discount cruises- got to cut corners so..

[Default] Thus spake Kurt Ullman :

In article ,
Goomba wrote:



I don't buy that any significant number of psych patients go to the
doctor asking permission to cruise....do you?
She may very well have been depressed as hell, but depressed people
cruise all the time, I'm sure?
We're not talking the ideal textbook situation here but rather real life.
Hanging in or around the Psych Biz for 25+ years now. Can't think of
one depressed person (or bipolar for that matter) who got a note from
the doc to go cruising or any other form of traveling. I can only think
of maybe 4 times where the patient asked for a copy of the script in
case their meds were lost.

296.70

Never asked, never thought of jumping over. Well, maybe during the
hairest chest contest, but I think there were other reasons for that.
--

- dillon I am not invalid

Men are like a carpet. Lay them well and you can
walk on them for years.

[Default] Thus spake Goomba :

Dillon Pyron wrote:
[Default] Thus spake Goomba :

Brian K wrote:

It also tells you about the state of passengers. Some let go of all
common sense, drink too much, try to do the "king of the world" shot
from Titanic or have doctors who don't see the signs and let a suicidal
passenger who should have been diagnosed as "not fit to sail" go on a
cruise.

Who routinely goes to a doctor for approval to cruise?

Carol got a solid NO from her oncologist while she was on chemo. It
would have been the week between, but she would have nadared on the
second day.

And that is someone who obviously has an interest in including her
doctor in her vacation plans and is cognizant of the risks, right?

How many psych patients do you actually think do so? How many psych
patients don't even bother seeing a doctor?

IMO, It is laughable that someone would suggest that some doctor (which
one? any one off the street? someone via telepathy??) should have told a
depressed passenger who had plans to go overboard that they were "not
fit to sail." I suspect someone who has little experience with psych
patients, suicide and so on.....

But that's not the question you asked. You asked "Who routinely goes
to a doctor for approval to cruise?" Not how many psych PTs, just
"who".
--

- dillon I am not invalid

Men are like a carpet. Lay them well and you can
walk on them for years.

On 1/20/2009 11:50 PM Dillon Pyron scrawled with a big red tube of
lipstick:
[Default] Thus spake Kurt Ullman :


In article ,
Goomba wrote:



I don't buy that any significant number of psych patients go to the
doctor asking permission to cruise....do you?
She may very well have been depressed as hell, but depressed people
cruise all the time, I'm sure?
We're not talking the ideal textbook situation here but rather real life.

Hanging in or around the Psych Biz for 25+ years now. Can't think of
one depressed person (or bipolar for that matter) who got a note from
the doc to go cruising or any other form of traveling. I can only think
of maybe 4 times where the patient asked for a copy of the script in
case their meds were lost.


296.70

Never asked, never thought of jumping over. Well, maybe during the
hairest chest contest, but I think there were other reasons for that.

I am not talking about getting permission to travel. If travel plans
are mentioned the doc can asses how the patient feels about traveling.
If he saw certain signs of suicidal ideation he can strongly discourage
the patient from traveling. If need be, the doctor can tell the patient
that he is not fit to travel. A psychiatrist or any medical doctor can
notify an airline or cruise line, that their patient is not fit to travel.

Any medical doctor can notify a government drivers licensing agency that
their patient is not fit to drive. In some states, if there is medical
proof that a patient is not fit to drive the physician is legally
required to notify the appropriate drivers licensing division. Likewise
in some states if a patient is not fit to travel, the doctor is legally
compelled to notify the carrier or other trip operator.

--
________
To email me, Edit "blog" from my email address.
Brian M. Kochera
"The poor dog is the firmest friend, the first to welcome the foremost to defend" - Lord Byron
View My Web Page: http://home.earthlink.net/~brian1951

On 1/20/2009 11:52 PM Dillon Pyron scrawled with a big red tube of
lipstick:
[Default] Thus spake Goomba :


Dillon Pyron wrote:

[Default] Thus spake Goomba :


Brian K wrote:


It also tells you about the state of passengers. Some let go of all
common sense, drink too much, try to do the "king of the world" shot
from Titanic or have doctors who don't see the signs and let a suicidal
passenger who should have been diagnosed as "not fit to sail" go on a
cruise.


Who routinely goes to a doctor for approval to cruise?

Carol got a solid NO from her oncologist while she was on chemo. It
would have been the week between, but she would have nadared on the
second day.

And that is someone who obviously has an interest in including her
doctor in her vacation plans and is cognizant of the risks, right?

How many psych patients do you actually think do so? How many psych
patients don't even bother seeing a doctor?

