Military Review

Ministry is, and health is not

Ministry is, and health is not

Does the state of medicine affect the state’s defense? It also influences how ... After all, we are talking not only about the physical fitness of the servicemen themselves, but also about their confidence that the home country is able to take care of their loved ones when the officers and soldiers themselves do their duty to protect the interests of the Motherland. And they, like their relatives and friends, naively believe in the veracity and objectivity of the reports of the officials responsible for domestic medicine. However, the harsh reality is ready not only to lower them to the ground, but also, perhaps, to send somewhere deeper ...

In the clinic as on holiday

The author, having done exactly a year ago, in August 2017, the operation to remove basal cell carcinoma on his face at the Oncology Research Institute of Tomsk NIMC, and without encountering any problems, he expected that the whole state of Russian medicine is approximately the same as there.

By the way, if it were not for the personal appeal to this center, the outcome would have been much more sad, since the Novosibirsk oncology in the person of the oncologist at the place of residence and the city oncological center recognized the author as healthy and recommended the “appeal in a year”.

And in Tomsk, a jaw lesion was diagnosed, immediate operations were performed, including plastic surgery, and moreover they did it completely free of charge. Then it took to be registered with the oncologist at the place of residence. It is possible to appeal to him only if there is a referral from the district therapist. And here the first surprises begin ...

In the clinic as a job

My attempts to sign up for the district doctor 31 July 2018 of the year on the website of public services were surprising, since the record was possible only on August 13. A call to the registry allowed to register already on 10-e, which caused quite reasonable assumptions either in the incorrect work of the site, or in the discrepancy between the data of the polyclinic registry and the data of the site.

After visiting the therapist, it turned out that the fluorography room in the clinic has not been working for a long time due to a malfunction and when it works, it is unknown. So you have to go to the next clinic, whose X-ray equipment serves much more than 100 thousands (!) People.

Our, one of the newest Novosibirsk polyclinics at ul. Tyulenin, 9, with great fanfare, opened in 2011 in the presence of the then mayor, and then the governor of the region, Vladimir Gorodetsky.

He said that “the construction of a new polyclinic in a growing microdistrict, whose population will soon reach 80 thousand, will help reduce the burden on head clinic No. 29, to which there have been many complaints because of the large flow of patients.” The estimated construction cost was 364 million rubles. Funding was mainly from the city budget.

Currently, the population of this district, which was called upon to serve the new clinic, has long exceeded the number already in 110 thousand people and continues to grow steadily.

But ... Incomplete general practitioners - 40 percent, and doctors of "narrow" specialties and even more. Polyclinic areas are involved a maximum of 50 percent ...

Thus, the promises of Vladimir Gorodetsky were not fulfilled. The situation has also worsened, as the burden on the basic 29 clinic, whose branch is a new institution, has increased even more.

Of course, the load on one doctor in such a situation significantly exceeds the norm. And the volume of documents executed by him is growing from year to year. As a result, the doctor often turns into a thoughtless Robot, more caring not about the cure of the patient, but about the preparation of correct reporting.

The head physician is responsible for staffing the polyclinic, but what can he do if the shortage of doctors in the city and region is the same, that is, 40 percent?

In addition, it is almost impossible to replenish the staff in the same 29 clinic with medical workers living in other parts of Novosibirsk, as they simply refuse to travel to 08.00 to work via chronic traffic jams on Teacherskaya Street ...

Attempts to enroll in the so-called “narrow” specialists, even if there is a referral from a therapist, are fraught with almost insurmountable difficulties.

In particular, I was ordered to come for the coupon at the 16 August registry on Thursday, at 07.30. Arriving there at 07.20, I discovered a queue of about 60 people. Having defended it, I heard from the window that there are no tickets anymore, and it is necessary to arrive “tomorrow at 07.30”. Came to 07.00, but found a queue of even greater length. And the answer of the registry was the same, but this time, “come on Monday, there will be an entry on September 3”. Of course, the situation repeated on Monday.

Exactly at 07.30 am the registry opens. Such is the picture. Queue people in 70 ...

By the way, in the queue you can hear a lot of stories about the true situation in medicine. For example, a retiree 73-years told how he, having received a cataract in both eyes, turned to a local ophthalmologist for help, and he sent him for an operation. The patient tried to ask him to operate on a quota. However, in response, he heard that he could wait for the operation for ... 5 years. And the man laid out 56 thousand rubles for the operation of his, as he put it, “death-money”. There are dozens, if not hundreds or thousands of such stories.

However, there is an opinion that any patient, not satisfied with the work of the clinic, can state their requirements in a letter to the head doctor of the medical institution and the medical insurance organization, after which they will inevitably be obliged to fulfill their obligations to ensure the provision of free medical care.

But ... What is this organization of the work of public health requiring such an approach ??? And is it, this is health care?

Many visitors are already tired of going to the reception endlessly. A "Book of complaints and suggestions," the wallboard, where patients write their reviews, are filled with complaints.

In the clinic as in penal servitude

The Novosibirsk Region is considered to be a region with a high incidence of cancer. The incidence of cancer in 2016-th year was 469,8 cases for 100 thousand population (in the Russian Federation - 402,5). The high level of patients with 1 – 2 disease stages - 61% attracts attention.

As of 2015, the number of oncologists in the Novosibirsk region was slightly more than 60 percent.

The most surprising thing is that both the Russian and the regional Ministry of Health in this state of staff say that “the priority direction of development of the oncological service is to increase the detection of malignant tumors, especially the 1 – 2 stage, survival, optimize patient routing, introduce modern screening programs, improve the quality of care , especially the availability of chemotherapy and radiation therapy, training ... "

What does this mean in translation from the official language into Russian? But what ...

At 110, the thousands of the population of the Novosibirsk regions Rodniki, Snegiri and Severnyy account for an 1 oncologist who was on vacation at the time of the appeal.

Standards are supposed to have an oncologist 1 on 500 identified cancer patients. All those of the Novosibirsk region about 80 thousands. A simple calculation shows that such medical specialists should be around 160. But…

Incomplete only in the 29-th clinic and its branch on the street. Tulenin, 9 is an oncologist's 3-4.

At the same time, it seems that no one thinks about turning the declaration into real actions.

Only from this fact it can be concluded that in fact the work on the detection of cancer at an early stage is completely failed.

