The medical profession continues to dominate the top 25 highest and lowest paid professions in America. The first 9 places are occupied by various kinds of medical specialties, led by anesthesiologists followed by surgeons and orthodontists.
Executive directors("Chief executives", no. 10) and airplane pilots(No. 11), which moved up 3 positions, are breaking this medical cartel, but only temporarily. The next 5 places are returned to the well-cleaned hands of doctors and dentists.
Even lawyers do not appear on the list earlier than 17th place, having dropped by 1 position compared to last year.
At the other end of the scale are low- and low-skilled workers in restaurants, hotels, and leisure. Who has the lowest paid job? It is from the people who cook and serve in fast food restaurants, followed by the dishwashers, the waiter's and the people who wash your hair in the hairdressers.
According to government figures, the median salary of 31,030 anesthesiologists in the United States was $192,780 per year, having increased over the year by 4.6%. 2.6 million of those who work in cooking and serving earn $16,700 per year (+ 4.8%), which is 1 \ 12 of the annual income of anesthesiologists. The average annual salary in the United States for all occupations is $40,690 (+ 3.8% for the year).
In general, the lowest paid professions provide jobs 15.6 million residents of America, and the highest paid - only for 3 million.
Our numbers were taken from U.S. government's National, State and Metropolitan Area Occupational Employment and Wage Estimates("National, by state and city estimate of the level of employment and wages from the US government"). The most recent figures are based on 2007 data and are based on national a survey of employers of all types in all sectors of the economy. 801 professions were investigated.
The survey covers full-time and part-time workers who receive salary or salary... It did not include self-employed persons (“self-employed”), owners and partners in unincorporated firms, household workers and unpaid family workers.
During the study, questions were asked about basic pay (“basic pay”, standard salary, excluding overtime, bonuses or other additional payments), incentive payments and commissions, excluding overtime pay and non-monetary compensation (for example, stock options ).
This helps explain why average annual earnings seem less than one might imagine at the top of the list and more at the bottom of the list, where it is unlikely to accurately count unofficial workers and difficult to account for all sources of cash, such as tips.
It should, however, be remembered that the mentioned numbers are average for standardized specialties. They do not provide an answer to what the gap in wages may be for a specific specialty, or fluctuations in income for individual subgroups within one specialty.
The total compensation (salary and bonuses, excluding stock options) for the highest paid CEO on our most recent CEO compensation list was $ 192.92 million for Lawrence ellison from Oracle, which is 1274 times the remuneration for the average CEO.
Likewise, there are many lawyers earning much more than the average $118,280 for their profession, and, we can say with confidence, there are dishwashers who receive much less than average $17,060 in year. At the same time there is Warren Buffett, a Berkshire Hathaway CEO who pays himself below average at just $ 100,000 a year, although he is one of the richest people in the world.
Earnings can fluctuate greatly for the same specialty in various industries and territories. Garage workers employed by the federal government earn nearly double the national average for this type of activity. the same situation with cashiers working in intermediary firms of telecommunications companies.
Typically low-paying jobs involve low bonuses in industries that generally have high earnings. A small number of service personnel and housewives employed by research organizations earn on average 2/3 of the national average.
There has been a slight change in the list of the 25 highest and lowest paid occupations. Nobody dropped out of the list, but the order changed a little. Rooms 1 and 2 remained intact, while rooms 3 and 4 were swapped. Petroleum engineers climbed 5 spots from 24th to 19th, while air traffic controllers dropped 6 spots from 17th to 23rd.
Among the lowest paid jobs, numbers 1-4 remained unchanged. It was not a good year for head washers - they came from 8th to 5th in the list of the lowest paid. The bartenders receive applause. Their incomes increased, and fate gave them + 7 positions: from 18 to 25.
