Are Cruise Ship Doctors Sub-par or is This an Annomoly?

My wife and I have used a ship doctor on 2 occasions both of which were not serious or life threatening. Both times, we felt that we got good care.

DON

Unfortunately, I have needed to visit the ship's infirmary a few times in my cruising years with the first time being in Nassau when the Home Lines' Oceanic was at dock. Tripped on the steps of the Queen's Staircase and injured my knee to the point that I could not stop the bleeding. Quickly returned to the ship, visited the infirmary, and was patched up quite satisfactorily.

Other infirmary visits have been on HAL vessels with one visit after a knee joint injury suffered during a shore excursion. My situation was so severe that I thought my cruise would be over once the ship got to its next port. But, the doctor (who happened to be the Medical Director for HAL) was able to get me stabilized. They had the needed braces and pain medication that I needed in order to complete my cruise. I required arthroscopic surgery on the knee when I returned home, but my orthopedic surgeon was pleased with the on-board medical care that I had received.

I have always been pleased with the Nursing staff and the doctors with whom I have had contact in the ship's infirmary.

I feel lucky to be alive after the poor treatment received by a ship’s doctor. I was left onboard for 2 days with an obstructed esophagus. Should have been med-vaced off. But the MD on board didn’t think it was serious enough. Ended up spending 5 days in the hospital back home after surgery in St. Thomas. Truly scary. My experience, you go to them for bandaids...

 

 

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Obviously the Dr. made the correct call regarding life threatening.

My one experience was very positive: accurate diagnosis, lab work, doctor's time and two medications: $160! The doctor and his staff were comprehensive and very pleasant.

 

I think it is unfair to expect any doctor on a ship to expertly handle situations that require a specialist.

In reality, the ship's medical centre is consistent with a hospital Emergency Department and the ship doc is consistent with an Emergency Physician. While hospital EP's have the ability to have a specialist attend, the ship docs have specialist consultations available 24/7. The ship's doc has the ability to have a live video & audio meeting with a shore specialist/surgeon to discuss symptoms, diagnostic tests and treatment.

While the ship docs prefer to stabilise and then ship pax ashore for further treatment, they have been known to conduct surgery onboard in life threatening situations. While rare, any surgery would be completed with live consultation with a shore based surgeon.

At least on a cruise ship you have a doctor. If you are concerned with the ability of cruise ship doctors, I suggest you don't consider going on one of the many cargo ships that accept up to 12 passengers. Getting sick mid-ocean, with no cruise ship/naval vessel in close proximity, then the Captain is the doctor, and if required the surgeon.

While you are correct concerning malpractice, this was a case where the IMO's Manila Convention (MLC 2006) comes into play, regarding workplace conditions for the crew, and that the ship owner is responsible for proper medical care for crew injured or ill while on the ship. This is regardless of whether that medical care is provided onboard or on shore.

Expanding this point I offer an extract from a US Coast Guard "Cruise Ship Consumer Fact Sheet"

There are many aspects of the daily care of passengers and their on-board accommodation that are not covered by Government regulation. One example is medical care. The {US Government} does not require that passenger vessels carry a ship's doctor. Most, if not all ocean-going passenger vessels today do provide a doctor and medical facilities in order to offer attractive and competitive service. Passengers should realize that the quality of the medical care is not guaranteed by {US} regulations.

In other words .... while the USCG does required safety inspections which check a bunch of stuff for safety, crew qualification and environmental protection, and US CDC inspects cruise ships

to prevent and control the introduction, transmission, and spread of gastrointestinal (GI) illnesses

... primarily food handling .... no one inspects the 'hospital' or the qualifications of the medical staff other than the cruise line itself .....

I'm not making a comment; just offering data ...... if this has changed in recent years and I missed it I'm SURE someone will correct me.

Capt_BJ - I recall my first ship, which was a cadet training vessel with > 55 cadets and a total crew of over 100 carried a qualified medical doctor. At the time UK Merchant Shipping Regs required a doctor on foreign-going ships with > 100 crew.

