Is it possible to choose a therapist at will? Patient rights that you didn’t know about: how to change clinics when receiving compulsory medical insurance treatment

Current Russian legislation ensures that every patient has the right to choose a doctor and a medical organization. And, for sure, there will be citizens who want to take advantage of this right.

If many people have a more or less clear idea about paid clinics, then with budget institutions, many questions arise: where to go, what documents to collect and whether they can refuse to be assigned to another clinic.

And, as a result, ignorance of rights gives rise to doubts and uncertainty about the correctness of one’s actions or decisions.

To fully understand the situation, you should refer to the current legislation.

In accordance with Art. 21 of the Law of the Russian Federation of November 21, 2011 No. 323-FZ “On the Fundamentals of Health Protection...” (Law No. 323-FZ), a citizen has the right to choose a medical institution.

Order No. 406n of the Ministry of Health and Social Development of the Russian Federation dated April 26, 2012 approved the “Procedure for a citizen’s choice of medical ...” (Order No. 406n).

However, paragraph 1 of this Procedure stipulates that primary medical (pre-hospital) health care is carried out directly on the principle of attachment to a specific territorial area.

This means creating areas that serve groups of people. People are assigned to the appropriate area based on the territory of their residence, work or study.

The sites are approved by the head of the institution, taking into account the principle of accessibility of services.

In particular, the number of sick people per unit of workers is taken into account. The recommended indicators are contained in clause 18 of the Regulations approved by Order of the Ministry of Health of the Russian Federation dated May 15, 2012 N 543n.

For example, at one therapeutic site in a city, 1,700 people should be observed, and in a village – 1,300 citizens.

If, for objective reasons, the required indicators are not achieved (in some regions there is a shortage of patients at the sites) and in order for citizens to exercise their rights to prefer one or another institution, it is allowed to attach persons who do not belong to the medical territory. institutions.

It is possible to implement your choice under certain conditions:

1. You can only select an establishment in the region where the person lives. Exceptions are made for some categories (military, convicted persons).
2. Only an adult has the right to replace an organization.

The rights of young or minor children, as well as incapacitated citizens, are represented by their parents or guardians.

To select a medical facility, you need to follow certain procedures:

• fill out a written application and present it to the organization where you would like to be registered;
• Having received the document, the clinic sends this information to the institution where the person is registered within two days;
• the latter checks the veracity of the information provided and, if the data provided is correct, notifies the organization that accepted the application, also within 2 days;
• within two days the applicant is informed about admission to the medical institution;
• Then, within three days, the information is sent to the insurance company and the former medical center. institution.

Correspondence between organizations can be carried out by post or using electronic means. The citizen is notified by any available means: in person, in a telephone conversation, using postal services, via electronic mailing.

For a correct understanding, it is worth noting that the principle of the applicant’s choice of another medical institution implies his automatic separation from the organization where he was previously observed. That is, it is impossible to be registered in two different institutions at the same time.

Contents of the application for choosing a medical organization

The document must indicate:

• full name and location of the addressee;
• FULL NAME. the chief physician of the organization to which the document is addressed;
• information about the applicant (gender, age, where he was born, what citizenship he has, passport details, place of residence);
• compulsory medical insurance policy number and the name of the insurer that issued the policy;
• information about the medical institution where the applicant is served.

When submitting an application, you must present the original documents at the same time:

• passport;
• compulsory medical insurance policy.

The full list of documents is enshrined in clause 5 of Order No. 406n. It depends on the status of the citizen. For example, a refugee must be provided with an identification card, and stateless persons must be provided with a residence permit.

The applicant must be informed which specialists provide primary care in the institution. He is also notified of the number of people who have chosen a particular health worker, indicating the territory he serves when making a house call. This information may influence the correct choice of specialist.

Having chosen the right medical institution, the patient can choose a doctor, but in this case the legislation has limited the choice (Article 21 of Law No. 323-FZ).

A person has the right to make a choice only regarding:

• local therapist;
• area pediatrician.

The patient can choose a specialist independently, but under the obligatory condition - the doctor must give his consent (Article 70 of Law No. 323-FZ).

If a citizen decides to choose another specialist, the head physician is obliged to help him in exercising this right, according to the Procedure, approved. Order of the Ministry of Health and Social Development dated April 26, 2012 No. 407n (Order No. 407n).

