- How did you come to want to become a doctor?
- I have always been attracted by human nature, everything that is connected with the sciences of how it works: neurophysiology, psychology. My mother and aunt played an important role in choosing a profession: they wanted to try themselves in this profession. Mom laid this desire in me. This is how I became the first doctor in the family.
- Is an effective doctor-manager real? Is work in your medical specialty always combined with the functions of a business executive?
- There is one of the theories why the Soviet industry was making great strides and was so effective: directors went through all the job stages in their production, mastering each stage.
I came to the hospital 23 years ago as a nurse. All this time I was mastering new medical specialties. I had no goal in itself to become a manager. And I will combine the position of a doctor with practical medicine: these are daily rounds in departments, and assistance to doctors in performing operations, in everything related to the main profession.
Making managerial decisions helps to build a healing process. Our hospital joined the international ISO certification system, passed the appropriate certification of Roszdravnadzor. All certifications are designed to improve the work of a medical organization, improve the quality of medical care and reduce risks for the patient. The organization of the treatment and diagnostic process begins with the management of the so-called auxiliary processes (risk management, cost reduction). So management and treatment are very complementary.
Heroes and heroines
- What exactly will you change while at the post of chief physician, and what have you decided to leave as it is?
- The strongest part of the hospital is its staff. Now the staff is experiencing inhuman stress, absolutely all: doctors, nursing and junior medical staff, and the economic unit. In this "era of covid" we have teamed up with other medical organizations (hospital 10, polyclinic 14, Mikhailovskaya CRH - 62INFO were added to the OKB), and the way our employees cope is commendable. It is on the basis of personnel that a further development program can be built.
What I want to change is the historically formed fragmentation between the medical services. We need to make sure that each department understands the problems of the other. Let me explain using the example of the interaction of emergency and planned services, which have a division due to different approaches to work. The former work, so to speak, “off the wheels,” while the latter have a more measured approach to patients. I see it as my task to establish interaction between these areas, so that there is understanding of each other and more help. Routine medicine must take on certain risks; the emergency will always be included in the work in critical situations.
I also want to say the following. Behind many things that were performed exclusively in our hospital, behind some unique operations there is a certain person, a hero with his feat. More employees need to be involved in this process. It is necessary to establish the transfer of knowledge, to make the process systemic. So that when a person leaves (for example, on vacation), work does not stop, and the hospital feels more confident.
- Heroes are good, they are the driving force. But was it possible to organize an ambulance or a transplant service without outside support?
- Of course, any event requires preparation, a legislative base should be formed, an external administrative resource is needed.When the doctor Dmitry Karpov proposed to create a transplant service, Dmitry Khubezov supported him - as a surgeon, he understood that it was possible. A team was formed, equipment and materials for high-tech interventions appeared (and this is a continuous process, we are constantly updating).
The regional administration came to the rescue. Governor Nikolai Lyubimov enthusiastically supported this idea, supported by his authority. We needed this: transplantation is a very difficult topic, we faced obstacles related to the negative attitude towards organ transplants.
Health and responsibility
- Every cloud has a silver lining: the coronavirus pandemic helped raise the status of a doctor in Russia. But many people are still unhappy with domestic medicine. Why?
- I will return again to the Soviet era, where the preventive direction of medicine was formed. WHO has recognized our disease prevention model as the “gold standard”. But a huge disadvantage of the same model is that the relationship between the doctor and the patient was built on the principle of "parent-child", where the doctor became a kind of guide. But after all, medicine cannot magically restore health to a person, it is designed to heal diseases.
Unfortunately, not every person understands that he himself is primarily responsible for his health. Physicians can advise, recommend, improve the quality of life, save, but it should be remembered that your health is an irreplaceable resource from some stage of your life.
People are unhappy because many have inflated expectations of the health care system. Even at a young age, serious problems are often caused by "social illnesses": alcohol, drug use, smoking, and a sedentary lifestyle. The statistics of deaths among young people are associated with them.
But at the same time, in Russia, the level of accessibility of medical care, including high-tech medicine, is in our favor compared to other countries. We have the opportunity to change joints, heart valves, organs, the doctor comes to you and your child at home for free. It is not for nothing that all national projects began with the obstetrics system, with the construction of perinatal centers. And there is no such thing anywhere.
Yes, the health care system sometimes fails because it, like any other, is limited in resources.
Medicine abhors indifferent
- Is there a significant gap in the quality of paid and free medicine?
- I don't see much difference. Service varies, yes. You will not be offered coffee in a free clinic, but service and quality should not be confused. Paid medicine with good service can sometimes compensate for the insufficient quality of services. And their spectrum in public medicine is not inferior to paid clinics when it comes to really important things. For example, one flight of a medical helicopter costs the treasury at least 150 thousand rubles.
- How high emotional intelligence should a physician have? Can a non-empathic physician be a good specialist?
- Everyone who works with people should have empathy. No clinical practice guideline prescribes the ability to empathize. But without it, it is impossible to cure a single serious patient. The results of treatment with a physician with personal participation are higher than without him.
A doctor's lack of empathy is not a professional inadequacy. Fortunately, there are specialties where there is no direct contact with people. A laboratory diagnostic doctor, or a radiologist, for example.
But medicine does not tolerate indifferent people.
- Have you ever deceived patients for reasons of humanism?
- There are situations when medicine is powerless. I never give false hopes, but I am not talking about death either. The patient should not have a sense of hopelessness.
- You have less free time due to the appointment, what will you spend it on?
- I am a workaholic, I love my job.In my free time, I like to be with my family, read, do not forget about sports. But the best rest for a doctor is sleep and silence.