Legal status of medical institutions in the Russian Federation. Main types of healthcare institutions Questions for self-preparation for practical training

By order of the Ministry of Health and Social Development of the Russian Federation of October 7, 2005 No. 627, it was approved Unified nomenclature of state and municipal healthcare institutions . Today, the names of all healthcare institutions must comply with this Nomenclature.

The unified nomenclature includes four types of health care facilities:

Treatment and prophylaxis;

Institutions of a special type;

Institutions for supervision in the field of consumer rights protection and human well-being;

Pharmacy establishments.

Treatment and prevention institutions include:

1) hospital institutions;

2) dispensaries: oncology, tuberculosis, etc.;

3) outpatient clinics;

4) centers, including scientific and practical ones;

5) emergency medical care institutions;

6) institutions for the protection of motherhood and childhood;

7) sanatorium and resort institutions.

Clinical institutions are medical and preventive institutions (hospitals, dispensaries, maternity hospitals and other institutions) used for teaching purposes by higher medical educational institutions (faculties) or for scientific purposes by medical research organizations.

Hospitals . There are the following types of hospitals: local, district, city (including children's), and other types. Hospital facilities are intended for the treatment of patients in a hospital setting (from the Latin Stationarius - standing, motionless). Hospitals may include a polyclinic (outpatient clinic). It provides emergency medical care, as well as assistance to patients who require constant monitoring or the use of treatment methods that are impossible or difficult in outpatient setting- at home or in a clinic (surgeries, frequent intravenous, intramuscular and other injections and other manipulations).

Distinguish monoprofile (specialized) hospitals designed to treat patients with a single disease (for example, tuberculosis) and multidisciplinary - these are hospitals that include various departments (for example, surgical, neurological, therapeutic, etc.).

The hospital structure usually includes emergency department, therapeutic and diagnostic, medical departments, pharmacy, catering department, etc. Functional responsibilities nurses in a hospital depend on the profile of the department and the specifics of her work in it (admitting department nurse, surgical department, treatment room, ward nurse, etc.).

Specialized hospitals, including rehabilitation treatment, gynecological, geriatric, infectious diseases, drug addiction, oncology, ophthalmological, psychoneurological, psychiatry, tuberculosis.

Hospital - (from Latin hospitalis, hospitable) a medical institution designed to provide medical care to military personnel. In some countries, civilian medical institutions are also called hospitals.

Treatment and prevention outpatient institutions - These are clinics and outpatient clinics.

Clinic - a multidisciplinary medical and preventive institution designed to provide medical care to patients, including specialized care; if necessary - for examination and treatment of patients at home.

The clinic sees doctors of various profiles (therapists, surgeons, ophthalmologists, otolaryngologists, cardiologists, etc.), and also operates diagnostic rooms (endoscopic, X-ray, functional diagnostics), laboratory, physiotherapy department, treatment room.

The basic principle of the clinic's work is territorial and local. The territory served by the clinic is divided into areas, to which a local doctor and a local nurse are assigned, with a certain number of people.

The local doctor and nurse are responsible for carrying out all therapeutic and preventive measures in the territory of this site. Besides, great importance attached to medical examination of the population.

Clinical examination - This is the organization of systematic monitoring of the health of the population, the study of working and living conditions, and the identification of patients with chronic diseases.

The district nurse of the clinic helps the doctor during the reception of patients, maintains various documentation, explains to patients how to collect this or that material for laboratory research how to prepare for instrumental and X-ray examinations, fills out statistical coupons, referral forms for research, carries out doctor’s prescriptions at home, and, if necessary, teaches the patient’s relatives the elements of caring for him.

In addition to the district ones, the clinic has procedural nurses, physical therapy nurses, etc. Currently, the clinics have first-aid rooms: here the nurse measures the patient’s body temperature and blood pressure.

Outpatient clinic - this is a medical and preventive institution, which, like a clinic, provides medical care patients in rural areas. The work of an outpatient clinic, like a clinic, is structured on a local-territorial principle, but unlike a clinic, a smaller volume of medical care is provided here. There are usually no more than five doctors working in an outpatient clinic.

The work of an outpatient nurse resembles the work of a district nurse in a clinic, but requires even greater independence and responsibility from her.

Medical and sanitary unit - a specialized healthcare institution designed to organize preliminary (upon entry to work) and periodic (during employment) medical examinations of workers with harmful and dangerous working conditions at large enterprises. Their activities are based on the principle of shop division.

The structure of medical and sanitary units varies; they may include a polyclinic or outpatient clinic, a hospital, health centers, Dental clinic, dispensary, sanatoriums, children's health camps and etc.

The functions of medical units are varied. In addition to providing outpatient medical care and treating patients in a hospital, employees of the medical and sanitary unit carry out a lot of work but dispensary monitoring of the health status of workers and employees through systematic preventive examinations, identifying people suffering from chronic diseases, all sick people in an outpatient setting or in a hospital.

