{"id":14616,"date":"2017-05-12T16:32:12","date_gmt":"2017-05-13T02:32:12","guid":{"rendered":"http:\/\/www.debito.org\/?p=14616"},"modified":"2017-05-12T16:34:31","modified_gmt":"2017-05-13T02:34:31","slug":"asahi-joe-kurosu-md-on-ineffectually-low-doses-of-medicine-and-bureaucratic-intransigence","status":"publish","type":"post","link":"https:\/\/www.debito.org\/?p=14616","title":{"rendered":"Asahi:  Joe Kurosu MD on ineffectually low doses of medicine for NJ patients and bureaucratic intransigence"},"content":{"rendered":"<p>Books, eBooks, and more from Dr. Debito Arudou (click on icon):<br \/>\n<a href=\"https:\/\/www.debito.org\/handbook.html\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11452\" title=\"Guidebookcover.jpg\" src=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2013\/05\/Guidebookcover.jpg\" alt=\"Guidebookcover.jpg\" width=\"75\" height=\"100\" \/><\/a><a href=\"https:\/\/www.debito.org\/japaneseonly.html\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-11335\" src=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2013\/04\/japaneseonlyebookcovertext-150x150.jpg\" alt=\"japaneseonlyebookcovertext\" width=\"75\" height=\"100\" \/><\/a><a href=\"https:\/\/www.debito.org\/handbook.html\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-1298\" title=\"Handbook2ndEdcover.jpg\" src=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2012\/12\/Handbook2ndEdcover.jpg\" alt=\"Handbook for Newcomers, Migrants, and Immigrants to Japan\" width=\"75\" height=\"100\" \/><\/a><a href=\"https:\/\/www.debito.org\/inappropriate.html\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-8577\" title=\"inappropriatecoverthumb150x226\" src=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2011\/03\/inappropriatecoverthumb150x226.jpg\" alt=\"\" width=\"75\" height=\"100\" \/><\/a><a href=\"https:\/\/www.debito.org\/japaneseonly.html#japanese\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-1700\" title=\"jobookcover\" src=\"https:\/\/www.debito.org\/wp-content\/uploads\/2008\/05\/jobookcover-150x150.jpg\" alt=\"\u300c\u30b8\u30e3\u30d1\u30cb\u30fc\u30ba\u30fb\u30aa\u30f3\u30ea\u30fc\u3000\u5c0f\u6a3d\u5165\u6d74\u62d2\u5426\u554f\u984c\u3068\u4eba\u7a2e\u5dee\u5225\u300d\uff08\u660e\u77f3\u66f8\u5e97\uff09\" width=\"75\" height=\"100\" \/><\/a><a href=\"http:\/\/www.cinemabstruso.de\/strawberries\/main.html\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2735\" title=\"sourstrawberriesavatar\" src=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2009\/03\/sourstrawberriesavatar.jpg\" alt=\"sourstrawberriesavatar\" width=\"75\" height=\"100\" \/><\/a><a href=\"https:\/\/www.debito.org\/?cat=32\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-4921\" title=\"debitopodcastthumb\" src=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2009\/11\/debitopodcastthumb.jpg\" alt=\"debitopodcastthumb\" width=\"100\" height=\"100\" \/><\/a><a href=\"https:\/\/www.debito.org\/?p=12473\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-12474\" src=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2014\/06\/FodorsJapan2014cover-150x150.jpg\" alt=\"FodorsJapan2014cover\" width=\"75\" height=\"100\" \/><\/a><br \/>\nUPDATES ON TWITTER: arudoudebito<br \/>\nDEBITO.ORG PODCASTS on iTunes, subscribe free<br \/>\n&#8220;LIKE&#8221; US on Facebook at <a href=\"http:\/\/www.facebook.com\/debitoorg\">http:\/\/www.facebook.com\/debitoorg<\/a><br \/>\n<a href=\"https:\/\/www.facebook.com\/embeddedrcsmJapan\">https:\/\/www.facebook.com\/embeddedrcsmJapan<\/a><br \/>\n<a href=\"http:\/\/www.facebook.com\/handbookimmigrants\">http:\/\/www.facebook.com\/handbookimmigrants<\/a><br \/>\n<a href=\"https:\/\/www.facebook.com\/JapaneseOnlyTheBook\">https:\/\/www.facebook.com\/JapaneseOnlyTheBook<\/a><br \/>\n<a href=\"https:\/\/www.facebook.com\/BookInAppropriate\">https:\/\/www.facebook.com\/BookInAppropriate<\/a><br \/>\nIf you like what you read and discuss on Debito.org, please consider helping us stop hackers and defray maintenance costs with a little donation via my webhoster:<br \/>\n<a href=\"http:\/\/www.dreamhost.com\/donate.cgi?id=17701\"><img decoding=\"async\" src=\"https:\/\/secure.newdream.net\/donate4.gif\" alt=\"Donate towards my web hosting bill!\" border=\"0\" \/><\/a><br \/>\n<i>All donations go towards website costs only. Thanks for your support!