Pavel Breastin promised to dismiss the governor of Sparrow. Professor Pavel Vorobev about our medicine Pavel Vorobev Professor Doctor of Medical Sciences Biography

- Pavel Andreevich, how did you find out that you no longer work in the MGMU named after Sechenov?

The fourth of August I was called from the personnel of our 1st Honey (now - the first MIMM named after I.M. Sechenov. - Ed.) And they reported that I do not work there now. Recently, my contract was extended for a year, this year - for three months - without explaining the reasons. No one presented to me. We did not have conflicts with the management. There is, I know dissatisfaction with my civil position, my professional attitude towards what is happening in health care, but this is not a conflict. I believe that my rights are rudely pop. And humanly and by law.

- You have repeatedly criticized the course of health care reform in Russia, it turns out, now you felt it on yourself?

And for the second time. The first time my department was kicked out of the 7th Spearproof Hospital, the largest in the city. It was reduced, part of it was closed. It was in 2014. At the University of Sechenov, the last 18 years I have headed the hematology and geriatric department, and the hospital was our clinical base, in the institute of his beds a little. Somehow attached, of course, but 34 years in the hospital is a whole medical life.

You said more than once that the reform of health care is essentially the destruction of our medicine. Now your position just strengthened?

Everything is just like that. Over the past few months, 10 percent of the younger and medium medical personnel abolished in Russia. Think about the figure - it is 40-50 thousand people! They just escaped. This has been going on for several years. The last figures suggest that this "reform" does not stop. People go themselves. Low salary, colossal loads. The salary of nurse in the country is now 5-7 thousand rubles. People take 2.5 bets to earn at least 15-16 thousand. Now in hospitals, it seems to serve patients will be for money. Maybe they themselves will have to hire a nurse. Someone must change underwear, diapers, do dressing ...

During the reform, nurses were removed and in clinics, deciding that the doctor would cope with the registration of records himself. How did the clinic affected at work?

Made it just because the nurses just lack. We decided to portray reform activity, removing the function of the nurse at all. It is not right. Worldwide, on the contrary, three or four nurses work for one doctor. The nurse draws up all records, documents. According to international standards, the doctor pays for a patient about five minutes, and everything else does a nurse. Now our doctor sits and makes recordings and on the map, and in the computer ... But from this work, the doctor can be delivered at all, for example, using voice recorders that decipher call centers. All over the world, this practice has existed dozens of years, only we can not understand how to equip everything.

- Our clinics switched to a new standard of work - did it improve the quality of patient service?

Yes, now our clinics are already working on a new "reform" model, but this did not lead to an improvement in assistance. The amount of paper work did not decrease, it is not always easy to make an appointment, and the electronic record is also convenient for all patients and is available. Recently there were even cases when people died in a queue in the registry.

These are formalized games of officials who are not related to health care reform. They improve not the efficiency of the service of the population, but the effectiveness of the expenditure of funds. Medicine should be paid, who can not pay, that albeit sick and dies himself. And who does not want to work so, can go to business - we hear such advice.

The authorities talked about the fact that during the reform of the wages of doctors will grow and that they are already up to 80 thousand rubles ...

Salary of doctors grow - due to the fact that they are fired. Two doctors left, the third increased salary. But he will not work for three. Doctors have long been working on the limit of their strength.

- For what purpose, in this case, do we have this optimization of health?

This is a reform to save money. "No money, but you hold on." Here, for example, I recently published statistics on the disease of the inflammation of the lungs at home. Mortality in the city increased by 30 percent. This is fantastic! From the inflammation of the lungs at all should not die, banal homemade pneumonia, there are different antibiotics ...

I explain it only a bad medical care organization. Now they do not hospitalize such patients. For example, there are new limitations. Without high temperatures when inflammation of the lungs, it is not for the hospital. But in the elderly, there are usually high temperatures in this disease. As a result, people come to the hospital already in resuscitation.

- What changed the rules of ambulance?

The rules of work and ambulance, and planned assistance, and the rules of hospitalization have changed. Now it is impossible to put a person for a survey. All examination passes ambulatory. But in practice it is unrealistic, unavailable for the population. The clinic in one place, the examination should go to the other end of the city. And all the time require money for doing quickly. For example, MRI and CT, what should be done urgently when determining tumors is often prescribed in a few months - a queue. Want to do quickly - pay money. Because one of the tasks of healthcare now - making money. And this can be done, only by the abyss of the patients.

The "ambulance" now does not take off patients to the hospital without a clear threat of life. And the fact that the threat to life can come a few minutes after their departure, no one does not care. Calls are transmitted to the "Emergency", which can come and a day.

- What happens in the regions?

In the regions, everything is the same, multiplied by the remoteness of the territories. There is sometimes no ambulance at all. The number of FAPs (Feldsher-obstetric item) in the regions 2 times larger than the number of paramedics. There is no one to work there. But at the same time, medical institutions are removed in small settlements. Want to be treated - go to the nearest city, two days leave for the clinic!

- You somehow said that our reform goes on the American health model. This is true?

Practically, only we are late. Obama is already turning American health care for our, still Soviet principles. Yes, and many European countries have already appreciated the convenience and quality of our health system. And we, on the contrary, for some reason I refuse it. That the most "English model" is a Soviet model, it was simply adapted under the life of England. The basic principles are the primary health link, accessible to all, the separation for assistance on two levels is the primary stage and secondary. But the main emphasis is placed on the primary link, there are doctors and nurses of general practice.

- How do you rate the change in the health insurance system?

This is just a pure theft of money. According to the most modest calculations, 10 percent of our insurance goes not to treatment, not in patients, but on system maintenance. And the most important thing is that it has nothing to do with improved quality, efficiency, and so on.

And, by the way, no changes in the OMS in recently did not happen. Many principles were laid in the system in the early 1990s. No one reads laws: for example, the patient's right to move from one polyclinic to another - this is generally no innovation, it has already since 1993, but did not work, people simply did not talk about such an opportunity, and we ignite our rights to know .

- Trade unions of health workers somehow react to the situation? And can they change it?

The official medical trade union does nothing. There is an independent trade union "Action", which is trying to do something, but experiencing constant persecution. I myself do not believe in any party or trade unions.

- At one time, doctors were quite active, went on rallies. Why is there no such activity now?

Yes, people are rallying. But nothing happened. They deceived everyone. All promises of the authorities were PSHIK. Someone put the hand in money, there is no one. Doctors have fallen hands.

- At one time our authorities said that health care reform goes with errors ...

These were empty statements. I am sure that they did not have any specific plans for the reform turn, for some kind of adjustments. Everything goes as much as it went, the criticism on the ground just do not hear, but the criticizing - pursue.

