I'm not happy with the doctor at the hospital. Does the patient have the right to choose a doctor in the clinic?

Current Russian legislation ensures that every patient has the right to choose a doctor and a medical organization. And, for sure, there will be citizens who want to take advantage of this right.

If many people have a more or less clear idea about paid clinics, then with budget institutions, many questions arise: where to go, what documents to collect and whether they can refuse to be assigned to another clinic.

And, as a result, ignorance of rights gives rise to doubts and uncertainty about the correctness of one’s actions or decisions.

To fully understand the situation, you should refer to the current legislation.

In accordance with Art. 21 of the Law of the Russian Federation of November 21, 2011 No. 323-FZ “On the fundamentals of health protection...” (Law No. 323-FZ), a citizen has the right to choose a medical institution.

Order No. 406n of the Ministry of Health and Social Development of the Russian Federation dated April 26, 2012 approved the “Procedure for a citizen’s choice of medical ...” (Order No. 406n).

However, paragraph 1 of this Procedure stipulates that primary medical (pre-hospital) health care is carried out directly on the principle of attachment to a specific territorial area.

This means creating areas that serve groups of people. People are assigned to the appropriate area based on the territory of their residence, work or study.

The sites are approved by the head of the institution, taking into account the principle of accessibility of services.

In particular, the number of sick people per unit of workers is taken into account. The recommended indicators are contained in clause 18 of the Regulations approved by Order of the Ministry of Health of the Russian Federation dated May 15, 2012 N 543n.

For example, on one therapeutic area 1,700 people should be observed in the city, and 1,300 citizens in the village.

If, for objective reasons, the required indicators are not achieved (in some regions there is a shortage of patients at the sites) and in order for citizens to exercise their rights to prefer one or another institution, it is allowed to attach persons who do not belong to the medical territory. institutions.

It is possible to implement your choice under certain conditions:

1. You can only select an establishment in the region where the person lives. Exceptions are made for some categories (military, convicted persons).
2. Only an adult has the right to replace an organization.

The rights of young or minor children, as well as incapacitated citizens, are represented by their parents or guardians.

To select a medical facility, you need to follow certain procedures:

• fill out a written application and present it to the organization where you would like to be registered;
• Having received the document, the clinic sends this information to the institution where the person is registered within two days;
• the latter checks the veracity of the information provided and, if the data provided is correct, notifies the organization that accepted the application, also within 2 days;
• within two days the applicant is informed about admission to the medical institution;
• then within three days the information is sent to insurance company and former honey. institution.

Correspondence between organizations can be carried out by post or using electronic means. The citizen is notified by any accessible ways: personally, in telephone conversation, using postal services, via electronic mailing.

For a correct understanding, it is worth noting that the principle of the applicant’s choice of another medical institution implies his automatic separation from the organization where he was previously observed. That is, it is impossible to be registered in two different institutions at the same time.

Contents of the application for choosing a medical organization

The document must indicate:

• full name and location of the addressee;
• Full name the chief physician of the organization to which the document is addressed;
• information about the applicant (gender, age, where he was born, what citizenship he has, passport details, place of residence);
• compulsory medical insurance policy number and the name of the insurer that issued the policy;
• information about the medical institution where the applicant is served.

When submitting an application, you must present the original documents at the same time:

• passport;
• compulsory medical insurance policy.

The full list of documents is enshrined in clause 5 of Order No. 406n. It depends on the status of the citizen. For example, a refugee must be provided with an identity card, and stateless persons must be provided with a residence permit.

The applicant must be informed which specialists provide primary care in the institution. He is also notified of the number of people who have chosen a specific health worker, indicating the territory he serves when making a house call. This information may affect right choice specialist

Selecting the one you need medical institution, the patient can also choose a doctor, but in this case the legislation has limited the choice (Article 21 of Law No. 323-FZ).

A person has the right to make a choice only in relation to:

• local therapist;
• area pediatrician.

The patient can choose a specialist independently, but mandatory condition– the doctor must give his consent (Article 70 of Law No. 323-FZ).

If a citizen decides to choose another specialist, the head physician is obliged to help him in exercising this right, according to the Procedure, approved. Order of the Ministry of Health and Social Development dated April 26, 2012 No. 407n (Order No. 407n).

