Internal medicine

Rheumatology

Our approaches

Frequently asked questions on rheumatic diseases

Primary-care psychiatry

Services provided at our clinic include general internal medicine, rheumatology, and primary-care psychiatry. These services are provided by a physician who is board certified (US and Japan) in internal medicine and rheumatology with experience in primary-care psychiatry.

We are currently limiting primary-care psychiatry services to the following patient groups. To ensure we can accommodate your needs, please confirm with us by calling or e-mail (contact@parkeastmed.com) before making an appointment.

• Individuals aged 18 and over
• Those suffering from depression, anxiety disorders, somatic symptom disorder, illness anxiety disorder, stress-related disorders, adjustment disorder, dementia, or those who exhibit symptoms suggesting these conditions.

Vaccination

Making an appointment for vaccination

Vaccinations are by appointment only, so please be sure to book your appointment through our website or by phone. To ensure vaccine availability, please schedule your appointment at least four business days in advance (e.g., if booking on Friday, schedule for the following Wednesday or later). Note that while our system may allow you to book for the same or the next day, there is a chance the vaccine may not be secured by the time of your visit. In the rare event that we cannot secure the vaccine, we will contact you by phone.

Since we need to order the vaccine after you book your appointment, changes or cancellations to vaccination appointments must be made by phone. 

Vaccines available at our clinic

The vaccines available at our clinic are listed below (self-pay, tax included). Information about vaccines funded or subsidized by Koto Ward can be found in the subsequent section.

Vaccine	Product name	Manufacturer	Price (tax included)
Japanese encephalitis virus	ENCEVAC S.C.Injection	Meiji Seika Pharma	¥ 6,000
	JEBIK V	Takeda Pharmaceuticals	¥ 6,000
Shingles, inactivated	SHINGRIX	GSK	¥ 22,000
Shingles, live attenuated	VARICELLA VACCINE LIVE ATTENUATED"BIKEN"	Mitsubishi Tanabe Pharma	¥ 7,500
HPV, 9-valent	SILGARD9	MSD	¥ 26,000
HPV, 4-valent	GARDASIL	MSD	¥ 16,000
	CERVARIX	GSK	¥ 16,000
Pneumococcus, 23-valent	PNEUMOVAX	MSD	¥ 8,000
Tetanus / diphtheria	DTBIK	BIKEN	¥ 4,000
Tetanus / diphtheria / pertussis	TRIBIK	BIKEN	¥ 5,000
Measles / rubella	-	Takeda Pharmaceuticals	¥ 10,000
Rubella	DRIED LIVE ATTENUATED RUBELLA	Takeda Pharmaceuticals	¥ 5,800

If you are interested in a vaccine not listed above, please contact us first by phone or email at contact@parkeastmed.com.

Vaccines funded or subsidized by Koto Ward

Shingles vaccine

Cost

	Shingles inactivated	Shingles live attenuated
Price	¥ 22,000/shot	¥ 7,500
Public subsidies	¥ 10,000/shot	¥ 4,000
Patient will pay	¥ 12,000/shot	¥ 3,500

Eligibility for public subsidies

• Individuals who are 50 years or older as of the vaccination date, are registered residents of Koto Ward, and have never received a subsidy for a shingles vaccine (live or inactivated) before.

Instructions

• Please be sure to bring the vaccine questionnaire obtained from Koto Ward. For information on how to obtain the questionnaire, please contact Koto Ward.

The information above is sourced from the following website. Please note that updates may take some time to be reflected. Before making your reservation, be sure to verify the details on the website provided.

https://www.city.koto.lg.jp/260502/fukushi/hoken/yobo/06taijouhoushin.html

Pneumococcal vaccine

Cost

• Patient will pay　¥ 1,500

Eligibility for public subsidies

• Individuals who are 65 years old※ and have never received the pneumococcal polysaccharide vaccine, regardless of whether it was covered by public funds or paid out-of-pocket.
  • ※If vaccinated at an age other than 65, you will not be eligible for subsidies.
• Individuals aged 60 to under 65 with a Level 1 Disability Certificate, and who have impairments in cardiac, renal, respiratory functions, or immune function due to the Human Immunodeficiency Virus (HIV), and who reach the relevant age on the day of vaccination.

