Know when your local hospital is open
Anthony: We’ve been discussing health care a lot recently, but there are a few more topics I’d like to cover. To start, let’s discuss ambulances and emergency rooms. Not all hospitals keep their emergency rooms open for 24 hours a day, seven days a week. If you have an emergency, for example, in the middle of the night on a Saturday, the hospital that’s closest to you, or the one that you’re most familiar with, might not be open, and the ambulance is going to take you somewhere else. That was something that surprised me when I first arrived in Japan.
Amelie: I’ve heard about someone who experienced this before. An ambulance picked him up and had to take him to a hospital that was farther away, but that emergency room was full, so he had to be taken to yet another one. I should say that I’ve never used an ambulance in France, so I can’t compare this to how things work there. Have you used an ambulance here in Japan?
Anthony: Fortunately, I’ve never been in an ambulance in either Japan or the U.S.—knock on wood…
Amelie: Then, we should get Tamon’s input. Do you have to pay for ambulances in Japan?
Tamon: No, you don’t have to. Actually, we have a problem because of this. People call ambulances too much. For example, there have been cases where people called ambulances just to find out how to take their medicine. So, I should note that we have another number to call for these kinds of questions.
Regarding the emergency room issues that you brought up, the reason for this is that we don’t have enough doctors in every city. That’s why sometimes ambulances will have to take you to a different hospital than what you are used to.
David: We’ve been talking about ambulance rides, but there are times when you want to visit a hospital, you don’t want to wait until the morning, and you can get there on your own steam. Before heading out to your nearest hospital, you should check Google Maps or the hospital website to see if it’s actually open.
Anthony: Good advice.
Tamon: Actually, you can easily access this information on the website of your city hall. Keep in mind that the schedule changes from month to month.
Save time and money with referral letters
Anthony: Another useful bit of information that I’ve learned during my time here is that how much you pay out-of-pocket at a major hospital depends on whether or not you have a referral letter from a clinic. Unfortunately, I didn’t realize that during my early days of living in Japan. Back then, I would go to the large hospital that was closest to my workplace. I quickly learned that if you try to go there directly without going to a clinic first, you have to pay a flat fee of 5,000 yen in addition to your insurance-subsidized costs. However, on the flip side, once you pay that 5,000 yen, if you need to get treated again within six months, that fee is waived.
So for routine health issues such as colds and minor injuries, it’s good to stop by a local clinic first. If your problems escalate, the doctor there will write you a referral letter, and you can visit a full-service hospital with no extra charge. Have any of you dealt with that before?
Amelie: I had to go to a large hospital before, but I had a referral letter. What you described is good to know—I wasn’t aware of that system.
Tamon: That’s because large hospitals focus on specialized treatments. If we didn’t have this system in place, too many people with minor problems would overrun the these hospitals.
David: To me, the system is opaque. It’s quite different than in other countries. For example, in Belgium, I never had to get a referral. If I needed to go to the hospital, I just went to the hospital.
Here in Japan, I was once told by a doctor that if my condition didn’t improve, I might want to go to a hospital to see a specialist. It turns out that my condition didn’t get better, so I ended up going to the hospital and the staff there asked for my referral letter.
I said, “Well, I was just told to come here.” So they said I would have to pay an extra 5,000 yen or return to a clinic and get a letter. I wasted a lot of time because I didn’t know about this system. I took time to go to the hospital and was sort of turned away. I felt the 5,000 yen would be a waste of money, so I had to go back to a clinic and wait to see the doctor so that I could ask him to write a letter. He didn’t seem to like having to write the letter and kept asking me what he should write…
Anthony: You have a very interesting doctor…
David: Well, the thing is, I couldn’t go back to the original one. His clinic was closed that day. Because of that, I had to redo the whole original examination. That particular doctor said, “You should just wait a bit and see what happens.” So, I had to say, “I’ve already been through all of that. I’d like to skip that part of the process and just get a letter.” So, in the end, he wrote a letter and I went back to the hospital the next day. But, it was closed… [laughs]
It’s really hard to find out about this system up front. Now I know all about it, but the first time was all trial and error and a big waste of time.
Anthony: In summary, and to wrap up our conversation, the system makes sense when it’s explained in detail. The hard part is finding all of this out when you are new to Japan and have no idea how the Japanese medical system works.
So, I hope this conversation will motivate our readers to learn more about how the system works. If you do that, you’re going to be well taken care of no matter where you’re from.
If you are planning to visit Japan and are concerned about emergency medical treatment, the Japan National Tourism Organization has prepared a dedicated website filled with useful information provided in six different languages. You can visit the site and download convenient PDF guides by clicking here.
This roundtable discussion is an epilogue to our three-part series on healthcare in Japan. To read the previous articles in the series, click on the links below: