Mainichi: NJ medical intern death from overwork finally officially recognized as karoushi after 2 years

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Hi Blog. In a sad precedent, we have a clear case of death through overwork being officially recognized as such for a NJ doctor.  It’s sadder that it has taken so long (more than two years) for that official recognition to come through.  I’ve long realized that Japan has at times some pretty crazy work ethics (and a peer group atmosphere that encourages people to give their all, even until they die), but it seems even more crazy for NJ to leave their societies to come to a place that will work them to death.  Especially as a NJ “trainee”, where they have even fewer labor-law rights than the locals who are in similar work circumstances.  This situation has to be known about, since Japan’s immigration laws aren’t allowing a labor market where enough doctors (even imported ones) can satiate the perpetual labor shortage being referred to below.  Only when GOJ authorities realize that the jig is up, because the international labor force is avoiding Japan as a harsh labor market to work within, will things change.  Arudou Debito

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Death of Chinese medical intern recognized as work-related
December 26, 2012 (Mainichi Japan), courtesy of Yokohama John
http://mainichi.jp/english/english/newsselect/news/20121226p2a00m0na015000c.html

A regional labor standards inspection office in Aomori Prefecture has recognized that a Chinese trainee doctor who was working at a municipal hospital died from overwork, a lawyer representing the victim has disclosed.

It is reportedly the country’s first case in which a foreign doctor working in Japan has been recognized by a labor standards office as having died from overwork.

The Hirosaki Labor Standards Inspection Office in Aomori Prefecture acknowledged that the 2010 death of Lu Yongfu, a Chinese trainee doctor at a municipal hospital in Hirosaki, was work-related, in a decision on Dec. 20. Lu died at the age of 28 after working up to 121 hours overtime a month.

Ayako Hiramoto, a lawyer representing the victim, revealed the labor office’s decision during a news conference on Dec. 25.

According to the office, Lu had worked between 84 and 121 hours overtime per month before he died of an acute circulatory disorder in November 2010. His average monthly overtime hours surpassed 80 hours — the criteria for certifying death from overwork, or “karoshi” in Japanese.

The trainee was on duty almost all weekends except for the summer break, and had two to four night shifts a month that left him working on day shifts the following day without enough sleep, according to the labor office.

Lu had arrived in Japan in 2002 and graduated from the school of medicine at Hirosaki University in Aomori Prefecture before starting his internship at the hospital in April 2010.

Hiramoto said there were at least six other cases in Japan in which trainee doctors had died from overwork in the past.

“Regional areas are suffering from a serious shortage of doctors, while the management of their work hours is sloppy. Drastic measures need to be taken,” she said.
ENDS

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Original Japanese story

過労死:中国人研修医に初認定、残業最大121時間
毎日新聞 2012年12月25日 19時01分
http://mainichi.jp/select/news/20121226k0000m040047000c.html

青森県弘前市の同市立病院で研修医として勤務中の10年11月に急性循環器不全で亡くなった中国人の呂永富さん(当時28歳)について、弘前労働基準監督署が、長時間過重労働が原因だとして労働災害を20日付で認定した。代理人の平本紋子(あやこ)弁護士が25日、記者会見して明らかにしたもので、日本で働く外国人医師の過労死が認められたのは初めてという。

平本弁護士などによると、呂さんは02年に訪日し、弘前大学医学部を卒業。10年4月から同病院で研修医として外科や内科、救急部門の外科で勤務した。労基署の認定によると、この間最も短い月で84時間、最長で121時間の時間外労働をし、平均は過労死認定基準の80時間を超えていた。夏休み以外はほとんどの土日に出勤し、月2〜4回の宿直で十分な睡眠を取れないまま日直勤務についていた。

研修医の過労死は平本弁護士が把握しているだけでも過去6件。同弁護士は「地方の医師不足は深刻な上、研修医の労働時間管理はずさん。抜本的な対策が必要だ」と話している。

弘前市立病院の東野博院長は「労災認定されたことを重く受け止め、労働環境の再点検を行いたい」と話した。【東海林智】
ENDS

17 comments on “Mainichi: NJ medical intern death from overwork finally officially recognized as karoushi after 2 years

  • Loverilakkuma says:

    “The trainee was on duty almost all weekends except for the summer break, and had two to four night shifts a month that left him working on day shifts the following day without enough sleep, according to the labor office.”

    This is very serious problem. It’s totally against the standard labor law. Any kind of labor abuse that ignores the ethics of wellness, and demoralizes workers and/or trainees will not be tolerated in any developed country. The municipal hospital is held accountable for the negligence and some penal codes should be implemented for this disgraceful labor practice.