Don't have any experience with US Regs, but I suspect the latest ILO/IMO/MLC may address this requirement. MLC2006 did not come into force until 2013, which was after I retired. Chengkp75 is more current than me, so he may know, if it addresses a requirement for docs.

As I worked on the coast and almost always had at least 1 doctor or nurse as a passenger, when we needed medical assistance, it is not an area we needed to research. Therefore, I have never read the Canadian Regs pertaining to medical care.

Actually, since the US is not signatory to MLC 2006, and we are in the Jones Act trade (not going foreign), we don't have to be MLC 2006 compliant, though our company has chosen to voluntarily do so, as some of our ships do get occasional foreign charters.

MLC 2006 requires a doctor for ships carrying more than 100 "persons" (both crew and passengers), and engaged in foreign voyages of more than 3 days (the time factor exempts ferries).

While the definition of a passenger vessel remains as a vessel that carries more than 12 passengers, the medical requirements have loosened over the years, so that in the range between 12 passengers and 100 total souls, a trained officer and a requisite medical kit are all that is required.

And, yes, the US CDC (USPH) inspects the cruise ships' medical centers, but only for recordkeeping and procedures regarding reporting GI illness and sample collection and testing for GI illness. They do not check the medical equipment, nor the qualifications of the medical staff. It is up to the flag state to determine if the medical personnel meet their statutory requirements.

Thanks, appreciate the explanation. The requirements for a doctor haven't changed since I was deep sea.

While I had 2,052 pax + 48 crew, we were not foreign-going and only at sea for 90 mins each crossing, so MLC 2006 requirements for a doc weren't included in our ship specific manual. We only carried a medical kit and medications kit, which I could only release to a qualified doctor in the event of a medical emergency on board.

like I said:

They do not check the medical equipment, nor the qualifications of the medical staff.

like I said:

 

They do not check the medical equipment, nor the qualifications of the medical staff.

I was agreeing with you.

I don't believe most US medical school educated physicians could afford to sign on unless they are retired considering the cost of becoming a physician in US med schools.

I tripped and gashed my head on deck while walking over a chair to take a picture. In about 2 minutes they were there and the doctor from Colombia did a fine job stitching my head and checked on me every day.

Having read this article I now wonder about the qualifications of cruise ship doctors. This happened on the Norwegian Breakaway and the doctor is described as a "young, inexperienced, Columbia-trained physician". The doctor described in the article seems totally inept. I guess it's folly to expect that highly trained physicians from top medical schools would be found working on cruise ships, but one wonders - what are the typical qualifications of cruise ship doctors?

http://www.foxnews.com/health/2018/09/14/cruise-ship-doctors-error-led-to-workers-arm-amputation-lawsuit-claims.html

I was in the infirmary on my last cruise .The ships doctor appeared to be in his mid 30's .He seemed to be quite competent .When I came back from the cruise I wanted to look the doctor up on line and could not find any listing for him.

On my first cruise the doctor was about 70.He was retired and single and desired to work on a ship .

If I were a good doc, I could work New York or Beverly Hills pulling down 6 figures a year. Or work for a cruise line and get paid a small fraction and live in a 10 x 12 foot room with a port hole. You do know if you have anything worse than a broken finger, there's a very good chance you'll be put off the ship at next port.

Who says land based doctors are so good?

Do some research on US land based medical mistakes. IIRC, over 200,000 people die each year from medical mistakes.

Having had a nice 45 ICU stay due to a medical error, I had little faith in MOST doctors.

And yes, this was with a US doctor, US trained.

Doctors on the ships are doing the job because they WANT to. (I am referring to Holland America here where the bulk of my experience is). Most are semi or retired. They are not making choices to pay student loans but lifestyle choices.

The only bad experience we have ever had was on Oceania Riviera. The physician was trying to "sell" something to DH who knew full well it was not necessary.

We have had to hit the infirmary a couple of times for cruise crud (upper respiratory) and found the physicians knowledgeable and very competent on Holland America.

