Medical activity is an activity on which human life and health depend. Accordingly, the organization, the specialists who conduct them, must comply with a certain set of requirements. Have permission, license for your work. In this vein, we will consider the types of medical activities that are subject to compulsory licensing, especially (under the law) the process of obtaining a license.
What is medical activity?
At the beginning of the conversation, it would be nice to decide on a fundamental concept. Here is how Russian law explains it: these are the works and services that are included in the list attached to the Regulation on licensing medical activities (approved by Decree of the Government of the Russian Federation No. 291, the latest version of the document was produced in 2016).
The following assistance to the population belongs to medical activities:
- primary health care;
- specialized, high-tech;
- ambulance, specialized ambulance;
- palliative
- medical procedures at a spa institution;
- medical examinations;
- medical examinations;
- medical examinations;
- sanitary and epidemiological measures;
- transplantation of tissues and organs;
- donation.
Classifier
Types of medical activity are divided according to the general classifier:
- Sanitary and resort activity.
- Types of high-tech medical care.
- Specialized ambulance. Or an ambulance.
- Varieties of specialized medical activities.
- Medical assistance to women both during pregnancy and during childbirth.
- Inpatient medical care.
- Medical primary care.
- Outpatient activities.
- Varieties of medical first aid.
List of types of medical activities subject to licensing
The list of medical activities subject to licensing was approved by order of the Ministry of Health No. 142. This document is relevant in the current (2018) year. Entered into force on April 29, 1998.
According to this act, we will highlight below the entire range of types of medical activity, which is impossible to carry out without a state license of the established form. For convenience, we will divide them into subheading categories.
Primary medical care
What applies to the types of medical activities here? This is a combination of pre-medical (in other words, primary) medical care to the patient. By specificity it is divided into the following groups:
- Dentistry
- Orthopedic field of dentistry.
- Medical business.
- Obstetrics.
- Laboratory diagnostics.
- Epidemiological procedures.
- The sphere of nursing.
- LFK (physiotherapy complex).
- Nursing is like a department of pediatrics.
- Field of Dietetics.
Ambulance
Here, the list of types of medical activity will consist of three items:
- Medical ambulance.
- Emergency care for the patient - resuscitation.
- Medical support of the patient in the ambulance carriage.
Types of Diagnostics
The main types of medical activities in this category are divided into several subtypes.
Activities related to laboratory diagnostics:
- Toxicological, chemical studies.
- Parasitological analyzes.
- Biological, molecular studies.
- Microbiological analyzes.
- Studies of cytological material.
- Genetic analyzes.
- Immunological studies.
- Biochemical analyzes of the material.
- Hematological studies.
- Histological (they are also clinical and morphological) analyzes.
- Non-invasive research methodology - a set of general clinical analyzes.
A separate type of medical activity here is a set of radiation diagnostic measures:
- Magnetic resonance
- Computer.
- Thermography (the so-called thermal imaging).
- Radionuclide.
- Based on radio sound.
- All categories of radiological.
The following types of diagnostics that are completely independent of each other will include:
- Pathological.
- Endoscopy
- Functional.
Outpatient, outpatient care
A license for medical activities is required for this type. The types of activities here include a variety of medical care for both adults and children, which is provided on the basis of a polyclinic (outpatient treatment), another healthcare institution or at the patient’s home.
The following types of medical activity should be distinguished in the category:
- Andrology.
- Obstetric care.
- Allergological measures.
- Anesthesia.
- Resuscitation measures.
- Help related to the field of genetics.
- Hematology.
- Gynecology.
- Geriatrics.
- The help of a dermatovenerologist.
- Dietetic measures.
- Help for people with diabetes.
- Immunology and separately immunoprophylaxis.
- The activities of an infectious disease doctor.
- Parasitology.
- Cardiology. Separately - the work of a pediatric cardiologist.
- Resuscitation of patients with cardiovascular disease.
- Clinical transfusiology.