District (shop) doctors and nurses, paramedics at health centers study the working conditions of workers and directly at the workplace, identify occupational hazards and take part in the development of the complex preventive measures undertakings aimed at improving the working and living conditions of enterprise employees.

Health centers (medical, paramedic) are structural divisions of healthcare institutions or organizations and are intended to provide first aid to workers, employees and students. The health center is not an independent medical and preventive institution, but is usually part of a clinic or the medical and sanitary part of an enterprise. The medical staff of the health center (doctor, paramedic, nurse) provides pre-medical and first aid, carries out the necessary procedures prescribed by the doctor of the clinic or medical unit (injections, dressings), gives vaccinations, and performs sanitary education work.

Ambulance stations- these are medical institutions designed to provide 24-hour emergency medical care to patients at the prehospital stage in all life-threatening conditions (trauma, wounds, poisoning, bleeding), as well as during childbirth. At emergency medical stations, personnel work in teams consisting of 2-3 people (a doctor and one or two paramedics).

TO institutions for the protection of motherhood and childhood include antenatal clinics and maternity. Maternity clinics, like clinics, operate on a local-territorial basis. Here they carry out medical examinations, identify and treat women with gynecological diseases, and also conduct clinical monitoring of pregnant women.

Staff antenatal clinics and maternity hospitals carries out extensive sanitary and educational work with pregnant women and postpartum women. Nurses usually work in treatment rooms of antenatal clinics and maternity hospitals, as well as in operating rooms and children's departments of maternity hospitals as ward rooms nurses.

TO institutions sanatorium type include sanatoriums (from the Latin sanare - to treat, to heal), dispensaries, recreation camps for children, and sanatorium-improving areas. The activities of these treatment and prevention institutions are based on the use of predominantly natural healing factors (mineral waters, mud therapy), as well as herbal medicine, physiotherapy and physical therapy to treat patients.

In sanatoriums, patients undergo outpatient treatment. Dispensaries organized at large industrial enterprises are used for treatment and preventive measures, usually in free time.

The work of nurses in sanatorium-type medical institutions resembles the work of nurses in clinics, hospitals, dispensaries, etc.

Nursing home (hospital) - a healthcare institution to provide qualified care to elderly and senile patients suffering from chronic diseases and for health reasons not in need of active treatment.

Hospice - a healthcare institution to provide medical, social, spiritual, psychological and legal assistance to incurable (not amenable to treatment) cancer patients and their families, both during the period of illness and after the loss of their loved ones.

Leper colony (from Late Latin lepergosus - leper). Treatment facility for leprosy patients. In some countries (Brazil, India), leprosy is treated on an outpatient basis.

Clinics - medical and preventive institutions (hospitals, maternity hospitals and other health care institutions) that are part of higher medical educational institutions, medical scientific organizations or subordinates medical universities and scientific organizations are their structural divisions.

Questions for self-preparation for practical lesson:

1.Structural levels of the healthcare system in the Russian Federation.

2. State organizational structures dealing with nursing issues.

3.List outpatient and inpatient healthcare facilities.

4. Main types of hospital medical documentation.

Legislative regulation of the legal status (status) of a medical institution is carried out as federal laws, and by-laws and regulatory legal acts.

Fundamental norms defining legal status institutions (the general legal status of institutions in Russia) are contained in the Civil Code of the Russian Federation, which by institution means a unitary non-profit organization created by the owner to carry out managerial, socio-cultural or other functions of a non-profit nature (Article 123.21). An institution can be created by a citizen or legal entity (private institution) or, respectively, the Russian Federation, a subject of the Russian Federation, a municipal entity (state institution, municipal institution).

Medical institutions as non-profit organizations, firstly, are called upon to perform socially significant functions, and secondly, they do not have profit making as the main goal of their activities. However, these institutions can also carry out profit-making activities. entrepreneurial activity, but only insofar as it serves the purposes for which they were created.

Thus, medical institution is a non-profit organization created by the Russian Federation, a constituent entity of the Russian Federation or a municipal entity, carrying out medical activities as the main (statutory) type of activity on the basis of a license issued in the manner established by law.

Types of medical institutions:

1) government,

2) autonomous

3) budget.

Medical institutions of state, municipal, and private health care systems can carry out their activities only if they have a license for the chosen type of activity. The purpose of medical licensing is to assess the capabilities of a medical institution (organization) in terms of providing medical care in the volume and functions adequate to the level of personnel training, the state of the institution’s material and technical base and its equipment.

All medical institutions are subject to mandatory state licensing, regardless of their form of ownership and organizational and legal status (federal, municipal, all subjects of private medicine).

The legal status of a medical institution determines various legal guarantees for its activities, the place, role and position of the medical institution in the healthcare system and sectoral management, as well as its basic rights and obligations.

The structure of the legal status of a medical institution includes:

a) goals and objectives of the medical institution;

b) functions of a medical institution;

c) creation, reorganization and liquidation of a medical institution;

G) organizational structure medical institution;

e) guarantees of the rights of operation of a medical institution.

