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Thread: Japanese doctors, hospitals and pharmacies

  1. #1
    Twirling dragon Maciamo's Avatar
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    Japanese doctors, hospitals and pharmacies

    Pharmacies

    One of the first thing I noticed when I first came to Japan is that there were no visible pharmacies in the streets. In Europe, pharmacies are clearly indicated, usually by a large green cross. European pharmacies are typically spacious and shop-like with a wide window.

    In Japan, pharmacies are hard to find, usually in small backstreet near a clinic, hospital or doctor's office. I remember a hospital's pharmacy near Kyoto station for which it took me 10min to find the entrance, because there was no sign whatsoever; just a door leading a steep stair, at the top of which was a 20cm high hole in the whole where prescription could be exchanged for medicines with minimal eye contact. That's probably not the most usual kind of pharmacy though.

    When I asked Japanese people about pharmacies, they admit that they would not normally walk into a pharmacy and ask for some medicines, eg. for a common cold, as I would do in Europe. Medicines without prescription are sold in drug stores, chain-stores selling everything from cosmetics and shampoo to "kampo" (Chinese herbal medicine), drinks or even food. They are roughly the equivalent to the UK's chemist (e.g. Boots). In Continental Europe, most of these products are sold in supermarkets, except for medicines which are normally sold in pharmacies only.

    It seems that a law was passed a few years ago (from what I was told) making it illegal to sell most Western medicines without prescription. That is probably why Japanese pharmacies do not have to "advertise for themselves" with big signs. Doctors usually explain where to find the nearest pharmacy, so that pharmacies are completely dependent on their areas' doctors.

    Doctors and hospitals

    Another notable difference between Europe and Japan is that Japanese generalist doctors (GP's) almost never seem to receive patients at their home, but in a clinic shared with other doctors, like specialist doctors in Europe. What's more Japanese doctors do not go to the patients' homes.

    In Europe, the usual GP's have maybe 2 visiting hours in the morning and 2 more hours in the early evening, and the rest of the day they spend their time going from house to house visiting all the patients who called them and don't feel good enough to go to the doctor's office. That just doesn't seem to exist in a city like Tokyo (or even all Japan, from what I heard from Japanese coming from other cities or from the country). So if you have high fever, stomach ache and a serious cough and can't move, you still have to walk to the nearest clinic or take a taxi or, call an ambulance (which may explain why 90 percent of them are sent for non emergencies).

    Another difference is that Japanese doctors stop working quite early (often before 7pm) and many don't work at weekends. I asked many people how to do when one needs a doctor or pharmacy at night or at the weekend, and they all told me to go to a big hospital. That may be ok (although inconvenient, especially if one doesn't have a car) in Tokyo, but how are people supposed to do in the (remote) countryside ? To that question I was told that people just call an ambulance, even if the nearest hospital open is over 50km away ! That must cost a lot to tax-payers, as ambulances are free and financed by taxes in Japan.

    In contrast, the "European" system is to have one doctor and one pharmacy of "service" per district that people can call at night and weekends. Of course, these people alternate everyday and weekend among maybe 10 doctors and pharmacies, and the local newspapers or websites announce which doctor and pharmacy will be available for "emergencies" (eg. a bad flu or bronchitis) for each night and weekend of the week or month. I have talked about this system to about 15 (adult) Japanese and none seemed to be aware of anything like similar existing in Japan. They "wait" ("gaman suru") until the next day/2days or if really necessary call an ambulance to a hospital.

    My image of ambulances in Europe was for serious accidents (car crash, etc.), heart attacks or the like, but never for an illness or even a broken arm. However, anything seem to be ok in Japan to call an ambulance. So don't hesitate, as there is often nothing else to do.

    I think it's important to know these things if you are living in Japan.

    If anybody has more information or a different explanation, they are welcome, as my only sources are my Japanese acquaintances and family and my personal experience in Tokyo and Kyoto.
    Last edited by Maciamo; Sep 12, 2011 at 18:03.

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    Ooh, i'm a green belt. Kamisama's Avatar
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    This is interesing, but not as informative as i would hope.
    Last edited by Kamisama; Dec 25, 2004 at 15:25.

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    Nihon ni itai na... wintersweet's Avatar
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    Quote Originally Posted by Kamisama
    and i care about this.. why?
    Oh, let me think.

    I know! BECAUSE YOU MIGHT GET SICK IN JAPAN.

