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Very Bad Experience With Doctor

******

A note to readers out there:

The actual name of the doctor has been replaced in this post and in the accompanying comments from those who have been following this discussion. I would like to state that none of the concerned parties in relation to this post have contacted me regarding this move.

By highlighting this situation, it is in the interest of concerned parents to know that such an occurrence is not unlikely in Japan (or anywhere else in the world for that matter). Hopefully, by bringing this incident to your attention, parents can learn from the pitfalls, form opinions and set expectations about what is required from healthcare professionals (doctors and hospitals alike) before finding yourselves in a similar situation.

To set the record straight, our experiences so far with the clinic staff and the other doctors whom we had seen previously were always satisfactory without any glitches. It is in our opinion that the clinic is still one of the best choices for foreigners in Tokyo.

I would like to thank everyone who has responded and left a comment so far, especially Woodrow Martin who got the discussion ball rolling.

Mini Me
(23 March 2010)

*****

Our experience with Dr XXX from Tokyo Medical & Surgical Clinic over the weekend left such a bad taste in our mouths that i feel other parents should know this.

Our 2 year old daughter fell and hit her head with great force on a sharp edge of a stone corner along a pavement yesterday. As it was Sunday, we called the clinic’s emergency telephone number to obtain the on-call doctor’s contact number and this was how the phone conversation went (thanks to the history list on my mobile phone, i could get the exact times and durations of the phone calls!):

At 12.00pm, i contacted the on-call doctor, Dr XXX, and was asked the questions below (my answers follow the questions):

  • How long ago did this happen? 10 mins ago.
  • Is she vomitting? “No”.
  • Did she lose consciousness? “No, but she seems sleepy/quiet.”
  • Is there any laceration? “There is some bleeding, a small hole and an inward depression on the wound.”
  • Can she move her limbs? She’s not moving much which is very unusual.

I was told to observe her and Dr XXX then spent the next half of the conversation emphasizing several times that the clinic was currently closed  and made it very clear that she could not see us. Obviously she felt it unnecessary for further medical attention.

The entire call lasted 4 minutes.

6 minutes later at 12.10pm, Dr XXX called back but i was not able to answer the call. We were busy trying to arrange for our daughter to receive further medical attention. At 12.29pm, I returned her call only to be told that she could see my child and that she was already in the clinic. She had a 1pm appointment with another patient so therefore, she could see us at the clinic before or after the 1pm patient. Somehow, between 12.04pm and 12.10pm, she apparently changed her mind and suddenly could see us at the clinic. Why else would she called me back? For obvious reasons, we did not take up her offer.

The next morning, the clinic called up to inform us that we would be billed for the “phone consult”. I was disgusted. It was not the fact that we had to pay (our insurance company pays for it anyway), but more so the fact that after spending half the time trying to convince us that the clinic was closed and that we could not see her, Dr XXX apparently changed her mind barely a few minutes later and offered us the opportunity to bring our child to her. If she did not have another patient to see at 1pm, would she have offered to see us at the clinic?

I have worked with trauma doctors for several years before. No one (especially doctors!) needs to be told that serious head injuries may involve injuries to the brain. The only way to assess the extent of seriousness is to do so with a face-to-face examination before any respectable conclusion can be made. Difficulty breathing, shock, spinal injuries, and severe bleeding are all life-threatening injuries that may occur along with a head injury and require immediate medical attention. Injuries to the spine, especially the neck, must be considered when a head injury has occurred. It is impossible to assess all these things through a phone call.

On the bright side, we managed to get our daughter to appropriate medical attention at Daikanyama Medical Clinic in Daikanyama Plaza on that Sunday (It’s in the same building as Daikanyama Dental Clinic and Hillsideview Orthodontic Office directly opposite Daikanyama Tokyu Apartment) . By this time, our daughter was already complaining of a headache, the bleeding did not stop and the swelling had spread to her nose. The clinic was equipped with an x-ray machine and a CT scan. There, our child received a proper medical assessment, a CT scan to confirm for any internal bleeding or skull fracture, and had her wound attended to. The receptionist there spoke very limited English but Dr Yasuyuki Ueki was able to communicate well in English.

Parents may want to note also that The American Academy of Pediatrics recommends that parents contact their child’s healthcare provider for advice for anything more than a light bump on the head.

This being said, most head injuries are usually mild and not associated with brain injury or long-term complications. Very rarely, children with more significant injuries may develop serious complications (eg, brain injury or bleeding around the brain).

