Clinical Exchange in Japan

My time in Nagoya has been one of constant discovery and cultural exchange. I have loved the opportunity to engage in dialog with both faculty and students throughout the Pediatrics and Family Medicine department (and I have found the level of English competency to be incredible!). I am extremely grateful for the open and honest answers and spirited discussions we have had, comparing the Japanese and American healthcare systems, customs, and cultures.

As a future rural family physician, I found it particularly interesting to see how the clinics operated in Nakatsugawa and Kachigawa. I felt welcome in both clinics from the minute I arrived, and truly had a wonderful experience meeting the doctors, nurses, and assistants. It was great to see how similar the clinic visits were, and yet how different the dynamic between the patient, nurse, and doctor are in Japan compared to America. In America it is very common for the practice of medicine to feel very sterile and impersonal, which is almost never the case in Japan. The appreciation and level of respect from patient to doctor, and from doctor to patient, was inspiring to witness. The clinic visits felt both friendly and efficient, with no wasted time. I hope to run my own clinic as efficiently one day!

It was also very interesting to discuss the advantages and disadvantages of our respective health insurance systems. While I have a great deal of respect for certain aspects of American healthcare, our insurance system is a disgrace, and I was very curious as to how Japan was managing to insure such a large population. I was impressed by the coverage options and relatively affordable patient payments, the Japanese system is truly set up to allow for anyone to access quality healthcare when they need it. If only America could adopt a similar system!

My rotation was truly highlighted by the daily lunches with different physicians. I loved being able to discuss their careers, dreams, and frustrations over delicious Miso Katsu (and other great food). I find the life of a Japanese doctor to be one of joy and hardship, joy in the completion of a hard days work and hardship in the necessity to hold multiple jobs in order to make a reasonable salary. I was shocked to hear how hard the average Japanese physician has to work to make half of what American physicians can make in salary. The life of any physician is difficult, but I can’t help but feel like Japanese physicians deserve to be compensated better to allow them to spend more time outside of the hospital and with their families. Work – life balance is a very important part of being a happy and successful physician and to prevent physician burnout, but I was told that Japanese physician burnout is not a big problem, despite the inordinate number of hours worked every month even after the completion of training. I do not know how to explain this apparent discrepancy other than to be impressed at the work ethic of Japanese physicians.

I hope I was able to provide some useful insights into American healthcare and culture to the physicians and students I worked with. I am greatly looking forward to beginning residency in a few weeks, and feel that this experience was an extremely useful and interesting cultural exchange that will help me to bring an international perspective to my future training. Thank you so much for the opportunity to work with so many different wonderful physicians!