Which doctors to undergo a medical examination. Application. The procedure for conducting a preventive medical examination. What does a screening include

Preventive examination and clinical examination are a set of measures that are carried out in medical organizations. According to the order of the Ministry of Health of the Russian Federation of March 13, 2019 No. 124N, both working and non-working citizens, as well as full-time students at the age of 18 years, undergo medical examination and medical examination. According to the results of these medical events, doctors determine the health groups of patients and groups for dispensary observation.

How is a screening different from a screening?

A preventive examination is carried out for the timely detection of diseases and risk factors for their development, as well as for the detection of non-medical use of narcotic drugs and psychotropic substances. Medical examination is a broader set of activities. It includes a physical examination, as well as additional examination methods that are carried out to assess the condition of certain population groups.

How often do you need to undergo a medical examination and medical examination?

A medical examination is carried out annually as an independent event, as part of a medical examination or during the first dispensary appointment in the current year. Clinical examination for persons aged 18 to 39 inclusive is carried out once every three years. According to the new rules, citizens over the age of 40 can take it annually.

What procedures include a medical examination and medical examination?

The annual medical examination among citizens aged 18 years and older includes the following activities:

• questionnaires to identify complaints, symptoms, identify risk factors for diseases, etc.;
• body mass index calculation;
• measurement of blood pressure;
• study of the level of total cholesterol in the blood;
• determination of blood glucose levels.

Adult citizens aged 18 years and older also undergo a fluorographic examination of the lungs or X-ray of the lungs once every two years. In patients aged 18 to 39 years inclusive, once a year, the doctor determines the relative cardiovascular risk, women in this age group are examined by a paramedic (midwife) or obstetrician-gynecologist.

Citizens over the age of 35 annually undergo electrocardiography during professional examinations, and at the age of 40 years - measurement of intraocular pressure.

In patients aged 40 to 64 years inclusive, the absolute cardiovascular risk is determined annually, and after the onset of 65 years, the risk of developing osteoporosis, depression, heart failure, uncorrected hearing and visual impairment.

The dispensary is carried out in two stages. At the first stage, for citizens aged 18 to 39 inclusive, once every three years, a professional examination, oncoscreening, a brief preventive consultation by a general practitioner, and an examination by this doctor are carried out. Citizens aged 40 to 64 inclusive and patients aged 65 years and older once a year, in addition to these procedures, also do a complete blood count.

At the second stage of clinical examination, patients are offered to undergo additional examinations by doctors of a narrow profile, their diagnoses are specified. A list of possible procedures is given in

Yulia Egorova talks about the new rules for medical examinations

The law obliges

Recently, in connection with the active social policy of our state, such a form of health protection as a preventive medical examination is becoming increasingly important.

The Labor Code defines the groups of people for whom examinations are mandatory.

Labor Code of the Russian Federation Art. 213 (extract):

Workers engaged in heavy work and work with harmful working conditions<…>undergo obligatory preliminary (upon employment) and periodic medical examinations to determine the suitability of these workers for the performance of the assigned work and the prevention of occupational diseases.

Employees<…>medical and preventive and children's institutions<…>undergo the specified medical examinations (examinations) in order to protect public health, prevent the occurrence and spread of diseases.

An important point, reflected in Article 213 of the Labor Code, is that the conduct of preventive examinations of these groups of employees is the responsibility of the employer and is carried out at his expense, during working hours and with the preservation of wages. The state supports this with the "carrot and stick" method. Gingerbread is a preferential taxation of the amounts spent by the employer on professional examinations. A whip is an administrative liability under Article 5.27 of the Code of Administrative Offenses of the Russian Federation for officials guilty of violating labor laws.

What to do with the obligatory examination, if, according to the law, medical examinations and interventions cannot be carried out without the consent, and even more so against the will of the patient?

Preventive examination is obligatory only for certain groups of workers in order to protect public health. The arrangement for such responsible work can only be voluntary, and consent to preliminary and periodic professional examinations is assumed to be automatic upon signing an employment contract, which most often includes an item on passing examinations as an essential condition.

