HCPs in Japan react on social media to proposed working time changes

Japan declares a 4-day week⁰To nurture dreams & futures sleek⁰A nation seeks to #propagate,⁰A balanced life, a kinder state.
In quiet homes new laughter will grow⁰thru fleeting time, love will softly sow⁰A path to life, both slow and grand,⁰To create a better land.#vss365

— Desdemona (@Desdemo23438449) December 13, 2024

Traditionally, Japan has had a culture of working long hours. They even have a word for deaths resulting from it, karoshi (過労死) which literally means ‘overwork death’.  

In an attempt to address overwork, declining productivity and an aging population coupled with a shrinking workforce, Japan passed a work style reform law in 2018 and has been implementing this in stages ever since.

The key elements of this are:

1. Capping overtime work.
2. Mandatory use of paid leave.
3. Equal pay for equal work.
4. “Highly professional” work system.
5. Promotion of flexible working arrangements.

As part of these wider national reforms, Japan’s healthcare system is undergoing significant changes aimed at improving working conditions for healthcare professionals (HCPs). These reforms, particularly the introduction of caps on physicians’ working hours, are designed to address issues such as overwork, burnout, and the uneven distribution of healthcare workers.

At CREATION, we have been analysing what Japanese HCPs feel about these reforms, by listening to their conversations on social media.  

Karoshi – Overwork death

One popular post from an HCP in Japan suggested that the issue goes right back to the end of the war, saying that the number of doctors has been restricted since then, placing a heavy burden on each doctor today.  This post also points to the challenges of balancing overwork with the fact there just are not enough doctors to cover things like night shifts. 

Another HCP asked X’s AI integration Grok to fact check this post. The response from Grok was also shared by other Japanese HCPs.

Grok’s response is that it’s true the number of doctors has been suppressed since the war and for many years budget and healthcare costs have led to less doctors being trained in favour of maintaining the quality of existing doctors.  As a result of the shortage of doctors, chronic overwork has become the norm.  Grok confirms that Karoshi, overwork deaths is a problem that has been in the news many times.  Whilst the new reforms are meant to address this the lack of doctors means it’s hard for the medical field to comply with the reforms.   

Long hours = commitment

Another Japanese word, ganbaru (がんばる), speaks to the culture of work in Japan and the idea that long hours equal commitment. While the issue is not specific to healthcare, there do seem to be some specific challenges for HCPs; one HCP shared a news article and commented on issues faced by hospitals trying to implement these changes pointing to specific issues with overtime. 

One comment on this post from someone who identifies themselves as ‘an old woman’ talks about self-sacrifice being a virtue, pointing to the deep rooted cultural issues and beliefs that form part of this complex challenge for Japanese healthcare.  So deep seated is the issue within Japanese culture that there is even a Karoshi Prevention Hotline (Japanese Karoshi Prevention Hotline for Consultation: 03-3813-699). 

What is clear is that HCPs are looking for answers, with one Japanese hospital pharmacist sharing a news article about the system in Iceland, where they have introduced a three day working week, and hoping Japan might follow suit.

What does all this mean for the Pharmaceutical industry?

With HCPs in Japan having less time to see and treat patients this also has a knock on impact to traditional pharmaceutical field force representatives. One client in Japan told me it was not unusual for their reps to be seeing HCPs at 9pm at night after their surgeries had finally finished – with the proposed reforms, that might no longer be an option!

All this means pharmaceutical companies in Japan are having to find other strategies and ways to engage HCPs. Analysing social media and finding HCPs online is one way to do that; we know they are there and active.   Whilst they may not be able to work longer hours, this does not stop HCPs going online after work. Just as an example, looking into our HCP Voice product for type 2 diabetes specifically we can see that in the last year we tracked over 3,000 posts by HCPs in Japanese language.  

And, digging into these posts a little deeper, we can see that the majority of these Japanese language posts are made in the evening or overnight (Tokyo time) whereas US and UK HCPs are much more likely to post during the working day.  

Conclusion

As Japan navigates the complex road of work time reform, it’s clear from social media that HCPs are not only aware of the changes but are actively grappling with the cultural and structural implications. From concerns about doctor shortages to reflections on deep-seated societal norms like ganbaru and karoshi, these voices highlight the layered reality behind policy implementation. For the pharmaceutical industry, these reforms could signal a turning point. With face-to-face time shrinking in Japan, digital engagement becomes not just a nice-to-have but a strategic necessity. The good news? HCPs in Japan are online, active, and vocal. 

Perhaps pharma companies should be investing in deeper social media listening, tailoring digital engagement strategies to fit new working patterns, and even advocating for solutions that support HCPs through this transition. If you want to stay relevant in Japan’s evolving healthcare landscape, listening and adapting is a must. If you’d like to understand how CREATION can help you address this please get in touch, we would love to discuss it with you.