and specificity of JAH and other clinical manifestations in diagnosing HZ-associated meningitis.
We conducted a retrospective study of medical records from a single institution, comparing clinical features between HZ patients who developed meningitis and those who did not.
A total of 70 HZ patients were identified, 17 of whom were diagnosed with meningitis and the remaining 53 who were not. JAH was significantly more prevalent in HZ patients with meningitis compared to those without (29.4% vs. 3.8%, p = 0.0077). The sensitivity of JAH for detecting HZ-associated meningitis was 0.29, while its specificity was 0.96. Other symptoms and signs, including fever, nausea/vomiting, headache in areas without a rash, altered mental status, paralysis, and neck stiffness, exhibited similar results.
While JAH demonstrates high specificity, it lacks high sensitivity in diagnosing HZ-associated meningitis and does not outperform other meningitis-related indicators.
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