Every time, upon learning about a medical examination organized at work, many are indignant: why is this necessary? Obviously, this is a fundamentally wrong approach. The employer organizing the medical examination shows himself with the best side. However, one should not assume that he does this solely for altruistic reasons. The fact is that, in fact, it is the boss who pays for each sick leave of an employee - he pays interest to the Fund social insurance, from which you are then given money. In addition, the time of a qualified employee can be infinitely expensive for a company, which makes it much cheaper to protect yourself from downtime through preventative measures.
To the employer and employees
Many, having returned to work or re-employed, have probably encountered the fact that they are sent for a medical examination to the clinic. For what? After all, I feel healthy or healthy!!! On the one hand, employers are now obliged to send subordinates to this event, and on the other, it is important for each person to identify the initial stages of various diseases in a timely manner and begin appropriate treatment. What are medical examinations of persons working in contact with harmful and (or) dangerous factors? Currently in Russian Federation The priority national project “Health” is being implemented, aimed at preserving the health of citizens and the labor potential of the working population. One of the important measures to preserve people’s health is preliminary (upon entry to work) and periodic medical examinations (examinations).
The main goals of the medical examination
Among the main tasks that a medical examination is designed to solve, seven main ones can be identified. This:
- determining the suitability (suitability) of workers and employees for the work assigned to them, ensuring labor safety;
- identification of persons with occupational diseases or suspected of such diseases, prevention and timely identification initial signs occupational diseases;
- identification of common (non-occupational) diseases in which further work in contact with occupational hazard factors may worsen their course;
- assessment of working conditions and development of sanitary and hygienic measures aimed at eliminating the causes of occupational disease;
- dynamic monitoring of the health status of workers under the influence of occupational hazards;
- timely implementation of preventive and rehabilitation measures aimed at preserving the health and restoration of workers’ ability to work;
- accident prevention.
The medical examination includes a very important examination - fluorography. This X-ray examination lungs for the presence of tuberculosis. Tuberculosis is a very common disease nowadays. People with high blood pressure must undergo regular medical examinations, as this problem can cause a heart attack or stroke. Vascular thrombosis occurs. People need to carefully look at their health status, as now
Arterial hypertension affects quite young people who may not even be aware of the disease. In this case, a medical examination will help identify disorders and specialists will advise what lifestyle is needed to prevent the occurrence of high blood pressure. blood pressure. An annual medical examination is especially important for people who are employed in jobs with harmful or dangerous working conditions (for example, underground work, etc.).
It is necessary?
Yes, if you:
- you work in a dangerous enterprise;
- connected with children (teacher, educator);
- work in a medical facility.
In all other cases, a person has the right to refuse to visit a doctor.
Which doctors should I see?
You will have to visit:
- therapist;
- psychiatrist;
- narcologist;
- dentist;
- dermatovenerologist;
- otorhinolaryngologist.
This is a basic program. For people working in hazardous enterprises, it can be expanded in accordance with the specifics of the activity.
Also most often, the medical examination includes basic tests:
- blood (general);
- smears for gonorrhea and pathogenic staphylococcus;
- biochemistry of urine and blood.
All of them will help make sure that the body’s condition does not pose any threat to you or others. Typically, such an examination is carried out once a year to keep employee health information up to date.
How often should you undergo a medical examination?
The frequency of periodic medical examinations is determined by Appendices 1 and 2 to Order No. 90 of the Ministry of Health and Medical Industry of Russia, but should be at least once every two years. Persons under the age of 21 undergo periodic medical examinations annually ( Labor Code RF, Art. 213).
Periodic medical examinations of employees can be carried out ahead of schedule in accordance with a medical report or according to the conclusion of Rospotrebnadzor authorities with justification for the reason for the extraordinary examination. Extraordinary medical examinations are carried out at the request of the workers themselves or in accordance with the recommendations of one of the specialists who participated in the examinations, as well as for epidemiological indications.
Employees employed at hazardous work and when working with harmful and (or) hazardous production factors for five years or more, periodic medical examinations are carried out in occupational pathology centers and other medical organizations once every five years. Of course, such centers must have licenses for examination of professional suitability and examination of the connection of the disease with the profession.
There are several types of medical examinations for workers:
1. Preliminary. Their goal is to find out whether the candidate’s health condition allows him to perform a particular job. For some categories of workers such examinations are mandatory.