My appeal to the direct line of the regional Ministry of Health allowed us to establish that calls to it are not recorded, and appeals from citizens are received in writing according to a set pattern that is available on the site. And the answer to them is given within 30 days.

That is, a potential patient, for whom, perhaps, the decision on admission by a doctor can literally be a matter of life or death, according to the Ministry of Health of the Novosibirsk Region, can wait 30 days ...

It is amazing, but in order for the regional Ministry of Health to own information about the real situation with queues in each clinic, it is enough to put a penny video camera in their lobbies and display the image from them directly to the offices of responsible medical people. And to provide effective methodological assistance in ridding patients of queues at clinics.

But this simple thought does not come to bright bureaucratic heads.

In addition, it turned out that the old service “City Electronic Registry”, which previously could have been registered with a doctor on the Internet, no longer works. A new service on the website of public services, according to registry workers, makes it possible to enroll to an oncologist for some reason only from 00.00 to 06.00 in the morning (?!) ...

Yes, and this site works very incomprehensibly, issuing messages like "The request did not yield results", etc.

And 22 August 2018, the appointment to doctors, at least in Novosibirsk, was not completely possible, because the electronic registration system in the entire city did not work completely ...

Summarizing, we can agree with the opinion of the Minister of Health of the Russian Federation Skvortsova about the unprecedented flourishing of Russian medicine and the general increase in the life expectancy of Russians.

It remains to assume that with such an organization of health care, requiring excellent physical fitness of sick citizens, they will die out. And so will increase the performance of domestic health care.

Sad ending

Indoors in the registry are an indication that medical workers visiting patients in the community should use the shoe covers provided by the citizens themselves. You can imagine that the patient, having found the temperature of degrees in 39, before calling the doctor, would immediately rush to the pharmacy for shoe covers?

Nearby you can see the information that 29-I clinic in 2018-th year participates in the project "Creating a new model of medical organization" (lean production). Production of what ??? Sick? Or healthy?

And if you work and decide to seriously take care of your health, it is better to take a vacation and be prepared for the fact that you have to go to medical institutions every day from morning to evening.

And if you are a pensioner, get ready to endure all the burden and deprivation of Russian medicine.

Of course, in the current situation there is no fault of either the doctors or the other polyclinic workers. They are forced to work according to the rules that they are let down by the federal and regional ministries. And they were so convinced that the medicine should not cure people, but provide them with services, that the very concept of “health” turned out to be “zamenetized” and “bureaucratized”.

Probably, medical officials are not familiar with the biography of the great Russian surgeon Nikolai Pirogov. And they never read Anton Chekhov's Stories of the Zemstvo Doctor. And if they read, they did not understand anything.

Let the still healthy citizens envy already sick.

PS And how in other regions of Russia?

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  1. samarin1969
    samarin1969 23 August 2018 05: 44
    Here's the deal! And I thought it was a transitional mess only in Crimea. The most offensive thing is that a lot of money is invested in medicine. But management mess often leads to wild things. People with acute eye problems, oncology are sent away for 1-2 months, call crazy coupons, suffer in "mausoleum" lines. A small number of doctors have become a familiar media background.
    Now a decision has been made to send 90% of medical students bypassing residency in polyclinics. Specialists will be still those ...
    1. Jolly oldster sailor
      Jolly oldster sailor 23 August 2018 05: 48
      Yeah ... Now it’s better not to get sick ...
    2. smershxnumx
      smershxnumx 23 August 2018 07: 35
      In Yekaterinburg - one to one! I can’t go to an oncologist for more than a year (although I’m registered). Last year, sinusitis happened - so I found out that there are more than 1,5 million inhabitants in the city - there are no otolaryngologists in polyclinics in the community! The therapist took me to the head (!?) Of the ENT department (and there’s not a single doctor!), The head looked at the pictures, analyzes, and .... sent her to the hospital No. 6. There I found out that the hospital is a day hospital 20 beds (FOR THE WHOLE CITY !!!), recorded in the queue (!!!), the queue for treatment approached after a week (almost did not wait laughing ) Just think some sinusitis laughing
      . Operations (planned) - they are done only in State Clinical Hospital No. 40 (also 20 beds). And emergency operations - only in maxillofacial surgery of the City Clinical Hospital No. 23 .... AND EVERYTHING !!! 60 beds for 1,5 million inhabitants !!!! Ohhhhhh .....
    3. New Year day
      New Year day 23 August 2018 08: 40
      Quote: samarin1969
      And I thought - this is a transitional mess only in the Crimea.

      so think in Crimea and medical workers. In May he was in the same Crimean Central Hospital. I was asked, as there, on the mainland. They were amazed that there too. They thought it was local freaks.
      Svetlana Soldatenko, Chief Physician of the Simferopol City Clinical Hospital No. 7: “According to the procedure for providing medical care, 255 full-time doctors are needed to ensure the work of the hospital, in fact 153 people. 466 people are required for paramedical personnel, 266 are required for work, 441 for junior medical personnel, we have 229. There is an acute shortage of staff among anesthetists, 28 are standard units, and there are 17. Cardiologists need 17, there are only 7 neurologists it should be 24, only 18 work. Radiologists - 7 instead of 15 ”.
      The Ministry of Health of the Crimea is most acutely short of doctors in Razdolnensky, Nizhnegorsky, Krasnoperekopsky, Pervomaisky districts and Armyansk. There staffing ranges from 53% to 68%. The coefficient of combination of doctors on average in the Republic is 1,17 (with the recommended federal indicator not more than 1,2). In Simferopol, Yalta, Yevpatoriya, Saksky and Bakhchisarai districts, hospitals and polyclinics are provided with personnel in the range of 81-86%.