The editorial office of the Portal Rasmir appealed for comments in the first MGMU. I. M. Sechenov and the Ministry of Health of the Russian Federation. Comments from the university we are still waiting for, while we present the answers of the Ministry of Health to our questions.

Is 10% of junior and middle personnel over the past months from the health sector, which is 40-50 thousand people? Why did this happen?

According to Rosstat, in 2016 (1 quarter), the number of medium medical staff in regional and municipal medical organizations decreased compared to the same period 2015 (1 quarter) by 11,755 people. (- 0.9%), and in comparison with all 2015 - by 8,687 people. (- 0.7%).

However, the pace loss of the number of secondary medical workers in 2015 decreased almost 2 times compared with 2014 (1.6% against 2.8%).

The staffing of the posts of medium-sized medical professionals in general in medical organizations in 2015 increased to 91.7% (91.5% in 2014). A similar trend was also noted with the staffing of the staff posts of nurses, which, in general, amounted to 92.1% in 2015 (91.8% in 2014).

Reducing the number of junior medical personnel occurs against the background of the growth of the number of employees of medical organizations of other categories. This trend is due to the redistribution of part of the labor functions on other personnel in the event that the work does not imply direct participation in medical activities and does not require any knowledge and skills.

Is the salaries of doctors grow from the fact that they are fired and the remaining doctors have to close 2-3 rates? What is the average salary of the doctor and its prospects?

The coefficient of part-time in the Russian Federation in medium health workers remains stable at 1.3, which does not confirm the opinions about increasing the burden on the average medical staff.

In general, according to the Russian Federation, according to Rosstat, in the first quarter of 2016, the average monthly wages of medical workers increased compared with the first quarter of 2015: the doctors - by 5.0% and amounted to 46.1 thousand rubles, secondary medical personnel on 4.7% and amounted to 26.8 thousand rubles; Junior medical personnel, respectively, by 6.2% and amounted to 16.9 thousand rubles.

Is it true that there are FPA in the regions, but there is not enough paramedics, and people have to spend two days to spend the clinics in a remote area? The Ministry of Health of Russia special attention is paid to the provision of medical care in certain areas of the country. It is worth noting that in 2015 there were changes to the Regulation on the organization of the provision of primary health care for the adult population in terms of organizing assistance to rural residents.

Thus, in rural settlements with the number of residents, more than 2 thousand people to provide primary medical and sanitary assistance should be organized medical ambulatory. If the number of residents exceeds 1 thousand people, but at the same time it does not reach 2 thousand people, a paramedic-obstetric item / Feldsher Sweep can be organized (if the distance to the nearest medical organization does not exceed 6 km) or the Center for General Medical Practice / Medical ambulatory (if the distance from the Feldsher-Okushetsky point to the nearest medical organization exceeds 6 km).

In settlements with the number of residents from 300 people up to 1 thousand, Feldsher-obstetric items or paramedic health health sites are created regardless of the distance to the nearest medical organization in the absence of other medical organizations.

Also important is the recovery.

The program "Zemsky Doctor" is implemented since 2012. One-time compensation payments in the amount of 1 million rubles are carried out by the participants of a program with a higher education who arrived in rural settlements or working villages, and which concluded an agreement with the authorized body of the executive authority of the constituent entity of the Russian Federation (the program "Zemsky Doctor"). According to the Federal Fund for Compulsory Medical Insurance on January 1, 2016, for the period 2012-2015 the total number of medical workers involved in the program "Zemsky Doctor" to work in rural settlements and working settlements, amounted to 19.02 thousand specialists , including in 2015 - 3 thousand people.

For 2016, the program has been extended, while the ultimate age of the program participants has been increased to 50 years, as well as the list of species of settlements, which apply to the action of the program, supplemented with urban-type settlements. At the same time, the ratio in co-financing the program was changed: from the budget of the federal fund of compulsory health insurance - 60%, from the funds of the budgets of the constituent entities of the Russian Federation - 40%.

Professor suggests that there are no significant changes in the OMS system. This is true?

Recall that only over the past ten years there have been radical changes in the field of compulsory medical insurance of citizens. The main documents were adopted in this area, we are talking about the federal law of 29.11.2010 N 326-FZ, order of the Ministry of Health of the Russian Federation of February 28, 2011 No. 158n, order of the Federal Fund for Compulsory Medical Insurance of December 1, 2010 №230 " On approval of the procedure for organizing and conducting control of volumes, deadlines, quality and conditions for providing medical care for compulsory health insurance "and order of the Federal Fund for Compulsory Medical Insurance of December 26, 2011. № 243 "On the assessment of the activities of insurance medical organizations."

The OMS sphere is becoming increasingly attractive to the private sector.

How have the principles of ambulance work changed? Now she does not take off without an obvious threat of life? What are the new rules of hospitalization?

We emphasize that the principles of ambulance, as well as the procedure for its provision have not changed. First medical care is in the event of a threat to life, and urgent help in all others.

The procedure for emerging emergency care was approved by the Order of the Ministry of Health of Russia of 06/20/2013 No. 388N "On approval of the procedure for providing an ambulance, including ambulance specialized, medical care":

clause 11. Reasons for the emergence of ambulance in emergency form are sudden acute diseases, states, aggravation of chronic diseases, representing the threat of the patient's life, including:

a) violations of consciousness;

b) respiratory disorders;

c) circulatory disorders;

d) mental disorders accompanied by a patient's actions representing the immediate danger to him or other persons;

e) pain syndrome;

(e) injuries of any etiology, poisoning, injury (accompanied by bleeding, representing the threat of life, or damage to the internal organs);

g) thermal and chemical burns;

h) bleeding of any etiology;

and) childbirth, threat of interrupting pregnancy.

clause 13. Reees to call ambulance in emergency form are:

a) sudden acute diseases, states, exacerbation of chronic diseases requiring urgent medical intervention, without explicit signs of the threat of life specified in paragraph 11 of this Procedure;

p. 14. When providing an ambulance, including emergency specialized, medical assistance, if necessary, medical evacuation is carried out.

Suddenly dismissed! On Friday evening, a bitter message from Professor Pavel Vorobyeva, head of the Hematology Department and Geriatric IPO, the first MIMM named after IM, appeared on the social network Facebook. Sechenova: "Yesterday they called me from the personnel department and said that I was fired. Of the first honey. From the Institute, where I lived for more than 40 years, but worked - 36. Of these, 18 years old - in the position of the head of the Hematology Department and Geriatria. COME CREATED . Not a single comment, no recovery, is always only positive and achievements. About 700 scientific publications, including theses and foreign articles. About 100 books, guidelines, reference books. More than 20 protected dissertations under my leadership. " Chairman of the Moscow City Scientific Society of Therapists, Professor Vorobiev told the legal man that he thinks of health reform in the country.

