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    Twirling dragon Maciamo's Avatar
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    Jul 17, 2002

    Japanese doctors, hospitals and 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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