best island for medical treatment

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Sep 26th, 2003, 12:14 PM
  #1
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best island for medical treatment

My husband had a serious medical issue last April so we cancelled a trip. Can you please tell me where the best facilities are located what carribean island we need a vacation.!!!! Just in case
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Sep 26th, 2003, 12:59 PM
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In your post you say "had a serious medical issue". Is he still ill, or are you being cautious?

I would think San Juan, Aruba off the top of my head.

I would pick an island, then choose a resort. Call the resort that may interest you and call, as they always have on call doctors and facilities.

There is always a cruise which usually has a medical staff on board and anyone can be airlifted to land if necessary.
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Sep 26th, 2003, 01:04 PM
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This topic was discussed under the heading "What Caribbean islands have first rate medical facilities?" awhile back. Type "medical" into the text search box and you'll see it.
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Sep 26th, 2003, 01:08 PM
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I'd also add that I know a couple guys who have worked as cruise ship doctors.
In general, these are not the type of people you want taking care of you if you have a serious illness.
They're often physicians in training (fellowships/residencies) or nonconformists of some type.
Most cruise ships don't pay physicians all that well, so ask yourself, why would a good physician want to work on a cruise ship? The adventure aspect gets pretty old after a few cruises.
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Sep 26th, 2003, 01:18 PM
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To gplimpton: I'd be cautious in generalizing about the quality of shipboard doctors. On a shore excursion from Ocean Princess in Alaska two years ago, my travelling partner took a bad fall. The emergency department of the local hospital correctly diagnosed a broken kneecap, but pronounced her fit to travel with conditions. The shipboard physician could not have been more solicitous or accommodating, and looked after her every need from wheelchair, to walker and painkillers. He set up appointments with specialists back in our home town, made alternate travel arrangements for us at the end of the cruise, did all the negotiations with the insurance company, and kept in contact even after the cruise. And he arranged for an extra cabin to give us more space.

To Jazz 56: Back to the question at hand. I don't know the 'best' island but I do know it is NOT St. Vincent and the Grenadines. Most of my friends who live there go off-island, if they can, to (variously) Barbados, Trinidad and Martinique.
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Sep 26th, 2003, 05:40 PM
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To curiousx: you are referring to medical concierge services. I'm speaking of medical expertise. They're very different things.
Cruise ship doctors are carefully instructed about their unique role as representatives of the cruise line, in addition to being physicians. You'll usually find that a cruise ship doctor will treat you with greater emphasis on solicitousness than a local doctor at home.

I'm not sure why you think that the physician's kindly attitude had anything to do with his or her abilities as a doctor. Anyone who knows physicians will tell you that there's little or no correlation between ability and attitude. And in fact, often it's the opposite. Many very gifted physicians have poor personal skills for a variety of reasons.

My point remains that if you have a serious illness (not a cold, a scrape or a bloody nose) cruise ship doctors in general aren't stellar physicians.
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Sep 26th, 2003, 05:56 PM
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Just Curious.......but how many people that travel need life or death medical treatment. I know it does happen in the form of a sudden stroke, heart attack etc..but I know that is quite rare. How many people that are very ill pack a bag, get on a plane and just go without a doctors permission or a contact with someone to call at their destination.

My father was very ill but wanted one last vacation with his family. He first had to get an ok from his doctors at Sloan Kettering and they had given us contact numbers in case of an emergency.

I know people die every day but I doubt it is at the hands of "cruise ship doctors". You can't live everyday thinking something could happen and you will not have the best care. That's not living. If you think that way, stay home, watch the travel channel and consult Web MD for every ache and pain.

Just use a little common sense and enjoy your trip. In the span of a person's lifetime how much of that is actually spent on vacation anyway?
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Sep 27th, 2003, 05:59 AM
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To gplimpton: I do take your point about the difference between caring and medical expertise. Would that the two were more often combined ! It is highly probably that a knowledgeable doctor with a patent-friendly approach is going to be more value to the patient than one without.

In the case I cited above, the shipboard doctor's careful and thorough interrogation of my travelling partner, when we reboarded after leaving the emergency unit of the local hospital, revealed a couple of medical issues that had not been evident to the local team, and that he was quick to address.

Furthermore, our contact has continued post the cruise encounter, so I know that this doctor is now working with a first class emergency services hospital unit in North America. All this indicates the fellow is more than capable.

While your generic critic of shipboard doctors may have merit, my only caution to you remains that you should avoid tarring all with the same brush.

To Sandyfeet: A bit off the topic, but thought you enjoy this story. A friend of mine runs a small hotel in the Caribbean. A family group arrived and the husband then explained to my friend that his wife was in the terminal stages of cancer.

The husband explained that they had not disclosed this to the hotel, for fear the booking would be refused.

The family had brought with them all the drugs required to sustain the mother through the holiday period, although they expected, correctly, that she would die before then.

After getting over her initial shock, my friend says that watching this family tend their mother with such joy and love was one of the finest experiences she and the hotel staff had ever had.
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Sep 27th, 2003, 06:31 AM
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Thank you curiousx for your very touching story. My father believe it or not wanted to go to Disneyworld as he wanted to have fun with his family and his small grandchildren. He couldn't do much or eat very much, but he loved watching the kids and having the family together. He did not use a wheel chair, but walked as he wanted to be like everyone else and for a short time feel normal. I know the feeling very well...he passed away at a very young 64 a little while after. The kids still remember their Papa in Disney even though it was 2 years ago. It was not easy, espically for my mother who took care of him, but it was his wish. It makes us happy that we could do that for him.

