Healing Medicine.(Japanese physicians)

Keichi Kawafuchi always wanted to be a doctor. That is, until he became one. In his recent best-selling memoir "Don't Call Me Sensei," Kawafuchi writes about young doctors so green they still didn't know how to operate respirators, yet were left alone at night to staff wards. Colleagues, he recalls, were asked to prescribe medicines they didn't understand. And Kawafuchi himself wasn't immune from such potential malpractice. During his first week out of medical school, a senior cardiovascular specialist fobbed off care of a terminally ill heart patient to him. "The patient got worse and died two weeks later," Kawafuchi told NEWSWEEK. "I was terrified that the family would blame me, a mere intern. But being Japanese, they didn't ask questions."

The Japanese public, however, is no longer quietly taking their medicine. Kawafuchi's is but one voice in a growing chorus of outrage at Japan's insular medical system. Assertive patient-advocacy groups, a wave of malpractice suits and even some damning government studies are exposing professional negligence at some of Japan's most respected hospitals. And these revelations are being met by a surprising ally: doctors. Physicians, especially the younger set, are demanding an overhaul of how medicine is practiced. Until recently, Japanese doctors abided by a strict code of silence. But doctors know best what an ailing state Japanese medicine is in. "Even Japanese doctors don't want to be treated in Japan," says Gen Nomura, spokesman for a Tokyo-based health-care consultancy. "They don't trust their own system."

Japan's socialized health-care system resembles a well-heeled guild. Hospitals keep problems internal. Peer review boards don't exist. Most of the high-school graduates who fill the coveted slots in medical school are physicians' sons and daughters; their place is secured by pedigree, not performance. Inside hospitals, status is conferred by age, not achievement. And Japan's all-powerful medical lobby, the Japan Medical Association, staunchly defends the system. In essence, many Japanese doctors believe they are beyond reproach. While they have the necessary basic skills, many are never trained in newer treatments and lack the medical ethics considered commonplace elsewhere. "Patients are essentially walking into an examination blind," says Yuko Noma, an analyst with U.S. health-care consultancy Best Doctors Inc. "And doctors expect them to stay quiet and obey orders."

It's difficult to even assess Japan's medical woes because the government doesn't require hospitals to release data on success rates. But Toshihiko Hasegawa, a director at the National Institute of Health Services Management, announced at a medical conference last ...