Japanese Health Care


Stella has a nasty summer bug. High fever, vomiting, food refusal along with a nice dose of whining and Oh MAH GAH DON'T PUT ME DOWN. And so, I decided to take her to the doctor. And then write about it on my BLAAAAAWWWWG. And so here you go: a little peak into Japanese pediatrics.


There are many aspects of the Japanese medical system that are really really great. Here are a few:



  • Typically, you don't need to make an appointment. You can rock up to the clinic at any time, and hang out in the waiting room until the doctor can see you. For a mother of a child on an unpredictable schedule, this is fantastic. 

  • Doctors offices are typically open on Saturdays. Working mums woot!

  • Despite being appointment free, wait times at the doctor are no longer than what I’ve experienced in the US.

  • Medical care is pretty affordable. Most people in Japan have nationalized health insurance which covers the bulk of the cost (we have foreign insurance, so things work differently for us but a clinic visit costs about ¥5500 {about $71} and a couple prescriptions set us back ¥1500 {about $20.})

  • Some things are free. Like certain vaccines. And a few initial well-baby visits. Though you do have to go through a bit of an annoying rigamarole to get said vaccines. Still. Free.

  • Medical medical practices are, typically, a one-person show. That means that you know your doctor and he/she knows you, and you won’t be stuck with a strange grumpy doctor. I kind of always love going to the doctor, because everyone is just so nice.


 


Then there are things that, on the surface seem a bit eep! but are actually fine.



  • Medical facilities are not shiny new gleaming chrome-clad sparkle-pads like in North America. They are stark. Dinged up, with pealing paint. Uniforms are faded, toys outdated, decor nonexistent. Things just look a bit old and dingy. Still, everything is really clean and sterile. And, once you're used to this aesthetic, it's really fine, and doesn't impact on the level care you receive at all.

  • Doctors prescribe medicine in powder form. Totally weird. But, if you know the trick (dissolve it in water, shoot into kid’s mouth with a syringe) it's not such a big deal.

  • Doctors are also big fans of suppositories, or bum bum pills, as I like to call them. They're kinda intimidating at first, and then you learn that they're really no big deal.

  • The vaccine schedule in Japan is different than it is in the US. They take a less aggressive approach and administer fewer vaccines over a longer period of time. Personally, I think this is a good thing. The only down side is that you are required to make a separate doctor's visit for each and every vaccine. So, for a few months, we were going to the doctor just about every week. Which is not so convenient. 


 


Then there are things that are less awesome.



  • No one, no where ever, EVER, EVER! takes a credit card. You have to take a wad of cash with you to the doctor if you have international health insurance like we do. This is less than ideal if you are admitting your newborn baby to the NICU, and the administration is demanding about $10 000 in CASH. Some persuasive pleading, frantic phone calls to insurance companies, paper-work signing and general running around was enough to work out a deal between the insurance company and the hospital in our case. 

  • Informed consent is not what it is in America. The expectation is that one trusts one doctor, and doesn't ask questions. Thus, finding a Western-friendly doctor can be important. Not because Western-training is tantamount to better care, but it helps the doctor understand your approach to the Doctor-Patient relationship.

  • Similarly, doctors take less time to talk to you during well baby visits; there’s no developmental milestone check list, no detailed discussion of sleep problems and feeding schedules etc. Therefore, it is really important to be aware of any developmental issues, and to be fairly assertive in brining up any concerns to your doctor. 

  • Doctors throw around antibiotics willy-nilly. Stella was prescribed antibiotics for a suspected viral infection. And I'm not a fan. 

  • Sometimes doctors will advise you to do things that you KNOW conflict with medical advice that you would receive at home. For example, I was told to stop nursing a vomiting Stella. But she wouldn't eat or drink anything else, so I ignored that particular piece of advice.

  • If you don't speak perfect Japanese, hospital administration will ask you to have a friend come down to the hospital to assist you. Which is a bit of an imposition on your friend, to say the least.


 


So, there you have it. There are many differences with the medical system in Japan. Some are GREAT. Some are medium. Some are less than awesome. However here are my tips for managing these differences:



  • If possible, find a doctor who has had Western training and / or experience. Not because Western medical practice is superior to Japanese, but because it will make your doctor more understanding of your approach and your expectations.

  • Find a doctor you feel comfortable with then trust him / or her. Not having to question and second guess every judgment makes you feel much happier. 

  • Accept that things will be different, then roll with it. I mean, Japanese people are really healthy. And their medical outcomes are typically much better than those in America.

  • Be an advocate for yourself and / or your child. Be informed about things like vaccines, developmental milestones, breastfeeding, and typical childhood illnesses 

  • Be prepared to do a bit of extra legwork in the paperwork department; if you know you'll be seeking expensive medical care, work with your insurance and the hospital well in advance to organize payment. You'll probably get a lot of resistance from the Japanese side, put persevere, and it might work out in your favour.

  • If the hospital administration asks you to bring a translator, you probably don't really need to. Odds are, there will be SOMEONE at the hospital who can speak enough English to get you and your child treated. 

  • It can be helpful to have a Western backup doctor, or at least someone whom you can call for a second opinion. Often foreign insurance plans have a number which you can call for assistance of this kind. 


 


In sum, there are things that are great about health care in Japan, there are things that are a bit strange at first but eventually turn out to be fine, and there are things that aren’t ideal. However, the same can be said about healthcare in any country. The best thing to do, is be informed, be flexible, and be accepting of the fact that things are different here. And different doesn’t mean bad.