St. Lukes is Full of Tae!

[SoCalMark 49]

I have had two experiences with St. Lukes and their so-called accurate x-rays. I have come to the conclusion that 90% of all their required sputum exams are nothing but a ploy to get extra money from American fiancée's and husbands.

After my wife went through the horrid sputum exam on both her K-1 and her I-130 and they made her wait the 60 days -- When she arrived here in the United States a REAL doctor checked those x-rays of her out and she had independent exams. Not once was TB or any scarring present in her system. There needs to be a checks and balances for the Philippines denying so many girls their positive exam results. I have heard of the same rip-off from many of the pinay after they arrive here for their full physical exam.

The idiots at St. Lukes are just another reason why people distrust the Philippines government so much. If you get one of these sputum exam holds then I would say that your fiancée / wife is most likely 99.9% without problems.

Edited October 30, 2014 by SoCalMark

[Hank_ 9,171]

... very possible... but the hard reality is... SLEC is in the chain of "gods" that control this whole adventure... sort of like "fighting city hall". Plus I think SLEC errors on the side of caution to keep CDC happy.

Does SLEC charge an extra fee to complete the SPUTUM testing?

As for the rip-off by a civil surgeon for a 2nd medical exam; reality is the K-1 doesn't need to go to a civil surgeon at all (99% of the time, certain cases with noted medical conditions are required), only a copy of the DSD-3025 is required for AOS - per the I-485 instructions, page 4, section 7c.

[jhonster 23]

I have had two experiences with St. Lukes and their so-called accurate x-rays. I have come to the conclusion that 90% of all their required sputum exams are nothing but a ploy to get extra money from American fiancée's and husbands.

After my wife went through the horrid sputum exam on both her K-1 and her I-130 and they made her wait the 60 days -- When she arrived here in the United States a REAL doctor checked those x-rays of her out and she had independent exams. Not once was TB or any scarring present in her system. There needs to be a checks and balances for the Philippines denying so many girls their positive exam results. I have heard of the same rip-off from many of the pinay after they arrive here for their full physical exam.

The idiots at St. Lukes are just another reason why people distrust the Philippines government so much. If you get one of these sputum exam holds then I would say that your fiancée / wife is most likely 99.9% without problems.

Hey Mark. I guess you're in So. Cal as well. Question? My wife and her daughter need to get their vaccinations done. Does St. Lukes do that as well? Or should we be looking for a clinic of some sort to get the vaccinations done prior to they going for their medical exam?

2nd.....do we need to wait for our package to arrive from NVC to the Manila U.S. embassy to go & get the medical exam done? Do they have to send us a checklist? Or can we just go now to get it out of the way?

Thanks in advance =))

[Hank_ 9,171]

Hey Mark. I guess you're in So. Cal as well. Question? My wife and her daughter need to get their vaccinations done. Does St. Lukes do that as well? Or should we be looking for a clinic of some sort to get the vaccinations done prior to they going for their medical exam?

2nd.....do we need to wait for our package to arrive from NVC to the Manila U.S. embassy to go & get the medical exam done? Do they have to send us a checklist? Or can we just go now to get it out of the way?

Thanks in advance =))

vaccinations are included in the medical at St. Luke's

[Alona_Dan 0]

My wife and 2 kids went through St Lukes and everybody came out clear. No extra tests required. I was there with them however, maybe that made a difference.

[Al422 221]

Being sent to sputum does not mean you have TB. All it means is that the chest x-ray did not clear you of TB.

Chest X-rays have a lot of false positives, but they use them because most of the negatives get cleared, and it gets completed on the same day. If you are one of the unlucky false positives, then you get the real test, the one that is much more accurate, sputum, but that takes 60 days. Apparently, the sputum cleared your lady as evidenced by the fact that she got her visa. If sputum did not clear her, then she would have to do 6 months of DOT.

As far as St. Luke's making money, since the sputum and DOT are included in the base exam fee, how do you figure they are making money by not clearing you on day one with the chest x-ray?

[SoCalMark 49]

; reality is the K-1 doesn't need to go to a civil surgeon at all (99% of the time, certain cases with noted medical conditions are required), only a copy of the DSD-3025 is required for AOS - per the I-485 instructions, page 4, section 7c.

Depends on the county you are living in sir ... we had to get cleared on this side of the Pacific

[VOL 425]

Is St. Lukes a rip off in general , For Sure. But it part of the process.

I checked out St. Lukes last week, small little medical building charging U.S. prices for Philippines Services. For the little amount of service they provide I would think around $45 would be a fair price.

