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Thematic table of contents (Medical tales)
One of the troubles that befell the domestic healthcare system is poor doctors. Tired, twitchy, sleeping on the go and, to be honest, most of them are losing the required professional level. Technologies and medicines in modern medicine change very quickly, the “half-life” during which the set of drugs changes by half is about 5 years, and with overload combined with a shortage of not only time, but also money, there is no time for self-education. I don’t even want to talk about mandatory periodic cycles of advanced training – it’s profanation.
A joke that has ceased to be a joke is that a doctor works at one and a half times the rate, because if he works at one rate, then there is nothing to eat, and if he works at two times, then there is no time. In reality, the doctor works even more, since in addition to one and a half times his salary, he also takes night shifts.
At the same time, a balance was established between doctors and management. Since many doctors fled from the profession, a lot of holes were formed, which were filled with internal and external part-time jobs. On the other hand, one and a half rates allowed the doctor to somehow make ends meet. But such plugging of holes is of no benefit to healthcare, doctors or patients. A tired doctor who has not read specialized literature for 10-20-30 years is a bad doctor. But there are no others, if this one leaves, the new one will be even more tired.
But in Lately in Moscow (we are talking only about it!) the situation has changed radically. Moscow spends significantly on healthcare most budget than the regions (and the whole country, if anything, comes here for treatment using their own policies and referrals from the Ministry of Health and other pieces of paper that are not backed by money). Behind last years She not only tried to somehow rectify the situation with the equipment, but also fed the doctors with Luzhkov additives. Sobyanin continued the tradition. And so, this year the average salary of a Moscow doctor was 72 thousand rubles. Yes, of course, with one and a half rates and duty, of course, this includes the lion’s share of salaries and bonuses for management, but still...
And here, as in the well-known aphorism: when the wolves became full and the sheep were safe, the question arose - what to feed the sheep?
Doctors' salaries were raised to an amount lower than the Moscow average - up to 40 thousand. At one and a half rates and with shifts, they reached an average of more than 70. Now, instead of a hungry, ragged, tired and sleep-deprived illiterate doctor, we see a well-fed, well-dressed, tired and sleep-deprived illiterate doctor. I'm happy for the doctor, but what about the patient?
Previously, the doctor worked abnormally hard to make ends meet, now - because they pay well for it. So what to do next?
In most countries, a reasonable system has developed where doctors, on the one hand, are highly paid specialists, and on the other hand, they experience strong competition for places and must monitor their professional level. But the vicious system we have today cannot be broken overnight. Firstly, there simply is not the required number of doctors. Secondly, if we start creating a system for objectively assessing the level of training of doctors in their competitive struggle... with our fursenks from education, armed with the most advanced Unified State Examination... with a very peculiar structure of the population of Moscow, when many hospitals and clinics have already become almost mononational, and all of them from one village... In general, I feel that I will have something to write about for a long time...
This is the head of the central clinical hospital Khimki
The richest chief physician of the Moscow region was identified by specialists from the regional branch of the ONF, having studied the income declarations of doctors running district and regional medical institutions. He turned out to be the chief doctor of the Khimki Central Clinical Hospital, whose monthly salary was about 750 thousand rubles.
As MK learned, activists checked the income information of 277 doctors. It turned out that the average salary of the head physician in the Moscow region last year was about 200 thousand rubles. More than 100 medical workers senior management received 150 thousand rubles a month last year. The income of 57 people amounted to 190 thousand rubles per month, 26 - 230 thousand, the salary of 11 chief doctors reached almost 300 thousand, five - 380 thousand, two - almost 600 thousand rubles per month and two more - more than 700 thousand. “It is worth noting that the average salary of doctors, as follows from Rosstat data, is 48 thousand rubles,” said Alexey Maly, co-chairman of the regional headquarters of the ONF. - It turns out that the salaries of the heads of district hospitals are many times higher than those of ordinary staff. ONF activists will send a request to the Ministry of Health of the Moscow Region in order to obtain justification for such high incomes of chief doctors in hospitals in the region.”
The richest doctors in this ranking, in addition to the head physician of the Khimki Central Clinical Hospital, were the head doctors of the Reutov City Clinical Hospital, the Lytkarinsky Dental Clinic and the Lyubertsy district hospital. And the most modest incomes went to the head doctors of the Podolsk blood transfusion station, the Moscow regional anti-tuberculosis dispensary, the Klin dermatovenerological dispensary and the Royal children's psycho-neurological sanatorium.
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Doctors in many Western countries belong to the stratum of the richest and most respected people.
For example, in the United States, a doctor has an annual income of $200-400 thousand, and an hourly salary of $100-200 at daily norm A dozen patients here will surprise no one.
In this rating, experts from the Richest Lifestyle publication will talk about the 10 richest doctors on the planet who have amassed multimillion-dollar fortunes thanks to their professional or acting, entrepreneurial talent and Lady Luck.
10th place: Dr. Robert Rey, net worth: $15 million.
