Important points for foreigners receiving consultations in medical institutions.

Transcription

1 Important points for foreigners receiving consultations in medical institutions. (Things we want foreigners to be aware of when getting a consultation) 1.Knowing the types of medical institutions. Medical institutions are divided into hospitals and clinics. Hospitals are institutions that have more than 20 beds and hospitalization facilities. Clinics are smaller institutions. Hospitals are divided as well into those dedicated to acute stage treatments, general medicine, rehabilitation, etc. depending on their characteristics. In cases when a disease starts or the patient s condition changes suddenly, an acute stage treatment hospital is needed. However, when the condition stabilizes, the patient may be either transferred to a general hospital, or be transferred to a rehabilitation hospital in case of in need of rehabilitation. If the symptoms are not too bad, firstly you go to a clinic nearby, and if you are told you need a more specialized diagnosis, getting a referral form and going to a big hospital is thought to be the best step to take. In case of not having a referral, there are cases in which you have to pay an extra 1000 yen or more in addition to the first consultation fee for First consultation cure diagnosis. Hospitals in Japan are not measured by their size or their treatment averages. In other words, a big hospital is not necessarily good and a small hospital is not necessarily bad. The most important point is to choose the hospital with a department that can treat your symptoms. Even in general hospitals, there are some that do not have a gynecology or psychiatry department. 2.Knowing the flow of the consultation at the hospital and the functions of the different places. When going to a hospital, knowing the general flow of the consultation and the functions of each place will help you avoid confusion. (ⅰ) General Reception:In first consultations, they will check your insurance card, fill in your interview sheet and print your consultation tickets. (ⅱ) Diagnosis and Treatment Department (ambulatory) Reception:It is normally next to the consultation room, after registering there, you wait for your consultation. (ⅲ) Consultation: The doctor checks you. There are cases in which you get simple treatments as well. 1

2 (ⅳ) Urine/blood tests, X rays, etc.:when the doctor says so, these simple tests are done in a separate room. (ⅴ) Consultation:There are times in which a diagnosis can be made after the tests while other CT scans and MRIs are also ordered. In this case you make an appointment and come another day. (ⅵ) Payment:You pay your consultation fee at the teller window. After this the prescriptions are printed. There are hospitals in which they print the prescriptions before paying. (ⅶ) Pharmacies outside the hospital:there are some hospitals with a pharmacy or dispensary. However, in most cases you will be told to go to a separate pharmacy to have your prescription supplied. (check Important points when going to the Pharmacy) Additionally, admission procedures are also done when requiring hospitalization. In big hospitals you can find a Medical Counseling Room (also called Patient Support Center). When needing help or wanting counseling on things like transfers to other hospitals, welfare institutions after being discharged or medical fees, it is advisable to go to this Medical Counseling Room. They ll tell you where to find it at the reception. In hospitals with emergency facilities, there is a section reserved for the Emergency Unit. In case of being brought in on an ambulance, procedures are done at the Emergency Reception. Treatment is not given in order of arrival, triage is used and the patients with more critical conditions are treated first. Hospitals have shops and restaurants. You can buy towels, tissues, toothbrush sets, diapers, magazines, food and beverages at the shop. 3.Cautions for the General Reception/First Consultation Reception If this is your first visit, first state your reason (symptoms) and the consultation procedures are done. If your Japanese is not very good, you should print out and bring with you the information found at the website below. It is also useful to bring an electronic dictionary. Manuals for Medical and Dental Consultations in Foreign Language When you are not sure about the department you should go to, explain your symptoms and they ll guide you. If you cannot communicate well your symptoms to the reception staff, they may direct you to the wrong department and you may waste 2 to 3 hours. Please be aware. In case of a follow-up consultation, procedures are done at the Follow-up Reception If you Japanese is not good, ask for a Medical Interpreter to be dispatched to you. The doctor makes his diagnosis through the patient s words, if there is a misunderstanding along the way, it leads to a misdiagnosis. The Medical Interpreter is trained for this purpose and will know and understand medical terminology. 2

3 Even if the patient can speak English, the hospital side may not be able to tend to them properly. In those cases, let someone at the Medical Counseling Room. Sometimes, at hospitals, you may be asked to bring someone who can speak Japanese. In cases like this, please refrain, as a rule, from having children interpret for you, their unfamiliarity with medical terminology and the inherent stress of interpreting may become a mental burden for them. Even in the case of friends or acquaintances, there may be words they do not know or fully understand. Please be aware. 4.Points of caution inside the hospital When going to a hospital, avoid excessive make up and perfume/cologne. It could interfere with your diagnosis. Hospitals are full of viruses and bacteria. It is advised to wear a mask when going to a hospital to avoid infection. Avoid talking loudly in the hallways and waiting rooms. There may be lots of people around you who are not feeling well. Do not run inside the building. There are patients on wheelchairs or carrying IV racks which you could collide with. Smoking is prohibited in hospital premises. If you cannot help smoking, do it in the assigned area. Turn off your cell phone. The signal may affect medical equipment like pacemakers. Use the telephone booths in the hospital or talk outside. 5.Points of caution at a hospital department. Bring your insurance card whenever the month changes. Also bring your disability or lactancy certificates in case of having them. There are some seats in front of the department s reception or the consultation room. Once you have registered, please wait for your turn. If it is a busy hospital, this is the part where you wait the longest. When bringing children, they may get bored. It is advisable to bring toys or picture books to keep them entertained. The order may change depending on the condition of the patient or hospital circumstances. Unless only a particular doctor can give proper treatment and depending on the condition or illness, the patient cannot choose the doctor who will see them. In case of a follow up consultation, an appointment is set and the patient goes to the proper department at the appointed time. However, getting the consultation at right that time is very rare. The appointment time is an estimate of the department and it may be delayed if the 3

