Koltunov doctor. Treating in a new way: what will change in the work of the Central District Hospital. – What will change in the work of doctors? Workload, salary

Medicine and society Interview with an expert

Igor Koltunov: “Morozov Hospital is honest, multidisciplinary, modern”

He wanted to become a doctor since childhood. He came to medicine in 1985. He believes that a general practitioner and a cardiologist are the specialists who should have the most wide range knowledge. Chief physician of the Morozov Children's City Clinical Hospital, Doctor of Medical Sciences, Professor, Honored Doctor Russian Federation Igor Efimovich Koltunov tells MED-info about the hospital, medicine and life.

— When did you realize that you wanted to treat people?
— Any person probably has a natural desire for knowledge, for knowledge, for understanding how the world works. A, which gives the most holistic and complete picture of how the universe works, how it functions human body and how it evolved. I always wanted to be a doctor. Previously, I worked for about 15 years as deputy director of a research institute, supervising medical and scientific issues. And over time, I put into practice all the acquired skills in organizing the treatment process.

— Do you often have to examine patients yourself now?
“I examine children in the intensive care unit almost every day. I study their medical histories in detail. Every day at morning conferences we review all complex cases admitted to the hospital.

Every day, within 24 hours, from 150 to 500 children, of whom up to 80% need emergency and emergency specialized medical care, arrive at the emergency departments on the main territory of the hospital and its branches via ambulance and self-referral.

— Tell us about Morozov Hospital.
— Currently, it is an emergency multidisciplinary children's hospital, providing 24-hour care medical care. Every day, within 24 hours, from 150 to 500 children, of whom up to 80% need emergency and emergency specialized medical care, arrive at the emergency departments on the main territory of the hospital and its branches via ambulance and self-referral.

At stage 1, emergency medical care is provided in the emergency department or, depending on the severity of the condition, in the intensive care unit of the hospital. Primary specialized medical care is provided in short-stay emergency beds of the emergency department; if necessary, hospitalization is carried out in specialized departments of the hospital. The use of emergency beds in the emergency department allows you to increase the speed of sorting of incoming sick children and optimize the choice of organizational conditions further treatment, as well as reduce unnecessary hospitalization. However, up to 300 children are admitted to specialized hospital departments every day.

In accordance with the increased requirements for inpatient medical care, especially high-tech medical care, in last years Several new departments were opened at the Morozov Hospital: pediatric gynecology, gastroenterology, and modern endoscopy. This gives us the opportunity to treat the patient comprehensively. Thus, a patient hospitalized in a hospital no longer needs consultations from outside specialists, but can receive all the medical care he needs in one place.

The Morozov Hospital currently employs 5 main freelance pediatric specialists of the Moscow Department of Health - an ophthalmologist, hematologist, gynecologist, oncologist, and endocrinologist.

The second task that our institution sets for itself in the near future is to reduce the number of people not directly involved in the provision of medical care as much as possible. At the same time, we will have increasing requirements for the qualifications and training of nursing staff. Our nurses must become much smarter and more efficient, be able to perform more technologically complex manipulations, which will allow us to free doctors from performing these duties, and thereby increase the efficiency of their work. On the basis of our hospital, by order of the Moscow City Department, city clinical centers were created, such as the city, city Center for the treatment of cerebrovascular pathology in children and adolescents (children's stroke center), city Center for pediatric endocrinology, city Center for pediatric rheumatology and city Center for children's reproductive health and teenagers. Our hospital also successfully operates an otorhinolaryngology clinic, an ophthalmology and eye microsurgery clinic, a clinic for urgent and planned surgery, a clinic for planned and emergency neurological care and a gastroenterology clinic with an endoscopy room, an emergency and emergency radiation diagnostics clinic. A full-profile advisory center is actively operating within the walls of our institution. Moreover, the Morozov Hospital currently employs 5 main freelance pediatric specialists of the Moscow Department of Health - an ophthalmologist, hematologist, gynecologist, oncologist, and endocrinologist.

A year ago, by decision of the Moscow city leadership, it was decided to build a new 7-story multidisciplinary hospital on the basis of the Morozov Hospital medical building. The task has been set to create a high-tech modern medical institution in which all types of medical services almost all profiles, equipped with the best technologies that we have today in children's healthcare. This will allow us to provide patients not only with the most modern medical care in accordance with European medical standards, but also to create an appropriate level of comfort. Now, unfortunately, this is not always possible, since most hospital buildings were built according to designs from the middle of the last century, when other requirements were imposed on the organization of the treatment process.

The main task of the head of any modern children's medical institution, in my opinion, is to make the child’s stay in it as non-hospital as possible, to get away from everything that reminds us of the corridor system of Soviet times, when the patient was forced to lie in a 7-8-bed ward. The interiors, design, and level of communication with medical staff must meet this requirement. But all this can only be organized in an institution adapted for such purposes, in our case in a new modern building, into which we expect to move in the coming years.

“The main task of the head of any modern children’s medical institution, in my opinion, is to make the child’s stay there as non-hospital as possible.”

— Is being a doctor a profession or a calling?
— (Thinks.) A doctor is both. In any profession. In any profession, a person with a calling works better than without it. In addition to human qualities (decency, honesty, conscientious attitude to his work), a doctor must have good basic knowledge and clinical thinking.

— Morozov Hospital is a children's city multidisciplinary emergency specialized medical institution. Continue the sentence “I’m going there because she...”
— Honest, multidisciplinary, modern... Over the course of several years of the modernization program, the Morozov Hospital received a total of about 900 million rubles in equipment and funds. This is directly the money that was spent on the purchase of new equipment, and the money spent on the introduction of modern medical standards of treatment and care.

— How to motivate medical university students to go to work at the Morozov hospital or in free medicine in general?
— I think that students should first of all have the motivation that medicine is an eternal profession as long as people exist on earth. This is a fairly well paid profession today. The state and society have already understood this. In addition to the fact that you bring benefit to people and help them, you can also protect yourself and your family by possessing medical knowledge.

Over the course of several years of the modernization program, the Morozov Hospital received a total of about 900 million rubles in equipment and funds.

— In one of your interviews, you said that the higher , the greater the motivation and the higher the efficiency. How to achieve this understanding, the confidence that this doctor can be trusted?
— First of all, it depends on the doctor, because the doctor must understand and evaluate intellectual level the patient, the complexity of the problem, the disease and, based on this, select key points to earn his trust. And the patient, accordingly, should not have any deliberate rejection, hostility or aggression.

— I read that the hospital works with charitable foundations. How does communication happen?
— Funds make proposals and talk about their capabilities. When we have an emergency, we turn to them. Or, on the contrary, patients from the foundation come and say that such and such issues will be resolved by the foundation for them. Or the foundation contacts us with a specific patient whom it is ready to provide financially, and sets us a problem that we solve.