In some cases, a doctor has the right to refuse to serve a patient if such refusal is not associated with a threat to his life. In this case, the manager takes measures to select another specialist for the patient from among the clinic employees.

And here the point is not even that the doctor is too lazy to treat the patient. Basically, such refusals are associated with the doctor’s heavy workload or the remoteness of the patient’s residence, and the employee, understanding his job responsibilities and assessing real opportunities, will not risk taking on an additional person for service, risking not providing him with assistance at the right time, since for this there is disciplinary liability, but also criminal liability.

Therefore, when deciding to replace medical staff, you need to act wisely and consider these circumstances. There are, of course, situations based on personal relationships, but these are separate, isolated situations.

How does a doctor change happen?

The attending physician can be replaced for the following reasons:

1. If a citizen decides to replace a doctor, he must contact the head of the organization with a written request. He must also indicate the reason.
2. Having received the application, the head physician informs about which specialists work in the institution.
3. Based on the information received, the applicant can decide who he would like to see.

The choice of a specialist should be approached responsibly.

The general procedure is not acceptable in all cases. Some individuals can only be served in a certain order.

Such citizens include:

1. Residents of closed territorial entities (ZATO), as well as territories with unfavorable conditions by physical, chemical or biological indicators. The list of such territories is approved at the legislative level. Thus, by Decree of the Government of the Russian Federation dated July 5, 2001 No. 508, such settlements were approved. For example, ZATO - the city of Mirny Arkhangelsk region, the village of Voskhod, Moscow Region, etc. The features of medical care for such persons are determined by Decree of the Government of the Russian Federation dated July 26, 2012 No. 770. Medical assistance to citizens for such persons is provided free of charge from among the Federal Medical and Biological Agencies (FMBA) located in the area where they live or Such people work. RF PP dated August 21, 2006 No. 1156-r approved organizations served by the FMBA of Russia.
2. Military personnel, conscripts, contract soldiers. Their service occurs according to the rules of Art. 25 of Law No. 323-FZ. Depending on their status, they can count on medical services in departmental health care institutions or in accordance with Art. 21 of Law No. 323-FZ.
3. Persons suspected of crimes or convicted citizens who are held in specialized institutions receive medical care in criminal and criminal institutions executive system(Article 26 of Law No. 323-FZ).

Interpretation of Art. 21 of Law No. 323-FZ allows us to assume that a patient can be treated free of charge only if he has a valid compulsory medical insurance policy.

In this regard, many may have a reasonable question: is it possible to exercise such a right in a paid clinic?

Law No. 323-FZ does not directly provide instructions regarding the choice of specialists or the organization itself when a person pays for services. However, this was not correct, because any system in the state should give a certain choice to people.

A citizen who wants to receive honey. service for money, you are free to choose the appropriate organization and, therefore, a specific doctor. Legislative norms do not limit citizens in this. As a rule, the “word of mouth” principle, reviews, recommendations about the clinic and their staff, as well as the cost of services play a role here.

When contacting a private clinic, the consumer is offered to enter into an agreement with all the ensuing conditions. And here the principle of freedom of transaction applies (Article 421 of the Civil Code of the Russian Federation), which does not allow any coercion.

Thus, if the patient is not satisfied with the clinic, he can safely go to another one. This is a kind of freedom of choice.

Rights of insured citizens under compulsory health insurance

Receiving free help is directly related to the fact that individuals. the person must be an insured subject under compulsory medical insurance. Because otherwise, using free services will be problematic. In a receiving relationship medical care Three entities are involved: individual, a medical authority and insurer.

The legal status of such entities is regulated by the Law of the Russian Federation of November 29, 2010 No. 326-FZ “On Compulsory Medical Insurance...” (Law No. 326-FZ).

Article 15 of Law No. 326-FZ specifies which entities can carry out activities within the framework of compulsory medical insurance.

These include:

• organizations;
• individual entrepreneurs.

The important thing is that they must be in the appropriate register.

