Niwayama Clinic, located in Yokkachi-machi, Uonuma City, Niigata Prefecture, is a clinic specializing in internal medicine. Situated approximately a 12-minute walk from Koide Station on the JR Joetsu Line and equipped with parking, it offers convenient access for patients from surrounding areas. A distinctive feature of the clinic is its history as a family doctor serving the local community for three generations. Guided by the principle of providing prompt medical care and appropriate referrals to specialized facilities when necessary, while considering changes in the healthcare system from primary to tertiary care, it functions as a gateway to regional healthcare. The clinic has also introduced online consultations, primarily for patients who visit regularly for lifestyle-related diseases, taking into account local realities such as the aging population, busy farming seasons, elderly caring for elderly, and the burden of hospital visits on families raising children. This initiative to expand healthcare options for those who have difficulty visiting in person due to time or physical constraints has been highly evaluated. In terms of facilities, the clinic is barrier-free and accepts electronic payments, creating an accessible environment for various patients. The clinic actively promotes medical DX initiatives, including online identity verification, electronic prescriptions, and electronic medical record sharing services, while also encouraging the use of generic drugs. The clinic's consistent approach to balancing convenience and quality of care while continuing to provide community-based healthcare is reflected in its practice philosophy.