IN modern conditions main task The problem that medical institutions are called upon to solve in their activities is to ensure the constitutional right of citizens to health care and medical care, which is expressed in the provision of timely, affordable, high-quality medical care.

Efficiency The work of medical institutions is largely determined by the availability of medical personnel, their professional training, rational placement and use, organization of work of doctors, paramedics and other personnel.

Legislation Russian Federation, regulatory legal acts and internal documents of medical institutions position the chief physician as an official who represents his medical institution in all legal matters. On practice chief physician Quite often he gives his main powers to a deputy, remaining only a formal figure in the process of managing a medical institution.

One of the conditions for the effective functioning of medical institutions is budget funding in the required amount. For medical institutions budgetary sphere There is a characteristic deficit in the allocation of funds, which is associated with the dependence of budget financing on numerous factors of a political, economic, and legal nature.

As a consequence, the low quality of available medical services, the lack of medical personnel and their insufficient qualifications and, accordingly, a deterioration in the quality of functioning of the overall state and municipal healthcare system.

Competence of the medical institution. In the course of its activities, a medical institution acts not only as a treatment and prophylactic unit, but also as an economic entity that has the material and technical base for carrying out its main activities, and therefore, in order to solve its inherent tasks and perform functions, it must have the appropriate scope of rights and responsibilities. Rights and responsibilities are one of the most important elements of the administrative and legal status of a medical institution.

Rights of a medical institution in relation to higher authorities and healthcare organizations are mainly determined by the functions of improving the work of all its structural divisions and the medical organization as a whole. In this regard, the administration of a medical institution has the right to send applications to higher industry authorities with proposals for the creation of new and transformation of existing structural divisions, services, specialized departments and offices, the allocation of staff positions, the receipt of limited medical equipment, funds and limits for design work and construction of new facilities, sending highly qualified specialists to provide the population with specialized medical care, sending medical personnel for specialization and advanced training.

Regarding subordinates medical structures The rights of a medical institution are mainly realized in the process of providing them with organizational, methodological and advisory assistance.

The administration of a higher medical institution in relation to subordinate medical institutions has the right to: give orders and instructions, select and place management personnel, organize and conduct work inspections, encourage or impose disciplinary action on managers.

The peculiarity of the medical team is that, as a rule, chief doctors and heads of departments, in addition to managerial and organizational work, carry out management decisions, i.e. provide direct medical care. At the same time, the activity officials as participants in the management process is regulated by administrative legal norms, and as participants in the treatment and preventive process - by labor law norms.

Problems of efficiency of medical institutions. In modern conditions, the main task that medical institutions are called upon to solve in their activities is to ensure the constitutional right of citizens to health care, which is expressed in the provision of timely, affordable, high-quality medical care.

In order to ensure the rights of citizens to health care, the state has created and operates a system of state, municipal and private health care institutions, in which the rights of citizens to health care and medical care are realized.

Unlike private (commercial) medical organizations having general (unlimited) legal capacity, state medical institutions are endowed with special (limited) legal capacity, i.e. a set of only such rights and obligations as are provided for by the constituent documents.

The activities of state medical institutions are not only carried out in accordance with the legislation of the Russian Federation, but are also constantly monitored by regional health authorities (committees).

These institutions provide their services on both a budgetary and commercial basis, depending on the type of medical service and the patient’s need for it. The list of free services is regulated by annually adjusted federal laws on compulsory health insurance, as well as the internal charter of each state medical institution.

Today, public medical institutions of federal and regional importance have a number of disadvantages related to their legal regulation and management problems, which include:

Insufficient funding for medical institutions from the federal budget, which leads to low wages for medical workers, lack of opportunity to expand the material, technical and technological base of a medical institution, and a decrease in the quality of medical services due to the above factors;

Failure of many public medical institutions to comply with the compulsory health insurance program, which leads to patient dissatisfaction with the volume of services provided, mass appeal patients in commercial medical institutions, increased mortality among socially vulnerable categories of patients;

Declining birth rate due to distrust in healthcare and social policy of the state as a whole;

High level of corruption among the management of large public medical institutions; as a result, irrational distribution of labor time of medical workers, lack of material and technical means and medicines for certain categories of patients due to the commercial sale of medical services, which is not included in the requirements legal framework medical institution.

The activities of municipal medical institutions are similar to those of federal institutions with just one amendment: municipal medical institutions are financed by the authorities of a particular region, which increases the likelihood of more rational use budget funds.

(organizations) that are a public joint-stock company (PJSC) are few in the total share of medical institutions in the Russian Federation. Observations show that it is precisely such medical institutions that provide patients with the highest quality medical services.

Medical centers created at large enterprises - municipal or federal - are fully financed by these enterprises and therefore it is in their interests to carry out their activities efficiently so as not to lose a source of funding. Such centers most often provide the full range of medical services. Employees who use the center’s services undergo annual training here medical examinations, and, if necessary, therapeutic and surgery both outpatient and inpatient. However, such centers rarely accept patients who are not employees of the parent company, unless they have received the appropriate license to do so. Such medical institutions cannot be classified as for-profit, since they do not charge patients for the provision of medical services.

