Observing "Home Medical Treatment Innovations" that are rooted in the local community

Akihiko Ozaki, M.D., Ph.D. Physician at the Medical Governance Research Institute

Visit to the Higashi Osaka Clinic

On September 6th, I visited Okamoto Internal Medicine Clinic in Higashiosaka City. The clinic's director, Dr. Masayuki Okamoto, graduated from Nada High School and went on to Kyoto Prefectural University of Medicine. After working at his alma mater, he opened a clinic in his hometown of Higashi-Osaka.

Dr. Okamoto was a senior at high school of Dr. Masahiro Kami, the president of the Medical Governance Institute, and is a regular participant in the "Council for Promoting Medical Reform from the Field " organized by the Medical Governance Society. I was given the opportunity to visit the clinic.

I left Shinagawa Station at 6 AM and took the Shinkansen to Shin-Osaka Station. Dr. Okamoto came to pick me up at the nearest station in his small car, and served me iced coffee that I had purchased in advance Right from the start, I was touched by his thoughtful attention to detail, which warmed my heart.

In the morning, I visited the outpatient department. Since it was a Saturday, there weren't many patients, but the staff, especially the nurses, were very quick.

The idea of ​​"supporting those who want to support"

Dr. Okamoto was called in at key points and provided careful medical care, but in between I was able to ask him at length about his own thoughts on "management" and "social contribution."

At the core of it all was a very frank and honest attitude of "doing what you want to do" and "supporting who you want to support." This policy may sound simple at first glance, but I was able to understand it in a more concrete form during the home medical consultation I accompanied in the afternoon.

In the afternoon, I went to a home medical care with the doctor and his wife. The doctor drove around the area, while his wife, who also handles administrative duties at the clinic, organized information about the places they would be visiting in the passenger seat (I was also surprised that the doctor drove himself). Our first stop was a nearby restaurant, where I was shown how they prepare and distribute boxed lunches to patients.

There is fierce competition in home medical care in Osaka, and these efforts are said to be leading to greater patient satisfaction and a sense of security. "Some clinics even hand out two," he said with a laugh, conveying his willingness to care for his patients and his flexibility.

Making the most of welfare systems is essential

They also stopped by the affiliated Satsukikai Oka Clinic, where they were joined by director Yoshiaki Matsumura and continued their visit. Mr. Matsumura has extensive experience in the welfare field and emphasized that "it is essential to make use of not only medical but also welfare systems."

For example, by utilizing systems such as Type B continuous employment support, patients can receive an additional standard amount of welfare assistance (approximately 120,000 yen per month for single-person households in Osaka), and the support center can receive a stable income.

In fact, the restaurant where we picked up their lunches is also a Type B continuous employment support facility, and they accept people with disabilities there. It's amazing how all these different pieces are connected.

Mr. Matsumura runs multiple businesses with a staff of around 200 people, and supports the entire community through welfare. He said, "Unlike nursing care, welfare is important precisely because it has a flexible system," which left a strong impression on me. I realized that the perspective of linking medical care and welfare is enhancing the sustainability of local medical care.

Innovations in home medical care seen everywhere

The home medical care route is minute by minute. While traveling to the next site, she records the consultation and sends the information to the clinic and pharmacy. Mr. Matsumura also makes phone calls to the next site to help ensure the medical consultation goes smoothly.

In the field of home medical care, I saw many efforts to balance efficiency and courtesy. In apartment complexes, patients are asked to gather together in one place to ensure a smooth flow of visits. Furthermore, multiple clinics worked together to establish a medical treatment system that provided detailed coverage for the entire region.

It was impressive to see Dr. Okamoto making visits one after the other, with his wife's carefully organized notes in hand, while still providing close support to each patient.

The question I had in the morning, "Why a small car?", became clear during my afternoon visit. There are many narrow alleys in Higashi-Osaka that can only be accessed in a small car, and there were actually many times when we were able to arrive in the shortest time possible because we had a small car.

He jokingly referred to it as "an image strategy," but the practical benefits are great and it seems to provide patients with a sense of security.

Supporting the community through appropriate use of the system

Financial ingenuity is essential to continuing medical practice, but this is never done for the sake of profit, but rather based on the attitude of "making proper use of the system to support the local community."

At the heart of things like providing free lunches and designing efficient visits is the desire to bring peace of mind to patients.

What I felt after spending a day with him is that Dr. Okamoto's personality itself is a strength for local medical care. He appears to be bold and carefree, but in reality, he is very sensitive and sincere. I felt great energy in the way he learns about the systems in place and puts them into practice in the field, while also making adjustments.

"I believe that home medical care requires a holistic approach, so it is important for doctors, nurses, and service managers to communicate with pharmacies and administrative staff to ensure a smooth response," said Dr. Okamoto.

Even in tough times, doctors are putting down roots in the community through ingenuity and hard work. That was the kind of doctor I witnessed firsthand in Higashi-Osaka.

This article has been reprinted and translated from the Japanese original text published in Web Medical Times.20250917.