Confession of a Moscow doctor Bashny.Net

Eleven million seven hundred sixty six thousand nine hundred fifteen



part1

In the branch where I work, sales are very strict. Not fulfilled the plan for the first time — a fine and minimum wage. Not fulfilled for the second time — dismissed. In any paid medical institutions have a plan, the average patient. If the doctor that check fails and does not perform a monthly plan, he cautioned, fined, or even fired, if it is repeated several times.

A financial plan to execute it! Each medical center expects this amount specifically, how much on average per month in revenue should go to the doctor. For motivation to not insert the caps to the doctors and tell them every day how important it is to bring profit to the branch and to pay their crazy spending, make it the minimum salary and a good interest rate with every patient, that is, those services which the doctor vparivaet.

This system almost does not cast from any "Evroset" or "Svyaznoy", where the same technology. Vendors have a average salary of video and motivation to sell more, to earn a percentage of sales, then we get an interesting salary. Medicine has turned into "the sale of mobile phones", where at the health of the patient, and the number varennyh services.

Part 2

Today I had a patient with complaints of pain in the abdomen and in the groin area. The symptoms are described following: discomfort when walking, pain in groin after heavy lifting, a feeling of heaviness in the abdomen. After describing the symptoms, there was a clear suspicion for inguinal hernia. After inspection and palpation it became quite obvious. When the patient stood, there had been subtle changing in the size of the swelling, which disappears in the supine position.

This is a simple situation that does not require additional examination. Could he safely diagnose and send to a surgeon for elective surgery. But in our clinic (and any surcharge) you can't do that. Surgery to correct a hernia in our clinic is not carried out, and to send him to the hospital – it means to lose a customer and get a reprimand/fine from the management for failure to comply with the average check for each patient.

So I began to chase on our standard scheme of sales: General blood, urine, feces, abdominal ultrasound. Also sent to the urologist in the next room, which he, most likely, will hand over the analysis of prostate secretion and will pay for itself advice. The approximate total cost of all these services 35-40 thousand rubles.

At the clinic I work for 6 years. The above situation is a normal working routine. And even after this amount of time I still sometimes have pangs of conscience. They are already weak and almost not noticeable, but still having memories about what thoughts and hopes I was going to learn in medical school to help people and treat them, as bequeathed to Hippocrates. About any cheating and divorce on the average check then and thought it was not.

But as the head of the clinic where I work: "Hippocrates is not relevant, and had died long ago, my family and the children are alive and want to eat."

Part 3

"Because of people like you, mrazina my daughter was 10 months demodicosis diagnosed, not forgetting to ask for money for analyses including and dysbiosis, DYSBACTERIOSIS! visits to the immunologist, the allergist, the endocrinologist, and other parasites. And, the child has scars on the eyelids appeared. You burn in hell, creature."

This is one of the first comments I received on a previous post. The review is quite fair, I understand the feelings of this woman and sympathize with her. The situation that she described, occurs quite regularly. For each patient I receive a stack of tests and surveys. All these tests, I usually aim to give two doses to the patient has not shied away from imposing cost and is not suspected of excess of assigned surveys.

First, there is usually no need to take such a number of tests. But you already know about the plan, norm and check on each patient.

Second, you probably can't even imagine how they are doing and how your labs are forged in the laboratories.

There are several options:

Clinics that save the tests

Tests get assigned to a lot, and you pay the appropriate amount, but the study at best conduct only the most basic, or even not carried out. Why is this happening? Most likely, the hospital to which you came, bad things are going, so they save on tests. Accordingly, it appears inaccurate picture of your examination, and, as a consequence, inadequate treatment. As a result, health has not improved and is likely to worsen and cause the appearance of other ills. But it's not bad, because to go to the clinic you will be in for a long time and regularly. But do not all clinics, but only in those where the sales are bad, and even the clinic doesn't pay.

Clinic, missed an opportunity to make money even in a healthy patient

The tests you administered on the standard scheme, but fake their results. "Find" what you have is actually there. And this, incidentally, is not the worst because here you find only a minor illness that can be "cured", Prokopov few droppers and on drink a course of medicines. Difference the patient will likely not feel, but then pass the tests again, which will show that he is "cured".

