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The doctor: free medical care — a disservice to the patient and noose to the medic

Врач: бесплатная медицина — медвежья услуга для пациента и удавка для медика

Michael Kondratyev — pediatrician. During his studies he worked as a medic in an ambulance, a nurse in a hospital ward, after the University — the doctor of an accident ward of children’s infectious hospital. More medicine won’t work: after testing, the hospital does not extend a contract with him because of the complaints and related proceedings.

In fairness we must admit that our medicine is truly one of the most available all over the world. But the hostages this achievement become: doctors and patients. Health workers wearing pull multiple rates, overtime, night shifts — medicine in our country has long been a feat. On the other hand, patients abusing the accessibility and gratuity of medical assistance, the majority shifted the responsibility for their own health and the health of their children on the shoulders of doctors. I saw the situation from the inside and want to talk about why this great benefit, free medical care — not even good.


The majority of Belarusian parents of patients believe that they must. Pediatrician should get the call any the most insignificant matter. A parent will require a blood test, and chest x-ray on the first day of the disease. Call an ambulance to get to the hospital, not because the baby is very sick, but because it is a pity money for a taxi. Some went to the hospital because I was too lazy to go to the clinic and sit in the queue, because the child began to cough, and they drove past the hospital and “looked to consult”. Some are told to go to the hospital, they write the failure, warned that would be worse — the answer: so we we visit or call the SMP team. I cite all these examples not from the sky take it’s a true story from my practice.

And this was nothing compared to the horrors that happen, and happen quite naturally. But the root of those and the other one: carelessness, irresponsibility of the parents instilled in them the availability of free medicine. Here it is, a disservice!

What strain?

Swallowed a coin or the battery, fed smoked sausage in 10 months, drank a vinegar or bleach, found a syringe in the garbage and got stuck, played with matches — this and more can happen through the fault of the parents when the child was left without proper attention. Sometimes the simplest things lead to severe consequences.

In the situations described clearly the fault of the parent? An adult patient? At first, I was sure of it. But duty for duty watched infantile adults and asked myself: “how would I do in their place? Without medical knowledge, without experience?” And then came yet another question: “And why should they strain, fret, fuss, if you can call the precinct free, free ambulance, free to request the recipe, and just what is not to their liking — and then to write a complaint”. Why complexity, when you all ready? I write without reproach: why? Because fish is looking where it is deeper, and the patient is where the free…

And how to deal with such patients? We can help: give recommendations and let yourself go with God. They will come back again and again. And you can help really. Equip them with knowledge, interest, forced to take care of themselves and their children.

Surely in all these years nobody came up with the idea to develop for parents some basic advice on first aid to your child? When the temperature is, diarrhea is a runny nose treated so inhalation to do then, when a tick bite to do it. Elementary! It is obliged to know every parent, it should be always at hand, on paper, in your phone (in the form of an app, for example), these basics exam should be done in the clinic with a mandatory change. And until you pass — not to pay maternity! Yes, if you at least three times a graduate in Economics, if you temperature give your child an antibiotic, not an antipyretic — worth all your diplomas and medals because you can solve the problem of the whole factory, but to ease your child’s condition can not!

I will say that you have no special medical education, you don’t have to deal with. Answer is very simple: I have no special education in other areas. But I’m able to minimally maintain the car (change a tire, technical liquids), to install the program on phone and computer, clean them from viruses, configure program on the TV, etc. And I can assure you that those basic skills listed above, do not require special education, they just need to master by default.

Doctors lackeys?

I resent how parents justify the powerlessness of the child’s behavior. “Well he does not want to take pills!”, “Tearing it from the syrup!”, “Can’t you get him drunk!”, “She is not sitting on the inhalation!”.

I mean? In 4 years not on the pill? So him ranting that he doesn’t want to drink: this is not an increased gag reflex, and whims. As I can not drink in 3 years? And spoon – “don’t want” tried? Will cry? And when the catheter is in the pen will be put for the drips, I think laughing would be?

When I saw patients in the emergency room, and in some cases felt like a footman. Parents ordered tests, hurried with their implementation, caused in Boxing several times the doctor, nurse. Why patients, parents of patients feel themselves masters of the situation? Because you can complain to anyone they want. And, of course, believe.

Patients are spoiled by the opportunities received in free health care, and if they try to show border on the offensive: swing right, threatened with complaints and write them for the smallest thing.

How dare you tell me graduate after 7 years of study, in the first day of your illness, your 17-year-old 85-pound boy with a temperature of 38.5 and cough need an x-ray, if there are no rales in the lungs?! (Can not forget the first complaint that came to me.)

Врач: бесплатная медицина — медвежья услуга для пациента и удавка для медика

What she means to me, this is the complaint? This bell. “What did I do wrong? Where did I go wrong?” Starting to get nervous, repeatedly return to the problem patient. Think about it on the way home, and then home. I ask the house to home left you alone. (Yes! Doctors carry home your work.) And even, it would seem, in the obvious situation when you have nothing to worry about, a hundred times yourself before you can stop worrying. I know that other doctors have learned to empty complaints not pay attention. Maybe I just don’t have time to finish before their time.

Complaint — the noose

No one will reveal something new, but still sounded like a complaint is received superiors: I need an explanation, do an inspection, looking for faults. The easiest way is to find someone to blame and reported: “Punish!”, otherwise, the next complaint may arrive already in the guide.

Perfect example, who opened my eyes to the work with citizens in Belarusian. And arrogant parent in it. In the evening in our lobby ran an excited dad with a baby in her arms and began to require that its queue held for a visit to Laura. He was the answer: “To Laura to hold you can not come in the box, expect pediatric”. From Boxing he soon ran away, not waiting for my inspection, but the complaint had to write. In the complaint, no claims to me just how organized the process of receiving patients in our institution. Guess what I was deprimirotee? Because applying the patient was not registered in the appropriate register. “I had to write it down?” “No, nurse. But you’re responsible for her job!” — the words of the chief medical officer.

Here it is: complaint-noose on my neck threw parent, and tightened the loop — head.

The doctor is not the enemy of the patient. But the circumstances, the existing system of consumer attitude (both from the patients and guide) to slave labor provider, we parted on different sides of the barricades.

And while a late winter evening, a pediatrician is on the 50th visit in 22 hours, and my mother fusses over my baby because you don’t understand what to do, officials are looking for the guilty in the complaints that they send new disgruntled citizens. And officials know what to fix and what to fix, but not going to do it while you can “merge” all the blame on the rank and file of health workers.

I understand that my opinion may seem very one-sided, purely medical. It is not so. As a father, I sometimes noticed errors the other parents and found them. Tried to put myself in their place. Tried to find an excuse for their carelessness or, on the contrary, excessive alertness. Sometimes I managed. But more often I realized that you could not bring to the hospital — if the parents were more interested, more prepared, even without medical training. If the system is not spoiled them with free medical care, and taught how to be for your child if you are not a doctor-magician, the real superhero, able to save almost always.

© 2019, paradox. All rights reserved.

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