Realities of life at энц and as a doctor in Russia

Endocrinologists start their day at 9 AM and work until about 5 PM. Diabetes clinic might go until 8 PM.  Surgeons come to work at 7:30 or 8 AM. Operations start at 9:30 am and 2 or 3 procedures are done in a day.  Most doctors work at multiple hospitals, including operating at multiple hospitals.

Patients are admitted 1-5 days before surgery for workup. During this time, imaging, labs, and cardiology tests are performed or repeated.

All patients get an EGD before big operations (adrenalectomy, pancreas resection, modified radical neck dissection in older patients) to screen for peptic ulcer disease. If ulcers are found the operation is delayed to treat the ulcers.  Peptic ulcer disease is still quite common in Russia.

The regular inpatient rooms consist of 4 beds with no privacy curtains. There is a sink in the room. There is a common washroom at the end of the hall.
The doctors do not perform formal team bedside rounds on a daily basis but rather on a weekly basis.

Nighttime coverage at Endocrine Research Center (энц) consists of 3 doctors, a surgeon, an internist and an anesthesiologist. There are no overnight emergency admissions or consultations at энц.  

In Russia, 95% of doctors are women. However, fewer than 10% of surgeons are women. When we give lectures here at энц greater than 95% of the audience is female.

Patients wait for hours in the hallway outside of the surgeon's office for results of their labs or biopsies, or perhaps just to speak with the surgeon. Most of these consultations are unofficial.
Signs have been created to help patients modify their behaviors towards a more healthy lifestyle.
  

There is an electronic medical record, but everything is printed also and there is a paper chart that is kept for 20+ years in storage. 

Today we were told that the Russian government announced that they will reduce salaries for federally employed physicians in Moscow by 30%. We were also told that currently physicians in Russia have salaries that are similar to elementary teachers and waitresses in Russia. Doctors can also work in private hospitals for wealthy patients where they get a fee-for-service payment structure. In private hospitals doctors make more money if they see more patients, and if the order more tests, x-rays etc. Because of this, there are an excessive number of tests ordered and procedures per patient in private hospitals.