Doctors have increased their service – Newspaper Kommersant No. 199 (7400) dated 10/26/2022

Service “Action Medicine” conducted a survey among health workers on whether their institutions are facing a shortage of staff due to partial mobilization. More than half of the respondents (52%) said that the management of the institutions where they work makes reservations for employees, 43% said that they do not make reservations for them. 53% of physicians reported that their medical organizations did not receive summons for mobilization, and 33% of respondents faced delivery of summonses to their colleagues. The respondents expressed fears of a growing shortage of workers, but 70% admitted that medical institutions faced it even before the start of partial mobilization. Experts are also not inclined to see it as the main reason for the shortage of doctors and nurses. The Ministry of Health previously stated that the mobilization would not affect the quality and volume of medical care in the rear.

The Aktion Medicine survey (an expert support service for specialists from medical organizations; part of the Aktion group) was conducted from September 30 to October 23, 499 respondents took part in it. 80% of them work in state medical organizations. There were 19% of chief physicians and their deputies in this sample, and 12% of physicians. 56% of the respondents belong to the nursing staff. The respondents also included paramedics, obstetricians, pharmacists, pharmacists, lawyers, personnel officers and other employees of medical institutions.

Respondents have different experience of interacting with military registration and enlistment offices and mobilization commissions: for example, 53% reported that summons did not come to their institutions. The opposite answer (summons came and were handed) was given by 33%, 13% found it difficult to answer. More than half of the respondents (52%) indicated that the management of the institutions where they work makes reservations for medical workers. 43% said they don’t make reservations for them. The remaining 5% could not answer. “We book those who are possible, and also sent lists of the rest of the employees to the military registration and enlistment office,” the authors of the survey quote one of the respondents.

Only 7% of respondents reported that vacancies in their institutions are due to the mobilization of colleagues. 53% of respondents say that the reason for opening vacancies is the dismissal of employees at their own request.

Natalya Zhuravleva, a leading expert at Action Medicine, admits that the increase in the number of vacancies due to the dismissal of doctors and nurses “on their own” may be somehow connected with partial mobilization – for example, some health workers left the country after being fired. This, according to Ms. Zhuravleva, applies more to those who worked in private clinics, since their management is less likely to make reservations from mobilization. However, 70% of survey participants admitted that there was a shortage of staff in their medical organization until September 2022. A third of the interlocutors assured that there had been no changes in the personnel structure recently. “The shortage of personnel is connected with the general shortage of specialists,” the organizers of the survey quote the words of one of the respondents. “They don’t want to go after the institute. There is no connection with mobilization.”

In response to the question of how it is planned to fill the vacancies of mobilized health workers, 82% of respondents answered that it would be about increasing the workload through internal part-time work or expanding the service area.

Managers of 13% of respondents plan to invite doctors from other regions, 10% of respondents announced their intention to send specialists for retraining. According to the respondents, in the near future in medical institutions, the shortage of specialists will be therapists, surgeons, pediatricians, neurologists and anesthesiologists-resuscitators, as well as nurses – operating room, procedural and district. It follows from the quotes cited by the authors that some doctors are skeptical about the state of the industry, fearing that the mobilization of some personnel may aggravate it. “Medicine with this optimization is destroyed,” says one of the respondents. “Doctors quit, technicians were paid compensation to leave on their own. Polyclinics in the mud, as there is no one to wash. Such departments as a day hospital, a health center, offices in polyclinics, are cleaned by nurses themselves free of charge. If there is a mobilization of nurses, the hospitals can be closed.”

Regional authorities have noticed an increased shortage of doctors due to partial mobilization and are looking for ways to solve the problem. So, Deputy Chairman of the Government of the Trans-Baikal Territory Inna Shcheglova On October 23, on the air of the State Television and Radio Broadcasting Company, Chita noted that students and retired doctors were invited to replace the called-up doctors.

“Medical organizations have seen a shortage of doctors before. It worsened during the coronavirus pandemic, and then in September after the announcement of partial mobilization,” says Natalya Zhuravleva from Aktion Medicine. “It can be said that partial mobilization naturally aggravated the shortage of medical staff, but did not become the leading or only reason.”

It should be noted that in 2019, Deputy Prime Minister Tatyana Golikova reported to Vladimir Putin about the shortage of 25,000 doctors and 130,000 nurses.

As the co-chairman of the All-Russian Union of Patients, neurologist Yan Vlasov, told Kommersant, during the pandemic, for various reasons, more than 100 thousand doctors left medicine, so about 60% of doctors are now forced to work for one and a half rates and more than 30% for two rates. Andrey Konoval, co-chairman of the Deystviye medical workers’ trade union, cites the Leningrad region as an example: the passport of the regional program for 2021-2025 states that at the end of 2019, in state medical institutions, with a staffing of 9 thousand medical posts, the real number was 5.3 thousand. , or 65%. The combination coefficient reached 1.63. The actual number of nursing staff was 70% of the full-time, the part-time ratio was 1.54. “Mobilization against this background does not look like a big problem. Several thousand doctors to be called up from a two-million-strong army of medical workers are not so many,” says Mr. Konoval. “But if one specialist out of three workers is taken away from a hospital in a regional center, this will already have the most negative impact on patients.”

Earlier, the head of the State Duma Committee on Health Protection, Dmitry Khubezov, explained that it is planned to attract 300 medical workers to participate in the SVO. His deputy Badma Bashankaev declaredthat in total no more than 3 thousand doctors may be required.

According to Mr. Khubezov, paramedics, anesthesiologists-resuscitators, traumatologists, orthopedists with experience in a combat zone or in the system of disaster medicine have priority in the call.

Assistant Minister of Health of the Russian Federation Alexei Kuznetsov said “Kommersant”that partial mobilization does not affect the availability and quality of medical care. “All types of assistance, including high-tech, are and will be provided as usual,” Mr. Kuznetsov assured. “Health workers, in accordance with the law, can be called up as part of partial mobilization. At the same time, we see that there are many doctors, paramedics, and nurses among the volunteers who come to the military registration and enlistment offices on their own, expressing their readiness to help people.”

Natalya Kostarnova