I moved to Japan in the end of May, and I recently made a brief return trip to my home country (USA) for previously-planned surgery and I experienced complications stemming from previous surgeries I’ve had when I was very young. TL:DR, my doctor said “Wow, you have internal scarring everywhere, if you ever get care in the future they are going to want to know about this because it makes everything more complex and difficult”. Although I’m planning on staying in Japan long-term (5+ years) and have already signed up and paid for the National Health Insurance, I have not used the healthcare/hospital/clinic system in Japan yet and I feel a bit like a fish out of water with the Google searches I’ve made. Please bear with me, I’m new to this and my Japanese really isn’t where it would need to be for any of this. If I’m wrong about anything, please correct me.
From what I can tell, primary care is much less of a thing in Japan, with people going directly to specialists for most care and to hospitals for everything else. It is my understanding so far that although the insurance is on the national level, that actual care is on a fragmented, specialized basis and referrals for specialists aren’t required. I don’t mind going to specialists and informing them of the relevant medical history that I have, and I understand that I will need to be re-diagnosed for most health conditions that require medication. That’s fine. **My main concern is regarding transferring medical history for things that are not easily diagnosed independently, or would be invasive to do so (such as internal scarring). This is especially true in case of future emergency.** I don’t want to make assumptions based on my experience in the USA, which I understand are likely completely different from Japan.
Is there any sort of shared medical records between specialists (at private clinics?) and hospitals? If I wanted to try to provide context of medical history and conditions proactively so that it is accessible in urgent situations, where would I go and do you have recommendations about how to go about this? Should I get my current records professionally/medically translated into Japanese from English, or would they just be disregarded in favor of re-diagnosing me themselves (typically speaking, I know each place might be different) ?
I am genuinely worried that at some point in Japan, I will be in an urgent/emergency situation regarding at least one of these conditions where knowledge of the medical context of my situation would be extremely helpful but that I will be in no shape to provide a stack of documents, explain in Japanese (or even English, honestly), etc. If primary care isn’t super common and without knowing the situation of record sharing between public and private health entities, I’m very confused about how I should go about this. Any insight or guidance would be helpful. Please enlighten me, I have no experience here and just don’t want to be in for a (possibly preventable?) world of hurt. Thank you.
If it helps, I’m in the semi-inaka of Hiroshima prefecture.
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I’ve seen clinics here that are paper-only with no off-site or digital system at all. I wouldn’t hedge your bets on being able to submit anything to a network (unless it’s a hospital / university network).
Getting them translated may help.
* From what I can tell, primary care is much less of a thing in Japan, with people going directly to specialists for most care and to hospitals for everything else. It is my understanding so far that although the insurance is on the national level, that actual care is on a fragmented, specialized basis and referrals for specialists aren’t required.
I’m just going to take a bunch of what you said and comment inline like this.
Most people go to clinics (クリニック) or 内科 (naika, internal medicine dept) at a hospital for primary care. For example, if I have some minor medical issue or want a flu shot. In my experience these have been pretty hit or miss, don’t feel tied down if you go to one and don’t like the way the doctor treats you!
For a more specialized issue you generally CAN go to the specialist right off the bat, but depending on the place they may need a referral. Referral can be from the primary doctor of course.
BTW, ambulances here are FREE, do not hesitate to call one. <– as an American, I wish someone told me that
* Is there any sort of shared medical records between specialists (at private clinics?) and hospitals?
Not really… not at the level we have in the US at least.
When you go to a new clinic you will have to fill out the same type of intake form where you tell them any meds you are on/conditions you have. This can be expediated if you keep a list of all this vocab in your phone and copy from the screen each time. If your Japanese is lacking, write something up on a PC and just print it out for each new doctor you need to go to.
You will get a pharmacy book （薬手帳 kusuri techo) upon your first pharmacy visit here, and that is where info about any meds you are on can be stored. When you get something new the pharmacists will print out a sticker with the drugs name/dosage/etc and put it in. Most of these also have a section in the front/back to write any chronic conditions/allergies/etc.
* If I wanted to try to provide context of medical history and conditions proactively so that it is accessible in urgent situations, where would I go and do you have recommendations about how to go about this?
Write down a timeline of important diagnoses/surgeries, keep this on you at all times or present it to doctors as needed.
This will be further down the line of course, but if any doctors here know about your condition you can direct the person you want to provide context to to them. For example, maybe you are in an ambulance for an allergic reaction, you can tell the EMT that you got your epi-pen from xyz hospital, and to call them for more info. EMT and/or whatever hospital you end up at will call this doctor and get your relevant medical info.
* Should I get my current records professionally/medically translated into Japanese from English, or would they just be disregarded in favor of re-diagnosing me themselves (typically speaking, I know each place might be different) ?
In my experience, as someone who has had multiple conditions/surgeries diagnosed overseas, doctors have always taken my word for it. Honestly, I went to a doctor here and said something to the effect of “I have (illness), I’ve been taking (medication) for it for (number) years overseas, can I please get the same drugs going forward from you?” and got it without issue. Of course, ymmv depending on the meds in question; some medication simply is not available here.
If you do not have the Japanese ability and/or confidence to explain the issues yourself, get a translation, it won’t hurt.
I’ll add my experience. I came to Japan with a diagnosis of an autoimmune disease that is not very common here. I also had a prescription to manage it. I came with a decent supply but wanted to get everything setup pretty quickly so as soon as my insurance was setup I went to see a rheumatologist so establish a relationship for further care and continuing medication. The doctor wanted to see my records so I was able to get them in PDF form from my US rheumatologist once he saw that everything has been a piece of cake. When I need more medication (which is annoyingly expensive) I just ring him up and arrange a visit to go pick it up.
In regards to your question of medically translating your documentation, I think it really depends where you are located. Are you in a big city like Osaka or Tokyo? Many doctors read and understand English and can work with medical documentation that you provide. The most important thing is to probably print it. Again it really depends on where you are and how you access care.
Also, I worry that you might be in an emergency situation at some point where you might not be able to verbally advocate and in this content it would be good to keep a paper trail. In my own anecdotal experience, I find that Japanese doctors respond really well to paper documentation and will take the time to read and look at prior x-rays etc. I encourage you to at least have dates of past surgeries, medication and outcomes documented. In the Japanese system people have a pharmacy notebook where they track medications (although doctors tend not to look at it and it’s mostly the pharmacist). You could make a medical notebook in English and Japanese to ease the burden of care.
Sometimes it’s worth tracking down a specialist and paying the extra shoshin fee. It really depends. For example my wife travels from Kansai to Yokohama to meet with her trans care specialist. I would start asking around your community about where your friends go to access medical care. If you have a defined medical condition you can look up a specialist at a hospital and go from there.
Good luck! Hope everything gets easier.