In some cases, a doctor has the right to refuse to serve a patient if such refusal is not associated with a threat to his life. In this case, the manager takes measures to select another specialist for the patient from among the clinic employees.

And here the point is not even that the doctor is too lazy to treat the patient. Basically, such refusals are associated with the doctor’s heavy workload or the remoteness of the patient’s residence, and the employee, understanding his job responsibilities and assessing the real possibilities, will not risk taking on an additional person for service, risking not providing him with assistance at the right time, since there is disciplinary liability for this , but also criminal.

Therefore, when deciding to replace medical staff, you need to act wisely and consider these circumstances. There are, of course, situations based on personal relationships, but these are separate isolated situations.

How does a doctor change?

The attending physician can be replaced for the following reasons:

1. If a citizen has decided to replace a doctor, he must contact the head of the organization with a written request. He must also indicate the reason.
2. Having received the application, the head physician informs about which specialists work in the institution.
3. Based on the information received, the applicant can decide who he would like to see.

The choice of a specialist should be approached responsibly.

The general procedure is not acceptable in all cases. Some individuals can only be served in a certain order.

Such citizens include:

1. Residents of closed territorial entities (ZATO), as well as territories with unfavorable conditions in terms of physical, chemical or biological indicators. The list of such territories is approved at the legislative level. Thus, by Decree of the Government of the Russian Federation dated July 5, 2001 No. 508, such settlements were approved. For example, ZATO - the city of Mirny in the Arkhangelsk region, the village of Voskhod in the Moscow region, etc. The features of medical care for such persons are determined by Decree of the Government of the Russian Federation of July 26, 2012 No. 770. Medical assistance to citizens for such persons is provided free of charge from the Federal Medical and Biological Agencies (FMBA) located in the area where such persons live or work. RF PP dated August 21, 2006 No. 1156-r approved organizations served by the FMBA of Russia.
2. Military personnel, conscripts, contract soldiers. Their service occurs according to the rules of Art. 25 of Law No. 323-FZ. Depending on their status, they can count on medical services in departmental health care institutions or in accordance with Art. 21 of Law No. 323-FZ.
3. Persons suspected of crimes or convicted citizens who are held in specialized institutions receive medical care in institutions of the criminal and executive systems (Article 26 of Law No. 323-FZ).

Interpretation of Art. 21 of Law No. 323-FZ allows us to assume that a patient can be treated free of charge only if he has a valid compulsory medical insurance policy.

In this regard, many may have a reasonable question: is it possible to exercise such a right in a paid clinic?

Law No. 323-FZ does not directly provide instructions regarding the choice of specialists or the organization itself when a person pays for services. However, this was not correct, because any system in the state should give a certain choice to people.

A citizen who wants to receive honey. service for money, you are free to choose the appropriate organization and, therefore, a specific doctor. Legislative norms do not limit citizens in this. As a rule, the “word of mouth” principle, reviews, recommendations about the clinic and their staff, as well as the cost of services play a role here.

When contacting a private clinic, the consumer is offered to enter into an agreement with all the ensuing conditions. And here the principle of freedom of transaction applies (Article 421 of the Civil Code of the Russian Federation), which does not allow any coercion.

Thus, if the patient is not satisfied with the clinic, he can safely go to another one. This is a kind of freedom of choice.

Rights of insured citizens under compulsory health insurance

Receiving free help is directly related to the fact that individuals. the person must be an insured subject under compulsory medical insurance. Because otherwise, using free services will be problematic. Three entities are involved in the relationship for receiving medical care: an individual, a medical authority and an insurer.

The legal status of such entities is regulated by the Law of the Russian Federation of November 29, 2010 No. 326-FZ “On Compulsory Medical Insurance...” (Law No. 326-FZ).

Article 15 of Law No. 326-FZ specifies which entities can carry out activities within the framework of compulsory medical insurance.

These include:

• organizations;
• individual entrepreneurs.

The important thing is that they must be in the appropriate register.

The legal status of such persons is fixed in Art. 16 of Law No. 326-FZ:

1. Receive help for free.
2. Services are provided on the territory of the Russian Federation and the specific subject where the insured person lives.
3. Choice of insurer.
4. Choosing a medical institution and doctor.
5. Obtaining complete information about the services provided by clinics and hospitals.
6. Protection of the rights of the insured. This is a very important point, since not everyone knows that in case of violation of rights in the field of medicine, according to the state. guarantees, you can contact the insurance company specified in the policy. The functions of the insurer are reduced not only to issuing an insurance document, but to defending the violated rights of the insured.
7. Compensation for damage caused to individuals by both an insurance company and a medical organization. There is a lot of court practice in disputes regarding improper provision of services.

