Doctor op transcript. General practitioner - who is it? Activities of a general practitioner

Today, one of the most sought-after professions in medicine is a general practitioner. Almost every resident knows who he is. rural areas. The fact is that it is in villages that doctors of this specialty most often work.

General practitioner: who is he?

The main difference between doctors of this specialty and others is that they have basic knowledge in each section of medicine. However, they are not required to provide specialized medical care.

They must be able to solve relatively simple health problems and engage in the prevention of therapeutic, surgical and gynecological diseases in both adults and children.

Why are general practitioners common in rural areas?

It is in villages that you can most often find such a specialist as a general practitioner. All the villagers know who he is. General practitioners are most widespread in this area due to the economic inefficiency of building full-fledged medical institutions in each locality and providing work in it for large quantity doctors. From this point of view, it would be much more expedient to create small outpatient clinics staffed by a general practitioner (family doctor), nurse and a nurse. Such a recruitment of employees will allow the outpatient clinic to carry out full-fledged medical care residents of the region attached to it.

For those remote from large centers, a general practitioner becomes a real salvation. All residents of agricultural regions know who this is, because it is to him that they go first. He is capable of performing the simplest surgical and gynecological manipulations, and is familiar with the therapeutic pathologies of both adults and children.

How is a GP trained?

This specialist after graduating from higher education medical institution must complete an internship at one or more clinics. He needs to gain skills in therapeutic, surgical, pediatric, and gynecological profiles. As a result of such training, he becomes a specialist with general skills in diagnosing and treating diseases of any medical field.

How is the work of a general practitioner structured?

Prevention, diagnosis and treatment - all these are the main areas within which it conducts its professional activity general doctor. His work is based primarily on identifying among the population living in the area under his control the risks of developing certain serious diseases, as well as systematic activities aimed at counteracting their formation.

What does a specialist need to work?

A general practitioner's office should be equipped with a number of tools that help carry out initial diagnosis. We are talking about a phonendoscope, tonometer, glucometer, thermometers, spatulas, laryngoscopes, otoscopes, rhinoscopes, ophthalmological and gynecological equipment. In addition, the general practitioner's outpatient clinic should have the simplest surgical instruments.

Ideally, the outpatient clinic can also be equipped with a mini-laboratory. It greatly simplifies the work of a general practitioner. Those specialists in this field who do not try to equip their outpatient clinics have to constantly refer patients to regional medical institutions for simple laboratory tests ( general analysis blood, general urine analysis, biochemical blood test, etc.).

What services does a general practitioner provide to the population?

The work of this specialist is of great importance for the entire population served. Thanks to him, medical care becomes noticeably closer to people. Simple surgical procedures are performed in outpatient clinics. In addition, all conditions have been created here for injection (including in the form of droppers) administration of drugs. There is always a small bed capacity that allows patients to be placed in a hospital. That is, the patient can see a doctor and, if he deems it necessary, be treated without going to the hospital.

In large outpatient clinics, in addition to a regular specialist, a general dentist may also work.

If a person becomes very ill and cannot visit a doctor on his own, he has the opportunity to call him to his home. Moreover, most often a specialist of this profile attends such calls after lunch, and the appointment at the outpatient clinic is carried out before lunch.

Economic feasibility of outpatient clinics

Such institutions and the position of “general practitioner” (we have already found out who this is) were introduced not only to bring medical care closer to the population of rural areas. The fact is that it is also beneficial from an economic point of view. Firstly, there is no need to refer a therapist, gynecologist, surgeon, ophthalmologist, otorhinolaryngologist and others separately here. A general practitioner can handle all relatively simple problems. Those who present more serious complaints, or whose health condition causes concern to this doctor, are sent to higher-level health care institutions.

Prospects for the development of the profession in the future

Currently, a general practitioner (who is this, was described above) is not the most common, but at the same time very the required profession. This specialist is in demand in rural areas. At the same time, such a doctor saves the state significant funds, because in every locality it is not necessary to maintain a large healthcare institution in which a large number of doctors work. A general practitioner can handle many problems on his own. If the intervention of specialized specialists is required to combat a particular pathology, the patient will be referred to medical Center the corresponding profile.