However, as a parent, would you take the chance and rather downplay your child’s head injury instead of getting it physically assessed? Well, Dr XXX was certainly more than willing and very quick to take this chance with our child.

33 Responses

  1. You are lucky that Dr. XXX called you back….you have a short term memory and only wrote part of the conversation you had with the doctor…how do I know? I was with the doctor…you forgot the part where the doctor told you that they did not have the equipment or facilities to handle emergency cases such as your case…when a child suffers such an accident, you do not call a clinic…you go directly to the er (Emergency Room)….there are test that needs to be given that cannot be done by educated guesses (which seem to be the norm….40 years ago)…She agreed to see you again because she was going to take a quick look before assisting you in finding a quick place (somewhere near your location) and assist you with the communication part (she is a doctor not an interpreter but she does it anyway)…Does she take these things seriously? She was with her 1 year old child when you called…of course she is serious…you called a professional on a weekend, got advice and even stood the doc on the appointment and have the balls to not pay…try that in any other profession…let me go to your job…get all the info I need from you and stiff you on the bill because I didn’t get ALL of the answers I wanted…you should have showed up and your child would have gotten the best care possible don’t be mad…be glad someone was trying to help and even called you back…how often does a busy doctor call you back and like you said…in a few minutes after the initial call?

  2. There is no reason why I should consider myself lucky that she changed her mind about seeing my child after her initial reluctance. We are not expecting a free service from her.

    She did mention that the clinic did not have the facilities to handle such a case but it does not change the fact that she initially felt that there was no need to examine the child physically. Instead, she kept emphasizing that the clinic was closed.

    So what is your point?

    1) That the clinic was not equipped for such cases?
    2) That she changed her mind and wanted to “take a quick look” before assisting us with other options?

    If your answer is (1), then calling back would not have been necessary anyway because it does not change the fact that the clinic does not have the equipment. If your answer is (2), then Dr XXX should have said so during the first conversation and avoid putting herself in a position that made her seem as if this was an afterthought. In any case, there was no mention whatsoever during both phone calls that she intended to do (2). If she indeed did have such an intention, she could have said so at anytime. Instead, the only thing she mentioned during the 2nd phone conversation was that she had a patient at 1pm and that she could see us before or after this patient.

    And for the record, when the clinic administrative person called the next day and later connected me to Dr XXX, her first question was “What’s the problem”. I did not, at anytime, mention that I would not pay the bill. In fact, I made it very clear to Dr XXX to send us the bill which we are still waiting for till today. If she chooses not to bill us, then you cannot say that we don’t want to pay. Should she change her mind and decide to bill us for a lousy consult, then by all means, please do so. And I am sure you will be able to convey this message to her.

  3. I find it ridiculous and laughable when the doctor did a verbal consultation through the phone without taking a look at your daughter. Head injuries can result into other problems that is not visible to the naked eye, to make it worse, she is only 2 years old, her skull is definitely not as hard(best term i can come up with) as a normal adult so we will never know unless you do a thorough scan.
    The only positive thing i can say about the doctor is that at least he did try to make a call back although it might seem a bit too late at that point

  4. I would suggest that in the future, the on-call doctor should agreed to see to such cases immediately, even though the clinic may be officially closed, or the symptoms do not sound severe enough.

    This is unlike turning a diner away at a restaurant.
    A child’s well-being is at stake, and it sounds odd that an on-call doctor at the clinic called the “Tokyo Medical and Surgical Clinic” would flatly refuse to see a patient on the grounds of not having the right equipment. It is understandable that the rejection would not sit down well with anxious parents of a hurt child.

    It is also odd that the doctor would feel so wronged about not being paid for a short question and answer session. I mean, do you really feel like she added value to the situation? Perhaps it is the practice in Japan to be paid even for a short verbal medical rejection, but I’m sure universally you shouldn’t expect to be paid if you weren’t part of the cure.

  5. Mini Me I fully understand how anxious and helpless you felt at that point in time when the accident took place. I’ve a 16 months old at home who had an accident when she was 6 months old. I definitely can relate on how you feel.

    I hope and pray that that you little one at home is well and recovering.

    I would expect that a professional with a one year old to be able to understand the same anxiety as any parent would. Perhaps only if the same happened to their own flesh and blood that they will probably know how we felt at that point in time.

    Dr XXX will be luckier as she is a medical doctor who will be able to make the medical assessment on her own. Whereas we the “non-professional” will need to depend on “professionals”.