Instructions

• Please be sure to bring the vaccine questionnaire obtained from Koto Ward. For information on how to obtain the questionnaire, please contact Koto Ward.

The information above is sourced from the following website. Please note that updates may take some time to be reflected. Before making your reservation, be sure to verify the details on the website provided.

https://www.city.koto.lg.jp/260502/fukushi/hoken/yobo/05kouhai.html

HPV vaccine

Please note that if you wish to receive the HPV vaccine, you will first undergo a consultation and explanation on the day you book online, following which you will be able to schedule your vaccination appointment for two business days later or beyond.

There are three types of HPV vaccines eligible for full public funding. For more details, please refer to the website below.

https://www.city.koto.lg.jp/260312/fukushi/hoken/yobo/6858.html

	CERVARIX (2-valent)	GARDASIL (4-valent)	SILGARD9 (9-valent)
Protects against	HPV types 16, 18	HPV types 6, 11, 16, 18	HPV types 6, 11, 16, 18, 31, 33, 45, 52, 58
Doses	3	3	3 doses (if the 1st dose is given at 15 years of age or older)	2 doses (if the 1st dose is given before 15 years of age)
Dosing schedule	0, 1, 6 months	0, 2, 6 months	0, 2, 6 months	0, 6 months
Manufacturer	GSK	MSD	MSD	MSD

Eligibility for public subsidies

There are two types of vaccinations: routine vaccinations and catch-up vaccinations, and the eligibility for subsidies varies between them.

• Routine vaccinations：Girls from 6th grade in elementary school to 1st year in high school
• Catch-up vaccinations：Individuals who missed their vaccination opportunities due to a lack of active recommendation

Routine vaccinations

Eligibility for public subsidies

• Girls currently registered as residents in Koto Ward, from 6th grade in elementary school to 1st year in high school (born between April 2, 2008, and April 1, 2013), as of the vaccination date.

Cost

• No out-of-pocket cost (fully subsidized by the district)

Vaccines to be given by

• March 31 of the year in which individuals reach the equivalent age of a first-year high school student (until the end of the fiscal year in which they turn 16).

Instructions

• Individuals who are 12 years old on the day of vaccination must be accompanied by a parent or guardian.
• Individuals aged 13 to 15 on the day of vaccination can receive the vaccine without a parent or guardian present if a parent or guardian has signed the designated section on the vaccination questionnaire. However, as with other vaccinations, reactions such as fainting may occur after receiving the vaccine. To prevent incidents such as falls due to fainting, it is strongly recommended that a parent or guardian accompany the individual.
• Individuals 16 years of age and older on the day of vaccination do not need parental consent and can proceed with the vaccination based on their own consent. Please ensure that the individual signs the self-signature section of the vaccination questionnaire, not a parent or companion.
• On the day of your visit, please bring your Maternal and Child Health Handbook, the vaccination ticket sticker (white) obtained from Koto Ward, the vaccination questionnaire, and the consent form (if required, see the website below for details).

https://www.city.koto.lg.jp/260312/fukushi/hoken/yobo/6858.html

Catch-up vaccinations

Eligibility for public subsidies

• Girls born between April 2, 1997, and April 1, 2008, who are registered residents of Koto Ward as of the vaccination date.

Cost

• No out-of-pocket cost (fully subsidized by the district)

Vaccines to be given by

• March 31, 2025

Instructions

• Individuals who are 16 years of age or older at the time of vaccination do not need parental consent and can proceed with the vaccination based on their own consent. Please sign the self-signature section of the vaccination questionnaire that was sent to you.
• On the day of your appointment, please bring your Maternal and Child Health Handbook, the vaccination ticket sticker (light blue) obtained from Koto Ward, and the vaccination questionnaire.

The information above is sourced from the following website. Please note that updates may take some time to be reflected. Before making your reservation, be sure to verify the details on the website provided.

https://www.city.koto.lg.jp/260312/fukushi/hoken/yobo/6858.html

Rubella antibody testing and rubella vaccine

Vaccines to be subsidized

• Rubella monovalent vaccine
• Measles/rubella combined (MR) vaccine※
  ※Currently, the supply of measles-rubella vaccines (MR vaccines) is uncertain, and rubella vaccines alone are available. Please call us for details.

