Tonsils and lymph nodes ...

The tonsils and lymph nodes were not enlarged. BH - 18/min, rhythmical. Auscultation: the breath is held in all divisions, no rattles. HR = Ps = 92/min, regular, clear. Pulse full, rhythmic. BP = 140/90, the usual BP = 130/90, the maximum BP = 140/90. Tongue clean, moist. Stomach right ovoid shape, symmetrical, taking part in the act of breathing all divisions, soft and painless on palpation. Liver and spleen were not enlarged. Stools and urine output are normal. Symptom tapping negative. Neurological examination: the mind is clear, oriented in space, time, space and self. OD = OS, pupils normal, the response to the light alive. Meningeal and focal neurological symptoms, as well as no pathological reflexes. Status localis: attention is drawn to a sharp increase in pain with palpation of the chest on the left ... I think any doctor could make a presumptive diagnosis. Of course, MRNA not an indication for hospitalization ... But not from public places. In this case the employee is obliged to SMP hospitalized patients with any diagnosis. Because this case - not fiction, it is full, in detail, his utter. Paramedic service this call quite rightly, I think everyone will agree, was diagnosed with intercostal neuralgia, and hospitalized patients in the N-th hospital, then was forced to justify himself before the admissions staff, for having brought "this garbage" ... And what to do with it? Rules that the SMB is not we ourselves come up with ... And do they not get away ... In the end, after much punctuation, the patient did well given his worth to emphasize LEGAL bed hospital ... Of course, it is possible to calculate "treatment by ambulance to the emergency room doctors." And, most likely because it is. No need to keep an "emergency" her mistakes. Simply apply to employees of SMEs, whether physician or nurse, objectively ...

Specifics and peculiarities of the Russian model of compulsory health insurance

six destiny IA MD, Professor of BMI, Vladimir State University agree that sometimes nice sometimes, when your understanding of the situation and state of health services coincides with the Russians' understanding of your colleagues. It is doubly encouraging that such views and assessment takes the leadership of the country. So at a meeting of the State Council Presidium in Tambov, which dealt with the problem of compulsory health insurance system and search for ways of modernizing it was marked by inefficiency built in Russia by the model OMC. There is a view of the inefficiency in terms of quality service delivery and meet the health needs of the population, as well as opportunities for financial security. The regular ripe situation and outlines the real forms of modernization shaped the decade of national health insurance. One of the proposed ways, as we know, this selection in the medical services market (in the broadest sense) market segment of health insurance for retired pensioners.