    I do agree that the timing is bad. Accidents always happen when we least expect it. Dr XXX may not have been able to respond appropriately during the 1st call hence she made the second call to followup.

    However, I do feel that Dr XXX should have directed the anxious parent to the nearest ER since she knew she was not in position to help. I believe Mini Me would have been consoled and relieved knowing that someone with medical knowledge is giving her assistance.

    I will like to take this opportunity to remind Mr Woodrow that unlike other professionals, medical doctors deal with life and death situations hence their advice is invaluable. Financial considerations should be at the back of a doctor’s mind in such a situation.

  6. Woodrow Martin? Dr XXX?

    Are the two of you related somehow?

  7. I read with enthusiasm the comments surrounding the (lack of) management of MiniMe’s daughter following her head injury.

    From another medical professional’s point of view, it is always easier in retrospect to see what went wrong.

    Although I agree with Dr XXX that her clinic was not a suitable facility for diagnosis or treatment of potentially severe paediatric head trauma, her subsequent management and communication with the patient was lacking. Rather than lying about the clinic being closed and dismissing the patient, she should have clearly explained to the patient why her daughter should be referred to another clinic capable of performing Xrays and CT scans if required. A doctor cannot legally refuse medical treatment in life threatening situations and also has the duty of care to refer the patient to a doctor/facility that can.

    I presume that the reason why she called back was because she realised after she hung up that she may have made a poor judgement call. Trauma guidelines clearly state that any child who presents with an altered conscious state immediately following head injury (especially with obvious external signs such as lacerations and bleeding) needs to be immediately seen and assessed for potential lethal intracranial injuries as they may rapidly decompensate. This explains the abupt change of mind to free up her schedule to immediately assess her.

    I agree with MiniMe’s decision to take her daughter to another clinic with more facilities. If her daughter did end up having serious injuries, precious time would have been wasted spent in Dr XXX’s office as she would have eventually been transferred out anyway for medical imaging. 

    My advice to consumers is that if you are unhappy with a Doctor’s service, then you should take your business somewhere else. Personally, I would never charge for a telephone consultation especially if I never saw the patient or actually treated them. This case also highlights the importance of finding a competent, caring doctor who possesses excellent communication skills. 

    Dr Phil.
    Specialist Consultant Trauma Physician and Anaesthetist.

  8. For a developed country like Japan you would expect a higher level of medical professionalism than this.

    It seems to me that Dr. XXX cares more about the a foreseeable situation of accounts receivable turning into bad debt, rather than the well being of her patient.

    The way her related party responded to Mini Me is certainly not reflecting well on the doctor herself.

  9. Its obvious that Woodrow Martin & Dr XXX are related. It was indeed very unprofessional from the way Woodrow replied in this blog, especially about the medical consultancy bill.

    As a mother myself, I can fully understand the anxiety of Mini me. I would have look for alternative medical attention immediately.

    As a medical professional, she should have redirected Mini me to an appropriate medical facility immediately. She is listed as an on call doctor, so she should react accordingly. The bill should be waived, on this case. If she cant provide weekend medical attention, she should take her listing off.

    All this would have been avoided if she was more tactful.

  10. Having read Mini Me’s account of the incident and the response from Woodrow Martin who is obviously related to her I must confess I am amazed. If one were to act in a professional manner one takes the blame and make an apology instead of defending.Hind sight is a wonderful word. Would it not be better to act now then regret later even if she could not do anything about it.Just take a look at a movie celebrity who died because she did not follow up immediately after her sking fall

  11. This discussion is interesting. My friend’s pediatrician is attached to a local hospital here in Tokyo but they see him at his private clinic which is not in the hospital.

    Their newborn was vomitting non-stop and rushed to the hospital where their pediatrician was listed with, only to be told that they could not be seen because their child was not born in that hospital and they did not have prior records! (They chose to deliver the child back in homecountry.)

    My trust in the Japanese healthcare system was totally lost. I wouldn’t be surprised if the author had brought her child to the hospital only to be rejected.

    Somethings for you to read,

    http://www.asianoffbeat.com/default.asp?Display=1607

    http://www.japantoday.com/category/national/view/tokyo-woman-rejected-by-7-hospitals-dies-after-delivery

    According to the Japan Times on 29/7/09, “it took a record 26.4 minutes on average nationwide to transport a patient by ambulance to a medical institution in 2007, 6.5 minutes longer than a decade earlier, partly because some patients were turned away by several hospitals. This is due to the fall in the number of hospitals accepting emergency patients and ER doctors. According to an estimate by the Health, Labor and Welfare Ministry, 5,000 ER doctors are necessary to cope with such cases, but there are only about 2,800 at present.”