      I have information from Tsentrospas - they took a large number of children from Simferopol for treatment to St. Petersburg and Moscow. Now they switched to Krasnodar. Out of 3 AN-148 Tsentrospas flies 1. There are 2 superjets left, one ministerial. It is unprofitable to drive the Il-76. For a month, doctors have been playing the ball in Ramenskoye.
    4. aybolyt678
      aybolyt678 23 August 2018 15: 12
      Quote: samarin1969
      The most offensive is that a lot of money is invested in medicine.

      not invested in medicine, invested in imports. Our medicine is on guard of other people's money! Example: a joint prosthesis - two titanium plates that weigh fifty grams. Imported. cost from 40 to 200 thousand rubles. Let's calculate how much a gram costs. The lens of the eye is a piece of polymer that weighs 0,2 grams. and costs from 10 to 50 thousand rubles - also imported. An MRI device, formally assembled with us, is completely imported. worth many millions. And how many useless imported drugs are recognized as vital! An ordinary Viagra called Revacio costs more than 50 thousand rubles and is on the list of vital drugs for the core, people with disabilities get it for free and the state pays for it !! Is it really difficult to arrange the release of this plastic for the eyes? or stamping titanium plates? by ourselves? There would be a Supreme Will !!! so she is gone!
    5. Starover_Z
      Starover_Z 23 August 2018 21: 05
      in order for the regional Ministry of Health to have information about the real situation with the queues in each clinic, it is enough to put cheap cameras in their vestibules and display the image from them directly in the offices of the responsible medical persons

      No need for any expenses! It is just necessary that those medical bureaucrats from the ministries go to their polyclinics at the place of residence as ordinary citizens! And their departmental LechSanUpr-s to unsubscribe to the areas where they are located!
    6. ddmm09
      ddmm09 24 August 2018 18: 25
      Medicine is managed not only by the ministry, but also by FOMS, the latter are businessmen. What do you expect from them then ?! On the website of the regional ministries of health, read the health development program in your region. For our region, it is clearly written - a decrease in the number of beds in hospitals and an increase in the volume of outpatient care. How it looks in practice - no one has an idea.
      Do the mistakes of outpatient doctors outrage you? In the regions, look, sometimes a paramedic sits behind a narrow specialist, and a midwife in a antenatal clinic. For some reason you attribute all their flaws to doctors! Education does not allow them not to make mistakes.
      Doctors in our country themselves have declined, no one has reduced us. Thank you to everyone who in the person of all sorts of malachov created a negative image of a doctor. They demanded change, the ministry did it to you. Therefore, in order to get an appointment with a doctor, you need to have a policy, take a time ticket, a standard ticket from the registry, and all this takes time. Himself faced this more than once - you begin to get nervous. Although all doctors are now working with a double load. Say thank you that at least someone else is from the doctors! The regions have partially found a way out of this situation - they are recruiting doctors from Central Asia ... Draw your own conclusions.
      1. Old shoe
        Old shoe 29 August 2018 18: 53
        Yeah, FOMS ... Those are still aliens. When they come to medical institutions with checks, it is clear that they are only looking for something to complain about and withdraw money from the hospital. And in general, in their opinion, doctors should not use drugs, but treat them with a good word, so that they don’t transfer money for treatment to hospitals AT ALL! belay
    7. forester
      forester 28 August 2018 15: 02
      Well, how not to remember Vysotsky - "if the frail - right in the coffin - keep health so that people use tyranny"))))
  2. Vard
    Vard 23 August 2018 05: 53
    Try it through the public service website ... No problems with appointments with doctors ...
    1. avia12005
      23 August 2018 05: 57
      In Novosibirsk, he did not work yesterday. And because of the shortage of doctors, what does it matter where to register?
      1. ArhipenkoAndrey
        ArhipenkoAndrey 23 August 2018 06: 30
        And I have a firm opinion that our Russian medicine does not cure, but following the directive of the ministry reduces the number of potential and current pensioners by naturally decreasing thereof and this has nothing to do with treatment. In general, the Minister of Health and her ministry should have long been prosecuted for squandering the state. funds and violation of the Constitution of the Russian Federation expressed by not providing free medical support for citizens, namely, oncologists in Novosibirsk, after the death of patients, 80-95% usually lose cards, and all medical assistance is expressed in taking tests and ultrasound, and one of the methods of treatment is to wait for a doctor from various vacations and business trips somewhere.
        1. New Year day
          New Year day 23 August 2018 08: 53
          Quote: ArhipenkoAndrey
          our Russian medicine does not cure, but following the directive of the ministry reduces the number of potential and current pensioners by naturally decreasing thereof and this has nothing to do with treatment.

          I had a long conversation with the famous Roshal. Golikova stood on medicine, replacing Zurabova. So, Roshal retold his dialogue with Putin with the outrage in healthcare. Putin listened silently and did not answer.
          Skvortsova came and everything continued even more.
          Roshal, 2017:
          -In Russia, there is virtually no single structure of healthcare management, while the medical sector suffers from chronic underfunding.
          - At the current level of funding, effective health care is not possible. At the same time, the healthcare system is loaded with elements that do not play any positive role in the work of medical institutions. In particular, the pediatrician called medical insurance companies "unnecessary."
          “Let's remove the system of insurance companies that we do not need, which like leeches sit on our bodies and do not lead to an improvement in the quality and accessibility of medical care.”
          - Against the background of a number of outstanding successes of individual doctors who are not inferior to their Western colleagues, the professional training of the bulk of doctors is of serious concern.
          It is necessary to develop a clear state program on overcoming the situation of personnel shortages. It is not good to solve the problem of raising salaries for employees of medical institutions at the cost of reducing staff.
          So all this is state policy.
        2. Med_Dog
          Med_Dog 23 August 2018 13: 09
          Unfortunately it is. Do you think the Ministry of Health is getting enough funding?
          1. aybolyt678
            aybolyt678 24 August 2018 20: 49
            Quote: Med_Dog
            Do you think the Ministry of Health is getting enough funding?

            The 2018 health budget mainly consists of funds from the MHI fund. The President of the Russian Federation approved the budget of the fund for 2018-2020. The total health expenditures during this period will be distributed as follows: 1,8 trillion rubles in 2018; 1,8 trillion rubles in 2019; 2,1 trillion rubles in 2020. The health budget for 2018 also takes into account the income of the compulsory health insurance fund, which according to plans until 2020 will amount to: 182 billion rubles in 2018; 105 billion rubles in 2019; 146 billion rubles in 2020.

