As I was watching 救命病棟24, a Japanese-style "E.R.", I stopped in the middle to write this article. This time, like many other times before on TV or in real life in Japan, one thing that distrubed me was that the Japanese doctors care more about money than about the patient's health.

In this episode, the main plot was that the hospital E.R. boss refused to accept a patient which he knew had a negative balance on his bank account. I think this kind of behaviour is completely unacceptable from a doctor, especially in a hospital ER section.

This is to put in relation with my earlier observations on the unscrupulous profit-minded approach of Japanese hospitals and doctors (see this article).

I went a few times to the doctors in Japan, but everytime, I was surprised at how fast they inspected their patient, sometimes not even asking the patient's name (because the secretary had already taken it ?), not aksing any questions about personal medical history. In contrast, the doctors I went to in Europe (whatever the country) always took time to try to know their patients, remember their name (and medical history), etc. Whatever doctor I go to (G.P., any of the specialists), they do remember my name and my medical history, even if I only see them once every 5 or 10 years, and they usually inquire about my relatives that also go to this doctor. In Japan, at the doctor's I went to, patients are asked to fill their personal info on a piece of paper in the waiting room (if there is such a thing). From what I asked my Japanese aquaintances, it is not normal for a doctor to remember even their patients' name, except if that patient comes very often.

This is not only true of doctors, but almost everybody. I have just been back to my hometown for the first time in 1,5 years and I was surprised that even the bank staff or my optician remember my name (and even my previous address !) eventhough I hadn't seen them for several years and they have thousands of customers. In Japan, they don't even ask for my name (that is not because I am not Japanese, as they don't never ask my wife's name either).

Although Japan is famous for good customer service, I feel it is still all very superficial - like the incessant "irasshaimase" in shops, that people will repeat automatically even if you walk in and out the same shop 3x in 5 minutes (they just don't care enough to remember that you were there 2 minutes ago).

The fact is that many people working with a large number of everyday customers (bankers, doctors, shopkeepers, etc.) don't seem to care much about their everyday clients. After 2 weeks back to Europe, I was surprised at how people really seemed genuinely interested in each others in Europe, asking questions about their family's health or just how was life, and usually tried to get to know each of them personally. After 3,5 years in Japan, I had nearly forgotten that such a thing was normal "back home". Here, and I am not only talking about how Japanese treat me (a foreigner), but from my observation of everyday life around me, it seems that most shops, banks and even doctor's offices are extremely impersonal. They do their business, get paid, and that's all. Asking private questions is either considered as a waste of time (that is money) or unnecessary (if not even improper).

I don't want to say that Japanese look like automated money-making robots devoid of personal feelings, as they are generally very courteous. What shocked me when I came back from Europe yesterday was how all was so very impersonal and superficial in Tokyo, and I was doubly shocked that patients could be refused urgent medical care if they didn't have enough money.