Today, there are a huge number of different pathological conditions. What unites them is that each of them is much easier to cure in the early stages of development. The detection of diseases immediately after their occurrence is the main goal of the medical examination.
Clinical examination - what is it?
Clinical examination is a complex of therapeutic and diagnostic measures, which is aimed at maintaining the health of patients and preventing the development of diseases, including those of social importance.
Currently, everyone has the opportunity to undergo a medical examination. Thanks to this, he has a chance in the early stages of the development of diseases to receive the necessary medical care. This is the main goal of the medical examination of the population.
What is the medical examination for?
Clinical supervision requires quite serious costs from the Ministry of Health. Despite this, the medical examination goals that can be achieved thanks to such investments fully justify any expenses. The main goals are the following:
- Identification of diseases at the earliest stages of their development.
- Ensuring regular monitoring of patients with chronic pathology or an increased risk of its development.
- Conducting preventive explanatory work with patients in order to correct their lifestyle.
- Prevention of the spread of socially significant diseases (for example, human immunodeficiency virus, tuberculosis).
Due to the achievement of the main goals of the clinical examination at the state level, it is planned to implement the following tasks:
- Decrease in mortality, especially of working age.
- Reducing the incidence of cardiovascular and other noncommunicable diseases.
- Stopping the growth in the number of patients with socially significant diseases such as tuberculosis and HIV.
- Increasing a person’s interest in maintaining their own health.
- Providing monitoring of the dynamics of chronic pathologies in order to reduce the number of exacerbations.
- Budget savings by reducing the number of complex treatment methods needed to combat diseases in the late stages of their development.
If these tasks are achieved, one can expect an improvement in the socio-economic state of the state as a whole and the health system in particular.
The goals of dispensary observation of the child population
For this age category of patients, an increased frequency of dispensary examinations is assumed. This is due to the high rate of changes occurring in the body of the child.
The goals and objectives of the clinical examination for young patients are the same as for adults. Features are as follows:
- the need to detect diseases as quickly as possible in order to normalize the socialization of patients;
- ensuring constant control over the pace of physical and mental development of the child.
Medical examinations of minors are given special attention. The availability of diagnostic and therapeutic procedures for them is much higher than for adults.
Who should be examined?
To date, the frequency of medical examinations depends on the presence of certain diseases in a person. Absolutely healthy people should be contacted for medical examination at least 1 time per year. As part of such examinations, the patient is not only examined by doctors, but also undergoes laboratory and instrumental examinations.
In order to achieve the goals and objectives of the clinical examination, patients with chronic diseases undergo a medical examination more often (usually 1-2 times a year).
For children, the frequency of visits to the doctor is slightly different. They are very actively observed up to 1 year. Then it is necessary to undergo a medical commission at 3, 7, 10, 14, 15, 16 and 17 years. Thanks to such a thorough examination, it is possible to achieve the main goals of the medical examination in children.
Stages of dispensary observation
For the full implementation of the goals, the medical examination is divided into the following stages:
- Screening of patients.
- Conducting additional diagnostic measures, establishing a diagnosis and prescribing appropriate treatment.
At the first stage, patients need to undergo examination depending on age and the presence of chronic pathology. Absolutely all patients need to undergo the following diagnostic measures:
- general blood analysis;
- biochemical blood test with determination of cholesterol;
- general urine analysis;
- blood test for glucose levels;
- electrocardiography;
- fluorography;
- physical examination (height, weight, body mass index).
After the patient is 39 years old, he needs to undergo an ultrasound examination of the abdominal cavity organs as well as the pelvis once every 6 years. In addition, women should undergo a mammogram and examination by a gynecologist. In the process of such an examination, a smear from the vaginal mucosa is performed for subsequent cytological examination.
From the age of 40, the patient during the clinical examination also needs to visit an ophthalmologist to measure intraocular pressure. This allows timely detection of glaucoma, while preserving human vision.
From the age of 48, each patient is invited to take an analysis of feces for occult blood as part of the clinical examination. Such an examination allows us to identify pre-tumor and oncological diseases of the gastrointestinal tract at the very early stages of development.
According to the readiness of the examination results, the patient is sent for examination to the therapist. He examines the data of the diagnostic measures, clarifies the weight, height of the patient, determines the body mass index and conducts a medical examination with the mandatory measurement of blood pressure. This ends the 1st stage of the clinical examination. Its purpose is to identify abnormalities in patients. In the future, stage 2 of the clinical examination begins, which involves an in-depth examination of people with identified development risks or signs of acute or chronic diseases.
