RAS Academician Grigory Roitberg - in an interview with Kommersant FM
"Early detection of the disease does not guarantee a long life, but it significantly increases the chances."
Photo: Kristina Kormilitsyna / Kommersant
Clinical examination is not only important for health, but also beneficial to employers, sociologists have found out - it is savings on sick leave and a stable income that healthy employees bring. What are the types of medical examination? And where in Moscow is it better to take place? Academician of the Russian Academy of Sciences, President of OJSC "Medicine" Grigory Roytberg told Marat Kashin about this within the framework of the program "Goals and Means".
- Probably, there are no more people in our country who do not know what clinical examination is, that one should go to doctors not when something is already very ill, but it is better to check their health in advance. Most people know, but not everyone follows this rule. Let's talk about this now. Now you can convince skeptics who say: why go to the doctor, get checked every three years if you feel healthy at the moment?
- I do not set myself impossible tasks, I will not be able to convince. But maybe some part of people will listen to this, and this will also be very important. Modern medicine at the current stage of development shows very high efficiency in the treatment of many diseases. But the effectiveness is much higher when they are discovered early. There are early detection systems, they really help, this applies to almost any disease. Probably, the assertion that if you find hypertension or altered cholesterol, then we can act on the fact that a person does not develop early myocardial infarction or stroke, is already on edge. Everyone knows that early detection of cancer leads to completely different results. I'll give you one example. If you find lung cancer at the very initial stage, then you have a 75-80% chance of cure, and if after about a year, then a five-year survival rate is only 30%. I can cite such data on any disease, more or less serious. Everyone talks about male mortality at a fairly early age, everyone knows this - this is the scourge of the current state of Russian society, when the average age of a man is catastrophically low. And when we look at what causes death, excluding non-medical problems, such as deaths on the roads or the use of low-quality alcohol, the first is a complication of atherosclerosis, that is, strokes, heart attacks, and so on. And in fact, it is very simple to prevent a stroke, but first you need to detect it. It has been proven all over the world that early detection is not a guarantee that you will live very long, but it significantly increases the chances.
- Do I understand correctly that not all studies are included in the standard clinical examination program?
- In our clinic, for example, there are different programs. There is a basic one: for example, a person, 40 years old, he does not have any complicated anamnesis, relatives were not seriously ill at an early age - then the scheme is simple: seven studies, which we do within two hours. If a person, for example, has a close relative who was ill or died of cancer at different ages, the list expands. If we find something, then, of course, we continue to survey. But what do they usually say? Once, it's hard to leave work, and Saturday is a pity. Our usual routine examination takes three hours. And if it is complex, with the addition of complex methods, then it is about eight hours.
- Indeed, when people are asked why they do not undergo medical examination, they answer: there is no time, bad organization or poor quality of conduct. Another very popular answer: the employer will not let you in.
- You can contact employers. It seems to me that these people should be motivated. If they want, they will find such an opportunity. I would like to be realistic, I very vaguely imagine an employer who will say: today is just a more or less easy day, go for half a day for a medical examination. A normal employer will say: you have time after work, your own time. You have Saturday, you have Sunday, after all. Our clinic, for example, is open these days. Therefore, I do not think that employers will meet everyone halfway. The most important thing is the motivation of people. This is our psychology - "It won't touch me." Conventionally, I understand that smoking is probably not very good, but I will continue to smoke, because most likely it will not affect me. But a serious employer who is interested in employees in the long term understands that an employee who has worked for several years becomes much more expensive. Not more expensive for the heart, namely for the wallet, for the budget. Funds, soul and so on are invested in it. And losing it is not only a moral, but a monetary problem. Therefore, if employers understand that this is not only a decrease in the number of sick leaves, it is early departure from work in the literal sense, this is his loss as an employee - that is, an economic substance. By the way, the economic substance is the most important factor for us as well. For example, if you take the United States or other countries where the degree of social protection is sufficiently high, then it is very unprofitable to get sick. Even for a wealthy person, there is a risk of losing everything. Therefore, the first thing he will do is to undergo a medical examination, and the second is to have insurance that will cover the costs in case of illness. We don't have that yet.
- You work, among other things, within the framework of the compulsory health insurance system, how profitable is it to work at the rates offered by the state?
- No, and we refused many services. It is not profitable, and all the talk about changing the payment system has been going on, in my memory, for the last 20 years, but there is no movement. And this is after we signed the documents with the president of the country, we applied everywhere. But we are very active participants in the medical care and treatment of patients in high-tech medical care, where very expensive and very rare equipment and highly qualified personnel are required. So, we became one of the first to work in the compulsory health insurance system for positron emission tomography - this is a very interesting method for early detection of cancer. Or neurosurgery or radiation therapy.