The Declaration of Independence of Russian doctors

Maksim Osipov
A few months ago, a group of doctors from different cities of Russia has decided to describe a situation in which there is our medicine, and outline its most acute problems.

As such, doctors primarily referred to the lack of professional autonomy, the transformation of medicine from the creative professions in the services sector.As a result of discussions it was decided to adopt the Declaration - it is represented by the last five paragraphs in the following document.

Introduction - "On our state" - does not claim to be complete, it only contains a list of observations allow to conclude that the medical profession is experiencing a deep crisis in Russia.It is hoped that the adoption of this Declaration will serve as a consolidation of those doctors who are set to professional and responsible service to the people.

about our position

We observe with concern over what is happening in our profession: medicine passes from among the intellectual classes in the service sector, doctors are becoming

more dependent on officials, compounded by our backlog from the developed countries.The main trouble of medicine is considered a lack of money.Without disputing the need for multiple increase in funding, we believe that the main problem - in the other.

1. The lack of professional autonomy doctor

doctor - a creative profession, it can take professional decisions only on their own or together with colleagues.In reality, these decisions are often made under pressure from the administration of the medical institution or the payer in the face of government officials or experts insurance companies.

One tool steel received administrative standards of treatment effect of such pressure.The international medical community develops standards of treatment - the principles according to which are treated in the best clinics in the world.These standards are published in the form of formal documents, but do not suppress the doctor's freedom of action, but merely serve as a guide to him.Ministry of Health standards, on the other hand, the administrative limit physician freedom and substantively very far from the world of medicine standards.

In particular, they are forced doctors to treat patients for a long time and is not the most effective means.Verification of compliance with the standards involved have left the practice of medicine, experts insurance companies, which are based on the presumption of bad faith physician.At least the doctor checks see amateur cheater or distributor of drugs.This is, firstly, we humiliate, and secondly, leads to the emasculation of medicine as a creative profession.

bad doctors continue to work poorly, because experts are not interested in the essence and properly decorated papers.Conscientious, not wishing to compromise professional ethics, doctors are looking for highly specialized areas where these experts have not yet arrived.The result turned out to be fundamental in the largest decline specialty - therapy and general surgery.

2. Bureaucratic obstacles

medical care Deficiencies are trying to correct with new laws, while instead of introducing new legislation should cancel the old ones - the ones that transform medical practice in the art to circumvent them.

Even the help that the state is ready to pay, it is often impossible to obtain because of the formal obstacles: the wrong place of residence, age, past due information and analyzes.However, many federal agencies are idle at the end of the year due to lack of quota.

H and pharmacological market disappear inexpensive but the necessary preparations.But the market is full of drugs with unproven efficacy, and a lot of quack methods approved by the Ministry.There have totally unacceptable things: cancer patients die, screaming in pain as doctors are unable to freely prescribe them narcotic analgesics.

Planning, designed only to predict the situation begins to guide the work of medical institutions.Implementation of the plan becomes an independent purpose for which mass produce Registry, useless examinations and hospitalization.

Administrative barriers prevent direct communication between medical institutions.In our time, when the doctor from any corner of the country can directly contact him fit any major specialist clinics, learn about the latest achievements of medicine at the time of their occurrence, the vertical chain of command of medical institutions and professionals begin to interfere.Direct links between the medical institutions is almost there.Because of this complex medical care is never an emergency, and good clinics are concentrated in a few cities of the country.

3. Economic lack of independence of doctors and hospitals

Medical institutions shackled many limitations, they can not independently decide what to spend money.At the same time pay the doctor work is the cheapest part of the cost of treatment.

Good and actively working physicians should earn enough to ride to the international conference, training, subscription to magazines they have the means.To do this, the patient must be real, not declared to choose a doctor, and the state should only help the patient to pay for the work of the selected doctor.

The facility should have economic independence.procurement system, designed to prevent corruption, only makes it more sophisticated, thus paralyzing the activities of medical institutions.Any attempt to demonstrate the economic independence of regulatory bodies is considered as a criminal.The result is a situation where expensive equipment idle because of the inability to quickly get to him cheap consumables.

Payment of treatment does not depend on its actual value and not the outcome, and from where, and how long it lasts.As a result, instead of being treated as outpatients, many patients are needlessly in hospitals.

4. Attempts to reform the health care

In recent years undertaken many large-scale attempts to improve health care: national projects, the construction of high-tech centers, health care modernization, general medical examination.In comparison with the costs incurred by the use of these measures was low.

main efforts of medical institutions were aimed at providing the desired reporting and not on actual use.Expensive equipment is often idle due to lack of supplies and specialists, heavy patients in the newly opened centers do not fall because of transportation problems.Clinical examination is conducted formally and not in accordance with international ideas on screening.

5. Status of medical education

Medical Education, the institute's graduate and, in today's Russia is very poor.It needs a radical reform which will bear fruit not earlier than ten years, but without which Russia doomed medicine.

In medical institutions mainly focus on learning the details, aging for a few years, and not on their ability to critically reflect, to acquire new knowledge.Graduates of medical schools do not speak English - the international language of medicine.Postgraduate education is formal, and copies all the defects of practical medicine.Reform of medical education should start immediately.

6. Conclusion

fundamental flaw of Russian medicine - no freedom of its main deystvuschih those doctors.Without their release from administrative oppression improvement of domestic medicine possible.Therefore we sign the following declaration.

Declaration of Independence Russian doctors

1. Medicine combines the features of science and art.This is a creative profession, but not the scope of service, so the work of a doctor requires freedom and can not be described by the orders and instructions.

2. In the relations between the state and society as we stand on the side of society and do not want to deceive his trust.The state's task - to create the most favorable conditions for the doctor and the patient, independently acting individuals.

3. needed medical presumption of good faith - in medical and economic activity.Deciding how and what to spend the allocated funds, physicians should proceed from the interests of the patient, not the payer.

4. The administrative and financial pressure on the professional and ethical solutions doctor is not allowed.Work it can evaluate only the medical community, not the taxpayers.Insurance companies and the government should not control the healing process.

5. Reforming health care, the government should abandon the ambitious and ill-considered actions that are carried out formally, and only increase the burden on doctors and hospitals.The priority should be to reform medical education, our medicine is doomed without it.

Subscribe to the Declaration is available here.

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