Yuri to Boushi to Hon no Tabibito

A Shoujo ai centred Weblog

Day 5 – Japanese health system and stuff. If this bores you, DETEITE~~!!

Posted on | March 6, 2008 | 6 Comments |

So it’s my 5th day here in Japan and my third day working at this hospital – the Kameda Medical Centre in Kamogawa (Chiba-ken – apparently people only know it because there’s a place 5 miles down the road called “Kamogawa Sea World”) so I thought I would do my inevitable post about my views on the Japanese medical system so far.

Since I’ve been here I’ve been under the care of the general medicine team as well as the Nephrology senior Ohara Mamiko sensei (a very hardworking woman) but there’s also an American professor here by the name of David Gremillion who comes from North Carolina. He amuses me because he’s been here on and off since 2003 and doesn’t really speak much more Japanese than your basic American (he attempts a few phrases here and there). This is probably a mix of laziness on his part and his job which seems to be tutoring the medical staff in English.

I didn’t know when I applied, but Kameda has the biggest concentration of good English speakers of any establishment in Japan! It’s very impressive…

It’s also allowed me to actually work out how the Japanese medical system works. Take the UK and US as examples. In the UK, the person pays a proportion of their earnings as “national insurance” which goes towards funding the NHS. The NHS, subsequently, is a completely free system and therefore gets horribly abused as a result. We also have a small private sector with equally high prices. In America, the system is completely private with a few free clinics for the poor people, with people paying with their own money or via health insurance.

Japan on the other hand is a strange mix of the two. In Japan you also pay a national health insurance out of your earnings, but instead of getting a completely free service, you get your medical bills subsidised so that you can afford your stay. All in all, the government pays 70% of the medical bills, while the individual pays the last 30% up to a maximum of 70000yen a month. The hospitals are both government run and privately owned and there is also a get-out clause for the exceptionally poor, unemployed and old. Most of the money for the 30% paid by people comes from health insurance supplied through work.

It seems to me that the reason that the Japanese medical system works so much better than the UK system is that as a whole, Japanese people seem reluctant to consult unless it is really required. Possibly this is because it is not completely free (monetary deterrant), but it might also be the different mentality between the ever-complaining British and Americans and the relatively tactiturn Japanese. Therefore, clinics are not too full, operating waiting lists are short and patients move in and out of hospital efficiently. To give you an idea of efficiency, in America, you can walk into an orthopaedic clinic and get diagnosed with osteoarthritis and have your hip replaced in the same day. In Japan, it might take 3-7 days. In the UK, it takes 6 months. Don’t laugh. It used to take 2 years.

The residents and seniors are really friendly, especially the ones who can speak English. It’s interesting interacting and watching Japanese people here at a social level as well. In the broadest of broad terms, there are two different types of Japanese person (when interacting with foreigners, at least)The first is the “original” type who seems shy and apologetic, always bowing and apologising, while others are rambunctious and almost “Western” in comparison.

I sat in on an English lesson for nurses last night with Dr Gremillion and he made a really good point – that the Japanese have brains that work in a different way to Westerners. In Japanese people, sentences are formulated first in the head and then analysed as to whether they will cause embarassment or shame first of all before being spoken (probably more in the former type of person than the latter type) which makes it sometimes difficult to learn English.

However, as I was saying, the residents here are really friendly. One I have taken to calling “Fukuda-sama” because she suggested it and then told me to stop calling her it in public. I was reminded of Lucky Star ^-^. They don’t really seem different to their English counterparts, except that they work many hours more (not bound by the European time directive – up to 78 hours a week) and for about half the money English graduates get paid for doing half that.

The mentality among Japanese doctors seems to be a scientific mentality rather than a clinical one. In many cases, bad or sparse histories are taken and physical examination is not performed well in favour of a battery of laboratory tests – preferring to use test data and the history to come up with the differentials. In the UK, we have the opposite mentality – since tests are expensive, please come up with the diagnosis from the history so we don’t have to do so many tests! It’s interseting that a student here can go through 6 years of medschool and not see or examine a single real patient. Weird that.

There are many advantages to the Japanese medical system. One is that since there is a thick cultural background, patients tend not to lie, do what the doctor tells them to do and there are many things that can be taken for granted in the history, therefore making more time available for other things. Since Japanese people are humble by nature, Japanese surgeons are probably just about normal (in the eyes of the West anyway, where surgeons see themselves up there with Mohandas Gandhi) and lastly as a doctor (and this is really important), what you wear isn’t vitally important – as long as you wear a white coat over the top. A long way from the UK where we’ve just about banned every item of clothing. Soon we’ll have regulation issue figleaves.