———————————-
25 highest paying jobs in the USA
| № | Speciality | Income per year | Growth over the year | Employed | What do they do |
| 1 | Anesthesiologists | $192,780 | 4.58% | 29,890 | General anesthesia is performed during surgery and other medical procedures. |
| 2 | Surgeons | $191,410 | 3.94% | 51,900 | Treat diseases, injuries and disabilities with invasive methods. |
| 3 | Orthodontists | $185,340 | 4.77% | 5,200 | Malocclusion of teeth and malformations of the oral cavity are diagnosed and treated. A device for aligning teeth and jaws is modeled and manufactured. |
| 4 | Obstetrician-gynecologists | $183,600 | 3.12% | 22,520 | Diagnostics, treatment and prevention of female diseases, especially those that affect the reproductive system and the process of childbirth. |
| 5 | Maxillofacial Surgeons | $178,440 | 8.30% | 5,320 | Operations are performed on the oral cavity and jaws. |
| 6 | Prosthetists | $169,360 | 6.56% | 480 | Prostheses are made to replace missing teeth and other structures of the oral cavity. |
| 7 | Therapists | $167,270 | 3.98% | 48,700 | Diagnostics and non-surgical treatment of diseases and injuries of internal organs. |
| 8 | Other doctors and surgeons | $155,150 | 9.09% | 208,960 | All other doctors and surgeons outside of the main specialties. |
| 9 | Family doctors and general practitioners | $153,640 | 2.53% | 109,400 | They are engaged in the diagnosis, treatment and prevention of diseases and injuries that often occur in the population. |
| 10 | Executive directors | $151,370 | 4.68% | 299,520 | Define and develop a strategy and carry out overall management of the company or organization on the recommendations adopted by the board of directors. |
| 11 | Airplane pilots and flight engineers | $148,810 | 6.01% | 75,810 | They pilot and operate the flight of multi-engine planes of regular flights. |
| 12 | Psychiatrists | $147,620 | -1.58% | 24,730 | They are engaged in the diagnosis, treatment and prevention of mental disorders. |
| 13 | Dentists | $147,010 | 4.30% | 86,110 | Diagnose and treat diseases, injuries and malformations of teeth, gums and adjacent structures of the oral cavity. |
| 14 | Pediatricians | $145,210 | 2.67% | 28,930 | They carry out diagnostics, treatment and prevention of childhood diseases and injuries. |
| 15 | All other dentists | $120,360 | 11.09% | 4,560 | The rest of the dentists, with the exception of oral and maxillofacial surgeons, orthodontists and prosthetists. |
| 16 | Podiatrists(podiatrists specializing in the treatment of diseases of the feet) | $119,790 | 1.09% | 9,020 | Diagnose and treat diseases and deformities of the feet. |
| 17 | Attorneys | $118,280 | 4.06% | 547,710 | They represent the interests of the client in criminal and civil litigation, prepare legal documents, advise clients on legal agreements. |
| 18 | Technical managers (chief engineers) | $115,610 | 5.07% | 183,960 | Plan, direct and coordinate activities in industries such as architecture and technology, or the research and development of these industries. |
| 19 | Petroleum engineers | $113,890 | 12.07% | 15,060 | Thinking about ways to improve the production of oil and gas wells, determine the need for new or improved tools. Supervise drilling and help with technical advice. |
| 20 | Computer and information systems managers | $113,880 | 6.18% | 251,210 | Plan, manage, or coordinate work in areas such as electronic data processing, systems analysis, and computer programming. |
| 21 | Marketing managers | $113,400 | 5.38% | 159,950 | They determine the requirements for products and services, find potential buyers, develop a pricing policy, and control the need for product development. |
| 22 | Science Managers | $113,170 | 4.82% | 38,660 | Plan and coordinate work in areas such as life sciences, physical sciences, mathematics, statistics, and research and development in these areas. |
| 23 | Air traffic controllers | $107,780 | -2.26% | 23,240 | They control air traffic in and around airports, movement in the air at heights and between control centers in accordance with the established rules. |
| 24 | Commercial directors | $106,790 | 3.95% | 307,960 | Manage the distribution of a product or service to a consumer, establish training programs for sales representatives, and analyze sales statistics to determine sales potential and accounting requirements. |
| 25 | Financial managers | $106,200 | 4.68% | 468,270 | Plan, manage and coordinate financial accounting, investment, banking, insurance, security and other financial activities of an industry, office, or department of an institution. |
It remains only to rejoice for the American doctors and remember the well-known truth: it's good where we are not. I have already written about the salaries of Belarusian doctors, including the income of a novice doctor who will soon help. For several months the newspapers have been talking about a significant increase in salaries in the Belarusian healthcare, but things are still there. State medicine is a costly business.
