Reflexology is a branch of medicine that is based on ancient Chinese teachings - acupuncture and acupuncture. She specializes in the treatment of various pathologies by influencing active points of the human body. A reflexologist is a doctor who must have a number of special skills and a diploma from a higher medical school.
A reflexologist has the skills to treat diseases by influencing active points
What does a reflexologist treat?
Each human organ corresponds to a certain number of active points on the surface of the body. The influence on these points can reflexively have one or another effect, accelerating or inhibiting its work.
A description of these points is present in the works of oriental doctors of antiquity, who widely used acupuncture and acupuncture in the treatment of diseases. These techniques were most widely used in Ancient China, where they were refined and honed to perfection.
The mechanism of action of such treatment methods is that exposure to the surface of the body at a certain point causes the appearance of nerve impulses that excite the nerves. Improved innervation occurs not only on the surface, but also in organs that are located nearby.
Impact on certain points affects the health of the body
A neurologist-reflexologist treats a wide range of conditions. Among them are diseases of an infectious, inflammatory, and neurological nature. Using acupuncture techniques, he can help treat diseases of the following organs and systems:
- Digestive tract. It is worth noting that a reflexologist treats pathologies that are localized in various parts of the gastrointestinal tract, starting from the esophagus and ending with the rectum.
- Diseases of the female reproductive system.
- Diseases of the endocrine glands.
- Foci of the infectious process in various organs.
Gastrointestinal diseases are treated using reflexology
- Pustular, allergic, inflammatory diseases of the skin.
- Immunity disorders and allergic reactions.
- Diseases of the musculoskeletal system.
- Sexual dysfunction in men and women.
- Neurological disorders.
- Pain of various etiologies.
The help of a reflexologist may be required if pathologies of the musculoskeletal system develop
Based on the above, a reflexologist treats a very large number of pathologies. It is worth noting that the treatment carried out by this specialist can be used as a separate type of therapy or combined with the use of medications.
Consultation with a reflexologist is indicated for patients who have undergone major surgery or injury. With its help, you can significantly speed up the rehabilitation process and reduce residual effects caused by pathology.
When to see a reflexologist
You can contact this specialist if almost all diseases appear. But the main symptoms for contacting such a doctor are:
A reflexology session will help get rid of depression
It is worth noting that the usual reason for contacting a reflexologist is the ineffectiveness of traditional treatment methods. This can occur as a result of an allergy to the group of drugs that are needed for etiotropic treatment or due to an atypical course of the disease.
Reflexology is the most recognized area of alternative medicine among specialists who base their treatment methods on taking medications, manipulations, and surgical interventions.
There is also a children's reflexologist, because not only adults face such diseases.
There are reflexologists who specialize in treating children
Examination methods
The reflexologist does not use special diagnostic methods. Since contacting this specialist often occurs after visiting medical institutions, patients have data from laboratory and instrumental studies.
If the patient initially came to the reflexologist, then the usual examination plan is prescribed, which is based on complaints and objective data:
If necessary, referrals for ultrasound, radiography, and tomography can be issued.
How is the appointment going?
The reception takes place in a specially equipped room. The reflexologist’s office should be equipped with a couch on which manipulations are performed, a place to store sterile acupuncture kits, as well as modern equipment for performing electropuncture and similar manipulations.
An appointment with a doctor begins with taking an anamnesis
An appointment with a reflexologist begins with identifying the patient’s complaints, as well as assessing his condition. Determining the localization of the pathological process is very important when examining a patient, since based on this data a manipulation plan is drawn up. This is due to the location of biologically active points responsible for the functioning of a particular organ.
If a patient’s chronic disease worsens during a visit to a specialist, the doctor should be informed about this. Having studied the medical history, the specialist can develop or select an individual treatment program that will be the most effective for this pathology.
A reflexologist may practice:
- acupuncture;
A reflexologist uses acupuncture to treat patients
- micro-acupuncture;
- thermopuncture;
- pharmacopuncture;
- acupressure;
- magnetic puncture, etc.
These are far from the only treatment methods. Many specialists have their own developed treatment methods. But not a single technique will be effective if the patient does not follow a number of recommendations from the attending physician.
Treatment by a reflexologist can be carried out using magnetic therapy
It is better to prevent a disease than to treat it. To protect yourself from many diseases, a reflexologist can give the following recommendations:
- provide rest to your body;
- timely and balanced nutrition;
- light physical activity;
- stay in the fresh air for at least an hour a day;
- timely and complete treatment of all diseases;
To keep your body healthy, you need to regularly spend time in the fresh air.
- absence of any independent intervention in the treatment of diseases.
The main task of a reflexologist is the prevention, diagnosis, treatment and rehabilitation of neurological, psychological, traumatic and pathological diseases. He can not only cure many diseases, but also conduct course therapy for preventive purposes and provide comprehensive advisory assistance.
Who is a reflexologist and what methods does the doctor use to treat patients, see the following video:
In accordance with the requirements of the specialty, a reflexologist must know and be able to:
1.General knowledge:
Fundamentals of healthcare legislation and policy documents defining the activities of healthcare authorities and institutions of the Russian Federation;
Fundamentals of organizing medical and preventive care in hospitals and outpatient clinics, ambulance and emergency medical care, the All-Russian Service for Disaster Medicine;
Fundamentals of medical ethics and deontology;
Principles of activity of healthcare institutions and medical workers in the conditions of insurance medicine, basic issues of economics in healthcare;
Fundamentals of social hygiene and sanitary-epidemiological service;
General principles and basic methods of clinical, instrumental and laboratory diagnostics of the functional state of organs and systems of the body;
Etiology, pathogenesis, clinical symptoms, clinical features, principles of complex treatment of major diseases.
2. A reflexologist must be able to:
Provide emergency medical care in case of injuries and life-threatening conditions, carry out resuscitation measures in terminal conditions;
Organize and conduct receptions of primary patients of various profiles in outpatient and inpatient settings;
Obtain information about the general condition of the patient, identify general and specific signs of the disease in accordance with generally accepted modern medical criteria;
Determine the necessary complementary general and special research methods and analyze the data obtained;
Prescribe and carry out the necessary treatment using reflexology methods and complex treatment using them;
Apply the principles of communication psychology necessary in the work of a doctor, basic psychotherapeutic skills, and carry out sanitary educational work among the population;
Prepare medical documentation, apply statistical methods in healthcare, use a personal computer;
3. Special knowledge.
3.1. A reflexologist should know:
Organization of the reflexology service in the Russian Federation, its organizational and methodological structure, current directive and instructional documents; tasks and structure of regional and regional clinical centers of reflexology;
Tasks, work organization and functional responsibilities of employees of centers, departments and reflexology rooms;
Principles for planning activities and reporting of reflexology service institutions;
Methodology for checking the organization of reflexology services in the structures of health care authorities;
General methodology and underlying theoretical concepts of traditional acupuncture;
Traditional and modern theories of the mechanisms of therapeutic, preventive and rehabilitation effects of reflexology means and methods, indications and contraindications for their use;
Topography of corporal acupuncture channels and points, their classification, methods for specifying localization, indications for use, their diagnostic and therapeutic significance;
Topography of microacupuncture systems (auricular, cranial, hand-foot, nasal, oral), their diagnostic and therapeutic significance;
Special diagnostic methods used in reflexology, based on measuring bioelectric temperature, morphological and physiological parameters of acupuncture points;
Diagnostic value and interpretation of indicators recorded from acupuncture points;
Anatomical and histological foundations of reflexology, general physiology and pathophysiology of the central and peripheral nervous system, analyzer (visual, auditory, somatosensory) systems, physiology and pathophysiology of the autonomic nervous system and regulation of autonomic functions, physiology and pathophysiology of higher nervous activity;
Morpho-functional features of acupuncture points and channels, their innervation and vascularization;
Structural and functional foundations of viscero-somatic and somato-visceral reflexes that underlie reflex diagnostics and participate in the development of the therapeutic effects of reflexology;
Mechanisms of reflexology implemented by the somatic and autonomic nervous systems, peripheral and central levels of development of therapeutic effects;
Mechanisms of development of reflex analgesia, modern theory of pain, morphofunctional organization of nociceptive and antinociceptive systems of the body;
Biochemical and biophysical foundations of reflexology, other sections of fundamental medical and biological sciences, provided for by the unified training program for reflexotherapists;
General principles and specific schemes for combining reflexology methods with other methods of treatment, prevention and rehabilitation for various diseases and pathological conditions;
Application of reflexology methods in all areas of clinical medicine where they are not contraindicated;
The use of reflexology during clinical observation for preventive and rehabilitation purposes, in sanatorium and resort institutions.
3.2. Special skills:
Conduct a clinical examination of the patient, make a diagnosis according to modern nosological nomenclature and carry out differential diagnosis with related pathologies;
Conduct special diagnostics of the functional state of acupuncture channels and micro-acupuncture systems, using palpation, instrumental, hardware-software and other methods,
provided for by the unified training program for a reflexologist;
Identify indications and contraindications for reflexology;
Determine the optimal reflexotherapy methods for a given patient, their combination and use in complex treatment;
Carry out classical (acupuncture, moxibustion) and modern (electrical, laser, etc.) therapeutic methods of influencing acupuncture points and micro-acupuncture systems;
Provide for possible complications of reflexology;
Use emergency reflexology;
Use reflexology as an independent method of treatment and as an element of complex treatment for all nosological forms that have indications for its use.
TEACHING THE SPECIALTY "REFLEXOTHERAPY"
Postgraduate professional education in the specialty "Reflexology" has its own significant features, which leave an imprint on the entire organization of the educational process, forms and methods of conducting training sessions.
The residency training program has two sections: professional training and electives. Professional training accounts for 85% of all study time and includes theoretical and clinical training. The theoretical part makes up at least 5% of the study time and includes issues of the theory of reflexology, health care management issues, insurance medicine, and maintaining medical records. Clinical training takes up 80% of the training time, necessarily including 8 weeks of resident work in the clinic for the entire training period.
Elective courses in residency are aimed at more in-depth training in a specialty, its sections or related disciplines.
After the end of each stage of the educational and professional program, a final certification is carried out, and issues of training in related disciplines, healthcare management and electives are included in all forms of monitoring the knowledge of residents and cadets.
When conducting the educational process, focused on the qualification characteristics of a reflexologist, the following forms are used: lecture, seminar, practical classes, independent work of cadets.
An educational lecture is one of the forms of systematic training sessions, the task of which includes: determining the content of the subject being studied, familiarizing students with the development of science in the specialty "Reflexology", its connections with other scientific problems and health care practice, the formation of deontological principles.
The most complex theoretical sections of the course, which require deep understanding and logical presentation, are presented at the lecture. Depending on the goals and content, the following types of educational lectures are distinguished:
The introductory lecture introduces cadets to the essence of reflexology, the history of its development in Russia and abroad, its connection with other medical and biological problems, the latest achievements of science, and issues of healthcare organization.
