Japan Today



Hospitals in Japan: Invasive checkups, bungled diagnoses, botched operations?

A patient receives an injection at a hospital in Tokyo. Image: REUTERS file

“Hospitals are dangerous to this degree,” reads a headline in Shukan Gendai (June 8).

The allegations that follow are shocking. If true – and they are presented as facts, not as mere tentative opinions – they require immediate action. If false, medical and pharmaceutical authorities must come forward with convincing reassurance. Because the first reaction of anyone reading the magazine’s article, if not utter disbelief, can only be, “I will never consult a doctor or set foot in a  hospital again.” And that, of course, can also be dangerous.

“Enter at your own risk” is a sign that should be on every hospital entrance gate, if Shukan Gendai’s report is fair. Invasive checkups, bungled diagnoses, botched operations and drugs that do more harm than good are the perils a patient is said to court – Japanese patients in particular, if only because Japan’s medical system is so highly developed and advanced.

Japan has more hospitals than any other of the 36 member countries of the Organization of Economic Cooperation and Development (OECD), says Shukan Gendai, citing OECD research – roughly 8000, versus 5000 in the runner-up U.S. This makes for feverish competition among hospitals, which fuels heavy investment in ultra-sophisticated medical technology – CT scanners, for instance, of which Japan’s 13,500 are four times the OECD average.

But let’s begin – as Shukan Gendai does – with the humble x-ray. It is a routine part of the routine medical examination, considered de rigueur in Japan to an extent that other nations might regard as excessive. British research cited by the magazine shows Japanese doctors x-raying more frequently than doctors in any of the other 15 countries surveyed. Niigata University professor emeritus Dr Masahiko Okada figures x-ray radiation causes 3.2 percent of Japan’s cancers – some  32,000 cases a year. That’s heavily ironic, given that so many of those x-rays are taken for the sake of “early detection” of cancer – supposedly a potential lifesaver.

CT scans are, in casual layman’s terms, intensive x-rays. They reveal more, and irradiate more heavily – 20 to 100 times more, says Okada. Never mind, the magazine says; Japanese patients are trusting to a fault. “Headache? Have a CT brain scan. Stomachache? Intestinal camera. Shortness of breath? MRI scan.” And so on. Doctors propose, patients eagerly cooperate – not appreciating, perhaps, the intense pressures hospitals are under to make good their investments in technology that, once purchased, must be used, whether or not use is strictly necessary from the patient’s point of view.

Shukan Gendai tells this story of a young doctor not yet master of his art. The source is an unnamed nurse at the “major Tokyo hospital” in question. The patient, a woman in her 60s, had a growth on her pancreas. Was it cancer? A biopsy would answer that. But extracting the necessary tissue sample is not easy. The young doctor tried once and failed; tried a second time and failed again. This can’t go on forever; hospitals are crowded and busy; people are waiting in line. There was no time for a third try. The operation was performed – and subsequently found to be unnecessary. The growth was not malignant after all.

High blood pressure, diabetes, heart conditions, and some forms of cancer are part of the price we pay for our modern lifestyle – too inactive, too rich in the wrong kinds of food. Fortunately – or unfortunately – there are drugs that address these ailments; fortunately because they may work, unfortunately because they give doctors a profitable alternative to prescribing arguably the most medically effective, certainly the most cost-effective, cure of all: a healthier, more active, less gluttonous lifestyle.

“Your blood pressure is a little high,” the magazine pictures a doctor saying to a patient. “I’ll write you a prescription. Come back in two weeks.” Two weeks later, the prescription is rewritten, another examination scheduled. A month after that, the same. That can go on for life.

“Patients think their doctors are out to cure them,” Shukan Gendai says archly. “That’s not necessarily true. A patient cured, after all, is one customer the less.”

What is a patient to believe?

© Japan Today

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I have found that JP doctors are far more prone to prescribe medications than in the US. I have often wondered if the doctors' offices and clinics have business relationships with the pharmacies that are always next door or across the street from them. Always. Doctor's office ------- Pharmacy.

