But now, not so much. In my experience, Japanese doctors are on average quite good, and unlike in the U.S., you can actually walk into a clinic or hospital and speak to an actual doctor, not a PA or RN, within a reasonably short period of time... without having to go to an ER.
A very close friend of mine is an ENT, and her husband is an oncologist, so I've got a bit of insight into the medical system here. There's no direct equivalent of the AMA, so there's no artificial restriction on the number of physicians produced every year.
Starting pay for a new physician out of residency is much lower than the US, but rises quickly with experience. Also, to become a doctor, you aren't required to first get a BA or BS -- you just go directly into medical school for about six years, as I understand it. Followed by rotations and residency, just like we do it in the U.S.
Other than not needing to get a BA/BS first, medical training in Japan is effectively the same as the U.S.
There is one problem that deserves mention: "chinese medicine".
Many people, especially the elderly, prefer to seek 'traditional' treatment for health problems, so there are plenty of 'doctors' and clinics certified to practice chinese medicine.
These operate alongside, and sometimes inside, traditional clinics. They are part of the medical fabric here for historical reasons, and many Japanese swear by them.
Personally, I've had the misfortune of visiting one of these when I had a minor bronchial infection, back before I understood enough Japanese to know what I was being prescribed.
Two weeks of worsening coughing and hacking, and each visit I got a stronger packet of what, pardon the pun, boiled down to being some notably awful tea.
Once I figured things out, I visited a real doctor and picked up the local equivalent of a Z-pack (azithromycin), and was fine by the end of the following week.
I am convinced that for 99% of doctor visits the quality of doctors is completely irrelevant. So long as they can fill out prescription forms and scold you for your blood pressure/weight/drinking/smoking, you're going to have the same experience.
I would be more concerned about surgeon quality, but that sort of thing is rarely needed.
As someone who had Kaiser Permanente coverage as a young adult, I don't agree with you. The doctors were incompetent, incapable of diagnosing why I was falling ill with the same symptoms every month. They gave outright bad advice on the subject of an ankle injury, which scared me off from doctors for years. In my experience, the difference between a good doctor and a bad doctor is enormous.
I don't think it's the quality of doctors but the language barrier that limits your selection. There are some doctors that specialize in treating foreigners purely for financial reasons (not for better money but for income stability since the market is a bit competitive). Also, doctors tend to come from a position of authority and they don't really care to explain things thoroughly. It sounds like I'm proving your point but I've rarely had a negative experience with the quality of doctors. Dentists are another story...
Well, the basis for my opinion of Japanese doctors comes from talking to Japanese people, and from some books about Japanese expats.
I'm not even going to get into the stories I've heard from two Japanese women about being effectively molested by their family doctors around the age of 16.
