As medical students we were taught that a good history would provide a diagnosis in 80% patients - this advice has served me well in an age when a physical examination bloodwork and a PET scan 😳
Disgusting- mask wearing as we know is clinically BS - totally ineffective and probably harmful. Compulsion to wear is an act of subjugation snd wearing one is a badge of compliance. Of course those who wear by choice are misguided or virtue signalling.
We teach the same but older doctors haven’t got memo. However, I’ve been doing this for 18 years, I would like to think that it has percolated out there. If it has, I yet to see any evidence of it.
I have never had any close to a full medical interview. However, as I understand it, in the UK they do not ask family history and the taped medical interviews we use from there bear this out. Still, I have never even had a full HPI here and only once any part of past medical history. ROS is not done here.
insane that those common sense questions are not asked. I suppose too many patients might then think and perhaps tie it to medical procedures they had had before. If the point is not to get the patient better, what is the point?
Is this the inevitable, steady downward spiral of those controlling the substitution of AI and Virtual Medicine into our healthcare? And if not, are the "Drones" caring for us getting a proper education or are they sabotaging care intentionally?
No, it is an old problem in Japan. They have their way of doing things and are happy with them and resist change. Doctors are a powerful political body here and are among the most conservative, in that they do not like change. Change is taking place, but it is arguable if it is for the good. Change that would greatly improve patient outcomes is not really even considered. The only changes that seem to be thought of are those that reduce cost to the national treasury from where most of the money for basic medicine comes.
FYI re: buried reply... I was not aware you responded to my question until I checked "my activity." I verified my preferences in substack settings, all appeared to be correct, so I should have received a notification.
Troubling.
Almost as troubling as the arc of health care, education and future economic prospects.
Me too, I only get a few notifications. I have to go into the app and click the bell icon to see if there are any replies there. That is how I found yours right now. Troubling indeed.
The most troubling part of Japan’s system is that folks in the West hold it up as the picture perfect model for what we should have in our countries. That is MADNESS.
Good luck to your kid, I hope that he or she gets diagnosed and treated soon.
(A hot tip from a friend living in Europe: what about non-native doctors, if there are any? In Europe at least that sort of works, if there is an expat/immigrant doctor from a country with a more fundamental healthcare system they do a better job.)
Great idea. But the wife wouldn’t go for it. She is Japanese and works for Pf.
But to let you know, there is a clinic that caters to the expat community. All who work there, Japanese and non Japanese speak very good English. The doctor I have seen the most there is Japanese but graduated from a med school in St. Louis, Missouri. I no longer remember which one but it is one my dad spoke highly of when he was a paramedic. The last doctor I saw there, now years ago, was British. A problem is, that they are not registered in the Japanese health care system, so my insurance, though private, does not reimburse me for visiting there. It would be the same if I brought my kids there. Normally not an issue for me, but after the loss of hours due to the panic, it is for me, and the fact that they are not plugged into the Japanese system is a big problem for my wife.
There is a large hospital not so far away from us that several coworkers and friends have recommended to me. Additionally, I have had several med students who tried to gain employment there. Wife is absolutely against going there as they advertise a western style of medicine and are thus vilified by the rest of the medical system in Japan. Either my wife never was as open minded as she made herself out to be during our extended courtship, or she gradually closed her mind.
Wow, that’s tough. As for your wife, maybe she is as open-minded but the issues have gotten more complex. I’ve seen parents do the “head in the sand” thing sometimes when faced with their kids’s health issues because they are too scared to contemplate them and freeze up. I hope you both find a middle ground where your kid gets some real treatment. That hospital does sound promising. Good luck!
Her move to closed mindedness predates the birth of our first child. The story of hospital several referred me to predates the birth of our first child. It’s an ugly situation.
I have got a few friends who married cross-culturally, so I feel for you here. But, well, she did marry you. I can't imagine how tough that must be in a very monocultural environment. I wish you both the best: there must have been something that took you to Japan and that pointed her to you.
As medical students we were taught that a good history would provide a diagnosis in 80% patients - this advice has served me well in an age when a physical examination bloodwork and a PET scan 😳
As s junior doctor in UK it was:
Presenting Complaint
History of Presenting Compliant
Previous Medical History
Drugs and Allergies
FH and Social History
ROS
Examination would be followed by bedside tests
Permission required to order a CT
As a Specialist its more targeted
Interesting. Pretty much the same in the US and as we try to teach it in Japan.