American doctor's car.
The car of the Belarusian doctor.
Recently I had to write a prescription for my grandmother, I had to call the local doctor at home. I am absolutely serious: the district police officer (she is about 45-50 years old) arrived in the same car as in the photo above, only older. She said that she was very glad that she decided to use a personal car today: the site is large (private sector), and calls to the house are accepted until 14-00 and therefore they can easily give the last call to the other end of the site, when in half an hour or an hour you have to be on admission to the clinic.
25 lowest paid jobs in the USA
| № | Speciality | Income per year | Growth over the year | Employed | What do they do |
| 1 | Food preparation and service workers, including fast food | $16,700 | 4.8% | 2,461,890 | Carry out duties that include both cooking and serving visitors |
| 2 | Fast food chefs | $16,860 | 5.6% | 612,020 | Cooking in fast food restaurants with limited menus |
| 3 | Dishwashers | $17,060 | 5.4% | 502,770 | Cleans dishes, kitchens, cooking equipment and tableware. |
| 4 | Canteen service personnel, cafeterias and bartender assistants | $17,380 | 6.5% | 401,790 | They help the food service, put and remove dirty dishes from tables, serve food at the bar, distribute water, oil and coffee. |
| 5 | Head washers | $17,490 | 2.6% | 15,580 | They wash and color their hair. |
| 6 | Waiters in restaurants, lounges, cafes | $17,770 | 5.4% | 340,390 | They greet clients, set them at tables or in lounges and help to ensure the quality of service and service. |
| 7 | Service staff in cafeterias and cafes | $17,820 | 5.1% | 524,410 | Serve food to diners. |
| 8 | Doors, receptionist and lobby staff, ticket controllers | $17,880 | 2.2% | 101,530 | Assists clients during recreational activities by performing duties such as checking entrance tickets and placing seating. |
| 9 | Croupier | $18,120 | 6.5% | 82,960 | Manages table gambling games. |
| 10 | Recreation and entertainment service personnel | $18,220 | 3.9% | 235,670 | Performing customer service duties in recreational or entertainment establishments. |
| 11 | Agricultural and unskilled harvesting and plant growing workers | $18,350 | 4.1% | 230,780 | Manually grow, process and harvest vegetables, fruits, nuts, field crops. |
| 12 | Cashiers | $18,380 | 2.5% | 3,479,390 | They receive and give out money in institutions that are not related to financial institutions. |
| 13 | Waiters and waitresses | $18,570 | 8.0% | 2,312,930 | Receive orders and serve food and drinks to visitors' tables. |
| 14 | Personal and home carers | $18,940 | 4.2% | 578,290 | Help the elderly and disabled with their daily life at home or during the daytime outside the home. |
| 15 | Seamstresses, weavers | $19,280 | 4.4% | 75,150 | Clothes are made by hand or using machines. |
| 16 | Service staff of paid parking lots | $19,320 | 4.7% | 131,870 | They park cars or issue tickets to customers in parking lots or garages. |
| 17 | Food preparation workers | $19,350 | 4.7% | 871,470 | Carry out various duties in food preparation, with the exception of cooking. |
| 18 | Lifeguards on the waters, ski patrol, other security workers | $19,430 | 5.5% | 108,870 | Monitors recreational facilities such as swimming pools, beaches or ski slopes to help and ensure the safety of vacationers. |
| 19 | Maids and Housekeepers | $19,550 | 4.5% | 900,040 | Carry out minor cleaning duties in private homes and commercial organizations such as hotels, restaurants and hospitals. |
| 20 | Laundry and dry cleaning workers | $19,570 | 3.6% | 217,580 | They operate washing and cleaning machines for washing and cleaning work and household clothes. |
| 21 | Chefs in fast food restaurants | $19,580 | 4.6% | 189,610 | A variety of foods are prepared that require a short cooking time. |
| 22 | Crop sorters | $19,590 | 5.3% | 45,890 | Agricultural products are sorted, such as potatoes. |
| 23 | Childcare workers | $19,670 | 4.5% | 572,950 | Work with children in schools, enterprises, private homes and childcare facilities |
| 24 | Service station workers | $19,720 | 3.0% | 94,780 | The cars are filled with fuels and lubricants. Accept payment for goods and services. Can install car accessories and repair or replace tires. |
| 25 | Bartenders | $19,740 | 6.5% | 485,120 | Drinks are mixed and served to customers on their own or through waiters. |
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Tumors. Part 5. Treatment of a tumor
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We have come to the last part of the cycle devoted to the treatment of tumors. Today we will learn new medical words: palliative (facilitating, auxiliary) and fascia (connective tissue septum, a term from anatomy), as well as learn several new names for tumors. There is a lot of material, so it will be in the form of a synopsis.