In the future, a general practitioner may be re-registered as a so-called family doctor. This specialist is a doctor who specializes in medical care several families. He knows each of his patients very well. A small number of them allows him to delve into the problems of all his charges as deeply as possible. Family doctors are very effective method preserve the health of the population, but the activities of such specialists are possible only in conditions of a sufficiently developed economy. The fact is that wage such employee will consist of contributions from his direct patients. So the family doctor, if we talk about the widespread activities of such specialists, remains a prospect for the future. In many European countries, the institute of family doctors has existed for quite a long time and has proven its effectiveness. At the same time, the basis of the activities of such specialists is prevention and early diagnosis of any diseases.

In addition, the profession of a general practitioner himself is promising. Mobile complexes are now being created that can significantly expand the capabilities of a given doctor in the field of diagnosing certain diseases. We are talking about so-called specialized general practitioner cars. This complex includes a small laboratory, as well as a set for conducting the most important instrumental studies.

IN developed countries Most medical problems are resolved at an initial outpatient appointment with a general practitioner. A family doctor helps save not only patients’ time, but also money. In many cases, he is able to replace specialized doctors and even emergency care teams.

General practitioner - who is it?

When visiting a hospital with any symptoms, a person first tries to get an appointment with a therapist. At the same time, patients rarely ask the question: who is the general practitioner in the clinic? A family specialist also conducts consultations in medical institutions, but the scope of his activity is more extensive. Thanks to a consultation with such a doctor, you can quickly establish a diagnosis without unnecessary instrumental and laboratory tests.

Therapist and general practitioner - the difference

A qualified family doctor is a multidisciplinary specialist with knowledge in all areas of medicine. The main difference between a therapist and a general practitioner is the scope of his work. The responsibilities of a family specialist include more items. Unlike a therapist, the doctor described can perform the simplest diagnostic and therapeutic procedures, and the appropriate equipment is installed in his office.

General practitioner – qualification

The specialist in question first receives a basic higher medical education. Not all patients understand what a “general practitioner” means, confusing him with a therapist. Such a doctor has advanced qualifications. To obtain it, after a basic diploma and internship, you must complete a residency in the specialty “Family Medicine (General Medical Practice).” Hospital employees who received higher education before the introduction of the specified qualification, they can undergo accelerated primary retraining.

Where can a general practitioner work?

A family doctor is a universal specialty that allows you to get a job in both public and private clinics. While the work of a general practitioner is not appreciated in terms of material remuneration, many experienced professionals open their own consulting rooms. Some doctors only deal individual consultations one or more families.

The described specialist can perform various diagnostic and therapeutic procedures. A family doctor has not only a phonendoscope, a thermometer and a tonometer, but also other devices. According to the standard, a doctor's office should have all necessary furniture for the work of a specialist, a nurse and the following equipment:

portable electrocardiograph;
defibrillator;
express analyzers of urine, glucose, cholesterol, cardiac markers in the blood;
smokelizer;
pulse oximeter;
equipment for measuring physical indicators (scales, stadiometer, stopwatch, pedometer, medical tuning fork, etc.);
negatoscope;
spirometer;
artificial lung ventilation device;
peak flow meter;
tonometer for measuring fundus pressure;
sterilizers;
conicotomy kit;
dynamometers;
breathalyzer;
gynecological set, chair;
otolaryngological devices (tongue holder, mouth dilator, laryngeal forceps and others);
tracheotomy kit;
ophthalmoscope;
equipment for providing primary traumatological and surgical care (stretcher, wooden shield, crutches, ice pack and others);
otorhinoscope;
styling;
oxygen inhaler;
suction device;
bactericidal irradiator;
neurological equipment (hammer, light guide);
breathing tubes and apparatus;
sterile scalpels and other devices.

What does a general practitioner do?

A qualified family doctor provides any type of medical care on an outpatient basis. If a patient presents with a pathology that is not included in the list of what a general practitioner treats, he is referred to a specialized specialist. The doctor controls all stages of diagnosis and therapy of his “ward” and makes adjustments if necessary.