Among the disadvantages of medical institutions choosing such an organizational and legal form as an open joint-stock company, we note the following:

Danger of abolition in case of liquidation of the parent company. This is due to the fact that not every PJSC has the opportunity to short term change its organizational and legal form, while it does not have enough material and technical base and human resources to carry out its activities independently;

Limited target audience high quality medical services. This problem is more relevant for patients who do not have the opportunity to use medical services in such centers. A situation is being created in which the most qualified medical workers are not allowed to practice on a large scale, which has a detrimental effect on the overall level of healthcare.

Medical institutions that are non-public joint stock companies (NAO) are also few in number. You can select two main types of such medical institutions:

Specialized centers

Multidisciplinary inpatient clinics.

Specialized centers, which may include drug treatment, ophthalmology, infectious disease centers, allergy centers, etc., provide patients with a limited range of medical services, which are planned within the framework of a specific medical specialization. Such centers have specific regulatory legal documents that regulate their activities. The main question here is whether the center has been commercial since its founding or whether a state enterprise has been reorganized into a non-state enterprise.

Let us note a number of disadvantages of medical institutions choosing such an organizational and legal form as a non-public joint stock company:

Instability of the organization's activities due to internal problems of management and division of powers;

The danger of bankruptcy during global financial crises;

Labor intensity in drawing up statutory documents.

Private medical institutions(organizations) that are limited liability companies (LLC) are most common on the territory of the Russian Federation. Their massive appearance was due to Russia's transition to a market economy, which made it possible to turn qualified medical care into a way of making money.

Today, this organizational and legal form is chosen for their activities for the most part by those medical institutions that have small premises, limited staff, and also offer services that do not require long-term hospitalization.

There are a number of disadvantages in choosing this organizational and legal form for commercial medical institutions:

Incomplete compliance with the requirements of regulatory documents developed for all medical institutions of the Russian Federation due to the lack of certain management components. For example, we can say that supervisory authorities (SES, fire inspectorate) impose lower requirements on limited liability companies due to the fairly common practice of corrupt practices of medical LLCs;

Inconsistency of the quality of medical services with the expectations of patients, inflated prices for simple medical services, which leads to a devaluation of the professionalism of medical personnel, as well as a decrease in the image of the healthcare system as a whole. For example, many dental clinics create a markup on materials that is incommensurate with their cost. Also, multidisciplinary medical centers, in order to expand the target audience, often offer medical services for which they do not have qualified personnel or sufficient material and technical resources;

High level of competition, leading to frequent reorganization or liquidation of a medical institution due to bankruptcy or the imposition of administrative liability for poor-quality services provided. The instability of medical LLCs in the medical services market leads to a decrease in the level of responsibility for the life and health of patients, which has a detrimental effect on general level quality of healthcare.

Medical services provided by private medical institutions (organizations) are regulated primarily by civil law methods of influence within the framework of civil proceedings with reference to consumer protection legislation. This situation can be explained by the fact that in the field of private medicine it is expected to create competitive internal requirements of medical institutions (organizations) for the quality of the medical services they provide, which should ensure increased efficiency of patient treatment.

Thus, we can conclude: modern organizational and legal forms of medical institutions require correction due to the fact that none of the above forms of institutions is ideal for implementing medical activities on the territory of the Russian Federation.

The development of an innovative model of the organizational and legal form of a medical institution is the most pressing task of the Ministry of Health of the Russian Federation for the coming years.

Sales Generator

Reading time: 13 minutes

We will send the material to you:

Issues discussed in the material:

• What types of medical institutions are there?
• What are the advantages of private medical centers
• Is it worth opening a private medical center?
• What franchises of medical institutions are popular in Russia?

In Russia today, the prevailing trend is towards a gradual transition from entirely public health care to commercial or public-private. Paid medical services are becoming an increasingly profitable business. If you are interested in this industry and are a novice entrepreneur, then you will find our material about what types of medical centers exist and which of them are most in demand and profitable.

Medicine is developing rapidly, which cannot but affect the methods of therapy and diagnostics: they are being improved and multiplied. It is logical that the number of medical centers providing certain types of healthcare services is also growing.

A modern medical center is a combination medical equipment, created by last word technology and professionalism of medical staff. These institutions are various types and types and carry out different activities.

All medical centers and other medical institutions are classified primarily based on their principle of operation and are divided into two large types:

1. State medical institutions. The patient does not pay for the medical examination and diagnosis, but is forced to stand in a long line.
2. Private. All services of medical centers of this type are paid: appointments, diagnostics, appointments, etc. The advantages of these institutions lie in an individual approach to each client and a more detailed examination.

People value their own more and more free time and the opportunity to consult with a specialist, which is why commercial medical centers are increasingly in demand. By the way, they also come in different types.