The tactics of treating benign and malignant tumors are different , because the latter have infiltrating growth, a tendency to metastasis and recurrence.
TREATMENT OF BENIGN TUMORS
The main method of treatment is surgical. Occasionally, in the treatment of tumors of hormone-dependent organs, instead of or together with the surgical method, it is used hormone therapy.
Benign tumors that do not pose a threat to the patient's life, doesn't always have to be removed... If the tumor does not cause any harm to the patient, but at the same time there are contraindications for surgical treatment (severe concomitant diseases), then it is inappropriate to operate on the patient.
Indications for surgery:
permanent trauma to the tumor (for example, on the scalp, on the neck area of the collar, in the area of the waist in men)
organ dysfunction (closure of the lumen of a hollow organ, release of hormones into the blood)
not completely sure in the benignity of the tumor. During the operation, a biopsy is taken, and within 15 minutes the pathologist must look at the biopsy under a microscope and give an answer. Surgeons are waiting at this time, the patient is lying on the table under anesthesia.
cosmetic defects especially in women.
Remove the tumor as a whole (not in parts) , within healthy tissues, with a capsule (if any). The excised neoplasm is subject to mandatory histological examination. Relapses and metastases after removal of a benign tumor do not develop,
the operation cures the patient completely.
TREATMENT OF MALIGNANT TUMORS
This is a more difficult task. Are applied 3 ways of treatment:
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surgical (also basic), radiation therapy (radiation) and chemotherapy (drugs).
Surgery
it the most radical, and in some localizations, and the only method of treatment. When removing the malignancy of the tumor must be observed “ oncological principles“:
1.ablasticity: non-proliferation measures tumor cells during surgery (particle a- means absence, blastoma - tumor). Ablastic measures:
incisions only within known healthy tissues
avoid mechanical injury to tumor tissue
ligate (ligate) the venous vessels from the tumor as soon as possible
a hollow organ with a tumor is tied with ribbons above and below the tumor so that tumor cells cannot move along the lumen
removal of the tumor in a single block with fiber and regional lymph nodes
before manipulating the tumor, limit the wound with napkins
after removal of the tumor, change instruments and gloves, change limiting napkins
Antiblastic: measures for the destruction of tumor cells during the operation, torn off from the bulk of the tumor (a particle anti-means resistance). Tumor cells can lie on the bottom and walls of the wound, get into the lymphatic and venous vessels and cause tumor recurrence and its metastases. Ablastic surgery happens:
1.physical: the use of an electric knife and a laser, irradiation of the tumor before the operation and in the early postoperative period.
2. chemical: treatment of the wound after removal of the tumor with 70% alcohol, intravenous administration of anticancer drugs on the operating table.
Zoning and sheathing
The purpose of the operation is to remove the entire area in which individual cancer cells may be located. That is why the tumor is removed in a block (one of the ablastic measures). If the tumor grows outward (exophytic growth - into a cavity or lumen; exo - external), 5-6 cm recede from its visible border.If the tumor grows endophytically (in the wall of an organ; endo - internal), at least 8-10 cm recede ...
