* * * * * * * * F R U G A L W A T C H * * * * * * * *
A weekly roundup of how to be frugal in the world's most
expensive country to live (unless you read this!), written
and compiled by Wendy J. Imura.
Regular edition, January 20, 2006 Issue No. 85
- Medical Mystery Explained: Are those Specialists Licensed?
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*** Medical Mystery Explained: Are those Specialists Licensed? ***
Dear Frugal Readers,
The Japanese medical system seems to be full of mysteries.
Why, for example, do the small clinics of private practitioners
seem to advertise multiple, often unrelated, specialties?
Why, for example, does the local pediatrician also offers a neurology
specialty? Are those specialists even licensed in their fields?
Navigating the Japanese health system can be a frustrating process
simply dealing with unfamiliar procedures and languages alone,
without having to worry about these issues.
Below, read some very valuable "inside information" on the
state of the Japanese medical system that answers some of
the questions raised above. The information was related
by a young (early 30s) surgeon married to a longtime British resident
of Japan. Hopefully it will clarify some of these mysteries!
"There is no legal requirement for a doctor in private practice to
have specialist training in the specialties they advertise
themselves for. The only exception is for anesthesiology, where they
must have proper experience and certification. It's impossible to
tell from outside a clinic whether or not a doctor is a certified
specialist or not, as by law hospitals are only allowed to list the
names of their doctors and their specialties, address/contact
details, and opening hours etc. on their signs and advertisements.
Many doctors who are certified specialists will display their
certificates in their waiting rooms, though, and/or a copy of
"[One reason for] this lack of legal requirement for proper training
comes down to the heavy political clout of the Japan Medical Association.
Local medical associations predominantly consist of private
practitioners, and the national medical association primarily
reflects their interests. As the JMA is a major donor to the LDP
(Japan's ruling political party), it's been able to block attempts
to reform the regulatory framework. Even though its influence does
seem to be waning a bit (it wasn't able to stop Koizumi from cutting
the amount doctors will be reimbursed for treatment by over 3% from
this April), [stet.] the framework for private practitioners isn't
going to be tightened up any time soon.
"It's important to remember that surgeons going into
general practice advertise other specialties too, as they won't
attract enough purely surgical patients to make ends meet.
Pediatrics is another similar area: as the reimbursement rate per
patient is much lower for children than for adults, and the
birthrate is declining, it's increasingly difficult for purely
pediatric clinics to survive.
"So to find a reliable local specialist, it seems the first point
is to avoid single doctors who advertise multiple specialties,
and the second is to check the waiting room for a certificate of
specialist certification and an impressive resume."
Wendy J. Imura
PS: Also, how is this information related to frugality?
Well, frankly... it's not, exactly. However, if you are going to
spend money on medical services, it does make sense to choose a
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