Staying healthy in Japan

Features Health - October 7th, 1988

by Elyse M. Rogers

Atsushi IWAMOTO, M.D., Ph.D.

It’s hard for me to believe I’ve just finally met Dr. Atsu­shi Iwamoto after almost eight years of writing about health and medicine in Jaраn. The doctor has his clinic in the Imperial Hotel and, since I spent many days at that hotel when I first arrived in Japan before moving into our Moto Azabu apartment, and I’ve been a frequent visitor to that fine hotel many times since, you’d think I’d have run into this physician at least once.

But, happily, I’ve now had the opportunity to interview him and add his name to the list of the growing number of physicians who attend to the foreign community here in Japan.

CLINIC IN THE IMPERIAL HOTEL

I mentioned the location of the clinic and that’s an im­portant factor in this doctor’s practice. For not only does Dr. Iwamoto serve the general public; he acts as the unoffi­cial hotel physician (I say “unofficial” since his clinic is its own entity and not owned by the hotel) and takes care of guests if they become ill. He is also on call most evenings and, if he is not available, Dr. Ishikawa, who I’ve introduced before in this column (office in Roppongi) takes the calls from the hotel.

The clinic is located on the 4th floor of the hotel and is a small but well-equipped office. The day I was there it was teeming with patients, mostly Japanese, although the doctor estimates that about 15-20 percent of his patients are foreigners.

Being located in the Imperial Hotel is a real advantage for foreigners, even if they are city residents rather than hotel guests, because the hotel is well known and easy to get to. Some physicians’ offices arc very difficult to find, as many of you know. In addition, should you get lost between the lobby and the fourth floor, or if you should forget the number of the floor, English language help is always available in the lobby.

BACKGROUND ON DR. IWAMOTO

Most of the doctors I profile have fine credentials and varied experience, and Dr. Iwamoto is no exception. Let me give you some highlights:
• Graduate of Tokyo University Medical School.
• Ph.D. from Tokyo University, with a major emphasis on liver injury and disease, including chronic hepatitis, cirrhosis and cancer.
• Post doctoral research at Harvard University in nutrition, for almost three years. (His youngest daughter, Amy, was born in Boston.)
• Started the Japanese Student Scholar Association of America, Inc., while he was at Harvard, to help other Japanese students with the problems of living in a foreign country. Put out a monthly newsletter for the organization.
• Returned to Japan to clinical practice and later to industrial medical research for a major international pharma­ceutical company.
• Started his own clinic in the Imperial Hotel in 1975.
• Official physician for the Suntory Cup (tennis tournament) and other ten­nis tourna­ments includ­ing the Toray Pan Pacific Open.

THE DOCTOR’S PRACTICE AND PHILOSOPHY

Dr. Iwamoto is a specialist in internal medicine but treats all types of patients, including children. He is particularly interested in preventive medi­cine and gets many patients who wish to work on a health program because they’ve heard of his interest in this field.

Since it’s rare to find a physician so focused on nutri­tion, I asked Dr. Iwamoto about this area of medicine. This is a subject about which he feels strongly and thinks it should be more of a priority in clinical practice. Unfortu­nately, the government doesn’t pay for the doctor to do nutri­tion counseling, so there is little economic incentive for physicians to concentrate on this area.

I should mention that re­cently health insurance pay­ments for nutrition counseling have been authorized, at the somewhat astonishing fee of ¥200. (What can anyone do in Tokyo for ¥200? Not buy a cup of coffee, or step into a taxi, or…)

Anyway, the doctor does in­clude nutrition counseling in his program since he feels the quality of life of the individual can be enhanced by good nutrition. He has a well-known dietician who helps him—Miss Nakata.

Along with diet, the doctor recommends an exercise pro­gram, and he himself remains a dedicated jogger. For a while he had an Exercise Team he organized that met every Sun­day morning in Yoyogi Park, but he laughs and says the club petered out. Seems that at first there were about ten people, then five, then a few, and finally he was the only participant.

The doctor has put out a booklet for his patients, (only in Japanese), with recommendations for a good, healthy life-style for them to follow. There is a big NO SMOKING sign in the doctor’s waiting room. The doctor believes in the “no smoking” idea, but still smokes cigarettes himself. So, follow Iwamoto-Scnsei’s example in jogging and nutri­tion, but in the case of smok­ing “do as the doctor says, not as he does.”

CONSULTANTS AVAILABLE

Although Dr. Iwamoto has no full-time doctors helping in the clinic, he has a host of specialists who come in once or twice a week. These speci­alists cover the following areas: cardiology, opthalmology, endocrinology, orthopedics, diabetes, nephrology and gas­tric endoscopy.

Thai’s good news for for­eigners who want access to specialists, which is often dif­ficult since in Japan it’s usually done by physician introduc­tion. To see a specialist, the patient must first go to Dr. Iwamoto for general diagnosis, then will be referred to the appropriate specialist.

COMMITTEE TO STUDY HEALTH CARE FOR FOREIGNERS

I learned through Dr. Iwa­moto of a new group dedi­cated to helping foreigners find good medical care in Tokyo and I am always pleased to hear of such groups. The group of which Dr. Iwamoto vice president is one in which several physicians are associ­ated, as are several members of the Kaseisho (Ministry of Health and Welfare).

Heading the committee is Professor Gungi, M.D., of To­kyo University. The group is stilt in the developmental stage but hopes to become more active. One of their first plan­ned projects are surveys of both adult foreigners and for­eign students about the type of medical care they are receiv­ing and the problems they are having. Such data should be very helpful so I wish them much success. Dr. Iwamoto has promised to keep me post­ed, so I’ll pass on any new developments as I receive them.

On his own. Dr. Iwamoto, because  of  his concern for foreign students in Japan, a   special arrangement with Hosei Daigaku to treat their foreign students for a reduced fee. Pretty nice gesture, wouldn’t you agree?

CLINIC HOURS AND FEES

The clinic is open Monday through Friday from 9:30 a.m. to noon, and 1:30 to 4:30 p.m. (Closed on Saturday, Sunday and holidays). Appointments can be made, but drop-ins are also welcome. The doctor does not actively practice in any hospital but will refer patients needing hospitalization or acute care to other physicians. For foreigners he usually uses St. Luke’s International Hospital; for Japanese patients he refers them to Tokyo Universi­ty Hospital.

The doctor does accept Japanese national medical in­surance (kenko hoken) that treats many foreigners who do not have that insurance. He will give a detailed receipt of treatment, including the diag­nosis, for foreigners who need that information for their in­surance companies. Fees vary for private patients, depending on the time and treatments necessary, but usually the first-visit fee runs from ¥3,000 to ¥6,000, X-rays, lab work or EKGs, etc., are extra.

When you call the office, most of the staff of four speaks enough English to handle the call. If not, the doctor’s wife also works there, is happy to help and is a good English speaker.

Dr. A. Iwamoto, Imperial Clinic, Imperial Hotel 4F, 1-1-1 Uchisaiwai-cho, Chiyoda-ku, Tokyo 100. Phone 503-8681.