Selecting a Local Clinic as Primary Care
Selecting a primary care clinic in Japan means choosing a neighborhood internal medicine clinic and returning to it until it functions as a regular doctor.1 That habit replaces the GP registration step new residents expect from home, and it keeps routine care and specialist referrals inside one chart.
Procedures, fees, and requirements can change. Confirm current details at the Ministry of Health, Labour and Welfare (MHLW). This article is general information, not medical advice; for your specific condition, consult a licensed physician.
Overview
Japan offers free access to any clinic or hospital, but the working norm is clinic first for non-emergency issues.2 A かかりつけ医 (kakaritsuke-i, "family doctor or regular physician") is the doctor a patient returns to for ordinary care, not a name on a registry.31
This guide covers how that habit works, how to compare nearby 内科 (naika, "internal medicine") clinics, what the first visits build, and why the payoff compounds. It describes access paths and selection criteria only, not diagnoses or treatments.
No registration list: how the regular-clinic habit works
Japan has no GP registration system and no form that assigns a doctor to a resident.1 A patient simply registers as a new patient at whichever clinic they choose and returns there for anything that does not need a specialist.1
The Japan Medical Association describes a kakaritsuke-i as a physician the patient trusts enough to consult on anything health-related, who understands the patient's living situation and brings in a specialist when a problem sits outside their own scope.3 That description is a working definition of the role rather than a legal one, because Japanese law does not define the term precisely.1
Because the relationship builds through repetition rather than paperwork, bouncing between different clinics for convenience never accumulates a chart anywhere.1 The patient who returns to one clinic effectively has a kakaritsuke-i after repeated visits, even though nothing formal was ever signed.1
Since April 2025, a revised Medical Care Act requires most clinics and hospitals to report their kakaritsuke functions annually through the national G-MIS system, with prefectures expected to publish the results for residents to compare.41 The first reporting window under that system is scheduled for January to March 2026 (as of 2025-06; confirm current figures with MHLW).1
What the regular clinic covers
A regular clinic covers colds and fever, minor injuries, ongoing management of conditions such as hypertension or diabetes, routine checkups, and prescriptions.25 The Japan Medical Association scope adds vaccinations and health checkups alongside ordinary consultations, plus broad health consultation and linkage to care services.3
Prescription refills run through the clinic. The doctor issues an outside prescription the patient carries to a nearby dispensing pharmacy, and that prescription stays valid for 4 days including the issue date (as of 2026-07; confirm current figures with MHLW).2 Showing the お薬手帳 (okusuri techo, "medicine notebook") at the pharmacy lets the pharmacist check for interactions with current medications.2
When the clinic judges that specialist or hospital care is needed, it writes a 紹介状 (shokaijo, "referral letter") addressed to a named hospital and department.15 That letter carries the clinical summary forward so the hospital starts from context rather than from zero, the flow described in Clinic vs. Hospital: The Two-Tier System.1
Selection criteria: comparing nearby naika clinics
For a new resident without a strong preference, the simplest starting point is a general internal medicine clinic within walking or short transit distance of home.1 Most non-emergency, non-specialist care runs through internal medicine first, so the naika sign is the default filter.2
More than 100,000 clinics operate across Japan, and patients may choose freely and switch at any time (as of 2026-03; confirm current figures with MHLW).5 The comparison below narrows that field to five practical criteria.
Proximity and getting there when ill
A clinic the patient will actually visit outweighs a distant excellent one.5 Repeat visits, including checkups when not acutely ill, are what build the chart that makes later care smoother.1
Prioritize a clinic near home or the workplace, on a route that stays easy when ill or running a fever.15 Residents outside major cities should weigh realistic travel time to the clinic and to its usual referral hospital, since care density thins with distance from urban centers.1
Doctor disposition and communication fit
The kakaritsuke role centers on communication the patient can follow: unhurried consultation, plain-language explanation of results, and treatment goals shared with awareness of lifestyle.3 Judge that fit directly at the first visit by whether the doctor explains the diagnosis, discusses options, and answers follow-up questions clearly.5
Stating plainly at the first visit that the goal is an ongoing relationship changes the visit.1 Japanese clinics welcome that framing because it matches what kakaritsuke-i means to them, and it prompts the doctor to invest in the chart from day one.1
A one-line statement that you want this clinic as your regular clinic prompts fuller history-taking and a clearer plan for follow-up than a refill-only request.1
English availability if needed
English availability sits on a spectrum from a doctor who consults directly in English to staff who can only read a form.5 Confirm that the physician personally handles English, not only the front desk, since symptom description and diagnosis discussion need real conversation rather than a translation app.5
The AMDA International Medical Information Center offers multilingual consultation and facility referral by phone at 03-6233-9266 on weekdays from 10:00 to 16:00, with English available Monday to Friday (as of 2026-07; confirm current figures with AMDA).2 Since January 2025 it also offers a free telephone medical interpretation service during consultations (as of 2026-07).2
MHLW publishes a searchable list of medical institutions accepting foreign patients by language.2 Some local governments and international exchange associations dispatch medical interpreters or connect one by phone.2 Calling ahead to confirm English availability and the specific provider on the day remains the recommended step before visiting.5
Hours and reservation-or-walk-in policy
Many local clinics accept walk-ins with same-day or short waits, while phone or online booking is also common; the pattern varies per clinic.25 Hours are often limited, with closures on certain weekdays, afternoons, or weekends, so check the schedule against work hours before committing.5
A clinic open only on narrow weekday windows is a weak anchor for a worker who needs after-work or weekend access.5 The right policy is the one that lets the patient return consistently, since consistency is what builds the relationship.
