The Japanese medical system seems to be full of mysteries. Why, for example, do the small clinics of private practitioners seem to advertise multiple, often unrelated, specialties? Why, for example, does the local pediatrician also offers a neurology specialty? Are those specialists even licensed in their fields? Navigating the Japanese health system can be a frustrating process simply dealing with unfamiliar procedures and languages alone, without having to worry about these issues.
Below, read some very valuable "inside information" on the state of the Japanese medical system which answers some of the questions raised above. The above information was related by a young (early 30s) surgeon married to longtime British resident of Japan. Hopefully it will clarify some of these mysteries!
"There is no legal requirement for a doctor in private practice to have specialist training in the specialities they advertise themselves for. The only exception is for anesthesiology, where they must have proper experience and certification. It's impossible to tell from outside a clinc whether or not a doctor is a certified specialist or not, as bylaw hospitals are only allowed to list the names of their doctors and their specialities, address/contact details, and opening hours etc. on their signs and advertisements. Many doctors who are certified specialists will display their certificates in their waiting rooms, though, and/or a copy of their resume."
"[One reason for] this lack of legal requirements for proper training is down to the heavy political clout of the Japan Medical Assocation. Local medical associations predominantly consist of private practitioners, and the national medical association primarily reflects their interests. As the JMA is a major donor to the LDP (Japan's ruling political party), it's been able to block attempts to reform the regulatory framework. Even though its influence does seem to be waning a bit (it wasn't able to stop Koizumi from cutting the amount doctors will be reimbursed for treatment by over 3% from this April), [stet.] the framework for private practitioners isn't going to be tightened up any time soon."
"It's important to remember that about surgeons going into general practice advertise other specialities too, as they won't attract enough purely surgical patients to make ends meet. Pediatrics is another similar area: as the reimbursement rate per patient is much lower for children than for adults, and the birthrate is declining, it's increasingly difficult for purely pediatric clinics to survive."
"So to find a reliable local specialist, it seems the first point is to avoid single doctors who advertise multiple specialities, and the second is to check the waiting room for a certificate of specialist certification and an impressive resume."
By Wendy J. Imura. Copyright 2006.