Pavel Vorobyov. Photo: Eduard Kudryavitsky / AiF

- Pavel Andreevich, how did you find out that you no longer work in the MGMU named after Sechenov?

- Fourth of August I was called from the personnel department of our 1st honey (now - the first MIMM named after I.M. Sechenov. - Ed.) And they reported that I don't work there now. Recently, my contract was extended for a year, this year - for three months - without explaining the reasons. No one presented to me. We did not have conflicts with the management. There is, I know dissatisfaction with my civil position, my professional attitude towards what is happening in health care, but this is not a conflict. I believe that my rights are rudely pop. And humanly and by law.

- You have repeatedly criticized the course of health care reform in Russia, it turns out, now you felt it on yourself?

- And for the second time. The first time my department was kicked out of the 7th Spearproof Hospital, the largest in the city. It was reduced, part of it was closed. It was in 2014. At the University of Sechenov, the last 18 years I have headed the hematology and geriatric department, and the hospital was our clinical base, in the institute of his beds a little. Somehow attached, of course, but 34 years in the hospital is a whole medical life.

- You said more than once that the reform of health care is essentially the destruction of our medicine. Now your position just strengthened?

- Everything is just like that. Over the past few months, 10 percent of the younger and medium medical personnel abolished in Russia. Think about the figure - it is 40-50 thousand people! They just escaped. This has been going on for several years. The last figures suggest that this "reform" does not stop. People go themselves. Low salary, colossal loads. The salary of nurse in the country is now 5-7 thousand rubles. People take 2.5 bets to earn at least 15-16 thousand. Now in hospitals, it seems to serve patients will be for money. Maybe they themselves will have to hire a nurse. Someone must change underwear, diapers, do dressing ...

- During the reform, nurses were removed and in the clinics, deciding that the doctor would cope with the registration of records himself. How did the clinic affected at work?

- They did it just because the nurses just lack. We decided to portray reform activity, removing the function of the nurse at all. It is not right. Worldwide, on the contrary, three or four nurses work for one doctor. The nurse draws up all records, documents. According to international standards, the doctor pays for a patient about five minutes, and everything else does a nurse. Now our doctor sits and makes recordings and on the map, and in the computer ... But from this work, the doctor can be delivered at all, for example, using voice recorders that decipher call centers. All over the world, this practice has existed dozens of years, only we can not understand how to equip everything.

- Our clinics switched to a new standard of work - did it improve the quality of patient service?

- Yes, now our clinic is already working on a new "reform" model, but this has not led to an improvement in assistance. The amount of paper work did not decrease, it is not always easy to make an appointment, and the electronic record is also convenient for all patients and is available. Recently there were even cases when people died in a queue in the registry. These are formalized games of officials who are not related to health care reform. They improve not the efficiency of the service of the population, but the effectiveness of the expenditure of funds. Medicine should be paid, who can not pay, that albeit sick and dies himself. And who does not want to work so, can go to business - we hear such advice.

- The authorities said that during the reform of the wages of doctors will grow and that they are already up to 80 thousand rubles ...

- Salary of doctors grow - due to the fact that they are fired. Two doctors left, the third increased salary. But he will not work for three. Doctors have long been working on the limit of their strength.

- For what purpose, in this case, do we have this optimization of health?

- This is a reform to save money. "No money, but you hold on." Here, for example, I recently published statistics on the disease of the inflammation of the lungs at home. Mortality in the city increased by 30 percent. This is fantastic! From inflammation of the lungs should not die in the lungs, banal homemade pneumonia, there are different antibiotics ... I explain it only a bad medical care organization. Now they do not hospitalize such patients. For example, there are new limitations. Without high temperatures when inflammation of the lungs, it is not for the hospital. But in the elderly, there are usually high temperatures in this disease. As a result, people come to the hospital already in resuscitation.

- What changed the rules of ambulance?

- The rules of work and ambulance, and planned assistance, and hospitalization rules have changed. Now it is impossible to put a person for a survey. All examination passes ambulatory. But in practice it is unrealistic, unavailable for the population. The clinic in one place, the examination should go to the other end of the city. And all the time require money for doing quickly. For example, MRI and CT, what should be done urgently when determining tumors is often prescribed in a few months - a queue. Want to do quickly - pay money. Because one of the tasks of healthcare now - making money. And this can be done, only by the abyss of the patients. The "ambulance" now does not take off patients to the hospital without a clear threat of life. And the fact that the threat to life can come a few minutes after their departure, no one does not care. Calls are transmitted to the "Emergency", which can come and a day.

- What happens in the regions?

- You somehow said that our reform goes on the American health model. This is true?

- Practically, only we are late. Obama is already turning American health care for our, still Soviet principles. Yes, and many European countries have already appreciated the convenience and quality of our health system. And we, on the contrary, for some reason I refuse it. That the most "English model" is a Soviet model, it was simply adapted under the life of England. The basic principles are the primary health link, accessible to all, the separation for assistance on two levels is the primary stage and secondary. But the main emphasis is placed on the primary link, there are doctors and nurses of general practice.

- How do you rate the change in the health insurance system?

- This is just a pure theft of money. According to the most modest calculations, 10 percent of our insurance goes not to treatment, not in patients, but on system maintenance. And the most important thing is that it has nothing to do with improved quality, efficiency, and so on. And, by the way, no changes in the OMS in recently did not happen. Many principles were laid in the system in the early 1990s. No one reads laws: for example, the patient's right to move from one polyclinic to another - this is generally no innovation, it has already since 1993, but did not work, people simply did not talk about such an opportunity, and we ignite our rights to know .

- Trade unions of health workers somehow react to the situation? And can they change it?

- The official medical trade union does nothing. There is an independent trade union "Action", which is trying to do something, but experiencing constant persecution. I myself do not believe in any party or trade unions.

- At one time, doctors were quite active, went on rallies. Why is there no such activity now?

- Yes, people are rally. But nothing happened. They deceived everyone. All promises of the authorities were PSHIK. Someone put the hand in money, there is no one. Doctors have fallen hands.

- At one time our authorities said that health care reform goes with errors ...

- It was empty statements. I am sure that they did not have any specific plans for the reform turn, for some kind of adjustments. Everything goes as much as it went, the criticism on the ground just do not hear, but the criticizing - pursue.

