Wednesday, May 14, 2008

Why I'm not a member of the Japanese doctor's fan club

I've been feeling a bit unwell for quite a while now. For much of that time, I've found excuses as to why I was feeling that way, and so didn't do anything about it. Recently, I ran out of excuses and decided it was time to get to the bottom of what was causing me to feel ill for so long.

I'm not a fan of doctors at the best of times, and especially haven't had good experiences with Japanese medical professionals. One yelled at me when I asked a question (something you DO NOT do here, dare to question the doctor) and had a dentist tell me I had cancer, even though he knew well that I didn't have cancer, but he thought it was a good analogy.

I could no longer put it off, and so visited a doctor that we were pleased with when hubby got sick a year or so ago.

The conversation went a bit like this (in Japanese - doctor, and broken Japanese - me)

Doc: "What's wrong."

Me: "I've been really tired for about six months."

Doctor laughs.

Me: "No, seriously. I'm exhausted. I'm struggling to stay awake at work and then I often go home and have to go straight to bed. On the weekends I often can't do anything because I'm too tired."

Doc: "Everyone's tired. That's not a problem. Is there anything else?"

Me (shocked and upset): "Well yeh, for the same length of time, I've been getting these really bad stomachaches."

Doctor has me lie down and pokes my stomach a few times while I cry out in pain.

Doc: "Yes, you do have a stomachache. Maybe you have an ulcer. I've give you medicine for an ulcer."

Me (not feeling so confident in his abilities by this stage): "Well, I've also had reflux and heartburn."

Doc: "Heartburn, that's caused by the oesophagus, I'll give you medicine for that too."

The consultation goes like this for a while. Most symptoms the doctor ignores. I was gradually getting more and more frustrated as he treated me like a stupid hypochondriac. I was going to him because of a bunch of symptoms that had all been happening for about the same length of time and were all getting worse together. I suspect that something is causing them all, possibly a food allergy issue or a bug that I picked up in Vietnam last year. I was hoping to get answers and not a bunch of drugs to mask separate symptoms.

Me: "I've also been really lightheaded and dizzy. I've nearly fallen in class a few times."

Doc: "Dizziness. That's caused by the ear. I'll give you some medicine for your ears."

I have to say, he never even looked at my ears.

Me: "Well, I'd really prefer not to take medicines unless they're really necessary."

Doc (rolling his eyes at me): "Well you want to feel better don't you?"

There was no point during the whole consultation that he tried to connect a single dot to another. He just told me that things were wrong in all parts of my body and insisted upon different drugs for each. He never asked for more information and never asked about my personal or family medical history.

During the visit I insisted that I wanted to be tested for gluten intolerance. My mother is coeliac, a genetic condition that shares many of my symptoms. The doctor wasn't happy about it, and didn't even know what the condition was. He figured though, that it was a way of getting rid of the stupid foreigner.

Monday was the day I needed to go in for the blood test. I did something a little naughty. I pretended that my Australian doctor had written me a note asking me to be tested for the Vietnam bugs and to have my iron checked as well. I had my Japanese boss translate it before the appointment. The Japanese doctor was not happy at all, but luckily still did them. Once I get the tests back next week, I think it's time I find a new doctor.


tornadoes28 said...

You need to come see a doc in the United States. Although healthcare is expensive in the US, it is probably the most advanced in the world.

Brad said...

I can relate completely! My first time I had a huge rash on my leg. The doctor diagnosed it as exma (spl?) which I had never had before in my life. When I began to ask what caused it, how I could prevent it in the future he firmly told me to go wait outside while he got the medicine he prescribed after his 2 second checkup.

Second time I asked a doctor if he could check me for testicular cancer, a checkup that's very common and normal to get by a man in most countries I would think. The doctor began to blush and shook his head back and forth and refused to do it. REAL mature.

Shari said...

I hate to say this because I support the concept of socialized medicine, but the poor quality of care you receive in Japan (and I've experienced it, too) is a result of two things - socialized medical care and a lack of accountability because there is very little in the way of malpractice suits.

One of my students is married to a doctor and she's verified a lot of what I have observed peripherally. Doctors want to maximize profits and the only way they can do this within the restrictions of the current health care system is to see patients as briefly as possible and prescribe a lot of medications. Her husband sees 15 patients in a half hour at a hospital he works at and 45 a day at his private clinic (he'd see more if he could get more patients).

Doctors want to see patients for short periods of time so they can get you in and out fast and make the next chunk of money. They don't want to answer your questions or probe into your symptoms. When I've had serious health problems, I've gone to the National Azabu Health Clinic in Hiroo and paid from my own pocket completely for treatment. It's expensive (one visit cost me 24,000 yen - they don't take the Japanese health insurance), but it's a place that treats foreigners and the doctors are patient, competent, ask questions and listen carefully. They don't rush you out and are not rude to you.

