An ambulance paramedic's diary: about low wages, unbearable patients and medical humor. Day shift on the "ambulance" of the lowest paid jobs in the United States

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Tumors. Part 5. Treatment of a tumor

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There are contraindications. Ask your doctor for advice.

Defeating cellulite is real! Every woman wants to have healthy, smooth skin ...

We have come to the last part of the cycle devoted to the treatment of tumors. Today we will learn new medical words: palliative (facilitating, auxiliary) and fascia (connective tissue septum, a term from anatomy), as well as learn several new names for tumors. There is a lot of material, so it will be in the form of a synopsis.

The tactics of treating benign and malignant tumors are different , because the latter have infiltrating growth, a tendency to metastasis and recurrence.

TREATMENT OF BENIGN TUMORS

The main method of treatment is surgical. Occasionally, in the treatment of tumors of hormone-dependent organs, instead of or together with the surgical method, it is used hormone therapy.

Benign tumors that do not pose a threat to the patient's life, doesn't always have to be removed... If the tumor does not cause any harm to the patient, but at the same time there are contraindications for surgical treatment (severe concomitant diseases), then it is inappropriate to operate on the patient.

Indications for surgery:

permanent trauma to the tumor (for example, on the scalp, on the neck area of the collar, in the belt area in men)

organ dysfunction (closure of the lumen of a hollow organ, release of hormones into the blood)

no complete certainty in the benignity of the tumor. During the operation, a biopsy is taken, and within 15 minutes the pathologist must look at the biopsy under a microscope and give an answer. Surgeons are waiting at this time, the patient is lying on the table under anesthesia.

cosmetic defects especially in women.

Remove the tumor as a whole (not in parts) , within healthy tissues, with a capsule (if any). The excised neoplasm is subject to mandatory histological examination. Relapses and metastases after removal of a benign tumor do not develop,

the operation completely cures the patient.

TREATMENT OF MALIGNANT TUMORS

This is a more difficult task. Are applied 3 ways of treatment:

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25 highest paying jobs in the USA

