Cross-cultural communication （10）　

15）There is a problem with the list of facilities that handle foreigners
　 In 1997, I returned to Japan from France and took over my family's Kido Clinic in Osaka. Of course, my main job was to provide medical care as a family physician in the local community. However, I thought I could make some contribution to medical care for foreigners in Osaka by making use of my previous experience. So, I decided to have Kido Clinic added to the list of medical institutions in Osaka City Hall that can provide medical care for foreigners. The languages we handle are, of course, English and French.

The first patient soon visited Kido Clinic. She was an American woman in her late 20s who was an English teacher. She had complained of back pain, but she seemed to have a lot of complaints, and as soon as she sat down in the examination room, she started talking about her history at a rapid pace, like a machine gun.

She said that when she went to see an orthopedic clinic listed in the city hall's directory that offered English-language services, she was taken for six or seven lumbar spine X-rays without any explanation, and as a result, she was told that she had a suspected herniated disc, and was prescribed a mountain of painkillers, stomach medicine and other medication, and charged just under 10,000 yen for the consultation. In Japan, they don't even ask for the patient's consent or explain what they're doing when they take an X-ray, and they can easily diagnose herniated discs from a simple photo.

In short, she was dissatisfied with all aspects of the treatment she received at the orthopedic clinic, so she came to us for a second opinion. All of her points were things that made sense to me, so I explained the situation to her, giving her reasons for my decision. From the examination, it seemed unlikely that she had a herniated disc. When I offered to prescribe some medicine for her, she said that she had a lot of medicine at home, so she didn't need any. The consultation took about half an hour, but as there were no tests or prescriptions, the fee was just the standard consultation fee of 2,700 yen.

After that, there were a number of patients who came to see me because they were dissatisfied with the treatment they had received at other hospitals. And all of their complaints were about problems on the part of the medical profession, not the patients. This led me to think that there might be a problem with the list created by the city hall. When the list was first created, the only way to recruit medical institutions would be through self-application. However, if you really want to improve the quality of the list, you need to conduct a survey of the patients who visit the clinic and use the results to select and reject the registered institutions. Is it too much to ask the city hall to do that?

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