Cost

• No out-of-pocket cost (the district fully subsidizes the testing and vaccination fees)

Eligibility for public subsidies

1. Women aged 19 to 49 who plan or intend to become pregnant
2. Household members of the above (aged 19 and older)
3. Household members of pregnant women with low rubella antibody levels (aged 19 and older)

Currently pregnant women, or those who might be pregnant, are not eligible to receive the vaccination. Those who have previously received rubella antibody testing or rubella vaccination subsidized by the district are also not eligible.

Instructions

• Since we need to call and confirm your request with the Koto Ward Public Health Office before testing/vaccination, please contact us by phone before making your appointment.
• At your first visit, we will conduct an antibody test (blood draw) and schedule a follow-up appointment to review the results. Vaccination will be administered based on these results if deemed necessary according to the guideline set by the Ministry of Health, Labour and Welfare.
• If you already have documentation (such as test results showing antibody levels) confirming low rubella antibody levels as recommended by the Ministry of Health, Labour and Welfare for vaccination, you may receive the vaccination without undergoing an antibody test. Please make sure to inform us when you book your appointment if this is the case. For more details, please visit the following website.

The information above is sourced from the following website. Please note that updates may take some time to be reflected. Before making your reservation, be sure to verify the details on the website provided.

https://www.city.koto.lg.jp/260502/fukushi/hoken/yobo/31fuusin.html

Health check-up

Health check-ups examines your overall health condition and can be either mandated by law or voluntarily chosen by individuals. Screenings are targeted to detect specific diseases early, such as cancer screenings. Our clinic offers health check-ups.

Health check-ups can be divided into health examinations (健康診断) and health screening (健康診査) as below, both of which are available at our clinic.

Health examinations (健康診断)

Health examinations are intended to assess your health status and prevent diseases. They are divided into "mandatory health examinations," which are required by laws such as the Occupational Safety and Health Law, and "voluntary health examinations," which individuals choose to undergo based on personal decision. Mandatory health examinations are conducted upon employment (pre-employment health examinations, according to Article 43 of the Occupational Safety and Health Regulations) and periodically thereafter (periodic health examinations, according to Article 44 of the same regulations).

Health screening (健康診査)

Specific health screenings focus on visceral fat obesity, aiming to improve lifestyle habits that contribute to this condition and reduce the prevalence and risk group of lifestyle-related diseases such as diabetes. These are based on the Elderly Health Care Law and target individuals aged 40 to 74. After receiving a health screening, individuals can also receive health guidance aimed at improving their lifestyle habits.

Scheduling health check-up

Health check-ups are by reservation only. Please reserve your health check-up online or by phone.

On the day of your appointment, we will conduct an interview, physical examination, and diagnostic tests. You can choose to receive your results in person, online, or by mail (a mailing fee will be charged). Please specify your preference at your exit. For those who prefer in-person or online consultations, we will schedule a follow-up appointment (one week later or more). There is no additional charge for the follow-up appointment except for an online consultation system fee (¥ 1,000).

If further diagnostic investigation or treatment is deemed necessary based on the results, we may address it through insured medical services at separate occasions.

Koto Ward Health Screening (江東区健康診査)

Components

• Interview (past medical history, ongoing symptoms both subjective and objective)
• Height, weight, waist circumference※
  ※ waist circumference measurement is optional for those aged 75 and older
• Blood pressure measurement
• Physical examination (inspection, percussion, auscultation, palpation)
• Blood tests
• Urine tests
• Electrocardiogram (ECG)
• Chest X-ray (optional for those scheduled for or who have already undergone lung cancer screening)
• Hepatitis virus screening test (available concurrently with a health examination for those who have never undergone hepatitis virus screening before and wish to do so. Please make sure to request when you schedule your health check-up

Cost

• No out-of-pocket cost (fully subsidized by the district)

Direction

• The health screening will be available at our clinic from June 21, 2024, to December 26, 2024.
• Please bring the examination voucher (sticker) sent from Koto Ward, a pre-filled questionnaire, and your health insurance card (or an identification document if you are receiving welfare benefits).
• For chest X-ray and electrocardiogram:
  • Please wear clothes that are easy to put on and take off.
  • Please wear undergarments without any metal, buttons, or plastic.
  • (For women) Please wear separates, not dresses
  • (For women) Please avoid wearing stockings.
  • (For women) You will also be asked to remove your bra top before the examination.