What has changed in the examination?

Until 2012, professional examinations were regulated by several orders, some of which were issued back in Soviet times. Since January 2012, the Order of the Ministry of Health and Social Development of Russia No. 302n dated April 12, 2011 "On approval of the lists of harmful and (or) hazardous production factors and works ..." came into force. At the moment, this order and its annexes are the main regulatory framework for preventive examinations, and the previous orders have been canceled since 2012.

Compared with the old procedure for conducting professional examinations several fundamental differences emerged.

1. Now only an occupational pathologist should head a medical commission, and the commission's medical specialists need advanced training in occupational pathology.

2. The principles of formation of lists of employees sent for medical examination have changed. If earlier employees were included in the list depending on the position, now an employee can be included in this list only on the basis of workplace certification, which must be carried out in accordance with another order of the Ministry of Health and Social Development of Russia (No. jobs according to working conditions). That is, even if a person works at a uranium mine, but the job attestation card is not indicated in the employment contract, then he does not need to undergo a medical examination, and he has no medical contraindications to work.

3. A psychiatrist and a narcologist are included in the medical commission, their examination is now mandatory for everyone undergoing a medical examination, and not just for those who are hired or have a drug permit, as was the case before.

On the whole, these innovations can be considered positive, especially if professional examinations of employees are not reduced to a formality, as, unfortunately, sometimes happens. The emphasis on occupational pathology increases the preventive value of medical examinations, and the exclusion of persons with alcohol or drug addiction from hazardous work will certainly reduce the level of injuries at the workplace.

Health passport

Also, the so-called “health passport” is gradually being introduced into practice - a document of the established form, a sample of which can be found at the link medexx.ru. The passport contains information about the passage of professional examinations of employees, during the examination it is in a medical organization, and after it is issued to the employee.

The introduction of health passports does not cancel personal medical books. The procedure for issuing a medical book is regulated by the order of Rospotrebnadzor No. 402 dated May 20, 2002 “On a personal medical book and a sanitary passport”, which continues to be valid. In addition, the lists of employees who are required to have a health passport and a medical book are somewhat different, and employees of children's health institutions are required to have both. Of course, in this case, you can undergo an annual medical examination, entering the results of the examination in both documents. You can learn more about medical books and who needs them on the website of the Moscow Center for Hygiene and Epidemiology http://www.mossanexpert.ru

Organization of professional examination of employees

According to the order, now only a medical institution that has received the appropriate license can provide medical examination services. At the same time, the staff of the institution should have a permanent medical commission under the leadership of an occupational pathologist. Therefore, the natural desire for every health worker to undergo a medical examination directly at the place of work, unfortunately, is not feasible if the institution does not have the appropriate license.

The same is true with analyses. For an organization performing a medical examination, there is no regulatory document prohibiting the use of the results of analyzes and examinations performed in other medical institutions. But, given that this service is paid, it is unprofitable and quite risky for medical institutions to accept third-party results, since they can be faked. Unfortunately, it is also impossible to pass a medical examination in private - where you like it more, because the employer must organize a centralized examination and provide the medical organization with a list of names of employees, data on attestation of workplaces and harmful factors of production. Moreover, the medical organization must summarize the results no later than one month after the completion of the periodic medical examination. Then, together with the territorial bodies of the federal executive body authorized to exercise state control and supervision in the field of ensuring the sanitary and epidemiological welfare of the population, and representatives of the employer, the medical institution draws up a final act.

Our physical examination or medical examination of doctors

Let's talk about the features of a medical examination for health workers. According to paragraph 17 of Appendix No. 2 to Order No. 302n, medical personnel of all medical institutions must undergo a preventive medical examination annually. The "program" of the medical examination is presented in Table 1.

