Is it possible to change your attending physician in a hospital, clinic or residential complex. Is it possible to change a doctor or polyclinic Is it possible to choose a local doctor at will

The provision of medical care in Russian state clinics is carried out upon attachment. At the same time, it is not registration that matters, but the availability of medical insurance.
It happens that a person, simply not knowing his rights, cannot fully use the insurance policy not only in a foreign city, but also in his own. The time has passed when you had to go to the doctor in the clinic that is in your area. Now we ourselves can choose to whom and where to go for treatment (under the policy).
However, still not everyone knows how to transfer to another medical facility.

What is an "attachment"?

The state system of primary health care, which includes polyclinics, is built on the principles of territoriality, profile of health care institutions, continuity and stages of medical care.
That is, each house, street, district, and settlement is assigned a state medical institution (polyclinic, outpatient clinic, medical office, feldsher-obstetric station), whose specialists provide free medical care to the population living in this territory within the framework of the state guarantees program.
In addition, medical institutions are grouped into associations, which may include one or more polyclinics for adults and children, a antenatal clinic, a planned hospital, general practitioners' offices, various Centers, etc.
Thus, if a person belongs to one of the divisions of such a joint state outpatient clinic, then he has the right to receive the full range of medical care services provided in his divisions. The patient's belonging to the service in such an association is called - attaching.
If you are registered and live in the same place and at the time of issuing the CHI policy do not express wishes for the place of medical care, then you are automatically assigned to the medical institution that serves the area where you are registered.
In this case: the validity period of the attachment is permanent. Attachment confirmation is not required.
Also, you will not be required to make any preliminary applications, contacts with the clinic and annual confirmations of attachment if you are registered (registered) at one address, live at another, but are served by a medical organization at the place of registration (registration).

How to change clinic?

But what if you came to work from another region? Are you registered and rent an apartment in different parts of the city? Do you take elderly relatives from the village for the winter?

How to detach from the clinic, and then attach to another?

This question interests many citizens.
Indeed, according to the law, in accordance with Clause 1 of Article 21 of the Federal Law No. 323 dated November 21, 2011 a patient in Russia has the right to choose, to be served where it is more convenient for him. At its discretion, a citizen can choose a clinic, an attending physician, an insurance company. So, you can choose any budgetary medical institution of your choice.
Order of the Ministry of Health and Social Development of Russia No. 406n dated 04/26/2012 approves the procedure for choosing a medical institution by a citizen when providing him with medical care under the program of state guarantees of free provision of medical care to citizens.
Once a year, any resident of Russia has the right to change the clinic to the one that he likes best, and be treated there for free. At the same time, a citizen is not obliged to explain the reason for refusing the services of the former polyclinic. In addition, it does not matter in which area of the city you are registered and where you actually live. You just need to have an OMS policy.

Important: You can choose only the district clinic. This rule does not apply to specialized

To change the polyclinic, you need to contact the administration of the selected polyclinic, having an application, passport and compulsory medical insurance policy with you. Application forms can be obtained at the clinic's reception desk.

An adult patient fills out an application and attaches copies of the CHI policy and two pages of the passport (the first and with a residence permit).
Copies of his CHI policy, birth certificate and two pages of the passport of one of the parents must also be attached to the application for attaching the child to the polyclinic.
Some organizations additionally request SNILS, this is normal. Just take this document with you. And make copies ahead of time.

It does not matter which location was chosen to replace the medical facility where you will be observed. Whether it is a clinic at the place of residence or a non-resident. The list of documents is the same for these cases.
And, if there are no problems with the documents, and the clinic is not overloaded, you will be attached within a few days.

Note!
If you are going to change the clinic, then you do not need to detach from the previous one. When you have been accepted for service, the selected clinic will notify your previous clinic and request all necessary medical documents.
This order is written in the No. 406n. The document stipulates that after submitting an application (no later than 2 days later), the clinic must send a request to the medical facility to which the patient is attached. The answer must be sent no later than 2 days after receiving the request.
After confirming the information specified in the application, the head informs the insured person about his attachment to the selected healthcare institution. This information is also sent to the insurance company and to the medical institution to which the patient was assigned. And only after that the insured person is detached and removed from the service, and the patient's medical documents (their copies) are sent to the new clinic.

True, there is one caveat- a city medical institution can be any, but if it is attached to a polyclinic that does not serve the address of your residence, then you will not be able to call a doctor at home from this polyclinic. To get medical care at home, you will have to go to the clinic that serves the area where you live.

