Russian healthcare: diagnosis and prognosis

In five years our medicine will dieAndrey Bilzho, Snob magazine
For almost two years I have been hosting a program on St. Petersburg television called "A Sore Question".

This weekly program raised rather acute issues related to domestic medicine, officials and doctors were invited to this program. While conducting this program, I learned that we are ranked first in the world in tuberculosis, in suicides, that we have huge problems with an artificial kidney and many other problems.

The program was closed, but the problems did not disappear. Some time ago I participated in the program "Justice" with Andrey Makarov, where they also discussed the problems of medicine. Before going to this program, I decided to prepare: I called my friends – a well-known proctologist in Moscow, a major hematologist, an associate professor of the Department of Therapy of the Medical Institute, a professor of cardiology (I will not call their names, because it does not matter). They all told me with one voice that our medicine has five years left to live. About the same opinion was shared by my colleagues who were on this program. Then a catastrophe will inevitably happen in our country, because the country cannot exist without medicine. I'll try to explain what I mean.

Of the medical school graduates, only 20% remain in medicine, the rest leave. The salary of a doctor on the periphery is 9-15 thousand rubles. In Moscow, the salary ceiling of a doctor is 20 thousand. This is despite the fact that it is very difficult to find a private driver for 20 thousand. Therefore, when we express any complaints to doctors, we must understand that we demand from a person who has studied for six years at the institute and two years in residency and is engaged in such hard work for pennies that he still smiles at you and does not think that he needs to feed his family. There are doctors who receive money for operations, but surgeons, anesthesiologists receive money for paid operations, and the situation with therapists, urologists, gynecologists, oculists and others is much worse. Many specialties cease to exist at all, so, for example, dermatology is gradually becoming cosmetology, which is absolutely wrong – these are different specialties. Speaking about the low salary of doctors, I understand that simply increasing it will not solve these problems, but you also need to understand that in such conditions it is quite difficult to demand high-quality work.

Now mostly guest workers work in polyclinics – these are people who have graduated (at best, graduated, and not bought a diploma) from peripheral medical universities. If even a doctor's diploma from a Moscow or St. Petersburg medical university is not quoted in the world, then what can we say about a doctor who graduated from a medical institute, for example, in Penza (I don't want to offend Penza at all – I don't even know if there is a medical one there). So, if a doctor goes to this salary and works as a guest worker, then, as Stalin said at the time, the doctor must feed himself. The doctor feeds himself. Therefore, one of the most respected and highest-paid specialties in Europe is becoming approximately the same as the work of a waiter. Because the waiter in the restaurant receives very little money, but feeds himself – at the expense of tips.

Medicine as a prestigious specialty in our country is ending. A few years ago, Russia was in first place in the world for tuberculosis. I don't think that we have moved to the fifth or tenth place now – simply due to the fact that there is practically no phthisiology as a discipline, old phthisiologists are dying and retiring, and young ones are not doing it. It's hard to imagine an idiot or an idiot who studied for six years at a medical institute, then went to work in a tuberculosis dispensary. And so whatever field of medicine you take. I'm not even talking about the fact that we don't have preventive medicine either. There are no occupational examinations at institutions, fluorography, mammography, regular examination of schoolchildren, etc.

Of course, we have insurance medicine, I buy insurance every year. For this, I sometimes get more attention, but this does not mean that I receive qualified medical care. And even in insurance medicine, you can be put on the waiting list for some doctor for one and a half to two months. I'm not talking about polyclinics, this topic is closed – I hope that the participants of the "Snob" project do not visit these institutions. But we cannot live in an absolutely isolated world: the vast majority of people go to polyclinics, and these are the people we somehow encounter in institutions, in public places. If they are poorly treated, then they are contagious. If they have been in line, it means they are irritable, nervous and hate the whole world, including us.

I've been hearing about medical reform since I was a student. They keep saying that doctors get little, that medicine needs to be reformed somehow, but nothing happens. But there are laws restricting the use of foreign medicines – ostensibly to stimulate the development of the domestic pharmaceutical industry and shift the priority towards "native" medicines, but such laws will only finally finish both our dying medicine and our citizens. But one of the last people in power who was treated in Russia is Boris Nikolayevich Yeltsin, who had a heart operation here (at that time, Dr. De Beiki assisted in this operation). All the other powers that be, as well as their families, are treated in other countries, so they probably don't care about what is happening with medicine here. Besides them, there is no person who would not face the problems of our medicine. The problem of old people is generally unsolvable. Even for me, a person with medical connections, it turns out to be absolutely impossible to put my mother, a well-preserved, energetic, cheerful 87-year-old woman, for money, even for a big scam.

Medicine is attacked, and often rightly, but we must understand that we are considering only the symptoms of one huge, gigantic disease, which today, in my opinion, is incurable. If nothing is done, medicine will die.

We need to solve this in the very near future, because then it will be too late. But we are engaged in global projects, we are not up to it. We have to do Skolkovo. In which, I suspect, they will deal with the problems of aging so that neither the prime minister nor the president will ever grow old and that their terms 8 through 4 will be endless.

I would very much like the topic of domestic medicine to be discussed by the participants of the Snob project related to it. The club has doctors from different countries and cities. Let these doctors tell and share how it works in other places, and also suggest what options they would see, what can be done here. Because it's easy and healthy to tell what wonderful medicine is in Israel or in Germany. There are countries that have made this discipline a priority, these are highly developed countries. How to name the countries in which the treatment of the population is in last place, everyone can come up with himself, everyone will choose a word that is close to him in temperament and level of culture.

The artist, essayist and "brain scientist" Andrey Bilzho was born in Moscow and since childhood "painted pictures in the margins." In his youth, "impressed by the books of Vasily Aksenov and the film "Colleagues","he went into medicine, became a psychiatrist and worked for ten years at the Institute of Psychiatry. As a student, he became interested in caricature, drew "jokes on paper" for newspapers and magazines. In the early 90s, the main cartoon character Biljo - Petrovich appeared, about whom cartoons have already been filmed, books have been written, a computer game was released, and a bronze monument was erected to him in Venice – with a glass in one hand and a bottle in the other. In order to preserve the "whole layer of everyday culture" of the Soviet era, Biljo founded a chain of Petrovich restaurant clubs - a combination of a restaurant, a museum and a gallery – in Russia and not only. He conducted the TV programs "Analyses of the week" and "Total", "conducts reception" on the radio – in the program "At the reception at Biljo". He collects cameras, prefers old and strange things, because they "contain some kind of energy, time, memory." In addition, Biljo likes to sit on the Venetian embankment and drink white wine. Participant of the "Snob" project since December 2008.

Portal "Eternal youth" http://vechnayamolodost.ru13.09.2010