2,000 Patients per Therapist: What Changes Await Ukrainian Doctors from July 1st

Translated by Ollie Richardson

13:45:48
27/03/2018

strana.ua


The Ministry of Healthcare approved the decree for rendering primary healthcare, which doctors will start working in accordance with from July 1st.

This was reported by the acting Minister of Healthcare Ulana Suprun on her Facebook page.

“A very important document was approved – the Decree of rendering healthcare for primary branch doctors. From July 1st it will become a reference point for the work of all family doctors, therapists, and paediatricians. Together with the new rules of work, this document forms a new culture of interaction between the doctor and patient. Using it, doctors will be able to better build a confidential relationship with patients, so that each person feels that they are the center of attention,” it is said in the message.

Suprun also gave examples of what duties will belong to doctors of the primary branch (therapists, paediatricians, family doctors) from July 1st of this year, according to the Decree of rendering primary medical care:

  • Therapists, paediatricians, and family doctors will monitor the state of health, will carry out diagnoses, and will treat the most widespread diseases, injuries, poisoning.

  • Therapists, paediatricians and family doctors will deal with patients with chronic diseases and conditions.

  • If necessary the doctor will direct a patient to an expert of secondary or tertiary help – a ENT specialist, endocrinologist, surgeon, etc will give advice concerning treatment.

  • The doctor will also give emergency aid in the event that there is an acute physical or mental health disorder, if there isn’t a need for emergency, specialised, or highly specialised medical help.

  • The doctor should identify health risks in time. They will advice how to gradually ease addictions, and where to find additional help and to switch to a healthy lifestyle.

  • Primary care for a healthy child, uncomplicated pregnancy, and separate services of palliative care are in the competence of the doctor.

  • The doctor will also issue the necessary medical certificate, incapacity to work letter, the instruction to undergo a medico-social examination, and so on.

  • It will be possible to make an appointment with the doctor personally, by phone, e-mail, or other available means. If necessary the doctor can come out to the patient to their house. The doctor and patient decide on the details of departure together. This doesn’t concern emergency help – the ambulance service will work in the usual regime.

  • If a doctor is on holiday or can’t accept the patient for other reasons, the healthcare institution must provide a replacement and inform patients about this in advance.

According to the Decree, the optimum volume of practice for the family doctor is 1,800 patients, a therapist – 2,000, and a paediatrician – 900. However, depending on the demographic, infrastructure, and other features of the settlement the number of patients can vary.

The expediency of signing declarations will be coordinated with a large number of patients upon the conclusion of a contract between the medical institution and the national health service. For example, if the family doctor works in a village where more than 2000 people live, then all inhabitants will be able to be served by this doctor.


In order to understand how fatal this decision (decree) is, a map from the Dutch advertising agency EuroRSCG – which uses data from Doctors of the World” – showing the number of inhabitants per doctor globally is presented below. For example, in “civilised” Europe it is in the hundreds (France: 300), but in Africa it is in the thousands (Uganda: 12,500). At the time of collecting data (10 years ago) Ukraine had 240 patients per doctor. In other words, Ukraine’s ambition (an artificial one at that) to join the “European community” seems to have taken a detour… via Africa.

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