* The inclusion of a dermatovenereologist and an otorhinolaryngologist in the commission of a professional examination for medical workers is based on frequent professional contact with various kinds of allergens. On the recommendation of these specialists, an additional examination may be prescribed in the form of specific allergodiagnostics, examination of the function of external respiration and consultation with an allergist. ** Appendix No. 1 to Order No. 302n also indicates additional medical contraindications for work associated with adverse factors, such as hypochromic anemia, benign neoplasms, microcirculation disorders of any nature.

The result of a medical examination

If the subject does not have any health disorders, the occupational pathologist makes a conclusion about the suitability for the work performed. But what if any diseases are found during the physical examination? A complete list of contraindications is quite extensive and is contained in paragraph 48 of Appendix No. 3 to Order No. 302n.

It must be said that many of the points as applied to medical workers are controversial. For example, how stable angina pectoris, post-infarction cardiosclerosis, drug-compensated epilepsy, widespread ichthyosis, or even cancer in the initial stage can interfere with the performance of the duties of a therapist is not clear to me personally.

Of course, for emergency work in the ambulance, operating room, emergency department and similar areas, good health is necessary, but for scheduled appointments and advisory work, such requirements seem to me excessive. With detailed observance of all the contraindications indicated in this list, medicine risks losing a large number of age-related specialists whose knowledge and experience are of great value, despite their imperfect state of health.

Mandatory participation in the professional examination of an occupational pathologist involves identifying the relationship of detected diseases with professional activities. If an occupational disease is suspected, a medical organization issues a referral to an occupational pathology center or a specialized medical institution that has the right to conduct research on the relationship of the disease with the profession. Such a medical institution also draws up and sends, in accordance with the approved procedure, a notice of the establishment of a preliminary diagnosis of an occupational disease to the territorial body of federal executive bodies authorized to exercise state control and supervision in the field of ensuring sanitary and epidemiological well-being.

The employer, in case of detection of medical contraindications, is obliged to remove the employee from the work he performs or provide him with another one that is not contraindicated for him for health reasons. At the same time, at the first stage, the employer is obliged to offer the employee the vacant positions he has, and then, by the decision of the employee himself, an additional agreement is drawn up to the employment contract on the transfer or, in case of refusal, the procedure for suspension from work is applied, provided for in Article 76 of the Labor Code of the Russian Federation. At the same time, wages for the period of release from performance of labor duties are not accrued, but the place of work and position are preserved. If the period for which the employer is forced to suspend the employee for medical reasons exceeds four months, then the employee is subject to dismissal under Art. 77 of the Labor Code of the Russian Federation.

Individual difficulties in passing a medical examination may arise for employees who, for any reason, have a disability. Together with the referral for a medical examination, it is better for them to provide the conclusion of the next medical and sanitary examination, so that the commission can decide on admission to work.

There is something to strive for

Much attention is paid to the legal regulation of preventive medical examinations: clear rules for their conduct are defined, a list of works is given for which a medical examination is required, obsolete orders are canceled, and centralized control over examinations is introduced. However, perfection has not yet been reached. The most reasonable, probably, would be to issue a separate order on preventive examinations of medical personnel and some softening of the list of contraindications for working in medicine.

Conducting a preventive medical examination is aimed at early detection of certain chronic non-communicable diseases (conditions) that are the main cause of disability and premature death of the population of the Russian Federation (hereinafter referred to as chronic non-communicable diseases), risk factors for their development (high blood pressure, dyslipidemia, elevated blood glucose levels). blood, tobacco smoking, harmful alcohol consumption, unhealthy diet, physical inactivity, overweight or obesity), as well as the use of narcotic drugs and psychotropic substances without a doctor's prescription.

3. Preventive medical examination is carried out once every 2 years.

In the year of the medical examination, a preventive medical examination is not carried out.

Employees engaged in work with harmful and (or) hazardous production factors, and employees engaged in certain types of work, who, in accordance with the legislation of the Russian Federation, undergo mandatory periodic medical examinations, are not subject to preventive medical examinations.

