Igor Koltunov is the head physician of the Morozovskaya. Igor Koltunov: “The Morozov Hospital is honest, diversified, modern. Doctors and specialists

One of the oldest children's hospitals in Russia - Moscow's Morozovskaya - claims to be the best in Europe. What are the prerequisites for this? The RG columnist talks about this with the head physician of the hospital, Doctor of Medical Sciences, Professor Igor Koltunov.

Igor Efimovich, Morozovskaya nursery in the center of old Moscow. She has traditionally a decent reputation. Literally the other day, having met with children undergoing rehabilitation after oncological diseases in Kolontaevo near Moscow, I was once again convinced of this. Children told in detail where, how they were treated. And the majority called the same address: Morozov Children's City Clinical Hospital. The impression is that most of the children, including those with oncology, are treated in the Morozov hospital. Although, if my memory serves me, it was not considered the largest children's hospital in Moscow?

Igor Koltunov: Didn't count. But... In total, 260,000 children in Moscow need inpatient medical care. Of these, more than 100,000 children are hospitalized with us. In the last five years, we began to treat 3 times more children. Although we are inferior to other children's hospitals in terms of the number of beds. The total area of Morozovskaya is 53,000 square meters with 1,000 beds. Now the construction of a new 500-bed building is being completed. Without exaggeration, it is being built thanks to the daily control and daily support of Moscow Mayor Sergei Semenovich Sobyanin.

There will be completely different conditions of stay in the building. Comfortable conditions. Single and double rooms, designed for the stay of a child with his mother. The building will present all areas of surgery: cardiac surgery, abdominal surgery, neurosurgery, otolaryngology, ophthalmology, Maxillofacial Surgery. There will be departments of traumatology and orthopedics, urology-andrology, pediatric gynecology, department of orphan and other rare diseases.

For the first time in Moscow, a department of bone marrow transplantation is opening here, without which it is impossible to imagine the current oncology and hematology.

Is there already a "stuffing" for these departments? And most importantly, are there personnel to work in them?

Igor Koltunov: The Moscow Health Department has already purchased modern high-tech equipment for us. And you are right: the main thing is personnel. So, on the basis of our hospital, there are now two university clinics: one of the Russian National Medical University named after Pirogov, the second - Medical University RUDN. There are ten city centers for specialized medical care for children in the Morozov Hospital. These are centers for pediatric oncology and hematology, rheumatology, gastroenterology, endocrinology, pediatric stroke, centers for reproductive health of children and adolescents, orphan and other rare diseases, neonatal screening, a center for children with von Willebrand disease, a regional center for congenital hereditary diseases, genetic abnormalities ...

Have specialists, say, for bone marrow transplantation, already been trained?

Igor Koltunov: We traditionally cooperate with the Center of Academician Alexander Grigoryevich Rumyantsev, with its specialists in the field of bone marrow transplantation. We cooperate correctly: we do not lure their excellent specialists to us. We get out of the situation in a different way: with their help, we train our personnel for this current area of medicine. In addition, consultations are especially important in medicine.

And specialists in the field of bone marrow transplantation for children will both consult and hold consultations. Also, in accordance with the obtained license for education, we revived our own residency and postgraduate studies. We are reviving the Morozov school and training our specialists.

Parents from different parts of the country turn to the editorial office with a request to help in the treatment. When it comes to oncological diseases, they often ask to be sent to Morozovskaya. By the way, in the mentioned Kolontaev rehabilitation center, not all children are Muscovites. Meanwhile, cancer patients in Moscow are treated by the Blokhin Oncology Center, the Republican Children's Clinical Hospital, and the Dmitry Rogachev Center for Pediatric Hematology, Oncology and Immunology. How to navigate the parents of a sick child? Where to apply? Where are the best opportunities? Do you accept not only children with a Moscow residence permit?