Classification of public medical institutions

• (from the Greek polis - city and klinike - the art of healing). This is an independent city medical and preventive institution, which can be specialized or multidisciplinary, but sometimes clinics are part of united hospitals or medical units. Provides qualified assistance to visiting patients and treats patients at home: those patients who are unable to get to the clinic have the opportunity to call a doctor and receive help at home. If necessary, patients are hospitalized.

The services of clinics usually cover the entire range of therapeutic and preventive measures, since consultations are carried out by doctors of all specializations, the clinic has treatment and diagnostic rooms, and its own laboratory. Available in clinics and offices pre-medical appointment: There, patients' blood pressure and temperature are measured (this is done by a nurse).

• (from Latin ambulatorius - moving, mobile). This type of healthcare facility is intended to provide medical care (outside the hospital) to residents of a small settlement, like an urban settlement or village, or an industrial enterprise.

Unlike clinics, outpatient clinics have a limited range of medical services, as well as the number of full-time employees: usually, rural outpatient clinics employ no more than five specialists (therapist, surgeon, pediatrician, obstetrician-gynecologist). This type of health care facility serves fewer patients.

In rural areas, the functions of outpatient clinics are performed by feldsher-midwife stations - the main structural units of the health care system in villages. The local principle of serving the population makes it possible to detect patients, provide them with qualified medical care, monitor morbidity in the region, carry out disease prevention and conduct sanitary educational work.

• For large industrial enterprises with a large staff, they have their own analogue of an outpatient clinic - medical unit. Health care facilities of this type may include a health center, a clinic, a hospital and a dispensary. The activities of this type of medical centers are subordinated to the needs of the main enterprise.
• Health center is an element of other types of health care facilities - medical units or clinics established at industrial enterprises, at a construction site, at school, college or university.

In addition to providing first aid to those suddenly ill, injured or poisoned, health centers also carry out planned measures (therapeutic and preventive and sanitary and hygienic) aimed at preventing diseases and reducing the incidence rate. Health centers can be headed by doctors (and then called medical), paramedics, or nurses (paramedics).

• - highly specialized type medical center. In health care facilities of this type, treatment and prevention are carried out only gynecological diseases, and also monitor the condition of pregnant women.

A mid-level medical worker - a midwife - helps the doctor in the process of receiving patients, provides patronage to pregnant women and provides training for them (on child care, personal hygiene measures, etc.), conducts health education work, and is responsible for the implementation of medical prescriptions.

• To provide emergency medical care to the population in in case of emergency exist ambulance stations, working 24 hours a day. The head of the ambulance team is usually a paramedic. He independently goes to calls to patients, carries out hospitalization and provides emergency care.

If specialized medical care is required, an emergency team under the guidance of a qualified doctor comes to the patient. The paramedic assists him in transporting the patient and providing him with urgent assistance.

Most ambulance stations have their own vehicles, equipped with the latest technology, and can provide emergency qualified medical care, including special and intensive care, directly at the patient’s home or on the way to the hospital.

All these types of medical centers and healthcare facilities form an outpatient clinic unit that performs the following tasks:

1. Providing qualified medical care outside the hospital (in a clinic or at home).
2. Carrying out medical examination of the population.
3. Implementation of prevention in order to reduce the level of morbidity, prevent deaths and disability.
4. Conducting examinations of temporary disability.
5. Conducting educational work, sanitary and hygienic education.
6. Promoting a healthy lifestyle.

Where outpatient medical care is not enough, they connect stationary types medical centers.

• (from Latin dispense - to distribute) is an independent health care facility that has a special specialization and operates in a dispensary format.

This type of healthcare facility performs the following functions: early detection and registration of patients suffering from diseases of a certain group; regular dynamic monitoring of them; providing them with special medical care; development of recommendations for patients on improving the environment at home and in the workplace; study of morbidity, search for its causes; preventive actions; sanitary education activities.

That is, the dispensary is intended for the observation and treatment of a certain group of patients.

The Russian healthcare system provides such types of dispensaries as anti-tuberculosis, endocrinology, cardiology, psychoneurology, oncology, narcology, dermatovenerology, anti-goitrology, medical and physical education.

• Hospital- a large inpatient medical facility offering patients highly qualified treatment and care using the latest achievements medicine, technology and pharmaceuticals.

Hospitals can be city, regional, republican, etc. City hospitals can be:

1. Multidisciplinary (intended to treat patients with various diseases).
2. Specialized (focused on diseases of a certain type, be it tuberculosis, infectious, mental, etc.).

Residents of rural areas are served by republican and regional hospitals, providing them with specialized, outpatient, inpatient medical care, as well as consultations.

• Clinic differs from other types of inpatient medical centers in that it not only treats patients, but also scientific research, as well as training of nursing staff and doctors.
• Hospital called a hospital serving only military personnel and war invalids.

• Sanatorium(Latin sanatum - to heal, to treat) - an inpatient medical facility specializing in after-care of patients. As a rule, sanatoriums are set up in resort areas, in regions with a favorable climate, in places where there are sources mineral waters and healing mud.