8 ( +8 / -0 )

So far I have found Japanese hospitals to be very good, even out in the countryside where I live.

5 ( +6 / -1 )

Generally agreeing with Hello Kitty 321 here, but regarding the X-rays I have to agree with the article in one respect.

When I was hospitalized here in a national hospital, a mobile X-ray snail unit was wheeled around the wards every morning, as they took my temperature and blood pressure. After two or three days of this I refused to have the X-rays any more, and they accepted it without any protest at all.

3 ( +3 / -0 )

Sounds frightening, perhaps it calls for a more comprehensive, thorough and independent investigation? If true, then remedial action to protect patients and stop the appalling waste is urgently needed. If false then proof of the safety of the system can only help patient confidence.

0 ( +1 / -1 )

My experience in Japan is generally good as the hospital workers actually care and take pride in their work. I don't agree with the over prescription of pills but that is the same all over the Western world i think

2 ( +3 / -1 )

I know someone who went by ambulance to a Tokyo hospital with a kidney stone. They gave him an X-ray, said "There's nothing wrong with you." In agony he took a taxi to another hospital where they properly diagnosed him with an MRI, gave him enough painkiller to get the level of pain down to a tolerable level and gave him medicine to break up the kidney stone.

3 ( +3 / -0 )

Regular yearly checkups are very common in Japan, organized by employers, governments. etc. This may explain all the diagnostic machinery and its use.

4 ( +4 / -0 )

Haven’t seen a doctor in decades..really. There’s so much each of us can do without doctors. I may eat humble pie one day, but in the meantime I’m OK, past retirement age. I’m good. I know not everyone is as fortunate to not need medical help at every change of health, but I urge people to do their own self diagnosing. You might learn something or two about yourself.. and medicine.

-1 ( +2 / -3 )

Sounds like Shukan Gendai is trying to stimulate sales (the fear tactic).

-1 ( +0 / -1 )

I have had a couple of things botched but, overall, the care was pretty good at the hospital I was admitted to after contracting a life-threatening disease. They also don't seem to be as quick to give you strong opioids that can get you hooked.

0 ( +0 / -0 )

I was misdiagnosed with a brain tumor 5 years ago...was absolutely terrified. Turned out I was working too much, not sleeping enough, and stressed. I don't mean for people to think all doctors in Japan are this unqualified but it was certainly an eye opening experience...

2 ( +2 / -0 )

Good you didn't have one, but misdiagnosed happens in every country too.

Yes indeed, there's a documentary on misdiagnoses and medical errors in America on Netflix. Now that is pretty frightening.

1 ( +1 / -0 )


The small doctor's clinics and the pharmacies nearby usually have a business connection that is openly acknowledged. It makes sense. The pharmacy knows what kinds of medicines the doctor is likely to prescribe and can stock accordingly. The doctor can write prescriptions knowing that the patient will be able to get them quickly and conveniently (a big factor when a lot of patients are elderly and not able to travel far). At the end of the day, its not that different from having an in-house pharmacy in a big hospital and although the doctor might recommend the nearby pharmacy, the patient is still free to go wherever he or she likes.

0 ( +0 / -0 )

More than half of all Americans are taking a prescription drug. Over a third of all Americans are taking a prescription drug linked to depression or other mental disorder.

Yes, Japanese doctors hand out meds like candy, but they are usually short term and often (at least in my case) go straight in the garbage.

Generally it's wise not to trust any doctor 100%. They are human, they make mistakes, and you are just one of 100s of patients they may see. Hospitals are dangerous places, and should be avoided if at all possible.

0 ( +0 / -0 )

i can tell of my own history of misdagnosis of tumor or eye disease, of doctors giving me unwanted and nefarious medicine, as well as unnecessary CT brain scan. one of the reasons i left this country

0 ( +0 / -0 )

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