Work in Health Care of Russia

Healthcare in Russia

Main article: Healthcare in Russia

Salaries in medicine

Main article: Salaries in medicine

Zemsky doctor (state program for doctors)

Main article: Zemsky doctor (state program for doctors)

Morbidity among HCWs

Main article: Morbidity of healthcare professionals

2023

1 million health workers in Russia for the year received social payments for 74 billion rubles, except for salaries

In 2023, more than 990 thousand medical workers in Russia received special social payments totaling ₽74 billion. This became possible thanks to a special program implemented by the Ministry of Health of Russia. The data on payments were announced in the spring of 2024 at a meeting of the board of the Russian Ministry of Health.

According to Interfax, medical workers received payments under a program aimed at supporting specialists working in primary health care. In particular, amounts from ₽4,5 thousand to ₽18,5 thousand were paid, depending on the specialty and region of work.

𝓲

Freepik

As follows from the report of the Ministry of Health, special social support was implemented in order to retain and attract health workers to state medical institutions. In addition to federal programs, regional measures are also being introduced to increase the attractiveness of the profession.

The Federal Compulsory Health Insurance Fund (MHIF) clarified that payments were sent to 989 thousand medical workers, which is less than 1 million with the planned 1.2 million. In total, ₽75,9 billion were spent on payments, although initially it was planned to allocate ₽152,4 billion. These data were obtained from the foundation's 2023 budget performance report.

Of this amount, 65% were received by doctors working in the compulsory medical insurance system, 70% - by nurses and 47% - by junior medical personnel. It is noteworthy that only ₽24,8 million were allocated for payments to doctors for onconference, which is 45.9% of the approved volume of ₽54 million. The main reasons for the inadequacy of funds were cases of untimely establishment of dispensary observation and an insignificant amount of payments for specific health workers (₽250 and ₽500).^[1]

Reduction in the number of doctors to 41.5 per 10 thousand population

The provision of the population Russia with doctors working in state and municipal medical organizations in 2023 amounted to 41.5 per 10 thousand people. This is 3% less than in 2022 (37.2 doctors per 10 thousand people). This is evidenced by the data of the report Ministry of Health of the Russian Federation on the results of the work of the department in 2023.

From the report of the ministry it follows that by the end of 2023, three indicators of the federal project "Providing medical organizations of the health care system with qualified personnel" were not achieved:

• provision of the population with average medical workers working in state and municipal medical organizations (95.54% - 88.18 people. for 10 thousand people. with a planned annual value of 92.3);
• the provision of the population with doctors providing specialized medical care (95.5% - 15.44 people. for 10 thousand with a planned annual value of 16);
• provision of ambulance workers (96.5% - 7.6 people. per 10 thousand population instead of the planned 7.9).

𝓲

Unsplash

At the same time, a number of plans are overfulfilled. For example, the provision of the population with doctors providing primary health care amounted to 23.27 people. per 10 thousand population with a planned annual value of 22.20 (104.82% of achievement), the indicator of the number of doctors working in state medical organizations is 608.363 thousand people. with a plan of 589 thousand (103.29% achievement). The goals of providing the population with doctors working in state and municipal medical organizations (41.52 people) have also been exceeded. for 10 thousand people. with a planned annual value of 40.1 (103.54% of achievement)).

According to the Ministry of Health of Russia, the satisfaction of the population with medical care in 2023 reached 47.6% against 41.4% a year earlier.^[2]

In Russia, the number of doctors at ambulance stations decreased to 49,668 teams

By the beginning of 2023 Russia , there were 49,668 general-profile brigades. emergency medical aid For comparison, in 2020 this figure was 49,855. The corresponding figures are given in the report of the Federal state Statistics Service (), Rosstat published in early January 2024.

The number of medical teams decreased from 11,282 in 2020 to 9857 by the beginning of 2023, of which helping children - from 2705 to 1784. The number of paramedic teams was 39,811. It is noted that by the beginning of 2023, 4034 specialized emergency medical teams were operating in Russia. These are, in particular, 1449 anesthesiology-resuscitation machines, 1240 pediatric teams, 714 psychiatric teams and 172 pediatric anesthesiology-resuscitation teams. The number of air medical teams has increased many times - from 46 in 2020 to 1449 by the beginning of 2023.

By the beginning of 2023, there were 49,668 general-profile emergency medical teams in Russia

According to Rosstat estimates, in 2022, approximately 10.6% of the staff of ambulance stations (departments) were doctors, another 56.1% were nurses. For comparison: in 2020, the share of doctors was 11.4%, while the indicator for the average medical staff did not change.

