The Horror of the “Doctor Gacha” Currently Unfolding in Japan [A Roundtable Discussion by Four Practicing Physicians Using Their Real Names] Part 1

The Pros and Cons of “Convenience”

You can see a doctor at 9 p.m., or even on weekends and holidays. You make an appointment via LINE, and since you’re called as soon as it’s your turn, there’s little waiting time—

So-called “convenience clinic” models, which emphasize convenience, are gaining prominence. Opening inside train stations and shopping malls and incorporating online consultations, they are steadily increasing in number by skillfully catering to the needs of busy modern people.

However, while there is the benefit of “being able to see a doctor anytime,” drawbacks such as “doctors changing frequently” and “illnesses being overlooked” have also been pointed out.Four practicing physicians on the front lines of healthcare—Dr. Tetsuya Kubota (pediatrics), Dr. Yoshimasa Goto (internal medicine), Dr. Kina Takagi (psychiatry), and Dr. Kazutoshi Kameda (orthopedics)—shared their thoughts on the current state and challenges facing convenience store clinics.

Kubota: Chain pediatric clinics are opening in shopping malls across the country, and on weekends and holidays, they’re seeing a lot of patients.

Goto: “The fact that there are more medical facilities where people can get immediate care when they’re in trouble isn’t a bad thing in itself. Especially for families with young children, the peace of mind that comes from knowing they can be seen even at night or on holidays is significant.”

(Everyone nods.)

Kubota: In pediatrics, parents often ask for a specific diagnosis out of anxiety—saying things like, “It’s herpangina, right?” or “Is it hand, foot, and mouth disease?” In that sense, convenience store clinics do provide a quick diagnosis to put parents’ minds at ease.

Takagi: However, while parents may be satisfied in the moment, there are also cases where the diagnosis is incorrect, aren’t there?

Kameda: The speed of a diagnosis and its accuracy are two separate issues. At convenience store clinics, the doctor seeing the patient isn’t necessarily the same one every time. That’s also a problem, isn’t it? Since they need to stay open on weekends and holidays, multiple doctors have to take turns working.

Goto: At clinics with extended hours—like those open until 9:00 p.m.—the doctor on duty might change between the morning and afternoon shifts.

Kubota: Even if the diagnosis is the same, because the doctor changes, the medication prescribed in the morning might differ from what’s prescribed in the afternoon. I’ve had patients come to me confused about this. At convenience store clinics, inconsistencies in treatment policies are inevitable.

I don’t even know if they’re a specialist

Takagi: It’s risky when the attending physician in psychiatry changes so frequently. It makes it difficult to continuously monitor changes in the patient. Family relationships, work, daily routines… I think it’s dangerous to make judgments based on a single consultation.

Kameda: It’s the same in orthopedics. Understanding how the current pain differs from the previous episode, as well as the patient’s work and lifestyle context—that cumulative understanding is essential for providing the right treatment.

Goto: “I had side effects from this medication before,” “My father had diabetes,” “This child has had a febrile seizure,” “Last year’s physical showed these findings”—a primary care physician treats patients by building up this kind of background information over time.

Takagi: Convenience store clinics are well-suited for addressing immediate, day-to-day health concerns, but their role is different from that of a practice that provides long-term care for patients.

Kubota: If we rely solely on convenience, it’s inevitable that some issues will be overlooked.

Takagi: Have you heard of online psychiatric clinics? Even if you look at their website, you can’t tell who the director is, which doctor will be seeing you, or even whether they’re a board-certified psychiatrist. Clinics like that actually exist, you know?

Kubota: From the patient’s perspective, a highly convenient clinic and a long-established local clinic are both the same type of medical facility. People use convenience store clinics precisely because they’re convenient. However, they don’t know what kind of medical care system lies behind that convenience.

Takagi: In psychiatry, we don’t make a diagnosis based on conversation alone. We observe the way a patient walks into the examination room, their clothing, grooming, facial expressions, eye contact, the timing of their responses, and how they sit in the chair. We gather a great deal of information even before the consultation begins.Much of that is lost online. Depending on the connection, it can be hard to read facial expressions. Plus, the screen only shows the upper body. There are limits to confirming a diagnosis during an initial consultation.

Kameda: In orthopedics, we can often tell a lot just by watching how a patient walks or stands up from a chair. There’s definitely information that can’t be picked up through online consultations alone, isn’t there?

Takagi: That’s exactly why diagnosis is so important and difficult, but at convenience store clinics, you never know which doctor you’ll end up with. It’s literally like a “doctor gacha.” I’ve had patients referred to me from psychiatry who turned out to have leukemia. There have also been cases of hypothyroidism, Guillain-Barré syndrome, cerebral infarction, cerebral hemorrhage, and epilepsy.The truth is, there’s no time to waste—a mistake during the initial consultation can be fatal. I always order blood tests during the first visit to rule out other possible conditions. At convenience store clinics, blood tests are generally not performed, are they?

Kubota: I think blood tests are essential for ruling out other conditions, though…

Takagi: They don’t have nurses on staff. They don’t have time to draw blood. There are costs associated with disposing of infectious waste. They also need to manage inventory of blood-drawing supplies… The reasons vary, but the reality is that there are clinics that don’t perform blood tests.

Goto: I understand the circumstances, but that doesn’t justify skipping necessary tests.

[Roundtable Discussion with Four Practicing Physicians Using Their Real Names] Part 2: The Dangers of “Prescription Services” and the Challenges Facing “Convenience Store Clinics”

From the August 21 & 28, 2026, combined issue of *FRIDAY*