For example, a preliminary medical examination upon entry to work must be carried out by:
- people whose professional activities are related to management complex mechanisms and devices (crane operators, electricians);
- people who work in hazardous conditions(industrial climbers, sailors, oil and gas industry workers working in the Far North);
- people managing vehicles(drivers, pilots);
- food industry workers;
- workers of children's and medical institutions and others.
2. Periodic. Conducted in order to identify early stages diseases that may be dangerous to others or make a person unsuitable for performing a certain type of work, to track the dynamics of changes in health, as well as in order to identify possible occupational diseases and minimize the harm caused to the health and well-being of the employee. Employees under the age of 21 must undergo a medical examination annually.
3. Conducted in special cases– at the request of the employees themselves, when occupational diseases are identified during the last scheduled medical examination, in cases where someone in the team is diagnosed with a dangerous infection, as well as at the request of Rospotrebnadzor. Requirements for the frequency and procedure for conducting medical examinations are prescribed in the Labor Code of the Russian Federation (Articles 212, 213 and 266). And Article 5.27.1 of the Code of Administrative Offenses of the Russian Federation establishes that admission to work without undergoing mandatory periodic medical examination entails a fine officials and individual entrepreneurs in the amount of 15,000–25,000 rubles, for legal entities– 110,000–130,000 rubles.
The procedure for conducting medical examinations of enterprise employees
Organizing a medical examination is the responsibility of the company’s management, and it also pays for this event.
Briefly, the scheme for organizing a medical examination for enterprise employees looks like this:
Step 1. Formation of a list of employees who should be sent for a medical examination. The list must be sent to the territorial department of Rospotrebnadzor of your administrative district within 10 days.
Step 2. Concluding an agreement for examination of workers with a medical center. Agreeing on the timing of the medical examination.
Step 3. Signing an order on the frequency of medical examination and the order of its completion. Employees must be familiarized with this document at least 10 days before the start of the medical examination.
Step 4. Issuing directions for a medical examination. Referrals are issued in the organization in any form.
Step 5. Collection of signed and sealed reports with the results of the medical examination. The conclusion is signed in two copies - one of them is given to the employee, the other remains in the institution that conducted the medical examination.
Step 6. The medical center draws up a final act. This may take time, usually up to 30 days. Certified deed signed medical institution and organization, is sent to the territorial department of Rospotrebnadzor in its own way administrative district on approval.
Employees are required to report to the medical center with which the contract was concluded exactly at the time specified in the referral. You are required to have your passport and directions with you. If the employee does not show up, the employer must suspend him from work without pay until the inspection is completed. If the inspection was missed due to the fault of the employer or for reasons that do not depend on either the employee or the employer, the refusal to perform duties is regarded as simple and is paid in the amount of 2/3 of the employee’s average salary. As a rule, during a periodic medical examination, workers visit several specialists and undergo various instrumental and laboratory research. The specific list depends on the type of work and harmful production factors. The commission is formed by the medical center with which an agreement was concluded to conduct a medical examination. It necessarily includes an occupational pathologist, as well as other specialists.
If the responsibility of approaches to assessing professional suitability increases, then the quality of work in certain areas should indirectly improve, which, in the end, will have a positive impact on the well-being of the population as a whole.
Since 2012, a narcologist and a psychiatrist have been added to the list of doctors who must undergo medical examination to renew a medical record. This caused numerous discussions, speculations, outrages and protests. In fact, these specialists, especially psychiatrists, traditionally belong to the ranks of doctors of a special, specialized direction. They have not previously been associated with a general physical examination. However, since 2012, these doctors have been included in the list of mandatory visits when applying for a medical record and have become the only doctors (besides the therapist) who assess the professional suitability of civil servants.
Let's try to figure out why our country has begun to pay more attention to mental health and emotional state, as well as the degree of adequacy of workers in responsible areas. The bottom line is that medical assessments are indeed incomplete if they are focused only on the analysis of morphological, physiological indicators of health and at the same time completely lose sight of the psycho-emotional component. Meanwhile, it has long been proven and everyone knows that sometimes mental health and mood, as well as the emotions themselves, can determine the physical state, influence the processes occurring in the body, etc.
