As you would expect, it's not all that easy for a foreigner to visit a doctor in the inaka (countryside). I would argue that communication is the biggest barrier in accessing healthcare, followed at a close second by red-tape.
In Australia if I felt the need to see a doctor, it would simply be a matter of phoning in sick for work and then making an appointment. In Japan however, sick leave (or byoukyuu) is relatively uncommon and accessing it is even harder! It requires approval from the school Principal, BOE approval and documentation from a medical institution - even just for one day! Secondly, the system works a little differently here and if you find yourself needing the services of a doctor, you generally need to head to the hospital to be looked at (as this is where most of the doctors hide!).
Realising, last fortnight, that I needed to see a doctor set in motion for me a rather long winded process. First I had to ask my supervisor to come with me* - telling her what was wrong and trying to find suitable common free-time. Next I had to inform my school and teachers that I was going to be absent for the day and that I would be taking the time off as sick leave, papers pending. Then we had to figure which hospital and what time to go. Here too, there are many types of medical institutions to deal with particular ailments. Some hospitals are general purpose and can deal with most issues, but others specialise in areas like dermatology or pregnancy or health checks only for example.
Having set our sights on Tuesday afternoon, my supervisor phoned the local hospital to be sure I could be treated there only to discover that that hospital stops taking walk-ins after 11am. Unable to make Tuesday morning at such late notice, we rescheduled for the following week and agreed to meet up in the lobby at 8.15am.
The time arrives and I am greeted by a chorus of "ohaiyo gozaimasu"s by every person to pass me as I wait for my supervisor. Finally I see her strolling across the carpark and we enter the hospital together, headed for the check-in desk. A few forms later (all in kanji mind you) and I have been registered as a new patient to the hospital, my file prepared and ready to go. We take directions from the nurse and head to the General Ailment section, where we take a seat and begin the wait.
Two hours and two-dozen-people-in-before-me later and my name finally gets called. I enter through a set of sliding doors and am greeted by a young, Japanese, male doctor - the look on his face is priceless as he realises today he'll be treating a gaikoku-jin (foreigner). My supervisor introduces us and so begins the three-way conversation regarding symptoms, past medical history and my general daily habits. Fairly quickly the doctor realises he will need to refer me to another department and with that we are ushered out of the office, around the corner and into another sterile room. I sit on the bed, replying to the ageing nurse in broken Japanese and occasionally looking towards my supervisor for a bail out. The specialist arrives shortly and I am delighted to discover that she speaks quite passable English and that I am able to converse with her satisfactorily without a translator! I get thoroughly checked out (even the young male doctor comes across to have a gander) and within 30 or so minutes am back waiting at my original seat for the finalised paperwork.
The news is good and the specialist brings me my "discharge papers" herself, instructing me to come back in 3 months (on a Wednesday next time so I can see her without delay) before bidding me "odaijini" (or get better soon). My supervisor and I walk back to the check-in counter, hand over the papers and my bill is charged up. Despite accessing today's medical services without first filing for an insurance claim, my bill comes to a total of 1860 yen or roughly 25AUD. Bargain. I pay the nurses at the register and we take leave.
Before parting ways my supervisor tells me that I need to forward the papers to my Principal (so that I can get his stamp of approval for the sick leave), who should then forward the papers to the BOE (so that they too can give my leave the stamp of approval). She tells me that she will call me when the hospital calls her with my results and finally, at 12.30pm, we say our goodbyes.
Overall, this visit to the hospital wasn't too stressful and I was lucky enough to be able to get everything sorted out in the one go. I can only imagine how hard the process would be to complete successfully had I not had a native-Japanese-speaker accompanying me. I guess the upside to the system here is that having been referred by the initial doctor to a specialist, I was only a short walk around the corner from seeing her and I was able to get looked at all in the same day. The price was also drastically less than I thought it would be and as a result I have decided not to bother claiming these costs back on my insurance now either. The downside of course is having to semi-self-diagnose yourself just to make sure you go to the right place and having a non-appointment system that allows for blowouts in waiting time. All in all, only a mildly awkward, albeit arduous experience and one that I hope not to navigate through again anytime soon!
* Usually I would ask one of my Japanese-speaking friends to accompany me, but alas, he is on holidays at this very moment.
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