‘Do me a favor, I want you to serve as the president of our hospital. There are no suitable candidates except you.’ All of a sudden, our former chairperson of the board called me on a hot summer day in the end of July 2004. Initially I turned down the offer saying, ‘I’m afraid to say that I am just a clinician. Depending on the situation though, I would like to practice cutting-edge medical care in the U.S. years later. I have my medical license and medical specialist qualification there. Above all, I’m an amateur to run a hospital. There are so many candidates out there who desperately want to be a president.’ The former chairperson did not give up and said ‘From my experience, such aspiring presidents never did a great job. Rather, I believe that the one who kept making effort as a clinician would be a good president. Everyone starts from somewhere, including me. So, don’t worry. I’m begging you, serving just one year is enough.’ Having the same arguments over and over again, I finally accepted the offer under the premise of ‘one year’. The chairperson advised me to leave all management job to a general manager but even if I do so, I am the only one to take full responsibility in the end. Being a president means that my name will be on the chief administrator of medical institution list at municipal office. No matter what happens at the hospital, I will be the only one to take full responsibility including its management. THE BUCK STOPS HERE.

After I became a president, I was overwhelmed by incredible amount of documents to be approved. I found that I need to put seal on so many documents, too. In medical care, saving patients definitely comes first before making a profit. On the other hand, hospital bankruptcy might bring trouble to our patients, so we need to have a stable hospital management, too. For this, I needed to learn some special terms including medical operating income, medical operating cost, medical operating profit, pre-tax profit, non-medical operating income, profit and loss statement, balance sheet, labor cost ratio, medical supply cost ratio, capital adequacy ratio, patient’s cost per day, and more. I can understand cardiac catheterization tools instantly because that is my specialty. However, the above-listed terms are NOT. It’s like me, a high school student who liked mathematics, mechanics, electricity, and organic chemistry need to learn my worst subjects such as classical literature and geology. Still, I learned the management by asking others for help and reading books while treating patients daily. I must admit that I am not a so-called ‘charismatic manager’ though, with a big help from our brilliant administrative staff, our hospital keeps growing for 14 years since I started to serve as a president. Medical operating income and profit per staff keep staying in the top 3 of our medical corporation group. Therefore, the promise of ‘serving just one year’ no longer exists, as if it never happened.

About 20 years ago, Chiba-Nishi General Hospital was a small-scale hospital and had no residents. Now it became a large-scale general hospital with 680 beds, 1,400 staff and 31 departments. Also we train more than 20 clinical residents. Our Cardiology department that I lead and welcomes a lot of patients from both home and abroad, and its related Cardiovascular Surgery department are relatively well-known. However, other departments including Gastroenterology, Gastroenterological Surgery, Neurosurgery, Breast Surgery, Plastic Surgery, Urology, and others are also delivering an amazing performance these days. Needless to say, our Pediatrics, Obstetrics & Gynecology, Respiratory Medicine, and Neurology with high medical needs in our region are serving well, too.

Our doctors are all motivated. They also deliver medical lectures diligently to enlighten while treating patients. I turned 60 years old last year, but I would like to dedicate myself to medical care as long as possible.

Kazuo Misumi, President