    I wish i had known earlier that this is the way things are handled in Japan before coming to this country.

  12. I find it laughable that a responsible parent would CALL a clinic/hospital instead of TAKING the child to an ER after a head injury. Most responsible parents would. What did you expect to accomplish with a phone call?
    The questions/answers part of your rant wouldn’t of took 30 seconds. What was talked about for the other 3.5 minutes? You also failed to mention what the final diagnosis was.
    From the length of your rant, instead of trolling on the Web, you should be watching your child, making sure events like this do not take place and prevented. Place blame on the one that’s responsible. YOU. We are responsible for our children until we die.
    PS- When you rip somebody, have the intestinal fortitude to use your real name, otherwise your comments mean nothing.
    Yeah, yeah…Another troll is going to post that accidents happen.
    Sorry, I don’t believe that. I believe most accidents result from negligence.

  13. Responsible Parent:

    Is being told to “observe” without seeing a patient with a head injury considered a diagnosis?

    If you and your child were walking on the pedestrian pavement and a cyclist came from behind and ran right into your child, resulting in injury, can I assume you would feel responsible for making that cyclist ram into your child?

    Being in an ambulance does not guarantee you admission into a hospital here in Japan. The paramedics needed to get the approval from the hospitals to send us there. We had a Japanese person making the calls for us and doing the interpretation and her English was excellent so I have every reason to believe that her explanation was accurate.

    The several hospitals that we called either refused to take us because we needed an interpreter or gave the reason that their doctor was unable to take our case. All asked what language we spoke and whether we had Japanese health insurance. I don’t know of any other affluent country that gives medical attention based on language criteria. Was it because we were privately insured with a foreign company that they did not know how to handle this?

    We even called our private insurer abroad to obtain the contact for their counterpart in Japan hoping that they may provide a more efficient solution. Guess what? The Japanese counterpart confirmed that this was the procedure in Japan (ie. The hospitals must agree to take you first!) and that he too had to call and ask.

    Though it is of no fault of Dr XXX’s that the clinic is not equipped to handle such an emergency but she should at least be responsible enough as a medical professional to redirect us. She provided no further advice than to say the clinic was closed and that we should just observe. What was that supposed to mean anyway?

    I admit that I might not have been so upset if we were talking about the common flu, cough or even high fever in a young child. But we were talking about head injuries in a 2 year old. Dr XXX did not offer alternatives but yet felt that she should bill us for doing nothing and Woodrow Martin thinks we should be thankful that she called back.

    The doctor who finally provided us with medical attention, obviously had a very different opinion from Dr XXX. He felt that the injury was serious enough to warrant a CT scan – something which most doctors are careful about because of the need to detect a potentially lethal brain injury against the increased risk of future cancer caused by the scan’s radiation.

    If the injury had been any more serious, 10 minutes of carelessly dismissing a child’s head injury could cost a life.

  14. It’s appalling to read all that’s happening ! This is medical we are talking about and not some bad service rendered in some departmental store. Irregardless of whether it’s a child or adult, I personally feel Dr XXX’s attitude was truly uncalled for. If her clinic didn’t have the necessary equipments and facilities according to Woodrow Martin, the least she could have done was to immediately refer Mini Me to another clinic or hospital whom she knows would be able to assist.
    I have heard similar stories like Betty’s with regards to the hospital system in Tokyo so it’s no surprise Mini Me had been rejected by hospitals. It must have been very devastating and frustrating plus on top of that, deal with an uncompassionate doctor.
    Having said this, I think Responsible Parent, you have lived up to your name as responsible parents. “Child Accident” isn’t found in your dictionary because you have the means of watching your child 24/7 365 days … BRAVO ! Good for you ! But unfortunately not every parent has your kind of luxury. It would mean NO sleep, NO eating, NO baths .. NOTHING ! Because one needs to glue his/her eyes on the kid ! You are indeed a “model” parent and your kids are super lucky.
    Mini Me certainly reacted in any way a responsible parent would have.
    Dr XXX should be the one who feels lucky as Mini Me had only blogged this incident and not bring this up to the Japan Medical Association. This is also probably the reason why Dr XXX hasn’t sent out her consultation bill – embarrassment !
    I believe many of us out there reading this incident would be wary to approach Tokyo Medical & Surgical Clinic for any medical aid in future or any medical institute Dr XXX may later seek employment in.

