Panel 1: Human dry dock
The Ningen Dock (or human dry dock) is a comprehensive
medical check-up system that is unique to Japan.13 The Ningen
Dock started in 1954 at a hospital in Tokyo. At that time, this
service could only be aff orded by business and political leaders
because it took 6 days of consecutive stay in hospital and cost
the equivalent of 3–4 months of a civil servant’s starting
salary. Advances in automated blood analysers and other
testing apparatus reduced the costs, and the 1-day or 1-night
stay has become the main type of service. About 3 million
people per year are estimated to receive the Ningen Dock at
about 1500 medical institutions in the country. A key factor
that underpinned the rapid growth in the use of the Ningen
Dock was that several companies covered the cost for their
employees to ensure their good health.
The Ningen Dock emphasises the importance of a
consultation and a post-examination interview. Over
1–2 days, clients undergo a series of medical examinations,
such as blood, urine and faecal tests, radiography, and
ultrasonography, and a consultation with a doctor about
their medical history and lifestyle habits. After the
examinations, the doctor explains the results and gives
lifestyle advice to the clients.
The Ningen Dock might play a part in the primary prevention
of cerebrovascular and cardiovascular diseases through the
control of risk factors, such as obesity, hypertension,
hyperglycaemia, dyslipidaemia, and hyperuricaemia. It might
also be important for secondary prevention through the
detection of diseases such as the early stages of cancer. The
brain dock with MRI has expanded nationwide since it
started in 1988.14 There has also been a focus on using PET
scans to detect the early stages of cancer. However, the
cost-eff ectiveness of the Ningen Dock has been questioned.