4. Preventive medical examination of the adult population is carried out by medical organizations (other organizations engaged in medical activities) (hereinafter referred to as the medical organization), regardless of the organizational and legal form, participating in the implementation of the program of state guarantees of free provision of medical care to citizens and the territorial program of state guarantees of free provision of citizens medical care in terms of providing primary health care, with a license to carry out medical activities, providing for work (services) on "preventive medical examinations", "therapy", "radiology", "clinical laboratory diagnostics" ("laboratory diagnostics") .

If the medical organization carrying out preventive medical examination does not have a license for medical activities for certain types of work (services) necessary to conduct a preventive medical examination in full, the medical organization concludes an agreement with another medical organization that has a license for the required types of work ( services), on the involvement of relevant medical workers in the conduct of preventive medical examinations.

5. A citizen undergoes a preventive medical examination in a medical organization in which he receives primary health care.

6. A preventive medical examination is carried out with the informed voluntary consent of a citizen or his legal representative (in relation to a person recognized as legally incompetent, if such a person is unable to give consent to medical intervention due to his condition), given in the form and in the manner which are approved by the Ministry of Health of the Russian Federation.

A citizen has the right to refuse to conduct a preventive medical examination in general or from certain types of medical interventions included in a preventive medical examination, in the manner and in the form approved by the Ministry of Health of the Russian Federation.

7. The head of a medical organization organizes preventive medical examinations of the population receiving medical care in a medical organization.

A general practitioner (a district general practitioner, a general practitioner of a workshop medical section, a general practitioner (family doctor)) (hereinafter referred to as a general practitioner) organizes preventive medical examinations of the population of a therapeutic, including a workshop, section (a section of a general practitioner (family doctor)), serviced territory (hereinafter referred to as the site).

The paramedic of the feldsher's health center or the feldsher's obstetric station organizes preventive medical examinations of the population of the feldsher's section if he is assigned certain functions of the attending physician to directly provide medical care to the patient during the period of observation and treatment, including the conduct of a preventive medical examination, in order established by order of the Ministry of Health and Social Development of the Russian Federation of March 23, 2012 N 252n "On approval of the procedure for assigning a paramedic, a midwife to the head of a medical organization when organizing the provision of primary health care and emergency medical care of certain functions of the attending physician for the direct provision medical care to the patient during the period of observation and treatment, including the prescription and use of drugs, including narcotic drugs and psychotropic drugs" (registered Tried by the Ministry of Justice of the Russian Federation on April 28, 2012, registration N 23971).

8. The main tasks of the general practitioner during preventive medical examinations are:

1) involvement of the population of the site in the passage of a preventive medical examination, informing about its goals and objectives, the scope of the examination and the work schedule of the departments of the medical organization involved in the conduct of preventive medical examinations, the necessary preparatory measures, as well as increasing the motivation of citizens to undergo a preventive medical examination, including by conducting explanatory conversations at the level of a family, an organized team;

2) conducting a final medical examination of a citizen, establishing a diagnosis of a disease (condition), determining a group of a state of health, a group for dispensary observation (by a general practitioner or a doctor (paramedic) of the medical prevention office), prescribing the necessary treatment, if there are medical indications, referral to additional diagnostic studies that are not included in the scope of a preventive medical examination, or to receive specialized, including high-tech, medical care, for sanatorium treatment;

3) conducting brief preventive counseling, referral of citizens with identified risk factors for the development of chronic non-communicable diseases to the department (office) of medical prevention or a health center to provide medical care to correct these risk factors;

4) participation in the preparation (maintenance) of accounting and reporting medical documentation, including a health passport, the form of which is approved by the Ministry of Health of the Russian Federation (hereinafter referred to as the health passport);

5) summing up the results of preventive medical examinations.