            total, on average, for every Russian you need to spend 13 thousand rubles a year. Or a thousand a month. Here it is worth paying attention that this money is not spent on every patient. They are spent on each healthy and sick alike. It's not for nothing that Zdravookhranenie laughing
        3. Indifferent
          Indifferent 29 August 2018 11: 46
          My opinion is that the people who are writing here live in another country or write from the words of one woman who said something somewhere.
          I felt bad for a long time and could not understand what was happening. Until one doctor I know advised me to be tested for glucohemoglobin. The result shocked me and the doctor I went to, too. I was immediately sent to the city hospital number 9, and it was in the city of Saratov (which we jokingly call Zasratov). This is not Moscow. They were put in the intensive care unit, and later transferred to the general one. So I want to write that in Soviet times I was in hospitals and even completely new ones. But this hospital amazed me. The cleanliness is perfect. Everything is repaired, what is called a renovation. The toilets are ok and no need to sit down like a "mountain eagle at the top of the Caucasus ..." The staff is attentive and very professional. Everything on computers. No medical history. It is enough to come to the doctor and tell the last name and everything is already in front of his eyes. The equipment is all there. They turned me inside out like a teddy bear, looked at everything and, having made a diagnosis, returned to the original. Everything is fast, efficient and professional !!! And how they fed! I was just surprised. I didn't even eat what was given. The menu includes meat and fish and liver and chicken. Salads, juices, kefir, cheese, butter. Cash minimum. I just admire the hospital !!! Chambers for 6 people. Make new beds. Beds too. They unfold like transformers. Those who want to pay a little can go to the superior ward. For ten days it is quite affordable even for not rich citizens. I could afford it, but I need society. I would be very bored alone. So at the hospital level, I am delighted with our medicine. And the clinic is yes! There is a blockage. This level of service is in the corral. But all the same, we don't need to queue at 5 am. It is easy to make an application for a doctor's visit by phone. But you need to call from 8 am, as the reception opens.
      2. Sergej1972
        Sergej1972 25 August 2018 14: 23
        On this day, the public services website was crashing across the country.
    2. pin_code
      pin_code 23 August 2018 07: 21
      Have you tried it ???
  3. kuznec
    kuznec 23 August 2018 05: 57
    In our Krasnoyarsk Territory exactly the same. In the regional centers of the clinic without doctors.
  4. Alexander S.
    Alexander S. 23 August 2018 06: 05
    Himself from Novosibirsk. For more than six months I have been going to medical facilities as a relative of the patient. He went around 3 hospitals, two clinics and 2 consultations. And he made one conclusion. The author says that doctors and medical workers do not need to blame ... Moscow is to blame for everything .. the ministry. I thought so too, but when faced with a different organization of work, with different doctors I realized ... that the problem is not somewhere out there ... namely here ... in polyclinics and hospitals. A lot of medical workers absolutely do not want to work. Why, then, in 2 hospitals, the doctors refused medical assistance, and in the third they provided 30 minutes .. and they made round eyes, learning about the previous two .. Is Moscow to blame? They refused to attach to the registry office ... they demanded registration ... some kind of lease agreement ... went with a statement to the head doctor ... signed, without asking questions. The ministry is also to blame.? In one clinic you go constantly with the kicks of the doctors, you push them to move at least somehow. But in another, the doctors themselves try to help as much as possible .. they try to give directions for examinations as early as possible, and not after six months. So my conclusion is one. It all depends entirely on the local doctors, how they organize their work ... and generally whether they want to work. Moscow ... she is far away. And the hospitals are here ... and the problems are here. Here are the main problems - the low organization of work in medical institutions, the low qualification of medical workers, their low professionalism (unwillingness to work). Many will say ... they do a lot of paper work .. I, as a relative of a cancer patient, do not care much. Thank you for at least a few, but there are doctors who sincerely try to help patients ... without chasing them around the city (and nothing prevents them from doing this). But what prevents others?
    1. Jolly oldster sailor
      Jolly oldster sailor 23 August 2018 06: 14
      to me as a relative of a cancer patient
      If possible, send to Germany. Believe me, it will be better and cheaper.
    2. pin_code
      pin_code 23 August 2018 07: 26
      just medical workers still work in private (paid) clinics. and there they will willingly accept you, but for the money ... conclusion ... you need to either completely remove paid medicine, or free (state). some "doctors" are very beneficial to the current state of affairs.
    3. Baloo
      Baloo 23 August 2018 08: 12
      Quote: Alexander S.
      Many will say ... they do a lot of paper work .. I, as a relative of a cancer patient, do not care much. Thank you for at least a few, but there are doctors who sincerely try to help patients ... without chasing them around the city (and nothing prevents them from doing this). But what prevents others?

      You have telephones in the policy, do not hesitate to disturb the territorial MHIF and the insurance company. All that is written is not the whole layer of problems.
      Definitely, in the historical aspect, domestic medicine was developed by ministers-surgeons.
    4. BAI
      BAI 23 August 2018 09: 20
      relative to the cancer patient

      If a relative wants to live, let him go to 62 Moscow Cancer Hospital. Abroad for every sneeze you will not run into. I underwent surgery there, and in Israel they confirmed the high quality of the operation.
    5. g1v2
      g1v2 23 August 2018 11: 58
      Of the four St. Petersburg hospitals that I had to deal with, I can only advise one - St. George. The hospital was recently repaired, the attitude of the staff is good. And in general, all the rules. From the rest - only negative memories. In one, a father with a stroke spent 3 days in the corridor and no one approached him or even called his relatives. For some reason, all the acquaintances who were treated there, for some reason left ahead with their feet. In the third in the emergency room, the doctor was stupidly drunk. am
      I strongly doubt something that it was Moscow that gave the doctor a drink or forbade other doctors to approach the patient with a stroke.
      Moreover, the ambulance, in principle, in St. Petersburg - the norms. I remember how in the 90s people came to check out with empty bags. Now - the medical boxes are full of medicine. The ambulances themselves are also being updated.
      And the attitude is basically normal. It is clear that after talking with the citizens on duty, the team really wants some comrades to fall through the ground. But as a rule, they are quite correct. request
      In paid medicine, it’s even worse. Money with a vacuum cleaner, and the result is stable horseradish. By knowledge too. The edge was at all when I came to a not-so-young doctor with the results of the tests, and then I saw over my shoulder that he was clogging Google with a search for what they meant. belay
      As I understand it, there is only one panacea - personal acquaintance with an intelligent doctor. Only personal connections - and nothing else. Money does not help solve anything. But a familiar doctor, in the first place, can immediately refer to an intelligent specialist who will not treat him as a passerby from the street. Secondly, this doctor looking at the same prescribed tests immediately says - this is necessary, it is important, it is desirable. and they appointed you to rip off the money. request
      How to change all this - xs. I think we should start with medical institutes. To educate health workers about human beings. Everything else is already secondary.
    6. kakvastam
      kakvastam 24 August 2018 12: 44
      In absolutely right.
      Moreover, this is the state of affairs in all sectors, not only in medicine. The excuse for local officials is painfully good - all the "Muscovites" vows spoil, and we ourselves are pink and fluffy. Yes, and the population is comfortable - you can safely scold the distant Moscow with its countless ministers-parasites, but not quarrel with the close thieving bosses.
  5. avia12005
    23 August 2018 06: 13
    By the way, here is the list of vacancies in this clinic for July 18
    1. District pediatrician (4) - 33000-38000
    2. Doctor pediatrician DShO (2) - 23000-28000
    3. Otolaryngologist (2) - 23000-28000
    4. Ophthalmologist (1) - 23000-28000
    5. Orthopedic Traumatologist (1) - 23000-28000
    6. Pediatric urologist andrologist (1) - 23000-28000
    7. Pediatric Surgeon Nurse (1) 13800-17000
    8. Nurse DShO (3) - 13800-17000
    9. ENT Nurse (1) - 14800-18200