The review lecture concerns general, leading problems of reflexology, taking into account the latest achievements of domestic and foreign medical and biological science.
A thematic lecture is part of a systematic course of lectures, devoted to the analysis of one topic or one section of the curriculum.
The structure of the lecture includes an introduction containing the purpose of the lecture, the main presentation of the material and a conclusion with brief conclusions on individual sections of the lecture. Lectures are given by the most qualified teachers - the head
department, professor, associate professor. The volume of lectures in hours and by topic is determined by the curriculum of the cycle; the number of lecture hours per day should not exceed 4 academic hours (45 minutes).
For each lecture, methodological developments are drawn up, containing the title of the lecture, the amount of teaching time, its goals and objectives, the number of students, the sequence of presentation of the material (plan or outline), the nature of the illustrative material, a list of basic literature on the topic of the lecture. Lectures are previously discussed at a methodological meeting of the department.
Lectures are given in a specially equipped room that allows you to demonstrate tables, slides, instruments and work with other technical teaching aids. The lectures are attended by all students of the series, who are first introduced to the topic of the lecture.
The teaching load of the teacher giving the lecture is taken into account according to the time actually spent and is noted in the department’s teaching load journal and the report of the cycle curator.
2. SEMINAR.
A seminar is a systematic, most active and effective form of the educational process, facilitating a deep and detailed assimilation of the educational material included in the curriculum.
General goals of the seminar: deepening and consolidating the theoretical knowledge of cadets in a specific section, topic of the curriculum, developing skills and abilities to use them, developing the logic of thinking, the ability to make the right decision. The seminar is an important link between the theoretical development of the specialty of reflexology and the application of these provisions in practice, and serves to develop professional qualities and scientific thinking in cadets.
As a rule, the most complex sections of the program are brought to seminars, requiring deep understanding, logical actions, and the development of specific solutions. The volume in hours, topics and content of seminars are determined by the curriculum of the cycle.
In preparation for the seminar, the teacher should:
Clearly define the goals and objectives of the seminar, give it a name in strict accordance with the curriculum of the program,
Draw up a methodological development of the seminar, containing the order of work, a list of questions for discussion and literature necessary for preliminary study,
Use the content of theoretical classes (lectures) on the topic of the seminar.
Preliminary independent preparation of cadets for seminars is mandatory. It includes an introduction to the topic of the upcoming seminar, a list of issues discussed and the necessary literature. The duration of one training hour of the seminar is 45 minutes, the total duration of the seminar is from 1 to 4 hours. The management of the seminar is entrusted to the most methodologically experienced and trained teachers from among professors, associate professors, assistants, and in some cases - practical healthcare workers.
Increasing the effectiveness of seminars is facilitated by providing them with auxiliary means, which include posters, tables, diagrams, technical teaching aids, as well as educational and methodological materials (reference books, methodological developments).
Depending on the goals and objectives of training, the following types of seminars are used:
The seminar-colloquium is held to test the mastery of in-
formation received in classes, repetition and consolidation of knowledge, and their evaluation. The methodology consists of questions and answers (orally or in writing). Programmed test knowledge control. The teaching load is calculated based on the actual time spent according to the schedule of the teacher leading the seminar.
A seminar to discuss test work is held in order to clarify unclear issues and consolidate information. The teacher leading the seminar gets acquainted with the students' test papers and analyzes the mistakes made. The teaching load is calculated based on the actual time spent according to the schedule of the teacher leading the seminar.
The seminar-discussion is held with the aim of communicating new information, developing thinking, the ability to apply knowledge in practice, and introducing cadets to scientific activities. The teacher leading the seminar raises problematic issues for discussion, conducts a discussion, evaluates the discussion and sums up the results. The teaching load is calculated based on the actual time spent according to the schedule of the teacher leading the seminar.
A seminar-conference is one of the forms of a seminar, which is a link between the theoretical principles of science and their application in practice. The general goal of the seminar-conference is to communicate new information (results of scientific research, testing of new methods of diagnosis, treatment, rehabilitation, prevention, etc.) by one of the cadets of the cycle. The structure of the seminar-conference includes an introductory part, a speech by the speaker, a speech by co-speakers (reviewers), a discussion on the main provisions of the report, and a conclusion by the teacher leading the seminar-conference. The seminar-conference is conducted by the head of the department, professor or associate professor with all cadets of the cycle. The teaching load of the faculty of the department participating in the seminar-conference is determined from the actual time spent and taken into account by the conference leader and all teachers present at it.
A seminar - educational and abstract conference is one of the forms of a seminar that promotes a deeper and more detailed understanding of the subject, serves as a school of scientific thinking, the formation of the student’s creative thought, the connection between the theoretical principles of reflexology and their application in practice, and the development of interest in searching the literature for the necessary information , developing your own opinion as a future medical specialist. At the very beginning of the cycle, the head. The department and the curator, taking into account the composition of the cadets and the level of their training, outline the topics of the most relevant abstract reports and distribute the topics among the cadets. For each message, a consultant from among the teachers is appointed to help cadets in searching and selecting the necessary literature. The educational and abstract conference is conducted by the head. department or professor. Conducting an educational and abstract conference is possible by reducing the volume of the lecture part of the course. The frequency of educational and abstract conferences is no more than 1 time per 2 weeks. The educational and abstract conference is carried out with the entire cycle. The teaching load is taken into account for all teachers who took part in the conference.
The excursion seminar introduces cadets to the latest achievements in the science and practice of reflexology, promotes a deeper understanding of the subject, and broadens the horizons of future medical specialists. The object of the seminar-excursion can be departments and reflexology rooms of a medical institution, departments
and laboratories of various areas and problems of reflexology at research institutes. The objectives of the seminar-excursion are to familiarize yourself with work experience, familiarize yourself with the achievements of science, and development prospects. The main employees of the site being visited should be involved in conducting the seminar-excursion. The seminar-excursion is conducted with cadets of the entire cycle and is reflected in the class schedule and the teaching load log. The teaching load is taken into account by the curator of the cycle or the teacher accompanying the cadets of the cycle.
3. PRACTICAL LESSONS.
Practical training is one of the forms of systematic training sessions, close to the real working conditions of a medical specialist, aimed at developing the independence of cadets and acquiring the necessary skills and abilities for practical work.
Practical training in the cycle of specialization in reflexology is the most important component of the general course and consists of mastering the section on the anatomical foundations of reflexology, topography of acupuncture points, methods for determining the localization of acupuncture points, application of knowledge on the use of various methods of reflexology (classical corporal and auricular, electropuncture, laser puncture, etc. .). Practical training also includes patient supervision.
Practical classes can be of a demonstration or independent nature, during which cadets, on the recommendation of the teacher or according to methodological instructions, carry out the necessary stages of work. The duration of one lesson is 45 minutes, the total duration is no more than 6 hours per day. List of skills and abilities that a cadet must master during practical training
classes, is determined by the qualification characteristics of the reflexologist (Appendix 3 of the Order of the Ministry of Health of the Russian Federation N364 of December 10, 1997).
In preparation for a practical lesson, the teacher determines the goals and objectives of the lesson, provides the necessary equipment and other technical means, and draws up a methodological development, including criteria for monitoring knowledge, skills and abilities. The teaching load is calculated based on the actual time spent according to the schedule of the teacher conducting the practical lesson.
4. INDEPENDENT WORK OF CADETS.
Independent work of cadets, performed without the direct participation of the teacher, but on his instructions, is the main form of organizing the educational process. Independent work includes activities of various forms and organization, reflecting the types of activities of the doctor:
Working with educational literature and teaching aids,
Work in the form of educational tasks and exercises for drawing up acupuncture treatment programs (combination of acupuncture points depending on complaints, the patient’s condition, clinical and hardware acupuncture diagnostics),
Test and situational tasks,
Preparation of review, abstract and scientific reports,
supervision of patients, etc.
5. SYSTEM FOR CONTROL AND ASSESSMENT OF KNOWLEDGE.
Knowledge control is the main element of management of educational activities and is in close connection with other elements
pedagogical system - educational goals, organizational forms of training, didactic processes. The assessment of the knowledge and skills of students must be comprehensive, taking into account the requirements for the level of professional competence and qualifications of a medical specialist. The assessment of knowledge and skills is carried out primarily in relation to those actions of the cadet that are necessary for him to perform professional activities.
Training control is carried out at all stages of the educational process. There are preliminary (introductory, basic), current and final control. Basic control is carried out at the very beginning of classes in a cycle in order to determine the level of preparedness of cadets. This makes it possible to make adjustments to the curriculum of the cycle, correctly staff groups, and optimally structure individual training. Current monitoring is carried out during training sessions in order to establish the degree of mastery of educational material at a certain stage of training upon completion of a specific topic or section of the program. The final control (exam) is carried out at the end of training in order to evaluate the learning results and the level of achievement of educational goals.
Test questions and tasks must correspond to the learning objectives and relate to assessing the level of professional qualifications of each medical specialist. The following control methods are possible:
Control by the teacher
Control using technical means,
Self-control
Self-control using technical means.
The choice of control methods is determined by the goals of control, the contingent of cadets, the availability of control programs and technical means of control. They use various control methods: oral, written, practical and test.
Oral control will be exchanged during lectures, seminars and practical classes at all stages of the educational process. Its purpose is to assess the level of knowledge, understanding of educational material, logic of thinking.
Written control in the form of written tests, educational exercises, reviews, abstracts, reports is used at all stages of training.
Practical control, which evaluates, first of all, practical, manual skills and abilities in reflexology, is used as the results of a practical lesson and as a final exam to evaluate the achieved result.
Test control makes it possible to quantitatively assess learning results and measure (qualimetry) the amount of knowledge with minimal time spent in both small and large training groups. It is used as a basic and final control without and with the help of technical means. The set of test tasks must completely cover the content of the training program in the specialty (the “test bank” usually contains from 1500 to 2000 test tasks and sample answers).
Test classes can be conducted in the form of a seminar or practical lesson. The teaching load of the teaching staff conducting training monitoring is calculated based on the actual time spent.
The unsatisfactory state of the medical rehabilitation system and the lack of its necessary regulatory and legal framework in the country are noted in the Concept for the development of the healthcare system in the Russian Federation until 2020.
One of the components of rehabilitation medicine is reflexology and it is fully affected by the problem of imperfection and inconsistency of the regulatory framework. Individual documents from the system of legal support for the activities of a reflexologist often do not have a logical relationship with each other.
In particular, the equipment of a reflexology room is stipulated by two regulations:
Order M3 of the Russian Federation No. 38 dated 02/03/1999 “On measures for the further development of reflexology in the Russian Federation” (Appendix No. 10).
Order of the Ministry of Health of the Russian Federation No. 753 of December 1, 2005 “On equipping outpatient clinics and inpatient clinics in municipalities with diagnostic equipment” (Appendices No. 1,3,4);
At the same time, the table of equipment for the reflexology room, presented in Order M3 of the SR RF No. 753, is not identical to the similar report card in Order M3 of the Russian Federation No. 38.