The clinic, which detect the patient's serious or life-threatening disease

Most likely, this clinic with the lazy and stupid leadership with the post-Soviet mindset that only know about management, marketing and domestic sales. Save on everything, doctors are paid a modest salary. This greedy leaders that have only one clinic, because of the network scale, they will never expand because of their greed and stupidity. Therefore, in order to somehow stay afloat, and thus to earn on bread with caviar, engaged in outright fraud. The atmosphere in these clinics is depressing reigns, doctors are evil, and this is seen with the naked eye.

And the last option

This is a clinic, who do not fake, but thanks to competent management and marketing are manipulated by the patient to pass a large number of tests, additional tests and examinations. Patient diagnosis is put only after the execution of the plan, and then prescribe appropriate treatment.

Here in this clinic I just work. And let me tell you that this option is not the worst. Moreover, today, even the best in Russia. Yes, a patient will spend in 3-5-10 times more than necessary, but you definitely will know the accurate picture of your situation.

A few words about free medicine

In the review I wrote a lot of that time in private clinics so cashing in on the patients, therefore, it is better to go to a free local clinic. But tell me, what's best for you to recover though for a lot of money, or not cured at all, because "for free" on you who cares? In that light money is not required.

Part 4.

Time is now running out. Write the most memorable situations over the past week — later I will describe all in more detail. The other day we had an extraordinary meeting.

The authorities were extremely dissatisfied with the falling incomes of our branch — all chastised and threatened with dismissals.
The main claim: "You are at work just do that drink tea, and should be treated as patients"
This despite the fact that I'm the only one in twenty working days per month in cash worth 3.5 million rubles.

Set the task: "to Bite in any patient and if the symptoms described even remotely resembles a complex disease, to intimidate the patients and appoint local procedures and additional survey"

Our ultrasound specialist, frightened that she would be fired, pregnant healthy, the girl was told that she had premature oligohydramnios, placenta all the cysts that all
too bad, it is urgently necessary to put a dropper and to conduct a full examination, otherwise it may lose the baby.

The pharmaceutical company that promotes using our own "miracle drugs", has released a new tool for diseases of the gastrointestinal tract. The result — some patients complained of diarrhea and bleeding.

Urologist in the collection of material for PCR provoked bleeding from the urethra. The patient's blood stained the white coat of a doctor, and fear began to fuss, splashing drops of blood the floor of the Cabinet. When the doctor opened the door and went to call the maid, the patients waiting their turn, when they learned what had happened, got up and left. Something tells me that our urologist will be fired.

For those who are interested, what are the salaries in our clinic and how stimulated sales, tell. We have a minimum wage — an average of 10-15 thousand rubles. Everything else is interest. With the admission of the patient the doctor gets 20%, six months ago was 15. For a referral to another specialist 5%, six months ago it was 3%. For direction tests 8%, six months ago it was 5%.

If you are studying in medical schools and want to get a decent salary, I recommend to go to doctors neterpyntsi specialties. Money will get even more. Those who know how to count, have already guessed why. And for those who do not understand, next time I will write more.

Part 5

The funny thing that many of you probably noticed, but I don't know the ins and outs. If you notice, in Moscow, in many medical centers on the reception hang "honorary Board" with photos of the best physicians of the month, and I know what people think about this patients. But really, it's the doctors, which this month brought in the cash the most money. It's like employee of the month at the furniture store.

Many ailments, for which patients were treated in the clinic, can be cured after one or two consultations, based on the common core tests. This is enough to determine the pattern and prescription of adequate treatment regimen. But to heal completely unprofitable, and if you try, you will receive a cap from the leadership.

By the way the patient doesn't even have to intimidate, when he came with his problem. Simply enhance its already existing fears all sorts of hints and a shake of the head. But the most stable patients — those who are online, carefully study your symptoms. Having read all sorts of horror and agree to any all kinds of surveys.

The patient is unprofitable to treat, it is advantageous to remove symptoms and to delay to the last. But if the patient managed to earn dysbiosis from taking endless amounts of drugs, it is good. The patient becomes very sad and obediently walks to the reception and is ready on all treatments and additional tests.

Surely some of you had cases when you are a long time treated in any medical centre, and the improvement did not come, and then at some moment you have lost patience or have the financial problems and you have to quit. Then again, health and of course got better. Many of the sores recover either by themselves, or sufficient minimum intervention.

And maybe for someone will be opening, but most of the drugs that we (physicians) appointed by themselves do not accept even with similar diseases.

 

Source: realmedic.livejournal.com/