Igor Koltunov: It is very important that people have a choice. Especially when it comes to the hardest oncological diseases. There are no children of strangers and their own. They are all ours. Children with a Moscow residence permit can be treated in federal centers. And children with a different residence permit in a Moscow hospital. Another thing is that this requires the solution of some organizational issues. But this is our business, not the parents of sick children. The main thing in providing medical care is its availability. Availability, regardless of the thickness of the pocket, and even more so from registration. Unlike federal institutions, you don't need any referrals (not only from Moscow, but also from federal ones) to get to us for compulsory medical insurance. And again, unlike federal institutions, Morozovskaya works around the clock, including providing an ambulance, that is emergency assistance.

Our hospital owes its appearance 113 years ago on the map of Moscow to Vikula Morozov, the nephew of Savva Morozov. Vikula Morozov gave money to the city to buy land (a section of the former Horse Square) for the construction of hospital buildings intended for the treatment of children. Before starting construction, he sent the famous pediatric Russian surgeon Timofey Petrovich Krasnobaev to the best clinics in Europe for experience. And we are trying to preserve the tradition of access to medical care, using the best world experience. Here is your photojournalist took some shots in the department of pathology of newborns and premature babies. In the department, as usual, there are 50 such crumbs. Of these, 2/3 are Muscovites, the rest are from different regions of Russia. Everyone is with their mothers.

Are they free?

Igor Koltunov: They are paid for by the Compulsory Fund health insurance.

How do such crumbs from other regions get to Morozovskaya?

Igor Koltunov: You forget that we live in an age that can be called informational. About the birth of a baby with a minimum weight in any region of Russia, if there is suddenly no one perinatal center, the information arrives without delay. And the newborn child, together with his mother, is sent to the nearest similar department. We have neonatal resuscitation for such children.

Since we are talking about the century information technologies, explain the purpose of video monitoring, which occupies one of the walls of your office. Pictures keep changing...

Igor Koltunov: Of course they do. Yes, I see who came to the hospital, as parents with a child are sitting in the corridor, waiting for an appointment. If I see that they are waiting for a long time, I call the manager. The consequences of such a call require no explanation.

I have never heard you raise your voice.

Igor Koltunov: What for? Raise your voice in a children's hospital? This is nonsense. We need to understand each other perfectly. I hope there is such an understanding. Using video monitoring, I monitor the operation of operating rooms and the work of laboratories. I will not hide it, and everyone knows this, I listen to the conversations of our employees with patients, with children.

At one time there was almost a fashion: "A maternity hospital, benevolent to the child." To be honest, I could not understand whether a maternity hospital is possible, which is unfriendly to a child ...

Igor Koltunov: Any children's institution, and by and large not only children's, should be benevolent to a person. Perhaps you are not aware that Moscow health service institutions have clear criteria for evaluating the effectiveness of their activities. It is enough to go to the website of the Moscow Health Department, and any resident of the capital, and not only the capital, can find out the rating of this or that institution, express their wishes.

You have been at the helm of this hospital for five and a half years. Your arrival here was marked by the demolition of 4 old buildings. This caused, to put it mildly, misunderstanding: people are left without work, the possibilities of treatment are reduced. But when the construction of a new building began, when the hospital began to treat children 3 times more, passions subsided. And yet... Are the same wishes that appear on the website of the Morozov hospital important for you today? You, I know, still do not have hours for the reception of the population, employees. So the mother came with the child and decided that she definitely needed to talk to the head doctor. Will you accept her? Or does it have to go through some kind of filter before it gets into your office?

Igor Koltunov: Why a filter? You just need to take the place of this mother, her child and understand that at the moment when the trouble happened, communication with the head doctor is the most important thing for her. I'm a pediatrician. I am even the chief pediatrician of Moscow. And he is simply obliged not only to listen, but also to understand those who ask to help the child.

But there are 24 hours in a day...

Igor Koltunov: Believe me, there is enough time. There would be a desire.

Russian medicine has always been distinguished by humanity and compassion. But high technology, the ability to communicate on mobile phones, skype did not push all this into the background? After all, even doctors' consultations are often carried out using Internet technologies. It is believed that they can compensate for the absence of at least a paramedic's station in a certain outback, to which you can neither drive nor go.