Professor Pavel Vorobyov about our medicine is suddenly dismissed! On Friday evening, a bitter message from Professor Pavel Vorobyeva, head of the Hematology Department and Geriatric IPO, the first MIMM named after IM, appeared on the social network Facebook. Sechenova: "Yesterday they called me from the personnel department and said that I was fired. Of the first honey. From the Institute, where I lived for more than 40 years, but worked - 36. Of these, 18 years old - in the position of the head of the Hematology Department and Geriatria. COME CREATED . Not a single comment, no recovery, is always only positive and achievements. About 700 scientific publications, including theses and foreign articles. About 100 books, guidelines, reference books. More than 20 protected dissertations under my leadership. " Chairman of the Moscow City Scientific Society of Therapists, Professor Vorobiev told the legal man that he thinks of health reform in the country. - Pavel Andreevich, how did you find out that you no longer work in the MGMU named after Sechenov? - Fourth of August I was called from the personnel department of our 1st honey (now - the first MIMM named after I.M. Sechenov. - Ed.) And they reported that I don't work there now. Recently, my contract was extended for a year, this year - for three months - without explaining the reasons. No one presented to me. We did not have conflicts with the management. There is, I know dissatisfaction with my civil position, my professional attitude towards what is happening in health care, but this is not a conflict. I believe that my rights are rudely pop. And humanly and by law. - You have repeatedly criticized the course of health care reform in Russia, it turns out, now you felt it on yourself? - And for the second time. The first time my department was kicked out of the 7th Spearproof Hospital, the largest in the city. It was reduced, part of it was closed. It was in 2014. At the University of Sechenov, the last 18 years I have headed the hematology and geriatric department, and the hospital was our clinical base, in the institute of his beds a little. Somehow attached, of course, but 34 years in the hospital is a whole medical life. - You said more than once that the reform of health care is essentially the destruction of our medicine. Now your position just strengthened? - Everything is just like that. Over the past few months, 10 percent of the younger and medium medical personnel abolished in Russia. Think about the figure - it is 40-50 thousand people! They just escaped. This has been going on for several years. The last figures suggest that this "reform" does not stop. People go themselves. Low salary, colossal loads. The salary of nurse in the country is now 5-7 thousand rubles. People take 2.5 bets to earn at least 15-16 thousand. Now in hospitals, it seems to serve patients will be for money. Maybe they themselves will have to hire a nurse. Someone must change the underwear, diapers, do dressing ... - During the reform, nurses were removed and in clinics, deciding that the doctor would cope with the registration of records himself. How did the clinic affected at work? - They did it just because the nurses just lack. We decided to portray reform activity, removing the function of the nurse at all. It is not right. Worldwide, on the contrary, three or four nurses work for one doctor. The nurse draws up all records, documents. According to international standards, the doctor pays for a patient about five minutes, and everything else does a nurse. Now our doctor sits and makes recordings and on the map, and in the computer ... But from this work, the doctor can be delivered at all, for example, using voice recorders that decipher call centers. All over the world, this practice has existed dozens of years, only we can not understand how to equip everything. - Our clinics switched to a new standard of work - did it improve the quality of patient service? - Yes, now our clinic is already working on a new "reform" model, but this has not led to an improvement in assistance. The amount of paper work did not decrease, it is not always easy to make an appointment, and the electronic record is also convenient for all patients and is available. Recently there were even cases when people died in a queue in the registry. These are formalized games of officials who are not related to health care reform. They improve not the efficiency of the service of the population, but the effectiveness of the expenditure of funds. Medicine should be paid, who can not pay, that albeit sick and dies himself. And who does not want to work so, can go to business - we hear such advice. - The authorities said that during the reform of the wages, doctors will grow and that they are already up to 80 thousand rubles ... - the wages of doctors grow - due to the fact that they are fired. Two doctors left, the third increased salary. But he will not work for three. Doctors have long been working on the limit of their strength. - For what purpose, in this case, do we have this optimization of health? - This is a reform to save money. "No money, but you hold on." Here, for example, I recently published statistics on the disease of the inflammation of the lungs at home. Mortality in the city increased by 30 percent. This is fantastic! From inflammation of the lungs should not die in the lungs, banal homemade pneumonia, there are different antibiotics ... I explain it only a bad medical care organization. Now they do not hospitalize such patients. For example, there are new limitations. Without high temperatures when inflammation of the lungs, it is not for the hospital. But in the elderly, there are usually high temperatures in this disease. As a result, people come to the hospital already in resuscitation. - What changed the rules of ambulance? - The rules of work and ambulance, and planned assistance, and hospitalization rules have changed. Now it is impossible to put a person for a survey. All examination passes ambulatory. But in practice it is unrealistic, unavailable for the population. The clinic in one place, the examination should go to the other end of the city. And all the time require money for doing quickly. For example, MRI and CT, what should be done urgently when determining tumors is often prescribed in a few months - a queue. Want to do quickly - pay money. Because one of the tasks of healthcare now - making money. And this can be done, only by the abyss of the patients. The "ambulance" now does not take off patients to the hospital without a clear threat of life. And the fact that the threat to life can come a few minutes after their departure, no one does not care. Calls are transmitted to the "Emergency", which can come and a day. - What happens in the regions? In the regions, everything is the same, multiplied by the remoteness of the territories. There is sometimes no ambulance at all. The number of FAPs (Feldsher-obstetric item) in the regions 2 times larger than the number of paramedics. There is no one to work there. But at the same time, medical institutions are removed in small settlements. Want to be treated - go to the nearest city, two days leave for the clinic! - You somehow said that our reform goes on the American health model. This is true? - Practically, only we are late. Obama is already turning American health care for our, still Soviet principles. Yes, and many European countries have already appreciated the convenience and quality of our health system. And we, on the contrary, for some reason I refuse it. That the most "English model" is a Soviet model, it was simply adapted under the life of England. The basic principles are the primary health link, accessible to all, the separation for assistance on two levels is the primary stage and secondary. But the main emphasis is placed on the primary link, there are doctors and nurses of general practice. - How do you rate the change in the health insurance system? - This is just a pure theft of money. According to the most modest calculations, 10 percent of our insurance goes not to treatment, not in patients, but on system maintenance. And the most important thing is that it has nothing to do with improved quality, efficiency, and