A key element of Japanese business culture is the business card. This has been a difficult part of business for me to master. I tend to leave the cards in the office at key times. They just aren't an important thing for me to consider. To alleviate the problem, I purchased a business card holder. The sole purpose of this mini-wallet is to hold your business cards for distribution and give you a place to store cards. I wanted to have a card holder to assure that I would always carry the cards with me. This is critical to operating in Japan. Going without cards is like forgetting to put on pants. There is even a subtle ritual to giving and receiving the cards. When you give a card, you hold it with both hands, assuring that the lettering on the card faces the recipient. You slowly extend the card toward the recipient. When you receive a card, you accept the card with two hands. You carefully read the card, nod your approval, (an interesting process when you can't read many of the cards) and hold onto it throughout the meeting. You must be careful not to simply place the card in your pocket, since that is considered extremely disrespectful. It's a fascinating social phenomenon. Foreigners in Japan must be very careful to observe this ritual to assure they don't alienate the people they deal with. I believe I have it mastered now, but I am sure that I will learn an addendum to this procedure in the near future. With many of the social rituals here, the more you go through it, the more details emerge. Business ettiquette in the US is much less complex than it is here. The same type of formality exists, but in Japan, it's much more structured and rigorous. Every tiny move you make has some significance. As an American here, I find myself examining every little thing I do under a microscope. I am sure that I am still making some mistakes, but foreigners are _generally_ given some freedom from the social rigors that are so important to Japanese society. Still, I would like to master these rituals so I can feel fairly confident when dealing with Japanese businesspeople. With preparation I had in these forms of etiquette, I set out for my second round of tours in Tokyo. On the agenda today were a visit to St. Luke's Hospital and Johnson & Johnson. Again, the train left Kamogawa at 7:38 AM and arrived in Tokyo around two hours later. Chiaki accompanied me on this journey to serve as guide and interpreter. We arrived at St. Luke's around 10:00. From the outside, St Luke's looked very different from other Japanese hospitals. Foremost, there were lots of plants surrounding the hospital, giving it a more comfortable feel. There was also a giant cross on top of the hospital, clearly showing the organization's affiliation. The inside of St. Luke's was also atypical of Japanese hospitals. The lobby was large, open, and like a hotel. The hospital elements were hidden away. The rooms were all private. Most Japanese hospital rooms house two to four people. This difference has some important implications for infection control. Each room at St. Luke's had a TV, which is often not the case in Japanese hospital rooms. At Kameda, you check out the TV by the day and pay a fee for its use. St. Luke's also lacked the clutter in the hallways and sterile, white walls that typify Japanese hospitals. It looked like the best American hospitals. It was clean, modern, and gave visitors a feeling of comfort. Mr. Ishiyama, the Public Relations director, who gave me the tour, was a very pleasant man and was a strong advocate of the organization. It didn't need much help...the place did a good job of selling itself. St. Luke's also owns a tower next to the hospital which contains a variety of offices and restaurants. On the 46th floor, there was an observation deck. You could look over central Tokyo and see much of the city. It was a breathtaking experience. It also underscored the enormity of the city and the activity within. It is really something to think of a city where 12 million people live and work. When you look down into it, it's even more meaningful. The tower had some other significance. Since Japan has socialized healthcare, it is difficult for hospitals to make enough money to improve their facilities. St. Luke's bought the land for the tower long ago and built on it. They spun off a company to rent the office space for the tower to companies in the area. With Tokyo's notoriously high rent, a 45+ story building provides a lot of opportunity for money-making. This money is invested back into the hospital. They also make money from health consultations. Patients can pay to talk with a physicians for an hour or so. This is a significant opportunity. In Japan, people usually wait one to three hours in the waiting room for a five minute meeting with their physician. Only top physicians are involved in this program. With this extra money, along with some other endeavors, St. Luke's has been able to provide the best facilities and hire the best physicians. This puts them in a very strong position among Japanese