Going to the doctor

You probably either know or could guess that people think about, and do (or don’t do) health differently in Japan and Australia. In this post I write about some of the things I’ve experienced, heard, or noticed somehow, particularly in Japan.

Why do you go to the doctor?
Growing up, I rarely went to the doctor. It probably helped having medicos in the family, but I don’t think I ever went for an ordinary cold, unless it was with a chest or ear infection or something. An upset stomach would only get you a trip to the doctor if it didn’t go away after a few days or a week. If I went to the doctor, it was to try and find out what the problem was, so that I would either know not to worry because it would get better, or they might tell me how to fix whatever the problem was, and medicine might or might not come into it. I wouldn’t generally take medicine for a cold except maybe Panadol (paracetamol/acetaminophen) to bring down a fever or help with aches and pains.

It’s hard to say what’s different between Australia and Japan here, because I know plenty of Australians who like their Cold & Flu tablets, and I’ve heard of lots of people going to the doctor wanting antibiotics for a cold. But I have the impression that people go to doctors in Japan because they want medicine to make them feel better, which often equates to taking away their symptoms until their body gets over the illness. This impression comes from hearing people talk, and also from the time when a doctor asked me ‘OK, so these are your symptoms. What is bothering you the most?’ That was strange for me, because my main concern was that the CAUSE of the symptoms might be an illness that would ultimately be dangerous in some way.

One thing I’m sure is different in Japan is the concern with fever. I think everyone must have a body thermometer at home, because you’re always expected to know if you have a fever. And while sometimes I definitely know, I’m sure I can’t always tell… anyway, if you call up work to say ‘I can’t work today, I’m sick’ the next question will be ‘Do you have a fever?’ I guess they don’t believe you’re sick until you’ve got a fever. But 37.5 C counts as a fever here, because they always measure under the arm, not under the tongue.

The first time I got sick in Japan, I had a cold with aches and pains and general malaise and lethargy. My company didn’t believe I was sick, so they made me go to the doctor, which meant getting this local lady to take me. But they had to change my health insurance first, which meant going and sitting at city hall for a couple of hours. That was a waste of everyone’s time and money. I knew the problem, it was a cold, and it needed sleep, not dragging my sorry self around the town to be eventually given 4 kinds of medicine, two of which would have made me sick (they clashed with my permanent medication, which was a kind that that doctor didn’t know). The other 2 were harmless, if unhelpful. That being said, the same company sent me to a really useful doctor for another problem a different time.

Ok, so what doctor?

In Australia, if you decide to go to the doctor, the first port of call is the GP. If you’re not familiar with this term, it stands for general practitioner and that’s what you get, a doctor who can diagnose many problems and often treat them, and write necessary referrals to specialists where appropriate. Another way to think of it might be like your family doctor. Of course, if you have an emergency, e.g. you have nailed your hand to a plank, you go to the emergency department at a big hospital.

A hospital is, to my mind, a big building with several departments and many doctors, nurses, and other health care staff. Unless it’s an emergency, you don’t go straight to a hospital in Australia – you set it up through your GP. GPs generally work in smallish rooms in a medical clinic, which can also be called a surgery: a set of rooms where medical professionals work. (The dictionary tells me this is primarily a British usage of the word surgery.) A clinic often has several kinds of doctors, and maybe a counsellor, dietician, or another therapist who comes in on certain days.

No, we don’t really have that here.

In Japan, there are no GPs. You have to go to a specialist, though there are some general-ish hospitals. Where I lived in Gifu there was a general hospital like this. (It only had one doctor, so I’m not sure what made it a hospital as opposed to a clinic.) Now I should also mention that when you go to see a doctor in Japan, sometimes you have to fill in a form about your symptoms, and sometimes, especially if your reading skills are that of an 8-year-old, you have to tell the receptionist what’s wrong. It’s quite rare to get to the doctor without letting anyone know your symptoms and background first. At this general hospital in Gifu, I think they made me both try to fill in the form and also explain to the receptionist. It felt quite awkward trying to explain that it hurt to wee, and where it hurt, especially because one of my primary school students was standing there waiting with his mum at the time (it was the local hospital, my first month in a new town). Once the information was conveyed, I was ushered through the grey door to the inner waiting area where all the patients waited on a bench to get called to this or that nurse and finally the doctor. This waiting area was quite separate from the front one, which was used by people accompanying patients, people filling in forms, or patients who had seen the doctor and were waiting to pay. Back in the inner waiting area, the nurses and doctor at this hospital didn’t close doors to the rooms they were using, so I could hear this mum explaining about how her kid (another one from my school) couldn’t keep food down.

The medical mall

After that place, I found a multi-specialist ‘medical mall’ and while there were some of my students there in the various waiting areas, I didn’t have to do any more awkward semi-public explaining, and the doctor closed the door. That was a relief. They had a mega-reception where they did the accounts and told me where to go to reception for the doctor I wanted to see. I think they gave me the initial symptom/medical history form at the mega-reception.

The shed-dwelling urologist

Then there was the clinic really close to my house that almost never had any patients. It was quite a funny sort of place, because it was so small, it was only the doctor – no receptionist, no nurse, just the doctor. This meant that he had to be the receptionist and call the patients himself. So he would come around to the ‘reception’ area and take my health insurance card and clinic card, tell me to have a seat, then go around the back and come to the doctor door and call my name to tell me to go in and see him. We were the only two people in the building. At reception he was very formal, but in the consulting room he was quite chatty. I think he was probably bored, being by himself in that room every day with only a TV and his paperwork for company. He didn’t do very much paperwork, judging by the state of the reception area, or at least didn’t file it.

What usually happens

For most clinics or hospitals in Japan, there is a receptionist lady (yep, always a lady) who takes your health insurance card and makes you a kind of patient/member card for the clinic, which you then present to her on subsequent visits. Then you go and wait in the front waiting room, until a nurse (lady) comes and calls your name to tell you to go through and see the doctor, or to go and wait in another waiting area where you’ll be called to wee in a cup or get your blood pressure taken first if that’s necessary. Usually there’s a nurse in the consulting room with the doctor too, who can do useful stuff like looking up the medications/products you are using, which the doctor may not know if they’re not often used in Japan.

Most clinics are open approximately 9-12 and 3-6ish Mon-Fri, closed on Thursdays and open on Saturday mornings.

If you go to the gynaecologist (aka the レディースクリニック, ladies’ clinic) in Japan, they will ask you if you’re married, which comes with the ever-popular ‘are you sexually active?’ question. Which comes from the receptionist.

Doctors seem to be pretty mixed in both Australia and Japan, in all ways. I have the impression that Japan is a bit more old-fashioned than Australia, especially in mental health, but my experience is also much more limited in Japan. I haven’t lived in any big cities in Japan, whereas in Australia I live in Melbourne, so this comparison really is just an impression from here and there.

Future health-related posts I’m planning to write will broach such murky topics as sleep, sport, alcohol, and what counts as looking after oneself. And maybe even the health system, though that one will need considerable research.

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