How Do I Get Medical Care In Russia?
Hopefully, your visit to or stay in Russia is free of health trouble. In any case, if, for any reason, you need to seek medical attention in Russia, here are some frequently asked questions about healthcare in Russia.
By Иосипенко Александр Даниилович (IosAD3) (Own work) [CC BY-SA 4.0], via Wikimedia Commons
1. Where Do I Go?
Most of what is called primary care abroad are delivered through a network of state-run facilities called поликлиника (“polyclinics”). It is basically a community-based clinic for people living in a certain neighborhood (район) that provides general practitioner/primary care physician (терапевт) services, specialist services, lab work (анализы), and medical tests (медицинские обследования). Some doctors, called участковый врач, will make house calls (this service is called вызов на дом) for those needing urgent care. If you have a health insurance policy (полис медицинского страхования, often just полис), many basic services will be free.
There are also private clinics (частные клиники) where you will likely have to pay, but the service may be more patient-centered. Больницы (hospitals) often specialize in a certain area of medicine and provide in-patient services (пребывание в стационаре) — people refer to being admitted to a hospital as “лечь в больницу” (being in [a] hospital is “лежать в больнице“).
2. Do I Need An Appointment?
You will normally want to make an appointment to see a doctor — записаться на приём/взять талон к + dative for a provider or записаться/взять талон на + accusative for a procedure. Талон refers to the literal slip of paper with the details of your appointment. You can make your appointment in person (лично) or over the phone (по телефону). Nowadays organizations may handle appointments electronically.
- взять талон к кардиологу — make an appointment with a cardiologist
- записаться на анализ крови — schedule a blood test
Electronic appointment terminal//Domowenock.cuzya [GFDL or CC BY-SA 3.0], via Wikimedia Commons
Walk-ins (приём без записи) are also available, especially for the терапевт or участковый врач mentioned above. However, the line (очередь) may be quite long. In this case, it is called живая очередь (a “live” line, meaning first come, first served) as opposed to приём по записи/по талонам (scheduled visits). To join the line, you would ask: “Кто последний?” (“Who’s the last person in line?”) and keep track of that person.
3. Where’s The Waiting Room?
Traditionally, you would need to first check-in at регистратура (check-in window), usually located on the ground/first floor of the building. There, the receptionist would either start or find your patient chart (завести or найти карту пациента, respectively), which have until recently been exclusively on paper.
Image from Martin aka Maha on flickr.com
You would then take your chart and go upstairs to find the room (кабинет) of the medical provider you are looking for. Sometimes the staff has the chart sent up to the office because they don’t want patients tampering with records (not very patient-empowering, I know). You would wait your turn in line in the hallway outside the office door. American-style waiting rooms (приёмный покой) where you are called in from are uncommon.
4. Which One’s The Doctor?
Once you are called into the doctor’s office/examination room (кабинет врача), you may see more than one person behind a desk. It could be that several doctors share the same room, in which case you will need to sit down on a chair closest to your doctor’s desk. It is also common that the doctor shares the room with a nurse (usually медсестра, masculine медбрат), who helps the doctor during the visit (приём).
The nurse may be taking notes, preparing equipment or medications, or helping the doctor with the physical examination. Which brings me to another important difference — the doctor will be much more hands-on than in medical systems with a greater division of labor. They may take your blood pressure (измерить давление) or even perform certain diagnostic tests (провести диагностические обследования).
One medical team is usually located in a single designated room and does not go from room to room to see different patients. Moreover, the entire team is normally in the room the moment you walk in, and no one will be coming or going during your visit.
5. How’s The Bedside Manner?
Russian customer service (here, сервис) in general often leaves much to be desired, and Russian bedside manner may be harsher than what you are used to. Much of the biomedical culture still presupposes that “doctor knows best,” although that attitude may be more patient-centered in private, paid facilities.
Image from TaylorHerring on flickr.com
It follows from this philosophy that patient privacy (личное пространство — “personal space” or конфиденциальность — “confidentiality”) and dignity (достоинство) take a back seat to treatment concerns. As a result, hospital gowns, knocking on the door, and telling the patient when you are going to touch them are uncommon, the thinking is “I’m here to help you; I’m a medical professional, so there is no need to be embarrassed.” In practical terms, this means you will likely be asked to undress for a physical exam (осмотр) or a procedure (лечение for “treatment” or обследование for “test”) with the doctor, other medical providers and even patients present and will not be offered anything to cover up with.
It also follows that patient comfort may be less of a concern, meaning that some procedures that are done under sedation (под наркозом) abroad, are routinely done on an awake patient in Russia. Upper endoscopy (ФГС) is one such procedure, where only the patient’s tongue is numbed. Once again, private clinics will likely have more patient-friendly standards.
On the positive side, it may be relatively easy for you to ask for and get a referral (направление) for tests and imaging studies like an MRI (МРТ) or EKG (ЭКГ), especially if you are willing to pay. Russian medical providers often think along the lines of “better safe than sorry.”
I hope this was helpful for you to learn how the healthcare system works in Russia. What was your experience like?
~Maria