№	Speciality	Income per year	Growth over the year	Employed	What do they do
1	Anesthesiologists	$192,780	4.58%	29,890	General anesthesia is performed during surgery and other medical procedures.
2	Surgeons	$191,410	3.94%	51,900	Treat diseases, injuries and disabilities with invasive methods.
3	Orthodontists	$185,340	4.77%	5,200	Malocclusion of teeth and malformations of the oral cavity are diagnosed and treated. A device for aligning teeth and jaws is modeled and manufactured.
4	Obstetrician-gynecologists	$183,600	3.12%	22,520	Diagnostics, treatment and prevention of female diseases, especially those that affect the reproductive system and the process of childbirth.
5	Maxillofacial Surgeons	$178,440	8.30%	5,320	Operations are performed on the oral cavity and jaws.
6	Prosthetists	$169,360	6.56%	480	Prostheses are made to replace missing teeth and other structures of the oral cavity.
7	Therapists	$167,270	3.98%	48,700	Diagnostics and non-surgical treatment of diseases and injuries of internal organs are performed.
8	Other doctors and surgeons	$155,150	9.09%	208,960	All other doctors and surgeons outside the main specialties.
9	Family doctors and general practitioners	$153,640	2.53%	109,400	They are engaged in the diagnosis, treatment and prevention of diseases and injuries that often occur in the population.
10	Executive directors	$151,370	4.68%	299,520	Define and develop a strategy and carry out overall management of the company or organization according to the recommendations adopted by the board of directors.
11	Airplane pilots and flight engineers	$148,810	6.01%	75,810	They pilot and operate the flight of multi-engine planes of regular flights.
12	Psychiatrists	$147,620	-1.58%	24,730	They are engaged in the diagnosis, treatment and prevention of mental disorders.
13	Dentists	$147,010	4.30%	86,110	Diagnose and treat diseases, injuries and malformations of teeth, gums and adjacent structures of the oral cavity.
14	Pediatricians	$145,210	2.67%	28,930	They carry out diagnostics, treatment and prevention of childhood diseases and injuries.
15	All other dentists	$120,360	11.09%	4,560	The rest of the dentists, with the exception of oral and maxillofacial surgeons, orthodontists and prosthetists.
16	Podiatrists(podiatrists specializing in the treatment of diseases of the feet)	$119,790	1.09%	9,020	Diagnose and treat diseases and deformities of the feet.
17	Attorneys	$118,280	4.06%	547,710	They represent the interests of the client in criminal and civil litigation, prepare legal documents, advise clients on legal agreements.
18	Technical managers (chief engineers)	$115,610	5.07%	183,960	Plan, direct and coordinate activities in industries such as architecture and technology, or the research and development of these industries.
19	Petroleum engineers	$113,890	12.07%	15,060	Thinking about ways to improve the production of oil and gas wells, determine the need for new or improved tools. Supervise drilling and help with technical advice.
20	Computer and Information Systems Managers	$113,880	6.18%	251,210	Plan, manage, or coordinate work in areas such as electronic data processing, systems analysis, and computer programming.
21	Marketing managers	$113,400	5.38%	159,950	They determine the requirements for products and services, find potential buyers, develop a pricing policy, and control the need for product development.
22	Science Managers	$113,170	4.82%	38,660	Plan and coordinate work in areas such as life sciences, physics, mathematics, statistics, and research and development in these areas.
23	Air traffic controllers	$107,780	-2.26%	23,240	They control air traffic in and near airports, movement in the air at heights and between control centers in accordance with the established rules.
24	Commercial directors	$106,790	3.95%	307,960	Manage the distribution of a product or service to a consumer, establish training programs for sales representatives, and analyze sales statistics to determine sales potential and accounting requirements.
25	Financial managers	$106,200	4.68%	468,270	Plan, manage and coordinate financial accounting, investment, banking, insurance, security and other financial activities of an industry, office, or department of an institution.

It remains only to be happy for the American doctors and remember the well-known truth: it's good where we are not. I have already written about the salaries of Belarusian doctors, including the income of a novice doctor who will soon help. For several months the newspapers have been talking about a significant increase in salaries in the Belarusian health care, but things are still there. State medicine is a costly business.

American doctor's car.

The car of the Belarusian doctor.

Recently I had to write a prescription for my grandmother, I had to call the local doctor at home. I am absolutely serious: the district police officer (she is about 45-50 years old) arrived in the same car as in the photo above, only older. She said that she was very glad that she decided to use a personal car today: the site is large (private sector), and calls to the house are accepted until 14-00 and therefore they can easily give the last call to the other end of the site, when in half an hour or an hour you have to be on admission to the clinic.