Anyway, in conclusion, the Japanese medical system is great. It works, somehow, with the lowest level of spending for health – third lowest in the world after Turkey and Mexico who are set to overtake Japan in 2010 since the Japanese government has recently pledged to lower health spending O_o This compared to the US where 17 percent of the massive US GDP is spent on health care. (presumably the other 83% is spent on laser-missile-defences ^_^) I might not choose to train here because of the communication difficulties and the cultural barrier, but I really hope I do get to come back here for an educational reason so I can see how far they’ve come in the intervening.

I’ll be heading out to Tokyo on the late bus tomorrow – Whether I post my pics at the weekend depends on whether the capsule hotel I’ve booked for two nights has internet or not, or finding a cheap internet cafe! I’m heading out to Tokyo bay for the first time – to see the Tokyo BigSight in Ariake (the huge monstrous stupid looking thing where Comiket is held) – if not – pictures on Monday.

Over and Out

Yuribou

  

Category: Comment

Comments

6 Responses to “Day 5 – Japanese health system and stuff. If this bores you, DETEITE~~!!”

  1. Caitlin
    March 6th, 2008 @ 1:24 pm

    I love the medical system here. When I go back to the US, one of the top criteria is a good health plan because I’m fairly sure I won’t find anything as good (but I’m hoping for close). :( On the other hand, I have to admit that I like the US dental and eye care plans better.

  2. Kinoshita
    March 6th, 2008 @ 2:33 pm

    Humm…I thought I read somewhere that clinics or hospitals in Japan were overcrowded due to lack of doctors…Strange to read that the clinic were not too full though…

  3. Erica
    March 6th, 2008 @ 2:47 pm

    I don’t know how long you’re going to be in Tokyo, but if you’re around for Comitia 84, there’s going to be a speical Yuri circle section the Yuribu. Also at Big Sight.

    Enjoy!

    Cheers,

    Erica

    Hungry for Yuri? Have some Okazu!
    http://okazu.blogspot.com

  4. morical
    March 7th, 2008 @ 9:36 pm

    In Finland we have decent (as far as I know) health care system… The government pays for most of it. Downside is, that in case you have anything which does not require immediate actions, there tends to be long waiting lists (I waited for 1 year for a shoulder operation). And of course general taxes here are unbelievable high compared to ones in UK and US :(

    But back to my first comment, have you notices any differences in understanding Japanese spoken by females and males? Does the selection of words they use have differences in normal life? I mean in sense of politeness, because for lot of times (in anime obviously) I keep hearing this very polite (and more understandable) tone in the way women speak in general. Men on the other hand use lots of “street” language and basic forms of words, which I find difficult to understand. Especially when spoken fast!

    This is prolly due the fact that we foreigners learning the language are taught the polite version at first…

    Enjoy your time there!

  5. Yuribou
    March 9th, 2008 @ 2:19 am

    Erica – annoyingly, I have no control over when my elective is, so am going home on April 20th missing both the comic market I wanted to go to and Comitia 84 as well. If I could afford to stay here til then and miss out on next block I would, believe me ~_~

    morical – there is a difference, yes. though as I said it depends on the men. some are the quiet types who speak nicely and the others are the loud types that use a lot of slang. I haven’t found a woman who doesn’t use polite terms though…

  6. dr.arshi
    April 9th, 2008 @ 7:06 pm

    Well perhaps this will b a suprise!I m an Indian and i will tell as i see the system from a distance as an observer and then compare it to ours,here in India!
    The US/UK i think have a tendency to over do in health sector!HMO and doctors slugging it out in california shall prove it out!litigation prone is a second thought and a tendency to get poky at everything,by that i would mean, it was unbelievable when i heard lawyers roam in Hospitals, searching for clients and offer free service for litigation!(tht is overboard)!{pls do correct me i m wrong anywhere!}. so are the legal provisions. In a context they are supposed to help patients but who should decide for whom, and to what extent is the question!
    In India its like a WWE!free for all!Govt hospitals,pvt clinics,corporate hospt, nursing homes and what not!choice is wide but results are unknown(we r not statistically inclined nation)!and Govt run Insurance policies,TPA, and Pvt Insurance companies with their own premiums and policies make a murky picture murkier!so what is the advantage!
    as a doctor by the time u graduate,if u have done ur postings seriously, u would have seen atleast 10000 patients!wow!some practical knowledge that!teachers r excellent and knowledge base i high!so indian doctors r good at diagnosing and treatment modalities!
    Nice article tht and some insight now i have on Japanese system!
    what u said i very true!i think there r two ways of looking at medicine as a faculty of science!one,would be to look at it as something u will provide for treating patients and another as a science!science would encompass many things!not only knowledge of treatment but all of it that goes into it!Japanese perhaps have understood it!money driven socities will never find peace and satisfaction no matter how hard u try!

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