From Russia With Public Health Questions

From Russia With Public Health Questions

A different perspective on health care.

Oct. 18 is a significant day in Russian/U.S. relations. On that day in 1867 the Russian flag was lowered and the stars and strips were raised in Sitka, Alaska. It marked the transfer of ownership of what was to become number 49 of the United States.

One hundred and thirty seven years later, Oct.18, 2004, four Russian doctors and their Russian facilitator began a week-long visit in Alexandria under the sponsorship of the Alexandria Rotary Club as a part of Rotary International's Open World Program. They were here to compare their health system with ours, both from a public and private perspective.

"We liked the fact that there were no closed topics. We could ask questions on any topic and we would get answers. We have even been able to ask questions on sensitive political topics," Andrey Semenov, M.D., a district specialist in Dermatology and Sexual Transmitted Diseases, Konakova District Central Hospital, said.

"But, basically we have concentrated on issues relative to our specialties," Tatyana Ryzhenkova, M.D., oncologist and Chief of Outpatient Services, Magadan Region Cancer Treatment Center, said.

She came from the far eastern region of Russia, only two hours from Alaska.

"In some cases I send patients to Alaska for treatment rather than Moscow. I am more than eight hours flight time from Moscow," she said.

The two other physicians in the group were Nikolay Luginov, M.D., physician/ultrasound specialist, Hospital #1, National Medical Center at the Sakha Ministry of Public Health and Nikolay Tikhomirov, M.D., senior doctor, Municipal Medical Emergency Services and a cardiologist. They were accompanied by their Russian facilitator Pavel Pavlov, a biomechanics teacher and senior researcher at Kursk State University.

DURING THEIR STAY in Alexandria they spent time at both the Alexandria Department of Health and Inova Alexandria Hospital. "It worked out very well. We had them for a full day and we concentrated on our activities in public health," Dr. Charles Konigsberg, Jr, director, Alexandria Health Department, said.

"We really highlighted our activities in emergency preparedness and disease control. Plus we gave them a thorough tour of our new facilities and they were able to visit the Casey Clinic," Konigsberg said.

"It was interesting to note that they [Russia] rely more on primary care physicians than on specialists as we do," he said. "Their constitution also states that every Russian citizen has the right to health care."

When it came to their IAH visit, the physicians had an opportunity to view all physical aspects of the hospital and were able to meet with an array of staff to get first-hand information on topics of interest to them, Kenneth Kozloff, IAH administrator and IHS vice president, said.

"They had a very fulfilling experience here at the hospital. They saw so many things that they were not used to at a community hospital back in Russia," Kozloff said. Overall, they spent two days of their visit at the hospital.

"We were particularly impressed by the ‘sleep disorder treatment’ program. We have nothing like this back home," Luginov said. To which Kozloff added jokingly, "That's because it's more peaceful there." Luginov said he comes from one of the coldest places on earth. At one time it dropped to minus 72 celsius.

SEMENOV VIEWED the Public Health Departments as "the engine that pushes from behind to create all health care systems. It's a very important and much needed department."

In comparing the two health care approaches, ours and theirs, they agreed, "Both have pluses and minuses. Health care in Russia is accessible to every Russian. Every Russian has more primary care options than Americans."

When it comes to public health care system services, they said, "The Russian public health system has more influence over health policies and procedures than here." But, they also agreed the U.S. system is more advanced in high technology. "The U.S. system is more like a layer cake with greater achievements in high technology," they said.

The one thing they don't have in Russia, the group noted, was a shortage of physicians in the rural areas of their country. They attributed this to the relative equalization of physician income whether practicing in an urban or rural area.

Average starting salary for new doctors is approximately $100 per month regardless of location, according to their estimates. An experienced doctor, on average, can commanded approximately $300 per month.

There are two types of medical licenses, private and state. Most doctors hold both, according to the group.

In addition to their hospital and Health Department visits, they enjoyed a variety of tourist-type entertainment such as a visit to the Mount Vernon Estate and a trip to the Kennedy Center theater, according George Pera, spokesperson, Alexandria Rotary. They also participated in the local Rotary Club meeting last Tuesday. Two in the visiting group are Rotarians as are Kozloff and Konigsberg.