    Perhaps if you start to read a post that doesn't interest you, you could hit the back button and go read something else, eh?

    Maciamo, excellent post--thank you. It seems by the time a person needs to find this kind of information, it's already an emergency. So it's better to read it ahead of time. I was surprised in Taiwan that I had to go to the hospital for a problem I had--in Taiwan, you go to the hospital for all medical issues, not just emergencies or critical problems. It sounds like doctors in Japan are more like in American than in Europe. In the USA housecalls have been virtually unheard-of for decades.
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    I jump to conclusions mad pierrot's Avatar
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    Post Interesting...

    I know Japan some big issues with medications, I suffered from some complications in my transition from the states.

    BUT.....

    Don't take my word for it! Kansai Time Out just publsihed a great article on meds in Japan.

    Click here to fin out HOW EVEN YOU COULD BE A DRUG RUNNER.

    I was most surprised to see that ADD (Attention Deficit Disorder) and ADHD (Attention Deficit Hyperactivity) drugs were illegal in Japan.

  5. #5
    Banned Mike Cash's Avatar
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    I can't understand the trouble with finding a pharmacy. The drugstore variety typically stands out like a sore thumb. The ones which have an actual pharmacist and handle dispensing prescription medicines are also pretty easy to spot.

  6. #6
    Twirling dragon Maciamo's Avatar
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    Quote Originally Posted by mikecash
    I can't understand the trouble with finding a pharmacy. The drugstore variety typically stands out like a sore thumb. The ones which have an actual pharmacist and handle dispensing prescription medicines are also pretty easy to spot.
    Of course the drugstores are everywhere and easy to find (there are 3 within 1min of my station !), but I found it quite difficult to find the real pharmacy. The nearest from my house is 10min walk and I don't know any other less than 30min walk. And I don't live in an isolated area, there are over 15 convience stores with 5-10min walk from my house.
    In comparison, walking in a city like Paris you can't walk more than 2min without stumbling across a (well-indicated) pharmacy. In some European cities, pharmacies are almost as common as telephone booths and certainly more numerous than post offices or even banks.

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    Go to shopping PopCulturePooka's Avatar
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    Quote Originally Posted by Maciamo
    Of course the drugstores are everywhere and easy to find (there are 3 within 1min of my station !), but I found it quite difficult to find the real pharmacy. The nearest from my house is 10min walk and I don't know any other less than 30min walk. And I don't live in an isolated area, there are over 15 convience stores with 5-10min walk from my house.
    In comparison, walking in a city like Paris you can't walk more than 2min without stumbling across a (well-indicated) pharmacy. In some European cities, pharmacies are almost as common as telephone booths and certainly more numerous than post offices or even banks.
    But why do you need a real pharmacy when most drug stores have an attending pharmacist?

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    I noticed a couple of similarities between Finland and Japan:

    - doctors don't come to the patient's home. I know that in some countries doctors visit patient's homes and in Finland we're supposed to have a "personal doctor" system (meaning that you always get the same doctor but it doesn't really always work...) but you always have to go to a clinic or a hospital. The idea of a doctor coming to my home seems really weird to me o_o (we still don't have people calling an ambulance when they have a stomach ache, though) I mean, if you go to a clinic, the doctor is sure to have all the equiptment s/he needs to examine you etc...

    - doctors at clinics stop working "early". Doctors who aren't working at the ER stop working maybe around 6 pr 7pm. This is because you usually have an appointment for a doctor and when you ahve an emergencies you go to the ER. It's not usually possible for people to call to a doctor when they want to. If you have a condition that needs to be treated on the same day, you have to call the doctor in the morning (8-9am) to get an appointment... Is it like this in Japan, too?

    - doctors don't work on weekends/holidays. You have to go to the ER and queue for hours if you want to be treated on a weekend or holiday. It's one of the nicest things to do when you're really in pain -_-

    And one question about medicines. Here it's possible to get the pharmacy to change the brand of your (per prescription only) medication to a cheaper one if it works the same way, can you do this in Japan?

    But why do you need a real pharmacy when most drug stores have an attending pharmacist?
    Maybe it just feels weird to buy soda and meds at the same time?
    When I was in Estonia with my friend, she wanted to go to the pharmacy but wouldn't go in because at almost all the parmacies, all of the products were behidn the counter - you couldn't just browse if they have what you need. It's not all that difficult to ask the pharmacist for what you need, we're just not used to that here ^^ I would've gone in and asked them anyway, though...

