How is a general practitioner different from a primary care physician? Who is a General Practitioner? The activities of a general practitioner doctor vop decoding.

When we find out that our new acquaintance is a doctor by profession, we are always interested: what is the doctor's specialty? And when we hear in response: a general practitioner, we are perplexed, what kind of doctor is this, and whom does he treat, that he knows what he can, whether it is bad or good. At the same time, over the past 20 years, general medical practice has taken its place in Russia, has become a common practice, at least with the use of the name - family medicine. Is it introduced into our medical culture? Where did its origins come from? These questions are answered by the history of medicine, in which the practice of a family doctor is rooted in deep and not very antiquity.

In fact, the founders of modern medicine, like real Russian research doctors who laid the foundations of Russian medical science and practice - S.P. Botkin, G.A. Zakharyin, N.I. Pirogov, were the prototype of a general practitioner. This is a doctor who accepts the patient in full, and not in parts, able to assess the degree of involvement of each organ and part of the human body and identify the leading problem or problems. The relevance of this approach to the treatment process explains the widespread and high demand for general medical practice throughout the world. However, general medical practice, which was widespread in pre-revolutionary Russia in the form of the institute of a zemstvo doctor, which continued in the first decades of the USSR, was lost by the 1970s. And if back in 1950 any graduate of the medical institute could work as a general practitioner and a surgeon and conduct an examination of ENT organs and eyes, later the concept of specialization won, which, on the one hand, improved the quality of care in certain areas, but contributed, on the other hand, the loss of the doctor's vision of the patient as a whole, gave rise to "specialists in the little finger on the left foot."

Over the past century, medicine has been filled with a colossal amount of information and is updated daily. “One doctor cannot know everything equally well,” you say. Quite rightly noted. But the doctor now has a large number of sources of information that do not replace knowledge and experience, but make it possible to be a highly informed specialist. At the same time, without good basic professional training and experience in daily medical practice, it is impossible to understand the flow of information about new drugs and treatments. In addition, communication between specialists, colleagues of various specialties, joint management of a patient, sometimes with a diverse and complex pathology, is the basis of the daily activities of a general practitioner. Such a doctor does not work as a dispatcher, and does not "refer" his patient to another narrow specialist, but bears full responsibility for him. Such a doctor strongly recommends returning to him after consulting a narrow specialist or reporting the results of examinations, as this is required by the treatment process. Such a doctor is not afraid to admit that he doubts his diagnosis, that he wants to get more information, additional advice. In the context of the rapid development of medical science, this quality of the doctor gives an advantage to the patient.

In view of the fact that the tradition of general medical practice in Russia was interrupted and resumed only in the 1990s, the class of general practitioners is very heterogeneous in terms of origin and practical skills. Many doctors have acquired this specialty, having undergone retraining from internists, surgeons, pediatricians, gynecologists. And this leaves an imprint on their daily work. However, every year the number of doctors who have completed residency at the departments of family medicine / general practice is growing, which provides an optimal balance of knowledge and skills. But in practice, you can still see that there are doctors who are ready and able to deal with patients of all ages, from diapers to bright old age. There are general practitioners who, in parallel with their main activities, specialize more deeply in any industry (for example, in surgery or pediatrics, or in certain areas of internal medicine - gastroenterology, cardiology, etc.). The level of qualification of a doctor certainly depends on work experience. Many general practitioners easily and highly professionally cope with most of the problems of their patients, such as: acute viral otitis media, manifestations of congestive heart failure, chronic gastritis or purulent inflammation of the finger - panaritium. All these and many other conditions do not require a highly specialized approach, they can be successfully treated by the same person - your doctor. And he will also determine the indications for a consultation of highly specialized colleagues: if the diagnosis is unclear, the disease takes a non-standard course, or a problem is identified that requires highly specialized high-tech assistance.

Thus, a general practitioner is your attending physician who treats and prevents diseases in all family members: parents, their children, elderly family members, consults during pregnancy and breastfeeding. Such a doctor inevitably knows your personal characteristics, drug tolerance, hereditary history. It will provide assistance in most of the most common medical situations and optimally determine the time when it is worth contacting a highly specialized specialist.

Today, one of the most sought-after professions in medicine is a general practitioner. Who is this, almost every resident of the countryside knows. The fact is that it is in the villages that doctors of this specialty most often work.

General Practitioner: who is he?

The main difference between doctors of this specialty and others is that they have basic knowledge in each of the sections of medicine. However, they do not require specialized medical care.

They should be able to solve relatively simple health problems and engage in the prevention of therapeutic, surgical and gynecological diseases in both adults and children.

Why are general practitioners prevalent in rural areas?