In a medical organization, you also have the right to choose an attending physician at your own request.

You may be denied admission if the polyclinic cannot cope with the load and many patients are already assigned to it. The refusal must be in writing and be motivated.

The validity period of attachment to a polyclinic not at the place of registration is during the current (calendar) year. Confirm the attachment you dress up annually. Thus, if more than a year has passed since the moment of attachment to the institution at the place of actual residence, and you have not confirmed the attachment again, you will automatically return by attachment to the clinic at the place of registration (registration).

You can immediately complain about those who denied you your right to change a medical institution, the Department of Health and the Office of Rospotrebnadzor. By the way, for the proceedings it does not hurt to ask for a written refusal. Sometimes this is enough for the clinic to meet halfway.

The local pediatrician is a person on whom the health of your child largely depends. In the first years of a child's life, you meet with the pediatrician very often (scheduled examinations, diseases, examinations, etc.). And if your district pediatrician is a qualified, competent specialist, if you have developed a good, trusting relationship with him, you are very lucky.

Unfortunately, there are cases when parents do not trust the local pediatrician. These are cases of doctor's incompetence, incorrect diagnosis, refusal to send for hospitalization or examination (necessary, according to parents), rude, incorrect behavior of a doctor, and finally, just a personal conflict between parents and a doctor. Then the question arises of changing the local pediatrician.

Is it possible to change the local pediatrician?

Can. Moreover, you have every right to do so. There is such a document as Article 30 of the Fundamentals of the Legislation of the Russian Federation on the Protection of the Health of Citizens, approved by the Supreme Court of the Russian Federation on July 22, 1993 No. 5487-1.

This article states that

“when applying for medical care and receiving it, the patient has ... the right to choose a doctor, including a family doctor and an attending physician, subject to his consent, as well as to choose a medical institution in accordance with compulsory and voluntary medical insurance contracts” .

In our case, the patient is a minor child, so his parents (legal representatives of the child's interests) exercise his right to choose a doctor. But you need to pay attention to the moment that you can choose a doctor "with his consent." Those. the doctor you choose must agree to observe and treat your child, bypassing the principle of territoriality of public health care.

The Ministry of Health recommends that you obtain written consent from your new primary care physician for your child's treatment. But these recommendations have no legal value, and, in addition, lawyers explain that the phrase "with consent" does not mean "with mandatory consent." And here comes the moment when you need to contact the administration of the clinic - the head of the department or the head physician.

What should be done to change the local pediatrician?

The same article 30 of the "Fundamentals of Legislation ..." states that in case of violation of the patient's rights, he has one more right:

"The right to file a complaint directly with the head or other official of the medical institution in which he receives medical care, with the relevant professional medical associations and licensing commissions, or with the court in cases of violation of his rights."

All negotiations with the administration of the polyclinic must be confirmed by written documents. Otherwise, you may hear a verbal denial in response to your oral statement, and you will not be able to confirm anything further.

You need to write a reasoned statement in 2 copies with a request to change the district police officer in the name of the head physician of the clinic or the head of the department and transfer one copy to the administration representative against signature on the 2nd copy that remains with you. A sample application is provided below.

This situation often arises: the doctor agrees to see your child, but refuses to visit him at home, because. its own site is located far from your place of residence, and local doctors (with rare exceptions) are not provided with transport. Those. the same district pediatrician with whom you do not want to deal with will come to call home to your sick child.

But there is a way out of this situation, even two. The first option: you provide the doctor with transport, i.e. bring him to the call by taxi or by your own car, and take him away in the same way. The second option: if the pediatrician in this case also refuses to serve your child at home, you again write a statement to the administration of the polyclinic with a request that calls to your child be served by a doctor, “on call”.

In all children's polyclinics, house calls are accepted until a certain time (until 12.00 or 14.00), then they are served by the local pediatrician. If a call is received after the agreed time, it is served by a "call attendant". In some polyclinics there is a position of a doctor serving only “evening calls”, in others all doctors take turns doing “evening calls”. Thus, you and your child will be spared contact with an unwanted doctor for you.

It must be emphasized that the change of the district pediatrician should be due to objective reasons, and not to your whim.

Sample Applications

Manager (mu)
MLPU No….
Full name of the manager (mu)
From ...., mother (father) of a child registered with a polyclinic .....
Residing (go) at the address ...

