A Comprehensive Guide on How to Open a Clinic in Japan: Key Steps and Considerations

Opening a clinic may be challenging. However, this should not discourage you from starting this endeavor. In this article, Masanori Go offers valuable insights and practical advice on how to start your own doctor's office, highlighting key considerations to ensure a smooth launch and prevent future regrets. 

Process in Opening a Clinic

1. Define your concept and policy
2. ⁠Select contractors
3. ⁠Research your target location
4. Create a business plan
5. ⁠Consult with relevant parties and submit the necessary applications
6. ⁠Borrow start-up capital
7. ⁠Finalize the clinic design and interior
8. ⁠Select medical equipment
9. ⁠Hire your human resources and labor management staff
10. ⁠Develop your marketing materials
11. ⁠Prepare for your opening day

Opening a clinic typically requires over a year of preparation due to the numerous steps involved. It's crucial to allow ample time to ensure everything is in order.   

When defining the concept and policy of your clinic, using the 5W1H method can provide clarity:

• Who: Who is your target market? What type of patients do you aim to serve?
• What: What treatments or services will you offer?
• When: When do you plan to begin operations?
• Where: Where will your clinic be located?
• Why: Why are you opening this clinic and providing medical care?
• How: How will you implement your treatment policies?

Physicians who open their own clinics often transition from salaried positions, taking on significant risks. By clearly defining these factors, you'll have a strong foundation for your clinic’s management philosophy and overall concept.

Choosing reliable contractors and consultants is a critical step in the clinic-opening process. These professionals can assist with various tasks, such as liaising with financial institutions, finding a suitable property, and developing a solid business plan. While their expertise is invaluable, it’s important to remember that as the clinic's founder, you retain the final say on all major decisions. Medical trade shows are an excellent venue for finding reliable contractors and consultants to support your clinic venture.

After defining your clinic's concept and treatment policy, the next step is researching the area where you plan to open. Finding the ideal property is key—you want a space that meets your needs and creates a strong first impression both inside and out. Consider whether your target clientele is located nearby and if the location is easily accessible. If your practice has a specific focus, positioning yourself near complementary practices can also be beneficial. Once you’ve identified a potential area, you can assess fixed costs like rent.

Key factors to consider when searching for a property include:

• Property type (detached house, rental space, medical mall, etc.)
• Population and age demographics of the area
• Traffic flow and accessibility
• Presence and competitiveness of nearby clinics

A business plan is like a roadmap for your clinic. It outlines your objectives and provides essential details such as financial projections and marketing strategies. A well-structured plan is crucial for guiding the clinic's growth and securing any necessary funding. Key elements to include in your business plan are:

• Projected patient growth
• Average revenue per patient
• Fixed costs, including rent and medical equipment leases
• Personnel costs for doctors, administrative staff, and other team members

Opening a clinic requires submitting various applications to government agencies. It’s crucial to complete all procedures accurately, with special attention to the "Clinic Opening Notification" for the public health center and the "Application for Designation as an Insurance Medical Institution" to the Health Bureau.

According to the Medical Care Act, the "Clinic Opening Notification" must be filed within 10 days of opening. Without this approval, medical services cannot be offered. Once approved, you must promptly submit the "Application for Designation as an Insurance Medical Institution" to the Health Bureau. Failure to do so will prevent you from offering insurance-covered treatments, so ensure this step is not overlooked.

The required documents, including the "Clinic Opening Notification" and "Application for Designation as an Insurance Medical Institution," are as follows.

Consult with relevant organizations, such as the public health center and medical association, well in advance to prevent any issues that could impact your cash flow after opening.

Typically, start-up capital for a clinic is obtained through a combination of personal funds and loans from financial institutions. How much does it cost to open a clinic? The amount needed can vary based on the medical specialty, but it’s a good idea to budget at least 15 to 80 million yen in total, including both your own capital and borrowed funds.

To secure a loan, you’ll need to prepare a detailed business plan and financial projections and engage in negotiations with banks. Financial institutions scrutinize business plans for signs of "excessive investment" and the "reasonableness of income and expenditure plans," so it’s essential to present a well-crafted and realistic plan.

The estimated start-up costs for each medical department are as follows:

Start-up costs encompass various expenses, including clinic rent, staff wages, and the purchase or lease of necessary medical equipment and supplies. Key items to consider include:

• Medical Equipment: X-ray machines, ultrasound devices, endoscopes, etc.
• Examination Room Equipment: Desks, chairs, computers, etc.
• Waiting Room Equipment: Sofas, TVs/monitors, Wi-Fi, etc.
• Reception and Staff Room Equipment: Cash registers, printers, telephones, medical cards, etc.