It should be recalled that all these rights are available to persons in the compulsory medical insurance system.

Confirmation of this status is a compulsory medical insurance policy, which is issued and changed in the prescribed manner.

When choosing a medical organization, you need to inquire about the existence of an agreement between it and the insurance company specified in the medical policy. Otherwise, a refusal may follow.

Bringing mandatory information to citizens

When carrying out activities in the field of free medicine, such entities must provide their clients with information about the medical institution itself, what services it directly provides, as well as about the staff of specialists, indicating their qualification characteristics.

Information is posted on information boards near the registration desk. In addition, the law requires that this information be posted on the organization’s website.

What medical care can you get?

In accordance with the legislation, medical assistance is divided into types, conditions and forms.

Types of medical care:

• primary health care;
• specialized medical care;
• ambulance;
• palliative care.

Conditions for the provision of medical services. help:

• outpatient (in a clinic, at home);
• not at the location of the hospital building (the place where the ambulance or ambulance was called);
• in a day hospital (under supervision during the day);
• in a hospital (under 24-hour supervision).

Forms of assistance:

• emergency (when there is a possibility of a person’s death);
• urgent (in case of an acute, sudden, unexpected illness, but if the person’s life is not in danger);
• planned (if the patient’s health does not deteriorate when treatment is delayed).

Providing this type of service includes preventive and diagnostic measures, as well as treatment of diseases. In addition, it involves monitoring women’s condition and carrying out measures to prevent epidemics.

This type of assistance is organized mainly on a territorial basis, that is, close to the place of residence, work or education of patients.

Such assistance is divided into:

• pre-medical (it turns out to be paramedics, that is, personnel with secondary education);
• medical (it turns out to be doctors);
• specialized (provided by specialists of a certain narrow focus).

Primary care can be provided:

• in an outpatient setting;
• on the patient’s territory if he lives in a remote area (not an ambulance);
• in a day hospital;
• in an emergency room, which can be temporarily organized, for example, in gardening and summer cottages.

This assistance is provided by medical specialists.

It also includes preventive measures, diagnostic measures and treatment of diseases. However, unlike primary care, it requires special techniques, modern technologies, as well as subsequent rehabilitation. Therefore, such care is provided in a hospital setting or in a day care facility, so that it is possible to monitor the progress of the disease to the maximum.

Specialized assistance also includes high-tech assistance. Its peculiarity is the use of unique, complex treatment methods, the use of robotics and various techniques at the gene level.

To receive specialized care, you may need a referral from a general practitioner or pediatrician. The patient can also seek help independently. In this case, he has the right to choose a specialist and a medical institution himself.

When providing assistance as planned, the therapist gives a referral to a specialist. If the necessary assistance can be provided in several medical institutions, the attending physician must inform the patient about this so that he can independently select a specialist.

Receiving urgent or emergency medical care

Such a need, as a rule, arises if chronic diseases suddenly worsen, or a person becomes ill and the illness occurs in an acute form. The service may also be needed in case of poisoning or injury, when urgent intervention is necessary.

In some cases, it is necessary to evacuate the victim, which is possible using an ambulance.

Basically, these forms of care are provided in an inpatient setting, since in most cases surgical intervention and observation of the patient are necessary.

Palliative care is a comprehensive medical intervention aimed at relieving a terminally ill person of pain and improving their life.

Such cases, for example, include malignant tumors and progressive diseases. They are prescribed appropriate care, nutrition, transportation to and from medical facilities, and pain relief.

Orders of the Ministry of Health of the Russian Federation dated April 14, 2015 No. 193n, No. 187n approved the corresponding rules for such assistance for adults and children.

Help is provided in a clinic or in a hospital.

The choice of a medical institution or doctor depends on the type of assistance.

Primary health care.

Article 21 of Law No. 323-FZ gives the citizen the right to choose medical care. organizations once a year, not more often. The exception is cases when the place of residence changes.

In the same institution, patients can choose a doctor once a year.