The legal status of such persons is fixed in Art. 16 of Law No. 326-FZ:

1. Receive help for free.
2. Services are provided on the territory of the Russian Federation and the specific subject where the insured person lives.
3. Choice of insurer.
4. Choosing a medical institution and doctor.
5. Obtaining complete information about the services provided by clinics and hospitals.
6. Protection of the rights of the insured. This is a very important point, since not everyone knows that in case of violation of rights in the field of medicine, according to the state. guarantees, you can contact the insurance company specified in the policy. The functions of the insurer are reduced not only to issuing an insurance document, but to defending the violated rights of the insured.
7. Compensation for damage caused to individuals by both an insurance company and a medical organization. There is a lot of court practice in disputes regarding improper provision of services.

It should be recalled that all these rights are available to persons in the compulsory medical insurance system.

Confirmation of this status is a compulsory medical insurance policy, which is issued and changed in the prescribed manner.

When choosing a medical organization, you need to inquire about the existence of an agreement between it and the insurance company specified in medical policy. Otherwise, a refusal may follow.

Bringing mandatory information to citizens

Carrying out activities in the field of free medicine, such entities in mandatory must provide their clients with information about the medical institution itself, what services it directly provides, as well as about the staff of specialists, indicating their qualifications.

Information is posted on information boards near the registration desk. In addition, the law requires that this information be posted on the organization’s website.

What medical care can you get?

In accordance with the legislation, medical assistance is divided into types, conditions and forms.

Types of medical care:

• primary health care;
• specialized medical care;
• ambulance;
• palliative care.

Conditions for the provision of medical services. help:

• outpatient (in a clinic, at home);
• not at the location of the hospital building (the place where the ambulance or ambulance was called);
• V day hospital(under supervision during the daytime);
• in a hospital (under 24-hour supervision).

Forms of assistance:

• emergency (when there is a possibility of a person’s death);
• urgent (in case of an acute, sudden, unexpected illness, but if the person’s life is not in danger);
• planned (if the patient’s health does not deteriorate when treatment is delayed).

Providing this type of service includes preventive and diagnostic measures, as well as treatment of diseases. In addition, it involves monitoring women’s condition and carrying out measures to prevent epidemics.

This type of assistance is organized mainly on a territorial basis, that is, close to the place of residence, labor activity or patient education.

Such assistance is divided into:

• pre-medical (it turns out to be paramedics, that is, personnel with secondary education);
• medical (it turns out to be doctors);
• specialized (provided by specialists of a certain narrow focus).

Primary care can be provided:

• in an outpatient setting;
• on the patient’s territory if he lives in a remote area (not an ambulance);
• in a day hospital;
• in the office emergency care, which can be temporarily organized, for example, in gardening and summer cottages.

This assistance is provided by medical specialists.

It also implies preventive measures, diagnostic measures and treatment of diseases. However, unlike primary care, special techniques are required here, modern technologies, as well as subsequent rehabilitation. Therefore, such care is provided in a hospital setting or in a day care facility, so that it is possible to monitor the progress of the disease to the maximum.

Specialized assistance also includes high-tech assistance. Its peculiarity is the use of unique, complex treatment methods, the use of robotics and various techniques at the gene level.

To receive specialized care, you may need a referral from a general practitioner or pediatrician. The patient can also seek help independently. In this case, he has the right to choose a specialist and a medical institution himself.

When providing assistance as planned, the therapist gives a referral to a specialist. In the event that necessary help can be provided in several medical institutions, the attending physician must inform the patient about this so that he can independently select a specialist.

Receiving urgent or emergency medical care

This need usually arises if chronic diseases suddenly worsened, or the person fell ill and the malaise occurs in acute form. The service may also be needed in case of poisoning or injury, when urgent intervention is necessary.

In some cases, it is necessary to evacuate the victim, which is possible using an ambulance.

Basically, these forms of assistance are provided in inpatient conditions, since in most cases it is necessary surgery and monitoring the patient.

Palliative care is a comprehensive medical intervention aimed at relieving a terminally ill person of pain and improving their life.

Such cases, for example, include malignant tumors and progressive diseases. They are prescribed appropriate care, nutrition, transportation to medical institutions and back, pain relief.

Orders of the Ministry of Health of the Russian Federation dated April 14, 2015 No. 193n, No. 187n approved the corresponding rules for such assistance for adults and children.

Help is provided in a clinic or in a hospital.

The choice of a medical institution or doctor depends on the type of assistance.

Primary health care.

Article 21 of Law No. 323-FZ gives the citizen the right to choose medical care. organizations once a year, not more often. The exception is when the place of residence changes.