9. The main tasks of the department (office) of medical prevention of a medical organization, including those that are part of the health center, when conducting preventive medical examinations are:

1) participation in informing the population receiving medical care in a medical organization about preventive medical examinations, their goals and objectives, as well as in conducting explanatory work and motivating citizens to undergo preventive medical examinations;

2) instructing citizens who arrived for a preventive medical examination on the procedure for passing it, the volume and sequence of the examination;

3) performing pre-hospital medical examinations (survey (questionnaire) in order to identify chronic non-communicable diseases, risk factors for their development, consumption of narcotic drugs and psychotropic substances without a doctor's prescription, anthropometry, calculation of body mass index, measurement of blood pressure, determination of total cholesterol and blood glucose by express method);

4) determination of risk factors for chronic non-communicable diseases based on the diagnostic criteria provided for in the Appendix to this Procedure;

5) formation of a set of documents, including filling out the registration form "Route card for clinical examination (preventive medical examination)", approved by the Ministry of Health of the Russian Federation (hereinafter referred to as the route card), based on the results of studies conducted as part of a preventive medical examination, to refer the patient to the final examination therapist;

6) registration of citizens who have undergone a preventive medical examination.

7) explaining to a citizen with a high risk of developing a life-threatening disease (condition) or its complication, as well as to persons living together with him, the rules of action in case of their development, including the timely call of an ambulance team;

8) filling in the passport part and, in agreement with the general practitioner, other sections of the health passport.

10. Preventive medical examination includes:

1) a survey (questionnaire) in order to identify chronic non-communicable diseases, risk factors for their development, consumption of narcotic drugs and psychotropic substances without a doctor's prescription;

2) anthropometry (measurement of standing height, body weight, waist circumference), calculation of body mass index;

3) measurement of blood pressure;

4) determination of the level of total cholesterol in the blood by the express method (laboratory method is allowed);

5) examination of the level of glucose in the blood by the express method (laboratory method is allowed);

6) determination of the total cardiovascular risk (for citizens under the age of 65);

8) mammography (for women aged 39 and older);

9) a clinical blood test (the minimum scope of the study includes: determining the concentration of hemoglobin in erythrocytes, the number of leukocytes and the erythrocyte sedimentation rate);

10) examination of feces for occult blood (for citizens aged 45 years and older);

11) reception (examination) of a general practitioner, including the determination of a group of health status, a dispensary observation group (by a general practitioner or a doctor (paramedic) of the medical prevention office), brief preventive counseling, if there are medical indications, referral of citizens to receive a specialized, including high-tech, medical care, sanatorium treatment.

11. If a citizen has the results of the studies specified in paragraph 10 of this Procedure, which were carried out within 12 months preceding the month of the preventive medical examination, the decision on the need for re-examination as part of the preventive medical examination is made individually, taking into account all the available results of the examination and the condition citizen's health.

12. If a citizen, during a preventive medical examination, has medical indications for conducting research and examinations by medical specialists that are not included in the scope of the preventive medical examination in accordance with this Procedure, they are assigned and performed to the citizen, taking into account the provisions of the procedures for providing medical care according to the profile of the identified or the alleged disease (condition) and standards of medical care approved by the Ministry of Health of the Russian Federation.

13. The results of the examination by the general practitioner and the studies carried out during the preventive medical examination are entered into the route card, which is filed into the accounting form N 025 / y-04 "Medical card of the outpatient", approved by order of the Ministry of Health and Social Development of the Russian Federation dated November 22 2004 N 255 (registered by the Ministry of Justice of the Russian Federation on December 14, 2004, registration N 6188) (hereinafter referred to as the outpatient medical card).

14. On the basis of information about the passage of a preventive medical examination by a citizen, a medical worker of the department (office) of medical prevention fills out a "Card for the registration of medical examinations (preventive medical examinations)" in the form approved by the Ministry of Health of the Russian Federation.

Information about the preventive medical examination and its results are entered by the general practitioner in the health passport, which is issued to the citizen.