Since the lymph nodes and lymphatic vessels, through which tumor cells can spread, are located in the fiber between the connective tissue septa (fascia), for greater radicality of the operation, all the fiber is removed, for example:
even with a small tumors of the body of the stomach,
growing endophytically (inside the wall), the stomach is removed in a whole block, and with it the large and small omentum.
at breast cancer a single block removes the mammary gland, pectoralis major muscle, fiber with axillary, supra- and subclavian lymph nodes.
melanoma (the most malignant tumor) requires extensive excision of the skin, subcutaneous tissue, fascia, complete removal of regional lymph nodes, although the size of the primary tumor does not exceed 1-2 cm.
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Signs of melanoma. From left to right:
asymmetry - border unevenness - color - diameter (1/4 inch or 6 mm).
I have already written about melanoma in other parts of this series.
Melanoma on the face
Radical operations that cure a cancer patient can be performed only at stages 1-2 of a malignant tumor. In advanced stages of malignant tumors,
palliative and symptomatic surgery ... They do not cure the patient, but only alleviate his condition and
slightly prolong life. For example, with a disintegrating bleeding stomach tumor, gastric resection is performed, eliminating the source of bleeding. Multiple metastases can no longer be removed, so this palliative operation will not cure the patient, but only prolong his life by stopping bleeding and reducing intoxication.
Radiation therapy
Rapidly multiplying cells are more sensitive to ionizing radiation, although they are sensitive in different ways:
the most sensitive: connective tissue tumors with round cell structures.
Lymphosarcoma: A local swelling of lymphoid cells. If you remember, a common (scientifically, generalized) tumor of lymphoid cells is called leukemia (leukemia).
Myeloma: a tumor of plasma cells
(a type of lymphocyte, which, in turn, refers to leukocytes), accumulates in the bone marrow, which leads to the destruction of bone tissue.
Endothelioma: A tumor from the endothelium that lines the inside of the vessels.
highly sensitive: some epithelial tumors. With irradiation, these tumors quickly disappear, but they often recur and are prone to metastasis.
Seminoma: a malignant tumor of the cells of the spermatogenic (sperm-forming) epithelium of the testicle.
- chorionepithelioma: a malignant tumor from areas of the fetal membrane of the fetus, occurs during pregnancy or after an abortion.
medium sensitive: tumors from the integumentary epithelium (skin cancer, cancer of the lip, larynx, bronchus, cancer
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esophagus). If the tumor is small, then the patient can be cured with radiation.
low sensitivity:
1.tumors from the glandular epithelium (cancer of the stomach, kidney, pancreas, intestines),
2. highly differentiated sarcomas(if you remember, sarcomas are malignant tumors of connective tissue):
Fibrosarcoma: a malignant tumor of soft connective tissue,
Osteosarcoma: a malignant tumor of bone tissue,
Myosarcoma: a malignant tumor of muscle tissue
Chondrosarcoma: a malignant tumor of cartilage tissue.
3. - melanoblastoma (melanoma): from the name it is clear that the tumor develops from cells that form melanin (melanocytes). Thanks to the pigment melanin, our skin becomes darker when tanned. Melanin protects against
adverse effects of solar radiation ... Therefore, it is clear that for melanoma cells, radiation is like a dead poultice. The surrounding healthy tissue will die sooner. Hence one more conclusion: it is not necessary to sunbathe a lot, so as not to stimulate melanocytes once again.
Sunburn is very harmful (especially those obtained during childhood), which greatly increase the risk of developing melanoma.
Melanoma on the arm.
Radiation therapy methods:
external irradiation (installations for X-ray therapy and gamma therapy). It is carried out in courses for superficial tumors.
intracavitary irradiation : a radiation source is introduced through a natural opening into the uterine cavity, bladder, oral cavity, etc.
interstitial: sewn in radioactive capsules and
use radioactive isotopes, for example, I131 for thyroid cancer with metastases. Iodine isotopes accumulate in the thyroid gland and its metastases, acting very selectively
Complications of radiation therapy (you need to choose the right dose):
local: dermatitis (skin inflammation: redness, swelling, hair loss, pigmentation, dilation of small vessels), radiation ulcers (they are painful and practically do not heal).
general: acute or chronic radiation sickness (primarily the bone marrow and hematopoiesis are affected).
