Opinion

Patient Before Doctor

By CHRISTINE CUNANAN-NOMURA

In recent years, several cases of medical malpractice in Japan have come to light. These include the death of an elderly housewife who was mistakenly fed antiseptic through an IV drip and a baby who had to have five fingers amputated after doctors had over-prescribed antibiotics for him.

Of course, such cases can occur anywhere, even in the world's best hospitals. However, as a foreign observer and a long time Tokyo resident, I am constantly reminded of two things whenever I hear of such cases in Japan: one, the numerous misdiagnoses I keep hearing of; and two, the large gap between Japanese doctors and patients that prompts patients and their families to unquestioningly bestow full authority on their doctors.

In terms of medical equipment and resources, Japan is of course among the top countries in the world. However, many people who have had medical treatment in other First World countries — including myself — are flabbergasted at the frequent inaccuracy of medical diagnoses in Japan.

For instance, over the 10 years I have been in Japan, I have heard of many cases of foreigners being misdiagnosed or mistreated in Japan and who have had to seek medical treatment in other countries instead.

On a recent trip to the United States, in fact, I met an American acquaintance at the airport lounge who was flying to San Francisco and then on to Stanford (which is the location of one of the best hospitals in the world) to be with his wife who was going to be operated on shortly. His wife had decided to have a relatively simple operation done in a well-known central Tokyo hospital and this hospital had botched up the operation, forcing her to get help in the States.

Why do cases like these happen?

There may be many reasons, including the overcrowding of Japanese hospitals and hard working conditions for hospital staff. However, I also believe that the arrogant attitude of some doctors is also partly responsible. I believe that these doctors have become so used to dealing with docile patients and families and to the absence of a checking or questioning system that they have grown less concerned about their patients.

In many other countries, doctors are regarded as profession als who are paid for their services, while patients think of themselves as consumers who are entitled to as much information as possible about their doctors and about themselves. Patients and their families believe they have the right to question and to ultimately decide the treatment to be applied based on cost, degree of pain, chance of success and personal preference.

Furthermore, if a patient has any doubts about the diagnoses given, he or she will first get a second, third or even fourth opinion. It is also standard to receive the complete results of one's tests and to be able to bring these home for reference in case one needs to see another doctor or visit another hospital.

It is important for Japanese patients to be more pro-active about their own health by getting information and discussing options with doctors instead of just passively receiving whatever treatment is prescribed. After all, it is you who will have to undergo the treatment and help yourself recover, and it is also you who will have to pay for it as well.

Shukan ST: Jan. 26, 2001

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