Expat’s Japan remedy: assimilate

Hospital exec finds a little language ability, cultural awareness, the occasional bow go a long way


Don’t be a nail that sticks up. Assimilate.

That’s the advice John C. Wocher, executive vice president at Kameda Medical Center in Kamogawa, Chiba Prefecture, has for fellow foreigners eyeing a long-term stay in Japan.

Wocher, who was stationed at the Kamiseya base in Kanagawa Prefecture when he came to Japan in 1964 as a sailor, spent nearly three decades assigned to health care duties at various bases across Japan and the U.S., in addition to serving in Vietnam, before landing a job at Kameda in 1991.

The 66-year-old Ohio native, who has since settled here with his Japanese wife, two children and three grandchildren, says he has practiced the golden saying: “When in Rome, do as the Romans do.” Learning the language, culture and adopting some Japanese behavior, like bowing and being “a little more kind and gentle,” were among them.

The approach has worked. At Kameda, a nine-building, 900-plus-bed hospital complex where he also serves on the board of directors, he has succeeded in bringing about some sweeping reforms, including making Kameda in August the nation’s first facility to be accredited by the Joint Commission International, an international hospital accreditation body that evaluates the safety and quality of care.

Wocher, who attends many executive meetings, said he has even adopted the art of “nemawashi” (building consensus on an issue among major decision-makers before the issue is officially discussed and put to a vote in a meeting).

“I used to be more argumentative,” Wocher said. “I used to not enjoy confrontation, but was familiar with it. But I think I’ve learned here that confrontation is not the best way to handle issues. I like the idea of consensus or nemawashi . . . that kind of process was very very interesting for me to experience firsthand in Japan.”

For Wocher, the first non-Japanese employee at Kameda, the key to success is to “fit in,” including learning the language and culture.

“I don’t think learning the language will dilute your individualism at all,” he said. “You are always going to go back to the other language. I think it shows your respect for where you live — that you can at lease converse in the language.

“And I think (that you should) adopt some of the behavior here. Be a little more kind and gentle. Maybe bow now and then. You’ll be more respected for that than always being on the outside, always being different.”

Being comfortable with the Japanese way does not mean he holds back his opinions. In his 2000 book titled “Nippon no Byoin” (“Hospitals of Japan”), he exposed the grim reality surrounding many hospitals and doctors here, for not obtaining informed consent from patients, oversubscribing drugs, unnecessarily prolonging hospital stays and various other injustices and inconveniences.

But at the same time, he is also harsh with patients who blindly trust doctors and the health care system.

“If I’m going to be critical, I’m critical of patients who are passive,” he said. “I would like to see more of patient advocacy. We shouldn’t trust government and hospitals blindly. That’s part of group think.”

The lack of entrepreneurial spirit in health care fields and elsewhere in society is another aspect of Japanese society that he would like to see change.

“It’s just like when you ask the average Japanese who graduate from college, maybe an MBA, ‘What do you want to do with your life?’ ” he said. “(They would say) ‘Oh, I want to work for a first-tier company,’ ‘I want to work for Mitsubishi,’ or ‘I would like to work for a bank or for a big company.’ If you ask the average American, that’s not the answer you get. The answer is, ‘I want to own my own company.’ The idea of entrepreneurial spirit is still not alive and well here. And that’s one of the reasons hospitals have not progressed so much.”

But how was he able to fit in so well, especially in a rural area like Kamogawa, where some of the locals have probably never traveled overseas or have never interacted with foreigners before?

“If you are a good role model all the time, that will rub off,” he said. “You will be seen as someone reliable, someone ethical. If you act like this every single day, over time, your colleagues and your coworkers and your friends will recognize that you are genuine.

“And I also think that, if you are here for the long term, make an investment long term. Don’t keep talking about ‘Oh, this is not the way we do it in America,’ or ‘This is not the way we do it in Chicago.’ If you are here, make a commitment in the long term,” he said.

Now with more than four decades of on-and-off relations with Japan, Wocher, who plans to stay here permanently, said he feels comfortable living in Japan, calling it his “adopted home.”

“The longer that I’m here, at this point now, there really isn’t anything I miss,” he said. “I think in Japan you can get anything, too. You have the Internet, eBay and Yahoo and you have Costco. It’s pretty difficult to miss something.”