— You have held the post of chief physician of the Morozov Hospital since May 2011. What can you brag about?
— All achievements are the achievements of the entire team of our institution. In 2013, for the first time, Morozov Hospital was awarded the title “Best Hospital of the Year.” We have been working toward this for several years. In 2012, we received our first mayoral commendation for our achievements in healthcare. I think this is quite sufficient from an administrative point of view. As for what has been done for patients, we have completely solved the problem of being in infectious disease wards: there is one child in one ward. Previously, it was necessary to place two children in one box, because the number of declared beds did not correspond to the number of incoming children. We have completely solved the problem of being present: almost everywhere, except for intensive care, a mother can be with her child 24 hours a day, regardless of the severity of his condition. Not to mention the fact that the number of patients treated increased by 50%. We have developed new technologies and opened new clinical departments. And over the past 2 years, we have acquired 5 institutions that have helped us create a more high-tech, complex medical service that is more in demand.

— Parting words to our readers.
— Do not self-medicate and consult a doctor as soon as possible if any questions arise. Don't delay.

Photos by Oksana Plisenkova
Main photo provided by the press service of the State Public Institution of the Department of Health of the Central Administrative District of Moscow

V.KARPOV: 20 hours 6 minutes. The program “Lights Out” is on air.

About what is important now. Vladimir Karpov is at the microphone. Good evening everyone again. Now joining us is Igor Koltunov, chief physician of the Morozov Children's City Clinical Hospital.

Hello, Igor Efimovich!

I. KOLTUNOV: Good evening!

V. KARPOV: Well, as you probably already guessed, today we will talk about optimization, about the reform of the healthcare system in Moscow, if you can call it such. Well, of course, we will receive your phone calls, read your SMS, website messages...

First, let's dot the E. Igor Efimovich, are you a supporter of optimization, or an opponent of optimization? Who you are?

I. KOLTUNOV: Of course, I am a supporter of optimization.

V.KARPOV: Why “of course”?

I. KOLTUNOV: Because I am a member of it, therefore, of course, I am its supporter.

V. KARPOV: As I understand it, chief doctors may also fall under the same optimization, especially after we learned this week about 49% of supposedly unfit chief doctors in Moscow.

I. KOLTUNOV: You know, no one gets anywhere. I don’t know where you got the data about 49% suitable or unsuitable.

V.KARPOV: Moscow authorities...

I. KOLTUNOV: It’s difficult to say about chief doctors in Moscow... We have slightly different data, I know. Yes, indeed, we were tested, independently. We underwent training, passed various types of tests, both psychological, tests for a general educational level, a test for professional aptitude, and, of course, a number of specialists emerged who today do not meet modern requirements.

V. KARPOV: But 49% is, as I understand it, in your understanding, overestimated. You have slightly different data.

I. KOLTUNOV: I don’t know what data you are getting and where you are getting it from. I don’t think that every second doctor is unsuitable.

V.KARPOV: Chief physician

I. KOLTUNOV: Yes, chief physician. But in general, you know, in recent years the specifics of work have changed a lot, the legislation at the federal level has changed a lot. And, unfortunately, Moscow has lagged behind for many years in terms of compliance of its legislation with legislation at the federal level. There were very big differences, very big contradictions. If you remember, about 5-6 years ago there was a whole story about the instructions of our president - about bringing the legislation of the constituent entities of the Russian Federation into line with the legislation of our Federation. And Moscow was in the lead in discrepancies in the legislative framework.

V. KARPOV: Yes, but Yuri immediately retorts: “Unfortunately, was it lagging behind? Yes, it was fortunately lagging behind! Because, thanks to this discrepancy, Moscow received somewhat more, for example, than other regions. And now to refuse this is very painful."

I. KOLTUNOV: What does “more” or “less” mean? These categories are not applicable in medicine. There is an understanding of quality, there is a misunderstanding, a lack of quality. Everything that has taken root in a person’s life, again I repeat, cannot be more or less. We need to do everything as much as possible. As much as possible exactly as necessary for the patient to save his life, cure him or alleviate his condition.

V. KARPOV: Again, here it turns out - the maximum, but only within a clearly defined framework that limits that very maximum. These are the restrictions that will be introduced, how much will they affect your capabilities?

I. KOLTUNOV: You know, I don’t understand what restrictions are. I understand what medical standards are.

V. KARPOV: Single-channel financing is a limitation, in my understanding.

I. KOLTUNOV: Single-channel financing is not a limitation. Single-channel financing is, first of all, bringing it into compliance with the standard of medical services. Without an appropriate standard, you will not be able to control the quality of medical services in any way. Medicine is a fairly accurate science. And it is impossible to constantly interpret certain events and interpret them individually. In this way we will not have medicine, we will have fortune-telling using coffee grounds. In order to guarantee the quality of service to the patient and not just guarantee, but guarantee the quality in any medical institution is approximately the same, with a minimum degree of error, for this it is precisely necessary to switch to single-channel financing, and to introduce medical standards and to bring everything into compliance .

V. KARPOV: This optimization, which is talked about so much, has quite a lot of opponents. What do you attribute this to? If this is so long overdue?

I. KOLTUNOV: You know, it is human nature to love a certain constancy, it is human nature to resist any changes, especially if these changes are not clear and unknown to the person. There are areas such as sports, medicine, politics, in which absolutely everyone understands. You know, if optimization had been carried out in nuclear energy or in heavy engineering, I think there would have been fewer opponents of such optimization.

V. KARPOV: It is enough, for example, to say that some scientists or some enterprises will be laid off, this will always agitate society. Therefore, even if this relates to nuclear energy, one way or another, the words that they will fire people, make them redundant, or engage in incomprehensible re-profiling, will in any case raise questions.

I. KOLTUNOV: You know, I would compare the modernization of healthcare today with the reform that took place in our army at one time. In the army in the 90s it was dismissed a large number of people, and there was a whole program of what you said - about retraining, retraining officers and so on. I would probably compare the same thing that is happening now in medicine. Dismiss a huge army medical workers, not very qualified, unqualified at the wrong time when they started working, and not meeting modern requirements. Not meeting the requirements for modern medical equipment, which Moscow received as part of modernization - modernization that never happened. Those clinics that were equipped today with equipment that never existed there before. And, of course, there are people who need to be taught, on the one hand, and there are people who, unfortunately, need to be retrained or prepared for something else. Maybe to easier activities, maybe to slightly different stories. The same thing was carried out in the army at one time - reform and modernization. As you can see, we have moved away from a large, clumsy, huge machine and have come to fairly mobile, multidisciplinary, absolutely qualified medical institutions.

V. KARPOV: We have yet to arrive at medical institutions.

I. KOLTUNOV: Yes, we must come to high-tech medical institutions that must provide standard high-quality medical services to everyone, to all patients.

V. KARPOV: As for the army, for a very long time its reform was called “the collapse of the Russian army.” As I understand it, similar characteristics will be addressed to Moscow medicine. Do you think patients will experience improvement?

I. KOLTUNOV: Of course, they will feel it.

V. KARPOV: Why suddenly?

I. KOLTUNOV: Definitely. You know, a revolution took place very quietly in the city, when vascular centers, centers vascular surgery. It was very quiet in the city when we reduced the time it took to transport patients with acute coronary syndrome from the scene of the disaster to the medical facility. It happened quite quietly now that our life expectancy in Moscow has increased sharply. It is through the provision of qualified, timely medical care. Is no one screaming about this?

