Barriers and Associated Factors to Writing Case Reports Among Japanese General Medicine Physicians: A Cross-Sectional Study of the Japan Primary Care Association Members.

Background: Case reports are an important academic output for general medicine physicians; however, publication rates in Japan remain low, and barriers to preparing case reports have not been fully clarified. Thus, we aimed to identify barriers perceived by Japanese general medicine physicians when writing case reports. Methods: A web-based questionnaire survey was administered to physician members of JPCA between November and December 2021. Sixteen potential barriers identified in previous studies were assessed using an 11-point Likert scale (0-10). Participants were categorized into two groups based on their experience writing case reports. Group comparisons were performed using the Mann-Whitney test and chi-squared test. Logistic regression analyses, adjusted for age and sex, were conducted to estimate adjusted odds ratios (aORs) for each barrier. Results: Overall, 315 physicians responded to the survey (response rate: 10.2%). Of these, 159 (50.4%) had experience in writing case reports. Fifteen of the 16 barrier items scored significantly higher among inexperienced physicians. The aORs were significantly elevated for 13 items, excluding financial factors. The major barriers included lack of sufficient medical documentation to write a report (aOR: 7.99), unfamiliarity with writing case reports (aOR: 6.44), not recognizing suitable cases (aOR: 4.79), and difficulty identifying the main case points and clinical messages (aOR: 3.80). Experienced physicians not "having adequate time to write" remained the main obstacle (69.8%). Conclusions: Barriers to writing case reports vary markedly by experience. Systematic education, strengthened mentorship, and organizational support for protected academic time are essential to promoting case report writing among general medicine physicians.