  9. #9
    Regular Member misa.j's Avatar
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    Pharmacies are located to near hospitals because people usually go to the hopitals first to get prescriptions from the doctors, which makes it inconvenient for someone who is used to just walk in to the pharmacies to get medicine they want.
    A lot of Japanese people, especially elderly, don't mind going to a big hospital where they have to wait for hours to see a doctor for less than half an hour.

    In old days, your family doctor would come to your house when they were called, I don't believe that's happening in the U.S. anymore either.

  10. #10
    Banned Mike Cash's Avatar
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    Quote Originally Posted by FirstHousePooka
    But why do you need a real pharmacy when most drug stores have an attending pharmacist?
    Most drugstores (in Japan) have some staff wearing a white lab coat. They're not pharmacists, though. If there isn't some sort of sign outside specifically stating that the store fills prescriptions, then it's a pretty sure bet there's no actual pharmacist on the premises.

    As Maciamo indicated, very often the prescription-filling sort of pharmacy may tend to be less than conspicuous. That is because very often they are located within a very short walking distance from a hospital or doctor's office and do practically all of their trade from filling prescriptions. Anyone going there for toothpaste and hair tonic is going to walk away disappointed.

    Until a few years ago, practically 100% of prescription medicines were dispensed by the doctor/hospital and you got the prescription filled under the same roof where you got examined. The problem with this was that the area of which medicines to prescribe was the prime area of the national health care system that doctors could abuse to inflate their incomes. In an effort to address the problem of doctors overprescribing, the government loosened the rules and made prescriptions portable. You can get them filled at any pharmacy, so (in theory) the doctor has no financial incentive to load you up with pills and nostrums you don't need.

    What actually happened was that a lot of doctors became the owners or major investors in small pharmacies located about an anvil toss away from their clinics. They know that most people will get the prescription filled at their place. Either because it is close and convenient, or out of some feeling that it is what they are supposed to do.

    Places which combine aspects of both drugstore and pharmacy under one roof are still in the minority in Japan.

  11. #11
    Go to shopping PopCulturePooka's Avatar
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    Quote Originally Posted by mikecash
    Most drugstores (in Japan) have some staff wearing a white lab coat. They're not pharmacists, though. If there isn't some sort of sign outside specifically stating that the store fills prescriptions, then it's a pretty sure bet there's no actual pharmacist on the premises.
    Many of the places in Aobadai have a pharmacy in the drugstore. Usually a seperate counter.

    Plus I have a few students who are pharmacists (qualified) that work in drug stores.

  12. #12
    Twirling dragon Maciamo's Avatar
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    Quote Originally Posted by misa.j
    Pharmacies are located to near hospitals because people usually go to the hopitals first to get prescriptions from the doctors, which makes it inconvenient for someone who is used to just walk in to the pharmacies to get medicine they want.
    Yes, but why not just have the pharmacy inside the hospital then ? I have been to hospitals in England, belgium and Spain and everytime there was a pharmacy inside.

    Quote Originally Posted by mikecash
    Until a few years ago, practically 100% of prescription medicines were dispensed by the doctor/hospital and you got the prescription filled under the same roof where you got examined. The problem with this was that the area of which medicines to prescribe was the prime area of the national health care system that doctors could abuse to inflate their incomes. In an effort to address the problem of doctors overprescribing, the government loosened the rules and made prescriptions portable. You can get them filled at any pharmacy, so (in theory) the doctor has no financial incentive to load you up with pills and nostrums you don't need.
    Hmm, funny because almost everytime I or my wife went to see a doctor in Japan (for a cold, flu or the like), we ended up with a huge list of medicines to buy, most of which were not necessary (eg. medicines for sore throat and fever when I don't have either of them, and antibiotics, which I need even less).
    I guess they have some kind of arrangement with the pharmacy next door.

    Quote Originally Posted by FirstHousePooka
    Many of the places in Aobadai have a pharmacy in the drugstore. Usually a seperate counter.
    Well, maybe those where you live have, but among the 3 drugstore near my station, only one has a pharmacist (although only medicines without prescription), one has a lookalike pharmacist but for Kampo (漢方) only, and the last one doesn't have any medicine.