V. KARPOV: Maybe it’s just bad that they don’t shout? As a result, we only hear about the deterioration?

I. KOLTUNOV: But this is a fact, but it exists. And today the life expectancy of a Muscovite is growing, today the quality of medical services is growing. And the number of deaths from acute coronary syndrome is much lower, many times lower, than it was literally 4-5 years ago. This is also a fact. Today in Moscow medical examination is being carried out, in Moscow today they are producing preventive examinations. Today we are coming to preventive medicine, preventive medicine, we are moving towards something that, in principle, has not happened for decades, in our urban healthcare today.

V. KARPOV: And finally, it should appear. Because the wrong ones will be removed? But before this it was impossible to do this?

I. KOLTUNOV: You know, I don’t know what is right, what is wrong, what is possible, what is impossible.

V. KARPOV: You yourself say that you need to get rid of specialists who are non-specialists.

I. KOLTUNOV: There is no need to get rid of anything, there is no goal to get rid of someone, there is no goal to fire someone. The goal is to create high-quality, qualified medical care. Accordingly, it consists, as we ourselves understand, of three components: the first is the need for modern technological equipment, the second is the need for trained, competent, skilled specialists, the third is adapted buildings, structures and the logic of the treatment process, competently built from the point of view of organization healthcare. Thanks to these three components, you and I receive high-quality, guaranteed, standardized medical services.

V. KARPOV: From my point of view, as a layman, the more of these three components there are, the better it will be for us, patients. But we are told that in order for it to become better, it needs to become less.

I. KOLTUNOV: You know, bigger is not always better.

V. KARPOV: I agree.

I. KOLTUNOV: There should be as many as necessary. And therefore, if we are talking about the number of medical institutions, we understand perfectly well that we have such things as the population of the city of Moscow, we understand that we have the prevalence of certain most common diseases, such as infectious, and non-infectious. Based on this, there is an understanding of how many medical institutions there should be, what profile they should have, what bed capacity they should have, what equipment they should have, and throughput, the number of services provided by them.

V. KARPOV: Is this understanding clear? Again, today's news - plans to reduce the number of Moscow doctors must be prepared by chief doctors and sent to the Department of Health by the New Year. That is, it seems that today there is no such clear data.

I. KOLTUNOV: Of course, there is an understanding, absolutely. And of course, we clearly know what we want and what we want to achieve. I’ll tell you that in childhood, in pediatrics, it’s probably easier than for adult doctors, since we have about 1 million 800 thousand small patients in the whole city. Of course, there are many more adults than children. And the range of diseases in adults is much wider than in children. It’s probably easier for us in children’s healthcare in this regard. If you pay attention, fortunately, there are not so many complaints about pediatric care today, if we take it in relation to adult patients. And to date, not one yet little patient medical care was not denied. Moreover, we have an absolute breakthrough in pediatrics - we now care for children from 500 grams and above. What corresponds to European standards today World Organization healthcare. And this again became possible thanks to the modernization and equipment of medical institutions.

V. KARPOV: This has already been done.

I. KOLTUNOV: It was done just now. This was done 2 years ago. These children are now nursing, they then move on to the second stage. They then move on to the third stage, rehabilitation. All of this, understand, is not a one-day story. The healing process has its own logic, its own sequence of events. And, of course, there are a number of diseases when it’s very good, very beautiful, as they say, cut off and sewn on, and everything is fine. Often this does not happen, diseases are often cyclical in nature, and we often begin to provide treatment for diseases over many years. And this is a staged, staged, staged treatment so that the patient is healthy.

V. KARPOV: I’m still trying to understand: now, as part of this optimization, as part of this reform, they require more from you as a doctor or as a manager. Do you have to achieve efficiency in financial indicators or something else, or satisfaction of citizens' needs?

I. KOLTUNOV: You know, there is a whole specialty in healthcare, it’s called “Healthcare Organizer”. This is its own specialty, they teach for it, they give it a diploma for this specialty. This specialty combines management and treatment skills and everything related to the treatment process.

V. KARPOV: But what is your priority now? What exactly is required of you?

I. KOLTUNOV: Our priority now is the organization of specialized, highly specialized medical care. The hospital should move away from providing simple medical services that should be provided in a clinic. Do not engage in minor, let’s say, non-life-threatening, often reproducible medical services that can be provided in a simpler, less equipped institution.

V.KARPOV: That is, efficiency, financial indicators?

I. KOLTUNOV: Financial indicators are a consequence. This is not the goal. There is no task to earn some money, to receive this money. We have government agency. And, of course, no one will allow any large medical institution, in particular the Morozov Hospital, to be destroyed or bankrupted. It is clear that if the management in the hospital is ineffective, the management apparatus will accordingly be changed, the state will help the financial holes and install another more competent specialist. But no one will ever let the hospital collapse; that’s out of the question.

V.KARPOV: Let's take phone calls. It will be more convenient for you to wear headphones 73 73 948. Now we are listening to you carefully. Hello, hello!

RADIO LISTENER: Hello, hello! You know, I am frightened by various reorganizations in the country, I will explain, for example, the police were recently reorganized into the police - there is zero sense. Now we are going to reorganize medicine. I'm sorry, I haven't been listening to your program from the very beginning. But I want to know what kind of person your interlocutor is telling stories that everything will be fine. In my understanding, it will only be terrible, worse and worse and worse. If our medicine becomes commercial, it will be a disaster.

V. KARPOV: Here it is important to understand why, in your opinion, medicine should become worse?

I. KOLTUNOV: At the moment, she is, in my understanding, in critical condition. My father was in the hospital, in Botkinskaya, there are good buildings where people do not lie, excuse me, like cattle.

V. KARPOV: Yes, thank you, accepted.

Why should we get better if we have examples of other reforms that are not performing so well?

V. KARPOV: Let me remind you that Igor Koltunov, chief physician of the Morozov Children's City Clinical Hospital, is with us.

I. KOLTUNOV: Of course, there are good buildings, of course, somewhere there are bad buildings. This interlocutor very correctly says that it is necessary to undergo health care reform, namely that it is necessary to create institutions that will provide only specialized clinical care, such as, for example, the Botkin Hospital, the Morozov Hospital. To do this, these services need to be concentrated there, both human resources and equipment, and, as a result, government, compulsory medical insurance, and our funds will go there, which will make it possible to further develop this institution.

V. KARPOV: When they talk about medical institutions for adults, they most often remember grandmothers who do not have to come, just lie in the hospital, because they are provided with some kind of social services there, among other things. And when they talk about a children’s hospital, are we also talking about reducing the bed capacity, about the fact that children should not just lie in the Morozov Children’s Hospital? Just explain.

I. KOLTUNOV: Let's talk in numbers.

V. KARPOV: Let's do it.

I. KOLTUNOV: Three years ago, when we began the reorganization of the Morozov Hospital, the number of patients treated in the institution was about 32-34 thousand people. Today, in the same medical institution, this year we reach 72 thousand treated patients.

V.KARPOV: Twice as much.