It is in the villages that one can most often meet such a specialist as a general practitioner. Who is this, all the villagers know. It is in this area that general practitioners have received the greatest distribution due to the economic inefficiency of building full-fledged medical institutions in each settlement and ensuring work in it for a large number of doctors. From this point of view, it would be much more expedient to create small outpatient clinics, in which a general practitioner (family doctor), a nurse and a nurse will work. Such a set of employees will allow the outpatient clinic to provide full-fledged medical care to residents of the region attached to it.

For a remote from large centers, a general practitioner becomes a real salvation. Who is this, all the inhabitants of the agrarian regions know, because it is to him that they go in the first place. He is able to perform the simplest manipulations of the surgical and gynecological profile, he is familiar with therapeutic pathologies of both adults and children.

How is the general practitioner trained?

This specialist, after graduating from a higher medical institution, must undergo an internship on the basis of one or more clinics. He needs to acquire the skills of a therapeutic, surgical, pediatric, as well as gynecological profile. As a result of such training, he becomes a specialist with general skills in the diagnosis and treatment of diseases in any medical field.

How is the work of a general practitioner structured?

Prevention, diagnosis and treatment are all the main areas within which a general practitioner conducts his professional activities. Its work is built primarily on identifying the risks of developing certain serious diseases among the population living in the area under its control, as well as systematic activities aimed at counteracting their formation.

What does it take to be a specialist?

The office of a general practitioner should be equipped with a number of tools that help to carry out the initial diagnosis. We are talking about a phonendoscope, a tonometer, a glucometer, thermometers, spatulas, laryngoscopes, otoscopes, rhinoscopes, ophthalmic and gynecological equipment. In addition, the general practitioner's outpatient clinic should have the simplest surgical instruments.

Ideally, the outpatient clinic can be equipped with a mini-laboratory. It greatly simplifies the work of a general practitioner. Those specialists in this field who do not try to equip their outpatient clinic have to constantly refer patients to district medical institutions for simple laboratory tests (complete blood count, general urinalysis, biochemical blood test, and others).

What services does a general practitioner provide to the population?

The work of this specialist is of great importance for the entire population served. Thanks to him, medical care becomes noticeably closer to people. The simplest surgical manipulations are carried out in outpatient clinics. In addition, all conditions for injection (including in the form of droppers) administration of drugs are created here. There is necessarily a small bed fund here, which allows placing patients in that is, the patient can go to the doctor and, if he sees fit, be treated without going to the hospital.

In large outpatient clinics, in addition to an ordinary specialist, a general dentist may also work.

In the event that a person becomes very ill, and he cannot visit a doctor on his own, he has the opportunity to call him at home. At the same time, most often a specialist of this profile serves such calls after lunch, and an appointment in an outpatient clinic leads to him.

Economic feasibility of outpatient clinics

Such institutions and the position of "general practitioner" (who we are, we have already found out) were introduced not only to bring medical care closer to the population of rural areas. The fact is that it is beneficial from an economic point of view. Firstly, there is no need to send a separate therapist, gynecologist, surgeon, ophthalmologist, otorhinolaryngologist and others here. All relatively simple problems will be handled by a general practitioner. Those who make more serious complaints, or whose health condition causes concern in this doctor, are sent to higher-level healthcare institutions.

Prospects for the development of the profession in the future

Currently, a general practitioner (this is who was described above) is not the most common, but at the same time a very necessary profession. This specialist is in demand in rural areas. At the same time, such a doctor saves the state significant funds, because it is not necessary to maintain a large health care institution in every locality, in which a large number of doctors work. With many problems, the general practitioner will cope on his own. If the intervention of narrow specialists is required to combat a particular pathology, then the patient will be referred to a medical center of the appropriate profile.

In the future, a general practitioner can be re-registered as a so-called family doctor. This specialist is a doctor who provides medical care to several families. He knows each of his patients very well. A small number of them allows him to delve into the problems of all wards as deeply as possible. Family doctors are a very effective way to preserve the health of the population, but the activity of such specialists is possible only in a fairly developed economy. The fact is that the salary of such an employee will consist of deductions from his immediate patients. So the family doctor, if we talk about the widespread activities of such specialists, so far remains the prospect of the future. In many European countries, the institute of family doctors has existed for quite a long time and has proven its effectiveness. At the same time, the basis of the activity of such specialists is precisely the prevention and early diagnosis of any diseases.

In addition, the profession of a general practitioner is also promising. Now mobile complexes are being created that allow to significantly expand the capabilities of this doctor in the field of diagnosing certain diseases. We are talking about the so-called specialized cars of a general practitioner. The structure of such a complex includes a small laboratory, as well as a set for the most important instrumental research.

The definition of "general practitioner" has a more common name - he is known as a family doctor. In essence, he is equated to a local therapist, who is familiar to everyone since childhood. The difference between a general practitioner and an ordinary therapist is that he has a large set of knowledge and capabilities.

