From school medical checks to hospital visits, the average ALT has several medical encounters throughout their year(s) in Japan. Intrigued by my own experiences within the Japanese medical world, I interviewed 49 foreign English teachers in Japan about their healthcare experiences, and here’s what they said (in a much more condensed format):
Bad providers violate patients’ cultural expectations
ALTs perceived providers that “violated,” and/or did not perform culturally expected practices as “bad” providers. In other words, if a Japanese medical profession didn’t act as expected, the ALT perceived the experience and the medical provider as negative, or “bad.” As an example, one English teacher characterized the difference between a “good” and “bad” doctor. The following is an excerpt that distinguished between two physicians this English teacher encountered while seeking treatment for bronchitis.
“I walk into his [the doctor’s] office and he’s like, ‘Yeah, you’re not healthy I can hear you from outside. This isn’t just a cold is it?’ ‘No.’ Just from hearing me cough he knew that I wasn’t well. He says to me, ‘You either have bronchitis or pneumonia. We’re going to take an x-ray and blood tests to find out.’ Difference in doctor right there! One of them [the bad one] just hands out a diagnosis and is like I think you might need antibiotics and the other [the good one] is like I want to do a blood test and do an x-ray to make sure you need the antibiotics and if they’re the right kind. So that doctor, the good doctor, figures out all the information I needed. The bad doctor, is like, ‘I’m going to give you medicine now. Goodbye. Give me ¥600.’”
This ALT’s experience with an array of Japanese medical professionals within Japan allowed the ALT to construct a comparison and contrast of “good” and “bad” doctors. According to this ALT, good doctors either knew quickly what was wrong with a patient or took immediate action to determine what was causing the patient illness or discomfort as well as how to alleviate it. The “good” doctor sought to understand the patient’s perspective and the illness versus simply handing out an antibiotic which may not treat the illness for a fee.
Throughout interviews with ALTs, “bad” providers were described as:
- Ignited fear within the patient(s) by thinking out-loud and muttering possible diagnoses.
- Provided no verbal or nonverbal cues, especially on invasive exams like pap smears.
- Did not provide an “appropriate/adequate” diagnosis.
ALTs believed that “good” providers should attend to their cultural expectations (i.e., all of those standards and norms for practice in one’s home culture). In other words, “good doctors” should behave and act like one might expect in their home country. For instance, when discussing a positive time with a doctor, one English teacher said:
“People here don’t always smile when they meet you and things like that. As a westerner you think, ‘Oh you don’t like me,’ but no it’s just because Japanese don’t smile. When he [the doctor] first met me, he smiled at me, he introduced himself [in English], and so far it’s all been working out.”
Overall, “good” providers were described in interviews as:
- “Very nice and understanding.”
- “Similar to what I’d experience back home.”
- Had “appropriate” body language.
- Exceeded expectations on providing medical education, understanding, and comprehension to patients.
This study raises the importance of intercultural health communication training. More programs need it. English teachers are placed throughout Japan by numerous organizations and boards of education and are expected to live well. However, that “living well” can be complicated when foreigners expect intercultural interactions to progress flawlessly and as according to their own culture. Some ALTs even chose to not re-contract due to their health care experiences in Japan (and not necessarily because they are in poor health). Scholars argue about “who should adapt to whom,” but that doesn’t really help us in the day-to-day life of a foreigner navigating a medical system (in Japan).
Here are some suggestions, what others do you have?
- Expect difference.
- Do your homework.
- Research the Japanese medical system.
- What similarities, if any, exist between Japan and your home country?
- What differences, if any, exist between Japan and your home country?
- Google Japanese words for common symptoms and your current prescriptions.
- Ask questions to a friend, other English teachers, and co-workers (if you feel comfortable).
- What should I expect when I go to the doctor/dentist/hospital?
- What surprised you about the Japanese medical world? (to other foreigners).
- What over the counter medicine do you find works best for _____?
- Research the Japanese medical system.
- Laughter helps.
- Remember that Japanese medical professionals are trained professionals.
- Insert your tips here ______________!
This blog post is an adaptation of the scholarly article:
Simmons, N. (2016). (De-)legitimizing medical professional discourses: Evaluations from foreign English teachers in Japan. Language & Intercultural Communication, 16(2), 1-18. doi:10.1080/14708477.2015.1113984
Available at: http://www.tandfonline.com/doi/abs/10.1080/14708477.2015.1113984?journalCode=rmli20
This blog post was originally published at: http://jetwit.com/wordpress/2016/10/05/good-doc-bad-doc/