  15. I can’t believe what I’m reading here. How ridiculous that a doctor has the nerve of charging a patient over a phone conversation without first examining the patient? It was obvious that the situation was badly managed by Dr. XXX.

    I do hope that Mini Me’s daughter has made swift recovery…

  16. A note to readers out there:

    The actual name of the doctor has been replaced in this post and in the accompanying comments from those who have been following this discussion. I would like to state that none of the concerned parties in relation to this post have contacted me regarding this move.

    By highlighting this situation, it is in the interest of concerned parents to know that such an occurrence is not unlikely in Japan (or anywhere else in the world for that matter). Hopefully, by bringing this incident to your attention, parents can learn from the pitfalls, form opinions and set expectations about what is required from healthcare professionals (doctors and hospitals alike) before finding yourselves in a similar situation.

    To set the record straight, our experiences so far with the clinic staff and the other doctors whom we had seen previously were always satisfactory without any glitches. It is in our opinion that the clinic is still one of the best choices for foreigners in Tokyo.

    I would like to thank everyone who has responded and left a comment so far, especially Woodrow Martin who got the discussion ball rolling.

    Mini Me
    (23 March 2010)

  17. Everyone is still missing the point…when there is an “actual” emergency, your first move is not to call a “clinic”….you should immediately go to an “Emergency room” just as you would do if you if you were in another country. The missing conversation to the above case is that the doctor told the caller “mini me” that the clinic was closed and (the missing part of the conversation) that there was no way to access the equipment necessary to properly access the childs injury. Many of the physicians around would love to make the “house call” because it brings the doctor a larger amount of money (lets say to go to someone’s house on Sunday may start at 50,000 yen) even though in the end they would end up sending your child to the “ER” anyway. The doctor already had an appointment at the clinic and called the mother and child back to have them meet her there (at a cheaper rate) so that she could help her find a facility on Sunday that had a pediatrician available so that the proper test could be administered…to those that may not believe it…Dr. Marcus Welby doesn’t exist….she couldn’t actually go to your house and accurately say the child was ok…doesn’t exist today so don’t believe it. You need tests and the doctor was honest to let you know, they did not exist and was showing you the way…but instead you wanted your child to be seen at your house….doctor collects their big fee…tells you everything is alright and life goes on…should your child die later from a brain hemorrhage because the doctor guessed wrong, then you would be searching for a lawyer to make yourself wealthy…you should be ashamed of yourself for trying to paint a picture of the doctor as uncaring when in fact the doctor was being honest and wasted “hours” on you when she could have been spending a quiet Sunday with her family…..

  18. …in the end, you did exactly what the doctor advised….you eventually went somewhere where your child was administered tests so that you could have peace of mind…the doctor is happy that your child is fine…unhappy that all of the effort that is put in trying to get you the “proper” help…don’t blame the doctor…blame the clinic for not having the proper equipment for the doctor to do their job….quit thinking you can bring a little doctor bag to your house to make all well….this is 2010 not 1950…today everything is EBM (evidence based medicine) a concept the older doctors aren’t familiar with.

    * A note for readers: A portion of this comment has been removed because the writer was describing what he, as the husband of a doctor, did for someone else (babysitting) which is irrelevant to this discussion topic.

  19. By the way, the doctor waived the bill from the beginning…seems the the respondents are friends of the original writer…the doctor is not concerned with the financial part but as an outsider, I see how many people listen to the message before they actually speak to a physician on-call…many get the information and service they want and then act surprised when there is a bill. Seems easy to blame the doctors doesn’t it….remember doctors aren’t God…they are professionals and they do the best they can with what they have, they are working all the time and worry about people they don’t even know (in this case, you and your family)…You made it look like she was blowing you off and the responses seem to lean that way (your friends I suppose)…if you have any experience in Japan you will know that there are many medical facilities that would not have even accepted you or your child as a patient…you are lucky you had (I stress had) someone that made over ten phone calls in Japanese trying to find the best facility in Tokyo to accept your child…why is it irresponsible for a professional to direct you to the best possible care for your loved one knowing their facilities were ill equipped to adequately check your loved one? The doctor I DONT want is the one that visits your house and says your child is OK by just looking at them…keep that in mind the next time you are needed care…one that will direct you to the best care or a professional educated guess….which one do you feel safer with?

