The family doctor – than it is better usual

Unlike the usual therapist, the family doctor not only can render the necessary help by phone, but also will make it taking into account the maximum knowledge of the patient – since that, than that was ill earlier and finishing reactions to medicines and their components.

On “fast” many not profile calls really arrive, the family doctor, a member of the European association of family doctors Konstantin Zelensky who worked as the ambulance surgeon where it had to treat both adults, and children earlier tells: «At child ОРВИ, and mum, being afraid of complications, causes us though with this problem in a telephone mode the pediatrist well knowing the child perfectly would consult. At the patient the aggravation of chronic disease – too rushes a brigade». It is inefficient in every respect, Zelensky has counted in due time, and trained for a new profession in the general practitioner. Now it treats the most widespread diseases from different sections of medicine.

The family doctor should be able to treat a hypertensia and a stenocardia – from cardiology, a diabetes – from эндокринологии, a radiculitis – from neurology, to watch, whether normally passes pregnancy – from gynecology, варикозную illness of veins and furuncules – from surgery. To 80 % of illnesses at the patients – “will cure-will cure” good family Aybolit so much, confirm this system of medicine.

In the developed countries of the world on family doctors it also is under construction. Only there to the doctor address not because of illness which already progresses, and for preventive maintenance is more often.

The healthy client is is unprofitable?

Anatoly Viter, the manager of one of the Kiev enterprises, only on Chekhov yes on a film «the love Formula» knows, who such family doctor. «The doctor is full – and to the patient it is easier», – he quotes hero Leonid Bronevogo. To Use such doctor it does not hasten. «I have not enough time for conversations about we wash health. And not in ours it is mentality – to talk about state of health while the cock, as they say, will not peck. And if will peck – I will take advantage of the insurance and I will go to the narrow expert», – he speaks.

At Valentina Shostak medical insurances are not present. Therefore and itself, and with the child it is compelled to sit in turns to the divisional to receive consultation, on analyses and to open directions the sick-list. «Then it is necessary to go on other doctors, again to come here that this sick-list to close», – she complains.

In Ukraine really the stereotype that one person cannot be able to carry out all medical manipulations still is strong. Therefore patients also address to the narrow expert, doctors family assure. «Interest of doctors of narrow medical specialities – in that they had as much as possible repeated patients. Therefore and treatment is often spent so that to the patient a little полегчало, but through any time it became again bad. Clients throw from the expert to the expert on various consultations. Especially it concerns solvent patients. And the healthy client is is unprofitable», – Skokov confirms.

Family doctors dissemble, when speak, as if doctors of a narrow profile make profit of patients, Marina Nikolaenko, the doctor-cardiologist speaks. The family doctor – partly the businessman, considers it. Many of them do not hesitate to declare that live on the maintenance at the clients. “And” throwing of clients »about which Skokov speaks, – not from our practice. If we are compelled to direct the person on additional inspection it is completely justified», – she is assured.  With that the family medicine focused in basic on the preventive maintenance, «attacks heels» to doctors of a narrow medical profile, the majority of doctors of the general practice agrees. The basic conflict of family medicine to its “traditional” model also consists in it, they speak.

Most the doctor is necessary to family medicine

Ukraine reforms the medicine any more the first year. Leaving from medicine “local” to family, from treatment – to preventive maintenance, the system of the primary help fills the cones and itself demands «First aid».

Unfortunately, the family medicine did not become while enough popular. One of interrogations has shown that the majority of people at all do not know, who such family doctor, and more than thirds in case of problems with health follow the help to “the narrow” doctor, instead of to the family. Reform really goes «with a scratch», Zelensky agrees.

The present family doctors in Ukraine while units, recognise family doctors. More truly, training goes constantly, shots in high schools and at institutes последипломного formations annually prepare. But experts, family medicine not practising teach there basically.

Of the family doctor wish to make simply local therapist, having charged it with responsibility for all illnesses on light (thus reducing experts, children’s polyclinics and female consultations), complain doctors from family ambulance stations.

Not less serious problem – financing of family medicine. Financing of a primary network – ambulance stations where family doctors work – depends on quantity of the attached population. There is still a secondary network – a hospital. And the more patients with the serious illness demanding qualified medical assistance in hospitals, the more means are lost by ambulance stations. That is, the more people are ill, the great sums leave in hospitals.

If “the narrow” doctors working in hospitals, can be interested”in the prompt hit of the patient in a hospital other party of a medal – probability of that unfair family doctors will”tighten”illness. Roughly speaking, to treat heart attacks in-home lotions, if only not to admit the patient to a hospital.

The following hitch – private practice. In the conditions of a family ambulance station the family doctor acquires the right to conduct treatment privately. That is during the working day the family doctor under the contract accepts patients free of charge and gets wages from the budget of local council, and at leisure renders services which are paid by the patient. A question on засыпку: how to earn everywhere simultaneously? Some family doctors find on it the answer.

In the conditions of market relations the patient really turns to the client. All has the price – both a healthy way of life, and problems with health. Here only for what to pay – for to were ill and look well or be treated eternally and quickly to grow old – everyone solves independently.