Here it is impossible not to recall the common expression in everyday life: “all diseases come from nerves.” Moreover, we can safely paraphrase it, pointing out that many aspects of the treatment of diseases are also determined, in turn, by the state of the psyche and the emotional background.
Recently, being examined by a psychiatrist and narcologist has ceased to be something suspicious and frightening. It turned into preventative measure. At the same time, the doctors themselves in these specializations have had a little more work to do. Obtaining an opinion from any of them traditionally requires only a simple standard check to see if the person is registered with the relevant institutions. This refers to drug treatment, psychiatric registration, or registration as a person prone to antisocial behavior.
When it comes to inspections of civil servants and checks that accompany the issuance of a medical book, then just checking records is not enough. You need either a medical certificate from a narcologist and a psychiatrist as a separate document, or a conclusion from these doctors, which, accordingly, is reflected within the medical certificate for the civil service and the medical record form.
In turn, issuing a medical book and medical certificate for the civil service invariably involves a medical examination. It turns out that doctors work not only with documents, but also directly with patients in the form of, at a minimum, detailed oral conversations. Thus, if we take into account total people undergoing medical examinations, one can imagine how much work narcologists and psychiatrists have.
For patients who, in the process of getting a job, must receive the indicated conclusions, all these activities are undoubtedly burdensome. Additional medical examinations cannot be encouraging when it comes to a purely mechanical need - to undergo certain procedures and receive a final health document.
In fact, emotional and mental adequacy are important precisely for maintaining these forms of security. If a person is unstable in these relationships, then one cannot expect him to take a serious approach to anything, in particular, to proper medical examinations and ensuring sanitary and anti-epidemiological safety.
In addition, additional control is also necessary to eliminate poor performance by people of their professional duties, which are officially recognized as socially significant and socially oriented. It is truly wild to imagine a drug addict or mentally ill person as an employee of, say, a kindergarten or a practicing doctor.
Actually, all the difficulties here are associated with elementary additional actions. In fact, there is nothing wrong with additional medical examination and additional medical testing. Accordingly, there is nothing to be upset about. If the responsibility of approaches to assessing professional suitability increases, then it is worth believing that in some sense the quality of work in certain areas should indirectly improve, which, in the end, will have a positive impact on the well-being of the population as a whole.
Preventive examination and medical examination are a set of measures that are carried out in medical organizations. According to the order of the Ministry of Health of the Russian Federation dated March 13, 2019 No. 124N, both workers and unemployed citizens, as well as students in educational organizations full-time at the age of 18 years. Based on the results of these medical events doctors determine patient health groups and dispensary observation groups.
How does a medical examination differ from a medical examination?
Preventive examination is carried out for the timely detection of diseases and risk factors for their development, as well as to identify non-medical use narcotic drugs and psychotropic substances. Clinical examination is a broader set of activities. It includes a medical examination, as well as additional methods surveys that are conducted to assess the condition of certain groups of the population.
How often do you need to undergo a medical examination and medical examination?
A medical examination is carried out annually as an independent event, as part of a medical examination or during the first medical examination of the current year. Medical examination for persons aged 18 to 39 years inclusive is carried out once every three years. According to the new rules, citizens over the age of 40 can undergo it annually.
What procedures include medical examination and medical examination?
The annual medical examination for citizens aged 18 years and older includes the following activities:
- questionnaires to identify complaints, symptoms, determine risk factors for diseases, etc.;
- calculation of body mass index;
- blood pressure measurement;
- study of the level of total cholesterol in the blood;
- determination of blood glucose levels.
Adult citizens over the age of 18 also undergo fluorographic examination of the lungs or chest x-ray once every two years. For patients aged 18 to 39 years inclusive, once a year the doctor determines the relative cardiovascular risk, the women of this age group are examined by a paramedic (midwife) or obstetrician-gynecologist.
Citizens over the age of 35 years old undergo additional electrocardiography every year during medical examinations, and for those over 40 years old, intraocular pressure is measured.
In patients aged 40 to 64 years inclusive, the absolute cardiovascular risk is determined annually, and after the age of 65, the risk of developing osteoporosis, depression, heart failure, uncorrected hearing and vision impairment.
