A Year in Japan: Reflecting on My Giant Leap to Work Abroad
Background
After 1 year working at Ubie in Tokyo, Japan. I thought it may be a good time to reflect on the past year and share various challenges, successes and insights for anyone considering to take a giant leap this coming year. Whether that leap is working in Japan or abroad, changing roles or orgs, maybe trying something you’ve always wanted to do. This post is my way of giving you agency to say “f$#% it” and chase your dreams because sometimes things work out in unexpected ways. In my case, I took a chance with a Japanese startup and it’s been one of the most rewarding experiences for me both personally and professionally.
TLDR: Sharing insights for those considering a career abroad by documenting my cultural immersion and growth after one year working at Ubie in Tokyo, Japan.
Cultural Immersion
If you’ve never been to Tokyo, it can range from an extremely tranquil place, balancing the old with the new, to feeling like a vibrant sensory overload of neon lights and robots. While I work from home some days, my commute begins with walking to the nearby train station while constantly being amazed at how the biggest city in the world can be eerily quiet. Even in train stations, which may be packed during rush hour, the silence is somehow maintained with noticeable signage suggesting things like not talking on your phone and even wearing your backpack on your chest to minimize the risk of bumping into others on the train. After a year, navigating the maze of train lines has become second nature, even in stations like Shinjuku, where over 3 million people pass through daily.
Lunch might be a quick bite from one of the nearby konbini’s, slurping down ramen at a standing bar, enjoying a bento box in a park, or trying the incredibly large variety of snacks. As the day ends, the city transforms at night, where every business has a keen eye for lighting that can make you feel like you’ve crossed over into a different dimension of the city, exploring neon-lit backstreets and bustling izakayas.
We’ve also traded in our car for a couple of “mamacharis” (a nickname for family-style e-bikes), enjoying the option of having a healthy way to get around nearby areas and pick up the kids from school. At the same time, it’s a nice way to experience the city and a healthier option for getting around. I would be lying if I said I didn’t miss the convenience of having a car with kids some days… Especially wet and rainy ones.
As mentioned in my last post, language barriers still occasionally trip me up, but with a mix of the little Japanese I can speak and Google Translate as (a must-have) backup, I have figured out how to make it part of our new norm. The kindness of strangers and the unwavering politeness of many locals and my co-workers are also huge pluses that can help. Any inconvenience from language barriers is overcome by an appreciation of the experience and the willingness to make every day an adventure. It’s a life of constant learning, adapting, and discovering, a world away from the US, yet somehow, it’s starting to feel like home.
Our Incredible Team
The team at Ubie has also played a significant role in making this feel like home. I joined Ubie as a part of their Global team, a small but mighty group of visionaries obsessed with making an impact on the American healthcare space. As the design director, it’s exciting to work with a team willing to conduct some pretty bold experiments with our products and a consistent agreement that the ideas are only as good as the pain points they solve for users and our business. While the team is spread across time zones, I’m working closely with product teams nestled in Tokyo while simultaneously supporting our Sales & BD efforts stateside. From crafting intuitive user services for our AI-powered symptom checker to developing compelling narratives for marketing that will resonate with American audiences, our work is a constant balancing act of cultural adaptation and innovative problem-solving.
I’ve also been a big fan of Ubie’s adoption of the Holacracy model and a strong emphasis on OKRs (Objectives and Key Results), empowering each team member to take ownership while sharing accountability for results. This decentralized structure fosters a sense of responsibility and agency, allowing team members to operate autonomously and directly contribute to our overarching goals. By clearly defining objectives and measuring progress through key results, we maintain alignment and focus while minimizing the need for traditional management hierarchies. This flat organizational structure encourages open communication, facilitates rapid decision-making, and empowers individuals to take initiative, ultimately fostering a more agile and innovative work environment within our product teams.
A sense of individual ownership is further fostered and is critical for creating clear incentives for the team to drive quality. Despite the distance, we’ve cultivated a tight-knit team dynamic fueled by a shared passion and a commitment to making healthcare more accessible. It’s been fascinating to learn from the differences between the healthcare system in Japan vs. the US, leading to a diverse knowledge base of what’s unique to healthcare in certain regions vs. what we can apply to the challenges we’re tackling in the US. Something that will be critical to our success in the US for designing and delivering novel value.
What We’ve Been Doing
At the heart of Ubie’s offerings lies our AI-powered symptom checker, a sophisticated service designed to guide individuals through a personalized health assessment that helps them find possible causes for unfamiliar symptoms. The symptom checker analyzes user-reported symptoms and considers their medical history to create a dynamic, interactive experience that asks clarifying questions, mimics the diagnostic process of a physician, and helps users understand their symptoms in a more informed way. It’s not a replacement for professional medical advice but rather a tool to empower individuals to take control of their health and navigate the often complex healthcare system. It can help users determine the urgency of their situation, suggest appropriate next steps, and connect them with relevant resources, ultimately facilitating more informed decisions and better health outcomes.