I. KOLTUNOV: Absolutely exactly. Twice as much, just by changing the logic of the treatment process, routing patients who are directly tied, again, I repeat, to modern equipment, which makes it possible to provide medical care at a completely different speed. When we say that we are changing the speed of providing medical care, this is not a desire to earn more and faster, this is a desire to help the patient faster, because often the patient’s time is calculated in minutes and, at most, perhaps in hours. The doctor does not think about money, he thinks about how to quickly provide the patient with qualified medical care. Of course, recalling stories with you, when patients went to bed for treatment, to be examined, some time passed, in order for the patient to be diagnosed, it took 7-10-12 days. Why? Because there was only one tomograph, it worked twice a week, the recording was enormous, because the tests were done only on Tuesdays and Thursdays, and the results were given out only on Monday and Friday, and so on, and so on, and so on. I remember all these stories very well; today there are no such stories. Today, at the emergency room level, from 300 to 360 people come to our institution for emergency indications, 120 people are brought by ambulances from the substation, about 200 people themselves seek medical assistance in some emergency situation. For the first time, we have discovered such a concept as “pre-day hospitalization beds,” when today a child and his mother come to the emergency room and within 2-3 hours the patient receives round-the-clock care modern equipment, which has never been in our institution: this computed tomography, this is an ultrasound examination, if necessary, x-ray and completely laboratory diagnostics: biochemical tests, clinical tests, etc. Thus, in 2-3 hours the child leaves us, the so-called “pre-daily hospitalization beds”, and they will still feed him. The mother is with the child.

V. KARPOV: Let me clarify: will there still be a reduction in bed capacity at the Morozov Children’s City Clinical Hospital or not?

I. KOLTUNOV: In the Morozov Children's City Clinical Hospital, the bed capacity has long been reduced

V. KARPOV: That’s it, that is, you won’t be cutting anything additional?

I. KOLTUNOV: No. By the time the mass discussion began, all these conversations, reforms, in the Morozov hospital all this was completed long ago.

V. KARPOV: Then what will happen? What changes have you made in particular?

I. KOLTUNOV: When will it happen? What do you have in mind?

V. KARPOV: Well, now, during this optimization, when they talk about reducing medical personnel and bed capacity? How will this affect you?

I. KOLTUNOV: We have already gone through a reduction in bed capacity, we have already gone through a reduction in medical personnel and, unlike many other medical institutions that are now just involved in this process, we can already talk about the results of this process. Let's summarize this process.

V. KARPOV: That is, you, as an experimental site, have essentially already worked out your work.

I. KOLTUNOV: Yes, we are like a pilot project. There were 4 hospitals in the pilot project, the children's hospital was Morozovskaya, and by this time we had completed all our optimization

V. KARPOV: Separately, now I ask you to call those people who have had encounters with the Morozov Children’s Hospital in the last year, probably. Please remind me your phone number live broadcast 73 73 948. And you can say: Yes, there are noticeable changes, and you like it or you didn’t like it. Therefore, you are welcome on our broadcast. We are listening to you carefully now.

Hello, hello!

RADIO LISTENER: Hello, good afternoon! In a nutshell: I didn’t come across Morozovskaya, I came across Filatovskaya with Lately. But I want to tell you about the children's clinic. The situation is such that layoffs are coming, the doctors are all nervous. Making an appointment, the coupons they give, it doesn’t work. The time is calculated, but you still sit in line, you keep sitting there. What is characteristic is that recently a moment has appeared: if earlier, six months ago, all the tests that were prescribed were all done. Now - no, we’ll do everything for you, but this one, sorry, is paid. The doctor explains this by optimizing this process.

V. KARPOV: Okay, thank you! A slightly different example, but still close to you, please.

I. KOLTUNOV: You know, not quite close to us. We don’t have a clinic in our hospital, we don’t have an assigned contingent, so I can’t tell you now what my comrade is talking about. I don’t work at the Filatov Hospital, so I can’t say or comment on this either. Yes, indeed today there are a number of services that are not included in the mandatory system health insurance, as in all countries of the world: acupuncture is not allowed...

V. KARPOV: Let's clarify: before it was free - now they made it paid, for example. Are you talking about these services?

I. KOLTUNOV: You know what happened before, I’ll tell you now. Previously, a patient came to a doctor, the doctor did not care how he treated him, the doctor did not care how many tests he would prescribe, or what he would do with him. There were no criteria for assessing the doctor’s work, nor was there any understanding of what was being done to the patient and whether he needed to do it all or not need to do it all. Today, now they are trying to avoid such situations. Moreover, we now have electronic recording in our clinics and an emergency room. In theory, I think that this is all a temporary story, that doctors are nervous. In our country everyone walks around nervously various reasons, and not only doctors in the hospital. But over time, all this will pass, we are just moving towards such civilized things as psychological support from doctors.

V. KARPOV: You will also have this in place, and if you have already completed the modernization, you already have it.

I. KOLTUNOV: We also come to the conclusion that doctors need to do a psychological exam. You understand perfectly well that people who are constantly faced with human suffering, with seriously incurable patients, people who see death every day, of course, this affects them psychologically. Of course they can be irritable, of course they can be rude. To prevent this from happening, we are now providing psychological support to doctors, psychological relief for doctors. We are now starting to do all this too.

V. KARPOV: That is, you don’t have this yet, but you are now in the process.

I. KOLTUNOV: In the process, we are now testing this system. In the next 2-3 months, this will function permanently for us.

V. KARPOV: A question that arose for me yesterday about the compensation that Sergei Semyonovich Sobyanin promised to doctors who will be fired during this optimization. Doctors - half a million rubles, paramedical staff - 300 thousand rubles, junior medical staff - 200 thousand rubles. Who is this for? What is this for?

I. KOLTUNOV: It’s hard for me to say, I listened to the speech of our mayor just like you. So far we do not have a regulatory document that would spell out the procedure for paying this compensation, how it will be, and to whom. Therefore, I cannot say for sure, I do not have any documents.

V. KARPOV: Why is this being done? You probably know, you just don’t want to talk about it on air.

I. KOLTUNOV: No, I don’t want anything. But we understand perfectly well that there are deadlines for training and advanced training, and changing specializations. We understand perfectly well that there are a number of highly sought-after specialties for which we cannot find a person. Today the problem is to find a very competent ultrasound specialist, the problem is with specialists who can do echocardiography. Unfortunately, unlike foreign specialists, our cardiologists cannot perform cardiac ultrasound themselves and cannot interpret it themselves. Our general practitioners cannot interpret the cardiogram themselves, and for this we need technological assistants - other doctors, narrow specialists in diagnostics.

V.KARPOV: Will they be retrained somewhere, will they be paid 300 thousand rubles?

I. KOLTUNOV: And the person who studies does not receive a salary.

V. KARPOV: And for those who will receive half a million, this looks like an attempt to cajole the doctors so that they will not be too indignant.

I. KOLTUNOV: No, I don’t agree with you. Today, to become a specialist in another profile, you need to study for more than six months, which is more than 540 hours according to the standard. In fact, the person does not receive a salary for a year. You and I understand perfectly well what the average monthly salary in the industry is. This is actually the money that is given to a doctor so that he can retrain in a specialty that is in demand.

V. KARPOV: Let me remind you: with us today is Igor Koltunov, chief physician of the Morozov Children's City Clinical Hospital. Now there is a news release. Then we’ll come back and continue.

V.KARPOV: 20 hours 36 minutes. "Lights Out" program. Vladimir Karpov is at the microphone. Today with us is Igor Koltunov, chief physician of the Morozov Children's City Clinical Hospital. Naturally, we are talking about reform, we are talking about optimization. Your questions are accepted: live telephone number 73 73 948, SMS +7 925 8888 948.