State reflexology services are regulated by four current regulations:
Order No. 364 of December 10, 1997 “On the introduction of the specialty “Reflexotherapy” into the range of medical and pharmacist specialties”;
Order of the Ministry of Health of Russia No. 38 dated 03.02. 1999 “On measures for the further development of reflexology in the Russian Federation”;
Order of the Ministry of Health of Russia No. 210n dated April 23, 2009 “On the nomenclature of specialties of specialists with higher and postgraduate medical and pharmaceutical education in the field of healthcare of the Russian Federation”;
Order of the Ministry of Health of Russia No. 415n dated July 7, 2009 “On approval of qualification requirements for specialists with higher and postgraduate medical and pharmaceutical education in the field of healthcare.”
The last two orders are not entirely consistent with the first and with the State Standard for postgraduate professional training of specialists with higher medical education in specialty No. 040109.02 “Reflexology” approved by the Ministry of Health (Moscow, 2000), which regulates the training of reflexotherapists in clinical residency, general advanced training courses, and certification cycles, cycles of thematic improvement.
In addition, these orders are difficult to compare with the regulatory document that regulates the profile of pathology that requires the intervention of a reflexologist: Order of the Ministry of Health of the Russian Federation No. 266 of April 13. 2007 “On approval of recommended lists of medical indications and contraindications for the use of reflexology in clinical practice.”
The lack of system in the formation of the regulatory framework creates a discrepancy between the profile of diseases recommended for treatment by reflexology methods and the profile of specialists who are charged with its implementation.
Order of the Ministry of Health of the Russian Federation No. 266 is one of the most significant regulations on reflexology adopted in recent years. He gives clear, ICD-10-compliant statements of indications for the use of reflexology. These include: gastric ulcer and duodenal ulcer not specified as acute or chronic (K25.9. K26.7), chronic non-calculous cholecystitis (K81.1), recurrent bronchitis (diagnosis used in pediatrics) (J40.0), chronic obstructive bronchitis (J44.8), bronchial asthma (J45), pulpitis (K04.0), non-suppurative otitis media (H65), endometriosis (N80), kraurosis of the vulva and vagina (N90.4 and N89.8), chronic prostatitis (N41.1), etc. The effectiveness of using reflexology for all of the listed diseases has been confirmed by numerous studies and is reflected in the extensive literature of recent decades, both domestic and foreign.
In addition to Order No. 266, the use of reflexology for various pathologies is also regulated by the Standards of sanatorium care for patients with diseases of the esophagus, stomach and duodenum, intestines (Order of the Ministry of Health of the Russian Federation No. 278 of November 23, 2004), patients with obesity and other types of excess nutrition, disorders metabolism of lipoproteins and other lipidemias (Order of the Ministry of Health of the Russian Federation No. 223 of November 22, 2004), patients with diseases of the liver, gall bladder, biliary tract and pancreas (Order of the Ministry of Health of the Russian Federation No. 277 of November 23, 2004), patients with ear diseases and mastoid process, upper respiratory tract (Order of the Ministry of Health of the Russian Federation No. 275 of November 23, 2004), patients with urolithiasis and other diseases of the urinary system (Order of the Ministry of Health of the Russian Federation No. 210 of November 22, 2004), etc.
Thus, the regulatory framework presents a spectrum of very diverse pathologies indicated for reflexology. In this regard, it is not clear why the conduct of reflexology in Order No. 415n is legally assigned primarily to a medical specialist who has a postgraduate professional education in the specialty “Neurology,” while Order No. 210 clearly requires specialization in neurology for all reflexotherapists.
The qualifications of healthcare specialists are also regulated by Order of the Ministry of Health and Social Development of Russia No. 541i dated July 23, 2010 “On approval of the Unified Qualification Directory of Positions of Managers, Specialists and Employees”, section “Qualification characteristics of positions of workers in the field of healthcare”. According to clause 1.6 of the Appendix to the specified regulatory document: “Persons who do not have the appropriate additional professional education or work experience established by the qualification requirements, but have sufficient practical experience and perform efficiently and in full the job responsibilities assigned to them, on the recommendation of the medical certification commission organizations, as an exception, can be appointed to appropriate positions, as well as persons with special training and the necessary work experience. The employer is taking measures for further professional training of the mentioned persons.” In relation to a doctor-reflexologist, this position of the order quite clearly requires that, in addition to specialization in reflexology, postgraduate professional education in the specialty “Neurology”, although it provides some temporary deferment (which can be used, but realistically only until the next licensing or accreditation).
At the same time, postgraduate training programs for doctors in neurology (specialization and improvement) are concentrated exclusively on neurological pathology, and do not include issues of pathogenesis, clinical picture and diagnosis of somatic and any other diseases, including those for which the use of reflexology is indicated. Thus, high-quality reflexology for patients suffering from non-neurological diseases requires the additional participation of a specialist in the profile of the disease. In addition to additional financial costs for the healthcare system, in outpatient practice this provision creates additional barriers for the patient: the need to regularly visit two doctors, possibly with different schedules and queues for appointments, which reduces the availability of treatment and patient compliance. The regularity of such visits is unlikely. As a result, an assessment of the dynamics of the condition of a patient with bronchial asthma or peptic ulcer disease, carried out during a course of reflexology only by a specialist - a neurologist, will inevitably be focused primarily on neurological criteria and the patient’s self-assessment, which does not reflect the interests of the patient himself and is not consistent with the relevant protocols for the management of patients (Order Ministry of Health of the Russian Federation No. 241 of November 22, 2004 “On approval of the standard of medical care for patients with gastric and duodenal ulcers”; Order of the Ministry of Health of the Russian Federation No. 678 of September 25, 2006 “On approval of the standard of medical care for patients with asthma”, etc.)
The optimal situation, in our opinion, would be a situation where the doctor performing reflexology treatment of somatic, gynecological, otolaryngological, traumatology and orthopedic patients would be a specialist in the appropriate profile and, during the treatment process, would examine patients in accordance with the provisions of the relevant standards. The same opinion was shared by one of the leading Russian specialists in the field of reflexology, Professor V.G. Vogralik. In this case, the patient should be examined to the extent necessary and sufficient to assess the dynamics of the condition in this pathology. However, in this case, the costs for the implementation of basic specialization in neurology for a reflexologist were not justified. The costs (financial and time) of mandatory residency in reflexology for therapists, orthopedists or pediatricians working with specialized patients also do not seem justified.
Inconsistency of standards results in irrational costs and reduced availability of specialized medical care.
We see a solution to the problem in different ways. Improving the quality, cost-effectiveness and accessibility of reflexology could be facilitated by adjusting the qualification requirements for a reflexologist, namely, by introducing into the paragraph of the regulatory document regarding reflexology a reference to Appendix 5 to the current Order of the Ministry of Health of Russia dated 02/03/1999 No. 38 “On measures for further development of reflexology in the Russian Federation" ("Regulations on the doctor of the office (department) of reflexology"): "A specialist with a higher medical education in the specialty "General Medicine" or "(Pediatrics), who has undergone postgraduate training (internship) is appointed to the position of doctor of the office (department) , residency) or specialization in reflexology in licensed educational institutions.”
The positive aspects of this solution: firstly, it allows you to link two existing regulatory documents. Secondly, it is possible for specialist doctors in different fields to acquire the additional specialty of reflexologist and apply the acquired knowledge in their field.
A similar approach, by the way, is implemented in Order of the Ministry of Health and Social Development of Russia No. 415n dated July 7, 2009 regarding the qualification characteristics of a physiotherapist.
Physiotherapy and reflexology appeared in the medical lexicon almost simultaneously: “physiotherapy” in 1905 in Belgium, and “reflexology” in 1912 in France. Already known by that time in European countries, including Russia, the methods of ancient Chinese medicine - acupuncture and moxibustion - could equally be attributed to both physiotherapy and reflexology. The modern arsenal of physiotherapy technologies, as well as reflexology, is widely used in almost all areas of clinical medicine. The methodologies and methods of both medical specialties mutually enrich each other. It never occurred to anyone to limit the ability of doctors to specialize in physical therapy to any one basic medical specialty. Why this should be done in relation to reflexology defies any logical explanation.
At the same time, the issue of studying reflexology as part of basic medical education is long overdue. This specialty must be studied at different stages of medical personnel training, starting from the third year, as well as as a separate discipline in the training program for fifth-year students, when the clinical thinking of future specialists begins to form. For doctors of the 21st century, mastery of reflexology and reflexology is especially important due to the ability to conduct an integrative assessment of the patient’s health, both in the initial state and in the process of correcting identified functional disorders not only of the damaged segment, but of the entire organism as a whole, while simultaneously assessing the adequacy and effectiveness ongoing therapeutic measures.
It should be noted that over the past 10-15 years, the standards regulating the professional activities of a reflexologist have changed several times. As a result, we have a cadre of reflexotherapist doctors who at one time received their specialty on the basis of previously existing regulations and do not fit into the current regulations. The problem of the consequences of repeated redrawing of standards was taken into account in note 4 of Order of the Ministry of Health of the Russian Federation No. 112n dated March 11, 2008. “On the nomenclature of specialties of specialists with higher and postgraduate medical and pharmaceutical education in the field of healthcare of the Russian Federation,” which was in force until April 2009. According to the note to this order, persons who have received the right to professional activity in their specialty, as well as those enrolled in postgraduate programs professional and additional vocational education in accordance with previously valid regulations, retain the right to professional activity and further education in accordance with the existing specialty. This note, apparently, should be included in the new regulatory documents.
Thus, the current situation with the regulatory support of reflexology does not contribute to improving its quality and accessibility, leads to ineffective costs, loss of experienced personnel and therefore requires correction. Further development of the legal framework for the activities of reflexology specialists should ensure continuity and interconnection of individual regulatory documents. The inclusion of this discipline in the compulsory training program for medical students will undoubtedly bear fruit in the near future.
Literature.
1. Vasilenko A.M. Integration of the principles of physiotherapy and reflexology into dynamic electrical neurostimulation technologies. // Collection of materials from the international symposium dedicated to the 10th anniversary of DENAS MS Corporation, Yekaterinburg. - 2008. p.
2. Vasilenko A.M., Osipova N.N., Shatkina G.V. Lectures on reflexology: Textbook. - M.: Su Jok Academy Publishing House, 2002.-374 p.
3. Vogralik V.G. Vogralik M.V. Acupuncture: Basics of traditional oriental and puncture adaptation-energizing therapy of qi-gong. - M.: GOU VUNMTs M3 RF, 2001.
4. Ponomarenko G.N., Turkovsky I.I. Biophysical foundations of physiotherapy: Textbook. - M.: Medicine, 2006. - 172 p.
5. Grigoriadi N.V., Yablochkina T.N. The place of reflexology in modern medicine. New aspects of indications and contraindications for the use of reflexology in clinical practice (based on the Order of the Ministry of Health and Social Development of the Russian Federation No. 266 of April 13, 2007) // Doctor and pharmacy of the XXI century. - 2008.-9.-s. 12-14.
