Leaders Voice; Words to Inspire | Nikkei special edition

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Medical care guided not by profit but by a mission

Hizuki Hanafusa,
Healthcare Corporation Seiyukai

Minimizing the burden on patients

Hanafusa Dermatology Clinics, providing general and surgical dermatology care, are located in Tokyo and Saitama. The clinics also offer antiaging therapy, not covered by insurance, for aesthetic improvements in such areas as acne scarring and redness, warts, wrinkles, and sagging skin. In the area of surgical dermatology, in particular, a strong emphasis is on minimally invasive procedures. In the case of a skin growth, for example, rather than large incisions, a small incision is made and tissue is extracted or destroyed through it. This leaves a much smaller scar and reduces the burden on the patient. When we introduced such minimally invasive procedures six or seven years ago, we heard concerns from other dermatologists that this approach would increase the risk of recurrence, or prevent the collection of specimens for pathological examination. Gradually, however, we began to see a rise in patients visiting the clinics from as far away as Aomori, Tokushima, and Kyushu; and I became convinced that these minimally invasive procedures would help large numbers of patients. Patients would say, “I want this growth removed, but I was told that removing it will leave a big scar.” There were times when dozens of patients visited us each day, as a last hope, making me feel the strong need for spreading minimally invasive surgery. To that end, it would be necessary to demonstrate that in terms of safety and effectiveness, these methods were not inferior to traditional procedures.

Hizuki Hanafusa(Healthcare Corporation Seiyukai)

Providing only treatment confirmed to be safe

We therefore make sure to carry out procedures that have been announced in academic societies and reviewed, and only after their safety has been established. Putting safety first in medical care is the only approach that makes sense. This is especially true in dermatology, where nearly all the conditions are non-life-threatening. This is all the more reason for us to proceed with the strong belief that treatment must never end up harming health, or causing difficulties for patients. Our policy is that no matter how good a technique may be, we will not use it if its safety has not been established. If I may say so myself, patients who undergo our minimally invasive procedures tend to be happy with them, saying things like, “The surgery was over so quickly, and left almost no scar.”

At the time we introduced it, minimally invasive surgery was unusual in dermatology clinics; but today its success seems only natural. I myself suffered from atopic dermatitis as a child. I still have painful memories of how hard it was to overcome this condition, helping me to understand how patients feel. The biggest reason for wanting to become a dermatologist was to help people facing the same kind of suffering I went through. That’s why, no matter how difficult an ailment the patient has, I will never give up without trying. Our mission is to bring happiness to as many patients as we can.

Hizuki Hanafusa(Healthcare Corporation Seiyukai)

Sounding the alarm at today’s “business first” tendency

Lately a growing number of clinics besides ours have been introducing minimally invasive procedures. As they begin to attract patients, there is a tendency to expand the business by performing these procedures almost as routine work. Hearing from others in the field, it seems there are those who simply carry out these procedures like an assembly line, not even bothering with preoperative testing or postoperative pathological examinations. It is dismaying to see the current tendency to rely on techniques alone, without considering the safety or scientific backing. Once more, I would like to say loudly and clearly that safety and certainty must be part of the package. In the course of carrying on dermatology treatment over the years, every once in a while you encounter a case that makes you think, How could that be? Even with a growth that by all appearances is benign, the chances of it being malignant are not zero. If you adopt a policy of always conducting pathological examinations, you will catch the malignancy; but if not, there’s a chance it will spread and become a cancer of unknown cause, or even end up being too late for a cure. This is a reality most ordinary patients are largely unaware of. How to make people aware of this is an issue we face, but I believe it’s something we absolutely must do.

People who are guided by a mission are stronger than those guided by profit. A physician must always act based on conscience, morality, and a sense of responsibility. I carry out my daily medical treatment believing this is the correct way. Looking ahead to the future, I would like to open more clinics that live by this belief, continuing to put out our message, and further expanding our thinking and practices.