Mandatory health examinations (pre-employment health examinations、periodic health examinations)

Components

• Interview (past medical history, occupational history, ongoing symptoms both subjective and objective)
• Height※, weight, waist circumference※
  ※ waist circumference measurement is optional for those aged 75 and older
• Blood pressure measurement
• Physical examination (inspection, percussion, auscultation, palpation)
• Blood tests※
  • Blood counts (red blood cell, hemoglobin)
  • Liver function test (GOT, GPT, γ-GTP)
  • Lipid profile (LDL cholesterol, HDL cholesterol, triglyceride)
  • Glucose
• Urine tests
• Electrocardiogram (ECG)※
• Chest X-ray※
• Sputum test※
• Visual acuity test
• Hearing test

※Physician may decide to omit the following tests based on previous health screening results, the presence of subjective and objective symptoms, and other relevant factors.

• Height measurement
  • Individuals aged 20 and over
• Waist Circumference
  • Individuals under 40 (except those aged 35)
  • Pregnant women, and others whose waist circumference is not considered reflective of visceral fat accumulation.
  • Individuals with a BMI (Body Mass Index = weight (kg) / height (m) / height (m)²) under 20.
  • Individuals with a BMI under 22 who have measured their own waist circumference and reported the value.
• Chest X-ray
  • Individuals under 40 who do not fall into the following categories:
    • Ages 20, 25, 30, and 35
    • Those working in facilities regularly screened for tuberculosis under the Infectious Diseases Law (such as schools, hospitals, nursing homes for the elderly, and certain social welfare facilities).
    • Individuals subject to a triennial pneumoconiosis health examination under the Pneumoconiosis Law.
• Sputum test
  • Individuals who have been exempted from chest X-ray examinations
  • Individuals in whom no abnormalities were found through chest X-ray examinations, or who have been diagnosed as having no risk of tuberculosis onset based on chest X-ray results.
• Blood tests
  • Individuals under the age of 35, and those aged 36 to 39

Cost

• ¥ 12,000 (tax included）

Instructions

For chest X-ray and electrocardiogram:

• Please wear clothes that are easy to put on and take off.
• (for X-ray) Please wear undergarments without any metal, buttons, or plastic.
• (For women) Please wear separates, not dresses
• (For women) Please avoid wearing stockings.
• (For women) You will also be asked to remove your bra top before the examination.

Other health check-ups

Components

To be determined based on the requirements.

Cost

To be priced based on the test items.

Health maintenance

"Health maintenance" refers to a proactive approach that prioritizes prevention over treatment. It includes immunizations, health screenings, lifestyle counseling, and regular assessments of both physical and mental health. The goal of health maintenance is to reduce the incidence and impact of chronic diseases, preserve health, prevent illness, and enhance the quality of life. This approach goes beyond traditional "reactive" medical care by preventing diseases from developing, detecting potential health issues early, and managing minor health problems on an outpatient basis before they require more intensive treatment. This maintains an optimal level of health and aligns with broader public health objectives.

Vaccination

Health check-up

Smoking cessation

Consult Dr. Takada

Consult Dr. Takada for inquiries about vaccination planning, health check-up result interpretation, health check-up planning, and other health-related issues.

Dr. Takada is available for various medical and health-related consultations (self-pay) as below. If you are interested, please contact us by phone or email at （ ）

• Interpretation of health check-up results
• Planning health check-up
• Planning vaccinations
• Diagnostic work-ups or treatments you have received or that have been proposed at other institutions (we also accommodate requests for second opinions).
• Strategies to maintain or improve your overall health level
• Regarding the health or health care of your family members or loved ones.
• Other health-related issues

Consultation fee (self-pay, tax included)

~ 15 minutes	¥ 5,500
16 ~ 30 minutes	¥ 11,000
31 ~ 45 minutes	¥ 16,500
46 ~ 60 miuntes	¥ 22,000

Scheduling consultation

If you are interested, please contact us by phone or email at （ ）

• Needed time slots for consultation will be determined and secured when you schedule. If your consultation exceeds the allotted time and there is an available slot following yours, we will accommodate your request. However, if no subsequent slots are available, please understand that you may need to book an additional slot on a separate date.
• Please note that insurance-covered medical services cannot be provided during the consultation.