6. Breuner, S.C. Complementary Medicine in Pediatric: A Review of Acupuncture, Homeopathy, Massage, and Chiropractic Therapies. Pediatric and Adolescent Health Care. 2002, T. 32, N 10, p. 351-366.
7. Diehl, D. L. Acupuncture for gastrointestinal and hepatobiliary disorders //J. Altern. Comp. Med. - 1999. - N.5. - p.27-45.
Editor's comment.
Article by Doctor of Medical Sciences A.G. Polyakova and Ph.D. E.I. Maziloy continues and develops the discussion of this topic that took place back in 2002. The beginning was made by the following letter, published in No. 3 (3) of the magazine “Reflexotherapy” for 2002.
On the place of reflexology in the range of medical specialties.
Open letter to the first deputy
Minister of Health of the Russian Federation A.I. Vyalkov.
Dear Anatoly Ivanovich!
The decision of the Board of the Ministry of Health of the Russian Federation, held on March 20-21, 2001, provided for a revision of the nomenclature of medical specialties in 2002 (Medical Newspaper No. 1, January, 2002, P. 13). The issue of nomenclature is one of the most fundamental in all areas of knowledge and any human activity. The revision of the nomenclature is intended to help ensure the progress of the industry as a whole and the optimal development of its individual areas. The identification of a particular area of medical activity as a specialty should be based on certain criteria and objective realities of medical science and practice.
At present, the question of universal criteria for the formation of a nomenclature of medical specialties remains open. Most often, specialties are distinguished according to the criterion of the affected system; in other cases, the criteria of the predominant method of treatment, the main pathogenic factor, the most relevant goal of providing medical care or its stage are used. At the same time, some types of medical activities are awarded the title of primary specialty, others - additional, many remain in the rank of methods. At the same time, again, there are no objective criteria for classifying a particular medical activity, technology or method into the appropriate category.
The following formulation of the criterion for a medical specialty can be proposed for discussion: an area of medical activity characterized by a relatively specific holistic system of diagnosis and treatment, effective at various stages of medical care.
Along with obvious advantages, medical specialization also has negative consequences. Narrowly professional clinical thinking sometimes prevents the doctor from seeing the patient in all the diversity of his internal and external relationships. The principle of “treating the patient, not the disease” often fails to be implemented in practice. Patient management, despite the declared comprehensive approach, is often carried out sequentially.
The progress of medicine, like any other science, requires optimal balance between analytical and synthetic methods of cognition. Stefan Zweig owns the following words: “One can feel among the smartest and most humane doctors a longing for the old universalism, a desire to find ways from closed, localized pathology to constitutional therapy, awareness not only of individual diseases, but also of the person’s personality. Having explored the body down to the molecule, creative curiosity turns its gaze again towards the wholeness of the disease, different in each case.” Indeed, the attention of the progressive public has always been attracted by directions based on a holistic approach to man and his diseases in inextricable unity with the environment. This is how psychosomatics arose in European medicine and psychotherapists appeared.
The holistic approach is clearly evident in traditional Eastern medicine, in particular acupuncture. Gradually, a broader area of medicine, which in 1912 received the name “reflexotherapy,” which initially did not contain any restrictive instructions regarding the modality of therapeutic effects and the participation of certain sensory systems, turned out to be “monopolized” by acupuncture. Now we are restoring reflexology (RT) to its original, broader understanding, defining it as a therapeutic and preventive system based on assessing the parameters of peripheral reflexogenic zones and influencing them in order to regulate the functional systems of the body.
RT is characterized by the presence of a specific holistic system of diagnosis and treatment. Its effectiveness at various stages of medical care is proven both by the centuries-old “survivability” of the method and by modern data from clinical and experimental studies. Thus, RT meets the criterion of a medical specialty. According to the above definition, music, aroma, light and color therapy are returning to the fold of RT. Multifaceted research and clinical practice have provided RT with a modern scientific base. RT is recognized as a universal method aimed at regulating stress reactions and adaptation in all the diversity of their physiological and clinical manifestations.
In 1997, by order of the Ministry of Health of the Russian Federation No. 364 dated December 10, 1997, the Republic of Tatarstan was included in the nomenclature of medical and pharmacist specialties, and the regulations on the reflexologist, his qualification characteristics and certification procedure were approved. In 1999, by order of the Ministry of Health of the Russian Federation No. 38 dated 03.02 “On measures for the further development of reflexology in the Russian Federation”, regulations on the office and department of the RT and staffing standards for their personnel were determined.
Order M3 of the Russian Federation No. 337 dated August 27, 1999, according to which only doctors with a specialization in neurology have the right to receive a RT certificate, caused severe damage to the development of the RT service. It has been convincingly proven that RT is effectively used in many areas of clinical medicine, including those far from neurology.
However, the misfortunes of the Republic of Tatarstan did not end there. On 06/05/2002, order No. 186 was signed to amend Appendix No. 1 to Order No. 290 of the Ministry of Health of Russia dated 07/26/2001, which introduces paragraph 84 - Chief specialist in traditional medicine, and traditional medicine itself means “reflexotherapy, manual therapy, herbal medicine” , homeopathy, etc.”
The last of the cited orders introduced additional misunderstanding into the organization of the RT service. According to the current nomenclature, RT belongs to neurology, according to order No. 186 - to traditional medicine, which is generally absent in the nomenclature of medical specialties.
The belonging of RT to neurology is formallysignificantly limits the scope of its use and the receipt of appropriate training by doctors. Doctors - representatives of many areas of clinical medicine, in which RT has been used for a long time and very effectively, are forced to first obtain specialization in neurology. Thus, the 4-month training provided for by the unified postgraduate training program in RT should be preceded by a 5-month specialization in neurology. Please note that training is carried out on a full-time basis, away from work. Now let's ask the chief physician of any medical institution - is he ready to let his employee go for 9 months so that he receives a reflexologist certificate? - The answer will almost certainly be negative.
It is also not justified to classify RT as so-called traditional medicine. According to the definition adopted by WHO, traditional medicine is a body of knowledge and skills (whether or not they have received a logical explanation) applied in the process of prevention, diagnosis and treatment of physical, mental and social health disorders and based solely on practice and observations transmitted from generation to generation in oral or written form. Even in classical acupuncture, diagnostic and treatment algorithms are based on general scientific Chinese methodology, and not “solely on practice and observation.” Moreover, modern RT does not meet the criteria of traditional medicine formulated by WHO, the sanogenetic mechanisms of which are interpreted from the standpoint of the latest achievements of fundamental and biomedical sciences, and the methodological arsenal includes the latest information technologies.
A lot depends on which section of the nomenclature RT falls into - starting from the personnel training system, everyday issues of organizing the relevant service and the work of specialists, ending with the prospects for further development of the area. The above definition allows us to consider RT as an independent medical specialty, similar to the specialty of a family doctor. However, the revision of the nomenclature provides for a reduction in the total number of specialties, and not its increase.
RT is effectively used at various stages of medical care, but is most widely and reasonably used in prevention and rehabilitation. In most health care institutions, reflexologists most often work in rehabilitation departments. The largest number of candidate and doctoral dissertations devoted to RT are considered by the Academic Council at the Russian Scientific Center for Rehabilitation Medicine, Resortology, Physiotherapy and Physical Therapy.
When preparing the final edition of the nomenclature of medical specialties, we ask you to resolve the issue of the place of RT in it, taking into account the given circumstances and arguments.
Sincerely.
Chief Editor
magazine "Reflexotherapy"
A.Vasilenko
* * *
Since there was no response to this appeal, the Medical Newspaper published another, more detailed letter in the April (No. 4) issue - an invitation to a discussion on this topic.
Nomenclature of medical specialties: the place of reflexology - an invitation to discussion.
One of the most important conditions for the progress of medicine, like any other science, is the optimal balance between analytical and synthetic methods of cognition. Stefan Zweig owns the following words: “One can feel among the smartest and most humane doctors a longing for the old universalism, a desire to find ways from closed, localized pathology to constitutional therapy... Having explored the body down to the molecule, creative curiosity again turns its gaze towards the integrity of various diseases in every case." The specialization of doctors is a natural consequence of the success of the analytical approach in medicine. As knowledge about etiopathogenesis, the variety of forms of clinical manifestations of any pathology deepens, and therapeutic and preventive methods of combating it improve, new medical specialties are emerging. This natural process is correspondingly reflected in the nomenclature of medical workers.
Despite the obvious advantages, medical specialization may conflict with the interests of the patient. Narrowly professional clinical thinking sometimes prevents the doctor from seeing the patient in all the diversity of his internal and external relationships. The principle of “treating the patient, not the disease” often fails to be implemented in practice. Therefore, the attention of the progressive public has always been attracted by directions based on a holistic approach to man and his diseases, not only in the inextricable unity of all his internal relationships, but also in all the diversity of his interaction with the environment.
Let us turn to the current nomenclature of medical specialties. What principles underlie its formation - the designation of one or another medical activity as a specialty? Some specialties are formed according to the criterion of the affected system (dermatology, neurology,..). In other cases, criteria for the preferred method of treatment are used (surgery, physiotherapy,..); main pathogenic factor (traumatology, infectious diseases,...); stage or most relevant goal of medical care (resuscitation, rehabilitation...). Some types of medical activities are included in the nomenclature as the main specialty, while others are classified as “requiring additional specialization.” Many types of medical activities are not included in the nomenclature, remaining in the rank of treatment and prophylactic methods. Almost until 1998, the latter included reflexology (RT).
By order of the Ministry of Health of the Russian Federation No. 364 of December 10, 199? The city of the Republic of Tatarstan was introduced into the nomenclature of medical and pharmacist specialties, regulations on a reflexologist, his qualification characteristics and certification procedure were approved. In 1999, by order of the Ministry of Health of the Russian Federation No. 38 dated February 3, “On measures for the further development of reflexology in the Russian Federation,” the provisions for the office and department of the RT and staffing standards for their personnel were determined. However, in August of the same year, in accordance with the order of the Ministry of Health of the Russian Federation No. 337 dated August 27, 1999, the Republic of Tatarstan was classified as one of the specialties requiring additional training of neurologists.
Following the formal logic of this order, only neurologists can legally provide certified reflexology care in all areas of clinical medicine, where there is a wide range of indications for it. Where can you find so many neurologists, and even those with a specialization in RT, to treat many diseases of internal organs, gynecological diseases and provide obstetric care using RT methods, use them as an anesthetic aid and dozens of other areas far from neurology? A self-respecting neurologist will never undertake these tasks. Given the relatively small proportion of neurologists in the general medical cohort, the availability of RT appears to be sharply limited. At the same time, thousands of non-neurologist doctors who devoted themselves to RT found themselves formally excluded from their specialty. The nomenclature should contribute to the progress of the industry as a whole and its individual components. Does Order No. 337 meet this mission?