Statement

Dear (s) …. (Interim manager)!

I ask you to transfer my child ... (full name of the child) from the outpatient registration with the doctor ... (name of the doctor you want to refuse) to the doctor .... (Name of the doctor you are going to) on the basis of Art. 30 "Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens." The consent of the doctor (name of the doctor you are going to) is confirmed in writing.

The reason for my refusal from the services of a doctor (the name of the doctor you are refusing) was .... (The MOST COMPLETE AND DETAILED BASIS INVOLVING ALL NECESSARY INFORMATION, RECIPES AND REFUSALS)

If my application is left without movement within up to 14 calendar days, I reserve the right to appeal against your actions and the actions of the doctor (name of the doctor you want to refuse) to the Department of Health of the city of N, the Ministry of Health of the N region and the prosecutor's office of the N areas.

Sincerely, …. (your name)

Signature of the receiving person ___________

Signature transcript_______________ (position and full name)

Date of acceptance: ________________________

Complaint about the refusal to exercise the right to choose a district doctor.

To the City Health Department N

(Ministry of Health of the N-th region)

From…. (your name)

Residing at
………….

Complaint about illegal actions of an official

“__” _______ 20__, I submitted an application to the healthcare institution MLPU No. ... containing a request for a transfer from the attending district doctor .... (Name of the doctor you are refusing) of my child …. (name and year of birth) for outpatient registration to ... (name of the doctor you are going to). Doctor's consent ... confirmed in writing. The request was fully justified. The application was submitted by the head of MLPU No. ... (full name of the head (go)), about which there are corresponding marks on the applications.

My request in no way contradicts the law, and the right of a citizen to choose an attending physician is enshrined in Art. 41 of the Constitution of the Russian Federation, art. 30 "Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens."

Based on all this, the actions of the head of MLPU No. ... and the chief physician of MLPU No. ... are a violation of my constitutional rights and freedoms.

So, based on the above, I ask:

1. Transfer my child ... (full name of the child) to the outpatient registration from the doctor ... to the doctor ....

2. Head of MLPU No. ... announce a reprimand with entry in a personal file.

If my complaint is not considered within 14 calendar days, I reserve the right to go to court.

Application:

1. Application - 1 copy on 1 sheet

2. Insurance policy ... (full name of the child) - 1 copy on 1 sheet

3. Written consent of the doctor ... (full name of the doctor to whom you go) - 1 copy on 1 sheet

Sincerely, ________________

"___" ________ 20__
Signature of the receiving person ___________
Signature transcript_______________ (position and full name)
Date of acceptance: ________________________

_________________

Wrote the text and found typical application samples

pediatrician Lyudmila Sokolova specially for the site I am a young mother

We tell you what to do if you are not satisfied with your local doctor.

- I don't like my district therapist, he has made wrong diagnoses several times, and it's hard for me to find a common language with him as a human being. How to change doctor?

The right of the patient to refuse the attending physician and change him to another was legally fixed only a few years ago. In April 2012, the Ministry of Health and Social Development of Russia N 407n “On approval of the Procedure for assisting the head of a medical organization (its subdivision) with the choice of a doctor by a patient in the event of a patient’s request to change the attending physician” was published by the Ministry of Health and Social Development of Russia. This document clearly defines the mechanism for choosing and changing the attending physician.

To change doctors when providing general care (in a polyclinic, outpatient clinic, dispensary, hospital, etc.), you need to:

write an application addressed to the head physician of a medical institution;

State on your application the reasons why you are asking to change doctors. By the way, they can be different: the doctor was impolite, refused medical assistance, you have doubts about his competence, etc. Reasons for refusal may also be religious considerations or even an inconvenient doctor's work schedule.

Your application must be reviewed within three business days. After this time, the head physician must verbally or in writing convey to the patient information about other doctors of the institution and their work schedule. Based on this information, the patient makes his choice.

Can the doctor you have chosen not take you in?

Yes maybe. The transition to the selected specialist occurs only with his consent. The right of a doctor to refuse a patient is also spelled out in the order of the Ministry of Health. For example, a district therapist or pediatrician may refuse you if the number of registered patients in the area he serves already exceeds the standard (for a general practitioner this standard is 1,700 adults, for a pediatrician - 800 children). It is best to talk to the doctor you want to see in advance and make sure that he is willing to be your doctor.

