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Attempts to reform the health care system, unfortunately, bypassed key part of the industry - doctors, whose role is not disputed, but the actual daily practice is often ignored when making important decisions. Nevertheless, the doctor is the last line of defense of the population, whose health condition is approaching critical indicators. Effective system changes in health status requires accurate knowledge of the constituent components of everyday practice doctor and taking into account its views. Especially for outpatient doctors, most often in contact with the population. So, what is a one polyclinic doctor with whom the patient is found every day ?

According to a study in which polled about 1,300 physicians in 26 specialties 6 U.S. cities, about 40% of physicians at one time take more than 25 patients, with medical specialists for these numbers even more - more than 70% for dermatologists and 60% for neurologists. Slightly more than 63% of doctors can not be given to a patient more than 15 minutes. In addition, outpatient doctors are busy and on call, 48% of physicians load comes to 10 calls a day.
During this time, the average physician should assess the patient's condition and prescribe an appropriate treatment. About 43% of the physicians most often at one time co-administered three drugs (among cardiologists this figure reaches 58%), 37% of doctors prescribed at one time two drugs.

Interesting to evaluate what happens next with the prescribing physician. 21 % of physicians believe that patients always followed his appointment and about 75 % of physicians believe that often follow. Interestingly, the highest rates of strict adherence to the requirements marked for dermatologists (40%) and urologists (43%). And then already beginning to work largely economic indicators. 67% of their patients, doctors evaluated as poor, 31% as middle-income patients, and only slightly less than 2 % as horoshoobespechennyh. Win secured patients above dermatologists and gastroenterologists. As for the age estimates, the age of almost 77% of them are in the range of 40 years and older, with patients older than 60 years is about 25 %. Consequently, the picture would be incomplete without consideration paid medical segment. According to another study - 15 % of the population uses the services of paid medicine plus 10% and more to paid services dentist. Almost 9% use paid services therapist, gynecologist 3% and 2% of the cardiologist.

Returning to economic factors, the most tightly they appear on the most important part - choosing a treatment regimen doctor. Tracking study appointment of more than 800 drugs, we can confidently say that there is a gap between the catastrophic choice physicians most commonly prescribed drugs and their assessment of their therapeutic efficacy.
Below shows the top 10 most frequently prescribed drugs by doctors and the top 10 most highly effective for a number of pharmaceutical groups : cardiovascular, gastrointestinal, antibiotics, non-steroidal anti-inflammatory drugs, vitamins and minerals. As can be seen from the data, the number of matches is extremely small : the largest number of matches in this group - 5 drugs, 2 in gastrointestinal, cardiovascular, and vitamins, and one match in the group of antibiotics.

Causes and roots of these problems are obvious - we ( and the state, and end users ) are not rich enough to spend enough money for treatment. But the question can be put in another way, do we have the right to spend so little, especially as health announced almost a national priority. Actual practice only exacerbates the state of affairs. Introduction serious restrictions on vacation preferential drugs, reducing the list of subsidized drugs towards cheaper and most effective drugs, may in the short term lead to irreversible consequences. 40% of physicians share dispensed drugs at discounted lists up to 20 %. In the U.S., these figures are even higher. In conclusion, for the sake of completeness, you can refer to research lifestyle of doctors. As can be seen from the data presented, the doctors do not emit any social or professional optimism. Positive attitude to insurance medicine shows only 11 % of physicians in this case 58 % of physicians believed that fundamental changes are needed in the health system and only 2.4% of its fully satisfied.

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