Quality of medical care in Russia

The system of providing medical care belongs to the sphere of economic activity referred to as «range of services» in Russia.The main criterion in the provision of services is the receipt of the final intended effect, which fully satisfies the customer of this service. If the final intended effect is not achieved, then this service cannot be considered as completed.In medical care, there is no final guaranteed result. The purpose of providing medical care is the very process of its provision.The intended result of treatment cannot be guaranteed, but the provider of medical care is obliged to apply all their experience and knowledge to achieve the most useful effect for the patient.Russian legislation provides for the evaluation of the quality of medical care based on the final effect. This approach to solving the issue of medical care improvement quality does not allow the healthcare in Russia to adequately develop since the main emphasis is placed on the administrative command system of control and motivation of doctors to their work. The openness of the medical community to the society leads to an inadequate evaluation of the inevitable medical failures, complications and problems in the field of medical treatment. The absence of medical practice institution in Russia and the prevalence of hired labor of doctors deprive the medical community of one of the main criteria for the development of medicine — the discretion, provided personal responsibility before a patient. In fact, it is impossible to receive high quality medical care under circumstances where a physician is only a hired "addition" to the material and technical base of a medical institution.The solution to the above problems can be found on condition of separating healthcare in Russia into a special sphere of economic activity with its own legal determination, structure, management, legislation. It is necessary to isolate medical community from society as much as possible, to limit free access to special information for public inspection and non-expert accusations. We should rely on the development of medical practice in the country as it fullestly reflects doctor's competence independent on the will of the employer.