For people who spend long stretches on the road, work in remote or rural settings, or live far from reliable medical facilities, access to timely healthcare can be inconsistent — or completely out of reach.
Telemedicine helps close that gap by connecting patients with clinicians regardless of geography, reducing delays in care, and minimizing the challenges of transporting someone who is sick or injured. It ensures that routine concerns, emerging issues, and even medical crises are addressed despite the distance.
The University of Texas Medical Branch (UTMB Health) operates a maritime clinic that contracts with cruise ships traveling through the Port of Galveston, as well as with the United States Antarctic Program. The program manages medical operations and services for three U.S. stations — McMurdo Station, Amundsen-Scott South Pole Station, and Palmer Station — along with seasonal field camps and marine research vessels.
These services are provided through the UTMB Health Access Center, a 24/7 resource that helps patients schedule appointments, ask health-related questions, and manage care.
For the past 10 years, Paula McPhee, a registered nurse clinician, has case-managed care in the Access Center. Since 2024, she has been one of eight nurses serving on the maritime team.
“I was working in triage, but for the past two years, the maritime team has handled all telemedicine cases for cruise ships that could be anywhere in the world or here in port, as well as polar medicine cases,” she said.
“For cruise ships, we receive calls from the healthcare provider on the ship about an issue with a crew member or passenger, and one of our responsibilities as nurses is to coordinate consults with UTMB Health specialists,” she said. “We do consults in every specialty.”
UTMB Health physicians support ship doctors with cases ranging from minor issues to intubation and have even managed cases of multisystem organ failure.
“Generally, we have good outcomes, but occasionally there is a sad story,” she said. “Cruise ship doctors usually specialize in internal medicine or emergency medicine. They call our doctors for more recommendations. It doesn’t have to be an emergency. We often hear about patients with chronic conditions that can be handled through routine consults.”
When ships are at sea, video calls are often not possible due to poor reception. Even phone calls can be unreliable, requiring multiple attempts to connect. At times, several cruise ships may be coming into port at once, and although they are not at the bedside, nurses remain busy connecting ship doctors, patients, and UTMB Health providers.
“With cruise ships, we conduct telemedicine consults by phone and through photos we receive,” she said. “Many times, we receive photos of X-rays for orthopedic consults.”
For critically ill patients on cruise ships, evacuation is not always feasible, especially if the patient is intubated.
“People think it’s easy to just send a helicopter to evacuate a person, but logistically, that’s very difficult on a cruise ship,” she said. “They must send down a basket, load the patient, and carry them away. There are many situations in which a patient cannot survive that, so evacuations are not always an option.”
If someone at one of the Antarctic stations needs medical assistance, McPhee said UTMB Health physicians who reside there step in to provide care.
“The icy and uneven environment can cause injuries from slipping and falling,” she said. “We coordinate many orthopedic consults. They don’t have an MRI or CT scan, but they can take X-rays, which we send to radiologists for evaluation. There are also injuries involving equipment and drills, as well as accidents from recreational activities.”
Occasionally, cases are more unusual.
“Someone was bitten by a seal while engaging in approved animal research,” she said. “People don’t always realize that although seals are cute, they can be aggressive.”
The harsh, desolate Antarctic environment can contribute to mental health challenges to those living on the polar stations, leading to frequent consultations with UTMB Health psychiatrists and other mental health providers.
“Patients can discover issues they didn’t anticipate, and their mental health is affected in ways they didn’t expect,” she said. “UTMB provides psychological and counseling mental health support when needed, via email and Zoom calls. If evacuation is needed, patients can be flown to Christchurch, New Zealand, but only if weather conditions allow.”
Most physicians in the Antarctic Program are emergency specialists who can determine whether a patient needs surgery, a splint, medication — or evacuation.
McPhee said sometimes a ship or station doctor will call because they need one more recommendation or suggestion for a patient, and UTMB Health physicians are always ready to help.
“I love my job and enjoy working behind the scenes to get patients the care they need,” she said. “I also like coordinating care as quickly as possible. Once we get a call from a cruise ship or station, we are ‘on’ and work together to respond immediately.”