Adapting the Hospitalist Work Style to Japan's Work Style Reform: A Qualitative Study from the Perspectives of Japan-Trained Hospitalists in the United States.

Introduction: In Japan, the Work Style Reform Bill, enacted in 2018, aimed to reduce excessive working hours and promote diverse work styles. Following the full enforcement of physician work-hour limits in 2024, attention has shifted toward developing sustainable work styles that maintain the quality of care while improving efficiency and physician well-being. The United States (U.S.) hospitalist model-characterized by shift-based inpatient practice-may offer relevant insights; however, its feasibility in Japan remains unclear. This study explored the feasibility, benefits, and challenges of adapting the hospitalist work style to Japan from the perspectives of Japan-trained hospitalists practicing in the U.S. Methods: Semi-structured interviews were conducted with three Japan-trained physicians currently working as hospitalists in the United States. Interviews examined cross-national system differences, the contribution of hospitalist practice to Japan's reform goals, barriers to implementation, and recommendations for adaptation. Data were analyzed qualitatively using the Steps for Coding and Theorization method. Results: Four major themes emerged: (1) Conclusions: The hospitalist work style was well aligned with-and highly applicable to-Japan's work style reform. Despite institutional differences, several components were considered immediately transferable. Sustainable integration, however, will require transformation of work culture, enhanced institutional and public understanding, and the accumulation of evidence to support broader implementation.