IMO, It is laughable that someone would suggest that some doctor (which
one? any one off the street? someone via telepathy??) should have told a
depressed passenger who had plans to go overboard that they were "not
fit to sail." I suspect someone who has little experience with psych
patients, suicide and so on.....


But that's not the question you asked. You asked "Who routinely goes
to a doctor for approval to cruise?" Not how many psych PTs, just
"who".

Nobody goes to a medical professional and asks for permission to drive,
cruise, fly or engage in behavior dangerous to their well being. If
travel plans become known during a session along with evidence of
self-destructive symptoms the doc has a responsibility to prevent the
client from acting on their thoughts. That responsibility can be
extended to contacting any entity that may increase this risk. This
isn't much different than if a patient's doc has medical evidence that
said patient is not fit to drive, the doc is legally bound in many
states, to notify the proper authorities.

--
________
To email me, Edit "blog" from my email address.
Brian M. Kochera
"The poor dog is the firmest friend, the first to welcome the foremost to defend" - Lord Byron
View My Web Page: http://home.earthlink.net/~brian1951

Brian K wrote:

I am not talking about getting permission to travel. If travel plans
are mentioned the doc can asses how the patient feels about traveling.
If he saw certain signs of suicidal ideation he can strongly discourage
the patient from traveling. If need be, the doctor can tell the patient
that he is not fit to travel. A psychiatrist or any medical doctor can
notify an airline or cruise line, that their patient is not fit to travel.

Any medical doctor can notify a government drivers licensing agency that
their patient is not fit to drive. In some states, if there is medical
proof that a patient is not fit to drive the physician is legally
required to notify the appropriate drivers licensing division. Likewise
in some states if a patient is not fit to travel, the doctor is legally
compelled to notify the carrier or other trip operator.

Did you know many, MANY suicidal patients shock their friends, family
and acquaintances by their suicide? You'll hear time and again "He
seemed so upbeat! So much better than ever before!! I can't believe he
did this..." yada yada yada.

Medical professionals aren't mind readers, and patients have been known
to lie about many things.

In article , Brian K
wrote:

Nobody goes to a medical professional and asks for permission to drive,
cruise, fly or engage in behavior dangerous to their well being. If
travel plans become known during a session along with evidence of
self-destructive symptoms the doc has a responsibility to prevent the
client from acting on their thoughts. That responsibility can be
extended to contacting any entity that may increase this risk. This
isn't much different than if a patient's doc has medical evidence that
said patient is not fit to drive, the doc is legally bound in many
states, to notify the proper authorities.

A doctor may tell a patient they should not travel but they are not
going contact a cruise line. What a doctor is required to report to
entities is fairly limited, child abuse, infectious disease, gunshot
wounds.

--
Charles

In article ,
Brian K wrote:

I am not talking about getting permission to travel. If travel plans
are mentioned the doc can asses how the patient feels about traveling.
If he saw certain signs of suicidal ideation he can strongly discourage
the patient from traveling. If need be, the doctor can tell the patient
that he is not fit to travel. A psychiatrist or any medical doctor can
notify an airline or cruise line, that their patient is not fit to travel.

Nope. If a patient was actively suicidal, the doctor would be required
to have them hospitalized (against their will if necessary), but could
not involve the cruise line. Under HIPAA privacy rules they could not
tell the cruise line anything if they merely thought it was a bad idea.


Any medical doctor can notify a government drivers licensing agency that
their patient is not fit to drive. In some states, if there is medical
proof that a patient is not fit to drive the physician is legally
required to notify the appropriate drivers licensing division. Likewise
in some states if a patient is not fit to travel, the doctor is legally
compelled to notify the carrier or other trip operator.

First law I agree with. Find one instance for the latter because I don't
know of one.

In article ,
Brian K wrote:


Nobody goes to a medical professional and asks for permission to drive,
cruise, fly or engage in behavior dangerous to their well being. If
travel plans become known during a session along with evidence of
self-destructive symptoms the doc has a responsibility to prevent the
client from acting on their thoughts. That responsibility can be
extended to contacting any entity that may increase this risk.
Not under federal law and the Mental Health Privacy laws are even
more stringent than the feds. If they have self-destructive or other
destructive symptoms (usually something like a danger to self or others)
the medical professional has a duty to act immediately to get them into
treatment. But as soon as these symptoms dissipate, we have to kick them
loose.
But there is no duty, indeed a prohibition with heavy fines and jail
time attached, to tell anyone else. In fact, there are many times when I
admitted someone to the Unit I was working on from another city or state
and we couldn't even contact their regular shrink without permission
from the patient. If I can't talk to another doc, I certainly can't
start calling cruise lines.