In the same institution, patients can choose a doctor once a year.

Such provisions were most likely established to prevent abuse of rights by consumers of services. Since there are categories of dissatisfied people who are ready to change clinics or specialists almost every few days. In this case, the law also protects the rights of doctors.

Specialized medical care as planned.

To get help, you need to take a referral from your doctor. It should be noted that if there are several medical institutions providing the necessary services, the doctor must notify the patient about this.

Emergency and emergency assistance.

Since these types of assistance are provided promptly, there is no specific time frame for selection. Because you need to act immediately.

A citizen can seek help in person by choosing an institution. In this case, most likely, the institution will not have the right to refuse assistance, taking into account the moral component, as well as the medical oath.

You can get help by calling an ambulance. Departure time special brigade is established by the relevant regulations approved at the legislative level. In this situation, the choice of institution will depend on who is ready to accept the victim.

Palliative care.

The attending physician, after appropriate diagnosis, gives the patient a referral for help.

How to assert your rights in case of refusal

In most cases, clinics or specific specialists are reluctant to hire new people for service, since this is not financially justified, but increases their workload.

Although the rights of citizens are enshrined at the legislative level, in practice people often face refusals.

Someone, not knowing the law, agrees with the registrar’s arguments regarding the impossibility of observation in this institution, since citizens do not belong to the territory served. And some, even realizing the violation of their rights, simply do not know what to do next.

Where to contact

Where to go for help:

• health authorities;
• health insurance institutions;

In case of refusal of choice under Art. 21 of Law No. 323-FZ, statements of claim demanding that the defendant be obliged to perform certain actions are filed in a court of general jurisdiction, a district or city court (not a magistrate’s court).

The claim is filed in court based on the location of the defendant, that is, the organization that refused.

The legislation does not contain the exact form of the claim; the main thing is to adhere to the requirements of the law regarding the details of the application.

The claim must include:

• name of the judicial authority;
• Full name the plaintiff and the organization, indicating their addresses;
• violation of rights;
• normative justification;
• proof;
• request to the court;
• list of attached documents.

In court, the defendant may be charged all the plaintiff's costs incurred in the case under consideration - postage, state duty paid, representation services (lawyer, lawyer). You can also file a claim for moral damages.

The claim is subject to consideration in a court session in which all persons in the process participate. Other interested parties, for example compulsory medical insurance authorities, may be involved in the case.

The court interviews the parties, examines all evidence and issues a judgment. If the outcome is positive, the defendant has the right to appeal. After which, the decision is considered to have entered into legal force and is subject to execution.

Since the defendant has information about the judicial act, re-application to the organization is not required. The defendant must voluntarily comply with the court's demands. Even if his representatives did not participate in the process, a decision in absentia is made and sent to the defendant’s address.

However, it is better to worry and contact the head physician again, presenting a judicial act, since the matter may be left to chance.

If the decision is not executed voluntarily, it is necessary to resort to a forced resolution of the issue by contacting the bailiff.

Judicial practice on the issue covered in most cases is in favor of citizens. As an example, the following judicial acts can be cited.

Case No. 2-4638/2017 (district court of Arkhangelsk).

The citizen filed a claim against budgetary institution health care about imposing the obligation to take her for care. At the same time, she indicated that she was suffering diabetes mellitus and is currently being observed in the clinic at the place of her registration, but there are no necessary doctors. She filed an application with the defendant, but was denied due to the excess number of persons served by one full-time specialist. Also, the reason for the refusal was the fact that the woman lived in an area not related to the medical service area. establishment.

The court considered the defendant's arguments untenable and indicated that Regulation No. 543n does not contain such a basis for refusal as the territorial principle.

The claim was granted. The clinic was obliged to register the patient and provide her with the necessary services.

Case No. 6445/2016 (Angarsk City Court).

The woman made a request to the chief doctor treatment center so that she can be assigned to this institution for service. However, she was refused this. The head of the organization motivated the refusal as follows: the institution has staff turnover, overload and staff shortages.

The court did not accept such arguments of the defendant, considering them not based on the law.

The judgment was rendered in favor of the plaintiff.

In some cases, it is not the citizens themselves who turn to the courts. Their rights are defended by supervisory authorities.

This is confirmed by a court decision.

Case No. 2-3623/2016 (Anapa City Court).