V. KARPOV: Yuri writes: “Yes, so that doctors are silent. Your guest doesn’t want to tell you how a document has already been sent to all chief doctors so that all doctors who come to the rally will be handed over.”

Is this true or not? They sent you a document stating that you must, firstly, warn everyone not to go to the rally, and secondly, put everyone in prison after that.

I. KOLTUNOV: You know, so far I have only seen a document that came to our trade union organization with a call to go to a rally, but I have not received a document from our department with a call to “not go” to a rally.

V. KARPOV: Will you go to the rally?

I. KOLTUNOV: I won’t go to the rally, of course.

V. KARPOV: Why? Your doctors will go.

I. KOLTUNOV: I don’t know, maybe they’ll go, maybe not. I cannot speak for every specialist.

V. KARPOV: But you asked them not to go out?

I. KOLTUNOV: No, of course. Absolutely.

V. KARPOV: Why don’t you go? Don't support this rally? Don't support the concerns of doctors and patients?

I. KOLTUNOV: I do not support fears that everything will be bad, because we cannot talk about what we don’t know, what we don’t see. In order to judge something, you must, firstly, at least understand it. If we want to get some kind of constructive approach to this whole story, please, there are special public organizations, including medical and non-medical ones. You can create any working groups, and discuss and watch all this at a qualified level. There are indicators, there are proven methods absolutely all over the world, and you see, the healthcare reform that we have today was one of the first to be carried out by Margaret Thatcher in England. Then Obama carried it out in America; Schwarzenegger in California was one of the first to propose health care reform in his state. Now we are conducting in Russia. This is a fairly normal, natural process that follows the growth of new technologies. New technologies appear, new approach To provide medical care, completely new medical techniques are appearing. Of course, this requires a completely different logical approach to the treatment process.

V. KARPOV: Correct me. But I have the following feeling: now they are trying to turn medical institutions into some kind of factories to provide medical care for patients. In other words, the patient must arrive at a strictly fixed time, and within the strictly allotted few minutes he must be consulted and given a primary diagnosis. After this, he must go to the hospital, where he will undergo the required operation at a strictly allotted time, after which, even for 2 days, he must be carried out. I understand correctly?

I. KOLTUNOV: Partly.

V. KARPOV: What am I doing wrong?

I. KOLTUNOV: With the transition, in accordance with the health care reform, to per capita financing, today there is no understanding of appointment times, in particular in the outpatient department, as such. Since a certain amount of the population is attached to the clinic, this population may or may not seek medical help. The capacity of the clinic is calculated in such a way that the entire population living, and the frequency of calls is clear to you and me, these capacities must meet all the needs of the population. And therefore, the time allotted for the patient’s appointment fundamentally no longer plays any role. The doctor works calmly, he knows that he will serve all patients, not today, but tomorrow he will definitely serve them, give them all the qualified help.

V.KARPOV: Is there some kind of plan for the shaft?

I. KOLTUNOV: There is no plan for the shaft.

V.KARPOV: He sees 20 patients a day - does his salary depend on this?

I. KOLTUNOV: There is no such thing.

V. KARPOV: What is there? As it will be?

I. KOLTUNOV: I’ll tell you again: there is per capita financing. Each person is allocated a certain amount of money for a year in a given medical institution. We ourselves understand that out of the population, let’s say 100 people, well, I’m saying this exaggeratedly, 50-60 people will ask for help, no more.

V.KARPOV: Per year?

I. KOLTUNOV: Per year, yes. The money that is collectively allocated for per capita funding should be enough to serve all those in need. Accordingly, as you and I understand, the more of the population is attached to some highly specialized, highly equipped, outpatient multidisciplinary institution, the greater the chance of receiving qualified medical care there as quickly as possible. None regulatory documents There is no information about patient appointment times.

V. KARPOV: I have a feeling that they still existed before this, because the doctors complained all the time: I don’t have time for you, my schedule is 15 minutes per patient. That's it, I can't do it anymore.

I. KOLTUNOV: Yes, indeed, this happened before the health care reform. We did not have a single computer system in the clinics, which the Department information technologies Moscow City Hall developed and implemented. You and I didn't have electronic recording, you and I didn’t have the opportunity to sign up online, we didn’t have many, many things. You and I did not have equipment that was not just a tomograph, not just an ultrasound, not just an X-ray, but all of this was directly included in a single local computer network. This is an exchange of information, this is a completely different qualitative approach.

V. KARPOV: And now these 15 minutes per patient are removed?

I. KOLTUNOV: Yes, there are no 15 minutes per patient, there is no such thing.

V. KARPOV: Well, there were, but I didn’t come up with it.

I. KOLTUNOV: All that happened was. Well, you know, there was a lot.

V. KARPOV: Okay. 73 73 948 - live telephone number. Those people who have encountered the Morozov Children's City Clinical Hospital recently are especially welcome on our broadcast.

V.KARPOV: Please, 73 73 948, we are listening to you. Hello!

RADIO LISTENER: Hello!

V.KARPOV: Yes, you are on the air. Please.

RADIO LISTENER: I would like to say that the person who is in your studio literally deviates from all questions, to be honest.

V. KARPOV: Ask the question this way. so that Igor Efimovich does not evade, please.

RADIO LISTENER: Is he for or against the reform?

V. KARPOV: He answered at the very beginning - in favor. So, further.

RADIO LISTENER: But I don’t know how to express this, that is, he is in favor of leaving as few clinics as possible, as few doctors as possible, what does he stand for?

V. KARPOV: Thank you. Accepted. That is, look: the broadcast time goes by, but the questions remain, and the same questions remain. So what exactly are you?

I. KOLTUNOV: I am for high-quality, timely medical care.

V. KARPOV: If they reduce the number of clinics, will you welcome it or will you most likely not like it?

I. KOLTUNOV: You see, I repeat once again: the task is not to cut anything or fire anyone. The task is to bring medical care into line with that which exists today in modern world, in modern technology.

V. KARPOV: I accept. So, in order not to go too far from the clinics, you need to come and re-register before December 1st, in order to clarify things for all our listeners. Is this necessary for clinics or for patients, in the end?

I. KOLTUNOV: You need to come to re-register in order to understand how many people you and I live in this territory. Unfortunately, in our country, in our city, it is not clear: how many are registered, how many are not registered, how many of those registered live, how many of those registered do not live. We have an example of the Central Administrative District of Moscow, where in fact the population is probably 2 times less than registered. Because people rent out offices, etc., etc. Today we have the Central District - the most sparsely populated district. And literally 10-15 years ago it was the most populous. Tell me, please, clinics in the Central District, are they needed there when this population is not there?

V. KARPOV: Probably, for those people who still live there, they are needed one way or another.

I. KOLTUNOV: But in a different quantity, probably. And in Southern Butovo or Northern Butovo, or, in general, in the south, where new areas have appeared, clinics are needed there, they need to be opened. Do you think it would be right to reduce the number of clinics in the Central District, bringing them to the actual population today, and in the southern, southeastern district, where there are big problems today, to establish additional clinics, create new jobs for the same doctors.

V. KARPOV: Okay, I’ll clarify. You and I understand perfectly well that not everyone will re-register, but potential patients of these same clinics. So in the end, how can you trust this data?