25 lowest paid jobs in the USA

№	Speciality	Income per year	Growth over the year	Employed	What do they do
1	Food preparation and service workers, including fast food	$16,700	4.8%	2,461,890	Carry out duties that include both cooking and serving visitors
2	Fast food chefs	$16,860	5.6%	612,020	Cooking in fast food restaurants with limited menus
3	Dishwashers	$17,060	5.4%	502,770	Cleans dishes, kitchens, cooking equipment and tableware.
4	Canteen service personnel, cafeterias and bartender assistants	$17,380	6.5%	401,790	They help the food service, put and remove dirty dishes from tables, serve food at the bar, distribute water, oil and coffee.
5	Head washers	$17,490	2.6%	15,580	They wash and dye their clients' hair.
6	Waiters in restaurants, lounges, cafes	$17,770	5.4%	340,390	They greet customers, set them at tables or in lounges and help to ensure the quality of service and service.
7	Service staff in cafeterias and cafes	$17,820	5.1%	524,410	Serve food to diners.
8	Doors, receptionist and lobby staff, ticket controllers	$17,880	2.2%	101,530	Assists clients during recreational activities by performing duties such as checking entrance tickets and placing seating.
9	Croupier	$18,120	6.5%	82,960	Manages table gambling games.
10	Recreation and entertainment service personnel	$18,220	3.9%	235,670	Performing customer service duties in recreational or entertainment establishments.
11	Agricultural and unskilled harvesting and plant growing workers	$18,350	4.1%	230,780	Manually grow, process and harvest vegetables, fruits, nuts, field crops.
12	Cashiers	$18,380	2.5%	3,479,390	Receive and give out money in institutions that are not related to financial institutions.
13	Waiters and waitresses	$18,570	8.0%	2,312,930	Receive orders and serve food and drinks to visitors' tables.
14	Personal and home caregivers	$18,940	4.2%	578,290	Help the elderly and disabled in their daily life at home or outside during the daytime.
15	Seamstresses, weavers	$19,280	4.4%	75,150	Clothes are made by hand or using machines.
16	Service staff of paid parking lots	$19,320	4.7%	131,870	They park cars or issue tickets to customers in parking lots or garages.
17	Cooking workers	$19,350	4.7%	871,470	Carry out a variety of food preparation duties, with the exception of cooking.
18	Lifeguards on the waters, ski patrol, other security workers	$19,430	5.5%	108,870	Monitors recreational facilities such as swimming pools, beaches, or ski slopes to help and ensure the safety of vacationers.
19	Maids and Housekeepers	$19,550	4.5%	900,040	Carry out simple cleaning duties in private homes and commercial organizations such as hotels, restaurants and hospitals.
20	Laundry and dry cleaning workers	$19,570	3.6%	217,580	They operate washing and cleaning machines for washing and cleaning work and household clothes.
21	Chefs in fast food restaurants	$19,580	4.6%	189,610	A variety of foods are prepared that require a short cooking time.
22	Crop sorters	$19,590	5.3%	45,890	Agricultural products are sorted, such as potatoes.
23	Childcare workers	$19,670	4.5%	572,950	Work with children in schools, enterprises, private homes and childcare facilities
24	Service station workers	$19,720	3.0%	94,780	The cars are filled with fuels and lubricants. Accept payment for goods and services. Can install car accessories and repair or replace tires.
25	Bartenders	$19,740	6.5%	485,120	They mix and serve drinks to customers on their own or through waiters.

Have you seen the film "Arrhythmia" by Boris Khlebnikov? The picture is not much different from real life. Often the doctor is faced with a choice: to save himself or others. Why? An ambulance worker with twelve years of experience told us about this.

IN CHILD I WANTED TO TREAT THE MILITARY

I gave twelve years of my life to the ambulance. Now I am 33 years old. For a long time he worked in a small town in the Sverdlovsk region. Recently I moved to Yekaterinburg and have been working here for a year.

I got to the nurses not at will. When I was in school, I dreamed of a career as a military surgeon - it was still restless in Chechnya. I wanted to help our soldiers, who did not spare their lives in the fight against terrorists. After graduating from 11 classes, in 2002 he tried to enter a military institute. But he failed the entrance exams.

As a result, I went to study at a medical school. It seems to be four years ... But after leaving the school, I was terribly frightened: I would have to save a dying person, but I can’t do anything. Therefore, the first time I worked, acting, for sure. At the first calls, it was elementary, I did not know what to grab onto.

On an ambulance, every call is considered an emergency. Like everyone in the team, I need to work quickly and think ten steps ahead. When there are two paramedics in the brigade, it is easier to work. It often happens that the management sends only one paramedic to call. To argue is useless, since the orders of the chiefs are not discussed. One head and a pair of hands on a call is not enough!

It is often scary. I remember we come at night to call my grandmother, she meets us at the entrance, she shakes. We go up to her apartment, provide assistance. Suddenly her son comes out and says: “I recently returned from prison. If you do something to my grandmother, I will stab you. " Fortunately, everything worked out.

