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Checklist for 'black hospitals' to be avoided

27 Comments

"In economically advanced countries, the big three in terms of causes of death are cancer, heart disease and stroke. But there are also reports that the fourth major cause is excessive medical treatment."

So says Dr Masahiko Okada, professor emeritus at Niigata University and author of "How to Pick Doctors and Medicines."

Shukan Taishu (May 12-19) thinks it's on to something. Just as "black companies" have been generating controversy over the past year for their callous treatment of employees, it appears there's also such a thing as "black hospitals. And readers are advised to be alert for the seven warning signs that would identify a hospital as one they'd be wise to avoid.

The average Japanese sees a doctor 13 times a year -- tops among industrialized nations -- and picking the right hospital often means not picking the wrong one. Owing partly to the prolonged economic recession, plus intensified competition, many hospitals have been cutting corners and looking for new ways to milk the health insurance scheme.

The first sign that a hospital may be "black," says Shukan Taishu, is an unusually large number of departments relative to the number of physicians employed therein. Often in such cases, the doctors will be examining and treating patients outside of their own field of specialization.

Another warning sign is a hospital with extended hours for outpatient services, such as on evenings and weekends.

"They aim to attract more salaried workers who can't spare the time from their jobs to see the doctor on weekdays," a veteran physician tells the magazine.

Hospitals where the nurses are busy to the point of being pathologically harried are to be avoided, as this may be a sign they have reduced its staff to save money. And institutions where the doctors habitually attribute patients' problems -- any problem -- to stress don't have much to recommend them.

"Actually the cause of a medical condition may not be immediately evident, but there's no scientific evidence of anyone expiring from stress at a young age," says Dr Okada.

Another type of hospital to be avoided are those that order excessive testing. Yes, there are certain tests that need to be performed. But the hospitals also earn compensation from the testing, so it's in their interest to do more of them. But overexposure to X-rays can cause malignancies.

"According to a report from the UK, researchers determined that 4.4% of diagnosed cancers developed as a result of overexposure to X-rays," says Okada. "Tests for esophageal and stomach cancers are particularly scary. The strength of the X-rays for a stomach cancer examination are one-thousand times that used to check for lung cancer."

Another place to stay away from is where the explanations regarding treatment are "one-way," i.e., when doctors fail to advise the patient with guidance needed for "informed consent," which has become the medical norm.

And it's wise to steer clear of establishments that prescribe too many medications at a single visit.

"For example, if a patient suffers from high blood pressure, a physician can easily prescribe a variety of medications to reduce it. But most of the factors causing blood pressure to rise can be attributed to body type or lifestyle, and drugs will not remedy the root cause," Okada explains, adding "A good doctor will first make recommendations to change things like diet and exercise over several months, and then if the patient shows no signs of progress he'll start a drug regimen."

A doctor who prescribes medications in large quantities can be said to be indifferent to the patient's welfare.

"A responsible physician would never prescribe a large volume of medications to a patient all at once," says the aforementioned veteran physician. "First he should prescribe a week or 10-day supply, and then respond appropriately after examining the patient again."

© Japan Today

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27 Comments
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There's a hospital close to my house that meets at least three of those qualifications, and engages in a few other shady practices that have convinced me not to use it. I go to a place further away that's inefficient and somewhat disorganized, but the doctors seem to know what they're doing and with one noted exception seem to be ethical. But one who quit working there somehow got his hands on the patient database, and I was aghast to receive a postcard from him inviting me to make the switch to his new practice. So much for confidentiality!

5 ( +6 / -1 )

“A responsible physician would never a large volume of medications to a patient all at once,” says the aforementioned veteran physician. “First he should prescribe a week or 10-day supply, and then respond appropriately after examining the patient again.”

