Medical Mall in Japan: What They Are and the Pros & Cons of Opening One

A medical mall in Japan is a facility where various clinics and dispensing pharmacies operate in one location.

This article provides an easy-to-understand explanation of the types of medical mall in Japan that have been increasing in number in recent years, the reasons they are attracting attention, and their advantages and disadvantages.

• What is a medical mall in Japan?
• Why medical malls in Japan are attracting attention
• Types of Medical Malls in Japan
• Advantages of Medical Mall in Japan
• Disadvantages of Medical mall in Japan
• Who to consult when planning to open a business in a medical mall in Japan
• Summary

A medical mall in Japan, also called a clinic mall, is a facility where several clinics and dispensing pharmacies are gathered in one location, allowing patients to receive multiple medical services in one place, reducing travel time and waiting time from the patient's perspective.

The number of medical malls in Japan is said to be expanding. According to a survey* by a research group at Kyoto Prefectural University, the number of medical malls in Japan has expanded rapidly between 2005 and 2018, with the result that the number of medical malls in Japan has increased 8.28 times. As for the areas where medical malls in Japan are built, 80% are concentrated in urban areas: Tokyo, Kanagawa, Chiba, Saitama, Osaka, Hyogo, and Hokkaido. The same research group estimates that about 10% of all clinics in Japan are opened in medical malls.

*Source: Issues Related to Excess Demand and Medical Innovation Using Medical mall in Japans

Let's look at the social background as to why medical malls in Japan have attracted so much attention. Looking at the medical industry as a whole, the number of doctors is increasing while the number of hospitals and hospital beds is decreasing. The number of clinics is on the rise as a result of the shortage of physician positions in hospitals and the number of physicians seeking to become general practitioners. The increase in the number of clinics has led to increased competition among them. You can see the intensity of competition from the fact that the number of physicians per 100,000 population increased from 141.5 in 1982 to 269.2 in 2020, nearly doubling the number of physicians.

Trends in the Number of Doctors Figure

Source: Compiled by RX Japan based on the Ministry of Health, Labour and Welfare's Summary of Statistics on Doctors, Dentists and Pharmacists in 2020.

The business formats of medical malls in Japan can be broadly categorized into three types:

Let’s dig in deeper into the characteristics of each type of practice.

A village-type medical mall in Japan refers to a group of detached clinics on a single site. It is designed to be used as a medical facility from the construction stage, and its interior and exterior are uniform. In addition, instead of building a parking lot for each clinic, a single site is used by multiple clinics, which are grouped together in one location, thereby reducing the burden of patient transportation.

A building-type medical mall in Japan is a medical facility with clinics, dispensing pharmacies, and other facilities gathered in a single building. Like the village type, it is also characterized by the fact that it was designed from the beginning for the purpose of providing medical care. As such, it was built to be easy to use for medical professionals and patients, with barrier-free features and elevators to make them accessible to people in wheelchairs or using canes. For patients, it is also highly convenient, as it serves multiple purposes, from seeing multiple clinics to receiving medications in a single building.

While the village and building types were both specialized medical facilities, the attached type has a slightly different atmosphere because it is built to match an already existing facility.

Here are some of the most common attached types of medical mall in Japan:

Don't Miss MEDICAL JAPAN’s Clinics Expo—A Game-Changer for Clinic Directors, Chairpersons, and Physicians!

One of the major advantages of opening a clinic in a medical mall in Japan is that it reduces the burden related to attracting patients.

Medical malls in Japan are often built in easily accessible locations, and if they are attached to commercial facilities or office buildings, it is possible to open a clinic in a place where people can easily gather, and patients can easily visit. As a result, a large number of patients can be expected to visit the clinic immediately after its opening.

Opening a clinic requires various capital investments. However, opening a clinic in a medical mall in Japan can reduce the initial investment by sharing waiting rooms and medical equipment with other clinics clustered in the mall.

Another advantage is that medical malls in Japan are built and designed with medical facilities in mind, and some offer a rent-free leasing system, whereby rent is waived until the opening of the clinic. A clinic is not a business model that generates sales immediately after signing a lease contract. Since there are inevitably many expenses during the preparation period for opening a clinic, the availability of rent-free space can be a great help in managing the clinic.

