We all want to live, and even more to be treated. When needed. But how? Rushing to the aid of doctors “ambulance” upon arrival, “sick” beat the muzzle, in the hospital you are required to drag your mattress. Well, for the extra “Citramon” they may demand money.
Zemsky doctor ordered to live long
Before the Zemstvo reform in the Russian Empire, the population practically did not know medical care. They were treated with means of plant, animal and mineral origin. They used conspiracies, the services of healers, whisperers, spellcasters. But seriously, they just died.
Another very important reform in the organization of medical care was the introduction by the Zemstvo of its free of charge. The emergence of this innovation was not due to generally humane considerations, but due to the fact that even the minimum payment sharply reduced the number of people seeking medical help.
Only a fee was charged “for the dishes.” Inpatient care in county hospitals was also provided free of charge. But this did not happen immediately. In the late 60s of the 19th century, the costs of maintaining county hospitals were often covered from funds received for treatment.
In the Russian Empire, “zemstvo doctors” appeared (read Chekhov), they are also zemstvo doctors. Their activities left a noticeable mark in the history of Russia. Acting both at the provincial and district levels, they played an important role in the development of medicine, sanitary affairs, anti-epidemic measures, and education of the population. The vast majority of zemstvo intellectuals-doctors worked in the midst of the people, among the peasants. They sought to make their lives easier, to educate, they opened hospitals, parishes, and workshops with their own money.
Today, once advertised by the state “family” medicine, has long been ordered to live long.
First, as usual, no one wanted to go to the regions for free. And secondly, ordinary commercial clinics began to appropriate the name of “family doctor”. But their cost often costs the “wealthy” more than in the “Kremlyovka”.
So our citizens go to the big cities to ordinary “Soviet” polyclinics, and in the regions, especially in rural areas, they are looking for specialists throughout the region. The fact that we now often have self-sufficiency in hospitals is a separate conversation.
But the “family doctor” is a jack of all trades, who must treat almost everything. And sometimes even a simple operation. And at your home. It is clear that in more complex cases we resort to the services of narrow specialists, and sometimes to hospitalization. This is especially true for doctors in areas remote from the center. But they don’t go there – they don’t pay.
Semashko created an exemplary system, which was borrowed by many countries of the world
Even at the top, they admit that the health care system of the USSR was one of the best in world practice, since it performed all the functions assigned to it in terms of quality, accessibility and provision of medical services, medicines and materials.
But the authorities of the new Russia greatly reduced funding, highly qualified specialists in the field of medicine went abroad, scientific research in medicine ceased, and the production of medicines and devices for diagnosing and treating diseases was greatly reduced.
Interesting numbers to think about. If in the Russian Empire from 1889 to 1915 the number of doctors increased from 13 to 33 thousand, then in the Soviet Union already from 1920 to 1940 the number of doctors increased from 36 thousand to 140.8 thousand. And this is without taking into account dentists and military doctors.
The current realities are very modest. It is clear that if Siberia and the Far East are stuffed into Moscow or another center where there is work, there will not be enough clinics. It is all the more sad that even in our sparsely populated regions today there is not enough not just a “family doctor”, but even mid-level health workers. Some call the situation with the shortage of doctors in the regions even catastrophic.
The account of vacancies for medical specialists goes to hundreds. Some say that in higher education institutions it is necessary to increase the number of doctors, and at the federal level they are discussing an increase in the number of state-funded places for doctors, as well as various incentives for graduates to come to work in the public health sector. As usual. Discussing…
True, more than once, at a very high level, they spoke about lifting payments, the provision of housing, “governor’s millions” for those who move to the regions. But it turns out that the government raises salaries only for its own in the state apparatus, and those close to the body receive personal property and free apartments, probably worth more than “governor’s millions.” And not somewhere in Uryupinsk, but in Moscow. So there is still not enough money or time for Russian doctors.
Already in the central clinical hospital, where the cream of our bureaucracy is being treated, migrant doctors from Central Asia began to appear fifteen years ago. Where did our government manage to drive the domestic health care then. And they don’t go to the periphery, and you can’t see them especially in the center.