I. KOLTUNOV: You know, I’ll tell you, they re-register, they don’t re-register, how we once solved a problem in the Morozov hospital with compulsory medical insurance policies. Several years ago, when patients were brought in, they often did not have an insurance policy in hand. And what happened: if we go into a single database and see that patients do not have a policy, we cannot provide assistance to him within the framework of compulsory medical insurance, because he does not have a policy, he is not insured. But we cannot refuse a patient. What to do? And it’s done very simply: we took a registrar, put him on duty around the clock, and today in our hospital any patient who comes to us without a policy is given a temporary policy during the treatment process, which is then changed to a permanent one. And there are no problems. Without leaving the walls of the institution.

V. KARPOV: The problem is being solved this way only in Morozovskaya.

I. KOLTUNOV: I speak only for the Morozov hospital, I cannot tell you anything for the others.

V.KARPOV: Why is there such a difference between different hospitals, respectively? different attitude, different programs treatments and everything else?

I. KOLTUNOV: Treatment programs are the same everywhere. The attitude should be the same everywhere, this is where we started today’s conversation. And we started with the qualifications of chief doctors, we started with the standard of medical services and with assessing the quality of the treatment process. Now, if we fulfill all this with you, these commandments, these postulates, then everything will be the same for us.

V. KARPOV: So, there is a feeling that these commandments do not yet exist. The same 49% of chief physicians who were recognized as seemingly incompetent. But there is a feeling that there are still no standards that should be met, and if there are those standards, then it is very difficult to meet them.

I. KOLTUNOV: You know, there are standards, it’s probably difficult or not difficult to meet them, it all depends on the professional skills of the individual. But indeed, the process of retraining, including chief doctors, the process of bringing it into line with qualification skills - this takes time.

V.KARPOV: 73 73 948 - live telephone number. We are listening to you.

Hello, hello!

RADIO LISTENER: Hello!

V. KARPOV: Good evening! What is your name?

RADIO LISTENER: My name is Olga.

V. KARPOV: We can hear you perfectly, and Igor Efimovich is already listening to you.

RADIO LISTENER: I want, precisely, to directly ask a question to Igor Efimovich. Recently I had a question specifically with the Morozov Children’s Hospital.

V.KARPOV: Great! We were waiting for you.

RADIO LISTENER: My child is 3.5 years old, he has third-degree adenoiditis. The degree is decent. Elective surgery required. We were given a referral to the Morozov Children's City Hospital. I called there, the nearest help that can be provided to us free of charge is compulsory medical insurance policy somewhere June-July, not earlier. If I want to do this for a fee, the price is somewhere around 80 thousand. Question to Igor Efimovich: He considers this type of help timely in this situation, please tell me.

V.KARPOV: Good question. Please clarify again when did you apply?

RADIO LISTENER: The appeal was literally the other day - either yesterday or the day before yesterday. We were diagnosed the day before yesterday.

V. KARPOV: Excellent. Thanks for the question. Igor Efimovich!

I. KOLTUNOV: But as for the cost, open the hospital’s website, you will see that the cost is at least three times less, and not the amount voiced by our listener.

V. KARPOV: But she didn’t just pull it out of thin air, our listener.

I. KOLTUNOV: There is an official website. You can open it now and take a look.

V. KARPOV: Okay.

I. KOLTUNOV: I don’t interfere with the site, you see. The second question, regarding the queue - we have a queue today for the month of January. Indeed, there is a waiting list; adenoiditis is not an emergency surgical intervention. Removing adenoids takes a month or two, but there is a waiting list.

V. KARPOV: But this is not summer. And here we were told that June-July, just a listener. If she called the Morozov hospital, someone consulted her, probably over the phone, they told her the amount of 80 thousand, and they also gave her a deadline, if free of charge, June-July. And you say that this does not happen.

I. KOLTUNOV: I’m not saying that it doesn’t happen. There is such a service, but it costs at least 2-3 times less than the amount the patient announced, you will see on the website. There really is a queue, but today it is no more than 2 months.

V.KARPOV: No more than 2 months.

I. KOLTUNOV: Yes.

V. KARPOV: And then who to believe, who to contact, how to avoid such consultations if they do not correspond to reality. How is this problem solved?

I. KOLTUNOV: I think that in this case it is necessary to understand where and what number the patient called. It would be better if the patient contacted me directly. I would gladly accept it and solve this problem.

V.KARPOV: Actually, I don’t argue. It is always convenient to contact the head doctor directly if you can contact the head doctor.

I. KOLTUNOV: I consider all complaints daily. Every day. Every day I receive an overview of complaints on the Internet from the site, complaints in general from the Internet and written requests too.

V. KARPOV: That is, if a patient complains through your website on the Internet about a specific treatment, will you consider this complaint?

I. KOLTUNOV: In four days she will receive an answer.

V. KARPOV: Okay, accepted. In general, this story with the money that is collected from the patient, how will it be resolved?

I. KOLTUNOV: Our service is paid for when the patient begins to choose a doctor. There are cases where people want to see a specific specialist. We pay for the service when it is performed on a day and time convenient for the patient. As you know, every specialist has an 8-hour working day. But the doctor can go to work on Sunday, Saturday, weekends and holidays. As you and I know, from the 1st to the 10th are New Year holidays, but in our hospital we don’t have these holidays, people go to work, and whoever wants to earn money, the patient can quickly receive this service. It happens that the patient pays for some additional conditions of stay, this also happens. But today the volume of paid services in our hospital is about 6-7% of the total income.

V.KARPOV: The main thing is transparency. This transparency, in general, is somehow controlled so that it is clear - for what you should, or rather, can, pay extra, and for what - under no circumstances should you, even if someone asks you something?

I. KOLTUNOV: Absolutely exactly. There is a clear understanding, there are stands everywhere with explanations, with laws about what is paid and what is free. Everywhere there are lists of services included in compulsory medical insurance and those not included in compulsory medical insurance. Each patient signs a consent and an agreement on the provision of paid medical services. Today in our institution we do not have such an understanding of the service of a doctor visiting your home. It's only for a fee. This does not exist in our country and never has. If a person wants to go after his working hours, a doctor - I mean, then he calmly takes a paid order and goes to the patient’s home.

V.KARPOV: 686th or 6th writes the following. The daughter was saved in the ophthalmology department of the Morozov Hospital this summer flawlessly and professionally. I don’t know thanks to the reforms or in spite of them, but a low bow and sincere thanks.

73 73 948 - live telephone number. We are listening to you. Hello!

RADIO LISTENER: Hello, my name is Vladimir. I'm calling about the Morozov hospital. I also applied there. I also have a child with adenoids, we were in the Morozov hospital. We were told that we needed to have an operation and they told us the amount. The amount, naturally, is not the one your guest tells you. She was much bigger. As a result, we were afraid, or rather, we did not have such an amount and decided to apply to another institute. They didn’t do any surgery for us, we were cured and there were no problems. If they had gotten to Morozovskaya, we would definitely have had an operation and they would have given us good money.

I. KOLTUNOV: Tell me, can I ask the doctor’s name?

RADIO LISTENER: I can’t tell you the name of the doctor, because this was 1.5 years ago, and this is absolutely happening exactly as the previous person called you.

