Pavel Brand on his work as medical director of the Family Clinic

«Family» philosophy

Our global task is to work, helping people throughout their lives. We set ourselves the task of family policy in providing medical services - people really come to us with their families. Children who were served in our first clinics have grown up and now bring their children to us.

Personnel decide everything

This may sound a little pathetic, but personnel decide everything. We managed to assemble a team of professionals. In addition, the length of our existence on the market plays an important role - our network has been around for over 18 years. We have a certain number of established clients, we have a brand that inspires confidence in the consumer. Perhaps, these are our main advantages over new medical clinics.

Trust factor

We have an average of 50 thousand primary patients per year. We are not engaged in commercial "promotion" of the patient. You can come, get quality care and come back in a year or two, say, with a different problem.

As for the factors why a patient finds us and stays - this is, of course, first of all, the professionalism of our doctors. In today's realities, a doctor often becomes more important than a clinic.

Logistical convenience, that is, location, plays an important role: almost all of our clinics are located near the metro, in densely populated or business areas.

A single information system - thanks to it, our clients often use two or even three branches at the same time. In the morning, a patient can take tests near their home, and in the evening, after work, get a doctor's consultation at a clinic near the office.

There are clinical bases where patients look for doctors - including using the Medbooking resource.

Our patient

We are in the middle price segment. And our patient is a representative of that very "middle class", a working person of the most productive age from 20 to 50 years.

But this does not prevent us from working just as effectively with the elderly and children, because their relatives often bring them to us.

Who is a "good doctor"?

It is difficult for a standard patient to evaluate the medical qualities of a doctor. It would be wrong to say that we invite only doctors that patients like to work. Because people do not always like high-quality doctors.

As practice shows, patients generally like charlatans more, otherwise there would be no charlatans. They prosper better than many medical luminaries. Therefore, we pay more attention to the professional qualities of a doctor. Of course, communication skills and the ability to learn and gain new knowledge are also important.

We conduct a three-stage interview, and then the candidates undergo training. Of course, by this time we have time to understand the doctor's skills and personality before the patient gets to see him.

The ideal doctor-patient relationship

If I were to answer in one word what the relationship between a doctor and a patient should look like, my answer would be "professional". All people are different: some expect sympathy and compassion from a doctor, long, lengthy conversations about their health. And some want the problem to be solved as quickly as possible, as efficiently as possible, and preferably not to see a doctor again. Rather, it should be a fine-tuning in each individual case.

An individual approach and treatment of the disease as a whole, rather than specific symptoms - these are our guidelines.

Pavel Brand on the work of a medical director

One of the founders of the Family clinic chain invited me as a manager. By this time, I had already received a scientific degree and had experience in management in a large city hospital. Now management is a priority, but I have not abandoned my medical career, I see patients, and observe difficult patients.

I see my merits as a medical director in the fact that I managed to form an excellent, professional team.

And also to create a medical audit department that monitors a huge amount of documentation, develops our internal protocols based on international standards for the provision of medical care to patients, regardless of their source of funding. Be it voluntary health insurance or the patient's own funds, care must be provided to everyone with the same quality.

I also make sure that patients are not "twisted" into additional, not always necessary examinations. This is taboo for us. The patient should return to us not because we prescribed him a lot of additional tests, but solely for medical reasons.

I am a supporter of the fact that medicine prevails over commercial gain. If there is high-quality, not quantitative, provision of medical care, then the financial benefit will always come.

High-tech is unprofitable

Network clinics cannot be high-tech in principle, otherwise they are unprofitable. We have a high-tech surgical hospital where minimally invasive operations are performed. The patient receives high-quality care in the shortest possible time. On the day of treatment, a patient can undergo surgery and be discharged from the hospital in 24 hours and be observed on an outpatient basis in one of our clinics near home. We perform almost the full range of surgical interventions, including operations for cancer patients.

As for the outpatient clinic, we have all the necessary capabilities for examining a patient: ultrasound diagnostics, X-ray methods, endoscopy, cardio and neuro-functional studies. But we do not have radiation diagnostic equipment - CT and MRI - since maintaining them is again unprofitable. But we use the equipment of our reliable partners.

Private medicine in Russia: the fall of the insurance market

Private healthcare will develop. This is a fairly profitable sector of the economy, because the level of private medicine is growing, gradually replacing the state in some aspects. The state can no longer handle such a budget burden, especially in today's economic conditions. Therefore, large network projects will continue to develop.

But globally, a qualitative strengthening of private medicine is possible only with a change in the entire insurance structure. If insurance companies pay for treatment, as is happening in Europe, without limiting insurance programs, and begin to pay for some serious medical interventions, then private medicine will develop even more powerfully.

Now the insurance market is falling, and the medical market is growing.

Therefore, people have to pay their money for the provision of each service, and not pay for one-time insurance and receive the service at its expense. However, this is also due to the fact that Russia does not have an insurance culture, which has developed in many countries over the course of centuries.

Public Healthcare: The Concept of Evidence-Based Medicine

On the one hand, the public system has a huge number of highly qualified specialists, and this is great. Although now this percentage has begun to fall, and many "medical minds" are leaving for private clinics. Public health care is currently undergoing reform. And this reform, in my opinion, is "failing". It is difficult to say what will happen next. The availability of medical care in the public sector is falling, which we see in the increasing influx of patients to private medical centers.

But the problem is global, in my opinion, and is connected not even with the current reforms, but with the fact that the reform is being carried out "from the wrong end". An important aspect should be a total change in medical education. And then, against this background, it would be possible to begin reforming the healthcare system.

The training of specialists is poor. You can't study using textbooks that are ten years old. In the modern world, medical knowledge is updated every six months, or even more often. We must move to the concept of evidence-based medicine at the state level.

There must be clear criteria for evidence, standards, protocols, and recommendations that are not biased by pharmaceutical companies.

Then, based on this, you can teach future doctors who will use it. Modern medical science changed in the early 90s, when the concept of evidence-based medicine appeared, which, unfortunately, we still have not adopted.

However, there is another problem. In the current economic situation, we cannot fully transition to the concept of evidence-based medicine in the country, because it assumes the same standard of service provision not only in treatment, but also in examination and prevention, as well as the same equipment for all medical institutions. But it is practically impossible to equip a capital federal clinic and a hospital in a small village in the Far East with high-tech equipment.

This does not mean that some aspects of evidence-based medicine cannot be implemented now. We must get rid of drugs, methods and examinations that have no evidence-based effectiveness. We must completely revise the register of medical specialties - those that are lacking, for example, rehabilitation doctors or algologists (specialists working with pain).

Another important point: there is no good modern doctor without knowledge of English. No more than 10-15% of doctors today can read and understand scientific information in English, and this is a big gap. We pay very little attention to non-medical aspects of medical education. No one teaches doctors to communicate with patients.

There is a subject called "medical ethics", which is taught optionally. For example, in the USA they take a special exam with the participation of actors who imitate patients. Our educational system does not pay due attention to such a discipline as medical law. A doctor should know his rights and the rights of the patient.

How to choose a private clinic: 3 practical tips

1. Length of existence on the market. An important criterion. A clinic or network that provides low-quality services will not "survive"; people will simply not go there.

2. Reviews on the Internet. Is it worth paying attention to reviews about a clinic or doctor on the Internet? Yes, but you need to understand that patients cannot accurately assess their professional qualities. A doctor who is not the most polite can be described as a complete layman. But from a professional point of view, he can be a guru.

3. Constancy. I advise you to pay attention to the regalia of the employees and the length of time they have worked in one place. If a doctor has been seeing patients in one clinic for more than three years, this is a good sign.