*Information accurate as of time of publication.
Those who take that one step forward can change the world and the era
Oji Kitaguchi Medical Clinic
Contributing to community medical care with skills acquired in dialysis
Out of a desire to contribute to community medical care and support people who are in the prime of life, we provide outpatient services in early morning and night time hours. It was highly gratifying to be told by a patient who catches a cold annually at the same time of year, “I’m happy there’s a clinic that stays open to late hours, and that you have stuck to this schedule all along.” I believe the patient was appreciative of the value in continuing to provide the same service. We also provide home visit in the area surrounding the clinic. The specialty of our clinic is treating chronic renal diseases, and we also provide peritoneal dialysis at the patient’s home.
My decision to become a doctor able to contribute to community medical care came when I was still in high school. While I was compiling various kinds of experience as an intern after graduating from medical university, I came to feel that it would be good to acquire the knowledge and skills of a medical specialist as I became involved in community medical care. It was right at that time that I was approached about conducting new dialysis care at a university hospital in Tokyo. I then worked for more than ten years under the guidance of a medical professor. I was shown all types of dialysis treatment and became capable of performing most of them, but I was not able to meet the wishes of patients who said, “I want to return to my home.” At the time, dialysis could be conducted only in a medical institution; and it was necessary to visit the hospital periodically even in cases where progress was being watched at home. It was still a time when there was not one physician in Japan who both was knowledgeable in dialysis and provided visiting care. Believing I was capable of doing that, and determined to do it, I went independent in 2011.
In order to care for patients at their home until their death
When I first opened the clinic, I was filled with uncertainty, lacking confidence that I could make a success of it. There were people saying it would be good if there were longer evening hours. Eventually it became economically feasible to meet those needs, and at last I was able to free up the time to conduct home medical care. I went around by bus or bicycle, mainly on Saturdays and Sundays; but initially I wasn’t even sure what I should be carrying with me on these visits. It may have been that I wasted a considerable amount of time, but I believe it was thanks to those early struggles and experiences that I have come to the point where I am today. Gradually the framework has come together for provision of at-home medical care to the community, with the cooperation of physicians, home-visit nurses, pharmacists, care managers and other related service providers. Today, we are working toward the goal of being able to care for patients at home until their death as long as they so desire, assuming the consent of their family and no matter what limitations there are on the treatment, or what difficulties may be encountered. Initially, both the patients and their family thought that, “In this condition, staying at home would be out of the question”; but most ended up glad they had chosen home care, and I continued in the conviction it was the best course. The feeling that it is unnatural for human beings to spend their last days in a medical institution is one I myself experience most strongly, as someone who has spent so many years in such institutions. Being well familiar with how much hospitals can do and what they cannot do, I would like to continue conveying this frankly to patients, discussing the options thoroughly with them, and if the patient on this basis chooses home care, to do everything I can to honor that choice no matter what.
Nothing ends in failure alone; if there is something you have wanted to do, go ahead and do it
It has been twenty years since I became a physician, and eight years since I opened the clinic; but I sense the difficulty of simply continuing to do things the way they have always been done, as if that is only natural. I try always to return to my original ideals, wanting to be able to support the valuable service of caring for patients at home until their death, together with their family. Various medical care services are guaranteed in Japan, even with its severe budgetary constraints. While there are patients who have been able to have their wishes granted thanks to this, I have also seen many patients die within days, without having this information. My wish is that anyone can obtain information about home medical care more quickly, and make the choice on their own. I therefore believe it will be necessary for doctors active in the same field of home medical care, and experts, to compete in the good sense toward raising the level of medical care in Japan as a whole. If there is any work I can do to help toward this end, I would like to become involved actively.
What I want to convey to the young people responsible for the next age is, if there is something you have really wanted to do, then by all means do that to the extent possible. Even if it was something that did not go well at first, remember that nothing ends in failure alone. When you take the first step forward, there may well be uncertainty and fears. It’s also a fact that there are many people who say this or that, whether for good or ill, to try to stop you from any adventure. But there were those who decided to do something because it had never been done before, and those are the people who have changed the world and the era. There is no better way than steady efforts to succeed. I urge you to venture out boldly, believing that people will surely appear who agree with what you are trying to do and provide their support.
Takenori FunakiDirectorOji Kitaguchi Medical Clinic
- Born in Hokkaido in 1971, he grew up in Kobe, Hyogo Prefecture. In 1990, he graduated from Nada High School in Kobe. Then in 1996, he graduated from Asahikawa Medical University in Hokkaido. Following clinical resident training at Sapporo Tokushukai Hospital, The Queen’s Medical Center, Yoron Tokushukai Hospital, Shonan Kamakura General Hospital, and Chigasaki Tokushukai General Hospital, in 2000 he began medical practice at the Tokyo Women’s Medical University Medical Center East, working in both the internal medicine and hemopurification departments. He started the Oji Kitaguchi Medical Clinic in Kita-ku, Tokyo in 2011. He serves also as part-time lecturer in internal medicine at the Tokyo Women’s Medical University Medical Center East, director of the Japan Coordinator Association of Life-style related Disease, and supporting physician at a comprehensive care center for the elderly provided by Kita-ku.