Final diagnosis

Health 2023
Final diagnosis
Final diagnosis

The word "prevention" should not be an empty phrase - it's troublesome, but necessary. Check it out!

Final Diagnosis

The word "prevention" is associated with technical inspection - troublesome, but necessary. Why, while monitoring the he alth of our car, we do not consider it necessary to take care of our own he alth? And we catch on only when important systems and functions fail…

Meanwhile, our citizens have the opportunity to undergo regular medical examinations, and - what is especially important - to undergo it for free! In March last year, Minister of He alth Tatiana Golikova signed an order on additional medical examinations for working citizens. So far, the cost of medical examination of one person is 974 rubles, and by the end of the year it will increase to 1042 rubles. According to the minister, these funds are used to pay the salaries of medical workers who conduct medical examinations and to provide consumables.

Absolutely all working people who have a compulsory medical insurance policy (a compulsory medical insurance policy that every citizen of Russia should have) can undergo a medical examination. At the same time, the form of ownership of organizations does not matter - this applies to state employees and employees of commercial enterprises.

If the institution where the medical examination is taking place does not have the necessary specialists or certain tests are not carried out, the heads of medical institutions will have to conclude agreements with other laboratories or hospitals.

About the need for preventive examinations, as well as what types of treatment are available and free, "DO" talks with a doctor of medical sciences, professor, head. IRINA IVANOVNA CHUKAYEVA, Department of Polyclinic Therapy, RSMU.

DO: We all have come across similar events, when in the process of registering for a kindergarten, school, institute, we had to run around to doctors. To be honest, many felt that this was an unnecessary formality

HIC: Regular preventive examination (what is called clinical examination) is necessary! We live in an era of diseases, most of which are in the nature of "silent killings". For example, diabetes mellitus - we live with it, not knowing about it until complications appear. Oncological diseases, if detected at an early stage, are curable! And the main "silent killer" is arterial hypertension (AH). That is why it is so important to regularly (once a year, if there is no direct need to do this more often) to check the level of sugar in the blood, as well as to control blood pressure. A group of colleagues and I recently conducted an on-site examination of the staff of the Tretyakov Gallery and the teachers of the Conservatory. Bright, educated, intelligent people, but there is no time to deal with their he alth. And here are the results: more than half had high blood pressure and high cholesterol (which was a surprise to them!). In addition, a pathology of the nasopharyngeal organs was revealed in many - after all, we don’t go to the ENT at all, unless something out of the ordinary happens … We, doctors, are talking about the “rule of half”: only half of those who suffer from arterial hypertension (AG) knows about it. And half of those 50% who know what's wrong with them are being treated. And only half of that half are treated adequately. It turns out that only 4-7% of people with hypertension are fully treated! And this is a catastrophic picture - after all, hypertension can also be asymptomatic, it is not without reason that it is called the “silent killer”. Please note: the pressure of 140 over 90 is already AH! This is a high risk group. And if a person with such pressure also smokes, he is over 40 years old and his weight exceeds the norm, then the risk increases exponentially. Obesity is another "silent killer". Moreover, if earlier the indicator was overall fullness, excessive body weight, now it should be included in the standard indicators and waist size. A woman can have lush hips, but at the same time with a thin waist - such fullness is not a risk factor. But if fat deposits on the abdominal surface - this is already dangerous to he alth. Moreover, the fat that we have on the front wall of the abdominal surface is not so terrible, the one that envelops the internal organs is worse. But it is quite objectively established that certain physical activity allows you to cope with this problem.

DO: Unfortunately, as practice shows, not in every district clinic a person can undergo the necessary examinations for free

IC: Now working people from 35 to 55 years old, teenagers and pensioners can get medical examination free of charge. At polyclinics there are dispensary rooms or first aid rooms. They will measure your blood pressure, listen to your heart, if necessary, make an ECG, in addition, you can measure body weight and total cholesterol. Of course, there are still not enough specialists in city polyclinics. A few years ago, a decree was even issued on the need to train doctors specifically for polyclinics, and there have already been three graduations of such doctors, and they are starting to come to polyclinics. So the situation with doctors is starting to change for the better. Even more important is primary prevention. After all, people come to the doctor when the disease has already developed. Therefore, medical examination to some extent will unload polyclinics and hospitals - now they are crammed with people with extremely neglected, serious diseases. Those who have not paid attention to he alth for a long time.

BEFORE: What screenings are needed for cancer prevention and which ones should we get free of charge?

HIC: First, women need to see a gynecologist to rule out cervical cancer. And a breast examination - an ultrasound examination (which must be carried out for women under 35 years old annually). It is also included in the basic medical examination, that is, it is free of charge. If the clinic does not have ultrasound equipment, then the specialist should refer you to a consulting center of the appropriate profile. Such centers are the base for several district polyclinics. And women over 35 need an annual mammogram. And again, if this equipment is not available in this clinic, the doctor refers the patient to the appropriate advisory center. Men also need to undergo regular examination of the prostate gland. And all these events within the framework of the medical examination are free.

DO: Does CHI cover more high-tech research? Let's clarify what types of treatment are supposed to be free of charge? Are there certain social standards in our medicine?

IC: We already live in the era of standardization. An exemplary diagnostic algorithm is prescribed in medical standards, all studies that can be done, including for free, are prescribed. And these standards are valid both within Moscow and in the regions. Now each hospital is preparing its own standards related to the capabilities of the hospital. Here, for example, we have a CT scanner - if necessary, with a certain clinical picture of the disease, the patient is given this free of charge. Of course, if the doctor justifies such a need. But, if you come from the street and say: “I want to do a CT scan,” then you have to pay. Or if you take a heart operation, which costs about 17 thousand euros abroad and about the same here. It is so expensive, not because the surgeon's hands are somehow special, but because it must be technologically advanced. For those who are unable to pay, there is a direct, short cut: a district specialist sends them to a consultation center, which receives a special quota for them for a free operation. These quotas are not enough for everyone, but they exist for both Moscow residents and federal ones. Specialized medical centers equipped with modern technology operate not only in Moscow, but also in other major cities. There you will be further examined and, based on the results, they will give you a referral for the provision of high-tech assistance (for example, operations). But the standard path starts with the district doctor.

BEFORE: How can people who are far from medicine find out about this?

IC: They should be informed by the attending physician in an ordinary district clinic. Every doctor knows that there is free medical care provided at the highest technological level. And he knows the clinics where it is provided - this is his prerogative.

List of doctors who should examine you as part of the medical examination:

• therapist - district or general practitioner (family), • Obstetrician-gynecologist for women and urologist for men, • neurologist, • surgeon, • Ophthalmologist, • endocrinologist.

What tests will you have to take:

• CBC, • blood sugar and cholesterol test, • electrocardiography, • Mammography (women over 40, once every 2 years), • Fluorography (once every 2 years).

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