  20. Are you not reading the entire messages..the doctor NEVER makes a verbal consultation diagnosis and I hope none do. The questions that were asked are the basic ones that inform the doctor of the next step…

    I find it ridiculous and laughable when the doctor did a verbal consultation through the phone without taking a look at your daughter. Head injuries can result into other problems that is not visible to the naked eye, to make it worse, she is only 2 years old, her skull is definitely not as hard(best term i can come up with) as a normal adult so we will never know unless you do a thorough scan.
    The only positive thing i can say about the doctor is that at least he did try to make a call back although it might seem a bit too late at that point

  21. All of the comments by me are from me. This will be my final response. First and foremost…hope your child is better and you have learned your lesson about medicine in Japan. As I have a one year old, if she were to get hurt, we would call momma first and then of course momma would take us to the er. The reason we moved to Japan from Los Angeles was because my better half wanted to eliminate what you have experienced (in fact, that is how we met, I was unable to get help for a back injury)…You may know that the doctor isn’t at the clinic when you make your call but at home or whatever…that few minutes that you spoke of was scrambling to make phone calls and rushing to get to the clinic but obviously wasn’t fast enough for anyone writing on here…instead of trying to destroy the career of someone who has worked their entire life to care for others, you might want to provide some faster and more efficient solutions. (Your call wasn’t the only emergent call that day…there were others before you and there have been no complaints in 5 years) As a Mr. Mom who has sacrificed a career so my wife can serve you…it made me angry that you attacked the very thing she came here to do…to provide those that do not have the communication skills, the best care. If this means helping you get the help you needed by finding a specialist…then she would do it with no ego tied to it…she has no shame in finding the right person for you if she feels she cannot provide you with what you need. Unfortunately, you did not hang around to get the help and you were angry…your attack should have been on the system, not the doctor…because in the end the result was the same….someone looked at your child at a clinic (within 30mins to an hour), performed the proper tests (ct and other), and assessed the situation. You just bypassed going to the clinic and getting the help and a different manner…being escorted by a doctor to the ER and being helped…how do I know? I’ve been going on these so called “On-calls” with my wife for 5 years now….the emergent ones at 2am are a little hard to do with a 1 year old but we do it anyway….for you and with little gratitude…that is the way it is.

  22. From my point of view, repeatedly telling an anguished parent that the clinic’s closed only to call them back a few minutes later to tell them that it’s open for someone else and that she can book an appointment around the schedule of that someone else says a lot about Dr XXX’s attitude and customer service skills, or lack thereof. Moreover, the offer to meet doesn’t make sense to the patient if Dr XXX can provide nothing except reassurance. But it would make sense to Dr XXX if a higher bill can be put on the service for the face-to-face “consultation”. Since there already is another patient coming in at 1pm, another appointment at my convenience for a few extra dollars wouldn’t hurt. That’s how it seems to me. Customer service quotient = zero.

    As for Woodrow’s response, it is simply rude and will probably repel others from engaging in Dr XXX’s services, knowing the vitriolic diatribe that will be spewed out in her defense should they, God forbid, file a complaint.

    Stang

  23. If the incident really happened like Mini Me described it, and I can’t see any reason why it shouldn’t, then it is just outrageous what people like Woodrow Martin and Responsible Parent have to say about it. I think most of the readers agree to some points:
    1. If a child falls and hits its head, it is an emergency, no matter what the later diagnosis may be.
    2. If Dr. XXX correctly told the mother that the clinic is not equipped for such emergencies (which I find questionable), the proper thing to do would have been a recommendation for an ER where English is spoken. Duration: 1 minute. No need to call back, no need to bill.

    If a doctor has on-call duty, this includes DUTY, meaning that they have a duty and responsibility for patients even on weekends when they would love to spend their time with the family. Dr. XXX chose this profession, so she shouldn’t put her personal conveniences higher than the health of patients!
    As for Woodrow Martin’s last comments, I think he is the one completely missing the point. A house call was never in question and demanded, as far as I can read here, so why mention it? It has nothing to do with the incident. But reading between the lines money obviously does play a role for him.
    Dr. XXX’s judgement in this case was wrong, and her reaction inappropriate. She is lucky that the injury was not lifethreatening, because then she could have much bigger problems now than angry blogposts.
    As an expat in a foreign country, being not able to communicate freely with everyone, you should be able to rely on emergency services. Being turned away is not really reassuring. There should be no need to “learn a lesson about medicine in Japan”!
    I hope W. Martin is aware of the fact that his comments here are not helpful for Dr. XXX but instead show a very poor picture of both of them. They are lucky that the incident has no legal consequences for Dr. XXX.