Igor Koltunov: I am a supporter of the highest, most advanced technologies. Without them, we would not be able to approach personalized medicine. And, of course, they could not claim the title of the best hospital. But... No one will ever replace personal communication between a doctor and a patient.

So will Morozovskaya be the best children's hospital in the country, Europe?

Igor Koltunov: There are no limits to perfection. I just want to give people medical care corresponding modern technologies. And that it be accessible and free for patients. Especially when it comes to children.

Medical care should be timely and of high quality, and medical institutions should be available to patients. Governor Andrey Vorobyov sets such a task for regional healthcare.

About what will change in the work of our medical institutions, we talked with the chief physician of the Odintsovo Central District Hospital, Igor Koltunov, who headed it in April.

Prepared by Maria BAKHIREVA

- Igor Efimovich, you have extensive experience in the capital's health care system, for a long time you headed the Morozov Children's City Clinical Hospital. What is your impression of the Central District Hospital in Odintsovo?

- First of all, I saw a good well-coordinated team - specialists who have been working together for a long time. This is important, because the most important thing in our ministry is devotion to the profession, mutual understanding of like-minded people. I can especially note a wonderful maternity hospital with modern equipment. Of course, there are problems - you can't get away from them. But we will work with it.

What is the Odintsovo Central District Hospital today? The institution is on the path of great development. Now formed one system health care, the basic principle of which is: one municipality - one entity. At the same time, all operating units will continue their work. Consequently, the responsibility of both the head of the medical institution and all doctors will be completely different. In fact, the institution becomes directly responsible for the health of every resident of the district.

- What changes in connection with the reorganization await the Central District Hospital?

- For us, the primary question is what the patient will get from such a reorganization. In fact, each of our residents will be able to visit any healthcare facility in the district without certificates and referrals. As a result of the modernization, a single information space will be created. All medical documentation, all analyzes and studies will be in a single database. What is also important is that thanks to such a system, in places where, for objective reasons, there are no or not enough narrow specialists, we will be able to open a queue and call a mobile mobile team within seven days or organize a consultation of any doctor via telemedicine.

- What will change in the work of doctors? Load, salary?

– Personnel will receive at least a new modern equipment which is extremely important today. This guarantees more productive work of doctors, while reducing their current workload. Thanks to high-tech medicine, complications in the treatment of patients will decrease. As for salaries, we plan to raise the salaries of doctors and nurses by 20 percent during the year. I want to emphasize that this will not happen due to a reduction in staff, but due to logistical solutions for patient routing, modern equipment and new technologies.

Naturally, there will be an increase in the so-called completed cases, sorry for the professional terminology. Now we are “losing” patients with complex diseases, we are sending such patients to other medical institutions, more often to the capital. For example, today in the Odintsovo district there is not a single angiographic unit, so a patient with acute infarction myocardium cannot be provided with modern medical care. He is urgently sent to either Krasnogorsk or Moscow. The same is true for cerebrovascular accidents. To treat such cases, a round-the-clock team of neurosurgeons is required, at least a neurosurgical room should work. As a result of modernization, we will have all this.

- Is it possible now to talk about the specific timing of the program?

– Yes, we have determined the deadlines, the modernization has already begun. The first stage in the next six months is to equip the traumatology, ENT department, pediatrics and the maternity hospital. The second stage is the regional vascular center, it will take nine months - a maximum of a year. And the third stage, which we expect to complete in a year and a half, is a centralized laboratory service that will serve the entire district. It is important that such a service will enable us to detect oncology and treat severe diseases. chronic diseases, for which there is currently no base.

I repeat - we are creating a district health care system. It gives the doctor a decent salary, the opportunity to use modern equipment, and therefore consistently achieve positive treatment results. Patients will receive not formal, but real accessibility of medical facilities, a real choice where to be treated, whereas previously it was possible only by referral. The attachment system will remain, but it will be attached to the Odintsovo Central District Hospital, and you can visit any medical facility in the district.

