To contact or visit a doctor during a voyage, a seafarer will inform the responsible officer or the captain because by contract and on the basis of international conventions the company will usually take care of the costs. In most cases this implies that the captains’ permission is necessary for the seafarer to get medical advice. On the other hand the captain will also have to be informed of the decisions taken or the consequences of the medical visit, because of his responsibility for the safety of the vessel and the crew. Therefore, confidentiality of medical diagnosis is often not practicable. and the employer and officers will be aware of the diagnosis. Confronted with a medical request by a crewmember a captain will seek advice of a medical professional either by radio medical contact or in the next port of call.

The captains’ position is that of the owner’s representative, he is first of all responsible for the safety of the ship, the wellbeing of the crew and for safe manning. On the other hand he is also responsible for the costs.

If medical advice is necessary in a port, the captain will seek assistance of the Owner’s Representative in the port to help him find appropriate medical advice; usually this is the shipping agency.

These agencies have a relationship with the owner on a commercial basis that includes standards for the quality of service delivered. The agent will therefore provide the captain with help in line with his demands: proper assessment of the case, swift response and clear report with regard to the safety of the patient, the ship and the rest of the crew. This feature of the shipping industry is the main reason why seafarers often cannot or do not consult their own doctor for advice but are referred to port medical clinics.

By signing a contract of employment, one could argue that the seafarer voluntarily limits his freedom of choice with regard to medical advice, makes others party to his medical history in return for having to bear the financial consequences of any illness or injury that arises during the time of the contract. A port clinic functions against this background. The medical advice is given to seafarers on direct request of the captain. The port physician works for the patient but at the request of the owner and therefore becomes part of the work relation between the seafarer and his employer.