    Main building:
    1. District physician therapist (2) - 33000-38000 (274-01-92 Safronova Natalia Nikolaevna)
    2. Neurologist (1) - 23000-28000 (272-02-72 Piunova Tatiana Vladimirovna)
    3. Pulmonologist (1) - 23000-28000 (274-02-01 Nikolaeva Yevgenievna)
    4. Traumatologist-orthopedist (1) - 23000-28000 (274-02-01 Nikolaeva Al'ina Evgen'evna)
    5. Endoscopist (1) - 23000-28000 (274-02-01 Nikolaeva Al'ba Evgen'evna)
    6. Urologist (1) - 23000-28000 (274-02-01 Nikolaeva Al'ba Evgen'evna)
    7. Oncologist (2) - 23000-40000 (274-02-01 Nikolaeva Al'ba Evgen'evna)
    8. Doctor-surgeon (1) - 23000-28000 (274-02-01 Nikolaeva Al'ba Evgen'evna)
    9. Nurse precinct (therapist) (2) - 17800-21100 (274-28-03 Reshetnikova Natalia Nikolaevna)
    10. Midwife (2) - 14800-21600 (274-18-84 Makhmutova Rufiya Gazizovna)
    11. Medical Laboratory Technician (Medical Assistant) (1) - 14100-17800 (272-10-51 Lyukhovskaya Veronika Viktorovna)
    12. Physical Therapy Nurse (1) - 14800-18200
    13. X-Ray Lab (1) - 14800-18200

    Outpatient department № 3: (270-24-88 Bushueva Oksana Gennadyevna; 270-24-87 Arkhipova Nadezhda Valentinovna)
    1. Neurologist (Adult 1) - 23000-28000
    2. Obstetrician-Gynecologist (1) - 23000-28000
    3. District pediatrician (1) - 33000-38000
    4. District physician therapist (1) - 33000-38000
    5. Ophthalmologist (1) - 23000-28000
    6. Nurse of the district (pediatrician) (1) - 19000-22300
    7. Nurse District Therapist (Therapist) (1) - 17800-21100
    8. Midwife examination room (1) - 14800-21600
  6. Fox
    Fox 23 August 2018 06: 26
    in Tolyatti and Samara there is the same gimmick ... only terms in narrow specialists are up to 2 months. on oncology and detection: since the beginning of the year 5 people have died (on my street), of which three are oncology.
    with education even worse. 18 years of continuous change.
    1. Ingvar 72
      Ingvar 72 23 August 2018 07: 15
      Quote: Fox
      with education even worse. 18 years of continuous change.

      Hi Zema! hi With the formation of trouble, I agree. But the trouble is that in our medical camp there were no normal doctors at all, as in the Ministry of Internal Affairs, there were helpful people, those who were able to lick Rentsu (the head doctor).
      Yesterday I put my mother in the hospital, so one "specialist" there, five minutes later, by touch, diagnosed her with a "malignant tumor." And this is out loud, without any analysis and examination. Moreover, according to the description of the mother, an adult, not a kid. Medical ethics zero, not to mention professionalism. No words, one mate. Today I'm going to deal with this um ... professor. am
  7. afrikanez
    afrikanez 23 August 2018 06: 42
    Sheer hypocrisy in the government, in the localities.
  8. Rostislav
    Rostislav 23 August 2018 06: 58
    The statement of NI Pirogov "There are no big bastards in the world than generals from doctors" is true not only for the military.
  9. Greg Miller
    Greg Miller 23 August 2018 07: 26
    Yeah ... Nothing so special from Ukraine and no different in this area ...
    1. rocket757
      rocket757 23 August 2018 09: 08
      Capitalism here and there.
  10. Egg
    Egg 23 August 2018 07: 31
    "medicine should not cure people, but provide services to them"
    exactly !
    turned all medicine into commercial enterprises.
    We had a tomograph, installed and it stood for almost 1,5 years because there was no specialist.
    And by the way, often there are not enough specialists, not because they are not available or impossible to find, but simply because the chapters do. relatives of the doctor ended ... but he doesn’t want to take someone else’s.
    Jobs allow doctors to recruit substitutes and thereby increase their salaries, the quality of work while sideways.
    1. New Year day
      New Year day 23 August 2018 08: 58
      Quote: Telur
      "medicine should not cure people, but provide services to them"
      exactly !