Robert Miguel Rey Jr., a famous plastic surgeon who has appeared on American television screens more than 100 times in various incarnations, a participant in the reality show “Dr. 90210". One of the best plastic surgeons in Beverly Hills. 
9th place: Dr. Leonard Hochstein, net worth: $20 million.
Dr. Leonard Hochstein is considered one of the best and most popular plastic surgeons in Miami, specializing in breast plastic surgery. Owns a successful private practice. 
8th place: Dr. Terry Dubrow, net worth: $30 million.
Popular plastic surgeon in Orange County, California, specializing in cosmetic and reconstructive surgery. Author of famous printed publications. He has appeared on the big screen in TV shows such as Real Housewives and Orange County. 
7th place: Dr. James Andrews, net worth: $30 million.
James Andrews has made a name for himself in the field of orthopedic surgery. Dr. Andrews hosts renowned athletes and runs his own Andrews Sports Medicine and Orthopedic Center. 
6th place: Dr. Phil, net worth: $280 million.
Thanks to Oprah Winfrey, Dr. Phil is now very rich and a famous person. Dr. Phil was hired by Oprah in 1995 as a consultant. He became a guest on “The Oprah Winfrey Show” and was very fond of television viewers, so they began to invite him to the program every week. 
It even got to the point that Oprah gave Dr. Phil the opportunity to host his own talk show, which is still on the air (Dr Phil Talk Show). Dr. Phil's annual income is estimated at $80 million. He is a doctor of psychology and, before his television debut, succeeded in making an excellent career in this field.
5th place: Dr. Gary Michelson, net worth: $1.35 billion.
Dr. Michelson made his fortune through his company Medtronic, which deals with high-tech medical devices. Dr. Michelson holds more than 250 patents. Being a great animal lover, he established the Michelson Prize for the invention of a non-surgical method for sterilizing cats and dogs. 
4th place: Wu Yiling and his family, worth $1.8 billion.
Self-taught doctor practicing traditional Chinese medicine, Wu Yiling can rightfully be called Lady Luck's favorite. After several years of successful practice, in 1992 he created his own pharmaceutical company, which produces herbal medicines based on ancient oriental recipes. The company is doing well, and this year Forbes magazine estimated his personal fortune at almost $2 billion. 
3rd place: Dr. Phillip Frost, worth $3.7 billion.
78-year-old American doctor and entrepreneur Philip Frost is the chairman of the board of directors of the pharmaceutical giant Teva Pharmaceuticals. In 1987, he founded the company Ivax (who remembers the Stopangin throat spray?), which he later sold for $7.8 billion. 
2nd place: Dr. Thomas Frist, Jr. and family, net worth: $7.9 billion
Thomas Freist Jr. worked as a military surgeon before founding a hospital conglomerate with his father. Today, Thomas Freist Jr. can safely be called a shark of the medical business. The doctor is engaged in buying and selling hospitals - his company earns $29 billion annually from this business. 
Dr. Frist is one of the key architects of the Affordability Act. medical care(Affordable Care Act) in the United States and has enormous influence on American health care policy.
1st place: Dr. Patrick Soon Shiong, net worth: $13.1 billion.
Dr. Patrick Soon-Shiong is an American surgeon born in South Africa. Prominent businessman, medical researcher, philanthropist, teacher at the University of California at Los Angeles. Has interests in the pharmaceutical business. 
Known for revolutionizing cancer therapy by thoroughly studying several of the most common types of cancer, including lung cancer and mammary gland. As a researcher, Dr. Soon-Shiong worked to solve the problem of rising costs medical services in USA.
Dr. Patrick Soon-Shiong is the wealthiest person with a medical degree on the planet. Forbes magazine also named him the richest man in Los Angeles.
: Master of Pharmacy and professional medical translator
“Our Berdsk is a city of one hundred thousand. Readers often write to us that they cannot get to a gynecologist, a therapist, or a pediatrician. The city is only 50% supplied with doctors. Why? Because they quit because of low wages, says the editor-in-chief of the Kurier newspaper. Wednesday. Berdsk” Galina Komornikova. - A couple of years ago, the doctors and I held a campaign “Tell us about your salary.” On condition of anonymity, they published the salary slips of our doctors. Not a single doctor who worked two hours earned double salary.”
What's next? And then the editors collected the doctors’ papers and sent them to the Ministry of Health of the Novosibirsk Region. In response, the regional health care department sent several receipts with a salary of 80 thousand rubles. Gentlemen, journalists, aren’t you ashamed to write this? Everything is fine in our medicine. And doctors’ salaries are growing regularly!