Such provisions were most likely established to prevent abuse of rights by service consumers. Since there are categories of dissatisfied people who are ready to change clinics or specialists almost every few days. In this case, the law also protects the rights of doctors.

Specialized medical care as planned.

To get help, you need to take a referral from your doctor. It should be noted that if there are several medical institutions providing the necessary services, the doctor must notify the patient about this.

Emergency and emergency assistance.

Since these types of assistance are provided promptly, there is no specific time frame for selection. Because you need to act immediately.

A citizen can seek help in person by choosing an institution. In this case, most likely, the institution will not have the right to refuse assistance, taking into account the moral component, as well as the medical oath.

You can get help by calling an ambulance. Departure time special brigade is established by the relevant regulations approved at the legislative level. In this situation, the choice of institution will depend on who is ready to accept the victim.

Palliative care.

The attending physician, after appropriate diagnosis, gives the patient a referral for help.

How to assert your rights in case of refusal

In most cases, clinics or specific specialists are reluctant to hire new people for service, since this is not financially justified, but increases their workload.

Although the rights of citizens are enshrined at the legislative level, in practice people often face refusals.

Someone, not knowing the law, agrees with the registrar’s arguments regarding the impossibility of observation in this institution, since citizens do not belong to the territory served. And some, even realizing the violation of their rights, simply do not know what to do next.

Where to contact

Where to go for help:

• health authorities;
• health insurance institutions;

In case of refusal of choice under Art. 21 of Law No. 323-FZ, statements of claim demanding that the defendant be obliged to perform certain actions are filed in a court of general jurisdiction, a district or city court (not a magistrate’s court).

The claim is filed in court based on the location of the defendant, that is, the organization that refused.

The legislation does not contain the exact form of the claim; the main thing is to adhere to the requirements of the law regarding the details of the application.

The claim must include:

• name of the judicial authority;
• FULL NAME. the plaintiff and the organization, indicating their addresses;
• rights violation;
• normative justification;
• proof;
• request to the court;
• list of attached documents.

In court, the defendant may be charged all the plaintiff's costs incurred in the case under consideration - postage, state duty paid, representation services (lawyer, lawyer). You can also file a claim for moral damages.

The claim is subject to consideration in a court session in which all persons in the process participate. Other interested parties, for example compulsory medical insurance authorities, may be involved in the case.

The court interviews the parties, examines all evidence and issues a judgment. If the outcome is positive, the defendant has the right to appeal. After which, the decision is considered to have entered into legal force and is subject to execution.

Since the defendant has information about the judicial act, re-application to the organization is not required. The defendant must voluntarily comply with the court's demands. Even if his representatives did not participate in the process, a decision in absentia is made and sent to the defendant’s address.

However, it is better to worry and contact the head physician again, presenting a judicial act, since the matter may be left to chance.

If the decision is not executed voluntarily, it is necessary to resort to a forced resolution of the issue by contacting the bailiff.

Judicial practice on the issue covered in most cases is in favor of citizens. As an example, the following judicial acts can be cited.

Case No. 2-4638/2017 (district court of Arkhangelsk).

The citizen filed a claim against the budgetary healthcare institution to impose the obligation to take her for care. At the same time, she indicated that she suffers from diabetes and is currently being seen at the clinic at her place of registration, but there are no necessary doctors there. She filed an application with the defendant, but was denied due to the excess number of persons served by one full-time specialist. Also, the reason for the refusal was the fact that the woman lived in an area not related to the medical service area. establishment.

The court considered the defendant's arguments untenable and indicated that Regulation No. 543n does not contain such a basis for refusal as the territorial principle.

The claim was granted. The clinic was obliged to register the patient and provide her with the necessary services.

Case No. 6445/2016 (Angarsk City Court).

The woman asked the head doctor of the treatment center to be assigned to this institution for care. However, she was refused this. The head of the organization motivated the refusal as follows: the institution has staff turnover, overload and staff shortages.

The court did not accept such arguments of the defendant, considering them not based on the law.

The judgment was rendered in favor of the plaintiff.

In some cases, it is not the citizens themselves who turn to the courts. Their rights are defended by supervisory authorities.

This is confirmed by a court decision.

Case No. 2-3623/2016 (Anapa City Court).