The prosecutor filed a lawsuit in the interests of citizens and asked that the inactions of the city hospital, expressed in the failure to provide information on the institution’s website about doctors and their qualifications, be declared illegal. This was discovered as a result of the audit. Thus, according to the prosecutor, the rights of potential consumers of services are violated, since they cannot fully exercise the right of choice provided for in Art. 21 of Law No. 323-FZ.

The court agreed with the plaintiff and ordered the hospital to post the relevant information on the hospital’s official website on the Internet.

There are also negative court rulings. However, these are individual cases and the courts in such disputes take into account all the circumstances.

For example, in one of the civil cases, the court’s position was different than in those described earlier.

Case No. 2-4206/2017 (district court of the city of Chelyabinsk).

The plaintiff filed a lawsuit demanding that she be registered with clinical hospital. She indicated that she was not attached to any institution, but needed medical care. The defendant objected to the claim, citing that the woman’s territory did not belong to the hospital. In addition, the number of population served exceeds established standards. The woman was assigned for observation to another hospital in the city.

The court rejected the woman's demands. When making its decision, the court took into account that at the time the citizen filed her claim, her rights had not been violated. She was assigned to another hospital for service. The woman herself also explained that it doesn’t matter to her where she gets help, as long as she can do it.

Court of Appeal practice

Appellate courts generally uphold first instance decisions. In support, you can submit a ruling of the appellate authority.

Case No. 33-1492/2015 (Arkhangelsk Regional Court).

By the decision of the city court, the plaintiff’s demands were satisfied, in particular, the court decided to assign the patient to a clinical hospital medical center. The defendant did not agree with the court decision and filed an appeal to a higher court.

However, the second instance agreed with the arguments set out in the decision of the city court.

In addition, in the case the defendant was awarded compensation for moral suffering.

Supreme Court of the Russian Federation

A judicial act declaring certain regulations illegal.

Case No. APL15-354.

The citizen's case reached the Supreme Court. Her goal was to recognize clauses 10 and 11 of Order No. 406n as illegal, namely, she considered it illegal not to be able to be assigned to two medical institutions at the same time and to have two patient cards. She argued her position by the fact that the parents live separately, and the daughter periodically stays with her father and then with her mother. The rules established by law violate the principles of family law. In particular, the responsibility of both parents to monitor the health of their children.

The Supreme Court upheld all judicial acts adopted in the case, without thereby recognizing the clauses as illegal, indicating that they do not contradict the Constitution and current legislation. He also explained that the norms of the Family Code of the Russian Federation do not regulate relations in the field of medical activities.

To summarize, it should be noted that in modern reality there are quite a lot of people who want to replace a doctor or medical organization. This may be explained for various reasons, such as distrust of a specific specialist or a medical institution in general, unsatisfactory quality of services provided, or even purely objective factor– personal attitude towards the doctor. And the law in this situation is on the side of the citizens. However, when making such a decision, you should weigh the pros and cons. Because this step can literally affect your health. It is necessary to take into account both the workload of the staff and the distance of the institution from the patient’s place of residence. After all, it is not always possible to get there on time, both on your own and to the doctor, if he is called to your home. Therefore, the problem must be solved rationally and thoughtfully.

Dr. Matsko is a retired physician from Pittsburgh, Pennsylvania. He graduated from Temple University School of Medicine in 2007.

Number of sources used in this article: . You will find a list of them at the bottom of the page.

Sometimes there is a need to change doctors. Often this has to be done due to circumstances, for example after moving, but sometimes such actions may be the result of the patient’s dissatisfaction with the doctor. Whatever the reason for wanting to change a doctor, the process of finding a new one requires time, attention and research.

Steps

Part 1

Determine when it's time to change doctors. Changing doctors is a big decision. Sometimes changing a doctor becomes simply a necessity. For example, if you or your doctor are out of town, you may need to find a new one. Unfortunately, sometimes a neglectful attitude or poor performance by a doctor of his duties can push you to the decision to change him. You should consider finding a new doctor if you encounter the following situations:.

Decide what you will tell your former doctor if something happens. When you decide to change doctors, decide whether you need to explain the reasons for your actions.

Ask your doctor who he can recommend for you. Sometimes changing doctors is not the result of a bad doctor-patient relationship. If you have good relationship, best advice When looking for a new specialist, you won’t find anything your doctor can provide.