  24. Woodrow Martin:

    1) The hospitals refused to take us. It wasnt because we didnt want to go to the ER. [see my previous comment on 22 March, 2010 (Monday) at 2:18 pm]. Calling the Emergency Hotline of our regular English-speaking clinic seemed like the next sensible thing to do at that time.

    2) The topic of a housecall was NEVER mentioned.

    3) The doctor DID NOT advice us to to go elsewhere to seek medical attention.

    4) The doctor DID NOT waive the bill from “the beginning”. The clinic called us the next day with the aim to confirm the patient’s name/details AND ask for payment. [see my previous comment on 20 March, 2010 (Saturday) at 9:01 pm]

    5) “The doctor NEVER makes a verbal consultation diagnosis”. So what did the the doctor do during both calls that deserved payment? Nonetheless, we were still prepared to pay. [see my previous comment on 20 March, 2010 (Saturday) at 9:01 pm]

    6) Of cos i did not “hang around to get the help” after repeatedly being told the clinic was closed. I dont think anyone would if they were in my shoes.

    7) The end result was not the same. Neither was the process to getting to the end result. We called Daikanyama Medical Clinic, described the situation and were told to make our way there. No telling us they couldnt see us, no having to call back. Phone call lasted perhaps barely 5 minutes. Period.

    Last but not least, your arguments seem to have heaps of contradictions. I’ll leave it to the readers to decipher it for themselves…

  25. @ woodrow martin

    still don’t catch your motivation for this dogmatic and absurd monologue. However, thanks to your intervention, everybody reading this blog learned that:

    * you accept and defend a sick health care system
    * you don’t care about parents being worried about their child
    * you don’t hesitate to turn a mistake into an embarrassment for your spouse
    * you prefer arguing with your spouse’s clients rather than launching an “in-house lessons-learned-session” to work on your customer orientation

    Dr. XXX didn’t act accordingly (and humans make mistakes) but thanks to your wordy justification it finally looks like a totally inadmissable behavior. In other words Dr. XXX lost her face.

    Stories about your professional careers (in Los Angeles or elsewhere) don’t change anything or distract from the fact that YOU „are still missing the point“:

    * Dr. XXX demonstrated negligent reaction to a mom seeking help for her child
    * Not sure (will find out) but Dr. XXXs behavior probably not in compliance with japanese law
    * Job and duty of Dr. XXX is to come up with a solution and not explaning the constraints

    Everybody reading this blog will draw their conclusions and find a way to get in touch or evade Dr. XXX.

  26. It seems as though this “emergency” wasn’t an emergency…..

    “Our 2 year old daughter fell and hit her head with great force on a sharp edge of a stone corner along a pavement YESTERDAY”

    You waited “a day” before you tried to get help for your child that “hit her head with Great Force” on a “Sharp edge”

    The real point Matt is that the doc gave the caller what should have been enough…general inquiries about the child and an appointment all within the hour much faster than the 24 hours this concerned mother waited until she called someone….what else did you want?…please go to the American Pediatric Associations site and it will tell you the same info. The doc set up an appointment for someone that didn’t call anyone for over 24 hours after the injury…even you have to admit that it couldn’t have been an emergency. The reason for the appointment was a “solution”…Am I the only one that can figure it out among MiniMe’s friends? I do not represent my wife…she is her own person and she has a spotless record…just wondering why someone that waited 24 hours after an emergency suddenly want emergent care….that is me talking Matt….

  27. Woodrow Martin…still missing the point.
    This mother didn’t wait 24 hours to get help for her child, she waited 24 hours to WRITE THIS BLOG, because after her daughter had an accident, she had MORE IMPORTANT THINGS to do, for example GETTING HELP. Anyone too stupid to follow the time line should not leave comments here. May I cite your entry from March 23? “This will be my final response.” Please, do us a favor and stick to that!
    If you are not representing your wife, than why doesn’t she give us her point of view? Afraid of contradictions?

  28. Woodrow Martin, Woody or whatever name you want to be known as….

    If you even bother reading the post properly or have an ounce of common sense, you would know that i wrote the article one day AFTER the horrendous experience with Dr XXX.

    You will be surprised (and perhaps even disappointed) to know just how many people out there actually read this blog. I sincerely hope for your own sake that your wife, Dr XXX, is not one of those reading this.

    It is quite one thing to want to defend a loved one (understandable) but it is quite another to be sprouting all these nonsense which obviously has blinded your ability to even think or read straight, let alone get the facts right.

