Tuesday, December 22, 2020

Producing Doctors Not Enough if Russian Medical System Can’t Prevent Them from Leaving Profession, Malenky Says

Paul Goble

            Staunton, December 20 – Since the beginning of the pandemic, more than 400 doctors in the Amur Oblast alone have quit, part of the more than 80 percent of medical school graduates who no longer work in their profession and the real reason why many parts of Russia are suffering from a shortage of medical expertise, Regnum journalist Andrey Malensky says.

            Moscow has focused only on the production of medical specialists and not on maintaining or creating conditions in the regions and especially in rural areas that will keep them from leaving the profession, a shortcoming that all too often means “there are no doctors in provincial Russia and won’t be any” (regnum.ru/news/polit/3145946.html).

            Three aspects of the situation suggest, Malensky says, that there is little likelihood for improvement and that rural areas won’t be able to get doctors to come to them or keep them if they are assigned there after graduation. Instead, they will leave and with them the possibility that rural Russians can get medical treatment.

            First, the health ministry continues to talk about a glorious future without providing any details about how to get from here to there or any money to ensure that those who enter the medical profession will stay. Second, the latest plan is a crude copy of what the tsarist authorities called for in the first decade of the 20th century, an indication of how little has changed.

            And third, both because of official pressure and because Russians no longer expect any improvement, the issue of the absence of real medical care in rural Russia has ceased to be the subject of journalistic attention even in the places where the need is the most critical, the journalist continues.

            To make his point about the depth of the problem and the absence of any real hope that the situation will improve, he considers the state of medicine in the Tver Oblast city of Bely, where the hospital now lacks a chief doctor, a dentist, a neurologist, GPs, a gynecologist, and many other specialists.

            As a result, those without inadequate training are having to fill these positions, and the people of this Russian city are unable to get real medical care. The reason Bely can’t attract and hold specialists is that its top salary is 25,000 rubles (350 US dollars) a month, far less than medical professionals can earn in Moscow even in non-professional jobs.

            Producing more doctors in principle is fine, the journalist says; but the current system is doubly inefficient. On the one hand, the government spends a great deal of money on training them; but on the other, it doesn’t provide the financial support to keep them working in the positions they were trained for.

            Unless that changes – and there is no sign of Putin’s “healthcare optimization” program making such a switch – Russia will continue to take pride in the number of doctors it trains but suffer the shame of a system in which most of them don’t work in the profession for long, especially in rural parts of the country.

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