The prosecutor filed a lawsuit in the interests of citizens and asked that the inaction of the city hospital, expressed in the failure to provide information on the institution’s website about doctors and their qualifications, be declared illegal. This was discovered as a result of the audit. Thus, according to the prosecutor, the rights of potential consumers of services are violated, since they cannot fully exercise the right of choice provided for in Art. 21 of Law No. 323-FZ.

The court agreed with the plaintiff and ordered the hospital to post the relevant information on the hospital’s official website on the Internet.

There are also negative court rulings. However, these are individual cases and the courts in such disputes take into account all the circumstances.

For example, in one of the civil cases, the court’s position was different than in those described earlier.

Case No. 2-4206/2017 (district court of the city of Chelyabinsk).

The plaintiff filed a lawsuit demanding that she be registered at a clinical hospital. She indicated that she was not attached to any institution, but needed medical care. The defendant objected to the claim, citing that the woman’s territory did not belong to the hospital. In addition, the number of the population served exceeds the established standards. The woman was assigned for observation to another hospital in the city.

The court rejected the woman's demands. When making its decision, the court took into account that at the time the citizen filed the claim, her rights had not been violated. She was assigned to another hospital for service. The woman herself also explained that it doesn’t matter to her where she gets help, as long as she can do it.

Court of Appeal practice

Appellate courts generally uphold first instance decisions. In support, you can submit a ruling of the appellate authority.

Case No. 33-1492/2015 (Arkhangelsk Regional Court).

By the decision of the city court, the plaintiff’s demands were satisfied; in particular, the court decided to assign the patient to a clinical medical center for care. The defendant did not agree with the court decision and filed an appeal to a higher court.

However, the second instance agreed with the arguments set out in the decision of the city court.

In addition, in the case the defendant was awarded compensation for moral suffering.

Supreme Court of the Russian Federation

A judicial act declaring certain regulations illegal.

Case No. APL15-354.

The citizen's case reached the Supreme Court. Her goal was to recognize clauses 10 and 11 of Order No. 406n as illegal, namely, she considered it illegal not to be able to be assigned to two medical institutions at the same time and to have two patient cards. She argued her position by the fact that the parents live separately, and the daughter periodically stays with her father and then with her mother. The rules established by law violate the principles of family law. In particular, the responsibility of both parents to monitor the health of their children.

The Supreme Court upheld all judicial acts adopted in the case, without thereby recognizing the clauses as illegal, indicating that they do not contradict the Constitution and current legislation. He also explained that the norms of the Family Code of the Russian Federation do not regulate relations in the field of medical activities.

To summarize, it should be noted that in modern reality there are quite a lot of people who want to replace a doctor or medical organization. This can be explained by various reasons, such as distrust in a specific specialist or in a medical institution in general, unsatisfactory quality of services provided, or even a purely objective factor - personal attitude towards the doctor. And the law in this situation is on the side of the citizens. However, when making such a decision, you should weigh the pros and cons. Because this step can literally affect your health. It is necessary to take into account both the workload of the staff and the distance of the institution from the patient’s place of residence. After all, it is not always possible to get there on time, both on your own and to the doctor, if he is called to your home. Therefore, the problem must be solved rationally and thoughtfully.

Most of the medical services that an insured citizen has the right to use are provided by a doctor. The local therapist or pediatrician also makes a primary diagnosis and issues referrals to specialists. If the patient is dissatisfied with the quality of services, he has the right to change the doctor. Today, the mechanism for changing the attending physician and some other specialists is prescribed in the order of the Ministry of Health and Social Development “On approval of the Procedure for assisting the head of a medical organization in the patient’s choice of a doctor in the event of a patient’s request to change the attending physician” No. 407n dated April 26, 2012. The right to change doctors is enshrined in the Law “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” No. 323 of November 21, 2011 (Article 19). How often can you change doctors? What is the procedure and list of necessary documents to replace the attending physician? We will answer these questions in this article.

The procedure for replacing a doctor in a medical institution

The law provides for changing a doctor no more than once a year, excluding situations when the patient moves to another region. An insured citizen has the right to demand a replacement of a local therapist or pediatrician, family doctor, paramedic, gynecologist and other doctors of a clinic or hospital. If there is only one specialist in this profile, then the patient can change medical institution. When replacing a doctor, you can immediately indicate the specialist with whom the insured person wants to be observed. In this case, the selected doctor has the right to refuse to take on an additional patient due to the heavy workload or remoteness of the site.

