Amid the ongoing coronavirus epidemic, dentists, ophthalmologists and otolaryngologists who run their own clinics have become increasingly concerned over whether to continue medical examinations and treatments.
Doctors, particularly in these fields, face a risk of infection with the new coronavirus as they need to be close to their patients while treating them. In addition to such a risk, they are also concerned that their patients' conditions may deteriorate if treatment sessions are postponed. The number of patients is decreasing, making it more difficult for doctors to keep their clinics financially viable, leaving them caught in layers of dilemmas.
"I've never experienced anything like this in my 50-year career," said Katsuhiro Nakagawa, a dentist who runs the Sakurada Dental Clinic in Tokyo, expressing his confusion.
The clinic used to treat 20 to 30 patients a day, but since March there have been many days when it had fewer than 10 patients, as many patients are refraining from coming to the dentist.
Because the dental condition of many elderly people is highly vulnerable to deterioration, the clinic decided to focus on patients who need urgent treatment. Dental treatment and oral care are important for keeping the mouth clean to prevent infection and maintain immunity. However, dentists and other medical staff work with their faces close to patients' mouths, so it is easy for them to be exposed to airborne droplets during treatment.
Cases of dental staff becoming infected have been confirmed nationwide. Another dentist who was distressed over the situation said, "We are basically postponing sessions for nonurgent treatment, but if the current situation becomes prolonged, we just have no idea how to deal with it."
Ophthalmologists and otolaryngologists are in similar circumstances when treating patients. They also treat patients with conjunctivitis (also known as pink eye) and dysosmia (a disorder of the sense of smell), but the symptoms of these conditions overlap with those of COVID-19.
The Japanese Ophthalmological Society (JOS), among others in the field, said that "it is unavoidable to postpone nonurgent surgeries," but at the same time they are also concerned over a possible delay in treatment and deteriorating conditions due to patients refraining from coming to clinics.
The JOS on its website advises people who have sudden worsening of vision or severe pain to consult a doctor.
For many general practitioners, there is also a major concern over their business. This is because even if their income decreases they still have to continue to pay fixed costs, such as rent for the clinic building, leasing costs for medical equipment and personnel costs.
In the case of Nakagawa, who employs four staff members in his clinic, the monthly fixed costs total about 2.5 million yen. "I'm so worried about whether we can hold up in this situation," he said.
The Tokyo Shika Hoken-i Kyokai, or association of dental practitioners, has received many questions, such as, "Is there a compensation system or a loan system when the clinic is closed?"
An ophthalmologist who runs a clinic in Tokyo has also shortened her consultation hours. "Some doctors have almost no patients. If this epidemic continues, many clinics may have to close down for good," she said.
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