V. KARPOV: Thank you!

I. KOLTUNOV: Firstly, I didn’t mention any amount, if you noticed, I didn’t mention any numbers at all.

V. KARPOV: But you said that this is several times less than 80 thousand.

I. KOLTUNOV: This is the first thing, you can see it on the website. Secondly, I don’t know which doctor my friend went to, so...

V. KARPOV: Okay. Something could have changed in 1.5 years.

I. KOLTUNOV: Yes, of course. We have been reforming for only 3 years, and 1.5 years ago there could have been some specialists who would like to earn money not entirely honestly.

V.KARPOV: Did you carry out any cleanup?

I. KOLTUNOV: No purge, this is too harsh a word. But cash registers appeared in the Morozov hospital 2 years ago.

V. KARPOV: You said at the very beginning that you have already carried out the reform that the Moscow authorities are now carrying out. How many doctors have you laid off, fired or sent for retraining? How did this happen?

I. KOLTUNOV: The process is quite flexible - reduction, dismissal, hiring, retraining. I think that's the total. We started with a thousand beds, then we got two thousand beds, then we returned again to one thousand one hundred beds. We started with about 2,600 employees, now we have reached the point where we have 2,000-2,100 employees. Someone left, someone came. It was a soft, latent process. Roughly, harshly, we did not lay off anyone. Some were not satisfied with the working conditions. As an example, we have a big problem in Moscow with middle and junior medical staff. Unfortunately, Moscow residents do not want to work in the hospital as nurses and orderlies, especially as orderlies. And we had to attract residents of other cities: Tula, Ryazan, Voskresensk, etc. And they all wanted to work for days. But can you imagine when a nurse comes to work for you, works for a day, and three days later she appears again. How to control it, what to do with it? It’s even impossible to assemble the department’s staff. Because they can't come.

V.KARPOV: People from another city, I understand

I. KOLTUNOV: Yes. With the transition to a multi-shift 8-hour working day, visiting people refused such working conditions.

V. KARPOV: So you now have Muscovites working for you, or are you again receiving some of the people who constantly arrive here?

I. KOLTUNOV: There is no understanding - Muscovites or non-Muscovites. There is a task to ensure that the hospital has a permanent staff. And so that you can ask this person. And if a nurse worked the night today, I can come and ask in the morning what she did at night. And it’s not that she already passed the 8th shift and went to her place, and will appear only after 2-3 days again in the hospital.

V. KARPOV: And here’s the last clarification. You are saying that in your Morozov hospital, the reform that is being carried out now has been carried out for 2-3 years, and now they are trying to confront the fact that from 2015 everything will be new. There are fears that such sudden movements lead to an acute reaction and unpredictable consequences. There's no such thing?

I. KOLTUNOV: You know, you are probably right that it was necessary to carry out explanatory work with the population. Or maybe this reform coincided with some general tension: the events in Ukraine, now we have refugees in the country. More than 80 people, refugees, received treatment from us this year. And of course, for us this would be a long-forgotten story, fortunately, but we remember again Patriotic War. Of course, there is tension among the people, there are some economic situations, and everything coincided. It seems to me that now there will be more and more explanations and clarifications. And little by little it will all come into line.

V.KARPOV: Igor Koltunov, chief physician of the Morozov Children's City Clinical Hospital, was with us. Thank you! Come again!

I. KOLTUNOV: Thank you!

Paid services are provided there, but the main function is to ensure the right to free treatment- saved

Recently, some media reported that the well-known Morozov Children's Hospital in the capital began to gradually turn into a commercial institution. Doctors are forced to charge patients for additional paid services, and recommended by doctors expensive medicines replaced with cheap analogues. The head physician of the institution, Igor Koltunov, volunteered to refute the rumors.

The doctors who resigned from Morozovskaya told the media colorfully what was happening in the hospital with the arrival of new management. According to them, now they have to pay for any medical care that is not included in the standards of treatment for a particular disease. For example, a child was brought to the surgical department to have his appendix removed, but he needed ECG of the heart— for research in a non-core department, parents will be asked to pay money. Blood tests for hemosyndrome should also be done according to a separate registry, since these procedures do not apply to acute appendicitis. And it's also paid. There was such a case - mother infant, being treated for pneumonia, reported that his stomach hurt and asked for an ultrasound abdominal cavity. But the head of the department, in accordance with the instructions of the head physician, offered to pay her for the service. “I’m tired of looking at crying mothers who don’t have money to pay,” said one ex-Morozovka doctor. “It is not profitable for insurance companies to pay for expensive treatment, and they do everything to avoid paying.”

Mr. Koltunov does not see any crime in what is happening. Yesterday he confirmed that indeed everything additional research, which are not included in the standard of treatment, are performed at the Morozov Hospital not for beautiful eyes. “A patient with a hernia in the pediatric department will not receive free help - this is a non-core department. And they won’t do an ultrasound of his heart there. We are constantly checked by insurance companies, and if we are found to be violating standards, we will be fined. Services are provided for a fee that are not included in the standard, but which the patient wants to pay for. In addition, people can pay extra for some super TVs or comfort in the room, or for food from a restaurant. But our doctors provide paid services only after hours, on weekends and holidays. There is paid healthcare all over the world,” says Koltunov.

Today, the Morozov Hospital has begun to accept money from patients quite officially, but the main function of the state medical institution remains the same - to ensure people the right to free treatment. He notes that doctors have no incentive to encourage patients to pay for additional tests they don’t need.

According to Koltunov, today the Morozov hospital is financed from several sources - federal and territorial compulsory medical insurance funds, the city budget, donations, etc. And situations when a patient is asked to buy medicines, bandages, medicines, etc. no longer happen - everything is provided free of charge. “It is profitable for us to treat patients with high quality, otherwise insurance companies will deprive us of money,” emphasizes Koltunov. And he cites facts indicating an improvement in the situation in the hospital since his arrival. Thus, the average salary increased by 10-15% (up to 62 thousand rubles for doctors and 45 thousand for paramedical staff). Average duration bed stay decreased to 7 days. And on May 1, a new modern department with 98 beds was opened, meeting all European standards, with double rooms and conditions for mothers with children. But the main achievement is that in six months the number of operations at the Morozov hospital has increased 10 times. Moreover, if before endoscopic surgical interventions they almost never did it here, but now they mostly do only them. Koltunov explains the attacks in the media precisely due to the dissatisfaction of fired surgeons, average age of whom in the hospital before his arrival was 70 years old. Patients now complain less, and most complaints relate to the rudeness of the medical staff, and not to the quality of treatment. Koltunov considers this an achievement and promises to re-educate the medical staff.

ATTENTION!!

You are on an unofficial hospital website. The information on this site is outdated and is not a public offer.