NO CHANCE TO SURVIVE

For the first time in my life I delivered a baby in the ambulance. The brigade was summoned somewhere in the basement of the barrack - the girl was without a fixed abode. She gave birth in the eighth month instead of the ninth. A tiny thirteen-centimeter boy was born. But he was not breathing, we thought he was dead. It turned out to be alive, but barely - barely ...

My hands were shaking, I could not cut the umbilical cord with sterile scissors. She was very slippery, and it was even more difficult to perform this cunning procedure with gloves. But it worked out for me.

We hurriedly took him to the hospital. On the way, they sucked off mucus and performed an indirect heart massage with literally one finger. And in the hospital, the doctor said: "He has no chance to survive."

At that moment, the hands of the entire brigade dropped. Such emptiness was in my soul! The doctors took the baby to the intensive care unit. Saved.

And two years later, I learned that the boy we saved had died anyway. All because of the dissolute mother ... From this story, my heart ached frankly.

I burst into tears from work

Once we were summoned to the injured grinder. During the work, the disc flew off the tool and crashed into the unfortunate man's axillary region, damaging the vein and artery. There was a sea of blood. We came to the call together. While one was setting up the system, the other was pressing children's sheets to the wound - they were brought by the victim's wife. The bleeding was so severe that the bandages were not enough. We literally tamped these diapers into the place of injury. On the way to the hospital, the bleeding increased. Therefore, we did not go, but flew like on a rocket. They tried with all their might to save. They brought me to the hospital and put me in for an operation. And the next day he died. A young guy, about 30 years old ... It's a pity ...

We had to deliver patients to other cities. Our town is small - there is no modern equipment, no specialists either. Once a patient with an acute heart attack was taken to the hospital in Nizhny Tagil. She needed the help of doctors from the cardiology department. The patient was anesthetized. In order to calm her down, we talked to her throughout the trip. When we drove up to the Tagilstroy area, the woman fell silent. Her heart stopped ... In such cases, one can hardly maintain composure.

And sometimes, from your work, you frankly cry bitterly. In one of the apartments, two small children were poisoned by the gas. The kids were left at home alone. There we really didn’t have enough hands. One of us was holding an ambulatory ventilation bag. We only had one defibrillator with us, and we need two. They didn't save ...

FALLED FROM 5TH FLOOR AND SURVIVED

There are also good things in work: once a guy, having gone through with alcohol, fell from the fifth floor. Imagine, survived! They brought him to the hospital: they thought that his spine was broken. And he only had bruises. We went crazy when the guy just got up and walked away from us on foot.

There were also jokes. An accident occurred on the highway. We were told that a person was injured in the accident. In fact, the victim was an elk. And we were looking for this moose for half a day. We thought that if he was “that one”, we would take it for ourselves. The salary of doctors is small, and there is a lot of meat in this animal.

ARRIVED TO THE CALL WITH BRICKS, INSTEAD OF A FIRST AID KIT

I like to help people. But all these years I have been burdened by the low salary. In 2004, I received no more than 15 thousand rubles, since we were given three and a half thousand rubles each by presidential decree.

Today in the clinic I have a salary of 11,500 rubles. We have to take processing. If you work "without jambs" the prize is given - ten thousand rubles. Another option is to plow for two, then you can get from 30 to 40 thousand rubles. How else? It is unrealistic to support a family for 11 thousand. Many doctors and paramedics quit as soon as they get an offer to go to a private clinic or psychiatric hospital because they pay more.

Humor helps keep you afloat. I remember there used to be heavy metal suitcases (packing). So once we decided to make fun of our colleagues: we removed all the equipment from the suitcase: tonometer, ampoules with medicine, syringes, bandages; a couple of bricks were put in instead. We thought they would check the suitcase before leaving ... How much mat was when they arrived and opened the suitcase. They say even the patient laughed.

And in winter, somehow a quilted jacket with wadded trousers was taken out on the road and colleagues were called, allegedly, an unconscious man was lying on the street. They came and laughed.

