Four Doctors Reveal the Hidden Risks of Japan’s Convenience Store Clinics
Patients Who “Just Want Medication” and Clinics That “Just Dispense Medication”… A Good Doctor Doesn’t Simply Give In to Patient Requests
The pros and cons of convenience
You can see a doctor even at 9 p.m., or on weekends and public holidays. You make an appointment via LINE, and once it’s your turn, you’re called in, so there’s little waiting time—
So-called convenience clinics, which put convenience front and center, are becoming increasingly prominent. Opening inside train stations and shopping malls and combining in-person care with online consultations, they are steadily increasing in number by skillfully catering to the needs of busy people in modern society.
However, while the ability to see a doctor anytime is certainly an advantage, critics have also pointed to drawbacks such as doctors constantly changing and illnesses being overlooked. Four practicing doctors on the front lines of medicine—pediatrician Dr. Tetsuya Kubota, internist Dr. Yoshimasa Goto, psychiatrist Dr. Kina Takagi, and orthopedic surgeon Dr. Kazutoshi Kameda—engaged in a candid discussion about the current state of convenience clinics and the challenges they face.
Not medical care, but a prescription service
Takagi: There was a patient who was referred to us after not having had a blood test for several years, and when we examined them, we found that they had lithium poisoning. Dehydration and reduced kidney function can cause toxicity even at low doses, so when lithium carbonate is used as a mood stabilizer, it is generally adjusted while monitoring the blood concentration. Some psychiatric medications can impair kidney or liver function, while others can cause side effects such as diabetes or dyslipidemia. Not only with lithium, but prescribing medications indiscriminately without blood tests is extremely dangerous. Walk-in clinics are at particularly high risk of falling into this pattern.
Goto: That may not be a problem limited to psychiatry. Whether in pediatrics, internal medicine, or orthopedics, I feel that the practice of not doing any tests and just prescribing medication is gradually becoming more widespread. Patients themselves will clearly say, “I just want the medication,” too.
Kameda: Perhaps that is because more patients are coming to view a doctor who meets the patient’s requests as a good doctor. But medicine cannot be based solely on what patients want.
Takagi: Exactly. A doctor should diagnose the illness, conduct tests when necessary, and rule out the possibility of other diseases before prescribing medication. If that order is reversed, it ceases to be medical care and becomes a prescription service.
Goto: There was an advertisement for sleeping pill prescriptions using only a smartphone that became a hot topic on social media, wasn’t there?
Takagi: It is extremely dangerous. Sleeping pills and anti-anxiety medications are not drugs that you can simply take if you can’t sleep. Benzodiazepines in particular are addictive and should not be prescribed casually.
Goto: If prescriptions are continued without proper consideration, the medication may become less effective, leading to an increase in the dosage. In older people, that can then lead to problems such as falls and effects on cognitive function. And if the cause of insomnia is sleep apnea, sleeping pills cannot solve the underlying problem.
Kubota: In fact, we see a similar pattern with treatments such as Mounjaro offered under private-pay medical care. There are even dermatology clinics that prescribe Mounjaro as a private-pay treatment, which I find difficult to understand. Mounjaro is a GLP-1 receptor agonist, and it can cause not only vomiting but also serious side effects requiring caution, such as acute pancreatitis and gallbladder disease.
The other day, this came up in a conversation among some doctor friends of mine. There are clinics where a counselor explains the treatment online, and then, at the very end, a doctor appears for just a few minutes and prescribes the medication. Many of these doctors are part-time physicians, and apparently they are coached to simply say, “Yes, everything looks fine.” I was told that it is essentially a race against the clock: the more patients they can prescribe for in a single day, the greater the profit.
The reality of not being able to survive
Takagi: Patients aren’t at fault for using these services simply because they’re available. The same goes for nighttime house-call services. The system, which allows patients to see a doctor at home without going to a hospital, was extremely convenient.
Goto: As demand for the service grew, so did cases where people requested house calls simply because going to the hospital is a hassle or I can’t take time off work.
Kubota: Nighttime house calls are originally intended for patients who need emergency medical attention. But when convenience takes precedence, more people end up using the service in ways that differ from its intended purpose.
Goto: The more seriously a medical institution practices medicine, the harder things become. Medical fees are standardized nationwide. If you spend time examining each patient, conduct the necessary blood tests, and carefully provide lifestyle guidance, it becomes difficult to see large numbers of patients. That means losing out on potential revenue.
Kubota: Exactly. From a business standpoint, it is easier to stay afloat by operating like a convenience clinic—finishing consultations quickly, claiming every additional fee available under the system, and seeing as many patients as possible. Japan’s medical reimbursement rates are low compared with other countries. Yet labor costs are rising. The cost of medical supplies is rising. Utilities and rent are also rising. Even so, medical reimbursement rates are not increasing significantly. The reality is that unless you make maximum use of the system and maximize profits, you cannot survive.
Goto: Patients seeking convenient medical care. Local clinics struggling financially. A healthcare system constrained by medical reimbursement rates. Perhaps the convenience clinic emerged as a result of these three factors becoming intricately intertwined.
Kameda: I understand that being able to see a doctor on weekends, holidays, or at night is extremely valuable to patients. But we cannot simply turn a blind eye to safety concerns and health risks. If that is the case, perhaps we need to use these services selectively. For example, patients with stable chronic pain, patients with conditions such as gout whose medications have been well established, or patients undergoing ongoing rehabilitation could use convenience clinics or online consultations when they simply need a prescription.
Kubota: Even in urology, there are cases where online consultations can be used when a patient’s condition is stable.
Goto: Depending on the patient’s circumstances, I think it is important to make sure they receive regular in-person consultations, have blood tests at least once every six months, and undergo imaging tests when necessary. We need to directly check for changes in their condition. Rather than completing everything online, it is important to combine online care with face-to-face consultations.
Takagi: In psychiatry, face-to-face consultations are still preferable. In urban areas, more clinics are offering online consultations for relatively mild cases, but hospitals that handle involuntary hospitalization, hospitalization for medical protection, emergency psychiatric care, and patients at high risk of self-harm or harming others are facing a serious shortage of doctors.
Kubota: Younger doctors want to work in a way that gives them a good work-life balance. Young doctors tend to gravitate toward medical institutions that let them leave on time and offer high hourly wages—¥15,000 or even ¥20,000 an hour, for example.
Making convenience clinics the villain will not solve the problem. Medical reimbursement rates, regional healthcare, staff shortages, patients’ healthcare-seeking behavior everything is interconnected. But I believe there is something we doctors who run our own practices can do: protect the medical care that patients actually need. Convenience and safety. Efficiency and quality of care. Striking a balance between these is perhaps the greatest challenge facing Japanese healthcare going forward.
From the August 21–28, 2026 combined issue of “FRIDAY.”