What American medicine can learn from a cruise ship clinic

Recently, I had a wonderful opportunity to cruise the Mediterranean and visit some fascinating cities.  The land excursions were mind-expanding but quite physical. The rugged terrain and steep hills were not difficult to walk upon because I was in good shape and healthy.

But, what if I wasn’t?  Questions raced through my mind such as:

What if I got sick onboard the ship?

What if I got injured?

What type of doctor signs on to work in a ship instead of a more conventional office or medical facility?

A visit to “sick bay” and the medical center on the ship supplied me with answers to these questions.

Much like a visit to a healthcare facility in the U.S., a nurse who after a few cursory questions handed me a clipboard with several forms to fill out, first greeted me.  The top sheet contained questions concerning identity:

  • Name
  • Date
  • Address
  • Date of Birth

This was followed by lines for significant past medical and surgical history and a space for any allergic reactions experienced in the past.

The second form was again to fill out questions about your identity. The third sheet was a billing sheet for the pharmacy and the fourth involved ICD-9 coding.

Each form required a signature to designate that you understood that regardless of any insurance coverage you might have, you had to pay for services rendered at the time of your visit.  The patient to whoever their insurance company was could submit duplicate copies of all sheets but it was the patient’s responsibility.

Only then could a consultation with the physician be done along with accompanying examination and x-ray evaluation if necessary.

Office hours were 90 minutes in the morning and again 90 minutes in the evening.  Other than an epidemic onboard, the doctor had minimal duties during the day (although he was on call).

The system was fast and easy, much the same way it was before all the third party systems and governmental overview became involved.

It was also easy for the physician and nurse, no hounding of third party payers for reimbursement to ultimately exist beyond mounting office expenses.

Should healthcare providers choose to treat the patients for free or at a reduced rate, it was up to the provider — a good deed that made everyone feel good. This is in opposition to essentially treating everyone at a reduced rate due to the bundling by insurance companies and the government that is rampant today.

In years gone by, patients really knew their physicians and got personalized attention. But now we have “progress.”

Have patients benefited by the ongoing and ever increasing sacrifices that physicians are making with healthcare reform? To date, results have not panned out as expected or hoped for … yet.

Time will tell.  What do you think the future has in store for us?

Barbara Hales writes a monthly newsletter called The Medical Strategist. She is the author of Power to the Patient: The Medical Strategist.

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  • Alek Davis

    I’m wondering what exactly is meant by “increasing sacrifices that physicians are making”? Does this mean low pay? Long work hours? Something else?

  • Doug Capra

    “The system was fast and easy..It was also easy for the physician and nurse, no hounding of third party payers for reimbursement to ultimately exist beyond mounting office expenses.”
    Sure. No question. Totally one-sided. No wonder it was easy. Did you do any research as to patient attitudes toward this non-patient centered service? If your point is that the system can be simplified by becoming one-sided, totally focused on the provider pay checks and convenience, then your point is logical.  By the way — your system has absolutely nothing to do with “health care.” It’s all about provider convenience and money. I think there’s much more to learn about this system than you’ve indicated here.

  • Doug Capra

    “The system was fast and easy..It was also easy for the physician and nurse, no hounding of third party payers for reimbursement to ultimately exist beyond mounting office expenses.”
    Sure. No question. Totally one-sided. No wonder it was easy. Did you do any research as to patient attitudes toward this non-patient centered service? If your point is that the system can be simplified by becoming one-sided, totally focused on the provider pay checks and convenience, then your point is logical.  By the way — your system has absolutely nothing to do with “health care.” It’s all about provider convenience and money. I think there’s much more to learn about this system than you’ve indicated here.