Lifestyle Illness: Finding A Medical Professional In Japan

The Highly Specialized Japanese Healthcare System

By Rae DeFrane
August 7, 2020
Health & Beauty

This series is an exploration of my own experiences as a person living in Japan with a chronic illness, insights for those who wish to move to Japan, and a place to make resources and information more accessible and less shrouded in mystery. Your chronic condition doesn’t define you or hold you back from your dream of living in Japan!

No matter how much time you spend pouring over articles and blog posts, or preparing for each and every tiny detail you can imagine, arriving in Japan is a chaotic and unpredictable whirlwind. You can make the proper preparations and set yourself up for success by making sure you have enough of your specific medical supplies to last you for a few months, but to find the right doctor in Japan is a process, and it’s best to leave yourself plenty of time to get it right.

Find a doctor in Japan, before you need one

When I arrived in Tokyo during a particularly humid and heavy August in 2018, my first concern after touching down in Narita international, getting my hands on some water, and keeping my insulin cool in a fridge was finding a doctor. Sadly this need came up much sooner than I had anticipated. My body, raised in and used to a mild West Coast Canadian climate, became violently ill less than 48 hours after starting my new life in Japan’s harshly hot climate. 

I was escorted to an international clinic in Setagaya where I was told it was stress-related and given medication for my vomiting. Actually, I was hit with severe dehydration aggravating pre-existing conditions. 

my body, raised in and used to a mild West Coast Canadian climate, became violently ill less than 48 hours after starting my new life in Japan’s harshly hot climate

Unfortunately, I can’t really recommend this clinic unless it’s an emergency since they slapped me with a surprise ¥25,000 yen fee for my initial consultation—which was not covered under my National Health Insurance… This is not normal in my experience, but the staff was completely fluent in English, which did help while being so sick. Although I was thankfully covered by my National Health Insurance (NHI) the day after my arrival, I had not yet been issued my precious, precious NHI card, which caused some further problems. 

In Japan: no NHI card, no insurance 

health insurance card

Insurance is mandatory for anyone working or living in Japan, but the burden of proof remains with the patient. Rather than having the benefit of that 70% coverage immediately, I had to pay 100% upfront in cash (they had an ATM in this clinic, but some may not) and was told I could submit a claim later. Still, this large sum of money was unexpected, to say the least. I actually had to spend upward of ¥50,000 before I received my insurance card a month later. I was fortunate that I had the funds to make it through this initial start-up and adventure to find a doctor in Japan (which is already a steep cost), but beware that anything can happen with your health and it can happen very quickly.  

TLDR; visit your local city hall as soon as possible, and prepare yourself for expensive medical bills until you receive your NHI card. Without that card, it’s all out-of-pocket at the doctor’s office! 

Your visit to the doctor: the Japanese way

When on a quest to find a doctor in Japan, your first point of contact with the healthcare system here will likely also be a visit to a walk-in clinic to see a General Practitioner (GP). Here, it’s almost unheard of to have a ‘family’ doctor, or for one doctor to handle a variety of concerns for a patient. 

Each and every ailment is actually handled by a specialist. This includes everything from a cold and allergies being handled by an ENT (Ear, Nose and Throat Doctor) to a GP being unable to issue someone like me a prescription for insulin, despite all doctors—even in Japan—knowing that it is required for life for Type 1 Diabetics. 

[…]your first point of contact with the healthcare system here will likely also be a visit to a walk-in clinic to see a General Practitioner

Instead, they will refer you immediately to a specialist, likely at an affiliated hospital. In my experience, some doctors will not take into account your own research or opinions. I was extremely lucky to have met a friend in Tokyo with the same condition as me, and was put into contact with a very kind doctor who took me in as a patient despite her heavy patient load. This is not the norm, however, and is a precursor to the rigid regulations of the Japanese healthcare system. Rigid, I should clarify when compared to the Western ideas of patients having autonomy over their own treatment. 

A different approach

Here in Japan, the Doctor knows what’s best and does not leave room for discussion. There isn’t really an idea of “seeking second opinions” or “knowing what is right for your own body”. In fact, it can sometimes feel very restrictive to be a sick person in Japan due to the authoritarian system even around life-giving medications. 

Doctor taking notes with a patient

In Canada, since my illness has no cure and does not go into remission, I can have “standing orders” for tests and prescriptions to avoid constant visits to my doctor. Not so here. I must see my specialist every two months and only then can I get a prescription, and only for that two-month duration until my next visit. Let me remind you that without this medication, life is not possible for me. 

Similarly, my specialist in Tokyo only sees patients on Thursdays, which was during my workweek at the time. This is where proximity to your particular specialists and therapies becomes a lot more clear. The cost of travel for medical treatment can add up very quickly if they are not in the same town you are. 

But there is not only the doctor…

I won’t sugar-coat it, living in the inaka (Japanese countryside) might be impossible depending on your medical needs. As the rarity of the illness goes up, the number of doctors who might offer the necessary and specialized therapies goes down. Living in Japan is always possible, but this might be a large portion of your research into where you choose to live since you also deserve a convenient life.

For many American readers, Japanese healthcare can seem like a godsend with its 70% coverage of (most) treatments. For Canadians and those from countries with their own Universal Healthcare, however, might find the costs associated with treating chronic illness difficult to swallow. 

I won’t sugar-coat it, living in the inaka might be impossible depending on your medical needs

As a new ALT, I did struggle coming up with hundreds of Canadian dollars on a bi-monthly basis when I started my life in Japan and an expensive city like the capital. There is some relief in the fact that NHI is based on income, so new-comers to Japan will have minimal monthly fees for that coverage (if it is not a benefit included in your job) since they will have no prior income in this country.

Although you can stress that English is necessary for you and your treatment, I have found that healthcare professionals in Japan often embellish the English abilities of their staff. Many (not most) Japanese doctors have some grasp of English or can at least find a nurse who does. If you’re in a city like Tokyo, Osaka or Hiroshima, there is a higher chance of getting a fluent doctor. Sadly the wonderful clinic that I went to permanently closed its doors last year, but there are apps that are designed to assist foreign residents in Japan locate doctors that offer English. 

How to find the right Doctor in Japan: the to-do list

Living in Tokyo was a decision made in no small part for my ease of life in terms of my health. If you also want the easiest life possible when you initially move to Japan, I really cannot recommend the following enough: 

  1. Research your necessary medications/treatments in Japan, their availability, and their legality. 
  2. Research specialists in Japan for your medical needs, where they are located, and really, any information you can. Proximity to treatment can really make a difference in the quality of life.
  3. Memorize terms for your condition in Japanese. Even a handful of specialized terms will make your life easier in the event that you need to communicate with medical professionals, employers, and those around you of your needs.
  4. Consider the practicality of the impact on your daily life in a new country where you do not have familiarity with the healthcare system.

This is only step two in this series shedding light on living with chronic conditions in Japan. We want to hear from you if you have any questions or anxieties about moving so that we can work towards compiling as much helpful information in one space as possible, so please comment below on what would benefit you the most to see in future articles!