The Rosstat report says that during 2022, ambulance teams served a total of 40,728,350 people. In particular, assistance was provided to 627,352 children. 674,705 people received assistance from aviation medical teams.

It is also said that in 2021, out of 27.3 thousand full-time medical positions at stations and in emergency departments, 18.5 thousand were occupied. They employed 13 thousand specialists. In the segment of nursing staff out of 136 thousand full-time positions, 118.2 thousand were employed; approximately 93.6 thousand people worked for them.^[3]

Due to a shortage of personnel, medical institutions in Transbaikalia began to appoint directors without medical education

Due to a shortage of personnel, medical institutions in Transbaikalia began to appoint directors without medical education. This initiative was announced in early October 2023 by the head of the regional Ministry of Health Oksana Nemakina.

According to her, the problem with personnel in medical institutions is acute in the region. In difficult areas, where the personnel situation is most difficult, it is planned to introduce the position of director without medical education as an experiment. In this case, the director will be responsible exclusively for the financial and economic part, while the chief physician will deal only with medical issues.

In medical institutions of Transbaikalia began to appoint directors without medical education

The minister added that a similar management structure exists in railway medicine, and it significantly expands the possibilities for hiring heads of medical organizations. How in Transbaikalia they plan to combine such an approach with the desire of the Ministry of Health to introduce into the Regulation on licensing medical activities the requirement that the head of the clinic and his deputies have specialized higher education, accreditation of a specialist in the field of health management and experience in the specialty from three to five years, Nemakina did not specify.

The personnel problem remains, the personnel shortage remains. This is not only in the Trans-Baikal Territory, we, unfortunately, are not the only ones, there is a personnel deficit everywhere. We have developed many measures of social support - additional incentive payments, now there is an opportunity to organize a workplace for a doctor, - said Nemakina in June 2023.

Oksana Nemakina noted that by the beginning of October 2023, preparatory work is being carried out on this project. The pilot project is scheduled to launch by the end of 2023.^[4]

In Russia, the number of dentists is reduced

According to the data Rosstat (published in May 2023), the number of medical personnel (doctors and nurses) of dental institutions in the period 2018-2022. decreased from 78.8 thousand to 77.6 thousand people. The most tangible decrease (by 1.95%) occurred in 2022.

As Kommersant was told in the German Implantology Center, many clinics could not stand the test of the pandemic - they closed, and the employees had to repurpose, "says.

The number of medical personnel (doctors and nurses) of dental institutions decreased to 77.6 thousand people

The pandemic [coronavirus COVID-19 - approx. Zdrav.Expert] has formed a shortage of nurses in dentistry, - says and. about. Anna Solovyova, Head of the Department of Dentistry and Maxillofacial Surgery of the National Medical Research Center named after V.A. Almazova. - As a result, the provision rate has been reduced: previously there was one nurse per doctor, now for a number of specializations the norm is a nurse per two doctors, which is why it is often necessary to introduce extra-budgetary rates.

According to HeadHunter, the demand for dental specialties in Russia is growing annually. So, in 2021, 29.5 thousand vacancies were placed for specialists in the field of dentistry, in 2022 - 32 thousand. The share of state institutions in the demand for dentists, although it tends to grow, remains minimal: in 2021 it was only 0.6%, in 2023 - 2.3%. Service experts call this situation normal.

Anna Solomakhina, founder of the School of Medical Business, a business expert in the management of medical organizations, believes that the main reasons for the reduction in medical personnel in dentistry are associated with low wages for dentists in state institutions, an outflow of personnel to other countries, as well as professional burnout.^[5]

Ministry of Health - There are not enough 2 thousand endocrinologists in Russia

According to the Ministry of Health of Russia, by May 2023, the country lacks more than 2 thousand endocrinologists. In particular, the shortage of specialists for the adult population is about 1.5 thousand doctors, for children - about 600 people. Read more here.

2022

Ministry of Health: The number of doctors in Russia decreased by 1.3%

The number of doctors in Russia in 2022 decreased by 1.3% compared to the previous year and amounted to 37.2 specialists per 10 thousand population against 37.7 in 2021. Such data are given in the report of the Ministry of Health of the Russian Federation.

According to the publication "Medical Bulletin" with reference to this study, the highest rate of provision of medical personnel was in the North-West Federal District (43.9), the lowest - in the south (33.1). At the same time, a decrease in medical frames in 2022 occurred in all federal districts, except for the North Caucasus, where the figure increased by 0.3%.