so on. And, by the way, no changes in the OMS in recently did not happen. Many principles were laid in the system in the early 1990s. No one reads laws: for example, the patient's right to move from one polyclinic to another - this is generally no innovation, it has already since 1993, but did not work, people simply did not talk about such an opportunity, and we ignite our rights to know . - Trade unions of health workers somehow react to the situation? And can they change it? - The official medical trade union does nothing. There is an independent trade union "Action", which is trying to do something, but experiencing constant persecution. I myself do not believe in any party or trade unions. - At one time, doctors were quite active, went on rallies. Why is there no such activity now? - Yes, people are rally. But nothing happened. They deceived everyone. All promises of the authorities were PSHIK. Someone put the hand in money, there is no one. Doctors have fallen hands. - At one time, our authorities said that health care reform goes with errors ... - these were empty statements. I am sure that they did not have any specific plans for the reform turn, for some kind of adjustments. Everything goes as much as it went, the criticism on the ground just do not hear, but the criticizing - pursue. The editorial office of the Portal Rasmir appealed for comments in the first MGMU. I. M. Sechenov and the Ministry of Health of the Russian Federation. Comments from the university we are still waiting for, while we present the answers of the Ministry of Health to our questions. Is 10% of junior and middle personnel over the past months from the health sector, which is 40-50 thousand people? Why did this happen? According to Rosstat, in 2016 (1 quarter), the number of medium medical staff in regional and municipal medical organizations decreased compared to the same period 2015 (1 quarter) by 11,755 people. (- 0.9%), and in comparison with all 2015 - by 8,687 people. (- 0.7%). However, the pace loss of the number of medium-sized medical workers in 2015 decreased almost 2 times compared with 2014. (1.6% against 2.8%). The staffing of the posts of medium-sized medical professionals in general in medical organizations in 2015 increased to 91.7% (91.5% in 2014). A similar trend was also noted with the staffing of the staff posts of nurses, which, in general, amounted to 92.1% in 2015 (91.8% in 2014). Reducing the number of junior medical personnel occurs against the background of the growth of the number of employees of medical organizations of other categories. This trend is due to the redistribution of part of the labor functions on other personnel in the event that the work does not imply direct participation in medical activities and does not require any knowledge and skills. Is the salaries of doctors grow from the fact that they are fired and the remaining doctors have to close 2-3 rates? What is the average salary of the doctor and its prospects? The coefficient of part-time in the Russian Federation in medium health workers remains stable at 1.3, which does not confirm the opinions about increasing the burden on the average medical staff. In general, according to the Russian Federation, according to Rosstat, in the first quarter of 2016, the average monthly wages of medical workers increased compared with the first quarter of 2015: the doctors - by 5.0% and amounted to 46.1 thousand rubles, secondary medical personnel on 4.7% and amounted to 26.8 thousand rubles; Junior medical personnel, respectively, by 6.2% and amounted to 16.9 thousand rubles. Is it true that there are FPA in the regions, but there is not enough paramedics, and people have to spend two days to spend the clinics in a remote area? The Ministry of Health of Russia special attention is paid to the provision of medical care in certain areas of the country. It is worth noting that in 2015 there were changes to the Regulation on the organization of the provision of primary health care for the adult population in terms of organizing assistance to rural residents. Thus, in rural settlements with the number of residents, more than 2 thousand people to provide primary medical and sanitary assistance should be organized medical ambulatory. If the number of residents exceeds 1 thousand people, but at the same time it does not reach 2 thousand people, a paramedic-obstetric item / Feldsher Sweep can be organized (if the distance to the nearest medical organization does not exceed 6 km) or the Center for General Medical Practice / Medical ambulatory (if the distance from the Feldsher-Okushetsky point to the nearest medical organization exceeds 6 km). In settlements with the number of residents from 300 people up to 1 thousand. , Feldsher-obstetric items or paramedic health health sites are created regardless of the distance to the nearest medical organization in the absence of other medical organizations. Also important is the recovery. The program "Zemsky Doctor" is implemented since 2012. One-time compensation payments in the amount of 1 million rubles are carried out by the participants of a program with a higher education who arrived in rural settlements or working villages, and which concluded an agreement with the authorized body of the executive authority of the constituent entity of the Russian Federation (the program "Zemsky Doctor"). According to the Federal Fund for Compulsory Medical Insurance on January 1, 2016, for the period 2012-2015 the total number of medical workers involved in the program "Zemsky Doctor" to work in rural settlements and working settlements, amounted to 19.02 thousand specialists , including in 2015 - 3 thousand people. For 2016, the program has been extended, while the ultimate age of the program participants has been increased to 50 years, as well as the list of species of settlements, which apply to the action of the program, supplemented with urban-type settlements. At the same time, the ratio in co-financing the program was changed: from the budget of the federal fund of compulsory health insurance - 60%, from the funds of the budgets of the constituent entities of the Russian Federation - 40%. Professor suggests that there are no significant changes in the OMS system. This is true? Recall that only over the past ten years there have been radical changes in the field of compulsory medical insurance of citizens. The main documents were adopted in this area, we are talking about the federal law of 29.11.2010 N 326-FZ, order of the Ministry of Health of the Russian Federation of February 28, 2011 No. 158n, order of the Federal Fund for Compulsory Medical Insurance of December 1, 2010 №230 " On approval of the procedure for organizing and conducting control of volumes, deadlines, quality and conditions for providing medical care for compulsory health insurance "and order of the Federal Fund for Compulsory Medical Insurance of December 26, 2011. № 243 "On the assessment of the activities of insurance medical organizations." The OMS sphere is becoming increasingly attractive to the private sector. How have the principles of ambulance work changed? Now she does not take off without an obvious threat of life? What are the new rules of hospitalization? We emphasize that the principles of ambulance, as well as the procedure for its provision have not changed. First medical care is in the event of a threat to life, and urgent help in all others. The procedure for providing emergency medical care was approved by order of the Ministry of Health of Russia of 06/20/2013 No. 388n "On approval of the procedure for providing an ambulance, including emergency specialized, medical care": 11. Once upon a time of emergency call, sudden diseases are states, exacerbations of chronic diseases representing the threat of the patient's life, including: a) violations of consciousness; b) respiratory disorders; c) circulatory disorders; d) mental disorders accompanied by a patient's actions representing the immediate danger to him or other persons; e) pain syndrome; (e) injuries of any etiology, poisoning, injury (accompanied by bleeding, representing the threat of life, or damage to the internal organs); g) thermal and chemical burns; h) K.