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    Junior Member DoctorP's Avatar
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    Quote Originally Posted by Maciamo
    Yes, but why not just have the pharmacy inside the hospital then ? I have been to hospitals in England, belgium and Spain and everytime there was a pharmacy inside.
    All of the hospitals that I have been to have a pharmacy inside. But it is only open during "normal" hours. After hours and emergency prescriptions must be filled outside the hospital. But as was stated earlier there are usually a couple of places just outside the hospital doors.


    Hmm, funny because almost everytime I or my wife went to see a doctor in Japan (for a cold, flu or the like), we end up with a huge list of medicines to buy, most of which are ot necessary (eg. medicines for throatache and fever when I don't have either of them, and antibiotics, which I need even less).
    I guess they have some kind of arrangement with the pharmacy next door.
    They do issue out quite a lot of unneeded meds, but I just refuse the ones that I don't want/need. As for the pharmacies having an arrangement? Usually they do. I know that many of the smaller clinics you see, actually the pharmacy next door is owned by the doctor (but run by someone else). THis way once the doctor retires, he has something else padding his income. Actually pretty smart, but nothing says that you must use that pharmacy...most people I know go to a pharmacy near their home to get scripts filled!

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    遠いから行きません GaijinPunch's Avatar
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    Quote Originally Posted by Maciamo
    Yes, but why not just have the pharmacy inside the hospital then ?
    Well, most doctor's offices in Japan work this way, and is a completely effed up system if you ask me. I went in for a sore throat one time, and walked out with 7 (yes --- SEVEN) types of medication. It's in the doctor's interest to sell you lots of medication... most often placebo. IMHO -- the pharmacy and doctor shouldn't even know each other.

    Hmm, funny because almost everytime I or my wife went to see a doctor in Japan (for a cold, flu or the like), we ended up with a huge list of medicines to buy, most of which were not necessary
    Uh... guess I should've read a little further.

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    4n1m3 0bss3s3d .::b|ue Ash::.'s Avatar
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    Hmm, still sounds better then the deal we've got in America.

    With the exception of the pharmacy usage in Japan, it sounds just like most places in America.

    I've lived in small places (Maine) and larger places (DC area).
    You are extremely lucky if your doctor is open on weekends or past 4-6pm, you are lucky if ANY doctor in your town is open on the weekends, or late.
    A house call? I don't know anyone who does that, I've never had a doctor come to me, that's a foreign concept.
    Our alternatives often are to yes... go to a walk in clinic or hospital even IF you have a regular doctor because it can take days or weeks to get an appointment with your own family doctor.
    Then once you get to said clinic/hospital you are waiting for hours to be seen, and then discharged.

    Unless I'm on my death bed, I usually do not see a doctor. The last time I did was after 3 days with a fever of 104 (right before I left to Japan.) Going to Japan and wanting to be healthy while I was there was really the only reason I kicked my self all the way to the clinic 30 minutes away, to sit for 5 hours and pay $400.00 and then to suffer several more weeks on their extra strength Tylenol "treatment".
    Go go American health system! -_-
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    The Japanese health system doesn't look so different from everywhere else, except isn't maybe more drastic on some drugs (and I certainly agree with that - drug abuse is contained). But what about online pharmacies. Are there any?

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    Cute and Furry Ewok85's Avatar
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    Quote Originally Posted by kamisama
    Interesting that doctors control the flow of wear people get their medicine.. This could be a conspiracy for human guinea pig testing where people test the drugs and if they show good results the doctors report the findings. Interesting...
    So close to the mark and you just don't realise it...

    Quote Originally Posted by PopCulturePooka View Post
    But why do you need a real pharmacy when most drug stores have an attending pharmacist?
    Having a pharmacist does not mean they can fulfil prescriptions.

    Quote Originally Posted by Mike Cash View Post
    I can't understand the trouble with finding a pharmacy. The drugstore variety typically stands out like a sore thumb. The ones which have an actual pharmacist and handle dispensing prescription medicines are also pretty easy to spot.
    The big chain drug stores tend to not carry prescription drugs, but many of the smaller drug stores do have a counter within the store for fulfilling prescriptions.

    .... Which I think is more or less what you said...

    Quote Originally Posted by DoctorP View Post
    They do issue out quite a lot of unneeded meds, but I just refuse the ones that I don't want/need.
    I keep them, and the wife sorts them out and gives them to me if I get sick

    Got enough medical-grade iron supplement and antibiotics to start my own pharmacy at home I think...
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