15. The following criteria are used to determine, based on the results of a preventive medical examination, a group of the state of health of a citizen and plan the tactics of his medical supervision:

I group of health status- citizens who do not have chronic non-communicable diseases, do not have risk factors for the development of such diseases or have these risk factors with low or medium total cardiovascular risk and who do not need dispensary observation for other diseases (conditions).

Such citizens are provided with brief preventive counseling, correction of risk factors for the development of chronic non-communicable diseases by a general practitioner, a medical worker of the department (office) of medical prevention or a health center.

II group of health status- citizens who have not been diagnosed with chronic non-communicable diseases, have risk factors for the development of such diseases with a high or very high total cardiovascular risk and who do not need dispensary observation for other diseases (conditions).

Such citizens undergo correction of risk factors for the development of chronic non-communicable diseases in the department (office) of medical prevention or a health center, if there are medical indications, the general practitioner prescribes drugs for medical use in order to pharmacologically correct these risk factors. These citizens are subject to dispensary observation by a doctor (paramedic) of the department (office) of medical prevention.

III group of health status- citizens with diseases (conditions) requiring the establishment of dispensary observation or the provision of specialized, including high-tech, medical care, as well as citizens suspected of having these diseases (conditions) who need additional examination ***.

Such citizens are subject to dispensary observation by a general practitioner, medical specialists with medical, rehabilitation and preventive measures. Citizens with risk factors for the development of chronic non-communicable diseases are corrected in the department (office) of medical prevention or a health center.

16. The medical organization keeps records of citizens who have undergone a preventive medical examination, with the registration of studies performed during the preventive medical examination, and studies performed earlier outside the framework of the preventive medical examination (within 12 months preceding the month of the preventive medical examination) and taken into account during a preventive medical examination, as well as refusals of citizens to undergo individual studies.

17. A preventive medical examination is considered completed if at least 85% of the scope of the examination established for a given age and gender of a citizen is completed (taking into account studies performed earlier outside the framework of a preventive medical examination (within 12 months preceding the month of the preventive medical examination) and refusals of a citizen from passing individual studies).

______________________________

* Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation".

** Fluorography of the lungs is not performed if a citizen underwent radiography (fluoroscopy) or computed tomography of the chest organs during the previous calendar year or the year of the preventive medical examination.

*** Based on the results of an additional examination, the citizen's health status group may be changed.

Sobesednik.ru found out how often and for what purposes a medical examination should be carried out.

When is it necessary?

The ideal schedule is once a year, although some specialists should be visited more often - every 6 months: for example, this concerns the examination of the dentist and gynecologist. At the moment, there is a legally established procedure for the medical examination of the adult population under the CHI policy. You can get a free medical examination every 3 years - at the age of 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69, 72, 75, 78 , 81, 84, 87, 90, 93, 96, 99 years old. In other years (once every 2 years) you can undergo a preventive examination at the clinic.

Who needs?

Actually, everyone. In fact, regular (and conscientious!) physical examinations are the only way to detect some kind of problem in the body before it “shoots” itself and loads you with trouble. In terms of health, the principle “the sooner the better” works, and it is always easier, cheaper and more preferable to prevent a disease than to treat it later. For the purpose of early detection, regular medical examinations, screenings or medical examinations are carried out.

How is it necessary?

Naturally, there will be no point in medical examination if it is done for show, and the dialogue with the doctor will be based on the principle: “Is something bothering you?” - "Not". "Well, that's fine, here's a tip for you." This situation discredits the very idea of ​​a scheduled medical examination, but, unfortunately, it has often met before, and now. The meaning of medical examination is not to miss diseases that at first do not reveal themselves in any way, and when it goes far, unfortunately, they are not completely treated - these are cardiovascular diseases (ischemic heart disease, hypertension, etc.). ), various types of cancer, tuberculosis, diabetes mellitus, pathologies of the spine and joints. So, within the framework of a medical examination, at least there should be an examination itself, as well as a certain set of analyzes and studies, without which the picture will not be complete.

What do you need?

