7 Things You Should Know About Japanese Hospitals and Medical Care

Since moving to Japan many years ago, I’ve been to a lot of Japanese hospitals and visited various doctors.
I know that there are lucky people out there who managed to live in Japan without ever having to go, but I have a certain condition that requires me to visit the hospital at least every 3 months. Don’t worry, it’s nothing too dramatic! ^-^;
Thus I have a lot of experience with Japanese hospitals and doctors that I wanted to share with everyone.

Please bear in mind that I can only compare Japan with Germany as I have no experience with the medical care in other countries.
Also, this article is completely based on my personal experience, so don’t take everything I say here as a fact.

 

1. Medical Care in Japan:

First of all, health care in Japan seems so expensive to me!
The interesting thing about this is that most Americans I met say that health care in Japan is so cheap! So, I really guess it all depends on your home country.

For somebody like me who has to visit Japanese hospitals quite often, it is expensive. PERIOD.
There are different kinds of health insurances – just like in any other country. I don’t want to go into details.
Probably the most common (also among foreigners) is the “kokumin kenko hoken” (国民健康保険), the “National Health Insurance“, which will cover 70% of (most) of your medical bills.
For me that means that I have to pay 30% of the bill every single time I go and see a doctor – and if it’s only to get a prescription.

In Germany your health insurance will usually cover 100% of everything (as long as it’s something that is really necessary from a medical point of view).

For my usual blood check, prescription and medicine I had to pay between 3000-10.000 yen whereas in Germany I would have gotten all of that for about 500 yen. Can you see the huge difference?

 

2. Japanese Hospitals:

When you are sick – and even if it’s just a cold, you usually go to a hospital.
Yes, there are a few smaller clinics, but it’s very common to go to a hospital. That was very weird for me at first as in Germany we only go to the hospital for “bigger” examinations or if we’re REALLY sick!

The hospitals usually have a general reception (総受付) from where you’ll be sent to whichever section you need to go, e.g.:

• 内科: naika – internal medicine
• 外科: geka – surgery
• 皮膚科: hifuka – skin doctor
• 婦人科: fujinka – gynecologist
• 耳鼻科: jibika – ENT department

If you visit a Japanese hospital for the first time, you often have to pay more than usually (“introduction fee“) and fill out a lot of documents.
Apart from your name and address you also have to fill out details about your health.
Depending on which section you want to visit, you’ll get another document to fill out some related health information (e.g. about your period, pregnancy etc. if you want to go to the gynecologist).

After all the paper work you’ll receive a “patient card” that most of the time looks like a credit card with your name and patient number on it.
In many hospitals there are ATM-like machines where you can put your card in and it will print out the information you need, so you won’t have to go to the reception anymore.

Next, you just sit and wait …. and wait ….. AND WAIT!
Many hospitals have the policy that first-time visitors cannot make a previous reservation, so you end up waiting for many hours.
Especially in smaller cities, the hospitals are always very busy so that you might have long waiting times despite your appointment.

Once your examination is over, you’ll get the prescription (if any) and the bill.
With that you have to go to the “cashier” (会計) and wait again until they call your name and you can pay.
Some Japanese hospitals also give out medicine, so you hand in your prescription and wait A.G.A.I.N.

 

In smaller clinics there’s no “cashier”. You just go back to the waiting room and wait until they call your name. You’ll receive your bill, prescription and pay.
Usually you’ll have to get your medicine elsewhere, but a lot of clinics have pharmacies nearby!
All hospitals I’ve been to so far had a LOT of people waiting. They’re always busy!
I’ve had waiting times of 3 hours. It’s really inconvenient for people who have to work every day.
If you get sick during the weekend and need help immediately, you have to go to an emergency clinic (I did once).

All Japanese hospitals I’ve been to had vending machines, but some even had convenience stores inside the building! Almost all hospitals have huge flat screen TVs, so the patients can watch TV while waiting.

 

3. Doctors in Japan:

Just like in any other country there are good and bad doctors, so I shouldn’t generalize too much, I guess.
However, I’ve been to a lot of different doctors and I think I have yet to find a good one.
The problem with Japanese doctors is that they let you do all the talking!
If you don’t tell them what you want, what you think you have and what kind of examination you want, they won’t do anything.
In Germany (and I’m sure in most Western countries) you go to the doctor, tell them what is wrong with you and they will take care of the rest.
I mean, THEY are the ones who studied medicine in university after all, right?? Not us!!!

In Japan, they leave it up to us patients who don’t know anything about medicine.
Even some Japanese people I talked to about this topic said they don’t like that about the Japanese medical system.

I had skin doctors look at my skin problems from far away, literally throwing some random medicine at me without ever checking properly what was wrong.
At first I thought it might be because I’m a foreigner (e.g. that they don’t want to touch me), but I heard that they treat Japanese people exactly the same way.
With some doctors you have to be really persistent and tell them exactly what you want them to do.
If you have no clue what’s wrong with you, that’s a difficult task, though.