General practitioner - job responsibilities

Family medicine involves long-term systematic monitoring of patients’ condition, organization of consultations with highly specialized doctors and laboratory tests, inpatient treatment and disease prevention. The main responsibilities of a general practitioner:

collecting a detailed medical history of all family members;
thorough examination of patients using objective medical methods;
identifying specific studies and analyses;
establishing diagnosis;
entering all information into a personal card;
prescription of effective treatment, referral to hospitalization if necessary;
identification of risk factors for the development or exacerbation of chronic pathologies;
decor medical documentation(outpatient, sanatorium and resort cards, certificates, sick leave and others);
pregnancy management (rarely, more often this is done by a gynecologist together with a family doctor);
emergency assistance and consultations.

Necessary tests

and urine;
immunological and;
bacterioscopy;
biochemistry of urine.

If the basic set of tests is not enough, the family specialist will refer you for additional examinations:

hormonal panel;
blood test for sugar;
identification;
virology;
analysis for helminthic infestations;
cytology and others.

Types of diagnostics

There are many procedures that a family doctor performs - responsibilities include:

listening to heart sounds and respiratory tract sounds;
examination of lymph nodes;
percussion of the back and chest;
examination of the ears, larynx, nose;
palpation of the digestive and urinary system;
gynecological examinations;
diagnostics of the condition of the musculoskeletal system;
examination of the organs of vision;
neurological examination and other diagnostic procedures.

When to contact a general practitioner?

Any change in your health or physical condition, including pregnancy, may be a reason to consult with a family specialist. A general practitioner will not only make a preliminary diagnosis and give valuable recommendations, but will also develop an effective individual treatment regimen. If the identified disease is outside the scope of his competence, the patient is referred to specialists of the appropriate narrow profile, and a list of necessary laboratory tests is provided.

An experienced family doctor will help with the following symptoms:

high body temperature;
skin rash;
digestive disorders;
pain syndrome of any intensity and localization;
chronic fatigue;
insomnia;
deterioration of visual acuity or hearing;
the appearance of new moles or changes in the appearance of existing nevi;
shortness of breath, difficulty breathing;
dizziness, decreased concentration;
cough, hoarseness;
nasal congestion;
sudden jumps in blood pressure;
deterioration in performance;
unreasonable loss or unreasonable weight gain;
feeling of thirst, dry mouth;
tingling in the limbs, numbness;
limited mobility of the back and limbs;
neuroses;
depressive episodes and other symptoms.

In addition to treating existing diseases, a family specialist takes care of preventing the occurrence of pathologies. Standard doctor’s advice includes basic recommendations for leading the healthiest and most fulfilling lifestyle:

Get enough sleep. It is advisable to go to rest no later than 22-23 hours. Total time sleep is 8-10 hours.
Eat a balanced diet. The diet should contain vitamins, proteins, minerals, amino acids and carbohydrates. It is important to satisfy the body's daily energy needs.
Make time for physical activity. The minimum recommended by your family doctor is five to ten minutes of exercise in the morning.
Avoid emotional overload. Stress not only negatively affects the psychological state, but also impairs the functioning of the immune system.
Treat chronic diseases in a timely manner. In the presence of indolent pathologies, it is important to prevent their relapses by strictly following the preventive courses of therapy prescribed by the family doctor.
Attend regular checkups. It is advisable to undergo a complete examination once a year medical examination, consult a dentist or gynecologist every 6 months.

No need to go re-register sick leave, If:

there are notes in the margins of the sick leave if there is not enough space (cells) for the information clause 17 of the FSS Letter dated October 28, 2011 No. 14-03-18/15-12956 (hereinafter referred to as the Letter);
There are folds on the sick note due to the fact that it was folded.

New sick leave form approved By Order of the Ministry of Health and Social Development of April 26, 2011 No. 347n (hereinafter referred to as Order No. 347n) It has been in effect for more than a year, and everyone is more or less accustomed to it. But everyone is still worried about whether the Social Insurance Fund will reimburse benefits if there are shortcomings in the sick leave that the doctor made when filling it out? Although the Foundation social insurance and began to be more loyal to some of them; nevertheless, there are also errors in the sheet, in the presence of which it is necessary to require the employee to re-issue the submitted sick leave. What are these errors?