- Proctology.
- Cosmetology - both medical and surgical.
- Narcology (a license will be issued only to state and municipal medical structures - according to the Federal Law "On Narcotic and Psychotropic Drugs").
- Activities for physiotherapy exercises.
- Consultative and therapeutic neurosurgery.
- Neurology.
- Nephrology.
- Oncology. A separate license is for the work of the children's oncology room.
- The work of otolaryngologists.
- Phoniatrics.
- Audiology
- Ophthalmology. A separate license is for contact vision correction activities.
- Doctor’s work on family planning related to the reproductive function of patients.
- Sexology.
- In vitro fertilization.
- Pathology of professional activity.
- Pediatric work.
- Psychotherapy.
- Psychiatry.
- Radiology.
- Pulmonology.
- Rheumatology.
- Dentistry Separate licenses by category are orthodontics (specifically, pediatric and adult), orthopedics, and therapeutic care (for children and adults).
- Surgery - children's and adult.
- Physiotherapeutic procedures.
- Urology.
- Phthisiology.
- The activities of the endocrinologist are separate licenses for adult and pediatric specialists.
- Epidemiology.
- Endoscopy
- Activities related to the type of "day hospital" ( patient stay in a healthcare institution periodically, during the working day of the clinic for carrying out certain procedures, examinations, etc.)
General medical practice
A license for medical activities is also required here. The activities here are general medical as well as family medicine.
We move on to the next category.
Inpatient care
Another extensive category. It refers to the patient’s stay in the clinic, hospital for a certain long time.
Some types of medical activities related to inpatient treatment:
- In vitro fertilization.
- Obstetric work.
- Andrology.
- The work of a specialist allergist.
- Anesthesiology
- The activities of the resuscitation team.
- Barotherapy events.
- Hematology.
- Gastroenterology.
- Genetics.
- Female gynecologist.
- Geriatrics.
- Dermatology, dermatovenerology.
- Nutritional work.
- Help for diabetic patients.
- The complex of immunological measures.
- The work of an infectious disease specialist.
- Cardiology. Separately - pediatric cardiac rheumatology.
- Parasitology.
- Clinical pharmacology.
- Coloproctology.
- Clinical transfusion.
- Combustiology.
- Lithotripsy.
- Cosmetology - both surgical and therapeutic (without surgery).
- Work with groups on physiotherapy exercises.
- Narcology (as in the case of polyclinics, with regard to hospitals and clinics, Russian legislation allows licensing only to municipal and state entities).
- Nephrology.
- Neurosurgical activity.
- Neonatology
- Oncology (a separate license for the work of a pediatric oncologist).
- Audiology
- Otolaryngology.
- The work of the pediatric sector.
- Ophthalmology.
- Prosthetics - only within the boundaries of its main form of activity.
- Work with pathologies of a professional nature (obtained at work, production).
- Psychotherapeutic work.
- Psychiatry.
- Radiology.
- Pulmonology.
- Cardiovascular surgery.
- Rheumatology.
- Dentistry Separate license for orthodontic work, pediatric orthodontics, orthopedics, therapeutic care for adults and children.
- Maxillofacial surgery.
- Surgery. Separately licensed for children and adults.
- Endocrinology. The work of the pediatric endocrinologist is a separate license.
- Epidemiological work.
- Endoscopy
Pharmaceutical activity
Here we are talking about pharmacological departments on the basis of preventive or medical institutions.
Thus, the licensed types of medical activities in the group are as follows:
- The purchase of medicines is small wholesale.
- Storage of medicines in a warehouse.
- Medical and pharmaceutical control over the use of drugs from a hospital pharmacy in a healthcare institution assigned to it.
- Purchase, use, storage of narcotic drugs.
- Both the production of medicines inside the hospital and medical and pharmaceutical control over their use.
Traditional medicine
Licensing of medical activities directly affects the work of specialists, who use in their practice methods of folk (traditional) treatment. The following varieties of the latter stand out here:
- Homeopathy.