BRILLIANCE AND POVERTY OF CHIEF DOCTORS
IN RUSSIA AND THE USA, CHIEF DOCTORS RECEIVE THE SAME
“According to the Forbes rating, the first place in annual income in the United States is occupied by surgeons with an indicator of $219,000; second place - anesthesiologists with 212,000; third place - maxillofacial surgeons with 211,000; fourth place - orthodontists with 206,000; fifth place - obstetricians-gynecologists with 204,000; sixth place - general practitioners with 183,000; seventh place - other doctors with 174,000; eighth place - doctor general practice from $169,000,” writes Sergei Fedosov, co-founder of the ProDoctors project. - And only in ninth place are executive directors with $167,000.
Now let’s convert from dollars to rubles and get more than 5 million rubles per year, or about 450 thousand rubles per month. Now let’s compare the salaries of an executive director in Russia and the USA - they are almost the same!” In the States, the chief physician is called the executive director...
HOW DOCTORS DISAGREED WITH THE MINERS
Galina Komornikova approached Russian President Vladimir Putin with a proposal to regulate the difference between the salaries of a medical specialist and the chief physician.
“The solution is quite simple,” the president replied. - The manager can receive wages not higher than the average for the institution by a certain percentage.” Right? From the point of view of a doctor who treats patients, more than that. From the point of view of a manager, everything depends on the percentage, which should not be too small.
“If a miner’s salary is taken as “one”, then a line engineering and technical worker (ITR) receives no more than “two”, and the salary of an engineer top level(mine management, chief specialist) - at the “troika” level. I personally insisted that such a ratio should exist in the public sector: for doctors, teachers... We tried to resolve the issue at a tripartite commission between trade unions, entrepreneurs and administration,” recalls the chairman of the Russian Independent Trade Union of Coal Industry Workers, Ivan Mokhnachuk. - We were convinced that this was wrong, illiterate. After all, to lead - huge pressure! And the coefficient should be higher. Then we found a compromise at the “five” level. But then we were told that “five” was also not enough. You need at least “eight”. For some especially gifted people it can be indefinitely. Remember when the manager had a monthly salary of almost 3 million rubles?”
DOCTOR'S PENNY
“My salary is 20 thousand,” explains a doctor from Moscow. - And how much do you think I earn per month? Sixty! Everything else is extra. For my experience, I have had it for more than 30 years, and the incentive from the head physician is about 17 thousand.” Incentive payments are the same as a bonus. They can be canceled at any time if the doctor does something wrong in the eyes of management. For example, he will publish a bright photo from everyday work on social networks.
On the website of the project “Real Salary of a Health Worker,” doctors leave their salary slips. They are published without names, surnames and other personal data. The numbers are impressive. Today, the average medical salary in the specialty is 19,219 rubles 37 kopecks. With taxes - 22,091 rubles 23 kopecks. The salary for one position is 14,992 rubles 94 kopecks. An “arithmetic average” doctor receives... 99 rubles 47 kopecks per hour. Although he works more than he should - by 1.28 times the rate.
Approximately 45% of a medical worker's salary is his salary. A little more than the Moscow doctor with his one third. You still have to live to reach thirty years of experience. For a doctor's salary. People write to the project “Real Salary of a Health Worker” all the time. Here's some new information.
Endoscopist from the Sverdlovsk region. Salary - 6,997 rubles. The salary at the rate is 15,698 rubles 34 kopecks. As is the entire salary per month.
X-ray technician from Vladimir region. Salary... 4,413 rubles 20 kopecks. Salary per rate - 5,998 rubles 18 kopecks. The difference is only a thousand rubles. That's all the monthly salary.
Paramedic on an ambulance, Astrakhan region. The salary is slightly more than that of an x-ray technician. 4985 rubles 25 kopecks. The salary at the rate is 11,506 rubles 93 kopecks. Per month, for saving lives... 14,346 rubles! And thirty kopecks to boot.
Endocrinologist from the Ulyanovsk region. Salary - 6,782 rubles 60 kopecks. The salary at the rate is 10,851 rubles 51 kopecks. The same amount per month.
Another paramedic at the ambulance, Republic of Buryatia. Salary... 3464 rubles! The salary at the rate is 17,930 rubles 58 kopecks! For a month - 27,432 rubles 25 kopecks.
It turns out that human life is not valuable in our time?
AT LEAST A LITTLE BIT...
“When you said that healthcare funding would be “a little, a little” lower next year, I sank into my chair. We need “a little, a little” higher. Because the burden on the budget is growing with the same medical equipment,” Leonid Roshal, the “children’s doctor of the world,” director of the Research Institute of Emergency Children’s Surgery and Traumatology, addressed the president. - Previously, healthcare did not have ultrasound, CT, or MRI. Now we have it all. The laboratories are equipped, many reagents are available... Please do not reduce funding next year! But raise it at least a little.”
As for salaries... Is it worth convincing chief doctors to “moderate their appetites”? Perhaps the problem will be solved by an order that will establish “miner’s” coefficients?
P.S. The head physician - 450 thousand? Fine! But then the therapist, the neurologist, and the endocrinologist will receive 150 thousand rubles a month.
P.P.S. From myself: At the moment, the medical institution in my small provincial town lacks 19 doctors!