About the main thing - briefly:

You can change your doctor. It is enough to write an application addressed to the head physician of the medical institution.

The application will be reviewed within 3 days, and then the head physician will provide you with information about other doctors who work in the institution.

The transition to treatment to another doctor occurs only with the consent of the doctor himself.

If you have questions that you can't find an answer to, let us know and we'll try to answer them.

The issue of personal insurance is raised constantly and is quite relevant. It happens that a person, simply not knowing his rights, cannot fully use the insurance policy not only in a foreign city, but also in his own.

The Law on Insurance regulates all pressing and relevant issues of personal and medical insurance, you just need to use the information correctly. Legal awareness will help you take the right steps while saving time, money and health.

Can I choose my own clinic?

Law No. 326-FZ of the Russian Federation clearly defines the right of a citizen of the Russian Federation to use the services of a polyclinic in any city in our country. Moreover, this applies not only to emergency situations, but also to the usual reception at a medical institution. The principle of attachment to the clinic at the place of registration has been canceled.

Following the new law and additions to it, a citizen has the right to:

choose any clinic in any city;
choose a doctor of your choice;
choose ;
choose a private, departmental or regional medical institution included in the list of the insurance system;

It is important to remember one more important remark: all transfers and changes of doctors are free of charge and only once a year.

As an exception, a change is allowed more often, but only in cases of moving to another region or city.

In addition, it must be indicated that no explanation is required from the applicant regarding the refusal of his attending physician or, in general, the services of a particular clinic.

It is obvious that the changes made to the law fully protect human rights under universal health insurance.

What is written in the law, of course, must be respected. Another thing is that there are subjective circumstances that can hinder or slow down the change of clinic and doctor. The fact is that each polyclinic is funded by the number of citizens attached to it.

Another obstacle is also possible: the clinic where you want to go may be overloaded. Of course, neither one nor the other circumstance will affect your choice to change the attending polyclinic.

Changing clinics is possible, but somewhat troublesome. It is worth seriously thinking about all the pros and cons of a possible change in the clinic, insurance companies, doctors, and only then make the right choice.

How to attach to a polyclinic not by registration?

Often a situation arises when a person lives for a certain time not at the place of permanent registration or simply works in another city. The issue of health care can be acute at any moment. Attachment to a particular clinic allows you to avoid many difficulties as much as possible.

Start attaching by visiting the clinic and contacting the registry. You need to take the following documents with you:

the passport;
certificate from the place of work;
housing contract;
insurance policy;

Similar conditions apply for the attachment of a minor child. It is clear that he does not need certificates from the place of work, but a certificate from the school must be provided.

It does not address the issue of citizens who live and work illegally. Firstly, it is a violation of the law, and secondly, it brings a large number of additional problems. Deception of the state can cost too much.

Having officially got a job, having received a temporary registration, you can safely go to a nearby clinic and officially become its client. If you stay in another city for more than a year, you need to apply for attachment annually.

In the event that a citizen is refused attachment at the registry due to the lack of a local residence permit, it is necessary to appeal against the action of the polyclinic staff at the Department of Health.

You may need to contact your insurance company with this information. If this does not help, then a direct violation of the law can be appealed to the prosecutor's office.

Is it possible to get medical assistance, while being in another city? Definitely yes. Again, we turn to the law. Regardless of registration (the institute of registration has been cancelled), a citizen can use the services of a medical institution in any city, having a compulsory medical insurance policy in his hands.

You can exercise your right to medical services even if you do not currently have a policy, but actually do. Being anywhere in Russia, know that in this situation it is enough to call the territorial CHI fund of your region and clarify the number of the medical policy and the name of the insurance company serving you.

Every citizen has the right to basic health services:

primary health care;
emergency medical care;
specialized medical care (for tuberculosis, AIDS, infectious diseases);
with the necessary treatment of diseases of the cardiovascular, endocrine, nervous system;
in case of injury;
in a state of pregnancy or arising labor activity;
with acute dental disease;
in the treatment of skin diseases;
providing medical care to children;

The entire list of basic diseases, with which the polyclinic is obliged to acquaint, is located on the information stand.

The only rule that must be strictly observed: take an insurance policy with you on any trip! It will take up little space, but if necessary, it will save you from many problems.

Remember: the law protects the right of a citizen and it can be practically used.

How to change the doctor in the clinic?

Of course, any actions to change the clinic or doctor are regulated by the law on insurance. On the basis of this law, the entire system of work on the insurance provision of citizens has been formed.