Sorry to get off topic....
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Sep 27th, 2003, 06:56 AM
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"Just Curious.......but how many people that travel need life or death medical treatment".

To Sandy: the reason I offered my opinion about cruise ship doctors and serious illnesses is because that's what this post is about.
The original poster is asking about her husband and a 'serious medical illness'.

To curious: you'll note that each time I've referred to the abilities of cruise ship doctors I've qualified the comments with "in general" and "usually" etc.
As such, I don't think that qualifies as 'tarring all with the same brush'.

The reason I think this is an important issue is because many people I know (especially people over 50 years old) seem to think somewhat generically about doctors--that most all doctors are well trained and very qualified to do whatever they do. But if you look at physicians who work in itinerant positions you often find the opposite.

IF someone has a serious medical condition he or she will want to be aware of these issue before travelling for an extended period at sea.
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Sep 27th, 2003, 01:12 PM
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I've always heard that there is great medical care available in Aruba.
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Sep 27th, 2003, 01:22 PM
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There's a medical school on Grenada. I wonder if that means good medical care is available. Also, I've heard that medical care is of very high quality on the French-owned islands like Martinique and Guadaloupe, where the standards are supposedly the same as they are in France.
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Sep 27th, 2003, 01:33 PM
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Well we can only assume at this point. The original poster stated that her husband "HAD a serious medical issue" she did not state if he still has. There is a difference between a past medical issue that has been cured and a seroius medical "condition" which is still under some kind of treatment. Actually after reading all these posts, I would think that the condition would determine the destination. Meaning high altitudes, is walking a problem, is it a stomach problem, heart problem etc..would determine where to go.

Thanks for your information gplimton. Many people should be aware of these things. It is always best when making travel plans with an ill companion to let the TA know as well. I have made several arrangements (cruises mostly) for people, who may not be actively ill, but not in very good health. These arrangements may take a bit longer but can be done at no additional cost to the traveller. I have found the better the cruise line, the better the service. I don't know if it is a fact, but that has been my experience.
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Sep 27th, 2003, 08:26 PM
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I did a quick google search of cruise ship medical care and found the following quotes from reports by USA Today, Consumer Affairs, and American Maritime Officer:

"Reporter Douglas Frantz, in an article published in The New York Times and distributed over the Internet, documented several cases in which passengers with serious medical conditions or emergencies could not be treated in the inadequately-equipped shipboard infirmaries of foreign cruise ships, which are often staffed with doctors and nurses that would not qualify under U.S. standards".

"...infirmaries are not always stocked to deal with some types of medical emergencies and the doctors have usually received their degrees from foreign medical schools and lack the minimum training to practice medicine in the U.S., according to the article".

"Infirmaries are usually staffed by doctors who are not licensed in the United States. Regulation of shipboard medical care is largely non-existent".

"Most cruise lines have no formal procedure for reviewing doctors' work.
Doctors and nurses are independent contractors, not employees. Thus, the cruise lines are generally not legally liable for their actions".

"There is no international oversight of medical care because martime law does not require cruise ships to provide medical care for passengers, only for the crew".

"A few years ago, the American Medical Association conducted a study that found glaring inadequacies in shipboard care.
For example, the study found that 27 percent of shipboard doctors and nurses lacked advanced training in treating heart attacks, the leading cause of death on ships. More than half the doctors and 72 percent of the nurses lacked advanced training in dealing with trauma.
The AMA called on Congress to take action but the cruise industry's lobbying organization, the International Council of Cruise Lines, has so far kept the issue off the Congressional agenda".

"Inadequate medical care on cruise ships is an overwhelming threat," says Laurie Berger (editor of The Travel Letter), "an accident waiting to happen, especially when it comes to seniors and children. You have lots of opportunity for harm and injury, and cruise lines are not prepared to deal with them."
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Sep 27th, 2003, 08:59 PM
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And this rating by the World Health Organization of overall health care quality by nation (191 nations rated, based on things like infant mortality, life expectancy, # of hospital beds, health care access etc).
**Note that the methods used to make this list were highly criticized by many experts for ignoring many factors associated with high quality care. Most people would much rather have an illness treated in the USA than Bosnia, Croatia and Algeria (which rated higher):

#3 Italy
#4 France
#9 Japan
#24 Britain
#72 USA

Caribbean---
#8 Jamaica
#36 Cuba
#38 St. Vincent/Gren
#42 Dominican Rep
#49 Grenada
#54 St. Lucia
#59 Dominica
#79 Trinidad
#87 Barbados
#122 St. Kitts
#123 Antigua
#137 Bahamas
#139 Haiti
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Sep 28th, 2003, 01:27 AM
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Within the year I suffered an accident (badly broken wrist and dislocated thumb) on a cruise ship. Since I worked in a hospital I was aware of certain procedues..the nurse taking the x-ray was clueless and in what I gather is a cost saving procedure ony took one view..only after I insisted she take another view did she see the fracture.. When I asked the M.D. what he knew about orthopedics he said "not much". After calling my orthopedic (had worked closely with him that year in the hospital) from the ship. The wrist was set, I was given a packet of codeine and NOT ONCE was I contacted by either of the two M.D.s or the three nurses. There has been a court ruling recently in Florida after a death and a mistreatment which now holds the cruise lines responsible for their M.D.'s. My recommendation is to keep on a slip of paper in your passport a list of your M.D.'s and their phone #'s ..BTW I received a bill for the services 24 hours.
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Sep 28th, 2003, 01:54 PM
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My husband and I spent our honeymoon in Greneda and had a wonderful time. They have a medical school there. I would check out their facilities.
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