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З 1 верасня ў медыкаў вырастуць заробкі. Але, ці вырашаць заробкі праблему, якая назапашвалася дзесяцігоддзямі? Ці можа звычайнае падвышэнне акладаў зрабіць медыцыну больш прафесійнай? Ці можа дэ-юрэ бясплатная. а дэ факта яшчэ якая платная медыцына вырашыць праблему недахопу кадраў і нізкай якасці медыцынскага абслугоўвання?



Дарэчы, звычайна пра тое, што ў нашай краіне ёсць медыцынскія работнікі, узгадваюць толькі раз на год, у трэцюю нядзелю чэрвеня, калі лекары адзначаюць сваё прафесійнае свята.

Першыя палосы цэнтральных газет, інфармацыйныя перадачы радыё і тэлебачання стракацяць узнёслымі выразамі пра «самую гуманную прафесію». Яшчэ ў гэты дзень звычайна нагадваюць пра нядаўнія дасягненні нашых хірургаў у перасадцы органаў, якія адразу ж былі скіраваныя на заробкі валюты. Хаця, па вялікім рахунку, ганарыцца тут няма чым. Бо падобныя аперацыі ў краінах ЕС і нават краінах Лацінскай Амерыкі выконвалі ўжо больш за 30 гадоў таму.

Абавязкова скажуць, якімі павінны быць лекары: добразычлівымі, самаадданымі, уважлівымі, спагадлівымі, і г.д. Як быццам не такім ж павінны быць людзі ўсіх іншых прафесій, асабліва чыноўнікі самых розных рангаў. Але мець падобныя якасці лекараў абавязваюць так навязліва і зацята, што шмат хто пачынае бачыць у іх галоўныя прафесійныя праявы. Пра гэта сведчаць шматлікія пісьмовыя падзякі лекарам. Да прыкладу: «Хачу падзякаваць… за добрае стаўленне і кампетэнтную медычную дапамогу. Каб усе дактары і медработнікі былі такімі спагадлівымі, менш бы людзі і хварэлі» («НН» 16.04.2014).

Між іншым, у кожнага лекара ёсць два аўтарытэты — сярод пацыентаў і сярод калегаў. Аднак абодва гэтыя аўтарытэты далёка не заўсёды супадаюць.

Можна пагадзіцца з высновамі аўтара гэтай падзякі, калі слова «спагадлівы» замяніць на «ўважлівы». Бо сапраўды — 80% памылак у дыягностыцы і лячэнні абумоўлены няўважлівасцю лекараў.

А што або хто прымушае лекараў губляць уважлівасць у час сваёй «вельмі адказнай працы» і памыляцца? Зайдзіце ў любую паліклініку ці нават амбулаторыю, паглядзіце, што там творыцца, і вы адразу зразумееце, у чым справа. На прыёме ўвесь час нехта адцягвае ўвагу лекара, а ён засяроджаны на фіксацыі няведама чаго, і яму некалі ўдзяліць належную ўвагу пацыенту. Не на пустым жа месцы нарадзіўся такі анекдот: «Сучасная паліклініка — гэта такая ўстанова, у якой пацыенты перашкаджаюць лекарам працаваць з паперамі».

Ужо ў гады майго студэнцтва (1960-я) лекары былі заклапочаныя тым, што з-за пісаніны не могуць аддаваць належную ўвагу хворым. Потым, у выніку мадэрнізацыі справаводства, гэтая праблема была крыху вырашана. Зараз жа адбываецца тое ж самае, што ўжо было ў 1960-я гады.

Прычына даўно ляжыць навідавоку і добра бачная ўсім без выключэння. «Дачка (10 гадоў) зламала нагу… — паведамляе чытач «Нашай Нівы» (09.04.2014). — Наклалі гіпс на 3–4 тыдні… Але аказалася, што трэба кожныя 6 дзён ездзіць да траўматолага, каб… падаўжаць даведку аб вызваленні ад школы. Хоць гіпс раней не здымуць… І вось дылема: або цягацца з малой у няблізкую паліклініку… без аніякага практычнага сэнсу, або плюнуць… Зайшлі да загадчыцы: яна кажа, што такое правіла, і траўматолаг не мае права выдаць адну даведку на ўвесь час хваробы. Але тады чаго чыноўнікі з аховы здароўя наракаюць, што людзі занадта часта звяртаюцца ў паліклініку?» — слушна пытаецца чытач.