You get what you pay for with Japanese medical care, and the care is cheap under the National health care plan.

Brad said...

Yeah, the doctors get a HUGE profit from selling medicine. A friend of mine got a lotion for a broken arm. I kid you not.

Personally I use the Tokyo British Clinic in Ebisu. Great British doctor. Very professional. About the same price as the one Shari mentioned.

billywest said...

I'm covered under Shakai Hoken and make a huge payment every month. However, I never go to the doctor's.

When I do, I'm going to show them a calculation of just how much I've paid up to that point and then demand the royal treatment, dammit!

Well, it'll be worth it just to see the look on the nurses' faces.

Melanie Gray Augustin said...

Hey Tornado - Yeh, I've heard America is good as long as you can pay. I have a fantastic doc back in Australia, and am so tempted to fly home to visit him right now...

Hey Brad - That's just awful but really doesn't surprise me after the experiences I've had here. I have some serious (life threatening) allergies to medicines and had doctors refuse to listen and just prescribe what they want to. Needless to say, I didn't take the medicine. I might look into what foreign, private doctors they have around Nagoya.

Hey Shari - Thanks for the long comment. What you've said helps me understand more about what's going on. I hadn't considered the idea that they're just rushing everyone through to get more money. How truly awful! I don't think it's totally socialised medicine's fault though, in Australia the medical care is either free or very cheap, yet we have excellent care. There is more accountability than here though, so maybe that's got something to do with it. As I said just above, I think it might be time to look for a foreign private doctor. Rather annoying when I'm paying health insurance though!

Hey Billy - YEAH! I pay the city health insurance, which is not cheap and yet never go to the doctor. I've racked up quite a lot of money if you think about it that way.

Anonymous said...

Hey Melanie, hope you get better soon. The most advanced US medical treatment is only available if you have proper insurance. In the US the insurance determines what treatment you get... While we are at recommending: try Belgium, low cost, high quality.
By the way, I rarely read blogs, but I read everything that is in your archives!

Melanie Gray Augustin said...

Thanks Anon - you're so sweet!

PĂ©itseoga said...

Melanie, that's an awful experience! For some reason I imagined that healthcare would be really good and professional and clean in Japan!
I don't agree with the US system, I think health care should be free/covered by national health insurance, and everybody should get the best treatment.
In Germany it works quite well, but you do pay about 11 percent of your wages.
In Ireland a very small percentage of contricutions and taxes go into the health system, and it does not work well, you pay 50€ for every doctors visit, 190€ to see a consultant privately, and there are long waiting lists if you can't pay privately or don't have insurance. by long i mean, patients die of cancer while waiting for a simple test, to see whether they have cancer! insurance doesn't cover everything, either, to have a baby privately, you pay about 3000€ in addition to the insurance. This doesn't guarantee you a private room or even a room in a 3 bed room, you might end up on a ward!

Contamination said...

URGH! Sounds like the typical Hospital / Factory doctor. Minimum effort, here's a bag of medicine, next patient please!

It takes time to find a good doctor here.

Melanie Gray Augustin said...

Hey PĂ©itseoga - Wow, that's terrible about the Irish system. Now I feel like I shouldn't complain as much...

Hey Cont - It's just ridiculous. Quite a number of my students here will become doctors (the school is quite famous for turning out doctors), I'd love to instil in them, how important it is to listen to the patient. They are the ones who know how they normally feel and how they're feeling now.

** A bit of an update**

I went to the doctor for the test results the other day, am still feeling really bad. He handed me the negative results of the couple of tests he agreed to do in the end, laughed at me, then said in a smug voice "See I told you there was nothing wrong with you". I left, went home and cried all night.

I found an western doctor in Nagoya, but he's away for the next two months. Am now thinking of going to a "ladies clinic" to get a full "pre-conception check-up", hoping they might do it, they do in Australia....

Brad said...

Hope everything turns out okay!

As for the National Health Insurance, I'm paying about 25,000 yen MONTHLY and have only really used it once in 5 years.

Have heard when I leave Japan I can get a lot of it refunded though? I hope so! Or maybe that's the pension I'm thinking about.

Melanie Gray Augustin said...

Thanks Brad. I have my days when I freak out. We'd like for me to go home pregnant, but that means dealing with doctors for (hopefully) a large portion of my pregnancy. There are pre-conception blood tests that are standard in Australia and the USA, but the doctor I saw wasn't willing to do any of them! That just scares me.

I've heard that the pension is refunded when you go home, but I hadn't heard about the health insurance. If you find out, I'd love to know, it sickens (no pun intended) me how much I pay and then when I feel like I do need to use the doctor for once, the standard is awful.