The change of doctor is carried out at the personal request of a citizen. To do this, you must select a clinic that is part of the CHI system. Arriving there, a citizen must take with him:

the passport;
certificate of place of work;
pension certificate (for pensioners);
insurance policy;

Having written an application, a citizen becomes registered, under the supervision of the doctor he has chosen. Again, let's make a reservation that this is according to the law, but there is an ordinary life. Refusal to satisfy the request of a citizen may occur due to the overload of the doctor. Yes, there are certain workload standards for all areas of work, including for doctors.

As a recommendation, it should be indicated that the citizen himself must decide how much he needs to change the doctor. If we are talking about moving to another city, then everything is clear. Or the necessary narrow specialist is not available in their polyclinic and the administration cannot find a replacement, but help is needed now. These reasons may be valid, but if a citizen decides to "be capricious", then this is another matter.

It is important to remember that the right, of course, exists, but this does not mean that they must be used with or without reason.

From the video you will learn how to attach to the clinic that is convenient for you:

anonymous , Man, 35

Hello! In our polyclinic, the neurologist often changes, and each new one is worse than the previous one. We have a couple of dozen sites, a fairly large area is serviced, respectively, to a single neurologist, an appointment for 2-3 weeks in advance. I have had neurological problems since childhood. The last time the neurologist did not read what the previous one wrote, nor look at the results of the examinations, he simply asked briefly "where does it hurt?" Without even looking at me, he wrote osteochondrosis of the lumbar spine and that's it. Although, previous doctors, I was already diagnosed with this. To my requests to appoint examinations (X-ray, MRI, ultrasound), he said that now there is no nurse to write them out. It turns out, now again wait 3 weeks before the next dose. I told the therapist about my last visit to the neurologist and asked for a referral to another medical facility where the neurologist is not so busy, she just grinned and confirmed that his nurse was really on sick leave and offered to wait until she went to work. Still, do I have the right to request a referral to another doctor from another medical institution? Or even transfer to another clinic? Because, to be honest, our polyclinic is very inferior to many others in our city in terms of the number of doctors, availability of appointments, etc.

Hello. In accordance with the Federal laws on the fundamentals of protecting the health of citizens (Article 21) and compulsory medical insurance of citizens (Article 16), citizens of the Russian Federation have a guaranteed right to choose a medical organization (MO) to receive permanent outpatient medical care under the state guarantees program . The right to choose a MO can be exercised no more than once in a calendar year. This right is exercised in the manner approved by the Order of the Ministry of Health and Social Development of the Russian Federation dated April 26, 2012 No. 406n. The regulatory procedure stipulates that in order to exercise the right to choose the Ministry of Defense, it is necessary and sufficient for a citizen to apply to the chosen Ministry of Defense with an application containing the information provided for by Order No. , is obliged to inform the citizen about the attachment within 2 days. That is, the right to choose MO is implemented in a notification (rather than permissive) manner. The right to choose a specific district (pediatrician) is subject to the prior consent of the doctor. If no doctor "agreed" the attachment is at the discretion of the administration of the Moscow Region. If the citizen who has chosen the MO does not live on the territory of the district service by the doctors of this MO, then he is not provided with medical care by a general practitioner () at home. Specialized medical care is provided to citizens within the framework of the program of state guarantees in the direction of attending physicians and in accordance with the procedures for providing medical care and routing patients in a particular region (paragraphs 13-15 of the Order of the Ministry of Health and Social Development of the Russian Federation dated April 26, 2012 No. 406n). Accordingly, the patient can exercise his right to choose a specialist in the necessary medical specialty only within the information provided to him by the attending physician about the possibilities of choosing from organizations that have the necessary resource capabilities and have the obligation to accept a "foreign" patient on the doctor's referral. At the same time, the "broadness of choice" in a number of regions, for objective reasons, is limited to one single organization and one doctor. In your particular case, the replacement of a neurologist or an entire medical organization does not guarantee the quality of providing you with the necessary medical services in the future. The doctor's refusal to give you a referral to another is probably due to objective reasons (which I have indicated above). In order to resolve the problem, I would recommend that you file a written complaint about the quality of the neurological care provided to you with the insurance company that issued you the CHI policy, and also ask the insurer to protect your rights to quality medical care in the CHI system. An application (complaint) is submitted in free form and must be considered within 30 days.