Types of commercial medical centers

As for private medical centers, the most common types of these healthcare facilities are:

1. Multidisciplinary clinics providing a full range of medical services within a specific specialization. On multidisciplinary clinics usually the choice of those who need it falls comprehensive examination body.
2. Specialized clinics. They deal with problems belonging to one specific area of ​​medicine: gynecological, cardiological, etc.
3. One doctor centers- these are medical centers in which patients are treated by one famous renowned doctor.

Some people who have had negative experiences with paid clinics treat them extremely hostilely - as organizations that do anything for profit. However, even among commercial medical centers there are institutions for which, first of all, helping the patient and solving his problems is important.

Therefore, it is so important for the patient to choose the right clinic. Pay attention to how long it has been in business and what customer reviews are about it. And, of course, do not consider a private medical center as something like a meeting of wizards who can instantly cure you of any disease as soon as you pay money.

Advantages of private medical centers

Times when people were forced to undergo treatment in district clinics, are long gone: today we have a choice between public and private medicine. Consult about feeling unwell, you can now be examined and receive appointments in private clinics, which are presented in a wide variety.

Private medical centers are gaining popularity as people pay more attention to their health and quality of life. The success of commercial medical institutions depends on the effectiveness of the methods and technologies used, the competence of employees and care for each client.

There are many private clinics specializing in female reproductive problems, family planning, treatment of congenital abnormalities, aesthetic and cosmetic services. Obstetrics and gynecology centers and family medicine clinics are in a separate category.

In such medical centers, patients can count on examinations by all specialists, tests and other types of procedures at a convenient time and without any queues.

Many clinics are not limited to narrow specialization and are multidisciplinary, providing services to both adults and children. The staff of such medical centers includes doctors of various specialties: therapists, surgeons, traumatologists, otolaryngologists, etc.

Among the commercial clinics there are 24-hour and seven-day-a-week clinics. The ambulance team goes to the specified addresses at any time of the day or night to provide assistance to patients and, if necessary, hospitalize them.

Clinics are in great demand among the fair sex aesthetic medicine. Besides plastic surgery, rejuvenation procedures, etc. these medical centers, for example, solve problems with hair condition. Trichology is a relatively young branch of medicine, actively developing and developing its own technologies.

For commercial medical centers of any kind, one thing is important - polite and Attentive attitude to every patient. The client’s interaction with the clinic begins with the administrator, who must observe professional communication etiquette. As for doctors, their duty is to clarify all the symptoms as quickly as possible and prescribe appropriate treatment. The conditions in the clinic also matter: patients strive for safety and comfort.

How paid medical services are provided

Paid services from medical centers come in several types - rehabilitation, preventive, therapeutic and diagnostic care.

If desired, a contract is concluded with the patient for the provision of any of these services. Usually contacting paid clinic it happens like this:

1. In a day initial appointment For a new patient, they create a medical record at the clinic’s reception desk and sign in duplicate an agreement for the provision of paid services, as well as all the required attachments to it and consent to the processing of personal data.
2. During the appointment, the attending physician will physically examine the patient and question him about his symptoms. Then the doctor explains how the diagnosis will be carried out and what the likely treatment programs are, what will happen if you do not treat, what complications and risks you need to be wary of, what stages the therapy will consist of, how much it will cost (approximately). After this, informed consent for treatment is drawn up and, if necessary, a preliminary treatment plan is approved.
3. The consent document and the client’s medical record describe in detail all services provided.
4. The patient, with the participation of nurses and doctors, undergoes in the medical center all types of procedures prescribed by his plan, on the premises of the medical center itself and using the necessary equipment.
5. If the safety of certain measures and procedures is in question (for example, the patient is allergic to any drugs, is drunk or suffers from an acute infectious disease), the medical center does not provide services to him.
6. If during treatment or diagnosis it is discovered that the treatment plan needs to be changed or supplemented for medical reasons, the patient’s prior consent is taken. The patient’s refusal of additional interventions is also documented, explaining to him the possible consequences.
7. The patient signs a medical record and annexes to the contract, which reflect all the features and conditions for providing him with assistance.
8. After this, the patient must pay everything at the reception paid services(or issue a promissory note, if in this moment he does not have all the required amount). In commercial medical centers, payment for services personally to doctors is not allowed under any circumstances.
9. The initial appointment ends with the patient receiving a reminder coupon for the next or re-appointment, with date and time (if this technique is necessary).
10. If the patient's condition changes during therapy, he should inform the attending physician and attend an appointment as soon as possible to eliminate the problems that have arisen.

The provision of medical care on a commercial basis always ends with payment through the registry and the signing of a strict reporting form. If the patient, having made an advance payment, refuses to continue treatment, then the clinic recalculates for services already provided and returns the rest of the money to him within ten working days (in the same way the patient paid, or otherwise by mutual agreement).

Medical center: how to open and not burn out

Maintaining health remains one of the most important issues today, therefore, the opening of medical centers (of any type) is a relevant and popular area of ​​business.