Let's show with examples. In the sample sick leave certificate, errors for which the Social Insurance Fund will refuse compensation for benefits are circled in red, and those for which you will receive compensation are circled in green.

(1) The doctor made notes on the sick leave with a ballpoint pen and blue ink. paragraph 1 Letters

(2) There are corrections on the sick leave clause 56 of the Order

(3) The seal of the medical organization got into the cells of the information field, and because of this the text is not readable clause 56 of the Order

(1) The sequence of indicating the address of the medical organization is not followed clause 58 of the Procedure, approved. By Order of the Ministry of Health and Social Development dated June 29, 2011 No. 624n (hereinafter referred to as the Procedure). It’s not scary - the FSS can identify a medical organization by its OGR N paragraph 8 Letters

(1) The last name, first name or patronymic of the employee is incorrectly indicated clause 57 of the Order

(2) The seal of the medical organization is not readable clause 56 of the Order

(1) The sick note is filled out in words or in capital letters and lowercase letters, and not in capital block letters and pp. 1, 17 Letters

(2) Characters fall on or beyond cell boundaries pp. 1, 17 Letters

(3) The name of the employing organization contains quotation marks, periods, commas, dashes, or the name of the organization is indicated that does not coincide with that accepted in the organization itself. In these cases, the FSS can identify the employer by registration number specified in the section “To be completed by the policyholder" paragraph 6 Letters

(1) The deadlines for issuing and extending sick leave were violated. In particular, in case of illness or injury, the doctor alone can issue sick leave to the employee for a period of no more than 15 calendar days. clause 27 of the Order

(2) In the “Physician’s position” line of the “Exemption from work” table, “doctor” or “attending physician” is indicated without indicating the specific position of the doctor (for example, therapist, surgeon, otolaryngologist) paragraph 10 Letters

(3) Notes on sick leave are not readable paragraph 17 Letters

(4) No seal of the medical institution or signature of the doctor pp. 56, 58 Order

(5) No chairman's signature medical commission in the “Doctor’s signature” column of the “Exemption from work” table in cases where:

<или>sick leave is extended for a period of more than 15 calendar days by decision of the medical commission and clause 27 of the Order ;
<или>the certificate was issued to an employee injured as a result of an accident at work, by decision of the medical commission and clause 32 of the Order

(1) There is a space between the doctor's initials. Even before the Order directly established that a space should only be placed between the surname and initials of the doctor and clause 57 of the Procedure (as amended, valid until 04/22/2012), the FSS attributed such a defect to technical ones that do not require re-issuance of sick leave paragraph 17 Letters

(2) There is no dash in the empty lines of the table “Exemption from work” paragraph 2 Letters. Or the print goes beyond the boundaries of the designated field, ends up in adjacent cells, but allows you to read the text indicated in the sick leave line paragraph 17 Letters

In any case, do not forget to study carefully appearance sick leave so as not to miss a perfectly filled out obvious fake. It may differ from the original certificate of incapacity in color (the original sick leave is blue), it is unlikely to have multi-colored fibers and watermarks and approved Order No. 347n. Doubtful sick leave does not need to be paid. The FSS will definitely wrap him up.

If an employee brought you a sick leave with some non-standard error and you do not know whether re-registration is required in this case, contact your FSS department for advice. And if you act according to their recommendations, then there will be no problems with compensation for such sick leave.

For example, in the event of temporary disability (due to illness of the employee himself) while the employee is on annual paid leave, the vacation is automatically extended for the corresponding number of calendar days or, by agreement with the employer, another period can be postponed. The employee must promptly notify the employer of the extension of leave and the reasons. If the incapacity for work occurs before the start of the vacation, then, by agreement with the employer, the vacation can be postponed to another time.

When a citizen is discharged after inpatient treatment, a certificate of incapacity for work is issued on the day of discharge from the hospital for the entire period of inpatient treatment. If temporary incapacity for work continues, the certificate of incapacity for work can be extended up to 10 calendar days.

