how NOT to get a diagnosis at the doctor

Not long ago I wrote a how-to for translating medical terms – handy if you are in a bind or without a human translator. Now, whether you go and try on your own or take someone along with you, I’d like to offer a few points from my own exasperating experiences.

I’ve read about others’ great experiences at the doctor or hospital, indicating no problems whatsoever. Good for them and good for you too, if you are also so fortunate (no sarcasm). Though not all of my visits were traumatizing, the good majority were. And just to clarify, I have gone to several different hospitals and specialist doctors over the course of two years. By several I mean at least once a month if not more, such as during my long stretch of labrynthitis last winter (full story here) - something that only my doctor in the U.S. was able to diagnosis after three months of trying to get a diagnosis in Japan (Shizuoka).

Another thing to keep in mind is that most of my visits are in and around Shizuoka prefecture, so of course things may vary depending on location (and probably much easier in Tokyo or another metropolis).

How NOT to get a diagnosis at the doctor

1. Tell the doctor you are going for a second opinion – especially if he is male, and over 35. Every time my husband or I mentioned we were going to another doctor, or that we saw another doctor, they took offense. They take it to mean that they are incompetent, or a strike to their manhood, or something.

2. Question the doctor - often. In Japan most people generally defer to a doctor’s opinion no matter what he or she (but usually he) says. Questioning them questions their authority and can be taken offensively. I’m not sure how this process goes in other countries, and I know some chauvinistic, male doctors in the U.S. can also get offended, but in general, many middle-aged male doctors in Japan can’t seem to deal with it.

Every time I went to the doctor with symptoms of fatigue, dizziness, light-headedness, motion sickness, etc., they told me over and over it was stress. They would turn to my husband and explain that I should see a psychiatrist. (Um, yeah, because that makes sense. See a psychiatrist who can’t even speak my language? Literally and figuratively.) Insisting it wasn't stress questioned their all-knowing wisdom - they didn't seem to understand their constant suggestions for psychiatric help were probably causing me more stress than my illness.

However, female doctors I’ve seen in Japan are much more open to questions, though I’m sure it depends on the doctor. Anyway, once you’ve offended them, they probably won’t care to help you anymore. My advice? Try to find a doctor who is willing to answer your questions – and don’t be discouraged if this proves difficult.

3. Tell them the medicine they prescribed isn’t working – I don’t know why this one irritates so many doctors, but it does. Some of the prescriptions I’ve received have worked for certain issues, but most haven’t (because the doctors couldn’t diagnose me and were essentially guessing as to what could be wrong). So when I returned for a follow-up to explain that my symptoms had not changed, they became annoyed and insisted I take it longer. Of course, I usually emphasize (politely) that I am not keen on taking it longer because it isn’t helping and don’t prefer to fill my body with drugs unless they are doing SOMETHING. I think that goes through one ear and out the other. Though I’ve had better luck with female doctors.

4. Refuse to take the medicine. – It’s highly likely this will insult, offend or anger them – maybe even all three. To avoid this negative reaction, you could always get the prescription, just not take the medicine and lie about it later (or never return). Simply refusing straight-up though can be, and often is, taken offensively.

5. Go to a specialist outside of what is likely wrong with you – Maybe this is just Shizuoka, but regular family practice doctors (similar to the U.S. - I'm not familiar with other countries) seem few and far between. Most doctors outside of hospitals seem to specialize in something, whether it is internal medicine, gynecology, pediatrics, otolaryngology (ear, nose, throat), gastroenterology, allergy, etc. Though internal medicine doctors are often who you would see for general problems, they probably won’t be able to help you if you have, say, labrynthitis. It’s possible, but you would have better luck at an ENT.

However, since many people go to the hospital when something is wrong anyway, this may be a better option, particularly if you have NO idea about what may be wrong. The staff will usually direct you to the right department.

Feel free to try all of the above if you also want to find yourself unsuccessful and without a diagnosis. Then again, you could (and should) do the opposite of the above and still possibly find yourself in the same situation. I should emphasize that generally, doctors are competent and helpful, and I have met some very kind and understanding doctors. Perhaps I just draw the short straw on this issue – and really, my illness (labrynthitis) probably was more extreme than most of them see. I also had severe motion sickness so couldn’t travel very far, thus limiting me to fewer doctors. And as a final note, this isn't meant as a "rant against Japan." To be honest, I've had more bad experiences than good with doctors in the U.S. as well.

Fellow Japan residents (foreign and Japanese alike) – what kind of experience have you had with the doctor? (Don’t forget to mention general location, for our reference). Any other important tips?

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