Professor Pavel Vorobyov about our medicine

Pavel Andreevich, how did you find out that you no longer work in the MIMU named after Sechenov?

You have repeatedly criticized the course of health care reform in Russia, it turns out, now you felt it on yourself?

You said more than once that the reform of health care is essentially the destruction of our medicine. Now your position just strengthened?

During the reform, nurses were removed and in clinics, deciding that the doctor would cope with the registration of records himself. How did the clinic affected at work?

Our clinics switched to a new standard of work - did it improve the quality of patient service?

The authorities talked about the fact that during the reform of the wages of doctors will grow and that they are already up to 80 thousand rubles ...

For what purpose, in this case, do we have this optimization of health?

This is a reform to save money. "No money, but you hold on." Here, for example, I recently published statistics on the disease of the inflammation of the lungs at home. Mortality in the city increased by 30 percent. This is fantastic! From inflammation of the lungs should not die in the lungs, banal homemade pneumonia, there are different antibiotics ...

What did the ambulance rules have changed?

What happens in the regions?

Somehow said that our reform goes on the American health model. This is true?

And how do you assess the change in the health insurance system?

Trade unions of health workers somehow react to the situation? And can they change it?

At one time, doctors were quite active, went on rallies. Why is there no such activity now?

Yes, people are rallying. But nothing happened. They deceived everyone. All promises of the authorities were PSHIK. Someone put the hand in money, there is no one. Doctors have fallen hands.

At one time, our authorities said that health care reform goes with errors ...

Is 10% of junior and middle personnel over the past months from the health sector, which is 40-50 thousand people? Why did this happen?

According to Rosstat, in 2016 (1 quarter), the number of medium medical staff in regional and municipal medical organizations decreased compared to the same period 2015 (1 quarter) by 11,755 people. (- 0.9%), and in comparison with all 2015 - by 8,687 people. (- 0.7%).

However, the pace loss of the number of secondary medical workers in 2015 decreased almost 2 times compared with 2014 (1.6% against 2.8%).

The staffing of the posts of medium-sized medical professionals in general in medical organizations in 2015 increased to 91.7% (91.5% in 2014). A similar trend was also noted with the staffing of the staff posts of nurses, which, in general, amounted to 92.1% in 2015 (91.8% in 2014).

Reducing the number of junior medical personnel occurs against the background of the growth of the number of employees of medical organizations of other categories. This trend is due to the redistribution of part of the labor functions on other personnel in the event that the work does not imply direct participation in medical activities and does not require any knowledge and skills.

Is the salaries of doctors grow from the fact that they are fired and the remaining doctors have to close 2-3 rates? What is the average salary of the doctor and its prospects?

The coefficient of part-time in the Russian Federation in medium health workers remains stable at 1.3, which does not confirm the opinions about increasing the burden on the average medical staff.

In general, according to the Russian Federation, according to Rosstat, in the first quarter of 2016, the average monthly wages of medical workers increased compared with the first quarter of 2015: the doctors - by 5.0% and amounted to 46.1 thousand rubles, secondary medical personnel on 4.7% and amounted to 26.8 thousand rubles; Junior medical personnel, respectively, by 6.2% and amounted to 16.9 thousand rubles.

Is it true that there are FPA in the regions, but there is not enough paramedics, and people have to spend two days to spend the clinics in a remote area? The Ministry of Health of Russia special attention is paid to the provision of medical care in certain areas of the country. It is worth noting that in 2015 there were changes to the Regulation on the organization of the provision of primary health care for the adult population in terms of organizing assistance to rural residents.

Thus, in rural settlements with the number of residents, more than 2 thousand people to provide primary medical and sanitary assistance should be organized medical ambulatory. If the number of residents exceeds 1 thousand people, but at the same time it does not reach 2 thousand people, a paramedic-obstetric item / Feldsher Sweep can be organized (if the distance to the nearest medical organization does not exceed 6 km) or the Center for General Medical Practice / Medical ambulatory (if the distance from the Feldsher-Okushetsky point to the nearest medical organization exceeds 6 km).

In settlements with the number of residents from 300 people up to 1 thousand, Feldsher-obstetric items or paramedic health health sites are created regardless of the distance to the nearest medical organization in the absence of other medical organizations.

Also important is the recovery.

The program "Zemsky Doctor" is implemented since 2012. One-time compensation payments in the amount of 1 million rubles are carried out by the participants of a program with a higher education who arrived in rural settlements or working villages, and which concluded an agreement with the authorized body of the executive authority of the constituent entity of the Russian Federation (the program "Zemsky Doctor"). According to the Federal Fund for Compulsory Medical Insurance on January 1, 2016, for the period 2012-2015 the total number of medical workers involved in the program "Zemsky Doctor" to work in rural settlements and working settlements, amounted to 19.02 thousand specialists , including in 2015 - 3 thousand people.

For 2016, the program has been extended, while the ultimate age of the program participants has been increased to 50 years, as well as the list of species of settlements, which apply to the action of the program, supplemented with urban-type settlements. At the same time, the ratio in co-financing the program was changed: from the budget of the federal fund of compulsory health insurance - 60%, from the funds of the budgets of the constituent entities of the Russian Federation - 40%.

Professor suggests that there are no significant changes in the OMS system. This is true?

Recall that only over the past ten years there have been radical changes in the field of compulsory medical insurance of citizens. The main documents were adopted in this area, we are talking about the federal law of 29.11.2010 N 326-FZ, order of the Ministry of Health of the Russian Federation of February 28, 2011 No. 158n, order of the Federal Fund for Compulsory Medical Insurance of December 1, 2010 №230 " On approval of the procedure for organizing and conducting control of volumes, deadlines, quality and conditions for providing medical care for compulsory health insurance "and order of the Federal Fund for Compulsory Medical Insurance of December 26, 2011. № 243 "On the assessment of the activities of insurance medical organizations."

The OMS sphere is becoming increasingly attractive to the private sector.

How have the principles of ambulance work changed? Now she does not take off without an obvious threat of life? What are the new rules of hospitalization?

We emphasize that the principles of ambulance, as well as the procedure for its provision have not changed. First medical care is in the event of a threat to life, and urgent help in all others.

The procedure for emerging emergency care was approved by the Order of the Ministry of Health of Russia of 06/20/2013 No. 388N "On approval of the procedure for providing an ambulance, including ambulance specialized, medical care":

P. 11. Reasons for a challenge of emergency care in emergency form are sudden acute diseases, states, aggravation of chronic diseases, representing the threat of the patient's life, including:

A) violations of consciousness;
b) respiratory disorders;
c) circulatory disorders;
d) mental disorders accompanied by a patient's actions representing the immediate danger to him or other persons;
e) pain syndrome;
(e) injuries of any etiology, poisoning, injury (accompanied by bleeding, representing the threat of life, or damage to the internal organs);
g) thermal and chemical burns;

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Recently, many different interesting questions about medical timatics have emerged in articles and discussions on the eye of the planet. To help figure out this topic, we asked the Doctor of Medical Sciences, Professor, Deputy Chairman of the Formural Committee of the RAMS, President of the Interregional Society of Pharmacoeconomic Studies, Pavel Andreevich Vorobyev.

Dear readers until September 23, you can ask your questions regarding health care.

Biography Sparroweva Pavel Andreevich:

Vorobev P.A., born in 1958, graduated in 1980 1 Moscow Medical Institute. THEM. Siechenova and so far working in the walls of this university, having passed the path from the clinical order of the department of hospital therapy of the 2nd therapeutic faculty to the head of the Hematology Department and Geriatrics of FPPs.

In the doctoral dissertation of P.A. Vorobieva (1997) highlighted many years of experience of the author for the use of plasmapheresis in various diseases of the internal organs, including systemic vasculites, bronchial asthma, long-term compression syndrome, anemia of chronic diseases, acquired acute and chronic coagulopathy, including Pioneer Work on antiphospholipid syndrome, etc. The results of these studies are summarized by P.A. Vorobyev in the books "Intermittent therapeutic plasmapheresis", "Actual hemostasis" "anemic syndrome in clinical practice".