And we also have solidarity with our colleagues. Once the doctor of the emergency room, scolded one of ours for bringing a patient to hospital without medical indications. Well, we decided to teach him a lesson. They took him to the "reception" of all those in need: both people without a definite place of residence, and drunks - everyone who agreed to be hospitalized. I think the doctor has drawn conclusions.

But that was all before. Now there is little humor in hospitals and the atmosphere is not the same. There is a lot of negativity from the media, from patients, from their relatives, from the authorities. Some want to complain and complain, others want to remove incentive payments from doctors and save on salaries.

COMPLAINED FOR SMILE ON CALL

Over the years, there have been all sorts of complaints about me and my colleagues. That I came to the call and smile or, on the contrary, I do not smile. That we do not take off our shoes when entering an apartment or a house. Do not take off your shoes - an item from our safety instructions, by the way. In order, in which case, to be saved from inadequate patients.

Once an elderly woman came to me with a police outfit. Restless, she complained that I, they say, together with our driver dropped her off in the middle of the intersection and made her walk to the hospital. Funny and not true….

I don’t know what happened, but now it’s worse. Burnout, maybe? I have worked for so many years. Or the time was different. People used to be easier, I wanted to go to work. I worked for a day, came home in the morning, went to bed and went out again at night. Now I am going home after work as soon as possible. I don't need additional shifts, just to see no one. But maybe this is simply due to the profession and the constant horrors that you observe. All the time I thought: "I'm just about to leave." But he still stayed in medicine. True, now I am already working in a polyclinic.

This year I moved to a big city. Of course, you can't buy an apartment here, so we rent a house with our girlfriend. It's easier for two. One would definitely not have pulled it. I get involved in the work in the clinic and get used to its realities. There are a lot of patients: for an appointment from 30 people, calls to the house 20-25 a day, when I do not understand how doctors can treat them.

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Thematic table of contents (Medical stories)

A very revealing entry appeared in the killer doctors. Since there is a fear that the author will demolish it, I repost it with comments:

Equipment of the NSR in Default City
Dear killers, especially those who work at the ambulance. Please explain the situation to me.
So I call the ambulance for painful regulations. I feel very bad, so much so that my consciousness has already swam from pain and I perceive the world around me as through a haze. An ambulance arrives, and the girl (I don't know the doctor or paramedic) declares that she cannot help me in any way. The world collapsed for me at that moment. Then, twisting his lips, he says: well, I can of course inject No-shpu. "So prick!" I say. And I ask again - what, there is nothing more painkillers? She says no. And he also scolds me that I had to take pills and everything would go away. Yeah, pills, when my whole gastrointestinal tract has turned inside out with spasms and the pill will go to the same place as breakfast - to the sewer.
Attention to the question: WHY is there not at least the same analginum with diphenhydramine on the ambulance, but there is only No-shpa? The last time I called the ambulance for pain syndrome, though on a different issue, the uncles came, made the correct diagnosis, and rolled in the blessed analginum with diphenhydramine. And here is such a surprise.
If suddenly this is important, then everything happened in the company, and the ambulance arrived from Solntsevo.

she pushed to the left your analginum with demidrol, sure

I'm just at a loss. Does religion allow you to go to a gynecologist for the selection of medicines? Or, if you know that your period is so painful for you, buy this penny analgin and inject it yourself? No, you must drive an ambulance for free. There are people ...

You can also call an ambulance to get a pill from the locker. Do not get up from the couch myself if your periods are painful.
And if vomiting - let them take a candle in the refrigerator and insert it wherever it is inserted.

for painful periods - an ambulance? ohrenet, stupidly ohrenet, what a pity the doctors. but they did not reach someone because of such. a question to the doctors - and how often do you have this?

Quote from the TS magazine: "We live in some absolutely creepy society. Yes, we have a very problematic state, but besides the assholes in power, the main troubles are nevertheless ordinary everyday assholes."