Some excellent comments by Dr. Okada, but I have a minor bone to pick with home over this last comment. The national health insurance is responsible for this last one. If a patient reports back with the same complaint within two weeks then the national health insurance requires the patient to pay a much smaller amount, and the payment to the hospital is also smaller. This means that for long-term conditions it actually punishes the hospital for acting responsibly.

0 ( +1 / -1 )

Okay, so according to this article, I should avoid 99% of hospitals in Japan!

1 ( +6 / -6 )

Okay, this is helpful, I suppose but how about a published ranking system with an actual list of the hospitals that should be avoided and the ones that do excellent work? Is anything like that available?

1 ( +3 / -2 )

Actually, some of the things on this list I want in a doctor or hospital.

Sees patients at night or weekends? Great! I can't always take time off my job to sit around a clinic or hospital for things such as sports injuries or other issues. Sorry for the doctor, but it is the reality of working here. No, I cannot take a ton of time off so as to sit around in your waiting room all day.

Attribute problems to stress? While the stress itself may not be the direct cause of certain problems, the fact is that stress lowers the body's defenses and makes it open to every little foible, virus, and other element on the planet. So the root cause may actually be stress.

Prescribes a lot of medicine? While not perfect, I'd rather have this for many conditions than what I have received, which was minuscule, ineffective doses of medicines, many of which I could have gotten at a pharmacy, that have to be continued on for weeks and weeks (of course necessitating additional visits and fees for the doctor).

7 ( +7 / -0 )

Good article but also somewhat common sense. If a doctor prescribes medicine to cure something while going to the root of the problem first, is indeed a bad sign. Every problem here has mostly to do with money. Money money money.

-1 ( +0 / -1 )

Another warning sign is a hospital with extended hours for outpatient services, such as on evenings and weekends. "They aim to attract more salaried workers who can't spare the time from their jobs to see the doctor on weekdays," a veteran physician tells the magazine.

What the hell is wrong with this? Sounds like someone from the medical establishment comfortable with the status quo complaining about having to change for consumers. How about a balanced view on this "complaint?" Like how Japan is the only G7 country which closes hospitals on weekends (aside from emergency rooms).

6 ( +6 / -0 )

Ambrosia, you can buy magazines that publish hospital ratings in Japanese.

4 ( +5 / -1 )

gokai_wo_maneku: Ambrosia, you can buy magazines that publish hospital ratings in Japanese.

That's great! What are they called and who or what group is responsible for the standard by which the hospitals are ranked, if you know?

-1 ( +0 / -1 )

Fortunately the doctor my family uses is nothing like this. Recently my wife was diagnosed with a rather painful intestinal bug and the doctor referred her to a larger hospital for testing and treatment......he charged her ZERO for her visit, nor for the letter of introduction to the hospital she went to.

0 ( +0 / -0 )

Here's an idea -- root them out and close them down.

3 ( +4 / -1 )

The average Japanese sees a doctor 13 times a year—tops among industrialized nations

Gee, I wonder why crap hospitals are around- plenty of people heading to the hospital for a common cold. Insane.

And yes, Smith, close them. I have seen some shocking things in my time here and I have a list of places I will not go to even if I was dying.

-1 ( +3 / -5 )

Too late...My fiancé"s "old school friend" (who became a doctor) prescribed no less than 20 different kinds of medicine for high blood pressure... A couple of years later, my fiancé was in an irreversible coma and died two years and three months later.

3 ( +3 / -0 )

I think its ingrained in the people to see a doctor for the most minor things and it isn't really understood when I refuse the companies yearly medical check which includes checks done only when something is wrong. With that in mind its no wonder people here are sucked into the black hospitals thinking that they are going to be magically healed, like the more charms the better, by all the medicine they are prescribed.

1 ( +2 / -1 )

The average Japanese sees a doctor 13 times a year—tops among industrialized nations

I have seen a doctor once since the year 2000. But I actually find the figure of 13 rather hard to believe, unless some go almost every day. Japanese encouraged to visit the doctor for minor ailments, on the grounds that the symptoms could relate to something more serious, but you hardly catch a cold more than once or twice a year.