| Item | Detail | As of | Notes |
|---|---|---|---|
| Booking pattern | Walk-in, phone, or online depending on clinic | 2026-0725 | Confirm per clinic; walk-ins often same-day |
| Hours pattern | Limited hours with weekday or afternoon closures common | 2026-035 | Match against work schedule before committing |
The table above reflects current practitioner-reported patterns (as of 2026-07; confirm current figures with each clinic).25 Hours and booking rules differ per facility and are thinner outside major cities, so treat any single clinic schedule as local rather than national.1
Referral network for specialist routing
The clearest payoff of a regular clinic is the referral letter.15 When a doctor who already holds the history decides a specialist is needed, the letter addresses a named hospital and department, which waives the large-hospital surcharge and hands the specialist a summary instead of a blank intake.1
Qualifying large hospitals, specific-function hospitals and regional medical support hospitals with 200 or more beds, must collect a minimum selective-treatment charge from patients arriving without a referral: at least 7,000 yen for a first outpatient visit and 3,000 yen for a follow-up, on top of the normal insured copay (as of the October 2022 revision; confirm current figures with MHLW).61 Individual hospitals may set amounts above that floor.1
A candidate clinic should be able to name the hospitals or departments it routes to and confirm it provides referral letters, since that network determines how fast specialist care moves later.5
First visits: establishing the relationship
No advance registration is needed. A new patient registers at the chosen clinic on the first visit through a short intake form and returns there for anything that does not need a specialist.1
The chart above shows the sequence from choice to referral readiness, with each visit adding history rather than paperwork. Bring the health insurance card or My Number insurance card to reception, plus the residence card where requested.2 Without insurance proof the clinic bills the full uninsured rate, with later reimbursement handling.12
The intake itself is typically a paper or tablet 問診票 (monshin-hyo, "new-patient symptom and history form") covering current symptoms, allergies, and medications, followed by a short consultation.1 A short bilingual or Japanese-translated one-page summary of chronic conditions, past surgeries, allergies, and current medications fits that format better than a full overseas file.1
In practice, one to three visits typically establish rapport. Practitioner sources describe the same mechanism qualitatively, a handful of repeat visits accumulating a chart, without fixing an exact count (as of 2026-07).1 Bringing the medicine notebook and prior test results or imaging where relevant, and stating the ongoing-relationship goal at visit one, accelerates that process.12
Why it pays off: lower friction over time
Once the chart exists, repeat visits shorten the reception process and the doctor starts from known history rather than a fresh interview.15 A physician who has followed serial results over time notices shifts that a first-time examiner can miss.5
Referrals move faster with context attached, since the receiving specialist gets a clinical summary instead of starting from zero.1 Staying with one clinic also avoids defaulting to the nearest large hospital for routine issues, which would add the non-referral surcharge described above.1
With insurance, a standard clinic visit costs roughly 1,000 to 3,000 yen including basic consultation at 30 percent copay, with blood tests adding roughly 1,000 to 3,000 yen; without insurance the same visit runs roughly 5,000 to 10,000 yen (as of 2026-03; confirm current figures with the clinic).5 Practitioner pages report an annual routine-care band of 20,000 to 40,000 yen for a healthy adult with insurance, though that band is inconsistently reported (as of 2026-03).5
Good to know
Choosing on English availability alone and skipping proximity
A distant international clinic can solve the language question while creating a distance problem.5 Routine visits get deferred when every appointment means a long trip, and no nearby chart accumulates in the meantime.1
The stronger pattern is a walkable clinic the patient returns to consistently, with phone interpretation or a bilingual summary covering the language gap where needed.25 Language support matters most when the doctor personally follows the case over time.
Assuming one visit makes the clinic remember you
One visit creates a file but not a relationship.1 Kakaritsuke-i status is functional, built from repeated visits plus history on file, with no certificate marking it complete.1
Plan on returning for a second routine reason, a checkup, a refill, or a vaccination, rather than treating the first appointment as done.31 That second visit is when the chart starts paying back.
Visiting a large hospital first and paying extra without a referral
Walking into a qualifying large hospital without a referral letter is allowed but adds at least 7,000 yen for a first visit or 3,000 yen for a follow-up on top of the insured copay (as of the October 2022 revision; confirm current figures with MHLW).61 Genuine emergency arrivals are generally exempted.1
The patient still gets seen, just at higher cost and by whichever specialist is on duty rather than by a doctor holding the history.1 Starting at the regular clinic and carrying its letter avoids both the surcharge and the cold start.5
See also
- Clinic vs. Hospital: The Two-Tier System
- The Freedom-of-Access Norm: Seeing Any Doctor in Japan Without a Referral
- How Japan's Universal-Coverage System Works
- Maina-Hokensho: Health Insurance Card Going Digital
- Finding an English-Speaking Provider
- Specialty Department Signs: Reading Japan Clinic Placards