Alexey Kashcheev: "Is it appropriate to thank the doctors with money?"

"A doctor in civilized countries is a highly paid specialist who receives a worthy official salary in proportion to his knowledge and skills," the neurosurgeon writes on Facebook , answering the question under what conditions and how patients can thank the doctors.

"This principle in Russia is not respected and has never been observed due to the fact that the system of financing institutions and the formation of the salary fund is confusing, unfair and opaque; this contributes not only to the destruction of the quality work of doctors, but also to the outflow of specialists in the private sector, as well as from healthcare.

The result of this was the formation of a system of informal payments, a huge market for "left" services living according to its own rules, often irrational. Thus, the real income of doctors is formed in most cases from the fees of patients received by private order. This unfair system is generally harmful to all its participants, however, there are no prerequisites for its civilized changes and in the nearest historical perspective is not expected.

When the patient can pay an informal payment to the doctor:

- You are sincerely satisfied with the help that you have provided to you, that is, you understand what you pay for;

- You pay voluntarily, and not by force;

- You pay as much as you really can pay, and not so much as they are forcibly demanding from you;

- you pay after the service (after a successful operation, after discharge, after the procedure or manipulation, after consultation);

- You pay the real service to the Contractor, and not its high -ranking “curator” (otherwise your money with a high probability will settle in the pocket of the latter);

- You emotionally easily, sincerely, without tension give this money to the doctor.

When you do not need to pay, but, depending on the situation, you can demand justice / ignore "hints" / complain / change a doctor or clinic:

- When you do not have money, and you honestly reported it either it is obvious (most doctors do not rise to take a hand from an elderly, seriously ill, deprived person of the last);

- when you frankly extort money for an administrative decision (“Until you pay, there will be no bunk”, “There is no envelope - there is no operation,” etc.);

- when you are demanding money for providing emergency assistance in the face of the threat of your life or the life of your loved ones;

- when you require a fee before the service (in the evening money - chairs in the morning);

- when you see an obvious inconsistency of the price and the real price of the service (look at the price on the website of the private clinic; 25-40% of its cost usually makes up a real doctor's fee);

- When you feel in what is happening some implicit catch (in most cases of extortion, the patient feels him immediately).

What is appropriate to replace the money if you do not have it, and you want to thank the doctor:

- sincere human gratitude;

- handshake;

- written gratitude to the doctor, a review on the clinic website and other resources, mentioning a doctor on social networks and blogs, personal advertising to friends and colleagues;

- the provision of a service that you yourself can provide in exchange for a doctor’s service (I received a discount for tires, food in restaurants, theaters and concerts, medical services (if the patient is a doctor), free trips to legal, banking, financial issues and much more);

- an inexpensive gift that this doctor as a person can evaluate (I received a book, rare jazz discs, paintings, autographs of writers, diving equipment, climbing carbines and much more as fees);

- Gifts made with my own hands (I received poems, stories, drawings, applications, photo collages, clothes and crafts of hand Made);

- quality food and alcohol.

What should not be given to the doctor:

- poor -quality food, cheap alcohol (poured into the glass gunner) and other crap, bought in haste in the nearest "five" - ​​honestly, it is better to simply thank you verbally;

- perishable products (attention to patients from the Far East! Caution with caviar and fish!);

- cards without text, newspapers, magazines, scanwords;

- personal things;

- Do not offer a doctor sexual services in exchange for medical care, if you see that it is inappropriate. Yes. You did not misheard. "