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Weighing Up the Local Options for Healthcare

By Olga Kalashnikova
The St. Petersburg Times

Having to go to hospital in any foreign country is inevitably a stress, and Russia is no exception. While Russians are used to the system and know how to operate within it, it may seem like a quagmire of unfamiliar medical practices, bureaucracy and corruption to foreigners. Moreover, patients who speak little or no Russian are likely to get little understanding or sympathy at state clinics.
“I have never experienced medical treatment in Russian hospitals or clinics, but a number of friends who have been to Russian clinics spoke of subpar conditions and equipment,” said Elizabeth, a student from the U.S. who was treated in a private clinic in St. Petersburg when she fell ill while studying in the city.
Foreigners are also frightened by the possibility of being given the wrong treatment and unknown methods that could make their health complaint worse.
“Although you know you’re just being hysterical, there’s always the thought that the non-English speaking doctor is going to anesthetize you with no more than a couple of shots of vodka before proceeding to amputate your right leg — when all you had was an ingrowing toenail,” joked a representative of the American Medical Clinic & Hospital. Beneath the humor, there is however a grain of truth.
Such fears can turn minor ailments into more serious complaints, if patients fail to go to the doctor in time. Consequently, foreigners often solve their medical problems with a visit to so-called “Western-style” clinics.
“We need such clinics in Russia, as Russian state medical treatment undeniably differs from foreign systems in the diagnostic and treatment processes,” said Nadezhda Alexeyeva, the head of the Association of Private Clinics in St. Petersburg.
The phenomenon of “expat clinics” in St. Petersburg emerged 10 to 15 years ago. Such clinics were mainly aimed at providing emergency treatment with effective methods to help patients to recover in a short space of time.
“The clinic should help the patient by running all necessary tests, providing diagnostic procedures, and by finding a suitable treatment and doctor as quickly as possible,” said Maria Makarenko, client network manager at EuroMed clinic.
The primary service offered by “Western-style” clinics is multilingual staff.
“Medical problems are fully confidential, so using an interpreter is not desirable,” said Makarenko.
Patients of private clinics should expect to receive a high standard of treatment and comfortable surroundings. All medical reports are written in accordance with Western formats, and doctors generally have experience of working in hospitals abroad and of European standards of medical treatment.
“And of course, personnel take into account the psychological differences between Russians and foreigners,” said Yefim Danilevich, general and medical director of the American Medical Clinic & Hospital. “Doctors are familiar with the style of communication with patients that is the norm in Western countries: Open information and detailed explanations.”
“I was treated very well at the ‘Western’ clinic,” said Elizabeth. “All the doctors were Russian, but most spoke fairly fluent English. All had some medical experience or training outside of Russia. The doctors were respectful and forthcoming about my condition. I thought the standard of care was as good if not better than at many clinics and hospitals I’ve been to in the U.S.”
The attitude and service is a feature that attracts not only foreigners. If years ago, most clients of “Western” clinics were foreigners, nowadays more and more Russians are choosing to use their services.
“I heard lots of stories about attitudes to pregnant women in state hospitals, and I was afraid to go there — I wanted to have good service and treatment in order to feel stable psychologically,” said Anastasia, who gave birth to two children in a “Western” clinic in St. Petersburg. “I believe we have good doctors in state clinics, but you have to know how to get access to them,” she added.
Such services do not come cheap. Many patients of private clinics are covered by their insurance, and all their bills are paid directly by their insurance company.
“The reason I went to a ‘Western’ clinic was due to the fact that my insurance company only covered my expenses at a few clinics in St. Petersburg — all of them ‘Western,’” said Elizabeth. “Additionally, I had heard a number of horror stories about the medical care in Russian hospitals, which deterred me from going there other than in a serious emergency.”
“Foreign patients can face additional problems that should be solved by the clinic — travel arrangements for relatives, ticket and hotel reservations, and visa support in case the patient has to stay in Russia longer than they had planned,” said Makarenko. “It is important to provide medical evacuation to the patient’s native country.”
In this respect, clinics face other problems, which often supersede medical issues.
“[Such problems include] the form of evacuation — air or ground ambulance, schedules, international relations between countries and simply the mentality of the patient,” said Anna Plekhanova, deputy PR and corporate culture director at Emergency Medical Consulting.
“There was an incident when a Russian woman — now a Canadian citizen — emigrated with her daughter to Toronto,” she said. “The doctors recommended that her daughter be transported under general anesthetic. There were long days of cooperation with German, Turkish and Finnish airlines, with the Canadian visa department in Moscow, customs services and bank clerks. It was quite difficult to get the bureaucratic machine in motion, but we did it.”
Emergency Medical Consulting also offers to repatriate bodies, in a worse case scenario.
Doctors from ‘Western’ clinics offer aftercare to patients, providing remote consulting even after patients have been transported home, according to specialists from the American Medical Clinic & Hospital.
“The medical care in some Russian state hospitals is not as good as it could or should be,” said Elizabeth. “Also, I can imagine it would be quite frustrating and difficult for a non-Russian speaking foreigner to go to a Russian hospital, where there is not some sort of guarantee that they will be understood by the doctors. The western-style clinics cater to a very specific demographic — wealthy Russians and foreigners lucky enough to have a good insurance policy, or a policy through their country’s government.”
Providing medical care to foreigners requires additional skills and experience for which there is no need in state clinics, EuroMed representatives said.
“A foreign language–speaking doctor is a fairly expensive luxury that is not useful if they don’t work constantly with foreigners,” said Makarenko.
“That’s why western-style clinics that work with foreigners are certainly necessary in Russia.”

Источник: St-Petersburg Times, 25.05.2010

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