As far as reading X-Rays wrong, maybe it does happen. I personally wouldn't trust my dog to the Medical Services in the Philippines.

[Hank_ 9,171]

Depends on the county you are living in sir ... we had to get cleared on this side of the Pacific

You are IR/CR-1 , I was referring to K-1 processing AOS, and then the exception is certain medical conditions.

Edited October 30, 2014 by Hank_

[six7one 17]

As far as St. Luke's making money, since the sputum and DOT are included in the base exam fee, how do you figure they are making money by not clearing you on day one with the chest x-ray?

IF someone has to do DOT, the original medical exam will have expired upon completion of the treatment. You'll then be required for another medical exam and therefore pay for said exam. Is it fair to pay twice for the same exam? Not really, but at least the DOT iteslf is covered.

Edited October 31, 2014 by six7one

[Al422 221]

Most medical offices around the world who do this exam price things a la carte. In other words, you pay for every shot you need as well as things like TB treatment.

[manilaraf 28]

As a practicing physician to which someone earlier wouldn't trust their dog , let me give you the perspective on the other side of the table.

Again, I'm petitioning my wife for an IR-1 visa, so know that we'll be going thru this in coming months as well.

A basic chest X-ray is a screening test for any lung infection, including TB. Unfortunately, you can get false positives from it. Anything from not inhaling fully to artifacts from the shot can affect the chest film. I'm not sure about how they do it at St Luke's but in my clinic, if there's a possible TB case on a basic frontal chest Xray, the next step would be to take what's called an Apico-Lordotic shot. The patient is positioned for a better, clearer view of the lung fields (especially the upper lungs). My clinic screens a lot of patients for pre-employment and that's usually the next step. Often times, the APL shot will clear a patient with a suspicious density on a basic PA-CXR. If the APL still shows a suspicious finding, then it's referral to our Pulmonologist, the AFB smear, and possible treatment. The AFB smear is the definitive test for TB. It's not done for everyone for obvious reasons. The X-ray is cheap, quick. But unfortunately, there will be false positives. AFB has a significantly smaller chance of having a false positive, but it takes a long time to get back.

Keep in mind also that TB is common in the Philippines. Very common. I have friends practicing in the States and in Europe who have and will never come across TB. Here, basically it's common enough among the population that if there's suspicion of TB, there's the mindset of mask up, isolate the patient until the labs clear the patient. So maybe that's one factor behind the increased frequency of followup labs.

Now, will St Luke's end up having people undergo the AFB when it's probably not necessary? Yes, they probably will. But remember, this is the US Embassy and the US Government we're talking about. Remember the stink that happened a few years back when that Yahoo with Multiple Drug Resistant TB getting on a plane in the States to get married in Greece? Well, imagine the shitstorm if more than a few TB cases that pop up in the US get traced back to St Lukes clearing them.

As with everything medical and related to possible unnecessary medical exams and procedures, it all comes down to liability. Basically, they're treating you as a US Physician would, calling for possibly unnecessary labs, because of fear of getting sued or losing their license/accreditation from the US Embassy and by extension the other embassies that have their medical thru St Lukes.

Personally, my wife (who's also an MD and carries that much more risk of exposure to a TB case) will probably have a baseline CXR, PA & Lateral & APL soon. And maybe an AFB since it's early yet just as an FU to St Luke's. Although hopefully once the staff at St Luke's finds out we're both MD's maybe they give us a pass as a courtesy. =)

Just my $0.02 as a Physician and a USC petitioning my wife for an IR-1.

[Al422 221]

Thank you, doctor, on behalf of all of us. Makes sense to me that St; Luke's will protect the money they are getting from consulate medical exams first and put patient care in the back seat.

But I wonder why they don't do the secondary, more effective x-ray you mentioned before diving head first into sputum? They don't get extra money from the sputum, so the cheapest way to clear an applicant that is still effective should be what they want to do.

[tolitzpogi 37]

off topic but... natawa ako sa title, hahaha

[manilaraf 28]

Al422,

Well, again, the wife & I haven't reached that far into the Visa Journey so I have no personal experience as to whether they do that or not. So if people such as those who've chimed in earlier can say they haven't had it done, I can't say for sure as to why no follow-up CXR.

But yes, it's about liability. Think about it as Stop & Frisk there in NYC (I grew up in Queens & Westchester btw) by the NYPD. Basically in order to catch criminals (TB), you're willing to inconvenience and borderline/not-so-borderline violate the rights of innocent, everyday citizens (TB-negative patients having to do the AFB).