Carnival Cruise Ship Doctor
Can't Cure Industry Ails
November 20, 2007
Sex And Lies - No Cure For An Morally Ailing Industry
The cruise industry claims no responsibility for the doctors that float medicine on their boats. Ask anyone from the industry, and they will tell you that the doctors on board are independent contractors, not employees, who are qualified medical professionals. That is the industry line and they do not vary from it. On closer inspection, Cruise Bruise has found things are not exactly as portrayed. We take an indepth look into who gets hired, what kind of people they are and what qualifications these medical professionals have.
Independent Contractors?
What is an independent contractor? First look at the definition of the term 'independant contractor'.
- An Independent Contractor provides services to a company, but is not an employee of that company
- Someone who is self-employed
- A legal category of worker defined by the Internal Revenue Service. The key to the definition is that, unlike employees, independent contractors retain control over how the work they are hired to do gets done; the person or company paying the independent contractor controls only the outcome.
Given this description above, we would not expect a cruise line to give the 'independent contractor' a "job promotion", "salary", "pension", "life insurance" or "disability insurance". These are things 'independent contractors', who essentially own their own business and contract with another business to provide services must provide for themselves. Salaries and pensions are clearly benefits that apply to 'employees'. So, why does Princess Cruises use those terms in their advertisement for "JOBS"?
These terms are used on the Princess Cruises website, as well on a website advertising these 'jobs'. Clearly the promotional language is geared towards hiring people, not contracting with companies when it comes to physicians. Yet, the U,S Supreme Court allows this doublespeak and has ruled that the industry is not responsible for the doctors on their ships.
Moving one more step forward in this line of thinking, if the doctor is an independent contractor then the fees charged for his services should be billed by him, collected by him, and would comprise his earnings from services. Instead, as in the Princess language, he is paid a "salary", and the fees for his services rendered go the cruise line. That sure does sound like an employee to me.
Think of it in terms of the newspaper boy. He is not an employee in most cases. He buys his newspapers from the company, the customers pay the boy, and after his papers are paid for, he keeps the rest and any tips, because he is an independent contractor, per the contract he and his parents signed. This is a standard contract, for independent contractors. When the company who hired the contractor collects all fees then pays the
contractor a salary, this is an employer-employee relationship.
At Princess Cruises, Junior Doctors receive a 6% commission (in 2007) of the professional services charged to passengers. The Senior Doctors get a higher 'commision' in addition to their salary. Doctor Spencer Cheung, originally from Huddersfield, UK of Princess Cruises says when he is busy he can double his pay.
"Most of the crew lives in a sterile ghetto . . . however the ship physican is royalty"
Standards
The industry has been quick to reassure passengers that the doctors on board their ships are highly qualified medical practioners. Though they don't outline those guidelines in media reports.
We came upon some interesting guidelines, that to the average person may seem pretty complex. This is a simplified explanation. On all cruise ships owned by RCCL, Carnival, Princess, Celebrity, and most others, including those casino cruises of a day or two, the doctor on board need only have three years of experience in order to get hired on. In the U.S., this can mean he just got his license, yesterday. For other countries, it can be much worst.
In the U.S when a doctor graduates from medical school, he has a three year further training program called a residency. The first year of that residency is called his internship. During that three year period he works in what is known as a collegial relationship, meaning he can only work under the supervisor of a doctor who has attained his fellowship.
This is normally done in a hospital setting as well, where the doctor gets involved in a wide range of specialized areas. This varies in some states, but is the norm nationally. Once the three year residency is completed, the doctor can then apply for the license to practice medicine on his own without peer supervision. This is why the three year requirement is demanded by the cruise industry.
I have seen a lot of chatter about how doctors on cruise ships are paid less than doctors in the U.S. The standard theme is that cruise ship doctors make only about $40,000-50,000 a year, where U. S. doctors make two to three times that. This is simply not true. Seasoned doctors with ten years of experience or more, a clean record, and an established medical practice, rarely want to leave a six figure income, to work full-time on a cruise ship making less than unionized blue color workers.
In the U.S., residency can last as long as six years. The pay starts at about $32,000 for the first year and tops out around $48,000 for 6th year residents. Given cruise lines like Carnival are now targeting young people, having young doctors on board fits right in, and after all, those young inexperienced doctors are dirt cheap.
When it comes to other nations, the rules are different for the medical license reqirement. This is important because the doctors on board are rarely from the U.S. Instead they come from British Commonwealths and the European Union primarily.