Clinical examination is carried out in two stages. At the first stage, for citizens aged 18 to 39 years inclusive, once every three years a medical examination, cancer screening, brief preventive consultation by a general practitioner, and an examination by this doctor are carried out. Citizens aged 40 to 64 years inclusive and patients aged 65 years and older once a year, in addition to these procedures, also undergo general analysis blood.
At the second stage of medical examination, patients are asked to undergo additional examinations specialist doctors, their diagnoses are clarified. List possible procedures listed in
Any doctor will say that it is easier to prevent the disease, and if this was not possible, then you need to try to start treatment at the earliest stage, preventing it from developing into severe stage or chronic form. To prevent diseases and epidemics at work, the employer should great attention pay attention to the health of employees and regularly organize medical examinations.
Preventive medical examination, types
Medical examination of employees is a medical examination necessary to determine whether a person is fit to engage in a particular occupation professional activity or not. Employers are interested in conducting preventive examinations of employees, because this allows them to detect at the initial stages those diseases that can seriously affect the entire operation of the enterprise. Inspections are also widely used to ensure high-quality labor potential of an enterprise, thereby increasing operational efficiency. Medical examinations are divided into:
preliminary, which, in essence, is the selection of employees based on medical indicators before entering work. They determine professional suitability based on their health;Periodic, necessary to identify the first signs of occupational diseases in working employees, the occurrence of which is associated with the presence harmful factors;
Extraordinary, which are carried out if an accident has occurred at the enterprise or a mass disease has spread.
Who needs to undergo a medical examination?
Employees whose activities are associated with harmful or dangerous factors in the process of performing their work duties must undergo a medical examination. The employer is obliged to inform the employee before hiring about the presence of harmful factors in the workplace. List of harmful or hazardous factors and work that requires mandatory medical examinations is approved by law. In addition to employees involved in hazardous and hazardous work, medical examinations are also mandatory for employees who:
are engaged in construction production;
drive vehicles;
serve in private security;
are engaged in servicing electric power facilities;
work on railway transport;
are employees of catering enterprises, food industry and trade;
work in children's institutions (schools, studios, sports sections, kindergartens), universities, medical, treatment and preventive institutions, pharmacies;
provide public utility services;
work in water treatment plants.
In addition, workers under 18 years of age, professional athletes and office employees who spend more than half of their working time at a computer must undergo medical examinations.
What is included in the medical examination?
Scope of research included in the mandatory medical examination, directly depends on the presence of many factors that the employee faces. The medical examination includes an appointment with medical specialists, fluorography, general clinical blood and urine tests, and a cardiogram. If the employer decides, then it is possible to expand the scope of the medical examination by adding studies that are most important for workers in a certain field ( biochemical analysis blood, thyroid hormones, tumor markers, etc.). Preventative treatment with a medical specialist consists of collecting anamnesis and conducting an examination in order to identify the main disorders and health problems in your profile. The list of medical specialists usually consists of:
therapist,
ophthalmologist,
otolaryngologist,
neurologist,
surgeon,
gynecologist for female employees.
If a pathology is detected during medical examination of employees the doctor gives recommendations and referral for further examination. This could be an ECG, ultrasound, Holter monitoring, additional tests depending on the doctor’s specialization and the identified pathology. If it is necessary to clarify the diagnosis, determine what additional examinations and treatment are needed, then a full consultation with a doctor is necessary.
Fluorography is necessary to identify such a dangerous and serious disease as tuberculosis, which is early stages has no symptoms, but is already dangerous for others who are in close contact with the sick person, because tuberculosis spreads easily. In addition, this examination makes it possible to detect lung tumors.
A general blood test makes it possible to determine many problems and changes in the body, because the blood immediately reacts to all diseases and reflects the full picture of the disease. This test can detect the presence of infections, viral or bacterial, as well as inflammatory processes. In most large clinics and medical centers who carry out medical examinations use modern automated blood analyzers, which provide high quality analyzes performed. Blood for analysis is taken from a vein using safe vacuum syringe systems.
Urinalysis detects kidney disease and urinary system In addition, this test helps determine the presence of liver disease, endocrine system and assume the presence diabetes mellitus. This analysis is also performed using an automatic analyzer.
An electrocardiogram will give the doctor a picture of the condition of the heart muscle and will help identify various complications that have caused sore throats and races to the heart. blood pressure, will help detect incipient ischemia, which means a lack of oxygen for the heart, and even prevent the development of such an insidious and dangerous disease what is myocardial infarction?