4 previous consultation takes longer than expected. Make sure call and let the institution know if you are late. If your schedule interferes with your appointment, make sure to make a cancellation call. There is no need to give any doctor or nurse any kind of personal compensation or reward. 6.Points of caution in the consultation room It is very important to let the doctor know if you are taking any kind of medication for a pre-existing illness. Also notify them if you have any medication and/or herbal medicines sent to you from your country. It is also a good idea to bring the medication with you. Due to the language barrier, there may moments in which you cannot find the right way to ask something. It is advisable to bring notes on what you want to ask your doctor. Sometimes doctors may use terminology difficult to understand. When that happens, do not hesitate to ask. Also, no matter how busy the doctors or nurses look, if you have not understood something, say so. Also ask them to speak slowly and in a way which is easy to understand. If there is still something which you do not understand, write down the Japanese reading and kanji. Even if it is something you think you know, it is a good idea to double-check. Regarding surgery consent forms, sign only after you have read and understood thoroughly. 7.Points of caution in the examination room There are examinations of many types and purposes. Some have very specific instructions, like not eating the day before. Not following this instructions can prevent you from having the examination, so please be careful. Also, remove any metallic accessories when getting X-rays or MRI scans. Let them know if you have any tattoos. There may be additional instructions after the examination like using laxatives, refrain from driving or warnings like changes in the color of your stool. 8.Points of caution when being hospitalized Sometimes a deposit of around 100,000 yen is required. A toothbrush set, a cup, towels, underwear, socks tissues and diapers may also be needed. Listen carefully to the instructions of the hospital staff and gather everything needed. The hospitalization sections of the medical institutions are called Wards (Byoto).They are normally separated depending on the department. Each ward has a Nurse Station which also acts as the Reception of the ward. You may ask any questions you have here. You may hear unfamiliar words like otsuuji (stool), oshousui (urine) or oro(lochia). Do not hesitate to ask when in doubt. Though it depends on your condition, there are places you can shower in at some hospitals. It is 4

5 convenient to ask your nurse about bathing and showering in the ward. Rooms with fewer beds at a hospital are not covered by insurance and an additional charge is made. Fees for private rooms are the highest, costing as much as a luxury hotel. Even rooms for four cost thousands of yen a day in some hospitals. During your hospitalization, you will eat meals provided by the hospital. They are prepared taking into account the nutritional balance required for the patients condition. In case of wanting to bring food to the patient, the relatives must ask the nurse first, as, besides cases of injuries, some foods may actually worsen the patients condition. General care for the patients (feeding, brushing, changing, disposal of stool, etc) is given by the nurse. Relatives do not need to do practically anything. There are specific hours for visits. It is convenient to check the hospital s website beforehand. There is also a procedure for visits you need to follow. You can enter the ward after finishing the procedure either at the hospital s reception or the ward s nurse station. Please keep quiet when visiting a patient. 9.Points of caution in Gynecology and Pediatrics In Japan, gynecologists are not necessarily women. As soon as you know you re expecting, look for the medical institution you will deliver at. It is not uncommon to hear that women who did not start their monitoring early were rejected by institutions when looking for one in haste, already late in the pregnancy. Sometimes Motherhood Seminars are done at the hospital. Be sure to attend them. Also, make sure to carry your Mother and Child Health Pocketbook at all times. Regarding information about pregnancy, download and print the information in the Mom and Baby series on the website below. It is also available in English, Chinese, French, Korean, Portuguese, Tagalog, Vietnamese, Thai and German. Mom and Baby Series 10.Points of caution at the teller window Medical fees are paid at the teller window, where you also receive your prescriptions. Large hospitals may have an automatic payment system. For example, a monitor will show Bills up to number 1357 have been calculated and if it matches your number you can pay at the Automatic Payment Machine. As there are hospitals that can take credit cards, there are those which only accept cash, so be careful. If paying everything at once is difficult for you, tell them so at the teller window. There are cases in which you can pay in installments. If you do not have any kind of public insurance, you may have to pay 100% or 200% of the bill (the percentage varies with the hospital). 5

6 To get insurance you need to make a monthly payment based on your income. This is conceived as a system in which many healthy people support a part of the ill and injured and members pay monthly so they do not have to worry about their medical bills in the remote case they get sick or injured. As such, the insurance is not something you get only when you are sick. Make sure to get an insurance so everyone can provide the support. (However, there are cases, like with short stays or depending on immigration status, in which you cannot get the insurance.) 11.Points of caution at pharmacies outside the hospital Most hospitals only provide the prescription, not the medication. Pharmacies outside the hospital are the place to get it. You can get it in any pharmacy but there are some which may not have the medication you need. In that case, look for pharmacies around the hospital. You will probably be able to supply your entire prescription. Prescriptions are only valid for 4 days (issuing day included). Once this period is up, pharmacies will not be able to provide the medication. You will have to need another consultation. When getting the medication, the pharmacist will explain the way to take/administer the medication, listen to him/her carefully. There may be differences in the way medication are used between Japan and your country. However, do not decide by yourself when to stop taking it. Even if you feel it is not working, do not increase the dose by yourself. Always talk to your doctor first. 6