Proposed System Flow (Summary)

✅ Proposed System Flow (Summary)

Site name: Online University Hospital
The site is operated by a non-physician company
Over 50 physicians (who are employed elsewhere) register to the platform as part-time
Patients are matched to online-available doctors for teleconsultation
After the consultation, doctors issue referral letters and prescriptions, referring patients to external hospitals or pharmacies
Prescriptions are dispensed by the referred hospital or pharmacy
The referred hospital pays a referral fee to the physician who issued the referral
The site operator claims to provide only the system (IT infrastructure) and is not involved in medical practice

Prohibition of unauthorized brokering of medical services

Connecting patients with physicians for consultation and accepting referral-based compensation is classified as “illegal brokering of medical practice"
Referral fees paid to the doctor indicate commercial incentive, violating medical ethics and Japanese law

Prohibition of misleading names

The term “University Hospital" is legally reserved for official university-affiliated hospitals
A private or non-medical entity using this name can be subject to governmental correction orders or penalties

Inducing prescriptions or promoting medication through third-party referrals can be seen as illegal inducement or misleading advertising
Having one doctor refer the patient and another facility dispense medications creates a blurred responsibility and potential legal liability

Since diagnosis and prescription are split between different institutions, it’s unclear who holds medical accountability for adverse events or misprescription
This lack of accountability is non-compliant with standard medical regulations

Action	Legal Violation	Summary
Non-doctor company introduces doctors to patients	Medical Practitioners Act Art.31	Illegal brokering of medical services
Using “University Hospital” as site name	Medical Care Act Art.6-5	Misleading representation
Doctors referring to external facilities for prescription	Medical + Pharmaceutical Laws	Encouraging non-compliant treatment
Referral fees paid to physicians	Medical ethics + Act	Financial incentive = high legal risk

This avoids illegal brokering and misrepresentation
Physicians must belong to or be under contract with the clinic that runs the site

Doctors must not receive compensation from other hospitals for patient referrals
If referrals are needed, they must be based solely on medical necessity, and no money should be exchanged

Examples:

Avoid names like “University" or “Hospital" unless officially affiliated.

Site operated officially by a licensed medical institution
Physicians are formally contracted (part-time or freelance) with the clinic
Consultations and prescriptions are performed by the same doctor
Prescriptions are issued electronically and sent to the patient’s chosen pharmacy
No referral fees are allowed
Full compliance with the Online Medical Treatment Guidelines from Japan’s Ministry of Health, Labour and Welfare (MHLW)

Risk	Issue	Legal Solution
Illegal brokering	Non-doctor matching doctors/patients	Clinic must operate the site
Name misuse	“University Hospital” misleading name	Change to neutral, lawful name
Split treatment responsibility	Doctor ≠ prescriber	Unify consultation and prescription
Financial incentives	Referral fee to doctors	Must be fully prohibited

If needed, I can also create:

A visual flowchart of the legal online medical model
Sample documents such as:
　・Physician agreement templates
　・Online consultation terms of service
　・MHLW inquiry draft for pre-approval

Let me know if you’d like any of these.