State Duma Deputy Badma Bashankaev on why medical care should not be called a service

The Committee on Health Protection, the professional community, joint public experts and United Russia have been talking for a long time about the fact that medical care should legally be called assistance. It would seem, what’s the difference? Service? Help? The main thing is to treat on time, correctly and without complications. But a word is a very serious thing. Often one word can change a lot. If the doctor has found the right words, the patient will definitely feel better – this is a medical fact.

To put it very schematically, a service is something that a person, in principle, can do without, and help is something that a person cannot do without. He can go to a store to be served in person, or he can place an order online and have the order left at the door. He may or may not go to a beauty salon: plans have changed. He might get ready to go to the cinema and then change his mind. And so on.

With medical care, everything is completely different. If it is needed, then it is needed. That’s why she helps. The surgeon leaves the operating room after a difficult, many-hour operation – he saved the patient’s life and health. Did you provide a service? What about military doctors? Do they also provide services? And, as a doctor, I perfectly understand my colleagues who have always been offended by this term.

A doctor is a high-risk profession. This especially applies to surgeons, anesthesiologists, gynecologists, obstetricians and representatives of emergency medical specialties.

In December, our committee held a round table in the State Duma dedicated to the safety of doctors. One well-known and respected doctor said that the pleas of the relatives of a hopeless patient sometimes force them to try to do the impossible, and as a result of these efforts – a complaint: “But we still remain doctors and we will still do this, despite the fact that we will later get our brains. This is fate, this is our job. It would be nice if we weren’t imprisoned for this.”

I want to emphasize: when we discuss issues of the safety of doctors, this does not mean that they should be resolved at the expense of the safety of patients (who, by the way, are legally protected today better). There are enough aspects here in the topic of protecting doctors; a lot needs to be resolved. Determining the status of a medical worker (which currently does not exist) – not only his duties, but his rights and guarantees – is protection. Doctor’s professional liability insurance – protection.

Recognizing medical care as help and not as a service is also a defense. And not only from the ethical side, but also from the legal side.

In the interpretation of a medical service, even lawful, “on-the-case” and in accordance with accepted clinical recommendations actions of a doctor do not insure him from possible criminal prosecution.

The Investigative Committee annually receives more than 6 thousand complaints about medical errors or improper work of doctors. Less than 10% go to trial. What happens? Almost 6 thousand medical teams are victims of bias and, while legal procedures are ongoing, are in a state of severe stress. And how, in such a state, can you be effectively responsible for the health and lives of other people?

In other words, if you look at everything carefully and calmly, you can be convinced: the safety of doctors and the safety of patients are closely linked.

Recently, at a meeting with trusted officials, the country’s president supported replacing the term “medical service” with the term “medical care.” This is very significant, because he knows the value of words.

The author is Chairman of the State Duma Committee on Health Protection, United Russia faction