A large place in the works of P.A. Vorobyva belongs to the problems of intensive therapy in the conditions of natural and man-made disasters. P.A. Vorobiev participated in the work on the elimination of the accident at the Chernobyl NPP (1986), the consequences of the earthquake in Armenia (1988), the explosion of trains near Ufa (1989). This experience is dedicated to the book "before and after Chernobyl. View of the doctor "(1996), written in co-authorship with A.I.Vorobyev.

P.A. Vorobyev is one of the pioneers for the development of Geriatria in modern Russia. In 1996, organized an annual gerontological forum with international participation "Elderly Patient. The quality of life". Under his editors, the two-volumeman "Geriatry in lectures" came out. For the development of Herontofarmakology issues in 2003, P.A. Vorobyv was awarded the award. T.I. Veoshevsky.

P.A. Vorobyev developed the original thrombocyte-endothelial theory of aging, based on ideas about the interaction of platelets and damaged endothelium, the effects of growth factors and cytokines for immunocompetent cells and precursor cells, the development of fibroplastic processes and osteosynthesis locally in the vascular wall, which leads to a violation functions of organs, the development of seenile polyorganic failure.

Starting in 1986 to engage in the problems of automation in the work of the doctor, P.A. Vorobyov with a team of programmers and doctors of experts developed the original structure of automated workplaces of doctors: special consistent systems for the installation of basic therapeutic diagnoses. This work led to the emergence of a "interval satellite on laboratory and instrumental diagnostics", which sustained 5 reprints (1993 - 2001) and annually reprinted since 2004 "Drug Director of the Formural Committee of the RAMS".

Work on improving software for doctors caused a new direction in the development of modern health - standardization. The health standardization system is created under the direction of P.A. Vorobyev since 1992. Clinical and economic research, the development of algorithms and decision-making rules, has been closely adjacent to this activity. Since 1999, P.A. Vorobyev has been the President of the Interregional Public Organization "Society of Pharmacoeconomic Studies", which is the National Department of the International Society of Pharmacoeconomic Studies and Evaluation of Results (ISPOR). P.A. Vorobyv was inhabited and cooperating on the economy of healthcare with the London School of Economic and Political Sciences, under his leadership, a large number of clinical and economic research of various medical technologies was fulfilled, 3 manuals on this issue came out. In 2008, the international award of the ISPORDA Development of pharmacoeconomics in the region was awarded.

The optimization of clinical decisions was reflected in the series of methodological publications on differential diagnosis in internal medicine: "Differential diagnosis and treatment of hemostasis disorders", "differential diagnosis and treatment with anemic syndrome", "deficiency of the kidney function", "Gemoblastosis in the practice of the therapist", " Disseminated intravascular blood coagulation syndromes, "fever without diagnosis.

With the direct participation of P.A. Vorobyva, the Formular Committee of the RAMS was created. The activities of the Formation Committee, where P.A. Vorobyev is the Vice-Chairman, is a practical embodiment of the principles of medicine based on evidence and clinical and economic research in decision-making.

Much forces applies P.A. Vorobyev to the development of the Moscow City Scientific Society of Therapists. In 1999, he conducted a legal re-registration of society, established its financing, created 4 new sections (cardiological, angiological, "man and infection", pulmonological), began holding scientific and practical schools for the doctors of the city, resumed the publication of materials of MMNOT at the journal " Clinical gerontology, "and later in the newspaper" Bulletin McNot ". In 2007, P.A. Vorobyev developed a provision for the establishment of a premium instant. D.D.Pletnev for an outstanding contribution to the development of a domestic therapeutic school. Repeatedly P.A. Vorobyev performed at the plenary sessions of the Company, is a permanent opponent at meetings of the sections created by him.

P.A. Sparrows Author of more than 600 published scientific works, of these, 272 scientific articles, 235 theses of reports, 49 books, 20 educational and recommendations for doctors, 11 manuals, reference books and dictionaries. P.A. Vorobyev is co-author of about 700 orders of the Ministry of Health and the Ministry of Health and Social Development of Russia, 12 orders of Rostechregulation. When consulting and under the leadership of P.A. Vorobyva and defended 5 doctoral and 11 candidate dissertations in the field of pulmonology, cardiology, hematology, rheumatology, nephrology, etc.

P.A. Vorobyov is the editor-in-chief of the Clinical Gerontology magazine and the newspapers "Bulletin of the Moscow City Scientific Society of Therapists", a member of the Council of the Chief Editors of the Clinical Pharmacology and Pharmacoeconomics magazine, Deputy Chief Editor of the Journal of Standardization Problems in Health Care, Member of the Editorial Magazine "Problems of Hematology and blood transfusions, "clinical epidemiology and evidence-based medicine", a member of a number of editorial councils of magazines issued abroad (Armenia, Ukraine).

Below is its interview with the newspaper "New Izvestia" "Swine flu is a fictional disease, as well as a brief biographical information.

__________________________________________________________________________________________________________________

Natalia Timashova

The flu epidemic in Russia has declared. However, physicians are now afraid of the appearance of a new virus - based on the crossing of influenza viruses A (H1N1) (known as "pork") and H5N1 (known as "bird"), as stated by the chief state sanitary doctor of the Russian Federation Gennady Onishchenko. Perhaps this thesis is trying to use to substantiate the mass vaccination campaign from influenza, which is so actively protecting and promotes the head of Rospotrebnadzor. As you know, the vaccination of Russians against swine flu should have started in December. Meanwhile, in a number of countries, calls are already sounded to abandon influenza vaccinations from ineffective and unnecessary. This opinion shares a number of Russian specialists. Is the pork flu virus is dangerous, whether the President of the Interregional Society of Pharmacoeconomic Research, Deputy Chairman of the Formural Committee of the Russian Academy of Sciences, was needed to be taken from him and other infections, "Nor", Deputy Chairman of the Formural Committee of the RAMS, Doctor of Medical Sciences, Professor Pavel Vorobyev.

Pavel Andreevich, many specialists know your sharply negative attitude towards the hype around the swine flu. How much does the current situation look like a bird flu epidemic and a lot in all of what is happening truth?