<\/i><\/p>\n<p>Hi Blog. <a href=\"https:\/\/www.debito.org\/?p=14594\" target=\"_blank\" rel=\"noopener noreferrer\">In our previous blog entry, Debito.org Reader StrepThroat brought up the issue of Japanese medical prescription doses being too low to be effectual for some larger patients,<\/a> particularly larger NJ patients used to larger doses overseas. Some respondents recommended <a href=\"https:\/\/www.debito.org\/?p=14594#comment-1564122\" target=\"_blank\" rel=\"noopener noreferrer\">taking double the dose<\/a> and going to the doctor again for refill of the\u00a0prescription, while <a href=\"https:\/\/www.debito.org\/?p=14594#comment-1564592\" target=\"_blank\" rel=\"noopener noreferrer\">others self-medicated<\/a>\u00a0with overseas supplements, and still others mentioned falling through the system entirely (<a href=\"https:\/\/www.debito.org\/?p=14594#comment-1564137\" target=\"_blank\" rel=\"noopener noreferrer\">particularly when it came to painkillers<\/a>).<\/p>\n<p>Joe Kurosu MD, who runs a clinic in Shimokitazawa, adds to this discussion in a January 2010 series of opinion pieces in the Asahi Shinbun, by saying:<\/p>\n<p>\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/<\/p>\n<p><strong><em>Asahi: \u00a0&#8220;For reasons that are unclear, however, the indicated maximum dose is often significantly lower than that which is standard in other parts of the world. Difference in physical frame and incidents of side effects are some of the purported reasons, but a scientifically convincing basis is lacking.<\/em><\/strong><\/p>\n<p><strong><em>&#8220;A significant number of resident foreign nationals currently receive health care through the Japanese national health insurance system, but are ill-served because of these dosage standards.<\/em><\/strong><\/p>\n<p><strong><em>&#8220;The maximum daily doses indicated on package inserts of standard medications for high blood pressure, diabetes and depression, for example, are one-quarter to one-half of the standard doses in other countries for the identical drug. [&#8230;]<\/em><\/strong><\/p>\n<p><strong><em>&#8220;In any case, if the government requires foreign nationals to join the [National Health Insurance] system, it must be willing to provide services appropriate to that population. If this is not possible, then buying in the system should be voluntary [&#8230;] I urge the government and relevant authorities to return autonomy to the physicians so the medications can be prescribed appropriately for the patient, whether or foreign or Japanese, based on science and clinical judgment, rather than [mechanically applying the dosage levels indicated on the package inserts].&#8221;<\/em><\/strong><br \/>\n\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/<\/p>\n<p>Here are scans of Dr. Kurosu&#8217;s articles in English and Japanese, courtesy of Dr. Kurosu himself (<a href=\"http:\/\/pctclinic.com\" target=\"_blank\" rel=\"noopener noreferrer\">pctclinic.com<\/a>) and RJ.<\/p>\n<p><a href=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2017\/05\/KurosuEngAsahiShinbun.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-large wp-image-14618\" src=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2017\/05\/KurosuEngAsahiShinbun-1024x724.jpg\" alt=\"\" width=\"1024\" height=\"724\" srcset=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2017\/05\/KurosuEngAsahiShinbun-1024x724.jpg 1024w, https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2017\/05\/KurosuEngAsahiShinbun-300x212.jpg 300w, https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2017\/05\/KurosuEngAsahiShinbun-768x543.jpg 768w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/a> <a href=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2017\/05\/KurosuJPAsahiShinbun.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-14617\" src=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2017\/05\/KurosuJPAsahiShinbun.jpg\" alt=\"\" width=\"1978\" height=\"1114\" srcset=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2017\/05\/KurosuJPAsahiShinbun.jpg 1978w, https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2017\/05\/KurosuJPAsahiShinbun-300x169.jpg 300w, https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2017\/05\/KurosuJPAsahiShinbun-768x433.jpg 768w, https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2017\/05\/KurosuJPAsahiShinbun-1024x577.jpg 1024w\" sizes=\"auto, (max-width: 1978px) 100vw, 1978px\" \/><\/a><\/p>\n<p>PDF