Medical Facilities for Overseas Workers and Seafarers – There is a need for me to understand how they do their business!

Medical Facilities for Overseas Workers and Seafarers – There is a need for me to understand how they do their business!

In the past, I have always wondered and disagreed with medical facilities for overseas workers and seafarers when they require applicants to undergo elective appendectomy, hemorrhoidectomy (even for skin tags) and cholecystectomy for asymptomatic gallbladder stones prior to giving the go-signal to go abroad.

Lately, I had a patient with fibrocystic breast changes who was required to undergo needle biopsy for solid nodules seen on her breast ultrasound, despite three surgeons saying there was no need.

Let me just put it this way as to my insights when I encountered this patient and her situation.

There is a need for me to understand how these medical facilities for overseas workers and seafarers do their business!  I hope I can do something to help the prospective overseas workers, particularly in avoiding unnecessary operative procedures!

The patient was a 39-year-old Filipina applying for a job in a cruise ship as a  bar stewardess.  Part of her routine medical examination included a breast ultrasound ( I don’t know why – Is this now a routine for all females applying for a job abroad? – I have to verify this!)

At any rate, her ultrasound showed the solid breast masses on both breasts.

She was referred to and was seen by two breast specialists prior to seeing me.  The two breast specialists (general surgeons) were consistent in saying that what she had was just fibrocystic changes and what was needed was just observation and monitoring.

One of the certificates issued to her.

Despite the certificates, the medical facility for overseas workers and seafarers required her to undergo needle biopsy.  Otherwise, she would not be granted a certificate to be employed in the cruise ship.

Take note of the “Note: Clearance from the specialist is not a guarantee for fitness to work.”

This patient had no choice but to undergo a needle biopsy, which eventually showed benign mastopathy consistent with fibrocystic changes.

This is the first time I met such a situation on breast. I am concerned with two issues.

One, if ultrasound of the breasts will be a routine medical examination for prospective female overseas workers, with the way how radiologists report and how the physicians of the medical facilities interpret, then there will be a lot of unnecessary breast biopsies and operations.

Two, the policy “Clearance from the specialist is not a guarantee for fitness to work” will make the breast specialists inutile and helpless in helping the patients who don’t need a biopsy procedure.

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2 Responses to Medical Facilities for Overseas Workers and Seafarers – There is a need for me to understand how they do their business!

  1. margie says:

    Your one of the Great surgeon Dr.Joson…all of your data here are i certify TRUE…me too as well as my husband and million of seafarer dont understand this kind of Business…

  2. Dr. Rey says:

    Sir, nowhere in my readings of maritime medical certificate requirements in different countries has there been a mention of breast ultrasound/mammography. Pre-emptive surgery for asymptomatic gallstones, hernias, and possibly prophylactic appendectomy can be argued for based on the clause where a medical condition requiring onshore attention can rapidly deteriorate if evacuation from an offshore location is delayed.

    Although no special training is required of physicians giving medical certificates for such workers, many countries only accept certificates from physicians that register with the maritime authorities for doing this task. One mentions an annual offshore certificate load of at least 50 to qualify. The prospective patient is therefore under the discretion of the said physician and whatever requirements he may think up based on his interpretations/motivations. Employment agencies tie up with such physicians and their decisions are absolute, regardless of what other physicians say.

    Derrick Chua / September 17, 2012

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