How to go to a state clinic and not suffer

2024 Author: Malcolm Clapton | [email protected]. Last modified: 2023-12-17 03:44

An excerpt from the book "How a doctor would be sick" about how to properly prepare for an appointment and communicate with doctors.

Why you shouldn't give up public medicine

Everyone who has a compulsory medical insurance policy is treated here. It is important to understand that free services in a state clinic is a relative concept. After all, you do not consider car repairs with Casco insurance free of charge?

The good news is that, unlike car insurance, medical insurance premiums in the compulsory medical insurance system are fixed, so there is no reason to go to the clinic rarely, this will not affect tax deductions next year. The bad news is that most of us have a very vague idea of the list of services provided for under the insurance program, therefore, by default, it considers the clinic to be a bad option for treatment and agrees to pay extra in a public or private clinic for the services provided for free.

Yes, there are queues at polyclinics, and doctors have very little time to communicate with each patient. But, firstly, there are differences between the polyclinic and the polyclinic, and the medical institution can always be changed by choosing a less busy one (reviews on the Internet and an electronic registry will help, where you can estimate the number of coupons to specialists for the coming dates).

Secondly, it is important to remember that the polyclinic is the most obvious place where you will be provided with state-guaranteed medical services, including expensive and high-tech ones.

When smartly combined with private healthcare services, you can save money without sacrificing quality of care. For example, like this. Andrey has type 1 diabetes. Once every couple of months, he visits an endocrinologist at the clinic, who writes him a prescription for free insulin and test strips to control blood and urine glucose levels. Medicines are expensive, so Andrei does not consider it shameful to spend several hours in line to see a doctor and on the bureaucracy with the preparation of a prescription. But for a full-fledged medical examination to an endocrinologist and other doctors, Andrei goes to a private medical center. So he is calmer for his health.

Or so. Alena recently had a child. She goes to the children's clinic to get her baby free of charge according to the national calendar, while for additional vaccinations, which are officially allowed only for children at risk (for example, from rotavirus infection), she goes to a private pediatric clinic.

Sometimes patients complain that in a polyclinic it is impossible to immediately get to a narrow specialist - you first need to visit a local therapist. Firstly, this is not entirely true: you can get directly to a number of doctors who receive them under the compulsory medical insurance. For example, a gynecologist, dentist or surgeon. In addition, do not underestimate the role of the therapist: this is a dispatcher who, depending on the severity of the situation, sends you to the “next level” - to specialized doctors. But he himself can diagnose and prescribe treatment.

More than once I have heard from friends that the therapist in the clinic is by default a mediocre doctor who knows almost everything, but not exactly. In fact, such doctors sometimes have encyclopedic knowledge in medicine and vast clinical experience. After all, it is impossible to fill your hand and eye and become a good diagnostician, if you do not examine tens and hundreds of patients day after day. Well, something, but there are always an abundance of patients at the local therapists.

How to get the most out of your doctor's appointment

As someone who has worn a white coat and worked in a clinic, here are some tips to help you connect with your therapist and optimize your lean consultation time.

1. If possible, make an appointment with the doctor closer to the beginning of his working day

First, there is less chance of sitting in a queue (after all, it accumulates due to protracted consultations and patients who have leaked into the office to “just ask”). Secondly, the doctor will be less tired, which means more attentive.

2. Think over your wardrobe so as not to spend a lot of time undressing and dressing

It seems nonsense, but unfastening the buttons on a shirt, unwinding scarves, undoing the ties and other exciting activities take up precious minutes, which are more useful to spend in communication with a doctor.

3. Prepare all the necessary documents immediately

Find the card in the reception (if in your clinic the nurses do not distribute them to the offices in advance); If you plan to show the doctor any tests, take them out of the bag, arrange them in order of importance, and ideally put them in a folder with files.

