My History
At our clinic, we focus primarily on home-based medical care through house calls. My specialty is geriatric internal medicine, and I treat a broad range of conditions—from sudden illnesses to chronic diseases. Japan is now a super-aged society, and even when hospitals are nearby, many older adults struggle to make the trip on their own. As a result, the demand for home care has been rising. However, the number of healthcare providers able to meet that need remains limited. That’s why we’ve built a multidisciplinary team and work closely with other medical institutions to offer care 24 hours a day, 365 days a year. As an enhanced-function, collaborative home care support clinic, we play a vital role in supporting community healthcare.
When the COVID-19 pandemic hit, Japan’s advanced level of home-based medical care began drawing international attention—particularly from across Asia. This wasn’t just thanks to the hard work of healthcare workers on the ground, but also because Japan actively shared data on its home care practices with the world. At the time, establishing a coordinated system where doctors made house calls in collaboration with government and healthcare networks was still relatively rare.
Today, our clinic is deeply rooted in Kyoto’s Nishikyo Ward. But my interest in community-based care goes back to the very start of my career as a physician. I’ve always believed that good medicine means understanding each patient’s unique values, living situation, and family dynamics.
That belief has fueled my desire to help build a system where primary care physicians can play a central role in supporting the health of the entire community.
The Present
In addition to providing house calls through our clinic, one of the efforts I’ve focused on is the KISA2 Team initiative. Back in December 2020, a heartbreaking case occurred in Kyoto: an elderly patient in their 80s, infected with COVID-19, couldn’t find a hospital bed and passed away at home. To address situations like this, I founded the KISA2 Team—a COVID-19 home-visit medical response unit. We worked closely with local governments, medical associations, acute care hospitals, home-visit nursing services, and pharmacies to deliver care to patients who couldn’t be hospitalized.
Although the KISA2 Team was originally formed to respond to COVID-19, our work hasn’t stopped—even after the pandemic eased and the immediate need faded. For example, when the Noto Peninsula earthquake struck in 2024, around 50 of us were on the ground providing support for 52 days. Through these experiences, I’ve come to value three key elements: centralized coordination, strong collaboration, and bold leadership. During emergencies, these three are essential. It’s not about trying to operate exactly as we would under normal conditions. Instead, we need to streamline operations—centralizing decision-making, consolidating evacuation centers, and coordinating every aspect of response. Leadership, in these moments, means deciding where and how to focus our collective energy. In a crisis, even brief moments of hesitation can have serious consequences. That’s why we need to act with conviction—moving forward with the mindset of “We’re going to make this happen, no matter what.” In situations like these, action must come before overthinking. And honestly, that kind of rapid, decisive approach may be exactly what this era demands.
Today, the KISA2 Team includes committed members from across Japan. One thing that makes us unique is our collaboration across professions—not only doctors and nurses but also care workers and professionals from outside the medical field. Compared to a few years ago, it’s become easier to form multidisciplinary teams. The next challenge is making sure we become truly effective teams—teams that act with unwavering dedication to serving the needs of patients.
For the Future
With Japan’s population continuing to decline, it’s clear that the country’s healthcare system will need to evolve in the coming years. While the demand for home-based medical care is expected to grow, the best way to provide that care will likely differ from region to region. I believe we’ll see a nationwide effort to explore and identify the most effective models of home care tailored to each community’s specific needs.
It’s also important to recognize that Japan isn’t alone in facing the challenges of a rapidly aging society—many other countries are dealing with the same issue. That said, Japan is uniquely positioned to lead in the field of home-based care. In contrast, there are places in the U.S. where it can take several hours just to reach a single household. Because I believe Japan will be the country most deeply affected by aging, I feel a strong responsibility to share our home care knowledge and experience with the rest of the world. What makes Japan’s model especially noteworthy is not just the quality of individual professionals, but the strength of team-based, interdisciplinary collaboration. The focus isn’t on individual excellence—it’s on what we can achieve together. I truly believe that Japan’s healthcare system still has the strength and potential to meet the challenges ahead. And I’m committed to sharing stories of innovation and hope from Japan with the global community.