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I think the dual job approach is just a temporary decision of problem of
low income in public health sector. It could not prevent a brain drain from
the public health sector because after some years of dual job experience many talented physicians leave the public sector in behalf to full private
employment. That is especially actual for management positions.
Moreover, in some cases dual job could result in ghost writing,
preconceived choice in drug therapy or other unethical activity.
Russia's health system urgently needs reforms, not just money
infusion. This reforms requires wide public discussion and involvement not
only health burocrates but also practical physician and patients.
Finaly, despite the growth of Russian GDP the well-being of Russian
physician remains the same. That is why I absolutely agree with Valeriy
Aksenov that Russia should be included in the list of cuntries with access
to HINARI initiative.
Competing interests:
None declared
Competing interests:
No competing interests
24 October 2005
Boris Bikbov
Coordinator of the Russian Registry of Renal Replacement Therapy
123182, Moscow City Nephrology Center, Moscow City Hospital 52, Pechotnaya str., 3, Moscow, Russia
And Russian doctors are not entitled to free access to all the
content on bmj.com because Russia is not included in the list of 113
developing countries, areas and territories included in the HINARI
initiative.
Dual job in Russian physicians
Many russian physicians are forced to have a dual job in order to
increase their income. Recent article in WHO bulletin detail dual job
(http://www.who.int/bulletin/volumes/83/10/jan1005abstract/en/index.html).
I think the dual job approach is just a temporary decision of problem of
low income in public health sector. It could not prevent a brain drain from
the public health sector because after some years of dual job experience many talented physicians leave the public sector in behalf to full private
employment. That is especially actual for management positions.
Moreover, in some cases dual job could result in ghost writing,
preconceived choice in drug therapy or other unethical activity.
Russia's health system urgently needs reforms, not just money
infusion. This reforms requires wide public discussion and involvement not
only health burocrates but also practical physician and patients.
Finaly, despite the growth of Russian GDP the well-being of Russian
physician remains the same. That is why I absolutely agree with Valeriy
Aksenov that Russia should be included in the list of cuntries with access
to HINARI initiative.
Competing interests:
None declared
Competing interests: No competing interests