When you first arrive, it’s a good idea to figure out where a good doctor might be before you actually need one.
You’re Sick or Injured and Need Help
Sick? Take care of it. If you’re sick, please go to the hospital. Japanese hospital staff excel in their work. Most doctors, including general practitioners, are found at hospitals. They will take care of you and help you return to health a lot quicker than if you ignored your situation.
When you’re sick, the first thing you should do is call your office. They will inform schools. They may also want a doctor’s note in order to give you sick leave (byoukyuu 病休). Be clear with your office (particularly if your office goes by the book) when you call in sick, to ascertain if you will asked to take paid leave (nenkyuu 年休) or be given sick leave. It’s best to be clear about this and not be surprised later.
If you have something other than cold or flu, it is a good idea to have the relevant vocabulary looked up in your JET Diary or a dictionary before you call your office to explain what’s wrong. Don’t be surprised if your supervisor visits your doctor after you have been examined to get an explanation of your condition. Your supervisor may also visit your house to see how you are. Try to remember that although this may feel like an invasion of privacy, it is with your best interests at heart.
The Hunt
Try to find out from your predecessor, other ALTs, your JTE, supervisor or other office members, if there are any doctors near you, with whom they have had good experiences. Some cities have hospitals with a specific focus. Tell them that you are looking for someone who can speak English; you could also ask if they know of any doctors that trained in a Western institution. The handy list of clinics, doctors, and specialists in this guide came to us by recommendation from other JETs. Having a specialist who has some familiarity with foreigners can really be extremely helpful in getting you on the road to recovery, or even with a specialized checkup.
If your visit to the hospital is serious and involved, and you will have to be there several times, you can also bring a translator with you. Your city hall may have volunteer translators, or perhaps you could get permission to ask a CIR for help. Keep in mind, if you have extended medical insurance, you may have to reimburse the translator. You’ll also find this website useful: English-Japanese Medical Terms.
Enter Patient
When you go to the hospital, bring your residence card (or alien registration card), your health insurance card (hokenshou 保険証), your JET Diary (for medical terms), and a dictionary. When you arrive, sign in at the reception desk immediately. If you go in the morning, you may have to wait as long as three hours. If you go in the afternoon, you most likely will cut your wait time in half. But remember, in some places, examinations aren’t available all day long.
Signing In
If you are alone and your Japanese is minimal, go to the counter, produce your identification and health cards and use your JET Diary glossary and your index finger. The glossary is extremely helpful and has the kanji and the English beside. If you don’t understand any Japanese, say, “Nihongo ga wakarimasen.” Most receptionists will be able to tell you where to put your name, address, and age and this is usually sufficient for their purposes.
Although some hospitals may have English-speaking doctors, it may not occur to them that you might like to communicate with one. Do tell them this is what you prefer, if it is at all possible. “Eigo wo hanaseru sensei ga irasshaimasu ka” is how to ask “Is there an English speaking doctor?” in Japanese. You will then be asked to sit down, or wait in another area; someone will lead you to where you should sit. Hospital staff are generally extremely kind and courteous. They also may take this time to ask questions about drug allergies and intolerances. So have your information prepared beforehand.
Doctor Doctor
When seeing the doctor, it’s possible that they won’t understand your spoken English, but many will have read English medical papers for years. Sometimes writing things down helps; most Japanese will understand the written word far quicker than the spoken one. After the doctor has examined you, and seems to know what’s wrong with you, ask them to write it along with the method of treatment.
Japanese doctors may be surprised when you want to have your diagnosis explained to you, or have questions about treatment or choice of drugs, or when you ask about what you are being prescribed. This is the part in Japanese culture where the doctor, being far superior on the socially respected professions chain, probably has not had much experience with being questioned as Japanese people do not question their superiors. To ask any question may be misconstrued as an insult. However, if done in a light and curious manner, with the feeling of genuine intrigue, interest, and a smile, the doctor will explain away your curiosity. You may experience thoroughness quite unfamiliar to you, well beyond the necessary scope of care. You may be given a saline drip to re-hydrate you when your illness is minor.
There is also the opposite end of the spectrum. Doctors, if they are unsure, may not make a proper diagnosis, for fear of making a mistake. There have been JETs sent home with ineffectual powders when they really needed penicillin to get rid of streptococcus. If you are ill, and receive little or no treatment and don’t feel better in a couple of days, go see another doctor. This idea may seem strange; to seek a second opinion is unheard of. If you need to give this information to your office, do so delicately, as one does not usually question the authority or wisdom of a doctor here.
Pre-Prescription Phase
You might get a prescription. Although the hospital has already asked and determined your allergies to medication, if the illness requires drugs, some hospitals will give you a small dosage in the waiting room to test for a reaction. A nurse will return and check for a rash or welts and to determine whether you have an allergic reaction. Bring a book.
Fractures – Stepping Lightly Towards Recovery
If you’ve fractured or even lightly sprained something, you will get a cast. The Japanese tend to overmedicate, and over care. Better this than benign neglect. The cast will be prepared, and put on with expertise. You will be given crutches. There will be a discussion of painkillers, which probably won’t be strong enough, considering what we are used to in the West. They will ask you to return to the hospital the following day to check for color change, if they’ve made the cast too tight, or perhaps the swelling hasn’t gone down. At this juncture, embracing the Buddhist principles for patience is a wise thing. You will, over the course of a few weeks have a great deal of x-rays and perhaps a change of cast. You will attend rehabilitation, which can include onsen foot baths, massages and structured exercises.
Exit Stage Left to Drug Dispensary
You may receive your drugs at the hospital, or you may be sent to a specific pharmacy. If this is the case, you will be given the drugs prescription form to take with you. Usually you do not have a choice as to where to fill your script. This may be one of the reasons they send you home with as many four items; when back home, we would get a single pill.
Payment
The government-issued health card pays for 70%, and we pay for the remaining 30%. JET Participants can file a claim with the JET Program Accident Insurance minus the ¥5000 deductible within the limits of the policy, but dependents are not covered. If there haven’t been any x-rays done, casts set, or drugs to buy, actual labor costs are relatively low. Keep all your receipts, including taxis to the hospital, if you plan on filing a claim for additional coverage, and make copies. When it’s time to leave the hospital, you will be given back your health card and a receipt for the treatment. You may also be given a plastic card, as your insurance details will now be on record.
Contributors:
Lauren Piech, Ibusuki City ALT, 2003-2006
Stephanie Held, Kajiki Town ALT, 2008-2009
Kagoshima JET 