    Reply
  • So wait … rather than actually “working so much is what killed you”, the determination of “death by overwork” is based on an abstract number of hours of overtime worked? Not only does that not make any sense (which is kind of par for the course in Japan), but a lot of people – myself included – have no way of recording overtime worked other than keeping track of it personally. My employer sure doesn’t care, and as a public servant I officially work 35 hours a week regardless of actual circumstances. My options are either cause extreme meiwaku and try to get my employer to recognize my overtime – yet still not pay me for it, in violation of the labor standards law, but that’s another issue entirely – or tell my wife that she’s SOL if I happen to die from overwork because I either didn’t have 80 hours of ganbariya-points racked up for the month preceding the day I kicked the bucket on or they weren’t kept track of by my employer? My mind is just kind of blown, though honestly I shouldn’t have expected any less.

    I’ll leave it to someone else to apply the government’s 80 hour metric to the Japanese concept of “working hard” ie staying late doing absolutely nothing and being criminally underproductive regardless.

    Reply
  • It might seem crazy for people to want to work in Japan, but remember that in most cases their local working conditions aren’t stellar either, and that it’s basically impossible to have any decent understanding of work ethics and customs in Japan before one actually goes there.

    As far as I know most people outside Japan are aware of the long work hours and the effort required to work in Japan, but think there is a good reason for it being so. As in, “there must be a better payoff in the end”, or “your career would advance faster”, or even “you must get paid accordingly”.

    It is not until one goes to Japan that he/she realizes that conditions are somewhat harsh, compensation is not proportional to the effort (especially for NJ), and that most (if not all) Japanese work habits follow no logic or common sense.

    Of course, we also have to factor in the “double-standard” applied to NJ as we all know about… You are expected to work as hard as the Japanese and follow the rules, yet are not eligible for any of the benefits for being NJ.

    Reply
  • If your employer makes “saabisu overtime” a regular practice, take my advice: keep a diary that notes what time you start and leave work everyday. Make a practice of sending one last e-mail just before you leave (even if it is just a note to your private e-mail address about what time you are leaving work). This is all good evidence if you ever want to file an unpaid overtime complaint, and don’t let concerns about “disturbing the wa” distract you, because Japanese employees do this, whether they admit it or not. You can only ever claim for the last 2 years of overtime, but it makes a hell of a surprise for your employer (only to be deployed when you have left the company of course.)

    Reply
  • And Jim, if gaijin go home, you are also disloyal to Japan….Damned either way.

    But then again, what can We Japanese expect? Gaijins are bound to go home sooner or later,so why give them rights? (Devil’s advocate perspective on the self justification of J rightists of not providing any incentives to stay).

    Come to think of it, this emphasis on “loyalty” is very 1930s, in contract to the postwar “incentive-based” approaches to economic problems, and also arguably dovetails with the LDP”s 50 year campaign to roll back individual rights in favor of obligations of the citizen to the state. Abe is the latest in this tradition, emboldened by a second term.

    Reply
  • Here are two articles relevant to this discussion. The first is about measures taken in South Korea to deal with the culture of overwork:

    http://www.japantimes.co.jp/news/2013/02/16/asia-pacific/workaholic-south-koreans-begin-to-get-more-free-time/

    The second is about the continuing prevalence of fax machine usage through out Japan, espesially in business:

    http://www.nytimes.com/2013/02/14/world/asia/in-japan-the-fax-machine-is-anything-but-a-relic.html?_r=0

    What I find interesting is the general attitude towards work related issues in Japan and South Korea.

    SK has faced up to on going problems in the work culture, recognised that society has changed and the authorities have made a pragmatic descision to deal with the problem (ensuring that employees work no later than seven pm) and then followed it through with practical measures to ensure implementation. Moreover, judging for the comments of the bank employee interviewed, workers have a clear understanding of why the policy needed implementation.

    Compare this with the comments in the Japan piece: Fax machine usage has nothing to do with an aging, conservative society, rather it is because Japanese innately love the warmer communication of the written word (even though the word is printed via fax) They also love being able to add ridiculous little requests to ensure that overworked bento makers have even more stress. This is all fine, as Japanese lunch boxes apparent go back to the Heian Era. Presumably fax machines do too.

    Anyway, the point is that in Japan, the whole culture of work is completely driven my ideology: Those women in the bento company aren’t being exploited/overworked and underpaid by their boss (putting up requests on the noticeboard to exhort them to work harder), they are continuing the unique civilisation that is Japan. They have won the lottery in life!

    When things as mundane as working for a wage have become so ideologically loaded, how can there be hope of change?

    Reply
  • Ahhhhh yes, the Japanese “work ethic”. More hours is the answer to everything. If 16 hours a day doesn’t do it, make it 24. Very productive indeed.

    I’ve worked at enough Japanese companies to know that they just can’t grasp the concept of “working smarter”. For example, if a certain procedure creates needless work, what do they do? That’s right, put in more hours. Here’s an idea: streamline the procedure! But nope, somehow that concept just can’t enter their narrow minds, so they keep plowing away doing needless tasks day after day, and congratulate themselves for being such hard workers.

    In fact, the way they define and measure how hard someone works is mostly by how many hours he puts in. Suzuki-san works 16 hours a day, so he must be a harder worker than Tanaka-san who only puts in 15 hours a day. Nevermind that Suzuki-san really doesn’t do shit. Given the current state of the Japanese economy, Suzuki-san better give some serious thought into what it really means to be “productive”.