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Chemotherapy
Impact on the tumor pharmacological agents. It is used for systemic oncological diseases (leukemia, lymphogranulomatosis) and hormone-dependent tumors (breast cancer, ovarian cancer, prostate cancer, etc.), and in courses and for a long time - sometimes for many years.
Groups of chemotherapeutic agents:
cytostatics (inhibit the process of tumor cell division)
antimetabolites (disrupt the metabolism in tumor cells)
antineoplastic antibiotics (produced by microorganisms, kill tumor cells)
immunomodulators(stimulates specific parts of the immune system to fight off tumors)
hormonal drugs (for the treatment of hormone-sensitive tumors; both hormone analogs and drugs that block the action of hormones are used).
Complications: all drugs affect both healthy cells and , disrupting hematopoiesis, liver and kidney function, etc. Treatment is carried out under the strict control of the blood count.
Combined treatment - when using 2 of 3
methods of treatment. If 3 methods are used, then the treatment is called complex.
Treatment of stages of breast cancer:
cancer in situ and stage I: surgery.
Stage II: radical surgery + chemotherapy (combined treatment).
Stage III: first, radiation, then a radical operation, followed by chemotherapy (complex treatment).
Stage IV: powerful radiation therapy. Operation according to indications.
Evaluation of the effectiveness of treatment:
the main indicator is 5-year survival (% of those patients who were able to live 5 years after diagnosis and treatment). If after 5 years the patients are alive and well, they are considered to have recovered from cancer.
Now let's look at advances in American medicine
(I did not find statistics on the CIS).
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Improving 5-year survival for the 13 most common cancers,
diagnosed in Ontario in 1997-99. compared with
In the figure from top to bottom:
all cancers except non-melanoma skin cancer thyroid gland
prostate melanoma of the skin
breast cancer (women only) *
body of the uterus
kidney and urinary system non-Hodgkin's lymphomas
intestine (colorectal)
oral and pharyngeal leukemia (leukemia)
cancer of the stomach (stomach) cancer of the trachea, bronchi and lungs
pancreas (pancreas)
* - in men, by the way, it also happens, do not be surprised (my remark).
As you can see, progress has been achieved in 10 years in all directions although the greatest progress has been seen in treatment prostate cancer... 5-year survival rate for thyroid cancer approaching 100%... Worst of all
with cancer of the pancreas, lungs and stomach. this one good a reason to at least quit smoking.
Let the example of Australian singer Kylie Minogue, who was diagnosed with breast cancer in May 2005, be before your eyes. She was operated on, and now the singer is gradually
returns to normal.
So the cycle about tumors has ended. You cannot cover everything here, and it is not necessary. Hope you now have a more holistic view of neoplasms. And if something is unclear or missing, ask in the comments.
Sometimes I go to LJ and enter the word “ medicine”In the search column. V 85% bloggers scold all medicine in general and doctors in particular for indifference, inattention, unprofessionalism, rudeness, rudeness and much more. Of course, the bad is remembered more strongly than the good. But still the problem “ the doctor is sick" and " doctor - relatives" exists.
Why it happens? Why representatives “ the noblest profession”Do they behave like that? For the sake of justice, everywhere it is noted that sometimes they still meet Doctors with a capital letter, similar to the ideal, but there are very few of them. I tried analyze the reasons not only from the standpoint of the patient, but also from the standpoint of the doctor. The reasoning refers to Belarus, but I think that the situation is similar in Russia.