Preliminary medical examinations are required upon hiring, and periodic ones throughout the entire period. labor activity employee, once every two years, and if the employee is not yet 21 years old, then a professional examination is mandatory for him annually. After all the results have been summarized, a medical commission report is drawn up, with which the employee is introduced, and the document is usually stored in the personnel department of the enterprise.
Employer's liability
The Labor Inspectorate regularly conducts scheduled inspections of enterprises to identify violations of labor laws, and also checks employee complaints. If it is revealed that the organization employs employees who have not passed the required medical examination, then the inspection has the right to fine either the organization in the amount of 30 - 50 thousand rubles, or the manager or other official in the amount of 1 to 5 thousand. You may also be fined the same amount individual entrepreneur. In addition, the activities of the violating organization may also be suspended for up to 90 days. In case of repeated violation, the official may be disqualified for a period of one to three years.
Modern business has increased demands on the health of workers. In order for people to work at their best, it is important for employees to be healthy to improve productivity and quality of work. This is a huge advantage for workers: they can take care of their health and detect diseases in a timely manner. This is also good for employers who have employees who are able to do their work on time, well and efficiently.
Yulia Egorova talks about the new rules for medical examinations
The law obliges
IN Lately due to active social policy In our country, such a form of health care as a preventive medical examination is becoming increasingly relevant.
The Labor Code defines groups of people for whom medical examination is mandatory.
Labor Code of the Russian Federation Art. 213 (extract):
Workers engaged in heavy work and work with hazardous working conditions<…>undergo mandatory preliminary (upon entry to work) and periodic medical examinations to determine the suitability of these workers to perform the assigned work and prevent occupational diseases.
Workers<…>medical and preventive care and children's institutions<…>undergo the specified medical examinations (examinations) in order to protect public health and prevent the occurrence and spread of diseases.
An important point reflected in Article 213 of the Labor Code is that carrying out preventive examinations of these groups of workers is the responsibility of the employer and is carried out at his expense, including work time and maintaining wages. The state supports this using the “carrot and stick” method. Gingerbread is a preferential taxation of amounts spent by the employer on conducting medical examinations. Whip is an administrative liability under Article 5.27 of the Code of Administrative Offenses of the Russian Federation for officials guilty of violating labor laws.
What to do with the obligatory medical examination, if by law medical examinations and interventions cannot be carried out without consent, much less against the will of the patient?
Preventive examination is mandatory only for certain groups of workers in order to protect public health. Employment in such responsible work can only be voluntary, and consent to preliminary and periodic medical examinations is assumed to be automatic upon signing an employment contract, which most often includes a clause on undergoing examinations as an essential condition.
What has changed in the medical examination?
Until 2012, medical examinations were regulated by several orders, some of which were issued back in Soviet time. Since January 2012, Order of the Ministry of Health and Social Development of Russia No. 302n dated April 12, 2011 “On approval of lists of harmful and (or) hazardous production factors and work...” came into force. On this moment this order and its annexes are the main regulatory framework for preventive examinations, and previously existing orders have been canceled since 2012.
Compared to the old procedure for conducting medical examinations Several fundamental differences emerged.
1. Now only an occupational pathologist should head the medical commission, and the commission’s medical specialists need advanced training in the field of occupational pathology.
2. The principles for compiling lists of workers sent for medical examinations have changed. If previously employees were included in the list depending on their position, now an employee can be added to this list only on the basis of certification of the workplace, which must be carried out in accordance with another order of the Ministry of Health and Social Development of Russia (No. 342n dated April 26, 2011 “On approval of the Procedure for certification jobs according to working conditions"). That is, even if a person works at a uranium mine, but the employment contract does not indicate a workplace certification card, then he does not need to undergo a medical examination, and he has no medical contraindications to work.
3. A psychiatrist and a narcologist are included in the medical commission; their examination is now mandatory for everyone undergoing a medical examination, and not just for those who are hired or have access to drugs, as was previously the case.
These innovations can generally be considered positive, especially if medical examinations of employees are not reduced to a formality, as, unfortunately, sometimes happens. The emphasis on occupational pathology increases the preventive value of the medical examination, and avoidance of hazardous work persons with alcohol or drug addiction will certainly reduce the level of injuries in the workplace.