My position is as follows: swine flu - fictional disease and all speculations on this topic are organized with one goal - to make more money on this. I mean not only super-profits of pharmaceutical companies promoting vaccines and antiviral drugs. Someone earns political capital, doctors are treated for patients, journalists write about sensations - all in business. Missed diseases are a very big problem of modern health. Do not understand the literally the word "fictional". Focused and excessively dramatized are not so much the diseases, how many consequences for people: some demonic properties are attributed to the pathogens, which in fact, of course, is not so. Over the past 20 years, we have repeatedly had the opportunity to observe outbreaks of certain mysterious, terrible infections that should be held thousands, millions of lives, twisted the foliation, but for some reason they do not carry and do not roll out. At first there was a cow's rabies, then Sars, known from us as atypical pneumonia, then a bird flu ... To combat them, a very big funds were required, about the need for television, radio, on the pages of a specialized and ordinary press, said WHO experts, Doctors and others. And millions and billions of dollars and euros were spent on this struggle in the world, after which all the conversations quickly went to no. Now we have another problem - swine flu. As far as it is serious, judge by yourself: there is evidence that among all viral infections in 2009, the swine flu virus takes only 5%. The conclusion suggests one: if the public affects any suddenly emerged illness, if they are talking about the need for high costs, then, most likely, we are talking about a fictional disease.

- What other diseases can you attribute to this list?

AIDS, hepatitis B and C. It is well known that not all people infected with the human immunodeficiency virus (HIV) are sick of AIDS, and the virus is not as actively approved. The same with hepatitis, which are far from all virus monosions.

- Let's go back to the swine flu ...

There is a lot of mysterious. For example, in April 2009, the World Health Organization (WHO) changed the definition of a pandemic, removing the keyword "dangerous" from it, and now any viral infection is falling under it, ranging from the Herpes virus, transmitting from person to person and quickly propagating All WHO zones in the world at the same time. And immediately began to talk about a pandemic of swine flu, and since the population has formed a clear association of the word "pandemic" with the word "danger", then, of course, people began to worry and actively discuss who and where died of swine flu. At the same time, every year in the world illustrates the flu to 10 million people and half a million of them are dying. In Russia, every year of influenza, pneumonia and other respiratory diseases die about 40 thousand people, and no one ever has never discussed this question as much as now. Well, the information that appeared in the press on the relationship of WHO experts with pharmaceutical companies only adds to us, doubting that swine flu is such a terrible disease, skepticism.

- After reading your words, many doubters will definitely decide to abandon influenza vaccinations ...

This is the only right solution for influenza vaccines, which are made on last year's strains and will not work this year. Every year we are ill with viral respiratory infections caused by about 200 pathogens. They mutate, change, but every year we carefully vaccinate not from the current one, but from last year's influenza. Everyone knows about it, but for some reason they continue to tell people about what should be harvested. My position in the grafs is radical. There are diseases from which, of course, need to be harvested. With regard to smallpox, poliomyelitis, tetanus, rabies the question is not discussed, because they are deadly dangerous at any age and people die from them. But there are a lot of vaccines invented in recent decades, the effectiveness of which is not actually proven, and no one is going to do this. Influenza vaccination belongs to such. So these vaccinations, in my opinion, do not do. There is another direction that causes a lot of questions: vaccines whose effectiveness is proved, they really reduce the number of cases, but we do not know what will be with grafted generations in the future. Therefore, I am categorically against the vaccines from measles, from children's infections. I will explain why. At the beginning of the nineties of the last century there was a sharp rise in the incidence of diphtheria, and it was not connected with what was stopped vaccinating, but with what the strain mutated. The causative agent of diphtheria has changed and stopped "to succumb to" vaccinations, it was only now. The same can happen with the causative agent of measles, the most dangerous illness, which turned out to once the population of countries, with the causative agents of the windmill, pigs. Mass vaccination campaign from them gives a real result, but we do not know what will happen later. In my opinion, vaccinations from childhood diseases are a very dangerous direction. It is better to overcome than to be taken.

I would be in the place of the graft considered myself unvacted. If you are afraid to get sick, take care of yourself just as if I had not been vaccinated. People must be stopped believing all the scary stories about swine flu and live in a normal life, following the usual safety rules. Strengthen the immunity, wash your hands, air the room, if you see that someone sneezes or coughs, go aside. It should be understood that the mask does not save from infection. It was invented so that the surgeon would not breathe in the wound to the patient, to filter the air exhaled by man, not inhaled. She does not delay viruses that walk around us. It is not necessary to wear a mask with healthy people, you need to wear it on a sick person, so that he does not sneeze and cough on those around him with his viruses.

- Do antiviral drugs help influenza?

No, they are ineffective, like vaccinations. A widely advertised arbidol does not treat flu and Orz, it is a symptomatic remedy that eliminates only from manifestations of the disease, and not healing from it. The world's most famous antiviral drug Tamiflu, which many, and I, among other things, consider one of the commercial components of the current influenza campaign, really improves the patient's condition for several hours, but there is no evidence to reduce the frequency of complications. The manufacturer was obliged to hang on the official website of the drug this information.

Our people love to engage in self-medication and flu is often treated with antibiotics, although doctors constantly say that this can not be done ...

Viral diseases antibiotics are impossible. Taking them with the flu, you harm your body - every non-working drug is dangerous in that it distracts a person from reality and leads to the fact that it is not treated on time to be treated. It may be sad. The current flu, caused by the A (H1N1) virus, has a number of features that need to know. They are basically young people (up to 45 years old), and he has a hard, although not frequent, complication - pneumonia. Her difference is that it is almost lightning and quickly leads to a fatal outcome. It is very dangerous, especially for pregnant women. A person dies from respiratory failure and thrombosis of pulmonary vessels, mortality from this pneumonia is monstrous - 10% of the sick, which is never happening when "ordinary" inflammation of the lungs. The outbreak of this pneumonia was in the Soviet Union in 1977, now the situation is the same, judging by the information from the regions in recent weeks. There is experience of its treatment, fundamentally different from traditional therapy. Without going into details, I will say that the main thing is not antibiotics (although they certainly should also be), but a round-the-clock introduction of oxygen and large doses of drugs for thinning blood and stopping the thrombosis. Such intensive therapy contradicts the generally accepted approach in the treatment of lung inflammation, but it allows you to save young lives. The Formular Committee under the Presidium of the Russian Academy of Medical Sciences issued its recommendations "How to treat pneumonia for influenza A (H1N1)", they hang on the Society of Pharmacoeconomic Research Society, they sent 17 thousand medical addresses, but as far as they are used - I do not know. The recommendations are not an order, they can be taken note, but not apply. It is necessary to fear not a swine flu, but its possible complications, and the problem is that neither doctors nor their patients warn about it and do not inform. We, therapists, pulmonologists, are very concerned about such a situation.

- How to recognize this pneumonia?

The main symptom is a shortness of breath, which appears not immediately, but about a week from the beginning of the flu. It can begin without a pronounced cough, without temperature lifts, and a person does not attach importance to its state, believing that he has not yet recovered from the flu. If you after a weekly influenza felt the shortness of breath, you do not have enough air, immediately call the "ambulance" and go to the hospital, without waiting for the disease to develop. Then the doctors will have a real chance of saving you.