Our reference

Igor Efimovich Koltunov- Doctor of Medical Sciences, Professor, Honored Doctor Russian Federation.

Born September 9, 1968. He graduated with honors from the Tashkent Pediatric Medical Institute with a degree in Pediatrics. He has the highest qualification category in the specialties "Pediatrics" and "Public Health and Health Organization", as well as valid certificates in the specialties "Cardiology", "Pediatrics", GCP, "Public Health and Health Organization".

Since 1994, he worked at the State Research Center for Preventive Medicine of the Ministry of Health. In 2011, he headed the Morozov Children's City Clinical Hospital in Moscow.

Since November 2018 - Director of the Scientific and Methodological Gerontological Center "Peredelkino" of the Department of Labor and social protection Moscow.

Since April 23, 2019, he has been the chief physician of the Odintsovo Central District Hospital.

Today, at the weekly planning meeting, the Head of the Odintsovo city district Andrey IVANOV announced that on November 6, the regional Ministry of Health appointed Igor KOLTUNOV as the chief physician of the Odintsovo regional hospital. Previously, he worked in the status of acting.

Koltunov himself confirmed this information in an interview with an Odintsovo-INFO correspondent.

Koltunov's big farm

Under the guidance of Doctor of Science Igor Koltunov now 4 medical institutions of the Odintsovo district, which were merged into a single structure. Odintsovo Central District Hospital, District hospital No. 2 (Perkhushkovo), District Hospital No. 3 (Nikolskoye) and Zvenigorod Central City Hospital. All of them now form the united Odintsovo regional hospital. Thanks to the restructuring, all residents of the municipality will be able to receive outpatient and inpatient medical care in a single medical facility.

Governor's Decision

The initiator of the merger of medical institutions is the Governor of the Moscow Region Andrey VOROBYOV. He signed the corresponding order on July 8, 2019.

The base institution will be the Odintsovo Central District Hospital.

The first stage of the transformation is the merger of the four largest medical institutions:

GBUZ MO "Odintsovo Central District Hospital"
GBUZ MO "Odintsovo RB No. 2" (Perkhushkovo)
GBUZ MO "Odintsovo RB No. 3" (Nikolskoye)
GBUZ MO "Zvenigorod Central District Hospital"

At the second stage, four more institutions will undergo the procedure:

GBUZ MO "Odintsovo City Polyclinic No. 3"
GBUZ MO "Golitsyn Polyclinic"
GBUZ MO "Ershov outpatient clinic"
GAUZ MO " Clinical Center restorative medicine and rehabilitation.

As a result, a single "Odintsovo Regional Hospital" will serve more than 350 thousand patients.

Who is Igor Koltunov?

Igor Efimovich Koltunov - Doctor of Medical Sciences, Professor, Honored Doctor of the Russian Federation.

Higher education, graduated with honors from the Central Asian Pediatric Institute with a degree in Pediatrics. He has the highest qualification category in the specialties "Pediatrics" and "Public Health and Health Organization", as well as valid certificates in the specialties "Cardiology", "Pediatrics", GCP, "Public Health and Health Organization".

Igor Koltunov has been working at the State Research Center for Preventive Medicine of the Ministry of Health since 1994. In 2011, he headed the Morozov Children's City Clinical Hospital (DGKB). He stepped down from his position as head physician in September 2018. At the end of November, he became director of the Peredelkino Scientific and Methodological Gerontological Center of the Moscow Department of Labor and Social Protection.

According to the declaration of income published in 2015, Igor Koltunov earned for 1 year more RUB 8 mln. Then he headed the Morozov children's hospital. Today, to the question of the correspondent of Odintsovo-INFO, on what conditions he signed an employment contract, chief physician declined to name wages.

I will fill out a new declaration of income - look at my salary. Now I am not ready to name this figure. Understand, this is not a secret, I just don’t know what my salary will be. But this amount will definitely not be less than now.