Over the past year, we’ve worked on a ton of improvements to enhance the user experience across Ubie’s services tangibly. Connecting patients to relevant resources such as PAGs (Patient Advocacy Groups) related to any possible causes we predict. We’ve also invested a lot of effort in reframing questions with plain language and adding clear explanations to empower users to understand the purpose behind each inquiry, fostering trust and transparency. We’ve heard that this focus on clarity is something that patients feel needs to improve when speaking with doctors and that they feel unable to have time to understand something or ask more follow-up questions. Additionally, providing upfront messaging about potentially sensitive topics and the option to opt out of questions gives users greater control, helping us focus on accuracy and account for how information makes users feel.
One of my biggest takeaways from talking to our users (and personally reflecting on our healthcare system) is that for an industry whose sole purpose is to make people feel better. Many healthcare providers seem to be doing a shitty job at it or, to put it more colloquially, need to work on their bedside manner. Inspired by this issue, “making people feel better” is something I’ve taken to heart as we’ve explored ways to make our service feel friendlier, knowing we may be asking questions and delivering predictions that can cause anxiety for folks. We’ve humanized the medical questionnaire with our friendly Shiba mascot to immediately set a more welcoming and anxiety-reducing tone, easing users into potentially sensitive health topics. Something many of our users have reached out to share their appreciation for.
Impact So Far
Regarding our expansion and influence in the US, 2024 has been a fantastic year. As a result of our efforts, we’ve reached over 2 million Americans in the first year, and user engagement has significantly improved, with a 30%+ increase from the previous year in users seeking care through a variety of channels. We’ve formed several strategic alliances, such as Google and Patients Like Me, which will increase the accessibility of our platform and offer insightful information on the needs and experiences of patients. Additionally, we’ve partnered with prestigious medical institutions like the Mayo Clinic and patient advocacy organizations like the American Kidney Fund (AKF), the Cushing’s Support & Research Foundation (CSRF), and the Crohn’s & Colitis Foundation (CCF) to give users access to new avenues for feedback on how to make our symptom checker more accurate and relevant.
Although, the most impactful measure of our success lies in the stories of the individuals we’ve helped. Stories like the woman in her 30s whose early MS diagnosis was prompted by our symptom checker to the 80-year-old man whose lung cancer was detected early thanks to our AI’s prompt, these stories underscore the life-changing potential of our technology. The woman in her 50s who received accurate early identification of bone diseases and the woman in her 60s who found our questions more comprehensive than her initial doctor’s visit further validate the value of our platform. Testimonials like “I got more answers in one minute through your site than I did in three hours with Google” and “Ubie seems much more caring and concerned about me and my symptoms” highlight the critical “make users feel better” goal I highlighted earlier and the profound impact we can have on people’s lives.
Reflections on Growth
This first year at Ubie has been a typhoon (see what I did there) of professional and personal growth. Navigating work and life in Japan reignited my curiosity about my surroundings, leading to new forms of inspiration from mundane everyday sources. I’ve found you appreciate more nuances of communication across time zones and languages, which has led me to be more thoughtful about how I present ideas and give/receive feedback. One of the most significant experiences has been the importance of building trust within a decentralized team where we continue to foster a culture of autonomy and accountability through shared goals vs. hierarchies. Building this type of culture has to be intentional, and it requires daily effort across everyone’s part vs. being executed with a top/down or bottom/up focus.
Outside of work, immersing myself in Japanese culture has been a transformative experience. I have embraced the quiet politeness of daily interactions, appreciated the craft put into everything, and watched my kids soak in such a wonderfully different place. I’ve learned to enjoy a different pace of life and continue learning about different ways of viewing the world. The challenges of language barriers are offset by the kindness of strangers and the unwavering support of my colleagues. While living abroad may not be a journey that is for everyone, and not all Japanese companies are like Ubie (or companies in the US, for that matter), it has broadened my cultural understanding and enriched my design perspective, reminding me of the importance of staying humble, emphasizing diversity, and simply never forgetting we’re all human. Getting to this point was a continuous learning journey, and I’m excited to see what the next year brings.
Thinking about working in Japan but still trying to figure out what it takes? Check out my “So You Want to Work in Japan?” post, where I talk about the process I went through to get and with links to many free online resources.
Are you curious to learn more about why I made the move? Here’s my original “Why I joined Ubie” post documenting my inspiration, reasoning, and plans for joining the Global team while based in Japan.
Want to more updates on my journey? Follow me on Medium for future blog posts or follow my Nihon Nuggets instagram page where I share fun facts about daily life and travel in Japan.