Well, if you have just a cold, it probably doesn’t matter, but if you’re really sick, it can become dangerous!

And I’m not the only one who thinks so: “How NOT to get a diagnosis at the doctor”

 

4. Nurses in Japan:

One thing that is also different from my home country is that you’re never alone with the doctor!
There are always a few nurses around as well. Even when at the gyno, there are a lot of other spectators (aka nurses) around. I hate that!! …
You definitely have much less privacy in Japanese hospitals or clinics than what you’re probably used from back home.
The nurses also approach you while you’re in the waiting room and ask you questions about your health that you definitely don’t want everybody else to hear (but they will)!

Apparently there have been issues in the past of gynos taking videos secretly.
You wonder how that is possible? In Japan they use a stupid curtain between the patient and the gynecologist, so they can’t see each other.
I usually open that curtain because I find it rather ridiculous.
However, Japanese seem to be so ashamed, that they don’t want to see the face of the doctor while being examined.
With nurses around the risk of secret videos is lower, I guess.

 

5. Dentists in Japan:

Dentists are yet a different story and maybe an experience you don’t necessarily want to make.
I go to the dentist at least once a year for a general check-up.
Again I can only compare it to dentist clinics back home, but I can’t imagine that things are so different in other Western countries.
In Germany there’s one room with one chair for the patient. You are alone with the doctor and one assistant and they’re solely concentrating on you until everything is finished.

In Japan, on the other hand, there are many chairs in one room. You can look into the mouth of other patients while passing by.
The doctor jumps from one patient to another quickly, so I really doubt it’s all as disinfected as it should be ….
You can not only hear, but see what happens to other patients … and they can also watch you while you sit there with your mouth wide open.

My teeth are still in good condition, but I have the feeling they need special care ever since I moved to Japan.
Japanese sink water has (almost?) no fluoride and there aren’t that many toothpastes with fluoride either! I also noticed that my teeth get stains more easily here in Japan.

 

6. Japanese Medicine:

Prescribed medicine often comes in small paper bags with your name on it and the basic necessary information (how much you have to take / how many times a day).
In Germany you’ll just buy the whole package of pills – no matter if you actually need all of them or not.
In Japan they will give you only the amount of medicine you really need.
So, if the doctor decided that your cold will be cured in 5 days, you’ll get medicine for about 5 days and that’s it.
It’s a very economic system – at first sight!
They often have each and every pill (or powder) wrapped individually which causes more garbage than necessary.
With the medicine you usually get a printout with a photo of the medicine and a description (side effects, what kind of medicine it is and what it’s for etc.)

 

7. Language:

Apparently you’ll find some foreign and thus English speaking doctors in bigger cities, but I wouldn’t know any details as I’ve never been to a foreign doctor in Japan.
From the start I’ve only visited Japanese doctors who could speak Japanese only!
At first it was difficult, of course. Before going I always made a list with necessary vocabulary.
Some doctors I met even spoke a little bit of German!
Do you know why you’ll find (esp. among older doctors) so many who can speak / understand medical terms in German?
That’s because Japan got a lot of their medical knowledge from German doctors!
Well, that’s another topic, but that’s why you’ll find so many katakana terms in Japanese hospitals that you won’t understand unless you’re German (or Japanese, of course).
Many Japanese people don’t even know that those are German and not English words!

Examples:
レントゲン – Roentgen – x-ray
カルテ – (Kranken)Karte – patient’s card
メス – Messer (Skalpell) – scalpel

It seems that a lot of doctors used to write in German when taking their notes so that the patients wouldn’t know what was being written.
Apparently psychiatrists used to do that often. I doubt it’s still very common nowadays. I see my doctors write in ugly characters that look like they could be Japanese – and I guess their secret is that their handwriting is so bad that the patient won’t be able to read it!

 

Conclusion:

As you can probably tell I’m not really a fan of the Japanese medical system.
The German system is far from being perfect and it seems to change for the worse continuously, but I still prefer that to the Japanese one.
Actually the medical system in Japan is one reason why I decided not to stay in Japan forever.
When I grow older and might have more severe health issues, I really wouldn’t feel that I’m “in good hands” here in Japan.

Also, since moving from the countryside to a place that’s even more out in the boonies, I’ve had problems getting my medicine.
It’s really annoying, costs a lot of time and money!
If you have any kind of sickness or have to visit the hospital often, then I highly recommend that you don’t move to a smaller city!
At least make sure that you have a bigger city with some big hospitals nearby!

Again, please bear in mind that this is only my own experience.
You don’t have to worry about your health care. Japan is a highly developed country.
I’m well aware that there are many countries that could only dream of a health care like this!

I’d love to know if living in a big city (e.g. Tokyo, Osaka) and visiting REALLY big hospitals is a different thing.
Anybody cares to share their experience?
I’d love to hear about other people’s experience with hospitals and doctors in Japan!

P.S.: I actually wrote this article while sitting in a Japanese hospital! *g*
Somehow you need to spend all that waiting time in a useful way, right?