The rationality of any classification is determined by the clarity and universality of the principles on which it is based. The current nomenclature is based primarily on the medical “disease-centric” paradigm, focused on eliminating the actual pathological process. Healthcare in the truest sense of the word corresponds to a “health-centric) paradigm, the basis of which is the preservation and enhancement of health, preventive and rehabilitative orientation. Medical specialties representing the health-centric paradigm are represented much more modestly in the modern nomenclature. The predominance of specialties based on a disease-centric paradigm reflects an analytical approach to the human sciences. The health-centric paradigm is more based on an integrative - holistic approach to the study of man in all the diversity and inseparability of his biological and social fusions and their manifestations.
Without calling for the abandonment of previously established principles for the formation of nomenclature, by way of discussion, the following formulation of the criterion for a medical specialty is proposed: an area of medical activity based on a certain paradigm, characterized by a relatively specific holistic system of diagnosis and treatment, effective at various stages of medical care. Most of the medical specialties included in the existing nomenclature meet the above criterion; does RT meet it?
Initially, RT was understood as any therapeutic effect that causes the activation of nervous reflex mechanisms. This was reflected in the first domestic encyclopedic definition of RT: “a therapeutic system that uses reflex relationships created in the human body during its centuries-old evolution to influence the pathological process” (A.R. Kirichinsky, BME, 1962, v. 28, p. 564). Subsequently, the understanding of RT was narrowed to the boundaries of the somatosensory analyzer: “a healing system based on reflex relationships formed in the process of phylo- and ontogenesis, implemented through the central nervous system through irritation of the receptor apparatus of the skin, mucous membranes and underlying tissues to influence the functional systems of the body” ( V.S. Goydenko, BME, 1984, v. 22. p. 244), and then limited itself to only the impact on acupuncture points: “a set of therapeutic techniques based on the influence of various, mainly physical, factors on certain point areas of the body surface - acupuncture points” (D.M. Tabeeva, KME, 1989, vol. 2. P. 603).
Thus, the initially broader semantic meaning of RT has been significantly narrowed. In accordance with the cited definitions, RT appears to be more of a therapeutic method than a medical specialty. This contradicts both the original essence of classical acupuncture, an integral part of which is its own diagnostic system, and the broader modern understanding of RT.
The limited understanding of RT appears to be due to the dominance of the concept of nervism since the early 19th century, which led to the term “reflex” acquiring a primarily neurophysiological meaning. It is appropriate, however, to remember that in a broader biological and philosophical sense, the category of reflection (reflex) is applicable not only to any form of relationship between an organism and the environment, but in general to all forms of existence of matter, because they are its basic property. Understanding reflex activity, and, consequently, RT should not be limited only to neural regulatory mechanisms.
Today's ideas about the essence of RT are based on the theory of functional systems, the modern interpretation of which is unthinkable without biophysical and information approaches. An integral part of RT is a variety of specific reflex diagnostic methods. These circumstances prompt us to turn to an initially broader understanding of RT and define it as a treatment and prophylactic system based on assessing the parameters of peripheral reflexogenic zones and influencing them in order to regulate the functional systems of the body. Unlike the previous ones, this definition introduces the presence of a relatively specific holistic system of diagnosis and treatment into the understanding of RT. It does not limit the understanding of RT to a neurophysiological framework, any type of receptor, a specific analyzer system, or modality of treatment. Music, color and aromatherapy are returning to the arsenal using the RT method. The most fully studied and popular area of traditional Chinese medicine - acupuncture, although it seems to be the most extensive, is still a particular method of RT. At the same time, classical mechanical and thermal methods of stimulating acupuncture points are increasingly giving way to factors of low and ultra-low intensity, which contain not so much energy as informational effects on the body.
Numerous diverse studies have made it possible to find an adequate modern interpretation of the main methodological principles of traditional acupuncture. Thus, the concept of “vital energy qi”, the canonical topography of acupuncture channels and points are explained from the positions of classical and quantum mechanics, modern ideas about the electron-ion-quantum level of biochemical reactions that ensure bioelectromagnetic homeostasis. Consideration of the phenomenology of acupuncture channels and points at the electron-ion-quantum level does not at all contradict the reflex theory, if we are not limited to its simplified neurophysiological interpretation.
Generalization of the results of studies conducted on various experimental models and in the clinic allows us to conclude that the therapeutic and prophylactic effects of RT develop due to the involvement of adaptive reactions of various levels. Adaptive reactions initiated by influences on acupuncture points are manifested in optimizing the functions of almost all body systems; however, the pain sensitivity control system plays a central coordinating role. This makes the use of RT highly effective for a variety of pain syndromes.
The pain sensitivity control system is an evolutionarily ancient homeostatic mechanism, occupying a leading place in the hierarchy of later formed mechanisms for maintaining the constancy of the internal environment of the body and its adaptive reactions. Changes in the functional state of this system cause changes in the response of other systems that ensure adaptation of the body not only under the influence of directly damaging (nociceptive) physical factors, but also under other stressful, potentially pathogenic loads.
Reflex diagnostic methods make it possible to identify functionally insufficient adaptation systems. Actually, therapeutic methods, replenishing the deficiency of these systems, make it possible to limit the pathogenic effect of stress, contribute to the elimination of existing pathogenetic mechanisms and the formation of sanogenetic functional systems. The stress-limiting and adaptogenic effects of RT provide a wide range of indications for its use for therapeutic and prophylactic purposes in almost all areas of clinical medicine and at all stages of medical care. This is reflected, in particular, in the content of the quarterly scientific and practical journal “Reflexotherapy”, published since 2002, the range of publications of which goes far beyond neurology. The current RT is a scientifically based, dynamically developing system, including several dozen diagnostic, treatment and prophylactic methods, the totality of which meets the requirements for the medical specialty.
Neither the modern theoretical basis, nor the established practice, nor the prospects for further development give grounds to consider RT as the exclusive prerogative of neurology. This far-fetched restriction does not exist in any country where RT methods are used in one or another regulation. Representatives of all areas of healthcare where there are indications for its use should have the opportunity to receive specialization in RT. Moreover, the current unified program of specialization in RT includes a significant amount of information, both on the general fundamentals of neurology and on the specifics of using RT in the clinic of nervous diseases.
The possibility of appropriate specialization for paramedical workers should also be discussed. A number of methods of reflex diagnostics and therapy, although they require certain preparation, are not at all more complicated than, for example, ECG recording, intravenous injections, or some physiotherapeutic procedures. The legislation of a number of Western European countries and American states allows persons who do not have a higher medical education, but who have undergone appropriate (usually two years) training, to practice acupuncture and some similar types of medical activities.
In conclusion, I would like to hope that the Russian Ministry of Health will continue the tradition of a careful and attentive attitude to the current state and prospects for the development of the RT service, the beginning of which dates back to 1956. It is necessary to provide opportunities for specialization for doctors working in those areas of clinical medicine where RT has long established itself as an effective, safe and economically attractive holistic approach that promotes the necessary integration of disease- and health-centric paradigms in today's medicine and the healthcare of the future.
Head of the Department of Reflexology
and manual therapy MGMSU,
Chief Editor
magazine "Reflexotherapy",
Doctor of Medical Sciences, Prof. A. M. Vasilenko.
* * *
From the Ministry of Health, it, like the first, remained unanswered, but caused dozens of responses from specialists who were not indifferent to the fate of the Republic of Tatarstan (Medical Newspaper No. 12, 2003). Here are some excerpts from them.
Responses to the article by Prof. A.M. Vasilenko “nomenclature of medical specialties: the place of reflexology - an invitation to discussion”, published in VG No. 4 (43), April, 2003.
In an address by Professor A.M. Vasilenko to the Ministry of Health of the Russian Federation raised the pressing issue of the situation with the medical specialty “reflexotherapy” in the country and the difficulties faced by practitioners in obtaining a certificate in this specialty. Without going into a lengthy discussion, I would like to note that in recent years, medical science has expanded its understanding of the mechanisms of the positive therapeutic effects of reflexology, just as the practice itself has provided numerous examples of its successful use in various fields of medicine.
Thus, it is considered proven that the therapeutic effect of RT cannot be explained solely from the standpoint of the classical reflex theory. Numerous data convincingly support the participation of endocrine mechanisms, as well as various parts of immune regulation when influencing biologically active points. Such a broad participation of various endogenous factors that restore disturbed homeostasis according to the most important principle of life - the principle of self-regulation, predetermines the success of RT in cases of various pathological manifestations in humans. Currently, the positive effects of RT are described not only in neurology, but also in the clinics of internal medicine, obstetrics and gynecology, urology, borderline mental disorders, etc.
In this regard, Order of the Ministry of Health of the Russian Federation No. 337 dated August 27, 1999, limiting the issuance of RT certificates exclusively to neurologists, is an undoubted obstacle to the use of RT in practical healthcare.
Noting the positive effects of RT in various diseases, we by no means consider RT a panacea and do not try to oppose RT to other medical specialties. Moreover, evidence is increasingly accumulating about the even greater effectiveness of RT if it is used both with methods of academic and other methods of traditional medicine.
From here it is clear that the more medical workers master the specialty of RT and use it creatively in treating patients, the better the success of our practical healthcare will be.
Head of the department
non-drug treatments
and clinical physiology
MM A im. THEM. Sechenov,
Doctor of Medical Sciences, Academician of the Russian Academy of Medical Sciences,
Professor V.G. Zilov
Opinion of the parent institute.
The issue of changing the order of the Russian Ministry of Health No. 337 has been long overdue. Developed and approved with the good goal of reducing the excessively bloated Nomenclature of medical and pharmacist specialties, this order turned out to be ill-conceived and largely inconsistent. The lack of clear criteria defining a medical specialty, in-depth study, and definition of privacy when discussing an order led to the infringement of the rights of a number of specialists.
It is noteworthy that the long-awaited discussion on this issue began on the pages of the “Medical Gazette”, the organ of the largest public professional medical organization. It is the Russian Medical Association, in our deep conviction, that, based on a broad study of the opinions of specialists, should develop and submit to the Russian Ministry of Health a draft new order that would reflect, on the one hand, the objective global trend towards a reduction in the number of specialties, and on the other, would avoid that subjectivity and inconsistency that characterize Order No. 337.
As for reflexology as a medical specialty, in our opinion, it cannot be strictly tied to any one basic specialty. In this regard, I would like to draw attention to the fact that at a recent scientific and practical conference held by the Russian Ministry of Health, respected Professor A.N. Razumov presented a draft of a new medical basic specialty “regenerative medicine”, to which reflexology is added as an additional specialty requiring in-depth study. In this case, reflexology will fall, as they say, “from the frying pan into the fire,” since both the scope of activity and the scope of training of specialists will be even more limited.
