And you'll be cured.: how to restore Russians' trust in public medicine
One in three Russians self-medicate after feeling signs of indisposition. This is evidenced by VTsIOM data. Less than half of the respondents turn to government clinics for medical care. The reason largely lies in dissatisfaction with the quality of medical care, which is reported by 52% of respondents. They see the main problems in the shortage of doctors and the lack of competence of medical staff. How to restore citizens' trust in free medicine — in the Izvestia article.
Crisis of trust
One in three Russians (35%) self-medicate. This is evidenced by the results of a survey conducted by VTsIOM. Citizens have become less likely to turn to state polyclinics for medical care, as only 41% of respondents do. For comparison, in 2006, the figure was more than half of the respondents (52%).
A similar percentage of Russians expressed dissatisfaction with the quality of medical care. According to the research center, it is caused by "structural problems of the healthcare system, including a shortage of personnel and competencies of medical workers," as well as "insufficient availability of a number of medical services." 83% of the respondents immediately pointed out these aspects.
Against this background, the demand for paid services is growing. Today, 17% of respondents apply to private medical institutions, although in 2006 their number was only 6%.
VTsIOM noted that, in general, the degree of dissatisfaction with the quality of medical care is decreasing at a slow pace — the negative still prevails in public assessments.
At the same time, one of the challenges of the modern healthcare system in Russia, according to the survey results, is the inequality of access to medical care. The level of satisfaction with medicine in Moscow and St. Petersburg is one and a half times higher than the national figure due to large-scale modernization programs, the introduction of innovations and the involvement of the best specialists.
In this regard, citizens are increasingly resorting to self—medication - it is becoming the main competitor of state medicine. However, according to VTsIOM experts, this practice should be considered not only as a consequence of inaccessibility or distrust of official medicine, but also as a reflection of a certain culture of health, faith in one's own knowledge of the body and the experience of previous generations.
The Ministry of Health warns
Such self-medication poses a significant health risk, the Russian Ministry of Health warns.
"Self—administration of medications, especially antibiotics and potent drugs, increases the risk of adverse reactions and the development of resistance to treatment, and also leads to late treatment with a doctor, which worsens the prognosis for serious diseases, including cancer and cardiovascular diseases," the department warns.
In general, the results of the VTsIOM study are not at all negative. They clearly show a serious sociologically significant increase (42% in 2025 versus 35% in 2009) in the number of citizens satisfied with medical care, the ministry's press service said. At the same time, the proportion of dissatisfied people is decreasing, which is the result of a consistent government policy to improve the quality and accessibility of medical care.
Since 2019, as part of the implementation of national projects, large-scale investments have been made in healthcare infrastructure, including the construction and repair of medical facilities, as well as their retrofitting with modern equipment. At the same time, federal and regional programs of social support for medical workers are being implemented, aimed at increasing the prestige of the profession and attracting personnel, the Ministry of Health recalls.
"These systemic changes have significantly transformed the entire landscape of Russian healthcare, leading to a transition to a more technologically advanced and patient—oriented model," the department emphasizes.
Personnel hunger
At the same time, VTSIOM data also confirms the existence of serious systemic challenges faced by public health, says Natalia Gavrilova, Chief physician of the Scandinavian Health Center.
"Despite the positive dynamics over the past 20 years (a 7% increase in satisfaction), the fact that 52% of citizens are dissatisfied with the quality — and in small towns this figure reaches 60% — clearly indicates that there are deep problems," she believes.
According to the Izvestia interlocutor, concerns are caused not only by the current level of dissatisfaction, but also by its key causes — staff shortages and unavailability of services.
The outflow of qualified personnel from the public sector today is due to several factors, says Sergey Kazimov, Chief Physician of the Diplomat Clinic Integrative Medicine Clinic, member of the Presidium of the Academy of Medical and Technical Sciences of the Eurasian Association of Medical and Environmental Technologies. The first of them is that the level of remuneration in private clinics is often higher than in public institutions.
The consumer attitude of a part of society towards the work of medical workers, which has been developing over the past decade, is also becoming a problem, the expert clarifies.
— If earlier the profession of a doctor was dominated by a respectful attitude in society, now many patients who come to state polyclinics perceive medical workers as a kind of service staff, already on the threshold and obligated to everything. This manifests itself in banal domestic rudeness, which is encountered daily in polyclinics, even doctors who are very dedicated to helping people can not stand it and leave, — says the specialist.
To solve the existing difficulties, a radical increase in the attractiveness of work in the public sector is required, Gavrilova draws attention to. In addition to mandatory work, decent wages, modern equipment, and continuing education programs are also required, she lists.
— In addition, it is necessary to introduce convenient and effective online recording systems, remote consultations, "second opinion", and an electronic queue. It is also important to formulate service standards, organize a patient quality assessment system, and provide public reporting of clinics on key indicators," the doctor believes.
She is convinced that the growing financing of healthcare should be directed to fighting queues, purchasing equipment for rapid diagnosis and stimulating the work of doctors in problem regions.
"Moscow is a striking example, where the equipment of urban polyclinics is at a fairly high level, doctors' salaries are not much different from those in private clinics, and in recent years more and more attention has been paid to patient orientation of medical staff and the speed of patient routing," Kazimov confirms.
Effective interaction
In general, problems can be found both in the public sector and in private medicine, but it is always important to assess the dynamics of changes, improvement of the quality of services and equipment, Kirill Masliev, Candidate of Medical Sciences, member of the State Council Commission "Long and Active Life", Head of the Department of Preventive Medicine at RUDN University, is convinced.
— In recent years, the public health sector has undergone a large-scale transformation: Medical institutions are being actively built and modernized, the material and technical base is being strengthened, and the list of compulsory health care services is expanding - from expensive drugs to high—tech interventions," the expert lists.
A significant contribution was made by the reform of the primary care, which was acute and in high demand, the Izvestia interlocutor clarifies. As a result, it proved to be effective, allowing the repair and re-equipment of a significant number of clinics.
There are many worthy highly qualified specialists working in public health institutions, especially in specialized clinical research centers, emphasizes Sergey Kazimov.
"A whole range of high—tech and high—tech medical care, such as high-quality transplant care, can only be obtained in government clinics," he draws attention.
At the same time, it is important to take into account that the private healthcare sector plays a significant role in the overall picture, adds Masliev.
— Competition among private clinics is traditionally higher, which stimulates the improvement of the quality of services, increasing customer orientation, the introduction of more modern technologies and flexible forms of service. Private networks are actively investing in equipment and service, which creates an additional standard of expectations for patients and indirectly pushes government agencies to accelerate their own reforms, the Izvestia interlocutor is convinced.
It is impossible to say which of these areas of medicine is of better quality, because today public and private clinics solve different tasks, Natalia Gavrilova points out.
— Private medicine in its modern form focuses on service, accessibility and patient comfort: appointment at a convenient time, no queues, extended appointment time, modern interior, comprehensive packages of services. It copes better with these requests and is an effective complement to the system, removing some of the burden from the public sector on paid services," explains the doctor.
State medicine, in turn, acts as the foundation and system of guarantees for all citizens, especially in the field of emergency care, the Izvestia interlocutor claims.
The ideal model for Russia, in her opinion, is a strong, well-funded and smartly organized state system that provides basic guarantees, and a dynamic private sector offering service, speed and additional options.
— Our task as a professional community is not to oppose, but to find points of effective interaction so that the patient benefits first and foremost. The problems of trust in medicine voiced in the VTsIOM survey are a challenge for the entire industry, and their solution will require the efforts of both the regulator and the business community," concludes Gavrilova.
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