Adventures in Japanese Medicine

A few weeks ago, I went to the hospital to get something that needed to be checked out checked out. I wanted to wait until after I got the results today to talk about Japanese hospitals since I did not want to jinx anything. To curb suspense: everything is fine and I am relieved.

The reason why I was relieved was because I was on the fence about going to doctor in Japan. I mean, I did go to the school one when I had a cold, but that was a cold and this was something that needed to be checked out.

First, there was the mild language barrier. I say mild because while I can speak Japanese very fairly, it is quite different when you go to the doctor, or talk about business, politics, economics, etc. In Japanese, there are special dictionaries for medical/economic/business terms because unless you are in a specific field in one form or another, you really don't need to know the vocabulary. Same thing goes for any language - do you really need to know what a quark is, unless you are an astrophysicist? I don't even know if I got the term and it's associated specialty right. But that is my point, if a lame one. This was rectified by using a particular online dictionary, the medical guidebook in Japanese that my old Japanese teacher gave to me as a parting gift and some snooping on Google Japan for more specific terms and lets just say I learned some interesting words that are very useful, but I hope to never use again.

Secondly,the presumed reputation of the Japanese medical system. The down low is their doctors are mostly old, don't update themselves on the latest advancements/developments in the field and that since the medical schools/colleges put so little emphasis on learning, do they REALLY know what they are doing? Latter concern proved by a Japanese kid I know at Kyodai who is studying medicine and says that there is really no pressure and that kids skip class. Also, my friend's friend's mom (Japanese) was diagnosed with breast cancer, and in spite of the fact that there are enough lumps to warrant a masectomy, the doctors brainwashed the poor woman and said it "was just a little cancer, don't need to do anything about it." So my opinion (which obviously held no water, only anxiety and hearsay) of doctors here was a little low.

So with the two factors combined together, I delayed and delayed and got so anxious I decided that I had to go or else I would get no peace.

Everyone - and I mean EVERYONE - gets the National Health Insurance. If you work for a company, then it gives Social Health Insurance, different being that it covers a bit more, I think. It's like England - I had health insurance from the state because of my student visa, so when I had the flu, I was covered. When I first got here, I got the little green card and tada! I am covered. Never really thought about it till this past vacation, when I had too little to do and too much time to think.

When you go to a doctor, you first notice that there is no appointment system. At small clinics and private practices, there is a sign outside indicating the hours of operation. I went to the Japan Baptist Hospital (JBH), and there was a nice PDF file on the internet explaining the hours of the particular specialties in English, and because it can be a concern for many, whether or not the doctor is female. So, two weeks ago, I hopped on my bike, slogged uphill and got to the hospital (more a collection of outpatient clinics with some inpatient stuff) when they opened on the dot at 8:30am.

My first impression was "This is NOT a hospital." It doesn't SMELL like a hospital. It was very nicely and subtley decorated and did not have tacky chairs and such. It was comfy. I didn't feel like the axe of death was going to hang over me. I sound a bit exagerrated but you get the point. It was...comfortable, as much as hospitals can be. Think Seattle Grace on Grey's Anatomy (which is actually an outpatient VA hospital in Cali) but on a smaller scale.

Maybe it was because I was in the outpatient/clinic section, the inpatient section might be different. I went up to the front desk, told the person that I was new and handed over my insurance card. ALWAYS have to carry this with me, or else I have to pay the full fees as opposed to 30% (NHI covers 2/3 of medical costs). The nice thing about this hospital was that it is - to some extent - English friendly. The form that I filled out for new patients was in English, but the medical history form that I filled out when I got to the specific doctor was in Japanese. It was a good thing I brought my Nintendo with me; otherwise I wouldn't have deciphered it.

So when I filled out the English form for the "new patients" (which curiously asked my permanent address back in my "home country") I sat down and waited. They called my name, and this is where it gets interesting: first, I got a little "Japan Baptist Hospital" ID card with my name (in Japanese, which was spelled wrong - I spell my last name with one of the syllables elongated so it sounds more like it does in Greek as opposed to English) and an ID number punched into it.

Second, I got a yellow plastic A4 size folder. Japanese clinics/hospitals (same thing happened to me when I went to the school clinic for my cold/sore throat) use what I like to call a folder system. You go in and register your presence, the receptionist looks up your file on the computer and prints something out; this printout, along with your hospital ID card goes into the yellow folder which is given to you. Then, you go to the doctor you have to go to, and drop it off in a tray at that doctor's reception area. Presumably, they will look up your more detailed medical file which is in the doctor's office. The yellow folder I think is more a person-tally device, which indicates who is here and for what.

Then you wait. Even though I DID have an appointment today (sometimes you can schedule appointments) as opposed to two weeks ago, I still waited an hour for something that took less than two minutes - getting my results. So I waited. As did everyone else. Waiting for doctors is always hell. Especially when you are waiting for test results.

In spite of all the misconceptions I had about Japanese doctors, I actually did not mind going to the doctor. The JBH was established in 1946, but everything was brand new, clean and DID NOT SMELL LIKE HOSPITAL. I strongly emphasize this: when I was in high school, I worked at a hospital for the summer. I was in an annex building and not in the main hospital; but when I was in the main building, it smelled of hospital. My doctor was actually young and female so I was comfortable. And she spoke a little English which surely helped me to clarify that yes, I was fine and my results were negative. When I first went, I brought my American medical files with me (I got my doctor to photocopy a set before I left for Japan, in case I needed it) and she offered to photocopy them so that they were in my Japanese medical file.

After you finish with the doctor, you get the yellow (it could be any color but at JBH it was yellow) folder back and head down to the main reception area again, and give the folder to the cashier. And then you wait AGAIN to get your bill tallied up, since things are done on a points system in terms of determining medical costs. That's as far as I know, intricacies are beyond me. When I first went, I wasn't sure what test to get (the medical form in Japanese asked what was wrong with me so it was a bit vague and I checked off more than one box that were all related) or if the basic one was enough to get the thing I want tested, so I sorta went for the whole sha-bang to cover the bases. Total cost: about $250 or 24,500yen. Why? One particular test isn't covered by NHI so I had to pay the full $200. The doctor was nice enough to warn me abut that before she placed the order for the test on my medical forms, but I said it was ok. So, since NHI covers 2/3 of the bill that $50 was actually $150, so the actual bill would have been about $350. Not bad compared to American doctors but blah. Still, small price to pay for peace of mind. Today, it was only 330yen for me - I had forgotten to bring cash with me so THANK GOD I actually had 330yen in coins.

After you pay, you get your hospital ID back, walk out the door and with a huge sigh of relief and happiness, walk back down the hill that the hospital is on, teetering in your heels and enjoy the rest of the day.