The procedure for filling out the form for a certificate of incapacity for work

The line “subordination code” is required. The code included in it indicates territorial body The fund in which the policyholder is registered in this moment. The information in the “calculation conditions” line affects the calculation of the amount of the benefit and the duration of its payment.

If an error is made when filling out the form in a medical institution, then in this case the certificate of incapacity for work is considered damaged and a new certificate is issued in its place. If an error is made in the “filled in by the employer” section, then the erroneous entry is carefully crossed out, the correct entry is made on the back of the form of the certificate of incapacity for work, confirmed by the entry “corrected to believe”, the signature and seal of the employer. Errors may not be corrected by correction or other similar means.

Errors in sick leave: when to require an employee to reissue the certificate

(5) There is no signature of the chairman of the medical commission in the “Doctor’s signature” column of the “Exemption from work” table in cases where:

<или>sick leave is extended for a period of more than 15 calendar days by decision of the medical commission and clause 27 of the Procedure;
<или>the sheet was issued to an employee injured as a result of an accident at work, by decision of the medical commission and clause 32 of the Procedure

(3) The name of the employing organization contains quotation marks, periods, commas, dashes, or the name of the organization is indicated that does not coincide with that accepted in the organization itself. In these cases, the FSS can identify the employer by the registration number specified in the section “To be completed by the policyholder”, paragraph 6 of the Letter

General practitioner - who is it? Activities of a general practitioner

Currently, a general practitioner (who is this, was described above) is not the most common, but at the same time a very necessary profession. This specialist is in demand in rural areas. At the same time, such a doctor saves the state significant funds, because in every locality it is not necessary to maintain a large healthcare institution in which a large number of doctors work. A general practitioner can handle many problems on his own. If the intervention of specialized specialists is required to combat a particular pathology, the patient will be sent to a medical center of the appropriate profile.

It is in villages that you can most often find such a specialist as a general practitioner. All the villagers know who he is. General practitioners are most widespread in this area due to the economic inefficiency of building full-fledged medical and preventive institutions in each locality and providing work for a large number of doctors there. From this point of view, it would be much more expedient to create small outpatient clinics staffed by a general practitioner (family doctor), a nurse and a nurse. Such a recruitment of employees will allow the outpatient clinic to provide comprehensive medical care to residents of the region attached to it.

Filling out a sick leave form

Responsible persons when filling out sick leave are the manager and Chief Accountant organizations. They are the ones who sign the form. Filling out a sick leave certificate or checking that it is filled out correctly is the task of those officials, whose signature certifies the form. Responsibilities personnel worker may include entering some data on the sick leave: company name, insurance record and other non-accounting information. Job description The personnel officer must provide for these powers, otherwise it is unlawful to require him to fill out a sick leave form.

Below is the current official sick leave form for 2020. The form has not changed since 2011. However, from July 1, 2020, medical institutions began issuing temporary sick leave certificates to citizens. electronic format. Therefore, now the employee has the right to choose in what form to receive sick leave: in the usual paper form or in the new electronic form.

Filling out a sick note in a hospital

When sending persons injured in connection with a serious accident at work to sanatorium-resort treatment during a period of temporary incapacity for work, in the columns “From what date” and “To what date” of the “Exemption from work” table of the certificate of incapacity, the date of the start of sanatorium treatment is indicated in one line -resort treatment according to the direction of the medical commission; in the line “Stayed in a hospital” the length of stay in a sanatorium-resort institution is indicated.

in line "date 1" the date of change in the cause of disability, the expected date of birth, the start date of the voucher are entered - when sending tuberculosis patients on vouchers to specialized (anti-tuberculosis) sanatorium-resort institutions for treatment in the case when sanatorium treatment replaces inpatient treatment, as well as after-care after inpatient treatment, when a citizen is referred by a medical organization for treatment to a clinic of a research institution (institute) of balneology, physiotherapy and rehabilitation; when referred for follow-up treatment to specialized sanatorium-resort organizations (departments) immediately after inpatient treatment; when sending persons injured in connection with a serious accident at work to sanatorium-resort treatment during a period of temporary incapacity for work (hereinafter referred to as a voucher for treatment (aftercare);

All about certificates of incapacity for work

Article 83 of the Labor Code of the Russian Federation defines circumstances beyond the control of the parties, in connection with which employment contract subject to termination. In accordance with clause 5. Part 1 of Art. 83 of the Labor Code of the Russian Federation, such a circumstance is the recognition of the employee as completely incapable of labor activity in accordance with the medical certificate issued in accordance with the Issuance Procedure medical organizations certificates and medical reports(approved by order of the Ministry of Health and Social Development of Russia dated May 2, 2012 No. 441n).