Part 2

Find a replacement

1. Ask your friends. Seek advice from people you trust, such as friends or family members, as you search for a new professional.

   Search the Internet. Today there are many ways to find a doctor online. This can be especially useful if you are not yet knowledgeable in a given area and have no one to turn to for advice.

   Make your first appointment. Once you have found the doctor you think is right for you, make an appointment as soon as possible. There you can discuss your medical history and specific needs.

2. • Be honest with yourself. Did you feel comfortable in the doctor's office? Has your new doctor made the same mistakes as the previous one? You don’t want to rebuild again and leave with unresolved problems. If you are unhappy with the result, continue to look for the right doctor.
   • Was your doctor able to find an individual approach to you and understand specific medical problems? If your doctor doesn't have enough experience to help with your situation, keep looking.
   • Was the doctor patient and respectful with you during the visit? It is the lack of attention from the doctor that causes the desire to change specialists. Evaluate your conversation with your new doctor and determine if anything hurt your feelings during the conversation. You don’t want to repeat past mistakes again.

Part 3

Adaptation to change

1. Make sure your insurance covers this specialist if you come to the clinic. Without insurance, medical care can be very expensive for you. Make sure the doctor can accept your insurance plan.

   • You can call your insurance company or check online. Often, you can even find doctors through your insurance company. This is a great way to make sure your insurance will cover your treatment.
   • If you have questions about your insurance package and additional doctor fees, check with your insurance provider before visiting the doctor. You don't want to receive an unexpected bill a month after your visit.

Medical care must be of high quality and affordable. That's what it says in the Constitution. But in practice, achieving the quality services promised by the state can be difficult. We use examples to explain when and how to assert your medical rights.

MARIA RUSSKOVA

carried out a diagnosis of laws

How to return medicine to the pharmacy?

Situation. Vasily bought it at the pharmacy. But when I came home, I discovered that there were 12 tablets in the blister, and, according to the information on the package, there should be 10. And there were no instructions in the box at all.

Solution. According to the law, the buyer has the right to return “medicine of inadequate quality”:

with torn, wrinkled, wet packaging;

with an expired or missing expiration date on the packaging;

without package insert or with instructions for another medicine;

if the properties of the drug do not coincide with the description of its color, smell and taste, quantity from the instructions.

Refund for poor quality medicine before its expiration date. If it is not indicated or has been erased - within two years from the date of purchase.

Don't forget the receipt. The money must be returned within 10 days; if not, contact the Rospotrebnadzor office at your place of residence. Call the department or make an appointment. They will help you draw up a statement of claim and protect your rights in court.

If everything is in order with the medicine, then you will not be able to return it to the pharmacy and get your money back. This rule protects not the pharmacy, but other buyers: this way you can be sure that the drug was not in the wrong hands and was stored in correct temperature and humidity.

What laws regulate

How to change your attending physician?

Situation. Nikolai was hospitalized with pneumonia. On the very first day, he met the doctor who took care of all the patients in the ward. Nikolai didn’t like the doctor - he was rude and answered all questions through gritted teeth, reluctantly. From the complaints of neighbors in the ward, it became clear that a constructive dialogue was not expected in the future.

Solution. Every patient has the right to choose their attending physician. It is not necessary to tolerate rudeness, indifference or illiteracy; you can change doctors at any time (except perhaps in the middle of surgery). If contact with the doctor does not go well or he cannot devote enough time to you due to his workload, write a statement addressed to the chief physician. The statement must indicate the reason for your dissatisfaction.

By law, within three days chief physician or the head of the department must familiarize you in writing or orally with the list of available doctors of the same profile, their work schedule and provide you with the right to choose. In practice, a decision must be made quickly: it is not profitable for the hospital for the patient to occupy a bed uselessly.

You can immediately indicate in the application who you want to receive treatment from. Keep in mind that the doctor also has the right to refuse the patient. Therefore, it is better to agree in advance with the doctor you like.

You can change not only the doctor, but also the medical institution itself. You have the right to choose any of the clinics,

who cooperate with your insurance company,

have the necessary capabilities to diagnose and treat your disease.