For up-to-date information, please visit the official website http://morozdgkb.rf

Doctors of the Morozov Children's Hospital:

Chief physician of the Morozov Children's City Clinical Hospital: Igor Efimovich Koltunov
Deputy chapters medical doctor parts: Elena Efimovna Petryaykina
Deputy chapters doctor for clinical expert work: Elmira Rastemovna Samitova
Deputy chapters doctor for infectious diseases: Andrey Evgenievich Angel
Deputy chapters Surgery doctor: Sergey Granitovich Vrublevsky
Deputy chapters doctor for work with nursing medical staff: Yulia Sergeevna Arkhangelskaya
Deputy chapters doctor for civil and medical care: Alexander Nikolaevich Korolev

Head of the Ophthalmology Department: Leonid Borisovich Kononov
Head of the Department of Neurology, Neonatology, Eye Microsurgery for Children infancy: Igor Mikhailovich Donin
Head of the Department of Oncology and Hematology: Konstantin Leonidovich Kondratchik, Candidate of Medical Sciences, highly qualified doctor
Head of the Department of Neurology: Irina Mikhailovna Drozdova
Head of therapeutic department No. 1: Natalya Alekseevna Drozdova
Head of therapeutic department No. 2: Dmitry Yurievich Korneev
Head of the box-surgical department of combined pathology for infectious patients: Yulia Valerievna Romanova
Head of the Department of Emergency Surgery and Urology-Andrology: Oleg Sergeevich Shmyrov, Candidate of Medical Sciences, highly qualified doctor
Head of the pediatric department of combined pathology: Inna Romanovna Samsonovich
Head of the otolaryngology department: Yuri Lvovich Soldatsky, Doctor of Medical Sciences, highly qualified doctor
Head of the Department of Gastroenterology: Elmira Ibragimovna Alieva, Doctor of Medical Sciences, highly qualified doctor
Head of the pediatric department: Inna Aleksandrovna Pugacheva
Head of the Department of Traumatology, Orthopedics and Neurosurgery: Mikhail Anatolyevich Petrov, Candidate of Medical Sciences, highly qualified doctor
Head of the infectious diseases department for children younger age: Natalya Lvovna Valts
Head of the gynecological department: Elena Viktorovna Sibirskaya, Doctor of Medical Sciences, highly qualified doctor
Head of the Department of Pulmonology and Cardio-Rheumatology: Anastasia Aleksandrovna Glazyrina
Head of the Hematology Department: Viktor Yurievich Petrov, Doctor of Medical Sciences, highly qualified doctor
Head of the Department of Endocrinology and hereditary disorders metabolism: Irina Georgievna Rybkina
Head of the Department of Clinical Oncology with a resuscitation and intensive care unit for hematological patients: Olga Borisovna Polushkina, Candidate of Medical Sciences, highly qualified doctor
Head of the emergency department with emergency beds. short-term stay assistance: Nikolai Nikolaevich Kuleshov

Head of the Department of Reanimation and Intensive Care for Surgical Patients: Dmitry Valerievich Gorokhov
Head of the department of resuscitation and intensive care for therapeutic patients: Lyubov Petrovna Semenova
Head of the Department of Reanimation and Intensive Care for Newborns and Premature Babies: Konstantin Pavlovich Chusov

Head of the Department of Emergency and Emergency Radiation Diagnostics: Alexander Valerievich Gorbunov, Doctor of Medical Sciences, Professor, highly qualified doctor
Head of the Department of Anesthesiology and Reanimatology: Evgeniy Vasilievich Poduskov
Head of the Department of Ultrasound and functional diagnostics: Yanina Anatolyevna Galkina, candidate of medical sciences, highly qualified doctor
Head of the Clinical Diagnostic Laboratory: Artem Vladimirovich Bullikh
Head of the pathology department: Alexey Nikolaevich Kislyakov, candidate of medical sciences, highly qualified doctor
Head of the Department of Dentistry: Olga Petrovna Boltova
Head of department dietary nutrition: Victoria Petrovna Brovko, nutritionist

Head of the advisory center: Elena Anatolyevna Zhidkova
Head of outpatient service: Georgy Mikhailovich Zinker, Candidate of Medical Sciences

Branch No. 1
Head branch: Alexander Alexandrovich Bugulov
Head of the Department of Traumatological Rehabilitation: Irina Fedorovna Mayorova
Head of the Department of Orthopedic Rehabilitation: Galina Ivanovna Gribova
Head of department rehabilitation treatment: Irina Nikolaevna Ovcharova

Branch No. 2
Head branch: Natalya Vladimirovna Nikitina
Head of the therapeutic department: Andrey Alekseevich Sharko
Head of the Neonatology Department: Vadim Valentinovich Anisimov
Head of the Department of Reanimation and Intensive Care: Oleg Nikolaevich Nakovkin
Head of department emergency pediatrics: Natalya Viktorovna Lagutina
Head of the Department of Emergency Surgery: Kozlov Mikhail Yuryevich Kozlov
Head of the Department of Radiation and ultrasound diagnostics: Vera Ivanovna Lazarenko
Head of the palliative care department: Nikolay Aleksandrovich Denisov
Head of the emergency department with emergency beds. short-term stay assistance: Sergey Stanislavovich Alekseev

Medical care must be timely and of high quality, and medical institutions must be available to patients. Governor Andrei Vorobyov sets this task for regional healthcare.

We talked about what will change in the work of our medical institutions 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 working in the capital’s healthcare system, you for a long time 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 of specialists who have been working together for quite a long time. This is important because the most important thing in our ministry is dedication to the profession, mutual understanding of like-minded people. I can especially note the wonderful maternity hospital with modern equipment. Of course, there are also problems - there is no escape from them. But we will work with it.

What is Odintsovo Central District Hospital today? The institution is on the path of great development. Now being formed one system healthcare, the basic principle of which is: one municipality - one entity. At the same time, all existing units will continue to operate. 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 await the Central District Hospital in connection with the reorganization?

– 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 health care facility in the district without certificates or referrals. As a result of modernization, a unified information space will be created. All medical documentation, all tests and studies will be located 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 specialists, we will be able to open a queue and within seven days call a mobile team or organize a telemedicine consultation with any doctor.

– What will change in the work of doctors? Workload, salary?

– The personnel will receive at least new modern equipment, which is extremely important today. This ensures that doctors are more productive while reducing their current workload. Thanks to high-tech medicine, complications in the treatment of patients will be reduced. As for salaries, we plan to increase the salaries of doctors and nurses by 20 percent within a year. I want to emphasize that this will not happen through staff reductions, but through logistics solutions for patient routing, modern equipment and new technologies.

There will naturally be an increase in so-called completed cases, excuse 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 installation, so a patient with acute heart attack myocardium cannot be provided with modern medical care. He is urgently sent either to Krasnogorsk or Moscow. The same goes for violations. cerebral circulation. To treat such cases, a round-the-clock team of neurosurgeons is required, and at least a neurosurgical office must be open. As a result of modernization, we will have all this.

– Is it possible now to talk about specific terms for the implementation of the program?

– Yes, we have set deadlines, modernization has already begun. The first stage in the next six months is planned to upgrade the traumatology, ENT department, pediatrics and maternity hospital. The second stage is the regional vascular center, which 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 give us the opportunity to detect oncology and treat severe chronic diseases, for which there is currently no base.

I repeat – we are creating a district healthcare 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 to medical institutions, a real choice of where to be treated, whereas previously this 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 institution in the district.

Our information

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

Born September 9, 1968. 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 Healthcare Organization”, as well as valid certificates in the specialties “Cardiology”, “Pediatrics”, GCP, “Public Health and Healthcare Organization”.

Since 1994, he worked at the State Scientific Research Center for Preventive Medicine of the Ministry of Health. In 2011, he headed the Morozov Children's City Clinical Hospital of 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 held the position of chief physician of the Odintsovo Central District Hospital.