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A course, B course, or C course?

By on August 30, 2012

I do not mean the choice of lunch menus in Japanese restaurants, which are generally nourishing and good value.  I am referring to the different types of routine medical check-ups, the ‘human dock’ examinations offered in many Japanese hospitals and clinics.  Sometimes these  are referred to in terms such as standard, superior, and executive, with the implication that ‘more is better’.  But is it?Details of the tests are often set out in the lists of what is covered in the different ‘courses’, and, from some that I looked at recently, include important assessments as – I kid you not – mean corpuscular haemoglobin concentration, gamma-GTP and haemoglobin A1c.  Are they perhaps trying to blind you with science?  Also, the offering of tests for the early detection of cancer is playing on fear: you may be developing cancer and not know it and if you have high tech scans, blood tests for ‘cancer markers’, mammograms, etc., they may save your life.Further, in many cases the results are presented rather a like a school report, with grades A to E.  An A means everything is fine, but if you get an E you had better go and see the Headmaster!  This is patronising and can be misleading.  One may be ‘marked down’ because the numbers are wrong.  There may be little or no attempt at interpretation of the results.  So, a result may be above or below the so called reference range, but is it significant?  Does it matter for the patient?It is possible that, by chance, a serious disease might be discovered and some lives may be saved.  But how many tests for, say, stomach cancer, need to be done to save one  life?  In general, do death rates go down if screening rates go up?  In many cases there are no clear answers.

Check-ups are not without risks.  For example, in Japan stomach X-rays are often included, and if done yearly over a number of years the cumulative radiation dose may be harmful.  Then there are false-positives – results which are unclear but may be abnormal – for which morel tests may be recommended.  This will produce additional anxiety, trouble and expense for the person and it may be a false alarm after all.

Perhaps the main disadvantage of routine check-ups is that they can undermine someone’s confidence in their own state of good health.  In general, if you feel well, you are well, and you don’t need high tech tests to prove it.  It is sometimes forgotten that it is normal to be healthy.

On the other hand, routine check-ups can produce a false sense of security.  It is possible to undergo the super executive type of check-up, with all the results being normal, and then step outside the building and drop dead from a heart attack.

Insofar as it is on our own hands to stay healthy, the advice is simple: don’t smoke, don’t drink excessively, avoid being overweight, exercise regularly and eat a healthy diet. Note: The above is intended as general information only.  If you have concerns about your health or the need for a check-up, please see your doctor.

 

About Dr. Gabriel Symonds

Dr. Gabriel Symonds was the director of the Tokyo British Clinic. The clinic closed down in May 2014 after serving the expatriate community for 20+ years. Dr. Symonds has retired and the Tokyo British Clinic is now closed. Dr Symonds will continue to live in Tokyo and may be contacted by e-mail over any questions concerning medical records or related matters: symonds@tokyobritishclinic.com He will be available from another address for: smoking cessation psychotherapy/counselling circumcision information Tel: (03) 5458-6099 www.tokyobritishclinic.com