Calling an ambulance with men is normal.
but around - only freaks

Go to the doctor, he will give you an ultrasound scan, if, without organic pathology such as endometriosis, "Buscopan" prescribes some suppositories. But you will have to buy them. And walk to the pharmacy on your own.
And so convenient, yes - a pharmacy on wheels, only the assortment is bad.

In case of abdominal pain, afaik, ambulance does not have the right to inject anything anesthetic - so as not to smear the clinical picture. "No" was answered, I suspect, so that you would not continue to beg for what you were not supposed to.

off-line copy.

Sometimes I go to LJ and enter the word “ medicine”In the search box. V 85% bloggers scold all medicine in general and doctors in particular for indifference, inattention, unprofessionalism, rudeness, rudeness and much more. Of course, the bad is remembered more strongly than the good. But still the problem “ the doctor is sick" and " doctor - relatives" exists.

Why it happens? Why representatives “ the noblest profession”Do they behave like that? For the sake of justice, everywhere it is noted that sometimes they still meet Doctors with a capital letter, similar to the ideal, but there are very few of them. I tried analyze the reasons not only from the standpoint of the patient, but also from the standpoint of the doctor. The reasoning refers to Belarus, but I think that the situation is similar in Russia.

Lack of time... According to the standards approved by the Ministry of Health, one patient at a therapist in a polyclinic is allocated about 12-13 minutes(4.5 patients per hour). This norm was developed taking into account the fact that on 3 primary patients(first time users), on average, it happens 2 "repeat"... Naturally, “repeat” ones take less time. In reality, it turns out that in 14-15 minutes the doctor often does not have time to really talk with the “primary” patient, examine him, issue an outpatient card, prescribe treatment, explain to the patient about the treatment, regimen, diet. But even these standards are not met, especially in the winter-spring period, when there are many colds and up to 50-60 people per shift.

Add here house calls... In the summer there are not very many of them, and in the winter there are p about 10-20 calls... According to the standard, 1 home call is assigned 30 minutes... So think for yourself how the doctor should be able to do everything in time, to satisfy everyone and at the same time not to spend the night at work.

There is not enough time, even if the doctor thinks and makes correct (!) Diagnoses at the speed of a supercomputer... But this is a hypothetical option. In life, everything is more complicated.

The population of the CIS countries is aging. This means that at an appointment with a specific doctor the proportion of elderly and senile people is increasing... Usually they have a bunch of illnesses, they move slowly and think, often hear poorly. Standard 12 minutes here definitely not enough... Reflection: in private medical centers to see a patient allowed 30 minutes.

Lots of paperwork... The doctor and nurse have to do a lot of unnecessary, bureaucratic work. In recent years the number of securities is only growing... When you come to an appointment, the doctor has no time to look at you - he is tensely scribbling on the card. And sometimes he does not have time, he has to stay “after school”. I already wrote about this earlier in the revelations of the district doctor.

All in all, work on the conveyor and according to the template gives the same boilerplate result. There is no time to think and reason. In ancient times it was called Procrustean bed.

Overwork... Because of such a rather strenuous work (clinic + home calls), not everyone can stand on the site of a district doctor. It is generally scary to go to some home calls in the dark and without protection. That's why there are not enough doctors in Belarus.

According to the statistics of the Belarusian Ministry of Health, on average every Belarusian doctor works at 1.3 rates... That is, there is a lot of work. Patients need to be served. Doctors have to work for themselves and “for that guy”. V November 2007 in Belarus, the average earnings were Br736.4 thousand ($ 342), and doctors - 1,051.3 thousand rubles ($ 488.2)... Doctors seem to be making relatively good money, so why are they complaining? Let's divide $ 488 by 1.3 bets, we get 375 dollars, that is, slightly above the average in the Republic of Belarus. If all doctors worked for exactly 1 rate, as they should, then they would receive the average salary in the country.

