Cruise passenger doctor in San Juan: ship clinic, video visit or ER?

According to the CDC, ship medical facilities vary, but the large majority of passengers' health problems (about 95%) are treated on board. Respiratory infections are the most common reason for visits to the ship's doctor.

In practice:

While your ship is in San Juan, Dr. Diana Nieves Castro, MD, a Puerto Rico-licensed general practice physician with several years of emergency-department experience, sees you by video, in English or Spanish. We evaluate, diagnose and treat, including virtual urgent care for problems that aren't emergencies. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.

Request a visit online 24/7 — we confirm your time by email or text. Because the time is confirmed afterwards, request early and keep your all-aboard time in mind. We send you a secure video link; it works on your phone, tablet or computer.

A doctor visit is US$79, paid by card when you request it, with no membership; if the visit can't take place, you get a full refund. Everything about our service for visitors is on care for visitors.

The San Juan Cruise Port's contact page lists 911 and Ashford Presbyterian hospital ((787) 721-2160) for emergency services. Ashford, at 1451 Ashford Avenue in Condado, describes itself as the official emergency provider for San Juan's cruise terminals, and it has separate adult and pediatric emergency rooms.

If you left a blood pressure, diabetes or other medicine you already take (non-controlled) at home, see lost or forgotten prescription: the refill is a US$49 follow-up visit. Pick a pharmacy that is open before all-aboard, because the counter's hours don't always match the store's. For your next trip, read bringing medication to Puerto Rico.

The CDC advises taking motion-sickness medicine before travel. Some details from the CDC:

• A scopolamine patch takes 6 to 8 hours to start working and lasts up to 72 hours. It should not be used with glaucoma and is avoided in children.
• Meclizine starts working in about 2 hours and lasts 8 to 24 hours.
• Dimenhydrinate starts in about 2 hours and lasts about 8 hours.

The CDC notes that getting used to the motion is the most effective countermeasure. If you want something for seasickness before you re-board, the doctor will assess what is appropriate for you. More on seasickness.

Norovirus causes more than 90% of diarrhea and vomiting outbreaks on cruise ships, according to the CDC. Wash your hands with soap and water, especially before eating and after using the bathroom, and tell the ship's medical center if you get sick.

Drink fluids often. Get care if you can't keep fluids down, see blood in your stool or have a high fever. See stomach bug in adults.

We see adults and children of all ages. If the patient is under 21, a parent with patria potestad (parental authority) or a legal guardian signs the consent, stays on the video for the whole visit and shows photo ID. Another adult in your travel group cannot stand in. Seasickness patches are avoided in children; ask before giving any motion-sickness medicine to a child.

The doctor's license is a Puerto Rico license, so she sees you while you are on the island. Carry a list of your medicines and your medical history on board, as the CDC recommends. Staying on the island instead? See sick on vacation in Puerto Rico. Insurance questions: does Medicare work in Puerto Rico?. If you get sick and need to cancel or change your trip, see doctor's note for travel insurance.