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Back to the USSR
- Vasiliy Vlassov (20 July 2007)
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Vasiliy Vlassov, Professor Moscow Medical Academy
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Apart from the well known problems of Moscow with London and Washington, Russia goes well thanks to oil prices and strange sympathy of the Olympic Committee. This season brought special recognition to the Soviet past. First, the American CDC announced a new strategy for HIV testing which is very close to what Soviets did for decades and for which they were criticized all that time (1). Next the UK got a new health care minister from the narrow specialists, and - surprise - he decided to improve primary care. Moreover, the way to improve it in the new project is by creating big polyclinics. It is what Russia and other post-Soviet countries inherited from the communist past. The problems with primary care provided in these polyclinics are well known. They include first of all degradation of medical specialists of first contact who start to provide fragmented care, and degradation of specialists who in the polyclinic lost their qualification. Polyclinic system is expensive. It encourages overuse of specialist care. And much more. When the UK and other European and USA medical experts provided their technical expertise during the past 20 years to Russia, their first advice was, and still is, to develop a general practice. Second - to rearrange the primary care provision in cities - to abandon the polyclinic system and create instead a kind of group practice. To finalize the anecdotal way of development, it is noteworthy that in Russia top narrow specialists defend the polyclinic system... 1). Vlassov V. Denisov B. New old screening. http://www.annals.org/cgi/eletters/145/11/797 Competing interests: I was a member of the UK team providing the technical assistance to Russia in reconstructing its polyclinic system to one based on general practice |
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