The institution has the right to refuse - if the hospital has run out of quotas for certain type operations, and the clinic has exceeded the limit on attachments. It is better to ask for a refusal of attachment or hospitalization to be formalized. Sometimes after this it turns out that there are still places.

What laws regulate

Often the issue of replacing the attending physician in a hospital can be resolved during a personal conversation with the director. If the head is not there or you understand that the issue has not been resolved, write a statement addressed to the head physician.

And you can not only change the medical organization, but also choose it. You have the right to get on the waiting list at any clinic in your region according to the desired profile; moreover, many leading clinics in Moscow and other regions willingly invite patients from all over the country for treatment.

How to receive compensation for poor-quality treatment under compulsory medical insurance?

Situation. The boy Vanya broke his leg while riding a bicycle. His parents took him to the emergency room, where the doctor put him in a cast and sent him home to recover. But a control x-ray showed that the bones had not fused together correctly, and Vanya began to limp badly. The parents decided to go to a private clinic.

Exit. Doctors are responsible for causing harm to life and health and poor quality medical services provided. Including - for services provided within the framework of compulsory medical insurance.

If treatment has affected appearance or otherwise harmed health, this is a violation of the patient’s rights. You can claim compensation:

lost earnings (if a child was injured, the earnings of the parents);

moral damage;

all costs of treatment (including incorrectly prescribed treatment and treatment of complications, if any);

costs for additional food (if the doctor has prescribed a special diet);

costs for the purchase of medications, prosthetics, and the services of a nurse or attendant;

cost of sanatorium-resort treatment;

costs for purchasing special vehicles, preparation for another profession.

What documents to collect

agreement for paid services (if you were treated at your own expense);

checks confirming the fact of payment for any additional services related to the disease ( spa treatment, acquisition of special equipment, outside care);

copies/extracts from medical card, medical history, prescriptions;

receipts confirming the purchase of medicines;

tickets and payment documents for travel expenses;

documents and payment documents for accommodation (if you needed to go to another city for treatment).

First, contact your insurance company. If required, provide supporting documents and file a claim using the form established by the insurance company or the sample provided above. This may help resolve the problem without going to court.

It also makes sense to start negotiations with the insurance company if you were not cured (or made worse) as part of medical care under compulsory medical insurance, and after that you did not go to private clinics. Perhaps experts from the insurance company will offer you free help instead of poor quality.

If it doesn’t help, solve the problem in court. File a claim in your district court. You can compensate for damages for cases that occurred within the last three years.

What laws regulate

How to get money back for poor-quality treatment in a private clinic?

Situation. Elena treated caries in private dentistry. A few days later, the tooth hurt again, my cheek became swollen, my temperature rose, and I had to go on sick leave. Elena returned to the clinic to complain, but the administrator refused to accept her complaint and said that the clinic had nothing to do with it.

Exit. Your subjective impressions of treatment are not an argument for the clinic administration or for further proceedings in court. If treatment does not produce results or you feel worse, contact your local physician or a doctor from a private clinic and receive a written report on your condition.

With it, you have the right to demand from the clinic:

return money for poor-quality service or reduce the total cost of services;

compensate for losses due to loss of ability to work;

compensate for moral damage;

repeat treatment;

reimburse the costs of correcting deficiencies in treatment (if you had to go to another clinic).

To do this, write a claim in free form. Attach an extract from your medical record or a copy of your sick leave.

If there is no dialogue with the clinic, go to court. TO statement of claim Attach all collected documents.

What laws regulate

How can I get free treatment in a private clinic?

Situation. Galina Stepanovna has a small pension and bad teeth. But treat them in state dentistry she is afraid. There are many private clinics near the house, but the prices are high.

Exit. In fact, private clinics - including dental ones - provide services free of charge, under compulsory medical insurance. Check this point on the clinic’s website or by phone. If the dentist has an agreement with your insurance company, your teeth will be treated for free.

Free services for compulsory medical insurance policy in private dentistry:

treatment of caries, pulpitis, gingivitis, abscesses,

Preventive teeth cleaning to remove tartar every six months.

The situation is the same with private clinics of a different type: it is often beneficial for them to cooperate with the state, receiving a stable influx of patients with compulsory medical insurance policies. This way you can find yourself a private gynecologist, surgeon or ENT specialist. Or undergo a course of cardiac rehabilitation after a heart attack at the expense of the insurance company.