Health passport
The so-called “health passport” is also gradually being introduced into practice - a document of the established form, a sample of which can be found at the link medexx.ru. The passport contains information about employees undergoing medical examinations; during the examination, it is kept in the medical organization, and after it is given to the employee.
The introduction of health passports does not cancel personal medical records. The procedure for issuing a medical book is regulated by Rospotrebnadzor Order No. 402 of May 20, 2002 “On a personal medical book and sanitary passport,” which continues to be in effect. In addition, the lists of workers required to have a health passport and a medical book are somewhat inconsistent, and employees of children's health care institutions are required to have both. Of course, in this case, you can undergo an annual medical examination, recording the examination results in both documents. You can learn more about medical books and who needs them on the website of the Moscow Center for Hygiene and Epidemiology http://www.mossanexpert.ru
Organization of medical examination of workers
According to the order, now only a medical institution that has received the appropriate license can provide medical examination services. At the same time, the institution must have a permanent medical commission under the leadership of an occupational pathologist. Therefore, the natural desire for every health worker to undergo a medical examination directly at the place of work, unfortunately, is not feasible if the establishment does not have the appropriate license.
The same is true with analyses. For the organization performing the medical examination, no normative document prohibiting the use of the results of tests and examinations performed in other medical institutions. But, given that this is a paid service, it is unprofitable and quite risky for medical institutions to accept third-party results, since they can be falsified. Unfortunately, it is also impossible to undergo a medical examination privately - where you prefer - because the employer must organize a centralized medical examination and provide the medical organization with a list of employees, data on the certification of workplaces and harmful factors of production. Moreover, medical organization no later than one month after completing the periodic medical examination, must summarize the results. Then, together with the territorial bodies of the federal body executive power, authorized to carry out state control and supervision in the field of ensuring the sanitary and epidemiological well-being of the population, and representatives of the employer, the medical institution draws up the final act.
Our medical examination or medical examination of doctors
Let's talk about the features of medical examinations for health workers. According to paragraph 17 of Appendix No. 2 to Order No. 302n, medical personnel of all medical institutions must undergo a preventive medical examination annually. The “program” of the medical examination is presented in Table 1.
| Consultations and examinations | Who passes | How often to go |
|---|---|---|
| therapist, psychiatrist, narcologist, dentist, dermatovenerologist*, otorhinolaryngologist* | All | 1 time per year |
| clinical blood test (hemoglobin, color index, red blood cells, platelets, leukocytes, leukocyte formula, ESR) | All | 1 time per year |
| clinical urine test ( specific gravity, protein, sugar, sediment microscopy) | All | 1 time per year |
| biochemical screening (content of blood serum glucose, cholesterol) | All | 1 time per year |
| blood test for syphilis | All | 1 time per year |
| smears for gonorrhea | All | 1 time per year |
| neurologist, ophthalmologist, allergist, endocrinologist, oncologist | health workers whose work is associated with exposure to chemical, physical and biological unfavorable factors | Once a year or once every 2 years - according to Appendix No. 1 to Order No. 302n** |
| blood test for hepatitis B and C, as well as HIV | only workers who have professional contact with infected material or blood products, and only with the consent of the worker | 1 time per year |
| studies on carriage of pathogens intestinal infections and serological examination for typhoid fever | All | upon admission to work and in the future - according to epidemiological indications |
| helminthiasis tests | All | upon entry to work and thereafter - at least once a year or according to epidemiological indications |
| swab from the throat and nose for the presence of pathogenic staphylococcus | All | upon starting a job and thereafter - once every 6 months |
* The inclusion of a dermatovenerologist and an otorhinolaryngologist in the medical examination commission for medical workers is based on frequent professional contact with various kinds allergens. On the recommendation of these specialists, further examination may be prescribed in the form of specific allergy diagnostics, functional testing external respiration and consultation with an allergist. ** Appendix No. 1 to Order No. 302n also indicates additional medical contraindications for work associated with unfavorable factors, such as hypochromic anemia, benign neoplasms, microcirculation disorders of any nature.
