Doctors in Russia – Moskovskaya Pravda

A press conference on the topic “Doctors in Russia: real salaries and mobilization issues” was held on Thursday, October 13, at the site of the Rossiya Segodnya MIA.

The participants of the event, Valery Fadeev, Chairman of the Council under the President of the Russian Federation for the Development of Civil Society and Human Rights, and Yan Vlasov, co-chairman of the All-Russian Union of Patients, presented materials from surveys of doctors on real wages, workload, status in the profession and attitude towards it.

Fadeev recalled that the salary of a doctor should be twice the average for the region. This is a long-standing strategic decision. Rosstat data on accrued wages – 95,400 rubles. Inside sits personal income tax of 13%. The difference in the salaries of managers and ordinary doctors reaches twenty times, in the past there was a limit of eight. By region, the ratio differs by five times, depending on the budgetary provision. Doctors tend to find jobs where there is more money. As a result, the quality of life in poor regions is further reduced.

Under the pretext of budget problems, a pilot project to pay doctors has been postponed until 2025. Fadeev considers it necessary to conduct an experiment now, the situation with the budget is not so bad. We have a single country, why can salaries differ so much? The monetary allowance of military personnel does not depend on the budgetary security of the region. On the contrary, in difficult regions they are paid extra. Why should doctors be different?

Fadeev regularly brings topical questions to the public field, but no one gives an answer to them. But the opposite happens when he is forced to refuse the question, as was the case with the use of gloves during pandemic restrictions.

An anonymous survey of one and a half thousand doctors was conducted in sixty regions to find out how much the work of a doctor-doctor costs in the eyes of our state. Head physicians and nurses were withdrawn from the study. The results were presented by Vlasov.

The average salary was 51,989 rubles per month. 75% of doctors work in only one state organization. It turns out 30,150 rubles per bet, and not 60-70, as some officials report.

More than 30% work for two rates or more, 60% for one and a half. 19,677 rubles – the average therapeutic salary, everything else is an allowance. For a scientific degree they pay 2.5 thousand rubles. Traveling to opponents to defend a dissertation is more expensive.

The press conference participants believe that a doctor should have a salary of four minimum wages, a nurse two. Head the department receives 28 thousand in regional universities. The teaching staff must have six minimum wages, four in colleges.

In defense of Rosstat, Fadeev emphasized that he was not cheating, he had an accounting figure. This is the way it is and it needs to be changed.

The survey also showed that a doctor may have a conflict in the team and professional burnout. Professional burnout is not just fatigue, the doctor is ready to leave the specialty altogether. More than 80% of working doctors experience signs of burnout, 60% sustained burnout. Health care losses can be irreversible. Demotivating factors for young doctors are low salaries, the inability to work with highly professional colleagues, negative mentoring, and lack of involvement in the specialty.

Experienced doctors point out a heavy workload, unproductive use of time, lack of time for an appointment (12 minutes per primary patient), management attitudes and a negative corporate climate. In the zone of discomfort are relationships in the team and relationships with patients.

Russian health care loses 30% of specialists in three years. For ten years there has been a discussion that a doctor should be equated with an employee of the Ministry of Internal Affairs. The impetus was attacks on doctors. In 2019, Deputy Prime Minister Tatyana Golikova reported a shortage of 25,000 doctors and 120,000 nurses.

According to Vlasov, during the pandemic, losses amounted to one hundred thousand doctors. They are dead or gone, sick and unable to perform their professional duties. The shortage of doctors in primary health care is up to 55%, in rural areas 60-65%. The data depends on who thinks. According to the results of our research, the data is approximately the same as it was said.

Nurses are also a big problem. About three hundred thousand middle-level workers died or left their specialty.

The Ministry of Health has increased admission to specialized universities. There are more target recruitment contractors. But not all graduates return, so it is necessary to tighten the postscript to the place of work. The first three years, about 60-70% of graduates remain in the profession, in ten years half.

Answering questions, Vlasov spoke about the danger of migration from countries where vaccination campaigns are not conducted. Tuberculosis is coming from the south. Epidemiologists in Russia are only 40% of the need.

The problem is artificial. There are no clinical epidemiologists in the MHI tariff, because they are not eligible for treatment activities.

Vlasov gave an example of a lawsuit in connection with the rate of an epidemiologist of 11,500. Who will work for such a salary?

The shortage of epidemiologists has led to the spread of nosocomial infections. Because of them, three million people have an extended sick leave.

The participants of the press conference did not speak at all about such a problem as the legal prosecution of doctors. Dmitry Khubezov, chairman of the Duma health committee, decided to take up the problem seriously.

Lawyer Natalya Andreeva informed MP about seemingly exotic cases of prosecutions in which she specializes. For example, a radiologist was accused of the death of a patient, who did not see a person in the eyes and only consulted in absentia on the picture. From what the patient died, the investigator did not care. Moreover, the radiologist has already moved from Perm to work in Moscow for several years.

As a result of many years of creative efforts, Andreeva usually manages to defend the victim from persecution. However, time has been lost, and, accordingly, the healthcare system is suffering losses, which is what the persecution of doctors is aimed at.

For several different reasons, doctors of rare specialties are especially bad. Fadeev named cytology, oncology, radiology, pathomorphology, and genetics as rare specialties.

To conclude, I will have to emphasize once again that, despite the various forms of pressure on the domestic health care system, Vlasov and Fadeev did not say everything. Russian medicine remains the best in the world. Melita Vujnovic, the WHO representative in Russia, spoke about this, and the same was shown by objective data for different countries based on the results of the pandemic.

Various forms of persecution of doctors are successfully developing in different countries and not only in Russia. For example, we are discussing the problems of primary healthcare and listening to WHO recommendations to connect primary healthcare with psychiatry, and in some recognized developed countries of the West it is absent.

In recent years, thanks to the political decisions of the country’s leadership, projects for expanded neonatal screening, reform of the blood service with the creation of a registry of bone marrow hematopoietic cell donors, programs to combat oncology and, separately, children’s oncology are being implemented.

Misunderstanding of national characteristics gave rise to a version of Putin’s oncological disease, since he is so advocating for oncology. Then the pandemic put the brains in place a little. Despite all the problems, the organizational capabilities of Russian healthcare and patient routing turned out to be quite high. The United States has been lagging behind.

In Russia, perhaps, the national peculiarity of the personal mobilization of people in response to sublethal living conditions has affected.

Lev MOSKOVKIN.