Photo:Alex Proimos on Flickr

Seeing the Doctor in Japan

Well, it finally happened. As seems to be the case almost every year here in Japan, as the summer comes to a somewhat abrupt end and the temperature dips to a far more palatable level, my immune system struggles to keep up. Yes, you’ve guessed it, I got a cold. And it wasn’t just one of those 24 hour colds either. No, dear readers, this was the full blown head cold, complete with migraine like headaches, tickly cough, sore throat, and of course a nose that seemed to continuously switch between totally blocked and runnier than a leaky faucet!

Not to mention that I was coughing up all manner of mucus and other unpleasantness!

Anyway, now that I’ve put you off your lunch sufficiently, I’ll get to the point of today’s ramblings. In short, I was sick, so sick in fact that I had to commit that cardinal sin, that most abhorrent of actions that few Japanese would ever dare to commit. I called in sick and took a half-day off work!

However, it didn’t end there. Once I had phoned in, there was the small matter of going to see the doctor and getting the necessary meds to make myself better.

Photo : MIKI Yoshihito on Flickr

It got me thinking, the whole process around what to do when you get sick is really quite different in Japan from what it is in the UK, probably the US too.

Let’s look at some of these differences in greater detail.

First of all, there’s the issue of actually getting sick and how it affects your work. This will depend on your individual contract of course.

Whilst people from the EU may be used to some kind of statutory sick pay provision, Japan has no such obligations to its workers. Here, sick leave is very much a privilege rather than a mandated requirement. So, you may have the choice of either using some of your annual leave entitlement, or losing a day’s pay.

However, if you are enrolled on government pensions and insurance, which as a worker in Japan is a legal requirement, then if you are absent from work for 3 days or more, you can apply to the benefits office to have around 70% of your lost salary reimbursed. However, the procedure is complicated and will take some time, so make sure you have enough funds to get by readily available in the meantime.

Health insurance may be an unfamiliar concept if, like me, you come from a country that, despite the best efforts of the current government, still has universal healthcare.

Unlike the US, where to date a significant number of people still live without health insurance coverage, in Japan healthcare provision is almost 100%. This is because the Japanese system is something of a hybrid between a public contribution driven system like the UK and a more private enterprise like the US.

In principle, everyone who resides in Japan is expected to enroll in the national healthcare system. If you are a full-time worker, then deductions for both health care and pension will come automatically out of your monthly salary. However, as I have mentioned in previous posts, the line between full and part time worker is somewhat vague, and a number of companies do flout the law in this regard. If you aren’t classed as a full time worker then you still need health coverage and you can get this by going to your local city ward office and enrolling directly there. In this case, contributions can either be taken from your bank account monthly, or you can be sent a form every month for payment at the convenience store.

In either case, your health insurance will cover 70% of the cost of any treatments and medicines you will require when you visit the doctor.

As a rough ball-park figure, I received pain-killers, antihistamines and cough medicine, as well as having some tests done to rule out anything more serious. The total cost to me on the day, including the medicines was about 2,000 yen. You will be required to present both your residence ID card and your health insurance card when you check in at the clinic.

Of course, it’s also important to remember that costs will vary from doctor to doctor.

Another important point to note: depending on where you are from you may be used to calling up your doctor in advance to make an appointment.

In Japan, this is usually not the case. You can just turn up and wait to be seen on the day. However, bear in mind that there are peak times when the clinic may be particularly busy, especially in the case of clinics that cater specifically for children or the elderly. It’s best to try to go at quieter times, such as weekday mornings, if possible.

Also, Japan has relatively few “GP” type surgeries. In most cases doctors will cater to a particular specialism. For example, when I have a cold I go to see an Ear, Nose and Throat specialist, however last year when I had stomach trouble I went to see a totally different doctor. It’s a good idea to do some research ahead of time in this regard so that you know where to go before you get sick.

Another issue, particularly if you are a bigger person like me, is that sometimes Japanese medicines just don’t work as effectively as some of the medicines we know from the US and Europe. If the people who make Neurofen are reading this, please, open up a distribution branch in Japan!

Photo : Evan Blaser on Flickr

There is a simple solution to this conundrum though. Thankfully doctors in Japan are, I have found, a bit more approachable in this regard. If you ask them, they can give you a medicine of increased strength, or in some cases, they may even be able to source the foreign brand medication for you. Naturally, you can expect to pay a bit more for this though, so keep that in mind.

There is also the issue of brand names versus generic medicines. If you are like me, then you probably care little for brand recognition. My phone is Korean, my shoes are a non-descript brand and I’m proudly typing out this story on a mass-produced, cheap, Chinese-made laptop. So as in tech, so too in medicine, I am quite happy to “go generic” and this saves quite a bit of money on my medical bills.

Of course getting sick is never fun, but thankfully Japan has one of the best and most efficient healthcare systems in the world. Rest assured, you are in good hands.

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