The thought of seeing a foreign doctor in a foreign country while navigating a foreign healthcare system can understandably leave Department of Defense (DoD) civilians and their families living and working in Japan in a state of worry. The intimidation of venturing off-installation to see Japanese healthcare providers is an experience many opt to avoid to the detriment of their own health and peace of mind.
But there is not any need to panic – whether you speak Japanese or not, the process of going to a Japanese hospital and/or clinic is very user-friendly, and depending on the type of treatment sought, can be financially cheaper than if you saw a competing physician in the U.S.
Although the prospect of seeing a physician in a foreign country who potentially doesn’t speak English might seem intimidating, the experience of visiting a Japanese hospital or clinic is not frustrating at all.
So, let us navigate together what a general visit to a Japanese healthcare provider experience might be like for a first-time, English-speaking client. If you follow the outline below, perhaps your confidence for seeking treatment off-installation will increase, and even increase your cultural understanding of our partners in The Land of the Rising Sun.
To begin with, most Japanese hospitals will see patients of all nationalities, and often offer support for non-Japanese-speaking clientele to some degree, so choosing which facility to visit often doesn’t present much of a challenge. Once you’ve chosen your venue, it is just a matter of beginning the medical process.
Upon entering a Japanese hospital, you might find yourself overwhelmed by the size of the atrium, lack of familiar faces, or perhaps minimal English direction or guidance – that’s natural, but like any other hospitals, your journey begins at the reception counter, which in Japanese is ‘uketsuke madoguchi’ (受付窓口). If you see these symbols, you will be sure to be greeted with helpful staff members ready and willing to help in your appointment process.
Hazel Oira, U.S. Army Corps of Engineers – Japan Engineer District (USACE JED) administrative support assistant, was referred to nearby Kitasato University hospital, and explained the process for checking-in, and the support provided to her family.
“[Although the initial check-in process] took a time, everything was fine,” Oira said. “[The doctors, nurses, and staff] were how you would expect service in Japan.”
Standard procedure for new clientele at Japanese hospitals and clinics is to fill-out a form asking for information such as your name ‘namae’ (名前), birthdate ‘seinengappi’ (生年月日), place of residence ‘jyuushou’ (住所), contact number ‘renrakusaki’ (連絡先), allergies ‘arerugi’ (アレルギー), and brief medical history – much like you would fill-out at a hospital in the U.S.
Much like Hazel Oira experienced though, checking-in for a first-time visit can take time, as referencing patient history, insurance coverage, and potential military installations can cause delay, just like when you visit a clinic for the first time back home.
Regardless of whether a Japanese translator accompanies you, or you choose to utilize a translation application on your phone, often writing in English or even standard hiragana if you have been practicing Japanese, is enough for most facilities to understand your situation and point you in the right direction.
Once your pertinent details are provided to the reception counter, you might or might not receive a waiting number to take back to your seat, where you will wait to be called to proceed to the next area and see the resident doctor, or as they say in Japan, ‘sensei’ (先生).
It is important to note that, depending on your ailment or illness, the process for seeing a Japanese physician is one that involves multiple visits. Unless your stressor can be resolved with over-the-counter medication, the doctor will likely recommend a second, and sometimes third, visit, to see your recovery through until the end.
William Barlaan, JED’s Operations Officer, explains his experience with multiple visits.
“When visiting a new provider, your first appointment generally does not deal with the issue right away.” Barlaan said. “Additionally, if this is a re-occurring health issue, but it is your first time visiting a Japanese provider, they may want to do tests and other steps that meet Japanese medical requirements rather than just take the medical advice/documentation provided from U.S. physicians.”
Once called to enter the private room of the attending doctor, they will review your previously written form, and engage in conversation asking you in-depth about your ailment. Questions such as ‘when did your symptoms begin,’ ‘are you currently taking medication,’ and ‘do you have any prior history of this particular problem,’ are all common inquiries just like in the states and can be navigated with a combination of English and translation assistance if necessary.
Japanese doctors in general understand foreign patients’ uneasiness related to the language barrier, and as such, their bedside manner is usually accommodating, often involving a second or third nurse in attendance to help support the question-and-answer process.
For Caleb Dexter, USACE JED’s strategic planner, the level of comfort and ease felt throughout his multiple visits to Japanese healthcare providers has come to be one facet of the experience he appreciates most.
“The staff [are] great – very patient, understanding, and attentive,” Dexter relates. “Customer care is top-notch in Japanese hospitals.”
“Generally, the patient’s comfort is taken in mind when it comes to treatments, but provided on a, comparatively speaking, longer timeline and with dosages at a smaller scale than I was accustomed to in the U.S.,” noted Barlaan. “As an example, if I were expecting a quick, “take this strong medicine and go back to work tomorrow” treatment, [in Japan], I might be surprised to hear the doctor telling me to take a couple extra days to recover and giving me a week’s worth of medicine.”
Following the inquiry process, the resident doctor will often provide a recommendation for a prescription to be obtained at a pharmacy near the hospital and will return you to the waiting area ‘machiaijyo’ (待合所) where your payment process will then begin.
Returning to the area where you first arrived, you will wait for the billing reception counter to announce your name so you can provide payment.
Thankfully, the price of healthcare in Japan is much, much lower than the price of healthcare in America, something that may surprise you when you see the total cost of your visit.
Many, if not all, Japanese hospitals accept most major credit cards as a form of payment, but in the case they do not, atriums will often contain several ATMs from which you can withdraw Japanese yen. Bills can be paid in one payment, or even be broken up into multiple payments, depending on your preference.
At this point you can ask for an itemized receipt for the services you received that day. This receipt can be turned in to your American health insurance company for reimbursement for the day’s cost. The amount of reimbursement you might receive varies per insurer, so questions regarding insurance should be directed at your insurance company, not the medical facility.
When asking for an itemized receipt, please tell the reception desk ‘ryoshusho/shomeishou o kudasai,' and a definitively totaled receipt will be provided to you with all of the services rendered during your visit.
“At a military treatment facility, they send you a bill in the mail for services rendered,” Dexter said, reflecting on the differences between the American and Japanese systems. “[Oftentimes in America] you have no idea what the amount will be. At Japanese clinics, you pay the bill on the way out.”
Post-payment, your journey might have you follow-up with the physician at a determined later date, or send you to a nearby pharmacy, where your prescription will be waiting for you with a smiling face and simple instructions for use.
Making a visit to a Japanese healthcare provider might initially seem intimidating, but if you can put some of your fears aside and trust in the kindness of our Japanese neighbors, you might just find yourself frequenting off-installation healthcare facilities more often than you originally thought!
GLOSSARY OF HELPFUL TERMS
At the hospital / clinic
Reception Counter - uketsuke madoguchi - 受付窓口
Waiting Area – machiaijyo - 待合所
Doctor – sensei - 先生
Filling out the medical form
Name – namae - 名前
Date of Birth – seinengappi - 生年月日
Address - jyuushou - 住所
Phone Number - renrakusaki - 連絡先
Known Allergies – arerugi - アレルギー
Paying your bill
Itemized Receipt – ryoshusho - 領収書 - shoumeisho - 明細書
Split Payment – bunbetsuharai – 分別払い
Credit Card – クレジットカード