State healthcare institutions - both adults and children - have two main pain points: low level service and insufficient comfort.

This is due to limited budgets, which are not enough to purchase new modern equipment, repair offices, etc. Due to wear and tear of equipment, diagnostics are becoming less and less accurate and reliable, and this is very critical when it comes to human health or even life. In addition, patients at state clinics are forced to stand in queues for hours, becoming imbued with a depressing mood.

Clients of private medical centers are mainly wealthy people who can afford to overpay for services in order to receive quality care, an accurate diagnosis and attentive care.

Therefore, one of the main issues when creating a private medical center is the creation of a favorable, comfortable environment for patients. The clinic development plan must include appropriate measures and steps.

1. Is it worth doing?

Having assessed the level of free medicine, you will be convinced of the relevance of private clinics. The majority of the Russian population is ready to invest in their health and use paid medical services.

Your goal as a business leader is to provide potential customers with high level service, comfortable conditions and competent doctors. A medical institution that has a license and qualified doctors on staff will never be left without clients, especially if a business plan is competently drawn up and systematically implemented.

Almost everything will depend on the choice of the type of medical center: the size of the premises, types of equipment and materials, specialization of personnel.

The following highly specialized commercial clinics are most in demand today:

• dental;
• urological and gynecological;
• cosmetology;
• drug treatment

However, you can approach the choice of direction more creatively and open a specific health care facility, such as, for example, an acupuncture office or a hirudotherapy clinic. One of the promising niches is pediatrics, which has been actively developing in the last few years.

Generalist medical centers are also popular - their target audience includes people suffering from a wide variety of ailments. But opening such a medical center will require more substantial investments.

3. Premises for a medical center

Finding premises for a clinic is a very important step for a business creator. It is better to choose central areas, highways with a dense flow of people, buildings near metro stations, public transport stops. At the same time, be prepared for the fact that rent in the center is more expensive than in the outskirts.

The area of ​​the premises is determined by the profile of the medical institution. For example, for dental office 25–30 m2 will be enough (of which 14 m2 will be occupied by the office itself, 6 m2 by the sterilization room, and the rest of the space will remain for visitors waiting for an appointment). There are special sanitary standards for the area of ​​the premises that must be observed.

The premises can be rented or purchased as property. Purchasing real estate to open a medical center will not be cheap (from 10 to several hundred million rubles).

The optimal room size for a medical center is 150–200 m2. It must be electrified, equipped with ventilation and water supply systems, and have a bathroom.

In addition to medical and treatment rooms, the clinic must certainly have a reception area and a corridor along which you can freely walk to any of the offices.

One of the most significant expense items is the purchase of medical equipment various types. High-quality medical equipment has never been cheap. Thus, prices for ultrasound machines start from 160 thousand dollars, and for a device for analyzing tests you will have to pay 10–70 thousand dollars.

Patients expect competent and accurate diagnosis, so there is no need to skimp on equipment. However, you can purchase foreign used equipment. It will serve your clinic for many years.

Here is an approximate list of equipment without which a multidisciplinary medical center offering different types services:

• analyzer devices;
• scales;
• magnetic hanger;
• thermostat;
• centrifuge;
• water bath;
• drying cabinet;
• tile with heating surface;
• shakers;
• microscopes;
• devices for measuring physical parameters;
• mixing devices;
• muffle furnace, etc.

A multidisciplinary medical center offering therapy and diagnostic services to the population requires the following types of special equipment:

• A tomograph for MRI, which is used to examine internal tissues and organs.
• Angiographic installation (to study the condition of blood vessels and the heart).
• X-ray machine for layer-by-layer imaging, which does not require turning the patient over (necessary when examining patients with severe injuries).
• An ultrasound machine that allows you to examine any internal organs and obtain three-dimensional images.
• A digital mammograph, which is used to perform contrast diagnostics of the mammary glands if pathology is suspected.
• Electroencephalograph for studying the cerebral cortex and finding affected areas.
• An endoscope necessary for examining organs for pathologies and obtaining color images. It is used to check the effectiveness of therapy.
• System artificial ventilation to maintain the breathing of patients whose lungs are damaged. Modern devices have the ability to dose oxygen supplied to the lungs (to prevent overdose) and add medications in the form of fine mixtures.
• Holter heart monitor, which measures blood pressure, heart rate and other indicators. The device accurately displays all existing rhythm disturbances, which is necessary for making a correct diagnosis.
• Dialysis machines.
• An electrocardiograph, ideally the latest three-channel one, recording three lines simultaneously (this allows for a more accurate diagnosis).
• Defibrillator.

This is the most basic set of equipment. In addition to this, for the full operation of the clinic, gurneys (with adjustable height) may also be required. medical chairs, stands for IVs, gynecological tables (equipped with electric regulators of the patient’s body position). If health care facilities conduct surgical operations, you will need a modern operating table.

And, of course, no medical center can do without special storage cabinets medicines and instruments, without surgical lights and some other auxiliary types of accessories and equipment.