    Based on what you last wrote, you have given me every reason not to publish your comments in future so that i may spare the rest of the serious readers any more anguish from reading your foolish comments.

    I have bestowed you more courtesy than you deserve so far but this is where i draw the line. I am sure many others will agree with me…afterall this is an open blog for all to read.

  29. Martin Woodrow’s comments are completely inappropriate. It is obvious that he does not have a solid medical background and that he is blinded in his efforts to stand up for his wife.

    Firstly, I do not see what the point of stating his personal affairs with Dr XXX has got to do with this situation. All it tells me is that Dr XXX married her patient which is completely unprofessional. Also, if you are not a doctor, why are you following her to house calls anyway? As a patient, I would find that as a breach of confidentiality and an unwelcome intrusion onto my privacy. Furthermore, I am sure that Dr XXX is a big girl and does not need you there holding her hand. Personally, I would feel that unneccessary people interfere with the Doctor-Patient relationship and it would mean that there are even more people I have to “look after”.

    Do you even have consent from your wife to answer on her behalf as I am sure that you are not doing her any favours on this bulletin board and are just making matters worse. The truth is that all Doctors are normal human beings and make mistakes too. From what I see, not only was there was an error in clinical judgement but there was extremely poor communication with the patient. To make matters even worse, Dr XXX made the inappropriate decision to bill the patient for services she did not render and you have inflamed the situation further by making poor excuses for her.

    As soon as Dr XXX heard that there was a period of altered consciousness following head trauma, her immediate response should have been to refer her to a centre with medical imaging facilitaties and preferably somewhere with paediatric or neurosurgical capabilites. No further discussion or treatment from her is required. Any efforts to delay this by seeing the patient in her office or by making a house call (an even bigger waste of time) is potentially risking the child’s life. Dr XXX does not have the required facilities for definitive diagnosis or treatment anyway.

    Sometimes as a doctor, if you genuinely made a mistake, you just have to cop it on your chin. If she had taken the time to listen to her patient’s concerns and admit that the situation was poorly handled, the patient would have likely understood and be satisfied with their treatment. Let this be a big lesson to you in the future. Next time you might be able to save a public humiliation and be left with some form of a reputation.

    Oh, and as a doctor, you should never ever have a reason to lie. Even if you were too lazy to go in to see her, you should have never lied that the clinic was closed. The truth always ends up coming out and you just end up looking red faced.

    Dr Phil.

  30. Thanks to Woodrow MARTIN, it doesn’t take much to deduce that the irresponsible medical practitioner has the same surname as him. It seems like the doctor in question is no longer with Tokyo Medical Surgical Clinic though. Just as well and thank goodness.

    Our personal experience last year with a certain Dr Martin who used to work at that clinic was horrible. We brought our baby to her when he fell seriously sick with difficulty breathing only to be told he was fine and were subsequently sent home.

    The very next day, we had to rush him to the hospital where our son spent the next one week in ICU followed by another week in hospital. He was diagnosed with laryngitis subglottica, a form of acute respiratory systems illness at which the mucosa is inflamed and swollen up in the area of the larynx and the vocal cords.

    I can only imagine what the mother of the child who had the head injury went through and is certainly not a position i would like to be forced into.

  31. Wait… have these doctors even HEARD of the Hippocratic oath, much less swore it?!

    Its great that you got such great care for your daughter (and she was well!) but its quite shocking and, quite frankly, MUCH more than a little scary that any doctor, regardless of facilities or not, would tell you to “observe” your daughter instead of directing you to another facility or other.

  32. Doctors are human too and they make mistakes: the important thing is *realising* that they have made a mistake and trying to rectify it. Clearly, Dr XXX realised very soon – within 6 minutes! – that she had made a poor judgement call and phoned you back. Please give them a break.

    On the other hand, it is probably true that doctors – even those who are parents – do not share the same level of anxiety experienced by most other parents. This is partially because (1) they know how to deal with most eventualities that may arise, and (2) they’ve seen so much that they’ve become emotionally numb.

    Declaration of interests: mother is a doctor.

  33. [Addendum] Indeed, it would appear that Dr XXX’s principal error in this incident was failing to formulate her actions in a manner that would pander to an anxious mother, instead of failing in her duties as a medical professional as she quickly realised her misjudgement.

    You can probably tell that I’m rather lacking in empathy and this is exactly why (you’ll be relieved to hear, I’m sure) I opted against a career in medicine after hearing all the stories from my mother.

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