His doctor took smoke breaks and had my friend attend “kikou” sessions to “compliment” the chemo treatments. The cancer was at a late stage so I guess everything helped. Anyway, the “gift” a.k.a. money passed during the visit was unbelievable. A thank you for treatment at a well-known university hospital. A hospital were my friends father once worked.

My wife and I had very good dentists (both were trained in the US and one liked to practice his English so I found myself in the chair longer than usual). Unlike what I saw in the hospital, the equipment and technology was cutting-edge. Everything computerized, shoot and view, spelled out with reference in English and Japanese. I forgot the name of the dentist but he was located in the Dentsu Building.

Anyway, thank for the great post and comments!

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However, that really pales to what I`ve experienced here, from supposedly English-speaking gyno`s prescribing medications that were apparently lethal for my weight class, to doctors wordlessly slamming doors in my faces to very competent dentists who were just total assholes. And the kicker is I pay MORE here than I ever had in the states. My premiums in the US were a monthly $100 through my office and a co-pay of $5 for most things. Shit.

I think what MattALT said (I think…) about irregular things is very true as well. My friends experiences at the thyroid clinic speaks to it and I think a lot of expat experiences speak to it because I think Japanese doctors assume us to be irregular by default, before they`ve even taken a look.

Simply beyond that though, the thing I am the most upset by and where I really feel care is failing in Japan is the way they deal with mental health. No one I have ever known to go to a mental health facility here has ever come out better for it and in a lot of (personal) experiences they`ve come out worse, batshit insane on too many competing medications or far far worse, dead by their own hands or an accidental overdose when combining one of many medications with the alcohol almost everyone consumes here.

Part of it is cultural, and Japan has a very long history of shunning the mentally ill, but I think a lot more of it is a combination of psychologists here forcing the pills to do their job and using their patients as guinea pigs for whatever new drug a company tries to push at them.

It is not just the FDA, but the absolute compulsion to disregard all international evidence about the effect of a given medication and reinvent the wheel so to speak. The time lag on certain drugs used to good effect everywhere, sometimes based on some faulty notion about “Japanese bodies being different” – ie the pill, ends up limiting the choices of Japanese people. This is particularly true in areas of psychiatry. Btw, even the FDA accepts international trials up to Phase II.

Post-production Japanese trials are perfectly valid, so it would not be a matter of blindly accepting something approved elsewhere – although in NZ we do not do our own post-production trial and have no safety issues- problem here is that there is not enough variety of medications, actually.

Anyway, it might be a moot point, Japanese pharmaceutical companies are finally looking at the money to be made from not only imitating overseas medications years later, but looking to compete in producing new ones which I figure they would be able to do very well.

Why should the US FDA be the be-all and end-all of drug approval? How would you feel about the FDA giving automatic approval to a drug based on a European approval, without even looking at the drug? Or blanket approving any drug from China just because the Chinese government says it is OK?

And I can recall the FDA pulling approval lightning-fast after “bad news” stories.

None of these are unique to Japan, or the US, or anywhere else. Drugs = big business = money = politics.

Secondly, the variability of doctors – possibly Japan might have more than most places, but I have heard horror stories everywhere from everyone. Is their a generational issue at play? The only bad experience I have had is with an 80 year old doctor who looked like he himself needed medical care. Through our various family dealings while in Japan we have found GPs, chiropractors, dentists, psychiatrists and oncologists give straightforward, competent and timely assistance. Something I cannot say for most Western countries I have experienced.

Good doctors in Japan are by no means hard to find – I always do “due diligence” on medical professionals here, I do not see why I would not in Japan either. The extra access, even if it comes at a price, but an affordable one, is something I always appreciated about the Japanese system. @Roy Berman – I agree, the Uni hospitals here are definitely the places to go!

That’s one advantage to being a student at Kyoto University – no matter what you have wrong, they refer you to Kyoto University Hospital. In fact, although I wouldn’t have thought of going to a major hospital like that for fairly routine problems (coming from the American system), you actually can walk in their any weekday morning sans appointment and usually get to see a good quality specialist within a couple of hours.

So, I go to Kyoto U. Hospital for all my medical needs that can’t be taken care of faster and more easily at the on-campus clinic, and aside from their Byzantine scheduling system I really have no complaints. Prices are ridiculously cheap, even without insurance (although I do have it), the doctors are good, record-keeping is fully electronic so if your usual doctor is out they still see your entire file, medications are accurately labeled and given in proper quantities instead of the 2-3 day nonsense, etc. However, as others have said, the waiting time can be pretty bad, and they tend to only accept walk-in registration before 11AM, which can mean delaying a visit for several days.

MattAlt: The moth-in-ear thing happened to my friend Rick a few years ago, and I saw it! I was in the car with my friend Steve in front of Rick’s house while Rick went to get his wallet from his car, stuck his head inside, jumped, and just screamed at us “GUYS, I’m going to the hospital!” and just started the car and took off. We followed him in complete bemusement and arrived to find him checking himself in at the ER desk. After waiting around for about an hour, with Rick pacing psychotically up and down the halls muttering to himself “I can hear it flapping”, a doctor squirted a syringe of novacaine into the ear canal, waited a minute for the moth to die, and then flushed it out with a water spray.