The number of doctors in Russia decreased by 1.3%

The rate of staffing by emergency medical doctors was 70.5%. The level of staffing of ambulance paramedics is 87.7%. The number of ambulance drivers in absolute terms decreased by 3%. There was also a noticeable decrease in the provision of all medical organizations with medium-sized medical personnel - by 3% per year, or up to 81.5 per 10 thousand population.

Earlier, Nadezhda Nesvetaylo, deputy head of the statistics department for analytical work of the Central Research Institute of Organization and Informatization of the Ministry of Health, said that in 2022 the number of employees in state medical institutions decreased by almost 50 thousand, including doctors by almost 10 thousand, nurses - by 39 thousand. A significant shortage of medical personnel was noted in 22 subjects.

Andrei Konoval, co-chairman of the Action interregional trade union of health workers, connects the reduction of doctors with the abolition of "covid" (COVID-19) payments and a pilot project of a new industry wage system.

Before the introduction of allowances, many regions cut the salaries of doctors, but those who had "covid surcharges" (and there were many of them) turned a blind eye to this. And after January 1, 2023, the widespread cutting of stimulating floating allowances began, somewhere to zero, "he said.[6]

Mishustin allowed doctors to work as anesthesiologists and surgeons after completing courses

In December 2022, Prime Minister Mikhail Mishustin signed a decree approving the list of medical specialties in which doctors will be able to work after completing professional retraining courses and primary specialized accreditation. The list includes:

• anesthesiologists-resuscitators;
• orthopedic traumatologists;
• surgeons.

Михаил Мишустин и Mikhail Murashko (centre) visited Derbent City Hospital in April 2021

As specified in the government decree, accredited doctors with diplomas in the specialties "medical care" or "pediatrics" will be able to work in these specialties. Training in an additional professional program for the selected profile should take at least 1296 hours (9 months). The decree is valid until December 31, 2024.

Thus, in accordance with the government decree, non-core doctors after courses will be able to work as anesthesiologists and surgeons.

The adoption of the resolution provides for the expansion of the categories of persons who can be admitted to professional activities in the relevant medical positions, which will reduce the personnel deficit of anesthesiologists-resuscitators, traumatologists-orthopedists, surgeons and increase the availability of medical care, - explained in the Ministry of Health.

On December 15, 2022, Russian President Vladimir Putin, at a meeting of the Council for Strategic Development and National Projects, proposed introducing permanent positions of trainee doctors in primary health care for students studying in medical specialties at senior university courses. The head of state noted that the primary health care unit is experiencing a tremendous burden when working with patients, which is also associated with a lack of personnel. During the coronavirus pandemic, senior students and residents provided assistance to primary care doctors.^[7]

Russia lacks 25-26 thousand doctors

The minister health care Russia Mikhail Murashko , during the government hour To the State Duma in November 23, 2022, said that the shortage of personnel in the system for doctors is about 25-26 thousand, for nurses - about 50 thousand people.

This is not a critical deficit, but it is important, - the minister assessed the situation.

Mikhail Murashko

According to him, most often the shortage of personnel is noted in primary health care and rural medicine. And in cities in hospitals, as a rule, there is no shortage. With the exception of anesthesiologists-resuscitators, the demand for them is colossal, said Mikhail Murashko.

He noted that the outflow of medical personnel is mostly associated with the retirement of the older age group of health workers. According to the minister, in the most scarce specialties, as a result of the measures taken in the primary care, it was possible to prevent outflow and increase the inflow of personnel by 3%. Mikhail Murashko also said that in Russia by November 2022, the issue of mechanisms for stimulating primary care workers is being worked out.

The fact that the shortage of health workers in Russia is less than 100 thousand people, the Ministry of Health reported in October 2022. When preparing the state program "Development of Health Care," the ministry estimated that the shortage of health workers in 2022 amounted to 84.7 thousand people, of which 26.5 thousand were specialists.

The main reason for the reluctance to work as a doctor is "a tangible decrease in wages caused by a reduction in incentive" covid "payments," the draft program says. The Ministry of Health named labor migration from state organizations to private clinics as another reason.

The chairman of the trade union of health workers of Russia Anatoly Domnikov in November 2022 proposed to increase the salaries of doctors in order to solve the problems of a shortage of personnel and professional burnout of doctors. The union estimates the shortage of personnel at 30%.^[8]

3,000 doctors mobilized in Russia

Partial, mobilization which the president Russia Vladimir Putin announced on September 21, 2022, will affect no more than 3 thousand doctors and medical workers. This was stated by Deputy Chairman State Dumas of the Health Protection Committee Badma Bashankaev with reference to information from Ministry of Defence the Duma Defense Committee.