What does a general practitioner do?

A doctor of general specialization has to deal with representatives of all ages, diagnose and treat all types of diseases: from neurological to surgical. The main task of a general practitioner is to protect the health of those families that are assigned to him in the serviced area, to provide primary medical care. This specialist has knowledge in all areas of medicine, including:

sociology,
health economics,
psychology,
social medicine,
prevention and so on.

During the initial appointment, the doctor carefully examines the patient's medical history and conducts a thorough diagnosis. After that, he works to reduce or eliminate the risk of developing pathologies to which the patient is prone. Early detection of diseases is known to help many patients avoid more serious problems.

When should you see a general practitioner?

In addition to all kinds of colds and viral diseases, a general practitioner is consulted and observed when:

oncological pathologies,
atherosclerosis,
metabolic syndrome,
cardiovascular diseases,
thyroid disorders and overweight;
respiratory problems,
neurological diseases and many others.

In addition, general practitioners conduct an examination of temporary disability, determine the conditions that are optimal for work, and also recommend rational employment in Moscow. If signs of permanent disability are identified, these generalists refer their patient to ITU in a timely manner. They are also involved in the social protection of patients:

lonely
chronic,
elderly,
disabled people.

General practitioners have the right to represent their interests in social protection bodies, in charitable organizations, in the offices of mercy services.

What symptoms should you see a general practitioner for?

Contact a general practitioner in Moscow if you experience:

discomfort,
feeling tired,
inconvenience,
persistent headaches,
vasospasm,
insomnia
dizziness,
constant fatigue
pulling or pressing sensations and so on.

May be required:

general analysis of blood, urine, feces for eggs of worms;
ECG, radiography, ultrasound, fluorography, EchoCG, MRI, EEG, EchoEG;
HIV testing;
study on the Wasserman reaction and so on.

How to become a general practitioner?

In Moscow, specialists capable of becoming a general practitioner in the future are trained by many educational institutions, but the main ones are:

Moscow Medical Academy. I. M. Sechenov,
Russian State Medical University,
Pirogov Russian National Research Medical University,
Moscow Medical and Surgical Academy.

Famous specialists of Moscow

The provision of universal assistance to the population by family doctors has been practiced in Moscow for many centuries in a row. Back in the 18th century, such famous doctors as Yagelsky, Pogoretsky, Zybelin, Samoylovich fought epidemics. In the 19th century, Alexander I surrounded himself with educated people and patronized the development of medicine. The capital of Russia in all centuries has been rich in famous practitioners and scientists, such as Botkin, Magnitsky, Uvarov and many others.

The head of the Chelyabinsk Health Department Natalya Gorlova visited live radio Komsomolskaya Pravda-Chelyabinsk (95.3 FM). We asked her about these institutions.

How is it different from a regular clinic?

The General Practitioner's Office (OBOP) is a mini polyclinic. There is a treatment room where you can, for example, make injections. Surgical reception room, where the wound will be treated and sutures will be applied. Testing room, ophthalmological appointment and ENT doctor's room. In the offices of general practitioners, samples are taken from patients and taken to large polyclinics. There are no some narrow specialists, for example, an endocrinologist, a urologist, a cardiorheumatologist, an allergist. They are not needed every day. Therefore, the general practitioner examines the patient and decides whether he needs to go to a specialist in the central clinic, or the problem is solved on the spot.

What are medical offices for?

To bring health care closer to the population. There are remote areas, such as the village of Smolino, the farm Miassky, Churilovo, whose residents had to travel several stops by public transport to the clinic. Now they can get a doctor's consultation or take tests close to home. In addition, the OVOP allows you to reduce the load on the main clinics, there are reduced queues.

How many OVOP in Chelyabinsk?

So far, there are 14 of them. In the near future, we plan to organize several more in the North-West. This area is growing very fast, and the existing polyclinics are struggling to cope with the load. New OVOPs will open on Topolina Alley and in the area of the Krasnopolskaya site. One office costs about 15 million rubles, plus another two million are needed for equipment. Several times more money is needed to build an ordinary clinic. In addition, construction will take a long time.

Who works here?

In order to work as a general practitioner, you need to undergo additional training. This specialist should have basic knowledge of otolaryngology, ophthalmology, be able to provide primary surgical care. That is, it is a general practitioner. But, of course, he cannot work as a gynecologist or dentist. These specialists come to the OVOP from the main polyclinics once or twice a week. The calculation for offices is as follows: one general practitioner for one and a half thousand people.

How to get an appointment?

If there is a general practitioner in the area, the patient can be observed by him or go to the main clinic - at his own choice. In OVOP they accept the same - according to the medical policy. You can make an appointment both personally and remotely - via the Internet on the website talon.gorzdrav74.ru. For this you need a passport and a policy.