Cross-cultural communication （６）　

６）An attempted case of dodging the consultation fee
　I was on duty in the internal medicine department that day, but before midnight the emergency patients had all stopped coming in, and I went to bed thinking that my shift would end without incident. However, I was woken up at 4 am. When I went to the emergency room, the resident doctor and administrative staff, who had been waiting for me to arrive, told me what had happened. A foreign patient had come in with cold symptoms, and the resident doctor had dealt with the case, diagnosing it as nothing more than a cold and completing the treatment, but when it came to payment, it seems that the patient had no money and was asking for it to be free.

　The patient was a middle-aged woman from a developing country where English is an official language. It was the last day of her trip to Japan, and she was returning home in the afternoon. She said she had run out of cash on the last day of her trip, and asked if she could be excused from paying the consultation fee.

　No way! If you don't have any money, you should have told us before the consultation. This patient was not the first time she had done something like this, so I prepared to logically make her admit her mistake and pay the consultation fee.

　First, I listened to what she had to say. In addition to the fact that she was out of cash on the last day of his trip, she rambled on in fast-paced, rolling English, saying that this was a national hospital and not a hospital that made a profit, so please let her off the hook. An average Japanese doctor would probably have gotten away with this, but not against Dr. Kido, who had been trained in the cutthroat world of Brooklyn, New York.

　“I understand your point of view. First of all, it is not a logical argument that you can get away with not paying your medical bill at a national hospital, no matter where you are in the world. Also, you just don't have the cash at the moment, but if someone else pays for you, then there is no problem, is that it?” I asked her in a deliberately slow and calm tone.

　She reluctantly agreed with my point of view. I could have settled the matter right there and then by telling her how to resolve the problem, but I thought I'd teach her a lesson, so I continued.
　“You visited this hospital before 4 am with symptoms that didn't seem very serious. The resident doctor examined you properly and prescribed the necessary medicine. You say you can't pay for this proper service. The people of your country are known throughout the world as being good at business. Paying a fair price for a fair service. Isn't that the basis of business? Now, let me tell you how we solved the problem. Where are you staying?

　She reluctantly answered this question. It was the International Hotel (no longer in existence now) near this hospital. We called the hotel, explained the situation, and decided to have them procure cash using her credit card. (Our hospital did not accept the credit card then) It took less than 15 minutes to resolve the problem.

　The administrative staff and trainee doctors who had been listening to the whole story next to me thanked me profusely after the patient had left. They said that I had said everything that they had wanted to say but had been unable to say because of the language barrier, and they were so relieved that they almost hugged me.

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