According to him, first of all, graduates of military medical universities with training in the field of military field medicine, doctors with experience in military operations will be mobilized. Graduates of civil medical universities in the specialties of surgery, anesthesiology, traumatology will also be required. Doctors who do not have any relevant training or experience in combat conditions will not be required, they are not subject to mobilization by September 21, 2022.

Victory in any battle is unthinkable without the participation of doctors and nurses.

Health workers from those rural medical institutions in which there will be no one to work will not be mobilized. We cannot bare our own health care system, leave citizens without medical care, and everyone understands this, "Bashankaev said.

According to Bashankaev, since the beginning of the military special operation of Russia in Ukraine, more than 1,000 Russian doctors and nurses have already worked and continue (by September 2022) to work in medical institutions in the territories of the LPR and DPR, Zaporozhye and Kherson regions. Doctors provide assistance to the civilian population of these regions, he stressed. Moreover, if surgeons, traumatologists and anesthesiologists were in demand there six months ago, now therapists and pediatricians are increasingly required, he said on September 22, 2022.

On September 21, 2022, in his Telegram channel, the head of the Agora human rights group, Pavel Chikov, said that doctors in Moscow had begun to receive summons en masse. According to the publication "Лента.ру," this message is unreliable.^[9]

The Ministry of Digital Development asked for a delay from mobilization for developers of medical AI systems

The Ministry of Digital Development, Communications and Mass Media of the Russian Federation was asked for a deferral from mobilization for developers of medical AI systems. The corresponding letter addressed to the head of the department Maksut Shadayev was sent by the National Base of Medical Knowledge Association (NBMZ). Read more here.

Opening of 80 vacancies at pharmaceutical enterprises of the capital SEZ

Enterprises of the pharmaceutical and medical industries of the SEZ "Technopolice Moscow" announced the recruitment of technologists, microbiologists and other production personnel in connection with the expansion of existing plants and the launch of new ones. Employees are required at the enterprises of the Pechatniki sites in Moscow and Alabushevo in Zelenograd. This was announced on April 15, 2022 by Technopolice from the words of the Deputy Mayor of Moscow for Economic Policy and Property and Land Relations of the city, Vladimir Efimov.

{{quote 'Enterprises of the SEZ cluster of medical technologies, equipment and biopharmaceuticals recruit specialists of different profiles, mainly for pharmaceutical enterprises. Six companies claimed 80 jobs. Personnel are required by both large drug manufacturers and more compact manufacturers of medical specialty products. During the work, residents of the cluster have already created over 1.3 thousand jobs, having invested more than 20 billion rubles in the sites. With the launch of new large projects, the number of jobs will almost double, - said Vladimir Efimov. }}

About 30 enterprises operate in the cluster of medical technologies, equipment and biopharma of technopolis Moskva, of which more than 20 are resident.

They produce drugs for the treatment of oncological, endocrine, immune diseases, vaccines, ambulance products, products for urological and stomatic patients, disinfection equipment for medical institutions, - said the head of the Department of Investment and Industrial Policy of the city of Moscow Vladislav Ovchinsky.

Developing their production, Moscow SEZ enterprises are opening up new opportunities for both young personnel and experienced specialists, said Gennady Degtev, General Director of the Technopolice Moscow SEZ.

The TechnoWork project on the portal of the capital's special economic zone helps SEZ enterprises in solving personnel issues. Here companies regularly publish vacancies in various specialties, including for medical industries. The project accumulates a resume of potential candidates who get a chance to continue their careers in the technological community of the capital with a convenient infrastructure, a busy business life and an emphasis on innovation, "said Gennady Degtev.

In addition, vacancies of companies in the special economic zone are posted on the Moscow portal "My Career."

2021

Mishustin approved the categories of health workers for additional leave

At the end of December 2021, Prime Minister Mikhail Mishustin signed a decree of the Government of the Russian Federation, which approved the categories of medical workers to receive an additional 3-day paid leave. The innovation affected the following specialists in the presence of continuous work experience for more than 3 years:

• specialist doctors of the district hospital in rural areas;
• nurses of rural district hospitals, outpatient clinics and feldsher-obstetric centers;
• district therapists and pediatricians, including heads of specialized departments, in territorial sections of city polyclinics, polyclinic departments;
• district nurses of therapeutic and pediatric territorial areas;
• doctors of visiting ambulance teams, nurses of such teams, including those included in the visiting team for sanitary evacuation and for emergency consultation;
• senior doctors and paramedics of ambulance stations;
• paramedics of medical outpatient clinics and feldsher-obstetric centers;
• doctors and nursing staff of rural residential homes for the elderly and disabled;
• doctors and general practitioners of therapeutic and pediatric areas and departments.