4. Decide in advance what you will complain about

It sounds annoying, but most likely, the doctor will not have time to solve all your health problems in one short consultation. All secondary questions (“But my ear still hurts since last winter, I treated it with your colleague, it didn’t help”) postpone until the end of the meeting or until the next visit. Yes, according to the canons of propaedeutics of internal diseases - the section of medicine devoted to the examination of the patient - the doctor must find out about all the patient's complaints and independently decide which of them are significant and which are not.

But we are in an ordinary clinic, here, alas, we cannot count on a detailed consultation. Therefore, decide on the purpose of the visit in advance and as soon as the doctor takes his eyes off the pile of papers and utters the traditional: "What are you complaining about?" - immediately answer his question clearly and as briefly as possible.

5. If you have not been to the clinic for a hundred years or even found this doctor for the first time, be prepared to collect Anamnesis vitae, that is, a story about yourself

But this does not mean that you need to list all the diseases and details of your biography from birth to the present day, this is too long and is hardly valuable enough for making a diagnosis. Be ready to quickly remember about chronic diseases and previous operations, hereditary predisposition to certain sores, the date of the last consultation with the doctor (if you have already treated what you came to the doctor with).

6. It's a good idea to bring a recorder with you

Of course, you need to politely check with the doctor if he would mind if you record his recommendations in audio format. By the way, there is some chance that such an action will mobilize the doctor and become an incentive to formulate your prescriptions in more detail and more accurately. For example, do not prescribe biologically active additives (dietary supplements) for you in addition to pharmaceuticals: they are not included in the standards of medical care in Russia and in the overwhelming majority of cases do not have proven efficacy in the treatment of diseases.

7. Feel free to ask your doctor questions

Even if they seem silly to you. How to take pills that are prescribed to drink "three times a day before meals" if you never have breakfast, but only have lunch and dinner? How to sign up for an examination if the result is needed next week, and the specialist is on vacation? What to do if you suddenly feel sick? For example, if you went to the clinic because of heart problems.

The therapist may simply forget to tell you something important in the hustle and bustle of a busy work schedule, and then there will be no one to ask. You can make notes in a notebook right during the conversation so as not to get confused when the doctor makes it clear that the consultation is over.

8. If you have to return to the doctor in the coming days (for example, to close a sick leave), ask for a coupon right in your office

Then you will be able to make an appointment at a convenient time, as well as exclude the situation when there are no coupons for the required number in the registry.

9. Remember the names of your doctor and nurse, and always start communication with a personal address by name and patronymic

It would seem that this is a mere trifle, but according to some reports, 68% of patients miss this option. Calling by name and patronymic has a magical property: it turns you from a casual patient into a familiar patient. Probably, this technique works precisely because the majority of patients do not use it and a faceless distance remains between them and the doctors.

Greet a doctor and a nurse by first name and patronymic when you meet by chance in the corridor of the clinic and during a telephone conversation - this is nice, it is remembered, it sets you apart from other patients and may one day serve you well. We'll talk about other ways to improve relationships with a doctor in the fourth part of the book.

I understand the skepticism of those readers who have a persistent antipathy towards polyclinics: it is hard to believe that a visit to a state institution can be, if not comfortable, then at least not humiliating.

However, everything is slowly changing: now, even in small towns, it is possible to enroll in a polyclinic via the Internet, federal and regional funding often allows purchasing new diagnostic equipment for offices. Poor Soviet interiors and outright rudeness on the part of the registry staff are increasingly rare: the management of many hospitals monitors the quality of service and is open to comments and suggestions from patients.

If in doubt, try for the sake of interest to somehow go to a medical examination (a free medical examination, which each owner of the compulsory medical insurance policy is entitled to once every three years or even more often). And if it turns out that everything in the clinic is still hopeless, take out your wallet and go to a paid consultation with private traders.

Do I need to read about health on the internet? How to choose medicines? How to assert your rights in the hospital? Medical journalist Olga Kashubina will teach you how to be advanced patients. The kind that the doctor has to reckon with. The kind who feel confident in inhospitable hospital corridors because they know their rights. Patients who know how to recover.