      Press Service of the Russian Crimestat, 2018:
      -in January-June 2018, 42,2% of enterprises were operating at a loss. A significant share of unprofitable organizations is observed in the field of information and communications, culture, sports, leisure and entertainment organizations (80,0% each), health and social services (75,6%), in the field of hotels and catering establishments (73,5%).
      What do you want? You have to earn money, otherwise the remnants of the doctors will run away
  11. parusnik
    parusnik 23 August 2018 07: 31
    On the ground floor, at the house where I live, a children's clinic is located. The queue begins to gather from 5 a.m. The same thing happens in an adult ... We don’t have a better place in the area. If you recall the totalitarian past, it was better with medicine. We were in villages and outpatient villages, even hospital hospitals. There was no need to go to the district center. On the contrary, they were sent to village hospitals .. I was lying in such an examination as a child .. Modern equipment at that time, a pond with crucians, willows above it, a park with walnuts falling under my feet ..Now, at this place, someone’s estate ... And for the locals, a modest first-aid post, however, you don’t really need to go to the district center anymore ...
    1. avia12005
      23 August 2018 07: 49
      There is no one to ride ...
    2. rocket757
      rocket757 23 August 2018 09: 07
      In the "totalitarian" past, MEDICINE WAS for everyone.
      When people do not live to provide the necessary assistance, finally, because there is no money, including, what kind of state care can we talk about?
      We are not expressing our indignation about lovers of "hawthorn", although specific persons must answer for them too!
  12. Colonel
    Colonel 23 August 2018 07: 41
    About "lean manufacturing" in the clinic is great. Toyota's initiative lives and wins. By the way, the organization of lean production implies the presence of all kinds of supplies in the workplace for one working day. If patients are considered "reserves", then 5C in the polyclinic failed in the bud.
  13. cobalt
    cobalt 23 August 2018 08: 05
    Not surprisingly, my mother and I couldn’t get an appointment with a banal therapist in Vladimir for a month and a half, I’m silent about specialists in my native Sobinsky district, 150 km from Moscow to 2 cities and 1 ENT doctor, a child, an adult in general no, that's how we live, or rather we survive.
  14. Note 2
    Note 2 23 August 2018 08: 15
    Somehow I sat in a queue to the urologist and a woman sat in front of me and she told me that the doctor we want to see had given her the wrong diagnosis. Despite the fact that the woman had kidney problems, she told her that she was okay but the kidneys were they are sick and she went to a regional hospital where she was diagnosed with cancer of one of the kidneys and then promptly removed. I myself was diagnosed with three times the wrong diagnoses. But this begs the question for Mr. Prime Minister and due to this the lifespan of Russian people when such healthcare is increased ? According to statistics, about 40% of our fellow citizens do not live to be 60 years old. The article is correct, but the more you come across our medicine, the more squalor you see.
    1. kuznec
      kuznec 23 August 2018 10: 19
      Quote: Prim2
      lifespan of Russian people increased
      solely by changing the methods of collecting and processing statistical data.
    2. kakvastam
      kakvastam 24 August 2018 12: 57
      due to which the lifespan of Russian people has increased

      If we redefine the concept of "people", excluding those layers that strive to spoil the statistics, then everything turns out very well ...
    3. Med_Dog
      Med_Dog 24 August 2018 14: 38
      This question should be asked to the President. Just do not say that he is not in the know, etc. etc. And then, as always, the king is good, the boyars are bad ...
  15. Peter Smith
    Peter Smith 23 August 2018 08: 52
    Everyone is all fix. I mean the authorities. Assign to the posts of their friends and thieves. We have made repairs in the emergency department of the BSMP. Eliminated windows. The ventilation is not working. Die from the stench. The head doctor didn’t work with 70% of the doctors. A few old experienced surgeons remained. The rest do not know how. And he (head physician) in his place. Familiar Governor ...
    The comments show-- this is a system. Fish rots from the Kremlin. The conclusion is this.
  16. New Year day
    New Year day 23 August 2018 09: 06
    with the existing order of things, normal medicine will remain only in megacities and then, free of charge within the framework of the compulsory medical insurance. Everything else will be for the money. Peripheral medicine will die quietly and without noise due to lack of money and, as a result, lack of equipment and doctors. Good doctors will be drawn to Moscow, as I see from my hospital; recently, regular people from Omsk arrived. Bad people don’t come to us, they simply don’t take them.
    It remains only to pray and take care of your health and, if possible, not to leave the region of residence, there is a chance to survive. What was being brought to us from the region was deliveries from Ivanovo — the hair stood on end! There was no such thing under the Union.
  17. Harry_
    Harry_ 23 August 2018 09: 15
    Quote: afrikanez
    Sheer hypocrisy in the government, in the localities.

    .. for a long time there has been a deliberate extermination of the Russian people: education (EG), medicine, the labor code, pension reform, elective system (no choice), taxes, etc. (if something is not indicated, add)
  18. sunzhenets
    sunzhenets 23 August 2018 09: 43
    Ministry is, and health is not

    Well, so the Ministry of Health is not the only one. We also have the Ministry of Economic Development, but there is no economy or development.
  19. Mordvin 3
    Mordvin 3 23 August 2018 10: 10
    Optimization and capitalization result. Moreover, in the USSR they went to doctors much more, they were not afraid to get sick. However, in the west, they also got sick "less". In England, the number of sick leave has decreased by half in 20 years. This is how we accumulate sores, then we dump them in the clinic, but there are no specialists.
  20. alstr
    alstr 23 August 2018 11: 06
    Well what to say. This is not so at the same time.
    About lines and numbers. I don’t know how in other cities, but for a couple of years we have only been recording through the site. More precisely, they are now registering in polyclinics through the site. Only the reception only works on weekdays, and the site is around the clock. In the registry there are few numbers in reserve. This is on the one hand.
    On the other hand, during periods of epidemic, there are not enough numbers, and they go to the district police officer without one through the numbers.

    As for the specialized specialists, here it is really necessary to "get" the numbers.

    In general, the other day, in one of the discussion programs (the question of the rural population was discussed), the correct idea was expressed that in the pursuit of efficiency, we had completely forgotten about the availability of social services.

    The same fashion is to blame for the district treatment of all diseases from the same series. This may be good for rural areas, where it takes at least an hour to go to the nearest specialist and a couple of thousand people (at best), but in big cities it’s utopia.
    It turns out that now the norm in the clinic for a patient is 12-15 minutes. In this case, the doctor should interview and examine the patient, write everything on the medical record, and then add it all to the computer. It’s not more than 5 minutes to guess what is really possible for inspection in this mode. And this is absolutely not enough to make accurate diagnoses.
    And in practice, the norm is overlapped every two times. And what results can we talk about?
    And the doctor cannot be a specialist in everything (more precisely, such people meet, but there are only a few of them).

    Or another example, the same. Now for the "efficiency of service delivery" they have made that sick leave can be issued for no more than 10 days. Next, you need a commission. Moreover, they call for acute respiratory infections every 2-3 days.
    But there are diseases when the average duration of treatment is more than these 10 days. For example, all fractures are practically or also pneumonia. And okay fractures (they are not contagious), but inflammation can be contagious. And such patients are driven to the clinic every 3 days. So the queues are formed.

    For comparison, in paid clinics, 30 minutes are allotted for the patient’s appointment (with the same bureaucracy, only everything is immediately entered into the computer). And at the same time they receive from 1500 rubles per reception. And while there is no walking around the sick (more precisely, there is, but for an additional fee).
    Therefore, it is not surprising that doctors are leaving for paid medicine.
    The funniest thing is that sometimes the doctor in paid and free medicine is one person, but for some reason the results are different.