Прачытаў гэта, і адразу ўспомніў, як у першы год працы пасля атрымання дыплома да мяне з раёна прыехалі з праверкай два лекары, якія былі не намнога старэйшыя за мяне, амаль аднагодкі. У службовых паперах яны выявілі парушэнне: рабочаму саўгаса, хвораму фалікулярнай ангінай з абвастрэннем язвеннай хваробы страўніка, я выдаў бюлетэнь на 6 дзён (меў права — толькі на 3 дні). З маім тлумачэннем, што ганяць хворага па бездарожжы сюды-туды па 12 кіламетраў праз два дні на трэці ў той час, як яму трэба ляжаць у ложку, як мінімум, тыдзень (так нас вучылі ў інстытуце), гэта не лячэнне, а здзек і дадатковая рызыка развіцця ў яго ўскладненняў гэтых хвароб, правяраючыя пагадзіліся. Але «за перавышэнне паўнамоцтваў» я ўсё-такі атрымаў вымову.

У сваім бязмерным жаданні ўсё трымаць пад кантролем чыноўнікі ад медыцыны выдаюць супярэчлівыя клінічнай навуцы і не адпавядаючыя здароваму сэнсу пастановы і распараджэнні, якія робяць працу іх выканаўцаў бессэнсоўнай і нават шкоднай.

Падобныя пастановы і распараджэнні — галоўныя крыніцы непаразуменняў, канфліктаў і скандалаў паміж лекарам і пацыентамі, абцяжарваюць працу першым і ўскладняюць жыццё другім. Аднак відавочна, што ў гэтай сферы дзейнасці лекараў больш чым за 40 гадоў нічога не змянілася.

У часы перабудовы ў СССР пачаліся размовы пра больш сучасную і перспектыўную страхавую медыцыну, перавагамі якой ужо карысталіся ў большасці еўрапейскіх краінаў. А ў 1990-я гады ў Беларусі пра перавагі страхавой медыцыны ўжо гаварылі на поўны голас. Аднак ужо пасля 1994 года пра гэта забыліся. А зараз пра страхавую медыцыну ў нашай сацыяльна арыентаванай дзяржаве ўвогуле стараюцца не ўспамінаць.

Падобна, што надзеі лекараў на паляпшэнне ўмоў сваёй працы і павелічэнне сваіх мізэрных заробкаў у бліжэйшы час будуць марнымі. Што недахоп лекараў у сістэме аховы здароўя будзе толькі павялічвацца (калі ў 1970-я востры недахоп лекараў адчуваўся толькі ў раёнах, то зараз ён адчуваецца нават у сталіцы). Што лекары па-ранейшаму будуць «уцякаць з прафесіі». Калі ў 1970-я, каб пералічыць усіх «здраднікаў прафесіі» за некалькі гадоў запар, хапала пальцаў адной рукі, то ў нашы дні штогод 1100–1200 лекараў сыходзяць з сістэмы аховы здароўя, а яшчэ 140–160 выязджаюць за мяжу. І гэта адбываецца пры штогадовых устойлівых параўнальна высокіх конкурсах для паступлення ва ўсе медыцынскія ўніверсітэты краіны. Што, як і раней, лекары будуць вымушаныя ва ўзаемаадносінах з пацыентамі больш увагі аддаваць не пацыентам, а паперам. Бо ў адваротным выпадку будзе сабе даражэй.

Усё гэта толькі сведчыць пра стагнацыю ў дзейнасці сучаснай сістэмы аховы здароўя.

Самае ганебнае, прыкрае і крыўднае, што ўсе ўзнёслыя словы лекарам, прызапашаныя да іхняга прафесійнага свята, начыста забываюцца ўсімі, хто іх пісаў і казаў, адразу, ужо назаўтра, пасля свята. Да наступнага Дня медыка.

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