We are convinced that a representative of any medical specialty (therapy, surgery, obstetrics and gynecology, neurology, pediatrics, etc.) should have the right to receive a certificate of a reflexologist after appropriate training.
Director of the Institute of Reflexology
Federal Scientific Clinical
experimental center
traditional methods
diagnostics and treatment of the Ministry of Health of the Russian Federation
Doctor of Medical Sciences HER. Mazerov
One should not divide the indivisible - the opinion of therapists about the place of reflexology in the range of medical specialties.
Order of the Ministry of Health of the Russian Federation No. 364 of December 10, 1997 on the introduction of reflexology (RT) into the range of medical and pharmacist specialties was a natural consequence of many years of work by doctors and researchers in various specialties, which proved that RT is effective and safe, and is used in almost all areas of clinical medicine . The most attractive thing about RT is that its sanogenetic mechanisms are based on the regulation of natural adaptation processes at various levels. The stress-limiting and adaptogenic effect of RT ensures the feasibility and effectiveness of its use for the treatment and prevention of most widespread diseases.
Let's look at the list of indications for RT. Taking as 100% all nosological forms for which RT is indicated, it is easy to calculate that the first place among the indications is diseases of internal organs - 21.7%. Second place is occupied by pediatrics - 15%, third - obstetrics and gynecology - 10.6%, fourth - borderline conditions and psychiatry, fifth - diseases of the musculoskeletal system - 8%, and only sixth (7.5%) - diseases of the nervous system. Gastroenterology alone surpasses neurology in the number of nosological forms for which RT is indicated - 17 and 15, respectively. RT is indicated for 14 diseases of the bronchopulmonary system, at least seven diseases of the cardiovascular system and five different endocrinological diseases.
Already on the basis of this formal analysis, it becomes obvious that considering RT as a specialty additional to neurology, as provided for by Order of the Ministry of Health No. 337 of August 27, 1999, is completely unjustified. According to modern research, nervous mechanisms are far from the only ones, and, according to a number of authors, not the main ones in the implementation of the therapeutic effects of RT. Many years of our own experience in the clinic of internal medicine shows that the use of RT makes it possible to more effectively treat many complex diseases that are tolerant to pharmacotherapy, and to avoid drug burden on patients and many complications. Thus, neither from the standpoint of pathogenesis and sanogenesis, nor from the point of view of real clinical practice, the classification of RT as neurology cannot be considered appropriate.
Any classification, including the nomenclature of medical specialties, is a kind of convention that reflects current epistemological positions and practice. The current theoretical level of development of RT, world and own practice convinces that representatives of various fields of clinical medicine should be proficient in a rich arsenal of methods of modern RT.
What prevents doctors of different specialties from being certified in the specialty “reflexotherapy” as well? - Knowing the scope of the 4-month unified RT training program, which contains basic modern information on the etiopathogenesis and clinical picture of various diseases where RT is indicated, we can confidently answer - nothing! If this does not fit into the existing structure of the nomenclature, then it needs to be changed, and not try to artificially limit the use of RT within the framework of any one specialty.
At the same time, in no case should RT be allowed to lose its status as an independent specialty, the criteria of which it fully meets. It is necessary to maintain residency and other forms of postgraduate education in the Republic of Tatarstan. Considering the current situation and future prospects for the development of RT, there are reasons to think about including it as an appropriate course in basic medical education. As the 5-year experience of our University shows, the number of students wishing to take the elective course “Fundamentals of reflex, manual and information medicine” is increasing every year.
Today's RT, intensively developing on the basis of the latest achievements of fundamental sciences, using the latest achievements of microelectronics and information technology, is a vast area of modern healthcare, based on ideas about the integrity of man in all manifestations of his existence, relationships with nature and society, optimally meeting the principle of “treat not the disease, but the patient.” Attempts to “tie” RT to any of the existing specialties, or to introduce it into the vague boundaries of “traditional medicine” (Order of the Ministry of Health of the Russian Federation No. 186 of 06/05/02), or in any other way to deprive it of the status of an independent medical specialty, are fraught a number of negative consequences, primarily in the form of limiting its availability for hundreds of thousands of patients in need and large contingents of people in whom it is advisable to use it for preventive and rehabilitation purposes.
Head of scientific-educational-practical
Center "New Technologies in Medicine"
Academician of the Russian Academy of Medical Sciences, Professor L.E. Martynov.
Professor of the Department of Therapy No. 1 FPDO
MGMSU A.G. Evdokimov and V.L. Olkhin
Head Department of Therapy No. 2 FPDO
MGMSU Professor L. L. Kirichenko
Professor of the Department of Internal Affairs
diseases No. 3 MSMSU, Head. Course
occupational diseases A.M. Popkova
Associate Professor of the Department of Reflexology
and manual therapy, Moscow State Medical University,
Cardiologist with a 35-year-old
medical experience, Ph.D. Yu.P. Makarov
To the editor-in-chief of the Medical Newspaper, Professor G. A. Komarov.
Dear Georgy Alekseevich!
We are sending material for the “Discussion” regarding the article by Professor A.M. Vasilenko “Nomenclature of medical specialties. The place of reflexology is an invitation to discussion.” We fully share the concern of Alexey Mikhailovich, one of our country’s leading specialists in the field of reflexology, about the situation in which the specialty “reflexotherapy” found itself in connection with the publication of Order No. 337 of the Ministry of Health of the Russian Federation dated August 27, 1999.
The scope of application in medical practice of this specialty is clearly formulated in the order of the Ministry of Health of the Russian Federation No. 364 of December 10, 1997:
Appendix 2. 1.1. Doctor - reflexologist - specialist with higher education in the specialty “General Medicine” or “Pediatrics” ...” and further in Appendix 3, clause 3.1. Reflexology is designated as a “comprehensive clinical discipline in its own right.” Historically, over 47 years of existence in the country of reflexology, the practice has developed to use this type of diagnosis and treatment for a wide range of diseases within the framework of specialties included in the heading “General Medicine” and “Pediatrics”. This provision is enshrined in the order of the USSR Ministry of Health No. 106 dated March 10, 1959 “On indications and contraindications for the use of acupuncture”, as well as “Methodological recommendations” of the USSR Ministry of Health dated 1980 under the same name. Our practice and scientific research since 1957 (laboratory and research group of acupuncture, all-Union scientific and methodological center and department of reflexology at the Leningrad State Institute of Education and Science, then St. Petersburg MAPO) are evidence of the possibilities of reflexology and therapy not only for diseases of the nervous system, but and in the clinic of internal medicine (pulmonology, gastroenterology), allergology, obstetrics and gynecology, orthopedics and traumatology. The clinical application of reflexology is confirmed by fundamental scientific research, reflected in a large number of doctoral and candidate dissertations, the number of which has reached 300.
Against the backdrop of all the efforts and organizational measures of the Ministry of Health of the Russian Federation (including order No. 38 of 02/03/99 “On measures for the further development of reflexology in the Russian Federation”), order No. 337 of 08/27/99 destabilized the reflexology service throughout the country, reducing the specialty “Reflexotherapy” to the rank of “specialty requiring in-depth training.” Thus, in one fell swoop, a huge army of other specialists (therapists, allergists, obstetricians-gynecologists, pediatricians, etc.) was “cut off” from reflexology and deprived of medical care to thousands of thousands of patients who require effective drug-free care, which is reflexology. Doctors of the specialties listed above are put in a dead-end position: for example, a general practitioner, obstetrician-gynecologist, allergist must master neurology from scratch and pass an exam for a neurologist certificate (!!!). and then specialize in reflexology. Completing such a task is unrealistic. Thus, we support the point of view of our colleague and consider the optimal solution to be to give (or more correctly: restore) “reflexology” the status of an independent specialty.
Member of the Academic Medical Council, section “Traditional Medicine”, chief specialist in reflexology of the Health Committee of the Administration of St. Petersburg, professor of the department of reflexology of the St. Petersburg MAPO, doctor of medical sciences, professor A.T. Kachan.
Head Department of Reflexology St. Petersburg MAPO
Doctor of Medical Sciences, Professor N.N. Bogdanov
Narcologist's point of view.
In recent years, reflexology (RT) has been increasingly used in various fields of medicine. Much experience has been accumulated in the successful use of RT in narcology (V.A. Durinyan, V.P. Kokhanov, 1961; V.L. Lakusta, 1993, etc.). Modern methods of pharmacotherapy for drug addiction remain problematic. The use of medications often has its limitations and contraindications. It is not uncommon for our patients to develop dependence on medications.
It is often necessary to refuse to prescribe drug therapy due to the occurrence of toxic effects or side effects of the drugs. Therefore, along with the improvement of old treatment methods, the search for new and combined treatment methods in narcology is constantly being carried out.
Since the time that narcology was identified as an independent clinical discipline, RT has firmly occupied its “niche” in the complex treatment of addiction diseases. A large number of studies have been carried out to study the effect of RT on the activity of various body systems of patients dependent on alcohol (during the period of abstinence). This influences the neurotransmitter systems (adrenaline, norepinephrine, serotonin, acetylcholine, cholinesterase, hormones, histamine), including the state of the hypothalamic-pituitary-adrenal system. Much attention in the world literature is paid to the participation of opioid receptors and their ligands (enkephalins and endorphins) in the implementation of the effects of RT in the treatment of alcoholism. Therefore, the RT method is considered by many authors not only as a method of physiological non-drug treatment of alcoholism, but also as a way to study the pathogenetic mechanisms of this disease (Kokhapov V.P., 1992). Mention should also be made of the high results of treatment of tobacco smoking, where RT as the main method is effectively used in many countries of the world (Rudnev S.G.).
In modern medical institutions for drug treatment, RT is an integral part of a comprehensive treatment program. The use of RT is reflected in the standards (protocol models) for providing assistance to drug treatment patients. Treatment of our patients is carried out in several stages: detoxification, treatment of post-withdrawal state, rehabilitation period. RT is used in combination with the main treatment at a certain stage or throughout the entire treatment period, which is determined in each case individually. In some cases, especially during the rehabilitation period, RT is used as monotherapy (microneedling). Reflex diagnostic methods are also effectively used to diagnose and evaluate the effectiveness of treatment in narcology. The use of reflex diagnostics and therapy in narcology makes it possible to reduce the doses of medications used, strengthen psychotherapeutic contact with the patient and achieve more stable and high-quality remission.
Depriving narcologists of the opportunity to specialize (or improve their qualifications) in the Republic of Tatarstan primarily has a negative impact on the interests of our patients. It is difficult to imagine the presence of a neurologist on the staff of every drug treatment department or dispensary. But in our opinion, only the attending physician, who has complete information about the nature of the disease in a given patient and has emotional contact with the patient, can achieve a significant effect when using RT. We hope for the triumph of common sense and a more differentiated approach to resolving this issue.
Psychiatrist-narcologist -
reflexologist of the 17th narcological clinic
Moscow hospital G.I. Romashchenko
The common fate of reflexology and manual therapy.