- Lack of time... According to the standards approved by the Ministry of Health, one patient at a therapist in a polyclinic is allocated about 12-13 minutes(4.5 patients per hour). This norm was developed taking into account the fact that on 3 primary patients(first-timers), on average, it happens 2 "repeat"... Naturally, the “repeat” ones take less time. In reality, it turns out that in 14-15 minutes the doctor often does not have time to really talk with the “primary” patient, examine him, issue an outpatient card, prescribe treatment, explain to the patient about the treatment, regimen, diet. But even these standards are not met, especially in the winter-spring period, when there are many colds and up to 50-60 people per shift.
- Lots of paperwork... The doctor and nurse have to do a lot of unnecessary, bureaucratic work. In recent years the number of securities is only growing... When you come to an appointment, the doctor has no time to look at you - he is tensely scribbling on the card. And sometimes he does not have time, he has to stay “after school”. I already wrote about this earlier in the revelations of the district doctor.
- Overwork... Because of such a rather strenuous work (clinic + home calls), not everyone can stand on the site of a district doctor. It is generally scary to go to some home calls in the dark and without protection. That's why there are not enough doctors in Belarus.
- Burnout Syndrome... Occupations associated with working with people are susceptible to burnout syndrome (EBS). This is when work and sick bored to death, I want to literally not see them and, if there is no such possibility, even “ shoot”(I've heard this expression). According to some reports, about 50-60% of doctors have a CMEA at the initial stage and about 5-10% - in expressed degree. And work in constant nervous tension due to lack of time, fear of complaints (about them another time) and 1.5 bets this is very helpful.
- Lack of incentives... In the public health care system, remuneration is weakly dependent on the number of patients. It doesn't matter if the office doors are empty or there are constant queues - the salary will not differ much. Hence, it is tempting to have fewer patients. Favorite excuses of these doctors:
Add here house calls... In the summer there are not very many of them, and in the winter there are p about 10-20 calls... According to the standard, 1 home call is assigned 30 minutes... So think for yourself how the doctor should be able to do everything in time, to satisfy everyone and at the same time not to spend the night at work.
There is not enough time, even if the doctor thinks and makes the correct (!) Diagnoses at the speed of a supercomputer... But this is a hypothetical option. In life, everything is more complicated.
The population of the CIS countries is aging. This means that at an appointment with a specific doctor the proportion of elderly and senile people is increasing... Usually they have a bunch of illnesses, they move slowly and think, often hear poorly. Standard 12 minutes here definitely not enough... Reflection: in private medical centers to see a patient allowed 30 minutes.
All in all, work on the conveyor and according to the template gives the same boilerplate result. There is no time to think and reason. In ancient times it was called Procrustean bed.
According to statistics from the Belarusian Ministry of Health, on average every Belarusian doctor works at 1.3 rates... That is, there is a lot of work. Patients need to be served. Doctors have to work for themselves and “for that guy”. V November 2007 in Belarus, the average earnings were Br736.4 thousand ($ 342), and doctors - 1,051.3 thousand rubles ($ 488.2)... Doctors seem to be making relatively good money, so why are they complaining? Let's divide $ 488 by 1.3 bets, we get 375 dollars, that is, slightly above the average in the Republic of Belarus. If all doctors worked for exactly 1 rate, as they should, then they would receive the average salary in the country.
And they work for 1.3 bets not only from “innate greed”, but also because management asks to take a part-time job... The manager is responsible for the entire institution and must think about how to fill the staffing gap. Is it the fault of other patients that there is no doctor on their site? And money is also needed. And here the doctor is promised different bonuses for “ extended service area“, Bonuses ... Everyone needs money, because the salary of a doctor is small, especially for beginners.
Old joke:
Why do doctors work at 1.5 rates?
Because there is nothing for 1 bet, and there is no time for 2.
But to whom will the doctor help, who himself needs to be treated?
- I would live to see those years myself
- what do you want at your age?
- now everyone is sick with it
- you are so special, I don’t know how else to treat you.
To reduce the flow of patients "are used" inattention, rudeness, routine treatment the most simple (ancient) drugs without proven effectiveness. As a result, patients have no desire to go to such a doctor again. The goal is achieved: the office has no queues... And patients turn to a paid medical center, where, by the way, the same doctor can conduct a part-time appointment.