- Manual treatment procedures.
- All varieties of medical massage.
- Hirudotherapy.
- Reflexology.
- Methods of traditional diagnostics - but only those that are allowed by Russian legislation.
- A set of traditional healing systems. Also, a license can be obtained only for the type of activity that is not prohibited by the legislation of the Russian Federation.
Activities for the preparation of tissues and organs
It is possible to carry out work of such a plan with state permission. Licensing of certain types of medical activity is carried out:
- The removal, procurement and subsequent storage of materials - both tissues and entire organs.
- Harvesting and storage of sperm donors.
- Organization of donation.
- Procurement, storage, processing of human blood, its individual elements. The manufacture of drugs based on this donor material.
- Transfusiology production.
Expert activity
The order on the types of medical activities introduces mandatory licensing of the work of medical experts. We are talking about certain types of practice:
- Conducting examinations on the professional suitability of a citizen.
- Examination of the relationship of pathology, disease with occupational activity.
- Military medical examination.
- Military flight.
- Narcological.
- To assess the quality of medical care provided.
- Psychiatric.
- Pathological.
- Temporary disability.
- Minor health conditions.
- Forensic Medical.
- Forensic Psychiatric.
- Genetic.
- State of temporary disability.
- Forensic medicine.
- Biochemical
- Spectrological.
- Forensic chemical.
- Forensic Biological.
- Forensic histological.
- Forensic on corpses.
- Forensic medicine, which is carried out in relation to victims, accused and other participants in the criminal process.
- To give the right to own weapons.
Sanatorium-resort activity
Licensing of medical activities of sanatorium-resort institutions is also carried out. Permission is issued separately for the same categories that are allocated for clinics and hospitals.
Sanitary, anti-epidemiological work
The types of activities of medical organizations that belong to this group are also subject to mandatory licensing. The following categories of work are distinguished:
- Deratization.
- Disinfection.
- Pest control.
- Sterilization.
- Measures for bacteriological, sanitary control.
Who is licensing?
Let us examine in more detail the procedure for licensing medical activities in the Russian Federation.
The prerogative here is the Federal Service for Surveillance in Healthcare. It issues licenses in relation to:
- Medical organizations subordinate to the structure of the federal government.
- The institutions of the executive federal government, which provide for military service and service equivalent to it under the law.
- Organizations whose activities are associated with the provision of high-tech type of medical care.
- Other organizations and individuals who carry out medical activities in the territory of the Russian Federation.
Some functions are assigned to authorized structures of the subjects of the federation. This is the following:
- Submission and renewal of license documents.
- Providing copies and duplicates of licenses.
- Licensing control in relation to document applicants and these licensees who have submitted an application for re-registration.
- Termination of licenses.
- Maintenance of registers, lists of licensed documents already issued.
- Approval of a single license form.
- Providing information, advice on issues related to the licensing of medical activities.
- Placement of information necessary for license applicants in the media, on official state websites with contact information for communication.
Basic licensing requirements
To obtain a state license, an individual entrepreneur, an organization providing medical services, you need to comply with a large set of requirements:
- The presence (on the basis of ownership or other legal basis) of a structure, premises, building, corresponding to the norms of Russian legislation, designed to perform the declared work.
- The presence (on the basis of ownership or other legal basis) of devices, apparatus, equipment, tools, registered in a certain order, necessary for the work.
- The head of the organization, individual entrepreneur, has a higher, postgraduate or additional medical education, which meets the qualification requirements.
- The presence of a certain length of service.
- The presence of workers with whom labor agreements are concluded, the necessary specialization of medical education - higher or secondary.
- Compliance with the licensing requirements of the structure, staff description, the legal entity itself.
- Existence of a system of internal control over the quality and safety of the services provided.
The variety of activities of a medical institution is quite extensive. In our country, it belongs to compulsory licensing.