If a private clinic accepts patients under the compulsory medical insurance policy, this does not mean that all its services are free. For example, in a particular clinic you will be able to consult a cardiologist at the expense of compulsory medical insurance, but you will not be able to go to a gynecologist for free, even if they have one on staff.

To find out for sure, find a list of state-guaranteed procedures and tests in the territorial compulsory medical insurance program on the website of the local branch of the Ministry of Health. And at the clinic, check which services are covered by the institution’s contract with the insurance company.

Many private clinics provide certain services under the government guarantee program. For each such clinic, the Compulsory Medical Insurance Fund allocates quotas - the number of visits or studies that the state will pay for.

There is another interesting option. A number of medical organizations create compulsory medical insurance+ programs, under which you can receive any assistance in private clinics, but with a fixed additional payment per year and within the framework of a contract. Check if there is a Compulsory Medical Insurance+ program in private clinic, which you like.

To find out what services are available under compulsory medical insurance, call:

on hotline Roszdravnadzor: 8 800 500-18-35,

to the insurance company: the number is indicated on your policy,

to the department for the protection of citizens' rights Federal Fund Compulsory medical insurance: 8 499 973-31-86.

What laws regulate

How to obtain medical information about a relative's health?

Situation. Ilya was hit by a car, and he was taken away from the scene in an ambulance. Ilya’s girlfriend Nastya called the hospital to find out how he was feeling. But doctors said that this is a medical secret. Then Nastya went to the hospital herself, but she was not allowed into the intensive care unit: Ilya had not yet recovered from anesthesia after the operation, so the doctors could not get his consent to meet with anyone other than family members.

Exit. Doctors really do not have the right to disclose information about a patient’s health to anyone without his consent. Moreover, over the phone. Visits are also agreed upon with the patient. If he is unconscious and has not had time to give orders in this regard, then only “official” relatives can be allowed to see him: parents, brothers, sisters, adult children, legal spouse.

If you need health information loved one, the concrete way to get it is to issue a power of attorney from a notary. But sometimes an ordinary power of attorney drawn up without a notary is enough for the registry. Therefore, it makes sense to clarify this point in advance in a specific clinic.

But if your loved one is often or seriously ill, it is easier to immediately issue an official power of attorney. This document will make you the patient's representative in health matters. If necessary, you will be able to give consent on his behalf to medical procedures, choose a doctor and medical institution, receive full information about health status, complain about poor quality services and resolve any other issues.

Unfortunately, the issues of obtaining documents are not sufficiently explained by our legislation. It is important to distinguish the following types documents: medical reports, certificates, copies of medical documents.

Medical reports are issued to citizens based on the results of medical examinations, medical examinations, clinical examination, decisions made medical commission. Order of the Ministry of Health and Social Development No. 441n of 2012 established that such conclusions must be issued within 3 working days.

Wait for access to others medical documents will have to take up to 30 working days in accordance with 59-FZ “On the procedure for considering citizens’ appeals Russian Federation" In exceptional cases, the period may be extended by another 30 days.

Practical advice: ask for a medical report, indicating in the application a link to the deadlines specified in order 441n. If the document you require is definitely not a medical report - a medical card, x-ray, copy of the analysis - try to come to an agreement. More often medical organization issues documentation within a few days if you request it in writing.

Who must give consent to medical procedures?

Situation. Sonya's daughter is a schoolgirl. Returning after school, the girl said that a nurse came to their class today and took blood from all the children from a finger for some kind of analysis.

Exit. Everything that concerns your child concerns you, therefore, medical intervention is unacceptable without parental permission. Exception - emergency, When we're talking about about a threat to the patient's life.

A necessary condition for tests and generally any other medical procedures regarding your child is voluntary consent parents or legal representatives in writing. In this case, the parent (representative) must be informed about the goals and methods of medical intervention, consequences and expected results.

If medical procedure child was carried out without your consent and you are against it - file a complaint with the department of health and department of education at your place of residence to bring the perpetrators to justice.

It is better to submit the complaint in two copies, one of which, with the authority’s mark of acceptance, will be kept as confirmation of the fact of the appeal. The request must be responded to within 30 days.

What laws regulate

What other situations are worth knowing about?

If you have questions about health care or your rights in this area, please send them to us at [email protected]- we'll help you figure it out.

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