Medical Stuff: Avoiding Colds & Finding a Doctor

It’s been insanely windy this week, with the spring wind coming in strong.  The sudden weather change can be pretty rough for some, and even worse for those that suffer from kafunsho (pollen allergies), or what many Japanese refer to as hay fever. Find yourself coming down with something or trying to navigate Japan’s somewhat-confusing medical system?  This post might be able to help.

I’m one of those stubborn American people that don’t go to the doctor unless I’m dying.  I even got, what I found out later, was the flu a couple of years back for the first time in my life, and even then I just stuck to toughing it out on my own.  Maybe it’s because I wasn’t raised in a country with a national health care system, or maybe it’s a whole lot of stubbornness on my part.  Either way I’m weary to visit the doctor, so I always try to focus my efforts on not getting sick in the first place.  This can prove difficult because I generally work with children all day, and we all know that kids are little germ factories.  😉

I’m not a sickly person, so I generally can avoid colds and other nasties by taking vitamins and washing my hands before and after going to the restroom, and before eating.  I also keep anti-bacterial gel on me at all times, which is not only helpful for keeping germs away, but for wiping public restroom toilet seats before using them.  If I start getting some symptoms of what could possibly turn into a cold, I’ll give myself an extra shot of Vitamin C and take some Advil or other kind of Western ibuprofen.  Japanese ibuprofen (and over the counter medicines in general) are more expensive and weaker than their Western counterparts, so if you can I suggest stocking up before you come or whenever you visit home. For extra Vitamin C I swear by these lemon-flavored cough drops for that you can find in any convenience store:

© eringi

Seriously, my co-workers and I agree they do the trick every time.
© eringi

Despite all that, every now and then I still catch something or become slightly injured.  One of the perks of living in Japan is being able to enroll in the national health care system and receive a sizable co-pay on almost any health-related doctors visit.  That said, utilizing the system has a few disadvantages:

  1. The first year is cheap because you have no prior income to calculate your bill from.  After that, it gradually rises each year depending on your salary.  Yearly health insurance is split into 8 separate bills.  I pay around 34,000 yen ($340 USD) per bill.  This is cheaper than many private health insurance schemes in the U.S., but keep in mind that Japan’s national health coverage is only a 70% co-pay, where you’re responsible for paying the other 30%.  Luckily healthcare prices aren’t sky high like in the U.S., but doing a hospital stay or anything like that is still going to set you back a couple of hundred or thousand.
  2. The national health system is mandatory.  If you don’t enroll from the beginning of your stay and you decide to sign up later, you may be hit with back fees for all the years you weren’t enrolled.  Many ALT/eikaiwa companies won’t enroll you in the social health insurance scheme as they’re legally bound to, or might encourage you to dodge the system or use their own private (not legally valid) coverage.  If you plan on staying here for a long time, this probably won’t be to your advantage.
  3. Because the system is mandatory, there’s not really a way to get off it if it becomes too expensive for you.  The only options you have for deregistering are when you move outside the city/town/ward you live in, or when you move back abroad.  When moving within Japan to another city/town/ward, you can deregister from your city/town/ward hall and just dodge it by failing to re-register at your new city/town/ward hall.  But in the future if you want to re-register, you’ll probably have to pay back fees.  I avoided paying back fees for the three years I wasn’t on it by moving and just registering in our new city.   (Yes, sadly it was cheaper to move than pay three years worth of back fees.  Crazy, right?)  This loophole is possible because Japan is still more of a paper society than a wired one, and the offices don’t really have a good communication system between them.

Adding to that, finding a doctor here is can be really inconvenient.  In the U.S. there’s a general family doctor you can go to for just about everything, the dentist, and the optometrist.  It’s really simple and easy to understand.  You only go to a specialist, like a podiatrist or dermatologist, if the problem requires a very high level of care.   In Japan there isn’t any general medical doctor.  Based on what you think is ailing you, you have to go to that specific specialist.  Here’s a general breakdown:

  • naika (internal medicine doctor) – where you’ll go if you have a cold that isn’t caused by nose, throat, or ear sinuses, or if you have problems with your upper body/stomach/etc.  I believe they also do ear piercing
  • jibika (otolaryngologist) – anything having to do with your nose, ears, and throat, including respiratory problems
  • hifuka (dermatologist) – any skin or rash related issues
  • arerugika (allergy specialist) – if you need allergy testing or treatment
  • shika/haisha (dentist) – for general dental needs, but you might be referred to a specialist depending on the case
  • ganka (optometrist) – if you have any eye-related issues (vision tests are performed for free with any purchase at a glasses store, so you don’t need to visit an optometrist for a lens prescription)
  • shonika (pediatrician) – for general children’s medicine
  • fujinka/fujinsanka (gynecologist/obstetrician) – usually one and the same, but not all perform obstetrics (many obstreticians also perform abortions), and generally women give birth at these clinics instead of in hospitals
  • sokubyoka/seikeigeka (podiatrist, orthopedist/orthopedic surgeon) – go to the podiatrist for ingrown toenails or nail infections, but as for orthopedists it seems that there generally aren’t a lot of these in Japan outside of bigger cities, especially doctors making orthopedic prosthetics
  • geka (surgeon) – if you need an operation, but generally I advise you to do this at a public hospital over a clinic if you can
  • biyougeka (plastic surgeon) – I assume they do anything you could get done in your home country, but double eyelid surgery and rhinoplasty to make your nose taller are probably the most popular in Japan

If you’re looking for a more complete list I recommend the one here.  I also recommend finding a clinic where the doctor has more than one specialty or a bigger clinic that houses a number of specialty doctors, that way you save time having to search and sign up for each specialty doctor you could ever possibly need. Finding bilingual care, especially in more rural areas, can be very tricky.  On top of that, many Western medicine trained doctors running clinics in bigger cities may not take national health insurance.

The health care system and quality of medical care in Japan has some advantages and disadvantages compared with the U.S.  I don’t find the medical staff (especially nurses) as friendly as in the U.S., but overall I haven’t had a problem with the care.  That said, I’ve heard some real horror stories from both Japanese and other foreigners so I always try to find kuchikomi (reviews or word-of-mouth recommendations) on any medical facility first before making an appointment.

If you’re unsure of how to find medical treatment or a certain specialist, comment below and I’ll do my best to help out.  🙂

– J

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