Mikhail Mishustin approved the categories of health workers for additional leave

Health workers in rural areas and remote areas, in addition to additional leave, as of the end of December 2021, are offered one-time material support under the Zemsky Doctor and Zemsky Paramedic programs in the amount of 0.5-2 million rubles.

The decree will come into force on January 1, 2022. The Ministry of Health of the Russian Federation was instructed to provide an explanation on the application of the adopted resolution.

Some of the listed categories of medical workers had previously the right to additional vacations, but their regulatory regulation was enshrined in disparate documents of the USSR and the RSFSR. Now there is a single regulatory act.^[10]"

Senior nurses in private clinics in Moscow earn 180 thousand rubles

The service for finding a highly paid job SuperJob in November 2021 studied the proposals of employers and the expectations of applicants for the "Senior Nurse" position in private clinics.

The most in demand are senior nurses with work experience of 2 years and experience in commercial clinics. The salary maximum for a senior nurse in Moscow is 180 thousand rubles, in St. Petersburg - 165 thousand rubles, in Vladivostok - 140 thousand rubles.

Senior nurses in private Moscow clinics earn 180 thousand rubles

At the same time, the average market salary for a nurse in Moscow is 80 thousand rubles, in the northern capital - 75 thousand rubles, in Smolensk, Kazan, Volgograd and many Russian cities - 45 thousand rubles. The lowest in Kemerovo and Belgorod is 43 thousand rubles. At the same time, the initial salary range in most cities starts from 28-30 thousand rubles.

The duties of a senior nurse include:

• pre-medical care for patients;
• preparing patients for studies, procedures, and operations;
• sampling of biological materials for laboratory studies;
• performance of medical appointments;
• patient care in a medical organization and at home;
• monitoring of the work of intermediate and junior medical personnel;
• scheduling of duty of intermediate and junior medical personnel;
• compliance with the sanitary and epidemiological regime, sanitary rules and norms;
• collection and disposal of medical waste;
• maintenance of electronic medical records;
• maintenance of medical records.

According to SuperJob, among the requirements for applicants, it is indicated that there is a secondary medical education in the specialty "nursing," "medical care" or "obstetric care," a valid certificate in the specialty "nursing," knowledge of the basics of the legislation of the Russian Federation on healthcare, standards of medical care and the implementation of all types of medical nursing manipulations.

Launch of Healthcare Organizers Personnel Platform

In October 2021, the Central Research Institute for the Organization and Informatization of Health Care (TsNIIOIZ), subordinate to the Ministry of Health of the Russian Federation, launched a personnel platform for managers in the medical field. The project is intended for current and future health care organizers who want to develop medicine in their region and beyond. Read more here.

2020: The share of female doctors in state medical institutions in Russia is 71%

The share of women doctors in state medical organizations in Russia at the end of 2020 was 71%. This was announced in early October 2021 by the State Secretary - Deputy Minister of Health of the Russian Federation Alexandra Dronova, citing statistics collected by the Ministry of Health.

According to these data, by the end of 2020, about 400 thousand female doctors worked in state municipal medical organizations. 1.1 million women were registered in the category of secondary medical workers, which corresponds to 95% of the total. In 2018, these indicators were significantly lower, Dronova noted.

According to her, 167 thousand women study in educational organizations subordinate to the Ministry of Health of the Russian Federation under higher education programs, which is almost 70% of the total number of students.

The share of women doctors in state medical institutions in Russia at the end of 2020 exceeded 70%

Dronova also noted in early October 2021 that over the past five years, the number of women - heads of higher education organizations in the field of medicine has grown by 50%.

All these data allow us to conclude about the increase in the number of women who occupy key posts in the field of medical education and in general in the field of medicine, she concluded.

In addition, the State Secretary - Deputy Minister of Health cited data according to which the maximum increase in the number of women's doctors in 2020 was observed in the North Caucasus Federal District - by 4%.

The Republic of Ingushetia is the leader among the subjects of this district - 85% of women's specialist doctors worked there by the end of 2020. In the Republic of North Ossetia (Alania), almost 83% are women. There was also growth in the Central Federal District, and Moscow, Moscow, Tambov, Kaluga, Tula regions are leading. In the Northwestern Federal District, there is also a trend towards an increase in the number of women doctors, she said in early October 2021.^[11]

Notes