As far as I know, in the US at least, hospitals cannot refuse patients because they are “not fluent enough in Japanese” (please correct me if I’m wrong – I’m not from the US but lived there for a while).
But this is exactly the situation I am facing now in rural Japan. Flat out refusal to accept me because the doctors and nurses are “not confident they can handle me due to the language barrier” (I do speak enough Japanese for everyday life, so not completely helpless). So I guess I’m supposed to give birth at home unassisted because I am a foreigner? Even though I pay taxes like any Japanese citizen and have Japanese insurance.
Anyway, what I’d like to know is, is it even legal for hospitals here to refuse service based on my Japanese language proficiency? And is there any way to lodge a complaint about it, somewhere? At this point I’m not even trying to get admitted to any of these places (I’ll keep on searching for the one that can accept me as is), I just want to know if there is a way to hold them accountable, or if it’s totally normal here. I get it when it happens at restaurants and bars, but in public healthcare? That just doesn’t sit right with me.
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Hospitals can reject you here. While I don’t know the legality of your questions, when I was pregnant, my hospital’s OBGYN department asked me to bring my Japanese husband along for appointments in case there were language issues. My husband doesn’t speak English, but they wanted a native speaker with me at every appointment to make sure someone understood 100% what was being said. This was at the biggest hospital in Kansai, where they have English speaking staff and pocket translators on hand.
I had a similar issue , but in Kawasaki a couple of months ago … they kept making excuses , first an friend who speaks Japanese rang them to make an appointment and said no that I had to ring and that they spoke English … so I rang and I guess they didn’t speak English… then said my doctor/ clinic had to do it for me … so I went to the clinic and they rang for me then started with the whole is his Japanese good or what ?
My Japanese is not that great but like I went for a deviated septum surgery so not sure why they were so reluctant as you mentioned I paid my insurance, taxes etc….
Can you imagine if the UK or Germany tells a Japanese person will not look after you if you don’t speak German or English !? It’ll be all over the news on how racist they are in those countries!!
Not sure on the legalities and assuming that’s your only clinic / hospital you may just have to keep insisting and just show up … I’m sure they don’t want to argue with pregnant person 😁.. anyway good luck !!
There is a clinic in my city that hires specifically Portuguese speakers in addition to regular staff. The place is very busy with Brazilians. They know where to go when they’re sick. Rightly or wrongly sometimes you just got to find the right place.
Where are you located? In my kind of countryside hospital, we have interpreters for Portuguese and English on site. Every time I go I get asked if I need one.
I’m in the countryside near a middle sized city in the Chubu area. There are a lot of Brazilians because of car factories.
You may be able to find a hospital like that. I’ve had four kids in Japan and given birth at different hospitals every time. Please DM me and I can give more suggestions/advice.
You are also not allowed to be ill on weekends 😉
Lived in Tohoku before and can attest that people there can literally be “cold.” If you are in a place with few resident foreigners then it will be definitely hard to find a hospital that can accommodate you. Health should not be taken lightly and usually, hospitals require you to have a native companion so that there are no misunderstandings. Lawsuits are not as usual compared to US but they do happen.
Best way to move forward is to have your spouse/close friend who is native to accompany you every hospital visit. I understand your point that all tax paying individuals should be treated the same, but sadly there’s not a lot you can do to change the system if you are not talking to the right people or do not have any connections.
Being pregnant is already stressful as it is, I hope that you can find a hospital that will accommodate you OP.
Japanese hospitals are hit and miss, but Japanese OBGYNs are WAAAAAAAAAY more hit and miss.
There’s a HUGE national shortage of OBGYNs and they do THE most annoying shit ever to avoid liability.
We were having our first baby. T-2w: “The baby’s head is really big… might be a difficult pregnancy” T-1w: “The baby’s head is REALLY REALLY big… might need a C-section.” T-0d: “Come in every 2 days for checkup”
… lots of “weird he isn’t coming down… head still getting bigger”
T+1w: “Ok, we’ll admit you and induce labor. But the guidelines say that we can’t do a C-section.”
It was a difficult labor, the baby’s heart rate plummeted, and they ended up doing an emergency C-section.
Mother and child are both healthy now (this was 11 years ago), but we kept saying “oh, well if the head is so big we’d like a C-section since we’re paying out of pocket anyways”… “No… the guidelines say…”
I could definitely see them using some excuse like “the guidelines say we need X for people who don’t speak Japanese… but another rule says we can’t have X… welp, sorry Mrs. Foreigner, our hands are tied.”