This problem occurs because the doctor receives a salary not from patients, but from the state... In some ways, this system has its advantages (which ones - think at your leisure), but there are also many disadvantages. One consequence: admissions doctors subconsciously hate ambulance workers because they bring them work. After all, if the ambulance does not bring anyone, then you can do nothing for the whole shift, and the salary will not decrease from this in any way. And also all doctors are very fond of shift work to a colleague if there is any formal possibility. Less work means less responsibility, better sleep at night. Think about it what kind of medicine do we need- paid or free?
A ancient equipment, which has not been updated for many years and regularly breaks down, also does not cause any desire to improve its professional level. it psychological aspect, which I noted on my own.
In the West the problem of bad doctors expressed to a lesser extent. There is a doctor - respected person in society with a very decent salary. Working as an ordinary doctor “with us” can cause pity and sympathy those classmates who studied much worse, but now settled in the capital with a salary of 1.5-2 times more.
It is not easy to become a doctor abroad. Gotta endure big competition and be able to pay for studies... The clue lies in selection technologies... In the CIS and in the West, the selection of applicants for medical specialties of universities is significantly different. Take the selection of future doctors in Australia. Read this material yourself, but briefly I will say that our selection is only based on the amount of knowledge. In Australia and elsewhere, personal qualities: the ability to understand the interlocutor, feel him, empathize, support and much more. The selection is multi-stage, with several stages devoted to determining personal qualities of the future doctor:
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Thematic table of contents (Medical stories)
A very revealing entry appeared in the killer doctors. Since there is a fear that the author will demolish it, I repost it with comments:
Equipment of the NSR in Default City
Dear killers, especially those who work at the ambulance. Please explain the situation to me.
So I call the ambulance for painful regulations. I feel very bad, so much so that my consciousness has already swam with pain and I perceive the world around me as through a haze. An ambulance arrives, and the girl (I don't know the doctor or paramedic) declares that she can do nothing to help me. The world collapsed for me at that moment. Then, twisting his lips, he says: well, I can of course inject No-shpu. "So prick!" I say. And I ask again - what, there is nothing more painkillers? She says no. And he also scolds me that I had to take pills and everything would go away. Yeah, pills, when my whole gastrointestinal tract has been turned inside out with spasms and the pill will go to the same place as breakfast - to the sewer.
Attention to the question: WHY is there not at least the same analginum with diphenhydramine on the ambulance, but there is only No-shpa? When I called an ambulance for pain syndrome the last time, though on a different issue, the uncles came, made the correct diagnosis, and rolled in the blessed analginum with diphenhydramine. And here is such a surprise.
If suddenly this is important, then everything happened in the company, and the ambulance arrived from Solntsevo.
she pushed to the left your analginum with demidrol, sure
I'm just at a loss. Does religion allow you to go to a gynecologist for the selection of medicines? Or, if you know that your period is so painful for you, buy this penny analgin and inject it yourself? No, you must drive an ambulance for free. There are people ...
You can also call an ambulance to get a pill from the locker. Do not get up from the couch myself if your periods are painful.
And if vomiting - let them take a candle in the refrigerator and insert it wherever it is inserted.
for painful periods - an ambulance? fucking, stupid fucking, what a pity the doctors. but they did not reach someone because of such. a question to the doctors - and how often do you have this?
Quote from the TS magazine: "We live in some absolutely terrible society. Yes, we have a very problematic state, but besides the assholes in power, the main troubles are nevertheless ordinary everyday assholes."
Calling an ambulance with men is normal.
but around - only freaks
Go to the doctor, he will give you an ultrasound scan, if, without organic pathology such as endometriosis, "Buscopan" prescribes some suppositories. But you will have to buy them. And walk to the pharmacy on your own.
And so convenient, yes - a pharmacy on wheels, only the assortment is bad.
In case of pain in the abdomen, afaik, ambulance does not have the right to inject anything anesthetic - so as not to smear the clinical picture. “No,” they answered you, I suspect, so that you do not further beg for what you are not supposed to.
off-line copy.
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