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.