It sucks… keep searching. I hope you find a good place.
Long shot, but some towns have lawyers or other such qualified people who provide either reasonably priced or *pro bono* consultations for foreigners. I would imagine that someone like that would have a fairly good idea of the legality or otherwise of this issue.
When they say that, offer them English lessons
Fyi they refuse japanese people for all kinds of reasons as well. This isn’t exactly a racist issue. I don’t understand how they can refuse people at all.
Given hospitals here routinely reject Japanese patients in ambulances (in some extreme cases the patient ends up dying due to being rejected by all hospitals) I doubt there is any legal problem with them rejecting you for not speaking Japanese…
This surprises me because I’ve had a lot of medical issues throughout living in Japan for a long time and have never had this issue, even when I didn’t speak the language that well. I feel really bad for you; this sucks and it is really unacceptable! As you say, you pay for your insurance and you have as much right to use it as anyone else.
I suppose the only option is to keep looking around or enlist the help of a Japanese friend… not sure where you are located and how rural you are but many large hospitals have translation or interpreter services, so perhaps you can ask to be referred somewhere like that? I’m not sure about the legality of your question but my guess is that private clinics and hospitals can pretty much do whatever the hell they want but you might have better luck at a larger university hospital.
Also, not sure if you have any complications or chronic health conditions, but if so, please be aware that most birth clinics will refuse to take you on as a patient just for that alone (this happened to me). Even for something really minor like a thyroid condition, clinics will be really conservative and insist that you go to a large hospital that has a NICU ‘just in case’.
Do you have a general clinic where you go for checkups? Mine is always happy to give me recommendations to more specialized clinics. They might be able to get you a recommendation?
2 kids here, multiple hospitals, country side, little Japanese. No issues
It would be better if you shared where you are and how far you are along. Maybe people can help you find a place.
Typically the largest hospital will have better chances.
The reality is that you really do not want to be in a situation where your life or your baby’s life is in danger and you do not understand. While it may be rude to refuse you now, it may actually save your life. Will you understand when they ask you if you need an epidural, if you need to get a blood transfusion, if your baby has a condition, if you need to change position, if you need to be warned of something, if you need to sign a disclaimer, if you need to follow a breathing pattern, etc…
What I would do in your case is I would plan to give birth in a larger city. Two weeks before birth should be fine. However you should have local backup plan (call an ambulance, have a kit ready?).
This all seems a bit strange though, if you are just pregnant now you are just looking for an obgyn, right? If you are going to give birth in 2-3 months, then who serviced all of your checkups etc? Can they not introduce a place?
Hospitals can reject you here so at this point you need to call your 医療相談窓口 with the help of a Japanese friend to find an English speaking healthcare provider.
What works for me is I just show up and speak whatever level of Japanese I can manage. Google translate the forms with Google lens, write stuff out in hiragana, bring a print out of what you want to discus either translated by a friend or DeepL or yourself, learn the words or sentences you want to say, bring a notebook, and just ganbare. If you ask just about any clinic outside Tokyo if they have English support, the answer is no and panic. Even Japanese people fluent in English will panic and say they don’t know enough to provide English support. What I’ve found is if you show up as prepared as you can be, full on DeepL app out with a pre-prepared print you can just hand to them (I’ve found doctors love this) they are more likely to try to work with you.
Despite everyone panicking the second you ask about English, if you show up and are struggling, they WILL find that one person who knows a shred of English or bust out Google translate to help you. Also, most doctors can at least write in English, since they had to do well on tests to become a doctor. If you directly ask “do you have English support?” the answer is always no, but I live in bumfuck nowhere with abysmal English scores and doctors have still worked with me.
Early on in my time in Japan, I was told to go to a hospital for further testing because my tonsil swelling might be cancer. My supervisor at work called in an appointment for me and when the hospital saw my long foreign name they found the one nurse in the hospital that spoke some English and assigned her to me. Doctors got out a whiteboard or Google translate to explain what I couldn’t understand. Before the CT scan I learned the words for “breath in” and “breath out.” For my final visit they did ask me to bring a translator, so I brought someone from the local English club, but most of my hospital visits were by myself.