    In Soviet times, there were also lines to both local and specialists. But then there was no alternative.

    Therefore, the only way out is to put the availability of FREE medical care as the main indicator of the effectiveness of free medicine, and, secondly, its effectiveness (in the sense of recovery) and, at the very least, take the economic aspects of treatment (i.e. money itself).
    And it turns out that now the monetary side of the treatment is being assessed and completely drops, that before the treatment itself a significant part of the patients leaves or receives it much later than necessary.
  21. valek97
    valek97 23 August 2018 11: 15
    About the medicine. Stories happened to me. Occurred in the city of Kaluga. February 2018. Constant pressure surges up to 170, pulse under 160. CoB No. 3 pl. Chekhov St. Went to the therapist, prescribed pills, free. Why so, from which nothing surveys. I went to the neuropathologist for a month and recorded daily blood pressure, jumps from 120 to 170. I went to the neuropathologist and said that there’s either a heart problem or you’re crazy that you’re jumping like that. I went to a paid medical clinic, hung up a halter, smad. By the way, I'm 21 years old. Heart problems have been observed since childhood, but neither the pediatrician nor therapist saw anything, although according to the testimony I have persistent disorders. Halter diagnosed me: Supraventricular tachycardia, vertical eos. I was banned from cycling, they said I would die here and they will be raking. Peak pressure up to 200! doused with loads. As a result, put the ERW Syndrome permanent form. The impulse in the heart passes and does not subside. can go for 200+ under stress or at rest. Well, what about free medicine, you ask? I immediately turned to a cardiologist at a local clinic. He asked if she would accept me, didn’t accept me once, said no coupon. Knocked out a ticket from the head of my clinic came. With ambition she said that I got it, come ONLY when you have a ticket. And the situation is so dangerous that without antiarrhythmics there is a big risk of catching arrhythmia and dying from ventricular fibrillation. Later a month later I made a FREE smad, and only after 1 months I got on the halter. By the way, in order to knock this out I had to swear in the hospital for 7 months. The local therapist cannot take a cardiologist card, only to the regional hospital, and there is a turn of 2-2 months. I went to the manager, issued a ticket to a local cardiologist. In a week! Why is the coupon system organized so figs knows him.
    Another case. In May, acute food urticaria began. I went to a local hospital to see a general practitioner as an allergist. I also visited a dermatologist, they said purely allergic. He came to the regional hospital in Annenki, wanted to see an allergist, they refused me, even though my whole body was covered with continuous edema and itching, the temperature rose. They said that you NEED a referral from a doctor or paid for 2000 thousand rubles only for an appointment. I went to my therapist in my hospital, got in urgently, described the situation and showed. At this moment, my wheezing becomes bad and it is difficult for me to breathe. The doctor calls the honey sister, I urgently receive an injection of Dextomethasone Quincke's edema is removed after 15 minutes. An ambulance was called that drove 1.5 hours, although it should be urgently for 30 minutes. and the hospital was already closing at 19 and they took me 19 20. My sister was sitting with me. handed over, examined. They took me to BSMP in the Square of Peace. Arrived there. The doctor came did not begin to examine, the throat has already passed. I said a simulator! There is no swelling of the throat, there is a temperature. The fact that I have red allergic edema and so on did not pay attention. Kicked me to Infection. He arrived there, in 3 hours they drove me through all the sores that may be infectious, did not find anything, several times they injected a quick-acting anti-allergy injection. Parents are alarmed. We arrived quickly, took leave from work. Father was nearby. Thank you very much to the doctors for listening to me and watching this time. the statement was given that there were no infections, they were sent to Anenki for intensive care. He arrived there, the doctor didn’t play football, she listened, put big eyes that the BSMP doctor didn’t provide any help, and was surprised when I said that he didn’t examine me, said that such swelling throughout the body, it’s hard not to notice the fever and itch . they put it in a day and sent it to Kaluga to the Therapist’s department. There was also a scandal. When they called me they asked for originals of documents, they said they would issue them without problems. Father traveled, he only copies instead of the originals. He had a fight there. here that they did not agree and there is no workflow between them. Well, as a result, I stayed there for a week, they were dripped, there were acute exacerbations, but they were safely discharged.
    1. avia12005
      23 August 2018 11: 31
      There is simply no censored statutory expression for the work of the medical profession. On the front for such a shot would be. And they would be right. The Ministry of Health does not have enough SMERSH.
  22. astepanov
    astepanov 23 August 2018 11: 32
    The estimated construction cost amounted to 364 million rubles. Funding was mainly from the city budget.

    A total of 13 billion rubles were spent on the construction of the Yeltsin Center. And then how many more losses were covered from the budget! Due to the fact that money is spent on anything - to help Cuba, Skolkovo and Rusnano, on endlessly changing space programs, etc., but not on real "social services", we will NEVER have normal health care, no education, no affordable housing.
    In addition to the mess and theft, our other problem is the lack of responsibility of government officials for inactivity and incompetence. Read Art. 14 "Responsibility of a civil servant for failure to perform or improper performance by a civil servant of the duties assigned to him": A reprimand is the maximum! You can't even demote! That is why all these cattails, dimly and others wander from armchair to armchair, leaving devastation behind them. One involuntarily begins to think that the Stalinist methods of managing the State Apparatus would be oh so handy: he thwarted the "affordable housing" program or got caught - smear his forehead with brilliant green and stand against the wall.
  23. bubalik
    bubalik 23 August 2018 11: 59
    ,,, what else is interesting, wait for weeks / months by appointment, for a fee, right now everyone will do it ,,,
  24. iouris
    iouris 23 August 2018 12: 39
    And then there are the ministries of "economic development", "culture", "education" ... We have everything (but not for everyone and not always).
  25. vatov
    vatov 23 August 2018 13: 57
    And this is in large cities, but in the outback there is simply trouble ...
  26. faiver
    faiver 23 August 2018 18: 02
    PS And how in other regions of Russia?
    yes the same thing all over the country for mere mortals
  27. Radical
    Radical 23 August 2018 18: 06
    Quote: Vard
    Try it through the public service website ... No problems with appointments with doctors ...