    Reply
  • Winning Gold in Dressage Doesn't Count says:

    “Compare this with the comments in the Japan piece: Fax machine usage has nothing to do with an aging, conservative society, rather it is because Japanese innately love the warmer communication of the written word”

    The “old people can’t use kanji software” explanation is the one that I’ve heard most often. The are a number of other explanations as well, but the most likely one is institutionalization. Even in the 1990s not many people in the west had faxes in the home, but they were an extremely useful item in Japan where there was no logical system for physical addresses and mapping software was not widely available. People did frequently use them back then to show others how to get to their house, a restaurant, etc. So they were popular and they stuck. And yes, older people do still use them for this purpose.

    But you can play the antiquated technology games with just about any country. America still has the largest per capita number of landlines to homes. How quaint! And then there is this: http://www.theatlantic.com/technology/archive/2011/08/what-your-old-graphing-calculator-says-about-technology/244028/

    I’m not sure I’d make sweeping generalizations based on this sort of thing. What I will say though, is that Fackler needs to be a bit more original. Basically the same article without the frills of “people with opinions” appeared in the Washington Post half a year ago.

    http://www.washingtonpost.com/world/asia_pacific/in-japan-fax-machines-find-a-final-place-to-thrive/2012/06/07/gJQAshFPMV_story_1.html

    Reply
  • http://www.ons.gov.uk/ons/rel/icp/international-comparisons-of-productivity/revised-estimates-for-2009/international-comparisons-of-productivity.pdf
    One link to sum it all up. Look at how underproductive Japanese workers are – and then realize that they’re doing something like 1.5x-2x the hours of your average G8 worker. It’s almost comical how poor the actual work ethic is.

    It’s the same as the Japanese approach to education. Students falling behind? Clearly the answer is to do away with yutori kyoiku and add back in Saturday classes. Never mind doing something as simple as canvassing world education leaders or perhaps even a bit of examination of the fundamental problems of education here – no, it’s clearly just a lack of time. If they stare blankly at their books for a few more hours a week, they’ll absorb the contained knowledge through osmosis, obviously!

    Reply
  • Every new article brings new evidence of Japan’s decline.
    The benefits of its top-down leadership structure were abundant when it was growing.
    Now that it is shrinking, they are a big liability.
    Total disregard for workplace efficiency is a killer.
    I wonder when the people who run the country will figure this out, and issue a decree similar to that done in S. Korea?
    Maybe never…

    Reply
  • 9# Al Says

    A friend of mine who works in Japan talked similarly about the Japanese “work ethic” and how some of the Japanese employees spent more time taking coffee/cigarette breaks than doing any actual work. You can also see this system of inefficiency in Japan’s high schools. Whereas most countries in the developed world allow their students to type their reports on computers Japanese students still have to do theirs the traditional way and any mistakes require they write the entire report over. Not terribly efficient but sadly that’s become modern Japan.

    Check out gaijinchronicles. A website run by a fellow NJ who gives a more humorous summation of the craziness of modern Japan

    Reply
  • at post 10:

    The “old people can’t use kanji software” explanation is the one that I’ve heard most often. The are a number of other explanations as well, but the most likely one is institutionalization. Even in the 1990s not many people in the west had faxes in the home, but they were an extremely useful item in Japan where there was no logical system for physical addresses and mapping software was not widely available. People did frequently use them back then to show others how to get to their house, a restaurant, etc. So they were popular and they stuck. And yes, older people do still use them for this purpose.

    So, you agree, the reason why fax machines are so widespread in Japan is due to an aging conservative (and institutionilised) population? Your idea that it is due to address problem, sounds like a pretty minor one to me, but I suppose it may have some merit twenty years ago.

    As for your people with opinions quip: Do you deny that people think and justify nonsensical practices like this in Japan? If so, we lived in two different countries. Just listen to the political leaders.

    Reply
  • Winning Gold in Dressage Doesn't Count says:

    >Do you deny that people think and justify nonsensical practices like this in Japan?

    No, but with vox pops you can justify anything. “People” think a lot of things, and I could probably write an article that painted a different picture and “substantiate” it with such opinion. The WaPo article cited technology analysts and looked at data more thoroughly. It was simply a better piece.

    Reply
  • The thing is, though, that the situation actually backs up said “vox pop”. Compared to the measures taken in SK to deal with the culture of overwork and related problems, Japan has done what exactly? Half heartedly attempted to increase childcare, so that people can work harder? Slashed social support, in order to force people to work harder? Can you see the link here? Couple this with posts on this thread about the default setting towards problems in companies/schools and other organisations being “the floggings willcontinue until morale improves.”

    Actually, even the concept of karoushi is an ideogically driven one. Think about it: Overwork has become a tangible thing, a reality that can be diagnosed. It is part of life, like the air and mountains not a a fluid concept.

    You may dismiss it, but that boss in the fax machine piece is pretty typical of management level thinking in Japan, it could be Abe or Aso parroting the same popaganda.

    Reply

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