The result of the medical examination
If the examinee does not have any health problems, the occupational pathologist makes a conclusion about suitability for the work performed. But what if a medical examination reveals any diseases? Full list contraindications are quite extensive and are contained in paragraph 48 of Appendix No. 3 to Order No. 302n.
It must be said that many of the points applied to medical workers controversial. For example, how can stable angina pectoris, post-infarction cardiosclerosis, drug-compensated epilepsy, widespread ichthyosis or even oncological disease interfere with the performance of the duties of a therapist? initial stage- It’s unclear to me personally.
Of course, for emergency work in the ambulance, operating room, reception department and similar areas good health necessary, but for scheduled appointments and consultative work such requirements seem excessive to me. If all the contraindications listed in this list are observed in detail, medicine risks losing a large number of older specialists, whose knowledge and experience are of great value, despite the imperfect state of their health.
Mandatory participation in a medical examination by an occupational pathologist involves identifying the connection between detected diseases and professional activities. If an occupational disease is suspected, the medical organization issues the employee a referral to an occupational pathology center or a specialized medical institution that has the right to conduct research regarding the connection of the disease with the profession. Such a medical institution also draws up and sends, in the approved manner, a notice of the establishment preliminary diagnosis occupational disease to the territorial body of federal executive authorities authorized to exercise state control and supervision in the field of ensuring sanitary and epidemiological well-being.
The employer, if medical contraindications are discovered, is obliged to remove the employee from the work he is performing or provide him with another one that is not contraindicated for him due to health reasons. At the same time, at the first stage, the employer is obliged to offer the employee available vacant positions, and then, by the decision of the employee himself, an additional agreement is drawn up to employment contract about the transfer or, in case of refusal, the procedure for removal from work provided for in Article 76 of the Labor Code of the Russian Federation is applied. Wherein wage during the period of exemption from execution labor responsibilities is not accrued, but the place of work and position are retained. If the period for which the employer is forced to suspend an employee for medical reasons exceeds four months, then the employee is subject to dismissal under Art. 77 Labor Code of the Russian Federation.
Some difficulties when undergoing a medical examination may arise for employees who have a disability for any reason. Along with the referral for a medical examination, it is better for them to provide the conclusion of the next medical and sanitary examination, so that the commission can make a decision on admission to work.
There is something to strive for
Much attention is paid to the legal regulation of preventive medical examinations: clear rules for their conduct are defined, a list of works is given that require a medical examination, outdated orders are canceled, and centralized control over the conduct of examinations is introduced. However, perfection has not yet been achieved. The most reasonable thing would probably be to issue a separate order on preventive examinations medical personnel and some softening of the list of contraindications for working in medicine.
Preventive medical examination, just read it carefully! Prophylactic! This is why it exists to identify diseases in the early stages and prevent its development.
Preventive medical examination is a term enshrined in legislation and obliges employers to provide a procedure and make sure that they are hiring healthy person. A professional examination is part of the employment procedure and is carried out both at the beginning of work and annually.
For which professions is a medical examination required?
- Professions involving high physical activity.
- Specialists whose work is associated with harmful and dangerous conditions.
- Branches of production that require special selection for certain physical qualities.
- Professions in which work is related to serving the population.
The norm is also enshrined in law when a medical examination is mandatory for children entering school. kindergarten, school, higher educational establishments when a person wants to get a driver's license.
Where to get a preventive medical examination
The question is very ambiguous and in order to answer it you need to know a number of circumstances, for example, why are you undergoing a medical examination? If for the purpose of prevention and for self-soothing, then you are free to choose any clinic to your liking.
If for employment, then you should ask the employer if he has an agreement with a medical institution where it is necessary to undergo this procedure.
List of doctors for medical examination
The question also requires clarification. If the purpose of your medical examination is prevention and taking care of your health, then we start with a therapist, and then follow specialized specialists, for example, a cardiologist, gynecologist, urologist, ophthalmologist, dentist. Their list depends on your health status, gender and age.
Therapists usually advise that in the current situation with the environment and the spread of certain diseases, it is imperative to do a number of special studies, such as mammography for women, ultrasonography prostate for men, fluorography chest, Ultrasound of the thyroid gland.
Let's return to the medical examination when it is necessary for employment or is taken during the course of work to determine the possibility of working in a certain specialty. Then the list of doctors and medical research approved by various orders and strictly defined, it must be followed.
