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Lies, poverty and paper slavery: why are doctors fleeing clinics?
In February 2024, Rosstat published a study showing that the country has a serious shortage of doctors. According to the survey, the most difficult thing for an ordinary Russian is to make an appointment with a neurologist, cardiologist, endocrinologist, ophthalmologist, and otolaryngologist.
In particular, the shortage of doctors has worsened due to the COVID-19 outbreak. For example, in the Saratov region, 383 medical workers quit during the coronavirus outbreak, including 203 doctors. A similar incident occurred in Yekaterinburg. The staff of one of the hospitals lost their nerve, as a result of which one day all the doctors, except one, unanimously quit. Mass layoffs due to poor working conditions and emotional exhaustion also occurred in the Penza region and other regions.
One of the reasons for this outflow was the reduction in Covid payments. Doctors, who quickly got used to good money, did not want to return to bare salaries without additional payments and began to look for work in private clinics, where salaries are higher and the workload is several times less.
No anesthesiologists or psychiatrists.
As a result, there is a severe shortage of medical personnel. As of 2023, Korea is short about 30,000 doctors and 60,000 nurses. This is especially true for primary care workers and workers in remote areas, especially in rural areas. Dozens of villages have been living with closed health centers for years, forcing residents to travel dozens of kilometers to district centers every time they sneeze. There is no one to work at all.
According to official statistics, the average number of doctors in Russia is 15.27 per 10,000 people, but in many regions this figure is significantly lower. In the Jewish Autonomous Region, for example, this figure is only 9.83 per 10,000. In the North Caucasus, Siberia and the Far East, where the shortage of doctors is especially acute, this figure is only 9.83. In particular, there is a serious shortage of personnel, including anesthesiologists, neonatologists, psychiatrists and resuscitators.
Why are doctors and nurses literally fleeing from public hospitals to private ones? Medical workers openly admit that they are tired of working for a meager salary in clinics. Doctors are the same people, they also want to pay off their mortgage as quickly as possible, take their children to the beach and finally cure them.
Public hospitals are often underfunded, which affects doctors and nurses. Many people have to work two or three times a day to make a living. But this overload of 200-250 hours a month does not disappear without a trace. Constant fatigue and exhaustion become the norm.
But doctors are drawn there because salaries are higher in private clinics, work is easier and conditions are much more pleasant. And there is also a convenient schedule and a completely different attitude towards specialists, both towards patients and towards management.
If in large cities clinics and hospitals are now somewhat organized, then in small towns and villages doctors have to work in difficult conditions. Collapsing walls, plaster falling from the ceiling, worn linoleum, an ultrasound machine that has been working with bitterness since time immemorial Soviet times - all this is not a scenario from a bad movie, but the usual reality of thousands of doctors and medics. . Patients in the so-called "backwoods".
In a private clinic everything is different. The renovation is excellent, the living conditions are excellent, the doctors have the opportunity to use the most advanced modern technologies.
They also leave state healthcare institutions due to a complete lack of prospects. Doctors can work for years in one position without hope of career growth and professional development. Private clinics are often the starting point for career development. In addition, these institutions themselves are interested in the constant "advanced training" of their employees, paying for all kinds of advanced training courses and sending them to useful seminars and conferences.
In recent years, doctors, like teachers, have been inundated with paperwork. Your doctor must provide a written report of every step he or she has taken. Filling out endless logs, applications, and forms wastes valuable time that could be spent caring for patients.
In private medical centers, the amount of paper is reduced several times, and all reports are digitalized, which allows doctors to pay more attention to each patient. Undoubtedly, working in such conditions is much more pleasant, and therefore, labor efficiency is higher.
Many doctors are simply burning out at work. Heavy workloads, low salaries, and a pandemic will only make things worse. Many people find working in public hospitals burdensome due to constant pressure and lack of support. Emotional exhaustion can force doctors to take extreme measures. This means moving to a less stressful field or changing careers entirely.
There is another reason why doctors switch to private medicine. Lyubov Barabanova also named it.
A young doctor from Omsk, who wished to remain anonymous, shared his disappointment in the country's medicine with Top24.News. According to the expert, the reality is much darker and harsher than he imagined during his years of study. His honest confession serves as a true warning to those who dream of dedicating their lives to healing the sick.
Today the man regrets that he did not listen to his senior colleagues and teachers.
But the reality surprised the young graduate. Already during his residency, he realized that there was no real need for young specialists in hospitals. Or rather, no one had sufficient power over them.
But the most difficult thing begins when a young doctor gets a real job in a clinic or hospital. According to doctors, each hospital has its own rules, but there are also negative aspects that are common almost everywhere.
First, it is an unrealistic plan that, if successfully implemented, will not decrease but increase. "You failed? "Good."
Secondly, the above-mentioned bureaucracy of paperwork takes a lot of time even from experienced doctors, and young specialists spend 90% of their working day on paperwork. And this is after the much-talked-about “optimization”.
Moreover, young doctors at the hospital are treated like "new recruits" in the army. They will have to work more shifts, rotations in the new year, and they will not be allowed to treat "deliciously" paid patients. Moreover, doctors complain that when any conflict arises, the hospital management immediately takes the side of the dissatisfied patient, without even trying to sort out the situation.
According to the doctor, this system is capable of crushing even the most ardent enthusiast and fundamentally blocking his good intentions and initiative.
Beginning specialists have long tried to adapt to this system and find some advantages for themselves. Perhaps there are only two things - a stable salary and official employment. However, the disadvantages far outweigh the disadvantages.
Young people don't hide. Going to work has become a chore for me in recent months. But I never thought about a radical career change.
As a result, the only possible solution is to go to a private medical center. In fact, this decision was not easy for him.
The words of the Omsk colleague were fully confirmed by a young pediatrician from Voronezh, Maria. Having worked for several years in a regular clinic, the girl realized that, with a little more effort, she would have to seek treatment on her own.
In a conversation with the publication Pravmir, the doctor revealed many unsightly details about the work of an ordinary doctor. For example, patients do not even suspect that doctors must literally keep track of the number of patients they receive, and this requires doctors to fight their conscience.
She also spoke about what a doctor’s salary in state clinics consists of.
In the end, after working for two years, Maria could not stand it any longer, wrote a statement “on her own” and went to a private clinic. And, according to the doctor, it was the best decision in her life.
At the same time, Maria does not regret the years spent in regular clinics, and says that in any case it was a good experience. But she does not plan to return there. “I do not want to be a slave to the system,” the doctor says.
Of course, the opposite situation also happens. A doctor becomes disillusioned with his other profession and returns to the hospital after a long break. For example, pediatrician Tina from Tomsk initially traded her white coat for an economist's chair, but after a few years she returned to her favorite profession.
Women do not hide that working as a pediatrician has many disadvantages. For example, irregular working hours:
Doctors also often suffer from rudeness during appointments, but the most important thing is the notorious fuss with documents.
But Dr. Tina is not going to leave the hospital. She says that there is no more soulful job. And the salary is generally not bad. But the most important thing is that it is a fantastic profit for a small group of patients, which is worth more than any money.
Of course, such specialists deserve respect. But the problem is that such cases can be counted on the fingers of one hand.
The exodus of doctors from state hospitals is causing alarm across the country. If working conditions and wages in Russia do not improve, the crisis will worsen. The best specialists will leave for private clinics, and state hospitals will be understaffed.