About the second stage of the clinical examination
This stage is no less important for the implementation of all the goals of the medical examination of adults and children. Its main task is to additionally examine patients with signs of health problems or increased risks of developing pathological changes in the body. Thanks to this, the doctor has the opportunity to make a clinical diagnosis and prescribe the most effective treatment regimen. At this stage, the patient may be advised to undergo both the simplest and very complex types of diagnostic tests.
Special Populations
There are several separate categories of citizens who can undergo clinical supervision annually, even if they do not have any pathology. Among them:
- persons affected by the Chernobyl disaster;
- veterans of the Great Patriotic War and persons equated to them;
- internationalist warriors.
As part of the dispensary examination, people from this category are recommended to undergo some additional examinations (for example, people who suffered from the Chernobyl accident need to undergo an ultrasound scan of the thyroid gland).
Results of dispensary examinations
There is a concept of the effectiveness of medical examination. It implies not only taking into account the quantitative indicators of dangerous diseases detected at an early stage. It also matters the movement of patients from one group to another. Clinical observation is called effective, which allows people from a group of patients with serious pathology to go into the category of people with prolonged remission of chronic diseases or even completely healthy.
It is rational to evaluate a real assessment of the activity of a physician-therapist in conducting a medical examination after at least 8-10 years of constant work with the same patients. Otherwise, the results will not be objective.
The role of a nurse
Nurses are the main employees on whose implementation the implementation of all the goals of the medical examination directly depends. The nurse should keep a patient’s card file and provide them with an active call for the next examination on time. Most often, a telephone is used for these purposes. Less commonly, written notifications are sent to patients by mail. If a person does not regularly attend a medical examination and at the same time has a serious illness, which without medical supervision can lead to serious complications, then the nurse will visit the patient at home.
The nurse's task is also to timely inform the doctor about patients' evasion from the clinical examination, as well as the presence of significant deviations from the norm in the results of their examination.
The role of the GP
It is this doctor who is responsible for the implementation of the goals of the medical examination. He coordinates the activities of a nurse, develops a scheme of medical and rehabilitation measures, appoints an additional examination necessary for the patient. As part of the observation, the doctor can independently set the frequency of examinations required by a particular person with a chronic pathology. Moreover, their frequency should not be lower than that prescribed in regulatory enactments.
The therapist also analyzes the results of the medical examination, evaluates its effectiveness and develops measures to improve it.
Is it possible to refuse medical examination?
Not all patients understand and are close to the goals of the clinical examination. Many try to evade it. Those who do not wish to undergo a periodic examination should do the following:
- Contact your local GP with a request to provide the opportunity to refuse to undergo medical examinations.
- Fill out this application in writing.
- Fill out the form for refusing to undergo a medical examination (it indicates the possible consequences for the patient and the absence of complaints against medical workers).
This statement is certified by the personal signature of the patient and therapist. After that, medical workers will no longer bother a person with constant calls for a medical examination.
About socially significant diseases
Prevention of the development and spread of dangerous diseases such as HIV infection and tuberculosis is one of the main goals of the medical examination of the population. This task is extremely important due to the fact that such diseases have serious socio-economic significance. Over the past decade, the number of such patients has increased and continues to grow.
In order to prevent the spread of tuberculosis, patients are invited to undergo a fluorographic examination. The dose of radiation that a person receives during it is significantly less than when performing an x-ray. The same study reveals tumor diseases of the lungs in the early stages of their development.
HIV infection may be suspected by a general blood test. Unfortunately, deviations in it are not visible at the very first stages of the disease. Therefore, patients who have had sexual contact with a person whose health they are not sure about are recommended to take a blood test for HIV infection. This can be done as part of the medical examination.
Foreign experience
In many countries, a similar patient monitoring system exists. In states with a developed healthcare system, the level of monthly health insurance payments depends on the timeliness of the examinations. Those who do not comply with the recommendations of doctors have to pay an order of magnitude more.
A system of medical examination similar to the Russian one is available in the Republic of Belarus. Clinical examinations of healthy patients there are 1 time in 2 years. The complex of diagnostic examinations is also comparable. Moreover, the main goal of the medical examination of the population in this country is the same as in the Russian Federation.