Russian legislation guarantees the patient the right to choose a doctor. But in practice, this is the right people implement far from always. The author of this article outlines its gaze on the problem.
Content
Although the right to choose a doctor's patient and recorded in a law on medical insurance, in fact, the implementation of this right is associated with tremendous difficulties. Both objective and subjective nature.
The patient must choose themselves who and where will heal it, - say Russian legislators. According to the chief curator of national projects, it is the competition between clinics, which will ensure the free walking of insurance policies will allow to raise the quality of our healthcare.
Principle «Money for patient» Must redistributing financial resources between more and less successful medical institutions and more or less qualified doctors within the framework of one clinic.
True, as specifically, to run this new mechanism, which will require a serious (if not a cardinal) restructuring of the current system of compulsory health insurance, is still worth consider.
In fact, the right to choose a physician patient, and the free walking policies of compulsory medical insurance in Russia formally exist - they recorded legislatively. Another thing is that «in life» Take advantage of these rights it is extremely rare.
According to the President of the League of Defenders of Patients Alexander Sabvorsky, only in one year more than 100,000 complaints about physicians fails to assist patients, even if there were compulsory health insurance policies, but «Ascribed» to other medical institutions. About real cases when the dissatisfied patient, having come to the chief doctor, asked him to replace his attending physician, did not have to hear. Although, I repeat, the law on medical insurance is such an opportunity.
Idea «force» the doctor to fight for the patient, first of all, interested in his financial, not Nova. It was on this principle that the idea of generic certificates was based: each future mother, each woman in labor bring to the consultations in which they are observed, and the hospitals that give birth, concrete live money. At the same time, in relation to the maternity hospitals, as recognized in Roszdravnadzor, the trend of increasing patients in institutions with a good reputation is traced.
Obstacles, however, also abound. So, only in large cities there are several maternity homes that can compete with each other. And if we talk about women's consultations, then here is the right to choose «Refins» In need «walking distance» - You can, of course, want to be observed at the Super School, but if he takes at the other end of the city...
In general, the territorial principle of medical care is
Serious barrier in organizing a competitive environment. «Of course, from the point
the patient's vision is very good if he can choose, for example,
district doctor, - comments Professor Department of Management
health care medical academy. Sechenova Natalia Kravchenko. -
But it is necessary to make a report and in what difficulties can
arise. From organizational - when one specialist can
to be more patients than he is able to accept, and to financial
- Large load must be paid accordingly. BUT
Home Organization? After all, if you move away from the principle when
the doctor is fixed a certain area, you will have to look for options like
work on challenges in this case».
Serious barrier in organizing a competitive environment. «Of course, from the point
the patient's vision is very good if he can choose, for example,
district doctor, - comments Professor Department of Management
health care medical academy. Sechenova Natalia Kravchenko. -
But it is necessary to make a report and in what difficulties can
arise. From organizational - when one specialist can
to be more patients than he is able to accept, and to financial
- Large load must be paid accordingly. BUT
Home Organization? After all, if you move away from the principle when
the doctor is fixed a certain area, you will have to look for options like
work on challenges in this case».
Do not discount and factor in the subjectivity of patient assessments. Patients more often pay attention to «service» Doctor's work - as far as he is polite, attentive. Assess the very quality of medical care - whether all the necessary research was carried out, the treatment tactics were correctly chosen - only people with professional knowledge can, and not ordinary patients.
That is why, says Alexander Sabersky, it is necessary to develop clear standards and criteria for determining the quality of work and every doctor separately, and medical institutions in general. If you enter such a mandatory assessment and, moreover, to make such statistics open, the population will be able to obtain objective information, which will give an opportunity to choose.
Now in the Ministry of Health and Social Development, work on the project of the concept of the development of Russian health care. The goals are clear and formulated quite clearly: you need to do so that both the doctor and the clinic are generally focused on the end result, that is, the patient's recovery. And earned, respectively, based on this end result. How to achieve at the same time that the result is achieved with the least costs to come up with.