hospitals. After a spicy ramen noodle lunch and cup of Starbucks coffee (purchased in the St. Luke's tower), Chiaki and I went to Johnson and Johnson. The presentation was by Mr. Horio, the director of materials management. He did a Power Point presentation about his company, highlighting the diverse product line and inventory management. The latter topic was extremely interesting. They have an extremely powerful database program run on IBM AS/400 servers that uses a multiparametric equation to determine the amount of inventory needed at any given time. It is over 99% accurate. Data is put into the system daily, allowing the projections of inventory need to be as accurate as possible. This system is shared with J and J's Japanese partners and has resulted in decreasing labor costs in inventory management with increasing volume. The system completely blew me away. It's the kind of thing a computer nerd dreams of: using a computer to eliminate the need for labor and perfecting a process. Amazing! Mr. Horio was quite a delightful host. He spoke excellent English and made many jokes (and, yes, I am sure that he was making jokes and not making mistakes in speaking). Upon explaining how hot the meeting room was, he said, "If you get too hot, you can take off your pants. We are very casual here." He also announced that he was heading out for a "cancer break" halfway through the presentation. He had an unusually good sense of humor and went out of his way to make sure I understood his company's work. Overall, Mr. Horio was an excellent host and did an excellent job of explaining his work at Johnson and Johnson. I also was intrigued by Johnson and Johnson's labor composition compared to Baxter and Pfizer. I didn't see a single American in Johnson and Johnson. In the other companies, I saw many Americans. I am under the impression that the lack of Americans is a consequence of the autonomy of individual J and J offices. I wrapped up the day with a quick trip to the Ginza neighborhood of Tokyo. This neighborbood is home to the Sony Show Room. This eight-story building is filled with new televisions, Walkmans, computers, stereos, video games, car audio systems, GPS, and every other Sony product. They had some glasses with TV sets inside. I tried them on, but they were not designed for gaijin noses. I guess the term "long-nosed foreigner" has some real weight. I also beheld the wonder the Sumo on HDTV. I must get an HDTV! They look better than real life. DVDs look EVEN BETTER on these sets. I am going to have to wait a while, but when I get my HDTV, it will be WELL WORTH IT! A quick dinner at an Italian restaurant, followed by the train ride back capped the day. All in all a good day and a fine experience in Tokyo, once again. In other news: There is an interesting case of food poisoning here. A company called Snow Brand has been distributing milk that has been causing staph infections in their customers. Apparently they didn't clean one of their tanks and an infection in the tank tainted the milk and yogurt drinks. In addition, there is news that after the milk was recalled, they poured it into a bucket and sent it back out. Boy...that's responsible. As is typical in this country, the CEO resigned to take responsibility. So much from learning a lesson from your mistakes and taking responsibility for FIXING the problem. I guess that would make too much sense. Over the weekend, I went to another get-together at Chiaki and George's house. Nick, their British friend was there. He and I tried to think of the words with conflicting pronounciation or a different word choice in our two dialects of English. Here is what we came up with: British: American: Aluminum Al-oo-min-yim Uh-loo-mih-num Police Bobby Police Officer Potato Chip Crisp Chip French Fry Chip French Fry Missile Miss-EYE-l Miss-ul Elevator Lift Elevator Television Telly TV Garbage Rubbish Trash/Garbage Nick particularly enjoyed the discussion about missile. I told him of the fine Cold War-era movies, where Soviet sea captains would instruct their crews to "Fire a miss-EYE-l." He found that amusing. Both of us were pretty amazed by the number of differences between the two versions of English. Finding them made for a fun game. George and I also discussed the history of his home country, Romania. He gave me an interesting perspective on their 1989 revolution. I knew some of the story, but it's always interesting to hear a view of a situation from within. Fascinating stuff for a history buff, like me. As for work, I finally got a demonstration of the electronic medical record. It really has everything. The doctor from India that I went through the demonstration with liked the patient care implications. I was more interested in the technical aspects of it, like screen layout templates for every user. It was really remarkable. The rest of this week will be spent on getting work done on some of my ongoing projects. I have been away from the office so much, I may have a hard time getting going again.
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