I’d imagine it’s really scary for both parties to not have native language support, but it sounds like you are pretty far along and don’t have much choice at this point. If there is no better option like bringing a friend or finding a hospital with actual English support, DeepL a print out of concerns (with space between sections so they can write notes) and hand that to the front desk at an office. If you come across as anxious about your language skills, so will they. If you approach with confidence and effort even in minimal Japanese, they will too.
Over here, in Kanagawa, the hospital’s social worker put me in touch with a non-profit who offers translation services.
You are correct about your first sentence. Can confirm US hospitals actually don’t care at all about Japanese proficiency. Less sure about English proficiency.
the Neuro department in a (good! fancy!) hospital in Tokyo flat-out refused to make an appointment for me if I didn’t bring a Japanese friend, because even though the doctor might speak English, “you wouldn’t be able to handle the admin parts on your own”
I told them I could just try and translate it on my own, but I suppose they didn’t want to be liable in case of any miscommunication
but to be refused when you need help especially neuro help…
I think you need to reach out to the foreign moms network here – join Tokyo Mothers Group on facebook (it says Tokyo but I am under the impression you don’t have to be) or try contacting one of the mods Stephanie Kawai who is a doula directly. My delivering ob spoke English and so I didn’t have this kind of issue but I have seen women talk about having similar issues to this in different parts of the country more than once and people being referred there. While my birth went OK, for various reasons I kind of regret not at least trying to touch base with one of the several English speaking doulas in the country.
From my understanding, the Medical Practitioners Act forbids doctors from refusing any request for examination or treatment without just cause. However, it might be the case that they are justifying it by saying without high Japanese proficiency, they are concerned about the risk of medical accidents stemming from language problems. I’m not saying whether or not this is a valid reason, but it is a common presented reason. I don’t know about the legality of that policy though, I think it’s kind of a grey area.
There are also cases of hospitals making policies against foreigners because they fear “medical tourism” where people travel to Japan for medical procedures then return home without paying medical bills. Though normally those cases, from what I’ve seen, are merely putting strict restrictions on foreigners without resident cards and require any foreigners to show their resident card.
You can contact AMDA International Medical Information Center for medical information though. They’re a non profit group that is meant to provide medical information to foreigners and they could be of help as to what is best for you to do. You could also see if there is a Japanese person you know willing to help you and be a translator for you. Perhaps the hospital might accept that, but that is definitely not a guarantee.
Article 19, Paragraph 1 of the Medical Practitioners Act stipulates that “Doctors engaged in medical treatment shall not refuse a request for examination or treatment unless there is a justifiable reason .”
Unfortunately, as per MHLW guidelines, if appropriate treatment cannot be provided due to language difficulties, it is considered to be a justifiable reason in non-emergency cases.
My wife gave birth in America but her English isn’t great, the hospital and clinic had a translation service they would use where they would call on an iPad a Japanese translator and they would translate to for her during check ups and post birth appointments. I can’t believe Japan doesn’t have a similar service.
I’m really surprised to hear this in Tohoku, but that is only because of my personal experiences with hospitals.
Firstly, [in Japan hospitals can’t deny care](https://www.japaneselawtranslation.go.jp/en/laws/view/4006). Furthermore, The Medical Practitioners Act forbids doctors from refusing any request for examination or treatment without just cause. And a language barrier with the proliferation of translation apps and devices makes it not justifiable.
If a clinic or hospital thinks they can’t help a patient they are meant to refer them to a clinic that can help them. That has been my experience in the past when a clinic has refused me due to not understanding my condition or what ever else.
HOWEVER, this doesn’t mean it’s enforced by anyone.
If you are in Akita, I can’t think of a hospital or clinic in the city or in Omagari/Yokote that would refuse to see you. But again, that’s just personal experience and not to do with OBGYNs.
There are also telephone health translation services available for foreigners in Japan.
Regardless, sorry you’re going through this. Best of luck!
While doing the 88 temple pilgrimage in Shikoku, one temple priest told me of some foreigners collapsing from heat exhaustion and ambulances refusing to take them based entirely on how they looked, without knowing if they have any Japanese ability. Not that it would matter, they were passed out. It gave me extra pause because my Japanese son, born and raised here, looks foreign. Imaging ambulances refusing to help him based on his looks terrifies me.
My argument for this, whenever people say that Japanese is needed for the patient to communicate symptoms/issues etc is that babies can’t speak but no one denies them medical care.
In the UK no one can refuse you for not speaking English, which I’m very glad about.