A popular saying that preventing a disease is easier and cheaper than subsequently treating it has rational scientific evidence. In order to timely diagnose pathological conditions and maintain high levels of public health at the state level, such a concept as medical examination was formed. What is included in it, why is it carried out, as well as other relevant issues on this topic - in this material.
Clinical examination: what is it?
First of all, you need to understand what a medical examination is. According to a specialized medical dictionary, this term refers to a specific system preventive work in medical facilities. Such activities are regulated by regulatory documents that determine the amount of medical advice and research, the timing of their conduct. In addition, the enterprises write an order for medical examination for employees who require the specified medical examination.
It is carried out in the clinic at the patient's place of residence. A person has the right to refuse such an examination in whole or in part by writing a written refusal according to the established model and presenting a document to a local therapist (family doctor).
Clinical examination in our country: the history of formation
What is medical examination, how was such a concept formed in our country? For the first time, a routine inspection of workers was introduced into the medical care system of the population back in 1986. It was during this period that an order of the USSR was issued, according to which so-called preventive rooms were equipped in clinics. The essence of the activity of the medical examination departments of the clinic was the annual standard examination of working citizens.
Unfortunately, the organization of such work was not up to the mark, which led to large expenditures of budget money and their irrational use. As a result of the large employment of the local therapists, the work of the polyclinic as a whole was difficult due to routine examinations. Also, importantly, the main purpose of these measures was considered exclusively to diagnose diseases. The development of a treatment regimen and monitoring the patient's condition were not part of the duties of prevention rooms.
Thus, the specified system was ineffective and costly. In this regard, the development of a modern form of prevention of diseases of the population was required. A new era of medical examination began in 2006 - it was then that a new structure and innovative methods of work for medical examination of citizens began to be developed.
The purpose of the medical examination
As mentioned above, the main goal of the medical examination of the population is to preserve the health of the nation. Based on this, the following tasks of such a preventive medical event can be distinguished:
- diagnosis of diseases at an early stage, identification of the main risk factors for the development of health disorders;
- revealing the facts of the use of narcotic and psychotropic substances by citizens without indications and the appointment of a doctor;
- professional consultation of patients;
- determination of the patient observation group when detecting health disorders or the presence of risk factors for their development.
Organization Features
In the new modern structure of the organization of medical examination, there are such features:
- A citizen of the Russian Federation who has a medical insurance policy is entitled to undergo a free examination.
- A clinical examination is carried out at the place of residence once every three years (which years are allotted for an individual patient to undergo such an examination, you can contact the therapist). In addition, a preventive examination can be done annually, which is characterized by a smaller volume of studies.
- Responsibility for organizing and conducting a medical examination is assigned to the local GP or family doctor.
- The examination is carried out in 2 stages: standard and in-depth.
- The criteria for determining the concept of “risk factors for the development of diseases” have been developed and specified. This group includes citizens who have the following health deviations: malnutrition, alcohol abuse, high blood pressure, confirmation of the use of tobacco products, hyperglycemia, low physical activity, overweight or obesity.
- Expansion of laboratory research methods that are part of the program of free medical examination of the population.
- The number of health groups halved. At the moment, patients are divided into 3 groups instead of 6, namely: the first group includes people with a low or medium risk factor for the development of cardiovascular diseases, the second one with a high level, the third one with proven diseases requiring medical attention. Each group of patients is provided with the necessary amount of medical care.
How is the examination carried out?
Clinical examination of adults has 2 stages. A citizen who is sent for examination must have a passport and a medical insurance policy with him. It is also recommended to take the results of studies that were obtained during the previous examination.
Clinical examination begins in the local therapist's office - what does it include? Then the doctor will ask the patient to answer some general questions, the results are recorded in the questionnaire. Then the specialist will measure the basic anthropometric data (height, weight, waist, calculation of body mass index). After that, the patient is given the so-called routing sheet, which contains information on which tests and examinations which specific specialists will be required. Thus, the first stage of the medical examination occurs. What is the primary medical examination, what kind of research will the patient need to go through at this stage of the examination is described in more detail in the next paragraph.
The first stage of the medical examination
The purpose of the first stage is the diagnosis of noncommunicable diseases, including such as disorders of the cardiovascular system, diabetes, glaucoma, malignant neoplasms and others. In addition, the identification of risk factors for the patient’s health, as well as the use of narcotic and psychotropic drugs without prescribing a doctor, is an important task.
It will take at least two visits to the clinic to go through the first stage of the examination. For the first visit you need from 2 to 6 hours of free time. Despite the fact that if there is a referral for medical examination there is no need to stand in line, it will take a lot of time for the examination by doctors. What specialists carry out a medical examination? Doctors of the following profiles examine the patient at the first stage of a routine examination:
- general practitioner (district doctor);
- obstetrician-gynecologist;
- surgeon;
- neurologist;
- ophthalmologist.
Laboratory and instrumental studies
What is primary medical examination, what laboratory and instrumental studies are carried out at this stage of the examination? The exact list of necessary medical procedures is indicated in the patient bypass sheet. Since such a list is developed individually, taking into account the age of the subject and his anamnesis. Standard examinations for clinical examination are as follows:
- blood pressure measurement;
- determination of glucose and cholesterol in the blood by express methods;
- clinical and detailed blood count;
- general urine analysis;
- determination of the risk of developing cardiovascular disease;
- coprogram;
- analysis of scraping from the cervix and cervical canal for women;
- fluorography;
- mammography;
- Ultrasound of the pelvic organs and abdominal cavity;
- measurement of intraocular pressure.
Often the question arises as to whether an additional visit to a gynecologist is required if a woman has undergone a medical examination of the first stage? An additional examination will be required only if abnormalities are found in the scraping results.
The second stage of the clinical examination
If during the initial examination any violations in the patient’s state of health were identified, then a second additional stage is assigned to him. What is secondary medical examination, what is included in it? Such an examination includes consultation of narrow specialists and carrying out the necessary tests to confirm the preliminary diagnosis and decide on further treatment of the patient. Namely: the subject is invited to use the following free medical services (the list is determined by the testimony based on the results of studies during the initial medical examination):
- consultation of a neurologist, urologist, gynecologist, otolaryngologist, ophthalmologist or surgeon;
- necessary additional laboratory and instrumental studies.
After completing the examination, the general practitioner fills out a “Health Card”.
Clinical examination of children
Preventive examinations of newborns are carried out by the local pediatrician in the first three days after the baby is discharged from the hospital, on the 14th and 20th day. Then, during the first year of life, parents need to bring the child to the doctor to assess the growth and development of the baby.
Children older than one year should undergo a medical examination once a year. It is necessary to get advice from such children's doctors as a neurologist, orthopedist (surgeon), ophthalmologist, otolaryngologist, dentist, speech therapist according to the schedule of preventive examinations depending on the age of the child.
The obtained data of examinations and analyzes are entered in the baby’s medical record, if necessary (for example, for admission to the preschool educational institution) a special medical form is filled out.
Thus, we clarified what the medical examination is and why it is carried out. Such preventive measures will help to maintain health and increase the life expectancy of the population of our country.
