Japan: Impatient patients

In recent years, harsh criticisms have been focused at hospitals and healthcare workers about the quality of medical care. An example of the target of criticisms was a doctor conducting transplants using diseased kidneys in Ehime. And most recently, a pregnant woman, who lived just a few minutes away from a hospital, miscarried after a three-hour ambulance ride during which eight hosptials rejected to admit her.

On the other hand, cases in which doctors and healthcare workers are harrased by their patients have also been increasing. A survey [Ja] shows that at university hospitals acrross the country, there were at least 430 cases in which doctors and nurses were physically harrased and about 990 cases in they were verbally abused by patients and their families last year. A story on this issue which lists detailed descriptions of some of the actual cases can be found in an article at The Daily Yomiuri.

Here is what some doctors and healthcare workers had to say.

In response to a question asking for opinions about verbal abuse against mendical staff, a doctor-in-training writes at a BBS:

たとえこちらに非がなくとも裁判になると多大な労力を負いますし、モチベーションも下がります。私は来年から専門科にすすみます。選択肢のひとつとして産科もありましたが、この逆風がふきあれる状況下でとても進む気になれず他の科に決めました。マスコミ・裁判官は自分たちの報道・判決が産科・小児科医療を崩壊させていっていると認識していただきたいです。

Even if we are not at fault, when we get taken to court it is a lot of work, and my motivation goes down. I am moving on to take up a specialization. Obstetrics was one of the choices, but I didn't really feel like going in that direction because of the unfavourable situation, so I have decided to head for a different specialization. Media and judges should realize that their coverage and court decisions are destroying obstetric and pediatric healthcare.

Another doctor-in-training writes:

今の時代、医者は奴隷だ。ボランティア精神だけで成り立っている。仕事はキツく、労働基準法など適用されない。患者からの要求は高くなり、訴訟のリスクも高い。マスコミからは叩かれ、給料はどんどん引き下げられ、一般のサラリーマン並みだ。医者をサービス業と勘違いしてて一々クレームをつけてくるバカな患者も多い。情熱だけで仕事しろ?バカなこと言うな。情熱だけで仕事してる奴なんて世の中にどんだけいるよ?仕事ってのはまずは家族や自分の生活のためにやるもんだ。大事なものを守るための金が第一にあってのもんだろ。

In this age, doctors are slaves. [Health care in Japan] depends solely on doctors who work as if they were volunteer workers. The work is hard and the labour stardard law is not applicable. Demand from patients is getting high and the risk of getting sued is also high. We get bashed by the media and our salaries are cut back to the same level as that of ordinary salarymen. There are a lot of stupid patients who mistake healthcare for a service business and complain all the time. Work only with passion? Give me a break. How many people are there in this world who actually work with passion anyway? You work first for your family or for your own life. People would not work unless money to protect things important to them was offered.

A medical social worker gives their thoughts about the situation, pointing out to the government's ignorance as well as patients’ misunderstandings.

ここ最近思うこと。
医療ってサービス業のように言われてる。
患者さん達がよりよく治療・療養してもらえるように心掛けるようにしてる。
そしてそうしなければいけないと思ってる。

でもね、、、、
と言いたくなることが多すぎる。

This is what I have been thinking recently.
People are talking about healthcare as though it is a service business.
I try my best so that patients get better treatment.
And I think that's the way I should be.

But…
There are so many things I want to say.

医療費がかかりすぎてるーーー!!と診療報酬の引き下げばかりに精をだす政府。
ねぇ、そんな値段でちゃんと治療ができると思うの?と言いたくなる。
現に今の医療・福祉は正当な報酬が支払われているとは言えない。
(誤解してるかもしれませんが、医療福祉スタッフの報酬は驚くほど安いのです・・・Drもしかり)

“Medical costs are too high!!” — The government is busy only with cutting down medical treatment fees.
Makes me want to ask: “Do you really think at such pricing proper medical care is possible?”
Even now, medical and walfare are not properly compensated.
(you might misunderstand this, but medical and welfare workers’ wages are surprisingly low, and so are doctors’)

救急センターを夜間診療所を間違ったような利用もいくらアナウンスしても減りません。
救急処置をしているスタッフに「今から食事してくるから、おまえら待ってろよ」等とおっしゃいます。
今にも命を失いそうな人が運ばれてきても、「俺の方が先に来ただろう」とクレームをおっしゃいます。
夜中に自分が意図した専門医がいないと「患者”様”をなんだと思ってる」とおっしゃいます。
そして「高い医療費払ってるんだ」と権利ばかりを主張されます。
でもね、、、その中にホテルみたくサービス料は含まれていないんだよと言いたいのです。
そしてどれだけその診療報酬が安くできあがっているのかを知って欲しいのです。

[…]
No matter how many times we make announcements, the number of people using the emergency center as a night-time clinic does not decrease.
To medical staff who are giving emergency care, they say things like “I am going to get something to eat, so wait for me.”

Even when someone who is dying arrives, they say: “I came before that person,” and complain.

And they claim only their rights, saying: “I am paying a high medical cost”
But I want to say that, unlike a hotel service, service charges are not included [in the fees].
I also want people to know how cheap the medical treatment fees are.

今現在、病院は政府の思惑と患者さん達の思惑の狭間に埋もれてます。
結局の所、安かろうよかろうはできないと思うのです。

1高くても良いから良いケアを受けたい
2ケアの質が落ちても良いから医療費抑制をしたい

どちらかを選ぶしかないように思うのです。

アナタなら、どちらを選びますか?

Today, hospitals are caught between the government's intentions and patients’ intentions.
In any case, I think “the cheaper the better” is not possible to achieve.

1 get better treatment even if it costs more
2 supress the medical cost even though the quality of medical care decreases

I think you have to choose either way.

Which would you choose?

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