Private clinics: business in the black, patient in the red?

The new head of the Ministry of Health Care Talantbek Batyraliev suggested to abolish the requirement of five years of service in a public hospital before a doctor will be able to work in a private clinic. The official considered this norm "intentional barrier to the weakening of the private sector."

What doctors think about this? Do patients agree with such a proposal? And if it is right for private clinics to hire doctors who don't have sufficient seniority and pay for hosting a lot of money? 24.kg news agency asked respondents about it.

Ainura Baimuratova, administrator:

- First of all I go to a doctor, and not in any particular clinic. It is easier to meet a doctor in a private institution than in the state one. It is more convenient to come by appointment when the doctor's waiting for you at the reception. And the conditions at private clinics are better, and the number of patients is not so big. The doctor knows everyone in the face. A qualification - the main condition. Many private workers simultaneously serve in state hospitals. Of course, we shouldn't allow hiring students to the clinic. Let them to work in a hospital for ten years after graduation.

Irina A., doctor:

- As far as I know, this rule is not working today. I know doctors who exactly haven't worked 5 years in the specialty, but they work in private clinics. Of course, it would be better if employees of private centers had experience. Otherwise, for what are they paid? Or will they learn on patients? But there is a small nuance: private clinics don't take seriously ill patients, they simply don't need them. There is no need to spend your time, feel the danger that your patient, God forbid, will die when you can have more simple cases and easy money? Private clinic, in general, is focused not for the treatment of patients, but for making money. Personally, I don't believe in private medicine in our country a priori. So who will take your money - young or old, there is no difference.

In order private medicine to be truly effective, it is necessary to change the approach to its development in principle. Prepare, perhaps, some more documents that would protect the health of patient from the perspective of private medicine and would regulate this area more seriously than it is today. In the meantime, what we have, those laws and verification commission can't ensure that such centers take all patients and even seriously ill ones. They even don't have such resources. I don't know any private clinic with good resuscitation team. The more you get sick, the more profitable it is for them.

So back to your question, what's the difference if you take clinic of poor quality hires doctor of the same quality?

Tatiana Martynova, accountant:

- I believe that the norm of a 5-year experience for a doctor still worth keeping to receive job in a private clinic. Although my experience has shown that sometimes young professional is quite good. Work experience in a public hospital - an invaluable experience, which is always useful to a doctor in the future work. It is clear that young doctor doesn't want to work for a song in the clinic or hospital. But here we must understand that if you want to earn good money, you should endure hardship. I, as a mother, in most cases, take my child to a private clinic. Not because the government is bad, but because for the working parent it is simply more convenient. But I'm still not ready to pay money for unskilled doctor to gain experience on my child and for my money (and the sum is big enough - a visit to doctor costs a minimum 500 soms). If I pay the money, I want to get quality service from a professional with a solid work experience.

Gulnara Tashibekova, chief doctor of Bishkek family practice center №17:

- If a person graduated from university and has a diploma, it is a fully functioning doctor who can work. When I got my degree, immediately went to the site and was fully responsible for what I did. Why a specialist must work in the state clinic at first, and then go to private? If you have a diploma and a place in a private hospital, it can work there. And why not? Working on emergency because of the shortage of doctors, I was forced to appeal to the then Minister with a request to cardiologists of the second year of clinical training in residency could work half-days with us.

If there is no pace in the state hospitals, for example, for surgeons, gynecologists, and private ones won't take them until they have enough experience, what should specialist do? Why do we have such outflow? Because there are no conditions for yesterday students. There are doctors who work only at 0.25 rate. What sort of work is this?! On the contrary, the young should be given opportunities, in order they could work. Experience and practice are gained over the years. For example, in order the doctor of ambulance station become skillful, he should work there at least 5 years. And in general, to become doctors, everyone should work in ambulance in order to know everything. All of our academics and professors had such practice.

Nargiza Amanturova, secretary:

-To be honest, I do not go to private clinics. The same doctors work in public. Yes, we have to wait in line, but it is worth the same service several times cheaper. The only thing - almost all experts give out to everybody a bunch of referrals for tests in private laboratories, some of which, as it turns out later, are not necessary. Everyone knows well that any doctor advertises and sometimes "strongly recommends" to visit some private lab.

Egor Borisov, resuscitation:

-I do not think that abolition of this position will play a big role. The administration of a private clinic will bring responsibility. If they are willing to do so and are responsible for their young specialist, let them do it. Private medicine - is primarily a business, and then medicine. It is voluntary. The question is that they need to provide quality services as taking money for it. If I ask for help as regular patient, I would choose an experienced physician, at least based on the fact that I pay money for it. But it is by no means impossible to detract from the fact that young doctors can be excellent specialists as well.

-Some regions, for example, don't have public clinics with high-profile specialists, because all have gone to private centers. People have to go to them...

-There is some sensible element to attract doctors in state institutions. But perhaps it should be done in other ways.

Dinara T., medic:

-This is completely wrong. You can not cancel this requirement. The young specialist graduated from the university, even if he studied for 7 years, but he almost does not have practice. For example, there are enough local doctors in maternity homes, none of them will allow the intern take delivery. He can stand by side. Especially they won't be allowed taking part in surgery. Surgeons, dentists - the same thing. It is dangerous to allow inexperienced specialist treating patients. After all, books - one thing, and real life - other. There is nothing to say about quality. And then, young people do not have a feeling of fear. It comes only with experience, when you realize that a patient's health may be at risk. No wonder people say: it is necessary to measure seven times before you start cutting.

The state institutions have mentoring, there are supervisors, who can be contacted to consult. And private clinics - separate state. A doctor, who has worked in a public hospital, may at any time address to his colleagues and no one knows who he is, where he came from. Therefore, I am against the proposal to abolish 5-year experience. Quality of patient care and patient safety will depend on it.

Kamchybek Isabaev, the President of the Association of Private Clinics:

-The requirement of experience - one of the unpleasant moments. Indeed, there are very intelligent guys who finish their studies, prodigies. But they have nowhere to work, state institutions have no vacancies. Specialists have to work at 0.25 rate. What kind of practice is it? And private centers have all the conditions for training young specialists. Why not to work with them? Especially directors of these private centers bear full responsibility for it.

It would be very timely and correct to cancel this norm. Any self-respecting private center will look at human resources and equipment first of all. They will look only for smart and competent professionals, being responsible for quality. He will not work at his own expense. And if we criticize each other, only health will lose then. A young specialist should have a choice - where to work.

Emil Isakov, a resident of Bishkek:

-private doctor will always find reasons to justify the prices and reduce threshold of liability. They will say that young professionals have no places to work, and once they were given a diploma, they are considered to be specialized doctors. All this is bare-faced lie. The country has thousands of vacancies in state institutions, in Bishkek - hundreds. But who wants to gain experience for a small salary, if you can make a patient pay through nose? But experience comes only over the years, and so in any industry. The requirement for 5-year experience of a doctor from private clinic served as a kind of protection of patients. If you take money, at least some guarantee of quality should be. But the Minister proposes to remove this barrier as well. Why does he take care of these clinics?