Is the employer obligated to extend or postpone leave for an employee who has submitted a certificate of incapacity for child care? The period of incapacity for work began before the start of the vacation and ended during the vacation period. Article 124 of the Labor Code of the Russian Federation indicates that leave is extended or postponed in the event of temporary disability of the employee. Does this rule mean that leave is extended or postponed also in the case of caring for sick family members?

The FSS explained some of the nuances of filling out temporary disability certificates

If a doctor makes a mistake when filling out a sick leave certificate, he must issue a duplicate instead of the damaged form. The new sick leave must indicate that it is a duplicate, and the “date of issue” line reflects the day the new certificate of incapacity for work was issued. Such clarifications are contained in the letter of the FSS of Russia dated December 23, 2011 No. 14-03-11/15-16055.

In addition, the commentary letter explains the procedure for issuing sick leave for a long period of treatment for an illness, injury, or poisoning. From the provisions of paragraphs 11 and 13 of the Procedure for issuing certificates of incapacity for work (approved by order of the Ministry of Health and Social Development of Russia dated June 29, 2011 No. 624n; hereinafter - the Procedure), it follows that in such cases the doctor can independently determine the period of release from work with a frequency of 10 days, but no more 30 days in a row. After 30 days, the sick leave is extended by decision of the medical commission (until the day of restoration of working capacity, but for a period of no more than 10 months, and in some cases - for a period of no more than 12 months, with an extension frequency by decision of the commission no less than every 30 days) . That is, from the 30th day of illness, the certificate of incapacity for work is extended by the attending physician only by decision of the medical commission and for the period that it establishes. If the commission decides to extend sick leave, for example, by 30 days, then the attending physician must single-handedly formalize such an extension every 10 days (until the next meeting of the commission). In this case, with each extension of the certificate of incapacity for work, the signature of the attending physician and the chairman of the medical commission is placed in the “Doctor’s signature” column of the “Exemption from work” table.

How should a sick leave certificate be filled out correctly by a medical institution?

In the line “Was in hospital”, enter the start and end dates of inpatient treatment. If the illness requires a long stay in a hospital, then the citizen is issued a continuation of the certificate of incapacity for work. In this case, the first sheet is drawn up for presentation to the employer and receipt of benefits. In the initial form, instead of the date of return to work, code 31 (“continues to be ill”) is entered in the “Other” line. Such rules are contained in the order of the Ministry of Health and Social Development of Russia dated April 26, 2011 No. 347n.

The rules that a sick leave certificate presented by an employee must meet are spelled out in Chapter IX of the Procedure, approved by order of the Ministry of Health and Social Development of Russia dated June 29, 2011 No. 624n. Some features of filling out a sick leave certificate, which are not clearly stated in the order, are explained in letters from the Federal Social Insurance Fund of Russia dated December 23, 2011 No. 14-03-11/15-16055, dated October 28, 2011 No. 14-03-18/15- 12956 and dated September 14, 2011 No. 14-03-11/15-8605.

Disease codes on the certificate of incapacity for work

After being discharged from the medical institution, the person continued to work in the organization and an entry was made on his certificate of incapacity for work with code No. 6 “Performing prosthetic surgery in a hospital.” If he had simply suffered an injury that prevented him from performing his duties, then code 02 would have been entered.

An employee of the Malinovsky Klin organization, Ivan Ivanovich Ivanov, was at home, moving furniture. This activity was not related to his work. While carrying it, he made a careless movement and fell. Then he was taken by ambulance to the hospital, where he was diagnosed with a broken leg and was given prosthetics.

30 Jul 2018 760