Updates on Patient-Visit Trends at Navitas Clinic

Morihiro Takita, M.D., Ph.D.

Accessible Rail Medical Services Tetsuikai, Navitas Clinic Tachikawa, Department of Internal Medicine, Tokyo, Japan

Introduction

I am working for internal medicine consultations as a physician at Navitas Clinic Tachikawa in Tokyo. I am also consult once a week at Jyoban Hospital in Iwaki, Fukushima Prefecture. Besides, I am serving for research at the Medical Governance Research Institute, a specified non-profit organization in Tokyo. During my graduate studies, I was involved in clinical research at the Institute of Medical Sciences, the University of Tokyo located in Minato Ward, Tokyo, and Baylor University Hospital (Dallas, Texas, USA), focusing on transplanting pancreatic islets to patients with Type 1 diabetes and those with chronic pancreatitis.

In this article, I present statistical data gathered from patient-visit records of the three branches of Navitas Clinic (located in Tachikawa, Shinjuku, both in Tokyo and Kawasaki in Kanagawa prefecture). I report on the results and share my observations.

The origins of Navitas Clinic

The origins of Navitas Clinic trace back to "Collabo Clinic Shinjuku" in 2006. It was a small clinic situated in a building right in front of Shinjuku Station in the center of Tokyo, one of the biggest stations in the world. At this clinic, many young university students engaged in earnest discussions about the ideal clinic for urban Tokyo. Professor Kan Suzuki (Graduate School of Public Policy, the University of Tokyo and Graduate School of Media and Governance, Keio University) and Professor Masahiro Kami (Chairman of the Medical Governance Research Institute and a physician at Navitas Clinic Shinjuku) provided guidance during these deliberations.

From these discussions, the hypothesis was raised; "the young urban workers may be inadequately served in medical care." Indeed, accessing medical services after their daily work was challenging for them. This is due to the most of Japanese medical facilities closing in the evening.

To address this challenge, the idea of a new clinic inside the station that operates until late evening was conceived. This gave rise to the Navitas Clinic. Prioritizing the needs of younger patients, the clinic began its operations, ensuring its services extended into the evening after typical working hours. The clinic should be located strategically ‘within the hub station’ to align with daily commutes.

Past Analysis in 2018-2019

The question of whether Navitas Clinic has been effectively addressing the medical needs of urban workers has already been the subject of two published academic papers. (References: Tsuda et al., Medicine, 2018; 97:e9646 & Tsuda et al., Medicine, 2019; 9833:e16818).

A study focusing on patients who visited Navitas Clinic Tachikawa between 2013 and 2016 revealed that the median age of these patients was 38 years. Notably, there was a peak in visits between 6:00 PM and 7:00 PM. These findings highlighted how Navitas Clinic has successfully responded to a previously overlooked medical demand in urban Tokyo areas.

Analysis of Current Data as of 2022

In this latest analysis, we examined the data from 210,309 patients who visited the Navitas Clinics in Tachikawa, Kawasaki, and Shinjuku from 2017 to 2022. Among the patients, 57% were females, consistent with the national average for clinics across Japan. However, there was a notable difference in the age distribution. The largest patient age group was between 25 to 29 years old in Navitas Clinics. This stands contrast to the general outpatient clinics across Japan, where the most common age group of patients, according to the 2020 Ministry of Health, Labour and Welfare patient survey, was between 70 to 74 years old.

There was a significant influx of patients during the morning and early afternoon, but there's another peak from evening to night. At the Navitas Clinics Tachikawa and Kawasaki, about 60% of the patients resided within a 2-kilometer radius. These data suggest that young patients living near the clinics probably visit during daily commute to home from work place. It is common to see families visiting in the evening as our clinics also offer pediatrics and dermatology services.

The Navitas Clinic Shinjuku, in contrast, had a large number of patients from within Tokyo's 23 wards. Yet, many patients from outside Tokyo areas like Chiba, Saitama and Kanagawa prefectures. This might be associated with the transfer needs at Shinjuku Station during their railway commuting.

Conclusion

In our practice, we often hear stories from patients about how the COVID-19 pandemic has transformed their lifestyles. The surge in remote work has led to scenarios where individuals head straight to client locations from home without going to their office. There is a possibility that we will transition towards an approach combining both online consultations and face-to-face appointments to improve the convenience of medical consultations. Currently, we are analyzing the data categorized into groups based on the consultation type: online-only, in-person visit only, and a combination of both.

From this analysis, it's evident that Navitas Clinic primarily serves a younger demographic, underscoring the high demand for off-hours medical services. Holding true to our foundational mission, "Providing medical care to urban workers," we will continually explore ways to maintain our clinic's relevance and convenience for patients based on these new analytical findings.

About the author

Morihiro Takita, M.D., Ph.D.

Accessible Rail Medical Services Tetsuikai, Navitas Clinic Tachikawa, Department of Internal Medicine, Tokyo, Japan

Graduated from Yamaguchi University's Faculty of Medicine in 2004. Undertook initial training at Toranomon Hospital, followed by advanced training in 2004 at the Hematology and Oncology Department of the University of Tokyo Institute of Medical Science Hospital. In 2012, he graduated from the Graduate School of Medicine at the University of Tokyo, specializing in Reproductive, Developmental, and Aging Medicine. He holds a Ph.D. in Medicine. During his postgraduate studies, he was involved in pancreatic islet transplantation at the Baylor University Hospital and Baylor Research Institute (Dallas, Texas, USA). In 2015, he became the Chief of Clinical Trials Management at the Kanagawa Cancer Center'. Since 2019, he has been working at Navitas Clinic in Tachikawa and is also a part-time physician at Jyoban Hospital in Iwaki, Fukushima Prefecture. He's a certified specialist from the Japanese Society of Internal Medicine.

* Originally published in Japanese in Accessible Rail Medical Services Tetsuikai Weekly News, August 26, 2023.