A prerequisite for changing the attending physician is a written application addressed to the head of the medical institution or branch of the clinic. The document must explain why the patient refuses the services of a previously selected specialist. Regulatory acts do not establish specific reasons, so the applicant has the right to limit himself to any wording: inconvenient work schedule, conflict, lack of competence, etc. After 3 working days (no later), the patient must be provided with information about other clinic specialists indicating their appointment schedule. Taking into account this data, the citizen can decide on the doctor with whom he will be observed in the future. It is worth remembering that a local therapist (pediatrician) will come to your home when called, since the principle of territorial service at home remains.

What to do if the head of the clinic ignores the request to replace the doctor?

For complaints to higher authorities, a written refusal by the manager to replace the doctor is required. To do this, you need to write an application with a request to change the specialist in 2 copies, which will be endorsed at the clinic reception. The documents must indicate the filing date, entry number and visa “for management review.” The patient will receive a written response from the administration within 3 working days. If it is negative, then you can file a complaint with the Ministry of Health, using the right confirmed by the above-mentioned Law No. 323.

Conclusion

The possibility of changing a doctor is regulated by law, but you can change a specialist no more than once a year. If you move to another region after being assigned to a medical institution, you can change again. The replacement procedure involves submitting an application to the head of the medical institution, who must provide the patient with a list of similar doctors. The doctor has the right to refuse additional patients if he works under a heavy workload.

Increasingly, we receive emails with complaints about doctors in district, city clinics and hospitals.

In particular, these are requests in which readers ask for help in resolving difficult situations related to receiving free medicines issued using special prescription forms.

We wrote about this in one of our articles published on the site.

It’s such a custom in Russia that the legal rights of citizens are always violated as if seeds were being cracked, but protecting and defending them sometimes turns out to be quite difficult. This is exactly what they are counting on, that many patients will simply give up and will not want to hang around the doors of local law enforcement officers.

But among all the correspondence, there were also those where readers asked to help them resolve an issue with their doctor.

Not all specialists can meet the requirements of citizens, and now every patient has the opportunity to legally operate with their own requirements and replace the same therapist with one who, in their opinion, is more competent and has a long work experience.

This is especially important if a person in a white coat goes too far, behaves defiantly, is rude, prescribes too expensive medications or imposes some extraneous drugs, dietary supplements, which he tries to sell in this way and replenish his pocket or directs to taking paid tests and procedures that are optional, superfluous, or there is an opportunity to take them completely free of charge.

It makes no sense to blame them for this, since the salaries are low, the work is very responsible, you often have to worry, your nerves are spent quickly, but it is almost impossible to make up for losses. In addition, for several dozen patients (and in some areas several hundred) there is only 1 unfortunate person, who, of course, gets extremely tired. Do not forget that we are all human and we all tend to make mistakes and simply get tired. The human factor has not yet been canceled!

Remembering what conditions exist in our children's or adult clinics and hospitals, you involuntarily shudder. This is why many patients prefer to visit private clinics. But not everyone has the means to do this, given that treatment in private hospitals is extremely expensive.

Due to the above, the order of the Ministry of Health and Social Development of the Russian Federation dated April 26, 2012 No. 407n was adopted, on the basis of which any patient has the full right to change the attending physician (plus Federal Law No. 323 of November 21, 2011 and “Fundamentals of health legislation Russia").

These documents allow not only to resolve controversial issues, but also provide a kind of control over the activities of a particular specialist, which patients are increasingly refusing. There is a kind of pressure on medical workers who use their position, their powers in favor of purely personal gain.

This law contains some restrictions, on the basis of which it is not possible to exercise your right in all cases. Thus, you can change:

• district police officer
• therapist
• pediatrician
• gynecologist
• general practitioners (family doctor)
• endocrinologist
• ophthalmologist
• neurologist
• paramedic, etc.

If in a given medical institution there is only 1 specialist in a particular field, then you can seek help from another medical institution.

In addition, you can exercise your right only once a year.

Do not forget that the reasons for changing the doctor must be significant! It’s easy to brand and slander a person. If you do not agree with one, then before asking to replace him, consult with another similar doctor in the same specialty, and then draw conclusions.

There is no point in causing a scandal once again, because many patients often do not have even a small amount of knowledge to use in defense of their assumptions. Sometimes a conflict arises through the fault of the patient only when he, convinced that he is right, unreasonably accuses a person of his incompetence only because somewhere on the Internet it was said completely differently.

