Staying healthy in Japan

Features Health - January 29th, 1982

by Elyse M. Rogers

Emergency Medicine

In the last column I discussed the importance of choosing a doctor here in Tokyo because he would be your most important link with proper hospital care in any emergency. But just getting a physician’s name and registering it on your tele­phone list is not enough. Before you can depend upon your doctor in an emergency, or before you can reasonably expect good, personal care during a crisis, you must visit him and establish a rela­tionship. (Please understand that my use of “he” for a medical doctor is in the accepted English language use of “he” for both sexes. There are many fine woman doctors in Tokyo, and they are included in the impersonal “he.” It’s just a bit cumbersome to wade through he/she and him/her time after time.)

Your first visit with the doctor of your choice should ideally be one not connected with illness I or emergency. One adult can go land represent the entire family or you can all go. This first visit “just to talk” is important, but I’ll admit that getting such an appointment can be awkward; many receptionists will keep asking you to explain your medical problem, or try to figure out where you hurt, or if you have a fever, etc. If you do manage to get an ap­pointment, you may have to repeat the question-and-answer bit when you walk into the doctor’s waiting room. But just bring your sense of humor and the much-practiced patience that we all learn in Japan, and it’ll all work out, even though you may get a few stares because “you want to see the doctor and you’re not even sick!” Believe me, it will be worth it, because in Japan your doctor is not only your personal medical practi­tioner, but he’s your vital link to the Japanese-speaking medical and hospital system. He will find you a hospital bed in the approporiate hos­pital either in an emergency or for a more routine hospital stay.

When you do get past the receptionist and see the doctor, just what do you say, ask, or bring? Some of the following suggestions may help.

• Bring any important medical records.

Before you left your home country, you should have gotten copies of any important medical records, such as names of medications, treatments or “shot lists” that will be important to your new physician. The day is over when you can say, “I take a little green pill three times a day that’s supposed to help my heart.” With hundreds of “little green pills” on the market, you’d better know both the medication’s brand name and generic name, as well as the exact dosage. Xerox off a copy of those records before handing them over to your doctor, so you’ll have a copy should you move or change doctors. If you didn’t get that information before you left home, write and ask your doctor there to send it. Be sure to be specific in your requests—for example, “The name of the heart medicine for Harold, and the shot record for Billy.” If you just say “send our medical records,” his office staff may delay because they don’t know where to start, or they might send you a huge packet of records that are better stored in your home doctor’s office files.

• Compile a list of questions or topics you wish to discuss.

On the top of your question list should be, “What do we do in a medical emergency?” Be sure he spells out everything to your satisfaction, including whom you call first (day and night), how you get an ambulance, who arranges for the hospitalization, and what you should do dur­ing the “waiting” period. Be sure to cover, also, just what he considers an emergency. Obviously if you’re in a car accident and are bleeding, it’s pretty clear that you should call for help; but there are other times when the decision is not so simple. Suppose the baby’s temperature goes up, or Harold has chest pains, or Barbara gets something in her eye that won’t come out—these are situations to discuss so that both of you know what to do and when.

Other areas you might want to cover concern telephone consultations, appointment practices, costs and payment procedures, medical insurance forms, etc. Make this list before you get to the doctor’s, and put your question in order of prio­rity, otherwise you might run out of time before you’ve reached the most important matters.

• Be tactful, polite and business-like.

You’d be surprised how many people who are good in business or socially outstanding turn either tongue-tied and subservient, or demanding and belligerent when they visit a medical doctor. A physician is simply another human being and he responds best to the person who is friendly and business-like. Every relationship thrives on mutual respect and understanding, so work at developing that solid type of association.

Choosing a doctor—and making it a point to meet him and talk with him—are two important steps for proper emergency care in Tokyo. In the next column I’ll discuss standard emergency practices for those of you who do not have physicians, or do not have a clear plan of action to follow. I’ll explain the procedure for calling an ambulance, and what to do before and after the ambulance arrives.