By law, for most adults, a free medical examination is carried out once every 3 years. Here's what the survey plan looks like now:

Questioning (questionnaire), examination by a therapist

Measurement of height, weight, calculation of body mass index

Pressure measurement

Determination of cholesterol and glucose levels in the blood (express method)

ECG (at the first medical examination, then - for men over 35 and women over 45)

Midwife examination, cervical smear (for women)

Fluorography

Mammography (for women over 39)

Determination of cardiovascular risk

Blood chemistry

Fecal occult blood test (after 45 years)

PSA test (men over 50)

Ultrasound of the abdominal organs (after 39 years once every 6 years)

Measurement of intraocular pressure (after 39 years)

Examination by a neurologist (after 51 years once every 6 years)

Nevertheless, a personal plan may look different - from the timing to the volume of clinical examination. Here, the wishes of the doctors you are seeing can be taken into account (for example, a gynecologist wants to see you at least once every 6 months, a mammologist and a urologist - annually, etc.), and your individual diagnoses and risks. For example, for early detection of bowel cancer after 50 years, it is recommended to do a colonoscopy every 5 years, even without special indications, however, this study is not included in the general medical examination plan and is done only as directed by a doctor. Above is only a general scheme of the survey at the expense of the state.

Blood and urine will not be tested

The simplest analysis, to which a person will be 100% sent for almost any complaint, is UAC, a complete blood count. The same goes for a general urine test. Many generally do them on their own, without waiting for a doctor's referral, and come to the first appointment already with the results. Nevertheless, from 2018, these two studies will no longer be included in the mandatory medical examination plan: the new procedure proposed by the Ministry of Health excluded them from screening as “non-informative”. The agency clarified that neither a blood test nor a urine test will be performed by default on asymptomatic citizens - those who do not have any complaints. Only the level of sugar and cholesterol will be examined using the express method, that is, right at the reception.

point-blank question

Can they be forced to work?

No. In recent years, employers have begun to send employees for screenings, but even in this case, the principle of voluntariness works. By law, if the work does not imply mandatory regular medical examinations, the authorities can only offer to undergo medical examination, providing such an opportunity - for example, by entering into an agreement with a certain medical institution. This case is again purely voluntary, and the results of medical examination, if the employee has passed it, are a medical secret.

The clinic does not have the right specialist. What to do?

If you need advice from a specific specialist, whether as part of a medical examination or not, temporarily or indefinitely, you should be referred to another medical facility where one is available.

I have DMS. Is it possible to pass a full medical examination with such insurance?

If the type of policy does not limit the number of visits to specific doctors (this sometimes happens) - for example, no more than 10 visits to a therapist per year, 5 visits to the ENT, 2 appointments with an ophthalmologist, etc. - it is quite possible to take advantage of this opportunity. The absence of restrictions in this case allows you to make a medical examination more detailed, clarify the nuances and, as a result, possibly get more complete information about what is happening to your health than with a regular scheduled medical examination as part of the CHI.

Is it possible to skip a year or more?

When, to what extent and whether to undergo medical examination at all is your own business. Even if it seems to be necessary by age, it's still up to you to decide. Medical officials are calling for medical examinations to be made mandatory for everyone, and refuseniks to be “turned off” from some free medical services, but so far this is just an idea that is contrary to current legislation.

By the way

What is a medical check?

Check-up is another name for a routine medical examination, which is used in Western healthcare and, more recently, in domestic commercial medical centers. As a rule, a check-up is completed in one day - the program is designed so that the patient does not have to go to the doctors for weeks and months. The intensity of the program can be different - the simplest ones take 3-4 hours and include an examination of 4-5 specialists (gynecologist, ophthalmologist, urologist, therapist, dentist), 1-2 ultrasounds (usually gynecological and abdominal), several tests (for example , CBC, pap test for women, and Pap test to rule out cervical cancer) and a few other tests. A large check-in program can take a couple of days and even include options such as a full-body MRI. The price also depends on saturation.