Remember that you can write anything you want. Medical information distributed on the Internet is for informational purposes only and is not a basis for independently prescribing your own treatment!

Before buying any medicine based on your own diagnosis, always seek advice from a professional, specialized medical institution!

The Internet is only a source of additional information and should not encourage you to take serious action. Health is not something to joke about, because no amount of money can buy it!

How to change doctor correctly. Action algorithm.

To do this, you need to prepare a number of documents:

1. Passport of a citizen of the Russian Federation
2. Compulsory health insurance policy
3. Sometimes they ask for SNILS (not necessary)

With these documents, we contact the head physician of the hospital with a written statement in which we indicate the specific reasons for the refusal.

The head of the medical institution will be obliged to accept this document from you.

There have been cases when the application was not accepted and no reasoned refusal was provided, verbally or in writing. In this case, you can go a different route and not worry yourself once again in such a boorish institution.

We are filing a complaint with an organization already known to you and me - Roszdravnadzor, which monitors the activities of all (whether public or private) medical institutions. You can write an appeal in the form of a complaint either electronically (http://www.roszdravnadzor.ru/ - exactly how to write a complaint is described in the section:), or send a registered letter with notification to the address: 109074, Moscow, Slavyanskaya Square , no. 4, p. 1.

We warn you that anonymous requests (without full name and return address, telephone number, etc.) will not be considered.

Such complaints are immediately deleted. The period for consideration of a claim lasts no more than 3 days from the date of receipt. In the future, you will be sent a letter with a response or clarifying information.

If the head physician accepts the appeal, then exactly three days are given for a response, after which the patient receives an oral or written response, in which he is asked to choose from a list a qualified doctor of the same specialty. If the patient has chosen in advance and agreed with the doctor on his decision, then an affirmative answer should be received from the authorities.

It is worth noting in advance the fact that in case of refusal, it is necessary to demand a written and motivated refusal from the chief physician!

If such a document is available, it will facilitate further proceedings in this matter.

But the patient has the right not only to change the attending physician (including for the provision of specialized medical care), but also the medical institution where the examination and further treatment will take place.

How to choose and change doctor for a pregnant woman

Returning to our topic, I note that it is especially important for pregnant women to choose a doctor in advance.

When contacting an antenatal clinic, if you have not decided in advance on the gynecologist who will manage your pregnancy, then the pregnant woman will automatically be served by the specialist assigned to her at her specific place of residence.

This is a very important point, because the place of registration in the passport and the place of actual residence may be different! What is most important is the patient’s current place of residence, not her registration.

Thus, all patients are referred to the doctor who serves the area where they currently live.

If you are not satisfied with this doctor for some reason, then you can resort to the help of the law and replace the doctor in the antenatal clinic.

However, there is also a small nuance. You can ask for a replacement doctor only with his consent!

If you decide to be treated or examined by a specific gynecologist, but he refuses, you will have to look for another, or stay with the one to whom you are automatically assigned.

This is especially true for pregnant women who want to give birth in more favorable conditions (even regardless of their place of residence). You can choose the appropriate maternity hospital or antenatal clinic even in another city and you are required to provide free medical care if you have:

• compulsory health insurance policy,
• passport,
• pregnant woman exchange card
• maternity certificate.

The above is defended by the law “Fundamentals of Legislation on the Protection of the Health of Citizens of Russia”.

It is worth familiarizing yourself with it in advance in order to save your personal time and effort.

On its basis, every pregnant woman has the right to receive not only appropriate honey. help, but can also count on a humane and respectful attitude towards himself (Article 30). If this rule was not followed, then you can not only demand to change the gynecologist, but also demand compensation for moral damages.

Moreover, with a maternity certificate, you can come to your favorite maternity hospital and give birth to your baby there. But in order to receive it, you must be observed at the antenatal clinic for at least 12 weeks.

If you were observed in a private clinic throughout your pregnancy, no one will give you a maternity certificate. No one will want to admit a pregnant woman without this document, since only with its presence the medical institution receives a certain monetary reward for each such patient.

In order for a paid birth to be attended by a specific doctor (anything can happen and he may not be available during labor), it is worth concluding a written agreement with him in advance, in which you will specifically stipulate all the nuances down to the smallest detail. This service is agreed upon in advance by all parties. Otherwise, even if you pay for such a service, but do not have a document confirming this, no one will be held responsible for violating the oral agreement.