The coincidence of the dates of “birth” and “death” “12/10/1997-08/27/1999” of reflexology and manual therapy, as independent medical specialties, is obviously not accidental. Everything that Prof. writes. A.M. Vasilenko regarding the inappropriateness of limiting the use of reflexology to the framework of neurology can equally be extrapolated to manual therapy.
Our own medical experience, as well as an impressive number of observations from colleagues, quite convincingly indicate the advisability of using manual therapy in the clinic of internal medicine, obstetrics and gynecology, and other areas of clinical medicine that are quite far removed from neurology. Therefore, Order of the Ministry of Health of the Russian Federation No. 337 of August 27, 1999, which “places” manual therapy in the Procrustean bed of neurology or traumatology and orthopedics, significantly limits the possibilities of its use by doctors of other specialties.
232 doctors from Moscow, Moscow, Kaluga, Kostroma and Yaroslavl regions who attended the final conference of the Moscow Professional Association of Manual Therapists, held on October 26, 2002, unanimously voted for the decision, one of the points of which reads:
“To date, data have been obtained on the possibility of using manual therapy in the treatment of not only musculoskeletal disorders, but also a number of diseases of internal organs. This suggests increased use of manual therapy by various specialists. The current order to train specialists only from neurologists and traumatologists slows down the implementation of new developments in the clinic of internal diseases. The existing specialist training program (560 training hours) can be mastered by doctors who have received a specialty in general medicine or pediatrics, which will allow for a wider introduction of the achievements of manual medicine in the treatment and prevention of diseases in adults and children, which can become an integral part of a large-scale program for improving the health of the nation.”
A similar decision regarding reflexology was made by participants in the Congress on Traditional Medicine, which was held on September 27-29, 2000 in Elista. So, there is every reason to believe that the opinions of the majority of specialists in the field of reflexology and manual therapy on the issue under discussion coincide. Many doctors who have mastered reflexology become motivated to master manual therapy and vice versa. This is due to the commonality of a number of their sanogenetic mechanisms and mutual potentiating effects, which provide significantly more pronounced and sustainable therapeutic effects. Medical kinesiology is actively developing, combining the approaches of reflexology, manual therapy and physical therapy. Information medicine methods are increasingly being introduced into practice, the range of diagnostic, treatment and preventive capabilities of which also goes far beyond neurology.
The rapid development of the listed non-pharmacological approaches in modern medicine obviously requires appropriate reflection in the nomenclature of medical specialties. Practically and theoretically integrating on the basis of a health-centric paradigm, these approaches, which are different at first glance, form a single direction that does not fit into the current structure of the nomenclature of medical specialties. This is probably why they are often combined under the collective names of “alternative,” “complementary,” or “integrative” medicine.
Perhaps the most logical combination of them into a single specialty would be restorative medicine. The issue of introducing the latter into the nomenclature of medical specialties, as far as we know, is currently being considered by the Ministry of Health of the Russian Federation. The recovery stage is already provided for in any medical activity, so reflexology, manual therapy, homeopathy and other innovative medical technologies will not remain the exclusive domain of neurologists. The effectiveness of their integrated use is confirmed by the experience of the All-Army Rehabilitation Center, operating on the basis of the 6th Central Military Clinical Hospital of the Russian Defense Ministry. The argument about classifying them as restorative medicine is also supported by the practice of specialized scientific councils operating under the Russian Scientific Center for Regenerative Medicine and Balneology of the Ministry of Health of the Russian Federation.
In conclusion, we appeal to the Ministry of Health of the Russian Federation with a request, in one way or another, to remove artificial barriers to the possibility of obtaining specialization in reflexology and manual therapy for representatives of all those medical specialties where they have indications for use.
Head of manual therapy courses
and reflexology Department of Medical
rehabilitation and physical methods
treatment at the State Institute
advanced training for doctors of the Ministry of Defense of the Russian Federation Chairman
Council of the Moscow Professional
Association of Manual Therapists, Doctor of Medical Sciences,
Professor A.T. Neborsky
Head of the Manual Center
Therapy of the Russian Scientific Center
Regenerative medicine and balneology
Ministry of Health of the Russian Federation, President of Moscow
Professional Association of Manual
Therapists, Ph.D. A.E. Samorukov
Save Baby Reflexology!
According to the Ministry of Health of the Russian Federation, from 1990 to 1999, childhood morbidity for all groups of diseases increased by an average of 20%. Excluding known socio-economic factors, the increase in morbidity is due to an increase in the proportion of maladaptation diseases associated with environmental conditions, unjustifiably wide and intensive use of pharmacotherapy, leading to allergization of children and adults. Getting used to the constant consumption of medications from the period of intrauterine development, children, as V.P. Kaznacheeva become immunological “juniors”.
Against this background, it is especially important to use reflexology (RT) as widely as possible, which is based on the directed regulation of natural mechanisms of adaptation and sanogenesis. Reflex diagnostic methods make it possible to identify early (preclinical) manifestations of maladaptation and determine the most vulnerable body systems from the point of view of the possible development of pathology. Actually, therapeutic methods provide an individualized holistic approach to solving issues of prevention, treatment and rehabilitation, meeting the principle of “treating the patient, not the disease.” RT, in which medical procedures are carried out by a doctor, unlike most other medical specialties, provides greater opportunities for the necessary psychological interaction with the child and his parents. RT, aimed both at increasing the child’s general nonspecific resistance to various pathogenic influences and at treating specific diseases, can significantly limit the harmful effects on the body, which is in a state of environmental, psychological and medicinal stress.
With the current financial support for healthcare, the increasing cost of medical services, especially specialized medical care, and increasing prices of pharmaceuticals, the problem of maintaining health, preventing and early detection of diseases using economically affordable methods is of particular importance. RT does not require expensive equipment; it is affordable both for any medical institution and for the general population. The effectiveness of RT is not inferior to, and often exceeds, the level of effectiveness of pharmacotherapy, can replace a whole range of medications, has a very limited range of contraindications, and has virtually no side effects.
Based on these premises, one would expect a further increase in the number of pediatricians who speak RT and an expansion of the network of RT offices and departments in children's healthcare facilities. In fact, this does not happen, and the opposite trend is often observed. Thus, in 1993, the RT office was liquidated, which had been operating for 14 years in the advisory clinic of Children's City Hospital No. 13 named after. N.F. Filatova. In January 2001, after four years of work, the office of the RT DP No. 11 of the North-East Administrative District was liquidated. With these examples I would like to draw the attention of the management of the Moscow Department of Health to the organization of the children's RT service. The unfavorable situation of this service is due to a number of circumstances.
First of all, attention is drawn to the lack of awareness of both patients and, apparently, health care managers about the possibilities of RT and, although insufficiently developed, there is still an existing network of operating offices in clinics and hospitals. The patient has the right to receive information regarding all directions and methods that can be used for his treatment; the administration of the health care facility is obliged to provide this information, but usually does not do this. Against the backdrop of intrusive advertising of pharmacological drugs, there is a lack of information not only about RT methods in general, but also about the RT rooms available in the structure of children's healthcare facilities. Thus, the already poorly developed children's RT network is clearly underutilized.
The organization of any medical service begins with a nomenclature of medical specialties. According to the order of the Ministry of Health of the Russian Federation No. 337 dated August 27, 1999, the Republic of Tatarstan was classified as one of the specialties that require additional training of neurologists, and this despite the fact that the neurological morbidity of children under 14 years old, according to data for 1999, is only about 10% of the total morbidity. Our own 22-year practice in pediatric RT shows that approximately half of patients are referred to a reflexologist by neurologists. However, among these children, about 70% are patients with multisystem somatic pathology of a vegetative-visceral or psychosomatic nature. Thus, no more than 35% of patients need specialized neurological treatment, the rest need the help of a general pediatrician. The unified training program for doctors in RT contains all the information necessary for general practitioners to treat patients suffering from diseases of the nervous system. Various aspects of RT in pediatrics are well represented.
Order No. 337 impedes the availability of RT for numerous children in need and artificially limits the ability of pediatricians to master our specialty. A similar mistake has already been made when RT was classified as physiotherapy by order of the Ministry of Health No. 6931981. Modern RT is an interdisciplinary and dynamically developing field that meets the criteria of an independent medical specialty. Theoretical premises are maturing, and the practice of integrated use of RT, manual therapy, bioresonance therapy, homeopathy, homotoxicology and a number of other methods is being developed in the form of a methodologically unified system of providing medical care using apparently different biomedical technologies. However, one can hardly consider the attempt to unite them with the ambiguous term “traditional medicine” (Order of the Ministry of Health of the Russian Federation No. 186 of 06/05/02) successful. Rather, the term “complementary” or “integrative” medicine, which are used in the international professional lexicon, would be appropriate here.
One way or another, it is necessary not to limit, but to expand the opportunities for specialization in RT and ideologically related areas not only for representatives of various fields of clinical medicine, but also for healthcare in general.
reflexologist of the highest category.
Central children's clinic of the Ministry of Internal Affairs of the Russian Federation.
T.G. Tikhonov.
Pediatrician of the highest category,
reflexologist of the highest category,
DGP No. 140 North-Western Administrative District of Moscow
Ph.D. D.L. Kazbekova.
* * *
It is unlikely that the above materials did not come to the attention of medical officials; moreover, they were directly presented to one of the deputy ministers... But the then leadership of the Ministry of Health again did not honor us with any response, thereby demonstrating their indifference to the fate of the Republic of Tatarstan. The leadership of our professional Association will make sure that this issue of the journal falls into the hands of the current leadership of the Russian Ministry of Health. We hope that it will take the necessary steps to resolve pressing issues in organizing the RT service.
A reflexologist is a doctor who treats diseases of internal organs and tissues using acupuncture - stimulation of reflexogenic points of the body manually, physiotherapy and special needles; rehabilitates patients after severe operations, eliminates exacerbations of chronic diseases.
A reflexologist develops and introduces into medical practice new methods of influencing active points, stimulates the immune system and indirectly affects the onset of infections, prepares for childbirth, facilitates delivery and the postpartum period. In her professional activities, a reflexologist uses classical acupuncture and its micro varieties, acupressure, apipunktura, exposure to temperature, magnetic field, ultrasound (phonopuncture in combination with massage), medicines, vacuum, applications of therapeutic mud, algae, leeches.
A reflexologist is in contact with doctors of all specialties because he treats:
- Diseases of the joints and spine.
- Neurological disorders.
- Pathology of the digestive system.
- Endocrine diseases.
- Gynecological problems.
- Manifestations of allergies.
- Pain syndrome.
- Skin pathology.
- Sexual dysfunction.
- Insomnia.
In addition, the profession of a reflexologist involves the recovery of patients after severe surgical interventions, injuries, strokes, heart attacks, and medical support for sports teams.
Often, patients turn to a specialist when traditional methods do not help.