It may vary by cruise ship, but, generally speaking, these men and ladies are physicians, sworn to the Hypocratic oath and do want to give good attention as far as the facilities on board will permit. JMO and JME.

Who says land based doctors are so good?

 

Do some research on US land based medical mistakes. IIRC, over 200,000 people die each year from medical mistakes.

 

Having had a nice 45 ICU stay due to a medical error, I had little faith in MOST doctors.

 

And yes, this was with a US doctor, US trained.

Good point , have had several bad experiences with doctors in the good old USA.

I had dinner on one cruise with a ship's senior doctor. He told me he does it for a few weeks each year, just for the pleasure of it.

Unless there is a noro outbreak on board, it is usually an easy 'working vacation'. He was from South Africa, and told me that the ship requires doctor's to be "Board Certified" in emergency medicine....what ever that means, from which country...

What's wrong with Columbia medical school? It's ranked #6 for internal medicine among US schools, and #11 for research.

Nevermind

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What's wrong with Columbia medical school? It's ranked #6 for internal medicine among US schools, and #11 for research.

It's doesn't say in the article Columbia Medical school

It says Columbia trained...

So does that mean trained in the country of Columbia

Or

Graduated from the Ivy League Columbia University

Journalists today are rather sneaky aren't they?

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I had dinner on one cruise with a ship's senior doctor. He told me he does it for a few weeks each year, just for the pleasure of it.

Unless there is a noro outbreak on board, it is usually an easy 'working vacation'. He was from South Africa, and told me that the ship requires doctor's to be "Board Certified" in emergency medicine....what ever that means, from which country...

Our ships doctor who was at our table bought a nice wine for our entire table of ten each night he was there.

It's doesn't say in the article Columbia Medical school

 

It says Columbia trained...

 

So does that mean trained in the country of Columbia

 

Or

 

Graduated from the Ivy League Columbia University

 

 

 

Journalists today are rather sneaky aren't they?

 

 

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The country of Colombia is spelled with an O, the school, Columbia, with a U. This suggests it was the school.

The country of Colombia is spelled with an O, the school, Columbia, with a U. This suggests it was the school.

Yes I know that but the link to the article says "Columbia trained"

Why bother to put it that way? Why not be more specific?

Does that mean "training" at Columbia or degree from Columbia?

Internship/residency versus 4 year degree?

Bottom line....the article should have been more specific ...and said the entire name of the medical school attended..number of years as a doctor etc....because that would have lent more accuracy to the article....of course I doubt accuracy was even considered

We all should know by know that the point of most any journalist is to...confuse the readers into thinking the worst and based on things I've read recently I doubt the writer of the article even knew the difference in spelling the country Colombia or the school Columbia anyway.

Sorry but true.

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If I were a good doc, I could work New York or Beverly Hills pulling down 6 figures a year. Or work for a cruise line and get paid a small fraction and live in a 10 x 12 foot room with a port hole. You do know if you have anything worse than a broken finger, there's a very good chance you'll be put off the ship at next port.

Our experience when our fourteen-year-old came down with pneumonia on an RCI ship was that she received excellent care from the Australian female physician. She was given the correct antibiotic, seen three times per day for breathing treatments and recovered nicely. There was no talk of putting her off the ship. She has suffered a lot with upper respiratory conditions and this is the best care she ever received.

Did you mean 'anomaly'?

I do know that the level of education of Drs OUS is not as rigorous of those in the USA. They would not be allowed to practice in the USA.

That said, I know of several people with an MD behind their name, who went to school OUS and had no more education than a RN in the USA.

It is a buyer beware situation.

This situation is very unfortunate but not BS necessarily.

Yes, I am in the medical field.

Safe cruising!

Nonsense. Physicians educated in many countries OUS (Outside of the United States) including Canada, Australia, Western Europe, the United Kingdom, Ireland, Scandinavia, South Africa among others are equally well educated as those in the United States if not better.