The main thing you should look for when recruiting personnel for a medical institution is whether applicants have a specialized diploma and medical category. If a candidate for a position has experience working abroad and knows foreign languages, this will be an additional advantage.

A qualified health worker has at least three years of work experience. Professionals, whether doctors or nurses, are highly valued: as a rule, patients go to the clinic precisely for the sake of a good doctor, and not for the equipment, etc., and the level of staff work determines the reputation of the medical center. It will take a couple of weeks at best to assemble a team of real professionals, but be prepared for the fact that you will have to select staff for several months.

In parallel with the recruitment of personnel, it is necessary to draw up work schedules. Please note that the influx of clients in different time days is uneven.

When employees are hired, the head of the clinic faces a new task - to retain qualified workers (through decent salaries and other methods of motivation).

6. What documents are needed to legally open a medical center?

When the room the right size, which meets sanitary standards, has been selected; a license to provide medical services has yet to be obtained.

To make this possible, the medical center must purchase certified equipment and hire specialists with the appropriate level of qualifications.

After this, you need to collect the following package of documents:

1. Agreement of the founder of the enterprise.
2. The company's charter, which lists all of its owners.
3. Receipt for payment of state duty.
4. Application for registration of a company with the tax office.

Obtaining licenses to conduct activities and medical records of patients costs from 50 thousand rubles.

The licensing process can take up to a year. If you contact a lawyer who has experience in such cases, the issuance of a license can be expedited.

To reduce the tax burden on a medical institution, you can provide benefits to pensioners (this is also an additional way to expand the clientele: elderly patients will be interested in a clinic where they are promised discounts).

Taking all this into account, the total costs of registering, launching and beginning the development of a medical center can amount to up to 25 million rubles. If the founder of the clinic does not have enough own funds, he can take out a loan for business development or turn to investors. In both cases, you will have to draw up a detailed business plan, including all expense items and profit forecasts.

8. Additional features and risks

The financial plan for the development of the clinic must certainly include a risk assessment. If you remember them at every stage of work and take them into account in the business plan, risks will not turn into headache manager and a threat to the continued existence of the business.

So, what may pose a risk to a private medical center:

• There is no room with the required characteristics.
• Investments and purchase of equipment will be too expensive.
• Competition in the market will be very fierce.
• There will not be enough competent doctors and especially junior medical personnel.
• The population will not go to a private clinic because of distrust in paid medicine.

All these risks are not fatal; they can be dealt with if you think through your actions in advance and reflect them in your marketing strategy.

Medical center franchise

Creating a medical center through the purchase of a franchise is one of reliable ways opening a business. The risks here are minimal.

The owner of a company operating under an already promoted brand can immediately count on clients, even in the first months of work.

The franchisor provides support of all types - from consultations and financial planning to advertising, personnel training and business process development. The franchisee is only required to comply with the agreements stated in the contract.

One of mandatory conditions opening a franchise business (in particular, a medical center of one type or another) is maintaining a corporate identity trademark, a certain set of services provided and most often - price policy. Of course, these requirements impose some restrictions on the franchisee, but they guarantee him stable results and assistance in business development from the franchisor.

4 most famous franchises in Russia:

Array ( => 27 [~ID] => 27 => 11/19/2019 20:53:56 [~TIMESTAMP_X] => 11/19/2019 20:53:56 => 1 [~MODIFIED_BY] => 1 => 11/19. 2019 20:53:56 [~DATE_CREATE] => 11/19/2019 20:53:56 => 1 [~CREATED_BY] => 1 => 6 [~IBLOCK_ID] => 6 => [~IBLOCK_SECTION_ID] => => Y [~ACTIVE] => Y => Y [~GLOBAL_ACTIVE] => Y => 500 [~SORT] => 500 => Articles by Maria Plechikova [~NAME] => Articles by Maria Plechikova => 12516 [~PICTURE] = > 12516 => 11 [~LEFT_MARGIN] => 11 => 12 [~RIGHT_MARGIN] => 12 => 1 [~DEPTH_LEVEL] => 1 => Maria Plechikova [~DESCRIPTION] => Maria Plechikova => text [~DESCRIPTION_TYPE ] => text => Articles by Maria Plechikova Maria Plechikovoy [~SEARCHABLE_CONTENT] => Articles by Maria Plechikova Maria Plechikovoy => stati-marii-plechikovoy [~CODE] => stati-marii-plechikovoy => [~XML_ID] => => [~TMP_ID] => => [~DETAIL_PICTURE] => => [~SOCNET_GROUP_ID] => => /blog/index.php?ID=6 [~LIST_PAGE_URL] => /blog/index.php?ID=6 => /blog/list.php?SECTION_ID=27 [~SECTION_PAGE_URL] => /blog/list.php?SECTION_ID=27 => blog [~IBLOCK_TYPE_ID] => blog => blog [~IBLOCK_CODE] => blog => [~IBLOCK_EXTERNAL_ID] => => [~EXTERNAL_ID] =>)