    This is in Moscow, but in the regions? winked
  28. Maalkavianin
    Maalkavianin 24 August 2018 11: 26
    In the Tambov region, everything is the same. I will add that we also need to turn to paid specialists with caution. They can heal.
  29. kakvastam
    kakvastam 24 August 2018 13: 03
    It is a completely regular state of affairs in a class society.
    Do you really think that celestials will be punished for the death of some smerds?
  30. nikvic46
    nikvic46 24 August 2018 14: 28
    The author is a thousand times right. A scanty number of medical facilities that serve free of charge
    the population, in itself, speaks of the state of public health.
  31. 320423
    320423 24 August 2018 16: 33
    Now on the radio I heard about a pensioner, laughed for a long time. is there extra money in the country? So they think to vote for United Russia ....
  32. ddmm09
    ddmm09 24 August 2018 18: 35
    Quote: Vard
    Try it through the public service website ... No problems with appointments with doctors ...

    Sign up, but in most clinics a statistical coupon is not automatically issued, so you will have to wait a long time at the registry.
  33. vladimirvn
    vladimirvn 24 August 2018 21: 01
    With our healthcare, the living sometimes envy the dead. I know cases when doctors pulled money from patients to the last, although they already knew that they were not residents. People often give back their last savings, sell apartments, spending money on treatment. I told my wife if I get sick, it will be possible to spend on my health a clearly fixed amount that we can overpower and not a penny more. And there be what will be.
  34. Sotskiy
    Sotskiy 25 August 2018 22: 12
    PS And how in other regions of Russia?

    Yes, it’s similar, because oblique monetization with general optimization of power then proceeded throughout the country, and not in individual regions.
    And in general, do not fuck and mow under the sick, Skvortsova said that the Russians should live up to 120, so go plow the stallions "young"! You can’t - straight into the coffin, without these here rassusyukivaniya in the form of some kind of social medicine, this is superfluous, from the evil one! am laughing
    Sick, go pray to the nearest house of God, which were built on every corner - it didn't help, dig a hole for yourself, dispose of at your own expense, do not be a burden for "effective managers" from the ruling system. wassat
  35. The point
    The point 26 August 2018 13: 56
    The Affordable Medicine program is in action, along with Affordable Housing and at least Affordable Education. And when we (in the Far East) started talking about "Accessible Fish", I got scared in earnest.
  36. Commissar of the NKVD
    Commissar of the NKVD 26 August 2018 20: 47
    Quote: Alexander S.
    I, as a relative of a cancer patient, do not care much.

    Do you care about them? And they do not care about you. So will you spit out?
  37. Commissar of the NKVD
    Commissar of the NKVD 26 August 2018 20: 47
    Quote: vladimirvn
    although they already knew that they were not tenants.

    Are you sure that they knew for sure?
  38. Commissar of the NKVD
    Commissar of the NKVD 26 August 2018 20: 49
    Quote: valek97
    An ambulance was called that drove 1.5 hours, although it should be urgently for 30 minutes.

    Really should? Do you think that you are the only one in need?
    1. valek97
      valek97 28 August 2018 11: 46
      There are standards, there are indications. The doctors from the clinic called me, because I started to suffocate and would not have survived without long therapy, Quincke's edema is not a joke. For this, they call it EMERGENCY, and not ordinary.
  39. Sirocco
    Sirocco 28 August 2018 04: 10
    Yes, the impression is that there is a state war under the name of the Russian Federation with its population. The situation is one to one. The acquaintance was treated by oncologists, they took bribes even a day before death.
  40. Departure
    Departure 28 August 2018 16: 22
    And as you wanted, the male integrated into the global system, and by world standards, thatcher measured out another 15 million people. as in a cartoon, less is possible, no more. We integrate with krajina, we fulfill obligations.
    Recently, SOPs for treatment have been introduced in state polyclinics. Our Ministry of Health did not see the difference between repairing a vacuum cleaner and treating a person. According to the SOP, a strict algorithm of actions and ways of repairing "breakdowns" is indicated, it is impossible for the inspectors to explain that the treatment of each person needs an individual approach. If a discrepancy is revealed, the doctor can simply be fired ... Although with such a salary of 14t.r. in Moscow vryatli people will be very upset.
    In private clinics there are no sops (not yet). However. In winter, they lectured at the RMAPE, they say that some students entering the residency do not know where the organs are located and cannot show even approximately ... shots are such shots. so with private traders you need to be careful. And what do the medical students of Moscow say? the size of a bribe is terrible, what big, they teach, because no one wants to pay so much, except for ... nosy guests of the capital from Chechnya, who rush with bags of money along the corridors and increase the price tag.
    Good luck, citizens. Better not get sick.
  41. Kubatai
    Kubatai 31 August 2018 07: 25
    Um .. Yes it is everywhere. Somewhere I saw a tsifork about understaffing honey. the staff in Russia is 35–40 thousand; the percentage of shortage of narrow specialists in the region is 50–60%. Not to say that educational institutions do not graduate, just people do not go to the state. institutions because of the policy of the authorities, go to private shops, which the majority of the population simply can not afford ..
  42. Oleko
    Oleko 2 September 2018 02: 45
    May healthy citizens envy the sick

    I read all the comments carefully and said: "Thank you, the Almighty, for taking me by the scruff of my neck and bringing me to the Yoga School." The school is serious. It was 30 years ago. Without any theories about Purusha, Buddha, Shiva and other guys. Practice, practice, practice ... Classes once a week. The rest is at home. Daily. Now one medical card is in the Moscow region, in the Kaliningrad region it is not at all. For 30 years I have learned to heal and diagnose myself ... Only at the energy level. Any illness has an energetic character. The body is secondary. I replaced the sore energy with pure energy (by the way, the medicine has a charge of pure energy, but it also contains energy pollution, doctors call this side effects, they are in every medicine, but some are found, others are not) and the disease goes away.
    Why wrote. It was impossible to read. Sorry for the people. Yes, try at least for fasting, for three rubles on a mineral water, then for five days, eight. Clean the cells. Choose a complex, you can qigong or some other.
    But medicine will not give you health. Scientists have long established that the human body is able to produce drugs that surpass all existing medicines on the planet (newspaper Trud, fat woman.)
    1. Oleko
      Oleko 2 September 2018 02: 49
      I am 66 years old. There are sores but under control. They don’t go out, they are waiting in the wings.
  43. ximkim
    ximkim 25 August 2020 18: 52

    PS And how in other regions of Russia?

    No better. Dosikhpor I can't recover from my visit to the ophthalmologist ..