What to look for when choosing a doctor

Of course, this is his education. Specialists with higher education are valued much higher. It has always been this way. But work experience, although it plays a role, is not so significant, since hardened doctors with extensive work experience do not always turn out to be knowledgeable in the field of modern methods and methods of treatment used in modern medicine.

Such an “expert” often does not even accept anything new and is reluctant to retrain even at the request of higher management, motivating his action by the fact that his treatment methods have always given positive results, then why “reinvent the wheel”. Some experts even consider “retraining” or additional training a humiliating activity, because their experience can only be envied. Yes, they themselves will teach anyone!

As for a questionable situation in terms of making a diagnosis, any patient concerned about this problem has the right to contact other specialists of similar qualifications and specialties both in the same institution and to go to another hospital. He should not be prevented from doing this. However, to do this, he should visit a family doctor or a general practitioner, who will give a referral to a specific doctor.

However, we should not forget about the elementary culture of behavior. If one doctor thinks so, then you should not argue and swear with him. Feel free to seek help from another medical institution.

Some doctors in their professional baggage not only have many years of practice, but also academic degrees, they are published in newspapers or medical journals. They are much more versatile and tend to be up to date with modern innovations.

It is also worth paying attention to the reviews of other people left on various forums and websites. You can also take part in the discussion and ask your questions. This makes it much easier to obtain information about the quality of work of a particular doctor.

In addition, thanks to government funding, many city hospitals have their own official website, which contains all available information, including the possibility of electronic appointments. On such sites you can also leave your complaint, gratitude or suggestions for improving the quality of medical care.

When choosing a doctor, you should also think about where exactly he works. After all, not all hospitals and clinics are well equipped. For more severe cases, when there is difficulty in making a diagnosis, the amount of diagnostic equipment and its novelty play an important role.

But even if you take into account all of the above, no one can guarantee that the doctor you chose with such difficulty will be to your liking. It also happens that a person is unpleasant, he pushes you away, and not at all because he is somehow rude, but simply because he is not to your liking. That is why it is impossible to make a final choice without personal appearance.

We can only advise one thing: “Treat people the way you want to be treated.” Perhaps it will be enough to follow just this one rule...

Be healthy and happy!

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We tell you what to do if you are not satisfied with your local doctor.

- I don’t like my local therapist, he has already made incorrect diagnoses several times, and from a purely human perspective, it’s difficult for me to find a common language with him. How to change doctor?

The patient’s right to refuse his attending physician and change him to another was legislated only a few years ago. In April 2012, the Russian Ministry of Health and Social Development published N 407n “On approval of the Procedure for assisting the head of a medical organization (its division) in the patient’s choice of a doctor in the event of a patient’s request to change the attending physician.” This document clearly defines the mechanism for selecting and changing the attending physician.

To change doctors when providing general care (in a clinic, outpatient clinic, dispensary, hospital, etc.), you need:

write an application addressed to the chief physician of the medical institution;

indicate in your application the reasons why you are asking to change your doctor. By the way, they can be different: the doctor was impolite, refused medical care, you have doubts about his competence, etc. Reasons for refusal may also include religious considerations or even an inconvenient doctor’s work schedule.

Your application must be reviewed within three working days. After this time, the chief physician must verbally or in writing convey to the patient information about other doctors in the institution and their work schedule. Based on this information, the patient makes his choice.

Could the doctor you choose not see you?

Yes maybe. The transition to the selected specialist occurs only with his consent. The right of a doctor to refuse a patient is also specified in the order of the Ministry of Health. For example, a local therapist or pediatrician may refuse you if in the area he serves, the number of assigned patients already exceeds the standard (for a therapist this standard is 1,700 adults, for a pediatrician - 800 children). It is better to talk to the doctor you want to treat in advance and make sure that he does not mind becoming your attending physician.

About the main thing - briefly:

You can change your attending physician. It is enough to write an application addressed to the chief physician of the medical institution.

The application will be reviewed within 3 days, and then the head physician will provide you with information about other doctors who work in the institution.

Transferring treatment to another doctor occurs only with the consent of the doctor himself.

If you have questions that you can't find the answer to, send them to us and we'll try to answer them.