And they work for 1.3 bets not only from “innate greed”, but also because management asks to take a part-time job... The manager is responsible for the entire institution and must think about how to fill the staffing gap. Is it the fault of other patients that there is no doctor on their site? And money is also needed. And here the doctor is promised different bonuses for “ extended service area“, Bonuses ... Everyone needs money, because the salary of a doctor is small, especially for beginners.

Old joke:

Why do doctors work at 1.5 rates?

Because there is nothing for 1 bet, and there is no time for 2.

Burnout Syndrome... Occupations associated with working with people are prone to burnout syndrome (EBS). This is when work and sick bored to death, I want to literally not see them and, if there is no such possibility, even “ shoot”(I've heard this expression). According to some reports, about 50-60% of doctors have a CMEA at the initial stage and about 5-10% - in expressed degree. And work in constant nervous tension due to lack of time, fear of complaints (about them another time) and 1.5 bets this is very helpful.

But to whom will the doctor help, who himself needs to be treated?

Lack of incentives... In the public health care system, remuneration is weakly dependent on the number of patients. It doesn't matter if the office doors are empty or there are constant queues, the salary will not differ much. Hence, it is tempting to have fewer patients. Favorite excuses of these doctors:

I would live to see those years myself

what do you want at your age?

now everyone is sick with it

you are so special, I don’t know how else to treat you.

To reduce the flow of patients "are used" inattention, rudeness, routine treatment the simplest (ancient) drugs without proven effectiveness. As a result, patients have no desire to go to such a doctor again. The goal is achieved: the office has no queues... And patients turn to a paid medical center, where, by the way, the same doctor can conduct a part-time appointment.

This problem occurs because the doctor receives a salary not from patients, but from the state... In some ways, this system has its advantages (which ones - think at your leisure), but there are also many disadvantages. One consequence: admissions doctors subconsciously hate ambulance workers because they bring them work. After all, if the ambulance does not bring anyone, then you can do nothing for the whole shift, and the salary will not decrease from this. And also all doctors are very fond of shift work to a colleague if there is any formal possibility. Less work means less responsibility, better sleep at night. Think about it what kind of medicine do we need- paid or free?

Incompetence... If the doctor burnout syndrome, what kind of desire can there be to improve your professional level? And when a doctor works at 1.5 rates, then, with all his desire (which is rare), he simply no time to educate yourself... It's a pity, because medicine is constantly developing, doctors in the CIS have lagged significantly behind their foreign colleagues in the professional level ... There is a saying for good reason: every doctor has his own cemetery.

Once again incompetence... On the other hand, why do doctors need to know a lot if most patients cannot buy modern effective drugs due to their high cost? It’s not so much a matter of the price of drugs, but of a small pension or salary. It turns out vicious circle: patients cannot buy, doctors try not to prescribe. Moreover, this is included in doctor action template, and drugs are not prescribed even to those who can purchase them.

A ancient equipment, which has not been updated for many years and breaks down regularly, also does not cause any desire to improve its professional level. it psychological aspect, which I have personally noted.

Personality traits... To be honest, this the most important point but I deliberately put it at the end. Communication with the patient and relatives is a whole art, but very few people own and apply it. Medicine means “ give away“. Those who came here only to “receive” are disappointed and leave. This is what patients say about such doctors: “ I'd rather die at home, but I won't go to him“.

In the West the problem of bad doctors expressed to a lesser extent. There is a doctor - a person respected in society with a very decent salary. Working as an ordinary doctor “with us” can cause pity and sympathy those classmates who studied much worse, but now settled in the capital with a salary of 1.5-2 times more.

It is not easy to become a doctor abroad. Gotta endure big competition and be able to pay for studies... The clue lies in selection technologies... In the CIS and in the West, the selection of applicants for medical specialties of universities is significantly different. Take the selection of future doctors in Australia. Read this material yourself, and briefly I will say that our selection is only based on the amount of knowledge. In Australia and elsewhere, personal qualities: the ability to understand the interlocutor, feel him, empathize, support and much more. The selection is multi-stage, with several stages devoted to determining personal qualities of the future doctor: