Why was the Ent-D sickbay so small? And why only one doctor?

[The Rock]

For a ship far larger than the original Enterprise and with a far bigger crew, you'd think that sickbay would comprise an entire deck (I'm envisioning their own hospital with multiple doctors on hand instead of just Dr. Crusher, but Dr. Crusher being the head doctor). I mean, 1000 people to care for is a lot!

 

[thribs]

There were other doctors and the larger rooms could be modified into wards when needed.

 

[Tomalak]

Not sure why you think they only have one doctor - we saw several during the course of the series, plus plenty of nurses. There will have been several sickbays (at least one each in the saucer and the battle section) and triage areas throughout the ship. We saw cargo bays being converted to large triage areas on a couple of ocassions too.

 

[The Rock]

There were other doctors and the larger rooms could be modified into wards when needed.

Not sure why you think they only have one doctor - we saw several during the course of the series, plus plenty of nurses. There will have been several sickbays (at least one each in the saucer and the battle section) and triage areas throughout the ship. We saw cargo bays being converted to large triage areas on a couple of ocassions too.

Oh, there were other doctors? Huh, never noticed. I stand corrected!

 

[thribs]

There’s Dr Selar we see a few times in TNG, plus a few others

 

[Guy Gardener]

Free unlimited education.

A lot of people must have medical degrees in the future but can't use them, because there's not enough jobs to go round.

 

[Deks]

For a ship far larger than the original Enterprise and with a far bigger crew, you'd think that sickbay would comprise an entire deck (I'm envisioning their own hospital with multiple doctors on hand instead of just Dr. Crusher, but Dr. Crusher being the head doctor). I mean, 1000 people to care for is a lot!

Budget constraints are part of the reason.
Sickbays on ships should definitely be larger (or at least there should be several) and certainly have more than 1 doctor for catastrophic situations.
The Enterprise-D did have several doctors and multiple nurses (its just the emphasis was on Crusher and Pulaski).
But also, putting sickbay on just 1 deck seems inefficient. In a dangerous situation with casualties, people would need to be brought to sickbay... which would be a problem in case the transporters aren't working (and this can be a problem the larger the ship is).

However, I suspect that nurses (and various crewmembers) would also be capable of performing numerous repairs (and possibly surgeries) etc. which would minimize the doctors involvement and free them up for other patients who need more complex care and in-depth knowledge. Some repairs can probably be done in emergencies by non medical staff as long as they follow directions to use them.

In the 24th century, nurses are more like doctors of today, but actual doctors in the 24th century have more in-depth knowledge for complex tasks.
Kes on Voyager was technically a nurse, but she could also perform various medical surgeries (she certainly seemed to have more free range than nurses of today).

But you can also justify the smaller size of sickbays thanks to technology and automation.
Since various (or possibly most) injuries can be treated and repaired on the go with medical kits which are on every deck, it wouldn't be a stretch to think that critical cases would be smaller number-wise (to the point where usually they wouldn't overrun sickbay).

 

[NCC-73515]

The deck plans show several sickbay areas, some much larger than what we saw in the show

 

[Deks]

The deck plans show several sickbay areas, some much larger than what we saw in the show

That certainly makes sense... we just didn't get to see them.
I wonder if Voyager had more than 1 sickbay in its deck plans... the dialogue didn't suggest that... but I'd think that for such a vessel, SF would have realistically installed SEVERAL MK-1 EMH's in case of emergencies because with 150 people on board, having 1 doctor and 1 nurse also doesn't seem like its enough. It would be enough for your run of the mill situations, but if you're installing an EMH supplement to the medical staff, then I'd think you'd want several EMH's running around in such a case.

Although to be fair, in the 24th century, SF should have already implemented anti-grav medical drones which would come out of the walls or be materialized as needed in critical areas to treat most injuries and internal damage on crewmen whose vitals become unstable - they certainly had the technology to do that in the 24th century if TNG was any indication (and of course Discovery which had anti-grav drones which do internal clean-up and repair a 100 years earlier - we just never got to see them).

Would be interesting that remasters of Voyager and Ds9 (if they are made) included occasional background flying drones doing maintenance.

 

[Burning Hearts of Qo'nos]

I always figured that any important part of the ship (Sickbay, Computer Core, the Brig, Engineering, the library, etc..) that we actually saw on TV was only the main room of a much larger area. Like thecorridor outside Sickbay as seen on screen is a corridor within the greater Sickbay complex, and the area we see all the time is the CMOs personal ward/lab/office. We just don't ever see the other areas. Shame too, because all these places look like they'd be SUPER COOL to see on screen based on the deck by deck schematics. First time I saw those I really liked that my head canon was basically correct! I dreamed of seeing Shuttle Bay 1.

Side note: The shuttlebay and cargo bay complexes on Voyager are equally fantastic and deserve to be realized!

 

[trekshark]

Selar is listed by rank and name, so if you didn't remember she was a doctor she wouldn't come up in a search of this list, but searching for doctor comes up with 3 that are medical doctors some only mentioned in dialog
https://memory-alpha.fandom.com/wiki/USS_Enterprise_(NCC-1701-D)_personnel

 

[Mark_Nguyen]

I'm wondering how big the primary sickbay SHOULD be. In San Diego, they have pretty much all of the medical facilities on display on the USS Midway, which for an operational crew of over 4000 people they had some 14-16 patient beds, two ICU beds, two ORs (one of which tripled as a lab and x-ray room), and one pharmacy. Nearby, the dental care area (which has yet to be seen on ANY Trek, really) has three working spaces (which IIRC from the tour audio was apparently going round the clock with cleanings and operations). All of this fit into about the space of an American bungalow's main floor.

Video of the Midway's sickbay area is here:

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Scaling this to centuries in the future, in space, and with a fraction of the crew size would be tricky of course.. On a carrier, any truly serious medical issues would be stabilized as well as possible and then medevac-ed to a shore base, so on a Starship there should be ample excuse for more comprehensive facilities to handle regular things AND weird alien stuff AND shipwide pandemics for the entire regular crew, for months at a time or more. OTOH, when it comes to mass combat casualties, it would fall not only to any ship's medical staff but an army (navy?) of corpsmen trained for field medical stuff, so if the Midway was designed with one bungalow's worth of facilities for 4000+ crew's daily needs, would a Galaxy class ship need more than what we see for everyday indigestion and kayak injuries and so on? After all, Voyager had exactly one doctor and one nurse for a crew of 140, and they were meant to be closer to the average starbase than the Enterprise was designed for...

Mark

 

[DEWLine]

I'm wondering how many batches of Intrepids - as we've known them in the 24th Century - are currently assumed to have been put into service.

 

[Rusty0918]

What we saw of sickbay is a small fraction of what the whole complex was like. Also, they probably couldn't go grandoise because of budget limitations. I can imagine there's WAY more to sickbay than that small ward, the CMO's office, etc. There are separate examination / operating rooms as we've seen in episodes like "Transfigurations," "Brothers" and "Ethics." (which were all redresses of the same room, BTW).

 

[Mark_Nguyen]

There was also an isolation ward where the two "Brothers" could knock about and play dinosaurs or whatever. Plus a morgue. And in a S1 episode where the Enterprise actually separated (?!), the stardrive section's sickbay reported Doctor Crusher was there and fine when they warped out of orbit, so there IS one down there, even if it wouldn't be used much IMO.

The E-D blueprints seem reasonable to me. And just because some of these facilities are carbon copies of each other doesn't mean that they're all constantly in use. Or maybe one of them is specifically for kids and families on the Enterprise, though it would naturally be pressed into more general service if there were bigger emergencies. Others could be simply shuttered and be able to come online within certain standards of notice.

We don't know how many people there ARE on the medical staff; in any given Trek there are almost always enough people in blue to serve the needs of the plot. Would there be, say, ten fully trained Doctors for 1000 people? That's a lot even for the military, going by the Midway example. 4-5 may be more reasonable, seeing 1000 people once or twice a year for regular checkups outside of emergencies. On a Galaxy-class ship, some may even not be in Starfleet, covering civilian or family practice in the same way that Keiko was a civilian botanist.

And there were plenty of times in TNG and VOY where people would wander into a completely empty sickbay, too. I'm sure that in general people just don't get as sick as they do now, being on a spaceship or not. But as strange as it may sound, on the Enterprise I would be surprised if there were more than 30-40 medical people total, including doctors, nurses and technicians.

Mark

 

[DEWLine]

Supplemented by cross-trained extra personnel from other divisions during Yellow and Red Alert situations.

 

[Mark_Nguyen]

And bringing in DS9, Dr. Bashir was the ONLY medical doctor on a station of 300+, with one regular nurse as well, for much of the show’s first five years at least - even when the Defiant came along. They frequently said that Starfleet resources were pretty limited, but IMO there would have to have been a judgement call for what a minimum workable presence would be for a standard crew complement of that size, to say nothing of the resident and transient population.

And then there’s Discovery, which had two regular doctors AND the unseen CMO for a crew competent of 136…

And here’s some additional food for thought: according to the link below, “Naval personnel command typical apply certain health care provider/ patient ratio when determining the most appropriate manpower manning requirements for a carrier medical department. Typically a ratio of one physician per 1200 personnel and one corpsman per 150 personnel aboard ship are utilized.”

https://brooksidepress.org/Products...tionMedicine/AircraftCarrierBasedMedicine.htm

Mark

 

[Unicron]

Was rewatching "Ethics," today, and they mention that to deal with the larger than normal group of people on the Denver (which struck an old Cardassian mine), all of the shuttlebays are converted to serve as triage bases and Crusher asks those with medical knowledge to help supplement the normal medical personnel.

 

[Timo]

Which is where holograms might excel a few years later.

One MD on call per starship might well suffice in general, but in practice this would require two or three MDs aboard. Janeway's ship is a bit of an outlier there, then - but also the one with a very small crew and a short-duration mission.

That Lorca's ship would be filled with doctors is a slightly different matter, in that she's a research vessel: just about everybody in the crew might hold a doctorate, and half of his people would be engaged in cruel but war-winning medical experiments, distilling ridges-smoothening potions or cloning tribbles or whatnot.

Timo Saloniemi

 

[valkyrie013]

Well lets look at it from a staffing point of view.
You have 3 shifts normally, so you have 1 doctor each shift, and the CMO isnt counted in that so minimum 4 doctors.
Then you have I'd think 2 nurses per shift, so thats 6.
Now you have days off so you have to have replacement personel, so the CMO could take a day shift, but you'd need miminum 2 other doctors for time off, then another 4 nurses.

Now thats in a large ship like the Galaxy, for smaller ships, you may have 2 doctors, and 1 nurse a shift, with the doctors being on call if something comes up, like Phlox.

Now also consider the state of medical tech, unless you have an injury or away team injuries, you'd pretty much be bored, and doing research or the like during your shift, especially night shift.

Now I've always thought of the D sickbay as a quick clinic, you come in get scanned, get a shot or outpatint care. For long care, OR, etc, you have other areas, probably close by the clinic.