With financing secured, you can move forward with designing and constructing your clinic. It's crucial to work with reputable construction contractors and interior designers to create the desired ambiance. The clinic design should reflect its concept and medical policy, while also considering the preferences and comfort of your target patients. Ensure that the overall look and functionality align with your clinic's goals and meet the needs of those you serve.

What equipment is needed for a medical clinic? Your medical equipment should align with your clinic’s concept and policy, such as X-ray machines, ultrasound devices, and endoscopes. Keep in mind that even the same type of equipment can come in various grades. Select equipment that fits your clinic’s needs and budget, ensuring it aligns with the financial management plan outlined in your business plan. Attending medical trade shows is an excellent way to discover the latest medical equipment and innovations.

Additionally, implementing electronic medical records (EMR) is essential for new practices today. The government aims to have standard electronic medical records in nearly all medical institutions by 2030, making it advantageous to adopt EMR systems from the outset. With various companies offering EMR products, including those that use AI technology for voice-activated record-keeping, it’s important to choose the right system. When deciding which EMR product to implement, consider comparing the following features to make an informed choice.

To finalize your clinic, you’ll need to hire your medical staff. Start by engaging a social insurance and labor consultant to help prepare legal documents, including employment conditions and work regulations. Recruitment can be done through various channels such as referrals from acquaintances, job postings on relevant sites, or through the Public Employment Security Office (Hello Work). Select the recruitment method that best suits your clinic’s needs and circumstances.

Promote your clinic effectively to attract potential patients through various marketing strategies. How to advertise a clinic? Utilize both online and offline channels to reach your audience. Consider creating a website and establishing social media profiles, or opting for traditional methods such as billboards, posters, and pamphlets.

Additionally, enhance patient convenience by implementing an online reservation system and a medical interview system. These features not only streamline the patient experience but also encourage repeat visits by making it easier for new patients to engage with your clinic.

After finalizing the clinic's concept, policy, location, and handling all necessary applications, the opening day will soon be here. Before you begin, thoroughly review all preparations to ensure everything is in order. Be prepared for unforeseen challenges and insights that may arise once the clinic is operational. It's important to communicate these observations with your staff and continuously make improvements based on your experiences.

Starting a clinic, like any business, comes with its challenges. However, you can minimize potential regrets by following these key tips:

1. Eliminate excessive capital investment and consider leasing

It takes time for a clinic to become a stable business. Because of this, it’s important to make realistic capital investments rather than focusing on acquiring the latest equipment from the start. Opting for leasing medical equipment instead of outright purchasing can help conserve cash, allowing you to allocate funds to other essential areas of your business.

2. Rely on the experts to prevent opening date delays

Opening a clinic involves numerous responsibilities, and even a minor delay in one step can significantly impact your opening timeline. For instance, the deadline for submitting the "Application for Designation as an Insured Medical Institution" to the Health and Welfare Bureau generally falls between the 10th and 20th of each month, with processing taking about a month. Missing this deadline can delay your ability to provide insured medical treatment by an entire month.

To prevent such delays, consider hiring or consulting with professionals, such as a business start-up consultant, who can provide the expert support needed to keep your opening on track.

3. Focus on patient attraction measures

Even if your clinic is located in an area with many potential patients who align with your clinic's concept and policy, visibility is crucial for success. Without knowledge of how to advertise a clinic, it may struggle to thrive.

Both offline and online marketing methods are valuable for building awareness.

Offline strategies include distributing flyers in the neighborhood, using billboard advertisements, or hosting an open house to showcase your clinic’s interior and values. These efforts can help familiarize local residents with your clinic and its offerings.

Online measures are equally important. Creating a professional website can enhance credibility and reassure potential patients. A well-designed website not only establishes trust but also provides essential information about your services, making it easier for patients to choose your clinic.

4. Consider patients and staff when designing the interior and facilities

When designing your clinic's interior and facilities, prioritize the comfort and well-being of both patients and staff. The clinic design should create a stress-free environment where it provides a positive experience for everyone who spends time at the clinic.

For patients, incorporating comfortable medical clinic furniture, calming background music, and Wi-Fi can enhance their experience. Providing access to entertainment, such as video streaming on smartphones, can make waiting times more pleasant. Additionally, in areas with a significant elderly population, ensure that the clinic is barrier-free to prevent falls and includes handrails for added safety.

For staff, clinic design spaces that promote efficiency and comfort, which can contribute to a positive work environment and improved patient care.

The process leading up to opening a practice involves many challenges, and if you try to prepare while continuing your clinical work, it can become an extremely difficult task, and you may feel like giving up at times. However, when listening to the comments of those who have already opened their practices, most say, "It was tough, but it became a valuable experience." By going through this process, you will gain various experiences that you wouldn't acquire just by doing clinical work, so please keep going and do your best."