Thanks.
What do you make of the visit to the clinic with my 11 year old?
Disgusting- mask wearing as we know is clinically BS - totally ineffective and probably harmful. Compulsion to wear is an act of subjugation snd wearing one is a badge of compliance. Of course those who wear by choice are misguided or virtue signalling.
I have the same thoughts on masks. How about the whole experience at the clinic? I would to have your thoughts on that.
We teach the same but older doctors haven’t got memo. However, I’ve been doing this for 18 years, I would like to think that it has percolated out there. If it has, I yet to see any evidence of it.
I have never had any close to a full medical interview. However, as I understand it, in the UK they do not ask family history and the taped medical interviews we use from there bear this out. Still, I have never even had a full HPI here and only once any part of past medical history. ROS is not done here.
insane that those common sense questions are not asked. I suppose too many patients might then think and perhaps tie it to medical procedures they had had before. If the point is not to get the patient better, what is the point?
What’s the point? Money.
Is this the inevitable, steady downward spiral of those controlling the substitution of AI and Virtual Medicine into our healthcare? And if not, are the "Drones" caring for us getting a proper education or are they sabotaging care intentionally?
No, it is an old problem in Japan. They have their way of doing things and are happy with them and resist change. Doctors are a powerful political body here and are among the most conservative, in that they do not like change. Change is taking place, but it is arguable if it is for the good. Change that would greatly improve patient outcomes is not really even considered. The only changes that seem to be thought of are those that reduce cost to the national treasury from where most of the money for basic medicine comes.
FYI re: buried reply... I was not aware you responded to my question until I checked "my activity." I verified my preferences in substack settings, all appeared to be correct, so I should have received a notification.
Troubling.
Almost as troubling as the arc of health care, education and future economic prospects.
Me too, I only get a few notifications. I have to go into the app and click the bell icon to see if there are any replies there. That is how I found yours right now. Troubling indeed.
The most troubling part of Japan’s system is that folks in the West hold it up as the picture perfect model for what we should have in our countries. That is MADNESS.
Good luck to your kid, I hope that he or she gets diagnosed and treated soon.
(A hot tip from a friend living in Europe: what about non-native doctors, if there are any? In Europe at least that sort of works, if there is an expat/immigrant doctor from a country with a more fundamental healthcare system they do a better job.)
Great idea. But the wife wouldn’t go for it. She is Japanese and works for Pf.
But to let you know, there is a clinic that caters to the expat community. All who work there, Japanese and non Japanese speak very good English. The doctor I have seen the most there is Japanese but graduated from a med school in St. Louis, Missouri. I no longer remember which one but it is one my dad spoke highly of when he was a paramedic. The last doctor I saw there, now years ago, was British. A problem is, that they are not registered in the Japanese health care system, so my insurance, though private, does not reimburse me for visiting there. It would be the same if I brought my kids there. Normally not an issue for me, but after the loss of hours due to the panic, it is for me, and the fact that they are not plugged into the Japanese system is a big problem for my wife.
There is a large hospital not so far away from us that several coworkers and friends have recommended to me. Additionally, I have had several med students who tried to gain employment there. Wife is absolutely against going there as they advertise a western style of medicine and are thus vilified by the rest of the medical system in Japan. Either my wife never was as open minded as she made herself out to be during our extended courtship, or she gradually closed her mind.
Wow, that’s tough. As for your wife, maybe she is as open-minded but the issues have gotten more complex. I’ve seen parents do the “head in the sand” thing sometimes when faced with their kids’s health issues because they are too scared to contemplate them and freeze up. I hope you both find a middle ground where your kid gets some real treatment. That hospital does sound promising. Good luck!
Her move to closed mindedness predates the birth of our first child. The story of hospital several referred me to predates the birth of our first child. It’s an ugly situation.
I have got a few friends who married cross-culturally, so I feel for you here. But, well, she did marry you. I can't imagine how tough that must be in a very monocultural environment. I wish you both the best: there must have been something that took you to Japan and that pointed her to you.