"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