Another warning sign is a hospital with extended hours for outpatient services, such as on evenings and weekends.

Reminds me of Groucho Marx's comment about not wanting to be a member of a club that would have him as a member!!

0 ( +0 / -0 )

unless some go almost every day. Japanese encouraged to visit the doctor for minor ailments, on the grounds that the symptoms could relate to something more serious, but you hardly catch a cold more than once or twice a year.

Many elderly go every bloody damn - more a social thing than a "need" for health care. My MIL had Hep and they demand that she goes in for shots three times week. Every week. This has been going on for, oh, at least 10 years. Insane. And all about making money.

0 ( +5 / -5 )

...prescribed no less than 20 different kinds of medicine for high blood pressure... A couple of years later, my fiancé was in an irreversible coma and died two years and three months later.

Your inference is clear, but coma is not unusual in someone who suffers a stroke, and strokes are not unusual in people with high blood pressure.

1 ( +2 / -1 )

13 times a year?! 12 of them for sniffles, what was the other?

0 ( +2 / -2 )

In my case 12(monthly) for depression meds plus others.

Many people with chronic illnesses that require regular visits.

0 ( +1 / -1 )

13 times a year?! 12 of them for sniffles, what was the other?

If you have young kids, they tend to pass around a lot of infection - to other kids, and what they pick up at kindergarten or school. That gets around at home, and you get ear infections, colds, flu, eye infections, and other stuff. Some of it you can brush off, and with a bit of luck it goes away. However, you can find yourself visiting the doctor a lot more than before the kids were around.

Getting a flu vaccination - which I find more congenial than influenza - having an annual medical, it all adds visits. There was a time when I could go years without using a clinic or hospital. Not any more.

1 ( +2 / -1 )

The average Japanese sees a doctor 13 times a year—tops among industrialized nations

really? i don't think so... older people and kids see doctors a lot. if they include all age groups, then sure the number might be accurate but most japanese unless they are old or kids, do not see a doctor once a month..

-1 ( +0 / -1 )

How are they even allowed to operate legally? What a mindless system...

1 ( +2 / -1 )

My experience of Japanese hospitals has been good, with one exception. The lady doctor despised foreigners and men. I was both. After a crude examination, she let me go home even though I was bleeding internally, asking me to return in a week. I went to another hospital that day and was immediately hospitalised.you just have to be very careful which hospital you go to in Japan, and is in the Home Country. There are good and bad hospitals, and good and bad doctors and nurses.

3 ( +4 / -1 )

Before coming to Japan, I'd only had maybe two X-rays, both at dental clinics. Since coming, I've lost count the number of chest X-rays I've been obliged to have during the annual medical check-ups. Last year, my heart was found to be 'abnormally big'. After another X-ray, and another check (can't remember the name), I was told there was probably nothing to worry about. That's on top of X-rays I've had on my hand and leg for other problems which eventually disappeared on their own or I just learnt to live with.

One thing that has bugged me is the lack of privacy in some hospitals, as if curtains can somehow prevent other people from listening to your personal problems. I once had some minor problem 'down there', and I made sure I went to the hospital just before closing time to make sure I was the last patient.

3 ( +3 / -0 )

Another one to watch for is insurance shenanigans. My friend is an insurance adjuster, and she knows all the places that are preferred by insurance scammers.

0 ( +0 / -0 )

One reason Japan has such a high life expectancy is because people go to the doctor regularly. I suppose y'all could go back to your own countries and enjoy the perfect healthcare system there instead of languishing in medieval Japan?

-1 ( +1 / -2 )

I don't believe that there are black hospitals. The fame of a hospital depends on the doctors and hospital staff. A doctor might beyoung and inexperienced but if he shows care and importance to his patients, then there's no way I won't come back again.

0 ( +0 / -0 )

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