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Already it has become a tradition, when coming to the clinic, to face unexpected surprises prepared by the medical organizers-optimizers.
Continuing transformations in the work of medical institutions turn patients into quest participants who find it increasingly difficult to cope with meaningless obstacles and get to the victorious finish.
STARTERS OF THE FIRST LEVEL
12-year-old Irina complained of aching pain and aches in the fingers. Through the site of public services, mother recorded her daughter to a pediatrician (you can get to a specialist only through a local doctor). She sent to the orthopedist. But he has not been in the clinic to which Irochka is assigned. However, as in the other five branches. All that the therapist could do was to write out a referral for an x-ray of the hands and give direction to the orthopedists at the Children's City Hospital of St. Vladimir
At the reception of the hospital, a young patient was telephoned to an orthopedic traumatologist. Four days later, at the appointed time, Tatyana, taking time off from work, took her daughter to the doctor. They got a consultation to him in almost two hours, actually serving in the general line, although they had a ticket for a specific time.
Having examined the girl and examined the X-rays, the doctor suggested to the mother for final conclusion that the mother should come in two days after discussing the situation at the medical consultation center.
Two days later, Tatyana, once again asking for help from work, spent an hour in the queue (there was no one willing to miss the woman), and the doctor wrote out a direction for a computer tomography (CT) of her hands for the girl. They recorded it on the phone, but warned: they will not do the procedure without a referral from the polyclinic.
Mama Tanya again registered with the pediatrician and a couple of days later she again asked for leave from work in order to pick up a referral to a CT scan from the clinic. A week later, the daughter underwent a tomographic study and was sent for a second consultation with an orthopedist.
In the hospital reception without a referral from the clinic, they refused to write to him. Tatyana again made an appointment with the district pediatrician. Four days later, again asked for leave from work, again took the direction "in St. Vladimir ”, again called the hospital registry and signed up for an orthopedist. In the queue to him, he and his daughter spent more than an hour.
As a result, in order to hear the diagnosis of a specialist, I had to register three times with a pediatrician, three times ask for leave from work to take directions to the orthopedist, and five times to leave work to take the child to the doctors. On the number of hours spent on all these trips to clinics, hospitals, history is silent.
This story of the indignant reader of the "World of News" is complemented by other examples from life. So, Maria Petrovna Kozina, who called the editorial office, was indignant at the fact that nurses were taken away from the therapists and put them all at one post in the clinic's corridor:
– And only we had time to get used to this strange scheme, as after a time, coming to the clinic, we did not find a sister's stand at the usual place. It turned out that the nurses had been returned to the offices, but now, you see, their schedule and the schedule of the district doctor are deliberately not the same! Instead of one trip to the clinic, it is necessary to upholster its thresholds twice. Who needs such innovations?
But our other reader, Anatoly Ivanovich, is outraged by the fact that recently, in order to donate blood, you must first receive a referral from a therapist (it is written to him through the website of public services, in a polyclinic terminal or by using a multi-channel phone) sign up for a specific day and time of blood collection.
– Previously, with the direction of blood, you could come at any convenient day, and now what the hell did they do. I am 76 years old, I am on the Internet with “you”, and now I have to go to the clinic in the early morning so that, like other elderly patients like me, I can try to snatch the record “for blood” through the terminal. Of course, you can sign up by calling, but at 7.30, when new records are opened “for blood” or for ultrasound, it’s impossible to reach him, says Anatoly Ivanovich. – And when it turns out to break through to the line, it turns out that all the places are “for blood” or for other studies already taken. The whole hoverfly needs to be repeated anew the next day! And the test results have to wait a week, or even ten days! They marry them there, or what? I recently lay in a very large hospital, so there tests were ready in a few hours.
And yet, Muscovites are particularly annoyed by the very modest number of narrow specialists who remained in the clinics. Getting to them is the same as going through seven circles of hell: sign up with a therapist, open an appointment with an endocrinologist, for example, or a cardiologist, then wait for a decision of the medical commission for several days, and after receiving it, choose the time of admission , by multichannel phone or via terminal), if it will be. And even if all these levels of quest to pass, it is possible that the consultation with a specialist will have to drag far away from home.
– I live in Izmailovo. Recently, an urgent need for an optometrist. In my clinic, which is a ten minute walk from the house, there is an ophthalmologist, but there is no record for him. But the site of public services kindly offers me to go to an oculist in Veshnyaki or Novogireevo. From my house, for a minute, it's almost an hour by bus, ”the man who introduced himself as Igor was indignant over the phone loudly. – Yes, my vision is not very good, but I don’t want to see such medicine at all!
BEST THE ENEMY OF THE GOOD
Our hearing has long been confused by the words “optimization”, “logistics”, “routing” … No, this is not about business. This is about health care. Experiments with medicine did not lead to anything good, and outpatient care is becoming less and less accessible.
According to experts, 30% of the population, even if necessary, do not go to doctors, so as not to experience all the charms of the three-tier medical aid system invented by the Ministry of Health.
In 2013, when the transition began to her, everything sounded beautiful. According to the head of the Ministry of Health, Veronika Skvortsova, the first level is a focus on primary treatment, prevention and outpatient treatment.
Those same first-level clinics should have been within walking distance from the place of residence and include "all types of prevention" and treatment of the most common diseases that do not pose a threat to life.
The second level is working with more complex problems, often requiring inpatient treatment.
The third is the medical aid provided in modern clinics equipped with large standards, which gives "effect in particularly difficult cases, many of which were previously considered hopeless."
In theory, everything looked beautiful, but patients of the first level were clearly unlucky, something clearly went wrong during the reform process.
“For several years now, every day in the work of the primary link, new surprises, from which both doctors and patients are tired. The once harmonious system of medical care does not have time to respond to new installations, regulations and rules emanating from the Ministry of Health. It seems that everything is controlled by a traffic controller who randomly waves his hands, pointing simultaneously and immediately to everyone the wrong direction of movement. The Ministry of Healthcare creates as much as it can – it writes new orders, recommendations, standards, but they are executed locally by someone who knows how – because of their abilities and limited financial resources – Alexander Saversky, president of the League of Patient Advocates, commented on our situation. – Health care reform served to reduce the bloated administrative states under the sauce, and as a result, after the mass merger of polyclinics, the number of narrow specialists decreased by 3-5 times. They are really unavailable today. All these flaws in the state system force people to go to private medical centers. Recently, you can see for yourself that they grow like mushrooms after rain.
Photo: Tass / G. Kopytin.
Caricature of A. Khoroshevsky