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In Japan, many small medical centers are at risk of going out of business as a result of the coronavirus crisis. Even as the government eases COVID-19 restrictions, people continue to avoid the clinics in fear they might catch the disease there.
Now clinic owners are asking the government for help.
Toshihiko Yamazaki operates a clinic in the city of Urawa, north of Tokyo. He said clinics in the residential and office areas seem to be having a difficult time.
"Even if the state of emergency is lifted, patients won't be able to return as long as there is a risk of infection," he said.
Yamazaki has seven employees. His clinic has gotten through the crisis better than most because it is close to a major train station. Still, in April, revenue was down 17 percent.
Japan had about 16,600 coronavirus infections and around 850 deaths. It has mostly contained the virus without heavy restrictions on travel and business.
Citizens mostly have obeyed the government's call for an 80 percent cut to social interactions. Clinic visits for usual health care have decreased, as a result.
An industry organization, the Tokyo Medical Practitioner Association, surveyed 1,200 clinics in the capital. It says more than 90 percent of them suffered revenue loss in April.
The Japan Federation of Insurance Medical Associations carried out a similar survey nationwide. It found that more than 80 percent of 2,900 clinics also saw revenue loss in April.
Some of the business went to the internet, where doctors can provide telehealth services. But most doctors get only about half as much money as they would receive for in-person visits.
Experts also predict a decrease of about $4.6 billion in hospital revenues this year. Teaching hospitals have asked the government for financial aid.
And, medical and hospital groups are urging Japan's health ministry to re-direct aid for community health programs to small medical centers.
Health ministry official Kazuho Taguchi said the ministry was taking the issue seriously. Non-virus services must be continued, he added, saying the ministry was holding hearings on ways to deal with the problem of fewer patients.
Toshio Nakagawa is vice president of the Japan Medical Association. He points out that as revenue decreases, doctors may reconsider plans to buy equipment and hire workers. That, he says, could lead to a drop "in the quality of medical care."
I'm Alice Bryant.
Reuters News Agency reported this story. Alice Bryant adapted it for Learning English. Caty Weaver was the editor.