Places of work
Reflexologist works in multidisciplinary medical organizations, research institutes, rehabilitation and perinatal centers, antenatal clinics, maternity hospitals, sanatoriums, and beauty salons.
History of the profession
Acupuncture is an ancient medical practice and has its roots in China, where in 221 BC. The first book appeared, which described in detail the shape of needles, the topography of reflexogenic points, methods of acupuncture and cauterization. Since that time, acupuncture quickly spread throughout all countries of the East and became one of the leading methods of treating diseases.
However, until the 17th century, acupuncture was not used in Europe, and, having only begun to be used, due to the political and economic situation it was forgotten for three centuries. At the beginning of the twentieth century, the American W. Fitzgerald proposed a theory of the relationship between biologically active points and internal organs. According to it, the activation of each point leads to the launch of the mechanism of self-regulation and self-healing of a specific organ. In other words, it offered the possibility of treatment without drugs, which is so popular these days. Its practical introduction into official medicine dates back to 1949. From that moment on, laboratories were opened in different parts of the world to study this method.
Since 1971, acupuncture has been used in surgery as analgesia and anesthesia in the postoperative period. However, reflexology still does not have full recognition as an official technique, which does not prevent its widespread use as an auxiliary therapy. Since 1998, the specialty of reflexologist has been included in the register of medical specialties.
A promising direction in the development of modern reflexology is the development of a system of comprehensive rejuvenation of the body.
The doctor uses special needles to activate biologically active points on the patient’s body.
Responsibilities of a Reflexologist
The main responsibilities of a reflexologist are:
- Clinical and laboratory diagnostics, treatment (outpatient, inpatient, home) and rehabilitation of patients.
- Carrying out procedures: acupuncture, microcurrent effects on active points, thermal acupuncture, subcutaneous injection of drugs into acupuncture points, cupping massage, infrared effects.
- Homeosiniatry (a combination of homeopathy and reflexology).
- Preparation of documentation, medical reports and recommendations.
Requirements for a reflexologist
The basic requirements for a reflexologist are as follows:
- Higher medical education, valid certificate in Reflexology.
- Knowledge of acupuncture and acupuncture techniques.
- Knowledge in the field of neurology, therapy, topographic anatomy, psychotherapy.
- Knowledge of methods of clinical observation, social hygiene, epidemiology and sanitation.
- Ethics and ability to communicate with patients and their relatives.
More than 900 acupuncture points have already been opened, which correspond to internal organs.
How to become a reflexologist
To become a reflexotherapist you need:
- Graduate from a university with a degree in General Medicine or Pediatrics.
- Receive an accreditation sheet along with your diploma by passing tests, an exam and an interview with a special commission consisting of doctors of science and professors. This will give the right to work independently on an outpatient or outpatient basis.
- It is mandatory to work for a year in a clinic or outpatient clinic, and then enter residency (2 years) in the specialty “Reflexotherapy”.
In the process of work, doctors are awarded qualification points confirming accreditation: for performing complex manipulations, participating in scientific and practical conferences and seminars, for publishing scientific articles, books, and defending a dissertation. Every 5 years these points are summed up and assessed by the accreditation commission. If you score a sufficient number of points, you can continue working in your specialty for the next five years. If there are not enough points, the doctor is deprived of the right to treat. .
The growth of professionalism, level of knowledge and experience of the doctor is usually reflected qualification category. All categories are assigned by a qualification commission in the presence of the doctor himself, based on his written research work containing a description of skills and knowledge.
Assignment deadlines:
- more than 3 years of experience – second category;
- more than 7 years – first;
- more than 10 years – highest.
A doctor has the right not to qualify, but this will be a disadvantage for career growth.
Career and professional growth is also facilitated by scientific activity - writing candidate and doctoral dissertations, publications in medical journals, speaking at conferences and congresses.
Reflexologist salary
The income range is wide: reflexologists earn from 10,000 to 150,000 rubles per month. The profession is most in demand in the Moscow and Leningrad regions. The minimum salary for a reflexologist was found in Vladivostok - 10,000 rubles per month, the maximum - in the Moscow Dikul center "Losiny Ostrov" - 150,000 rubles per month.
The average salary of a reflexologist is 25,000 rubles per month.
Where to get training
In addition to higher education, there are a number of short-term training on the market, usually lasting from a week to a year.
The Medical University of Innovation and Development invites you to take distance courses in retraining or advanced training in the direction of "" to receive a diploma or state certificate. Training lasts from 16 to 2700 hours, depending on the program and your level of training.
The Interregional Academy of Additional Professional Education (MADPO) trains in the “” specialization and issues diplomas and certificates.
A reflexologist is a specialist who treats diseases through the use of acupuncture. Special points of the human body are directly related to various systems and internal organs. A professional in this field must have practical skills and extensive theoretical knowledge in the field of neurology. With a clear understanding of anatomy, the doctor can perform procedures without the risk of harming the patient.
The specialty “reflexologist” was approved in 1998. Doctors independently prescribe and perform procedures. The techniques have almost no contraindications, so patients can be adults and children.
Increased lymph flow and blood flow are observed in all biologically active points of the body. In these areas, oxygen is absorbed much more actively, thereby increasing sensitivity to pressure in certain places. In response to the impact, a weak electrical impulse is generated at the acupuncture points, which is transmitted to the organ affected by the disease through a number of nerve centers. The process not only stimulates the functioning of the organ, but also activates the recovery system.
What methods does he use for treatment?
During the treatment of diseases, a professional reflexologist can use various methods of influencing biologically active points.
- Acupressure is a technique that involves influencing acupuncture using acupressure with fingers.
- Pharmacopuncture, which is the subcutaneous administration of medications (in most cases, homeopathic remedies) to acupuncture points.
- Acupuncture, which is the most common reflexology technique, involves inserting thin needles into different parts of the body. The length of the needles used directly depends on how deep a certain point is located. Depending on the method used by the specialist, the injection technique is chosen - fast, slow, deep, superficial, with scrolling and combining several needles.
- Apitherapy, which involves the use of bees, as well as their waste products - honey, wax, propolis, royal jelly. Treatment can be carried out through direct stinging to biologically active points, as well as in combination with medications, hormones, exercise therapy and physiotherapy.
- Application reflexology, in which stimulation is carried out using special plates and balls that are attached to the skin in certain areas, after which they remain for several days or a day (in the case of the elderly and seriously ill, as well as children). Some reflexologists use sprouted seeds and grains, ginger, garlic, onions and other irritants as applications.
- Magnetic puncture is stimulation of points provided by alternating or constant low-frequency magnetic fields.
- Thermopuncture, in which the points are stimulated by cauterization with wormwood cigars and special cones. The procedure differs in that it has a slight irritating effect: the patient does not experience pain or other unpleasant sensations, but only feels warmth in the stimulated area.
Each method has its own characteristics, advantages and disadvantages. The choice of a technique that will ensure the achievement of the goal in the shortest possible time is directly carried out by the treating reflexologist.
In addition to these techniques, many doctors use personal techniques that have proven to be effective. To date, more than 900 acupuncture points have been discovered, which are associated with various systems and organs of the human body. Individual procedures and complex courses of treatment help improve overall well-being and also open channels for the flow of vital energy.
In situations where a patient suffers from a number of unpleasant symptoms, but doctors at the clinic cannot identify the cause, the best solution is to contact a specialist in the field of alternative medicine. The reflexologist uses his own diagnostic methods, during which he studies the state of the internal organs based on the “signs” displayed on the body. By influencing certain points and monitoring reactions, the doctor can draw conclusions about the presence of problems. In addition, thanks to modern technology and the use of advanced equipment, the accuracy of diagnostic procedures has increased significantly.
What diseases does it treat?
Among the ailments that a reflexologist helps to cope with are many pathologies of the musculoskeletal system (myositis, arthritis, bursitis, periarthritis, heel spurs, arthrosis). In addition, people suffering from hypertension, chronic bronchitis, gastritis, pancreatitis and headaches often turn to specialists. Reflexology helps to cope with nephritis, diseases of the genitourinary system, metabolic disorders, and anemia.
In addition to physical diseases, influencing various points of the body is an effective way to combat insomnia, depression, emotional instability and increased anxiety.
When should you see a reflexologist?
The help of a specialist can be useful not only during treatment, but also during preventive measures. Practice shows that people turn to a reflexologist when traditional treatment methods do not give the expected result. Professional help will help with:
- chronic pain and allergies;
- disorders of the reproductive system;
- chronic and acute inflammation;
- developmental delays in children and cerebral palsy;
- skin and infectious diseases;
- recovery after strokes, polio, epilepsy attacks.
Often, people suffering from alcohol, drug and other types of addiction who have become disillusioned with traditional methods of treatment seek the help of a reflexologist.
What organs does a reflexologist work with?
It is impossible to determine the main “working body” of a specialist in the field of reflexology - the doctor acts on all active points of the human body. The procedures allow you to cope with diseases of various organs, as well as prevent the development of chronic ailments.
It is an integrated approach to developing a course of treatment that helps achieve maximum results.
Reflexologist: how is the appointment?
The reflexologist conducts consultations in a fully equipped office, where there is a special couch, advanced devices for electroacupuncture and other manipulations using modern techniques, as well as a sterile cabinet in which kits for acupuncture procedures are stored.
At the initial stage, the doctor collects the patient’s medical history, identifies complaints and assesses his condition. It is very important to determine the localization of the pathology in a timely manner in order to competently draw up a manipulation plan. That is why it is necessary to provide the specialist with detailed and honest information about your lifestyle, diet, past illnesses and injuries. It is better to take with you a medical card, recent results of examinations and tests.
You should avoid going to a reflexologist during periods of exacerbation of chronic illnesses or warn your doctor in advance about your condition. Only with up-to-date information can a specialist create an effective treatment program that will not provoke negative consequences.
It is very important to consider that in order to achieve maximum results, it is important to complete the course of treatment, even if after several sessions the patient begins to feel relief. A decrease in pain does not mean that the problem is completely eliminated.
What tests need to be taken?
Before an appointment with a reflexologist, you usually do not need to undergo additional instrumental and laboratory tests. However, there are situations when a specialist can prescribe an examination in order to get an objective idea of the state of the human body. If you have ready-made research results and opinions of other doctors, you should take them with you.
Like all professional doctors, reflexologists recommend that their patients seek help in a timely manner, including regularly undergoing preventive procedures to protect themselves from a variety of ailments. Any disease is much easier to prevent than to cure.
- eat in a timely and balanced manner;
- regularly exercise and rest;
- stay in the fresh air for at least one hour a day;
- timely and fully treat all current diseases, including common colds, and also abandon untested folk methods.
Thanks to the effectiveness of reflexologists, confirmed by hundreds of thousands of positive reviews, the services of specialists in this field are very popular.
If earlier doctors of alternative medicine used only their hands, knowledge and intuition, today modern computers help them in the treatment process. The system ensures diagnostic accuracy and helps perform the procedure without harming the patient's body.
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