This
isn't much different than if a patient's doc has medical evidence that
said patient is not fit to drive, the doc is legally bound in many
states, to notify the proper authorities.
BIG difference since the HIPAA legislation specifically exempts these
kinds of mandated reporting.

[Default] Thus spake Kurt Ullman :

In article ,
Brian K wrote:

I am not talking about getting permission to travel. If travel plans
are mentioned the doc can asses how the patient feels about traveling.
If he saw certain signs of suicidal ideation he can strongly discourage
the patient from traveling. If need be, the doctor can tell the patient
that he is not fit to travel. A psychiatrist or any medical doctor can
notify an airline or cruise line, that their patient is not fit to travel.

Nope. If a patient was actively suicidal, the doctor would be required
to have them hospitalized (against their will if necessary), but could
not involve the cruise line. Under HIPAA privacy rules they could not
tell the cruise line anything if they merely thought it was a bad idea.

Yup. If the doctor has a "reasonable and substainable" belief that
you present a danger to you or to others, he/she is REQUIRED by law to
take appropriate actions, such as notifiy law enforcement officials or
initiate involuntary committment proceedings. But he can't even tell
your spouse, unless you have signed a "consent to disclose". Even if
the person you intend to harm is your spouse, unless the threat is
immediate.

Most of the hospitals I've worked with or at require that the PT
provide anyone who wants any information on your status, including
even if the patient is in the hospital, an identified. A couple of
years ago I had to have a friend admitted to a hospital because his
injuried were too severe for him to provide more than a brief amount
of information. I signed all of the paperwork, with a verbal (and
annotated) consent from him. Then I had to call his wife with the
identifier so she could check in on him.



Any medical doctor can notify a government drivers licensing agency that
their patient is not fit to drive. In some states, if there is medical
proof that a patient is not fit to drive the physician is legally
required to notify the appropriate drivers licensing division. Likewise
in some states if a patient is not fit to travel, the doctor is legally
compelled to notify the carrier or other trip operator.

First law I agree with. Find one instance for the latter because I don't
know of one.

Texas law requires that any instance in which a person loses
conciousness without a specifically determined cause must be reported
to the Dept of Public Safety. The DPS is then supposed to determine
whether or not to administratively suspend your license for up to six
months. Unless you're hospitalized, most docs don't. It's not quite
the same as digging a bullet out of a guy's leg the day after a
shootout.
--

- dillon I am not invalid

Men are like a carpet. Lay them well and you can
walk on them for years.

[Default] Thus spake Brian K :

On 1/20/2009 11:52 PM Dillon Pyron scrawled with a big red tube of
lipstick:
[Default] Thus spake Goomba :


Dillon Pyron wrote:

[Default] Thus spake Goomba :


Brian K wrote:


It also tells you about the state of passengers. Some let go of all
common sense, drink too much, try to do the "king of the world" shot
from Titanic or have doctors who don't see the signs and let a suicidal
passenger who should have been diagnosed as "not fit to sail" go on a
cruise.


Who routinely goes to a doctor for approval to cruise?

Carol got a solid NO from her oncologist while she was on chemo. It
would have been the week between, but she would have nadared on the
second day.

And that is someone who obviously has an interest in including her
doctor in her vacation plans and is cognizant of the risks, right?

How many psych patients do you actually think do so? How many psych
patients don't even bother seeing a doctor?

IMO, It is laughable that someone would suggest that some doctor (which
one? any one off the street? someone via telepathy??) should have told a
depressed passenger who had plans to go overboard that they were "not
fit to sail." I suspect someone who has little experience with psych
patients, suicide and so on.....


But that's not the question you asked. You asked "Who routinely goes
to a doctor for approval to cruise?" Not how many psych PTs, just
"who".

Nobody goes to a medical professional and asks for permission to drive,
cruise, fly or engage in behavior dangerous to their well being.

FAA physicals immediately come to mind. As does the physical I had to
get every year while I held my (now much missed) NHRA license.

If
travel plans become known during a session along with evidence of
self-destructive symptoms the doc has a responsibility to prevent the
client from acting on their thoughts. That responsibility can be
extended to contacting any entity that may increase this risk.

Nope. In fact, unless the PT presents and immediate and real danger
to a person, the medical professional can't even tell that person.
HIPAA has been my life for years and years.

This
isn't much different than if a patient's doc has medical evidence that
said patient is not fit to drive, the doc is legally bound in many
states, to notify the proper authorities.
--

- dillon I am not invalid

Men are like a carpet. Lay them well and you can
walk on them for years.