Furthermore, opening a clinic in a medical mall in Japan may make it easier to obtain financing from financial institutions. When opening a clinic, if your own funds are not enough, you will need to raise funds from external sources, such as financial institutions.

When a financial institution evaluates a loan, it will check the contents of the business plan prepared by the clinic, with two particular points being checked: whether there is excessive investment and whether the income and expenditure plan is appropriate.

In the case of a medical mall in Japan, it is more likely to be able to raise funds smoothly because it has the effect of reducing capital investment and is also in an environment where it is easy to attract more patients.

Depending on the treatment provided at a clinic, there may be cases in which the clinic collaborates with clinics of other medical specialties.

If a medical mall in Japan is a collection of clinics with different departments, they can refer patients to other clinics in the same mall.

For example, if a patient is being treated for diabetes, many patients suffer from a complication called “diabetic retinopathy. If there is an ophthalmology clinic in the medical mall in Japan, they can immediately receive treatment for diabetic retinopathy. One of the advantages of a medical mall in Japan is that clinics in a medical mall can provide higher-quality medical care by working closely with each other.

Medical malls in Japan are often located in good locations, and fixed costs such as tenant rent and management fees may be high. Immediately after opening a clinic, sales are often unstable, and there is a risk that fixed costs will put pressure on management, so it is necessary to carefully check the situation against the business plan to make sure that there is sufficient cash flow.

Unlike a stand-alone clinic, a medical mall in Japan requires shared decision-making, meaning you can't make all choices entirely on your own. You may be assigned to contract with a specific vendor for the design and construction of the clinic. Normally, you can obtain bids from multiple contractors, but if you request one specific company, you cannot compare prices, and as a result, you risk incurring higher costs.

Unlike the opening of a stand-alone clinic, a medical mall in Japan is a collection of multiple clinics. Cooperation within a medical mall in Japan is an element that can lead to benefits such as mutual referral of patients, as explained earlier, but it can also be a disadvantage if relationships between clinics break down.

If relationships deteriorate and cooperation with other clinics becomes difficult, information sharing and patient referrals may not go smoothly. Since it is necessary to actively communicate with other clinics on a regular basis and make efforts to build good human relations, physicians who are not good at socializing may need to pay somewhat more attention to their behavior.

Medical malls in Japan are most often produced by consulting companies. According to a survey* by a research group at Kyoto Prefectural University, this is 25% of all cases. They are also often produced by individual doctors or dispensing pharmacies.

In addition, real estate companies, medical corporations, and construction companies are sometimes called upon to open clinics in medical mall in Japans. As with opening a stand-alone clinic, the location of a medical mall in Japan has a significant impact on clinic management, so the ability to gather information is important. Those interested in opening a clinic in a medical mall in Japan should consult with an expert with experience and insight in business start-up consulting.

*Source: Status of Promotion and Development of Medical mall in Japans in Japan and Management Issues

The most important thing when starting a practice is to clarify the purpose of the practice. Once you have a clear objective, you will naturally have a clear idea of the direction you should aim for. The focus may vary from person to person, depending on whether you want to provide free medical services, full medical equipment, or financial stability.

Another important thing is to understand as many options as possible. While we have discussed the medical mall in Japan option in this article, there is also the “build-to-rent” option, which allows you to build a clinic with the layout you desire while keeping the initial investment low. Or you may choose to specialize in free online medical care and open a clinic in a room in your home. We hope you can make a meaningful choice based on your own vision.

Don't Miss MEDICAL JAPAN’s Clinics Expo—A Game-Changer for Clinic Directors, Chairpersons, and Physicians!

Editor Information

Supervisor: Shugo Tagashira

Biography:

• Graduated from Tottori University School of Medicine
• Director of Tagashu Online Clinic
• Expert in neurology, specializing in conditions such as dementia, Parkinson's disease, ALS, and other complex neurological disorders.
• Experienced online general practitioner providing comprehensive medical care for internal diseases, with a focus on carbohydrate-restricted diets and stress management strategies.
• A specialist of the Japanese Society of Oriental Medicine, skilled in diagnosing pathological conditions through patient consultations and prescribing tailored Chinese herbal treatments via online consultations.