versions here (click on link):<br \/>\n<a href=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2017\/05\/Kurosu2.pdf\">Kurosu2<\/a><br \/>\n<a href=\"https:\/\/www.debito.org\/wordpress\/wp-content\/uploads\/2017\/05\/KurosuArticleJP.pdf\">KurosuArticleJP<\/a><\/p>\n<p>There was another question as to whether <a href=\"https:\/\/www.debito.org\/?p=14594#comment-1564145\" target=\"_blank\" rel=\"noopener noreferrer\">Japanese medical testers screen for\u00a0Japanese as an ethnicity (or &#8220;race&#8221;) when it comes to clinical trials<\/a>. \u00a0Well, yes they do &#8212; as\u00a0<a href=\"https:\/\/www.debito.org\/?p=10563\" target=\"_blank\" rel=\"noopener noreferrer\">demonstrated here in Hawaii when I saw an ad in our campus newspaper back in 2012 calling for &#8220;Japanese&#8221; people to volunteer for a series of clinical trials &#8220;to help Japanese people&#8221;, sponsored by Covance.<\/a> \u00a0I inquired (as a Japanese citizen), but was told that they were only interested in &#8220;ethnic Japanese&#8221; (including those who didn&#8217;t have Japanese citizenship, but had &#8220;Japanese blood&#8221;). \u00a0Oh well. \u00a0Missed out on my body mass.<\/p>\n<p>Many thanks to everyone for helping make\u00a0Debito.org a valuable resource and forum. Dr. Debito Arudou<\/p>\n<p>=============================<br \/>\n<em>Do you like what you read on Debito.org? \u00a0Want to help keep the archive active and support Debito.org&#8217;s activities? \u00a0Please consider donating a little something. \u00a0<a href=\"https:\/\/www.debito.org\/?p=13748\">More details here<\/a>. Or even click on an ad below.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dr. Kurosu MD:  &#8220;For reasons that are unclear, however, the indicated maximum dose is often significantly lower than that which is standard in other parts of the world.  Difference in physical frame and incidents of side effects are some of the purported reasons, but a scientifically convincing basis is lacking.  A significant number of resident foreign nationals currently receive health care through the Japanese national health insurance system, but are ill-served because of these dosage standards.  The maximum daily doses indicated on package inserts of standard medications for high blood pressure, diabetes and depression, for example, are one-quarter to one-half of the standard doses in other countries for the identical drug.  [&#8230;]<\/p>\n<p>&#8220;In any case, if the government requires foreign nationals to join the [National Health Insurance] system, it must be willing to provide services appropriate to that population.  If this is not possible, then buying in the system should be voluntary [&#8230;]  I urge the government and relevant authorities to return autonomy to the physicians so the medications can be prescribed appropriately for the patient, whether or foreign or Japanese, based on science and clinical judgment, rather than [mechanically applying the dosage levels indicated on the package inserts].&#8221;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[54,22,34,26,4,60,46,64,55,8],"tags":[],"class_list":["post-14616","post","type-post","status-publish","format-standard","hentry","category-pinprick-protests","category-cultural-issue","category-exclusionism","category-ironies-hypocrisies","category-japanese-government","category-nj-voices-ignored","category-practical-advice","category-sitys","category-tourism","category-8"],"_links":{"self":[{"href":"https:\/\/www.debito.org\/index.php?rest_route=\/wp\/v2\/posts\/14616","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.debito.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.debito.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.debito.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.debito.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=14616"}],"version-history":[{"count":0,"href":"https:\/\/www.debito.org\/index.php?rest_route=\/wp\/v2\/posts\/14616\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.debito.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=14616"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.debito.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=14616"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.debito.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=14616"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}