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Medical commissions will check how frequently ill patients are treated. When will they be prescribed and for what purpose?
The ministry noted that the document is currently undergoing public discussion. But its main focus is to improve the identification of workers with symptoms of illness and initiate additional measures for their speedy return to professional activities.
Medical commissions will be able to analyze the medical history to determine the reasons for prolonged sick leave in each specific case and, possibly, adjust the treatment.
Nowadays in Russia people are "officially" sick less than in Soviet times, many try not to take sick leave so as not to lose their salary
There is no talk of "tracking" unjustifiably issued releases from work, although this aspect of the issue will obviously be carried out automatically during the work of the commission. The Ministry of Health developed the draft order following a meeting with Deputy Head of the Government Staff Olga Krivonos, where the issue of the need for the attending physician to take into account cases of multiple generation of sick leave certificates for one patient was discussed.
According to the authors of the document, the medical commission of a polyclinic or other medical organization will have to evaluate the effectiveness of the treatment prescribed to the patient, preventive procedures, diagnostics and rehabilitation, and then decide whether to extend the sick leave in each specific case. The document provides for exceptions: if the sick leave is issued to care for a child or a sick family member, for medical rehabilitation, which may take a long time, the commission will not be involved. There are also no plans to recheck cases of incapacity for work in patients with certain serious diseases (for example, cancer, tuberculosis, renal failure requiring regular dialysis procedures).
"The practice of having the attending physician raise the issue of convening a medical commission on the patient's condition when the total number of sick days during the year is exceeded has existed before," the co-chairman of the All-Russian Union of Patient Organizations, neurologist, professor Yan Vlasov told Rossiyskaya Gazeta. "And this is correct, because the problem concerns several participants in the process - the person himself, whose health may require closer attention, and the medical workers who provided him with assistance, and the employer, who needs to understand what kind of labor force he can count on."
However, it is not enough to analyze the duration of sick leave alone in order to accurately determine the patient's health and draw conclusions about his ability to work, RG experts note. In fact, it is proposed to assign this complex work to a medical commission.
"If we want to identify workers with symptoms of the disease at an early stage and develop measures to help them return to professional activity, it is not enough to take into account the frequency of issuing sick leave four times in six months," said Professor of Social Sciences. affairs. Academician Yu.P. Healthcare Galina Buslaeva spoke at the Lisitsyn Institute of Preventive Medicine of Pirogov University. - To develop criteria for identifying these cases, it is necessary to take into account not only the frequency, but also the total duration of disability, the duration of each case and the cause of disability."
"There is a task to reduce the period of sick leave, but if you look, now in Russia people often get sick "officially" either in the USSR or in a number of foreign countries. In order not to lose income, you need to pay attention to the duration of sick leave. Not to suspect fraud or fight the doctor's diagnosis, but to increase and improve the quality of life. Personal efficiency at work increases," says Yan Vlasov.
This requires systematic action, experts continue. "It is important to invest in opening sanatoriums, developing health programs, sanatorium and resort treatment, minimizing stress in the workplace by creating spaces of psychological well-being. An example is the situation with sick leave for rural doctors. - When doctors began to be provided with decent working conditions and a good social package, the number of sick leaves decreased, which may be indirectly associated with a decrease in stress levels," concludes Yan Vlasov.
- I don't think a doctor's order is necessary if sick leave is established for various illnesses. In six months, any person can get a viral infection, break a toe, aggravate a stomach ulcer or go into a hypertensive crisis.
During this period, it is recommended to visit a medical commission if a certificate of incapacity for work has been issued for the same diagnosis. For example, this category includes patients with arthritis of the hip joint or arthritis requiring joint replacement. Conducting a medical commission will likely speed up the process of providing surgical quotas.
In addition, the VK may refer patients with frequent exacerbations of chronic diseases to a medical and social examination to formalize disability or refer them to rehabilitation and hygienic and spa treatment. Ultimately, these plans can help minimize the unauthorized provision of sick leave to patients who do not actually need it.
- I am a pediatrician. This initiative does not apply to certificates of incapacity for work. However, I believe that it is impossible to impose additional responsibilities on doctors, since they already do so much. If the employer suspects that the employee is faking and does not want to work while on sick leave, the employer has the right to initiate an examination and request a medical institution, where a fee is established for this fact and interrogation. You will receive an answer whether the employee really needs help/transition to another job/disability or is doing this for some reason not related to health.
Doctors issue a sick leave certificate based on the signs of temporary disability detected in a person, the reasons for which may be different. Frequent exacerbations of chronic diseases are possible, especially if a person does not follow recommendations, does not lead a healthy lifestyle, has bad habits or has unfavorable living conditions. Unfortunately, this is very difficult to influence.
What about them?
In Germany, workers cannot be sick for more than six weeks if they do not want to lose their income. In fact, the employer pays wages only if the sick leave period is less than one and a half months, and if it is longer, the payment is made from the health insurance fund (it is mandatory for everyone living in Germany). You register with one of these companies, and they bring 7-8% of your salary), and the benefit amount is less than your usual income. And frequent sick leaves will raise suspicions, and the employer, if he considers him incapacitated, can report this to the same health insurance fund, which in some cases instructs her to check for fraud. If the health condition requires registration of disability, the citizen (or his relatives) must deal with this issue themselves. This process is slow and takes months.
There is no sick leave in the United States. The number of days you can miss from work per year due to illness is determined by how long you have worked for a particular company and how many days you have missed from work. However, employers often do not pay for periods of absence at all. In the case of disability, the Social Security Administration is responsible for registering. Benefits are paid to people who are unable to work due to an illness that lasts more than a year or may lead to death. This definition is enshrined in federal law. The application must be submitted in person. Moreover, this takes into account the length of service and the level of income (disability is not recognized if it exceeds a certain amount).