Professional Training

Family Doctor Service

Practitioner Services

The practitioner services consist of the Family Doctor Service, the Dental Service, and the Pharmaceutical Service. All these services provide the patient with the individual medical attention that he needs.

The professional attention of a family doctor is available to everyone. Patients may choose the doctor they wish, provided only that he is enrolled in the Service and that he agrees to attend them. They may also change their doctor. The doctor has the same freedom to accept or refuse patients as he wishes. He cannot be forced to attend any person against his will. The doctor working in the Service is entitled to attend paying patients who have not joined the Service, if he cares to do so.

The doctor in the Family Doctor Service is free to treat his patients exactly as the family doctor treated them in the past. If a serious illness develops or diagnosis is difficult, he may call in a consultant and get hospital treatment without reference to any outside authority.

The maximum permitted number of patients' names to be put on one principal's list is 3,500 and the present average number is about 2,200.

A doctor in public service is remunerated by a capitation payment for each patient registered with him, with an addition for every patient within the range of 501 to 1,500 on his list.

At present the Family Doctor Service includes the doctors of the own surgeries, to whom the patients go for advice and treatment unless the doctor visits them at home. A few doctors work in the health centers. Many general practitioners work only with one assistant. To become an assistant of the general practitioner (the principal) is a common method of entering general practice.

Only persons whose names are on the medical register can practice as doctors in the National Health Service, and only persons whose names are on the dental register can practise dentistry in Britain. The minimum qualification for registration of a doctor requires, five to seven years’ training in the medical school and hospital, and, for a dentist, four years at a dental school.

It also requires that before becoming fully registered and entitled to practise independently a medical student must spend at least a year after the completion of his examinations in satisfactory service in a resident medical capacity in one or more approved hospitals or institutions.

The General Medical Council is the governing body of the medical profession. It sees to it that no unqualified persons practice medicine.

There are 16 universities that grant degrees in medicine and surgery. In addition, the Royal College of Physicians and the Royal College of Surgeons grant diplomas which are recognized by the General Medical Council.

Higher degrees of Doctor of Medicine (MD) and Master of Surgery (MS), Membership or Fellowship of one of the Royal Colleges of Physicians (MRCP), Fellowship of one of the Royal Colleges of Surgeons (FRCS) may be obtained after examinations.

National Health Services in the United Kingdom

C: Good morning! May I come in?

M: Good morning. Come in please. Sit down. What can I do for you?

C: Let me introduce myself. I am a correspondent of the Russian journal “Medicine for you”. Our readers want to know more about the National Health Service in the U. K. Would you be so kind as to answer some of my questions?

M: I'll answer them with great pleasure.

C: Then, my first question is: When was the National Health Service established?

M: You know, our Service is rather young, it was established throughout the U.K. on the 5 ^th of July 1948.

C: And I wonder: What does it consist of?

M: Well, it consists of 3 main parts.

C: What are these parts?

M: They are the general practitioner services, the hospital and specialist services and the local health authority services.

C: Please, tell me about the practitioner services in detail.

M: You see, the practitioner services consist of the Family Doctor Service, the Dental Service and the Pharmaceutical Service.

С: And I am interested: What do these services provide the patient with?

M: They provide the patient with the individual medical attention that he needs.

C: Our readers ask: May the doctor accept private patients while taking part in the Service?

M: Yes, of course. Each doctor may accept private patients while taking part in the Service.

C: And what can you say about the pay? Where do doctors receive the pay from?

M: Our doctor can receive their pay both from our Service and from their private patients.

C: And what is the number of population using the Service?

M: If I am not mistaken, the number is 97 per cent.

C: Please, tell me some more about Family doctors. As far as I know, patients may choose the doctor they wish and may also change their doctors. And what about the doctors?

M: The doctor has the same freedom to accept or refuse patients as he wishes. He cannot be forced to attend any person against his will.

C: What can you say about the maximum permitted number of patients’ names to be put on one principal's list.

M: As far as I remember, this number is 3,500.

C: And what about the present average number?

M: Well, the present average number is about 2,200.

C: Thank you very much. I've got to know much interesting information about the National Health Service in the U.K. Our interview will be published in two weeks. I'll send you some copies of the journal.

M: Oh, thanks. I'll be waiting for it. I wish you good luck.

С: Thank you. Good-bye!

M: Good-bye!

Medical Service in the USA

In the final decades of the 20 the century, Americans increasingly view good health as something to which they have the right. Self-employed private physicians who charge a fee for each patient visit are the foundation of medical practice in the United States. Most physicians have a contractual relationship with one or more hospitals in the community.

They send their patients to this hospital, which usually charges patients according to the number of days they stay and the facilities – operating room, tests, medicines – that they use. Some hospitals belong to a city, a state or, in the case of veterans’ hospitals, a federal government agency. Others are operated by religious orders or other non-profit groups. Still others operate for profit.

Some medical doctors are on salary. Salaried physicians may work as hospital staff members, or residents, who often are still in training. They may teach in medical schools, be hired by corporations to care for their workers or work for the federal government‘s Public Health Service.

Physicians are among the best paid professionals in the United States. In the 1980-ies, it was not uncommon for medical doctors to earn incomes of more than 100,000 dollars a year. Specialists, particularly surgeons might earn several times that amount. Physicians list many reasons why they deserve to be so well rewarded for their work. One reason is the long and expensive preparation required to become a physician in the US. Most would-be-physicians first attend college for four years, which can cost more than 12,000 dollars annually at one of the best private institutions. Prospective physicians then attend medical school for four years. Tuition alone can exceed 41,000 a year. By the time they have obtained their medical degrees, many young physicians are deeply in debt. They still face three to five years of residency in a hospital, the first year as an intern, an apprentice physician. The hours are long and the pay is relatively low.

Setting up a medical practice is expensive, too. Sometimes several physicians will decide to establish a group practice, so they can share the expense of maintaining an office and buying equipment. These physicians also take care of each other‘s patients in emergencies.

Physicians work long hours and must accept a great deal of responsibility. Many medical procedures, even quite routine ones, involve risk. It is understandable that physicians want to be well rewarded for making decisions which can mean the difference between life and death.

Health Services in the USA

Situation for intercultural communication: A Russian doctor comes to the USA for a tour and speaks to an American guide about the problems of health services in the USA

Tourist: I know that there is quite a difference between our two systems of medical services. How is medical service organized in your country?

Guide: You see, in the USA there are three levels of organization of medical services.

T: What are these levels?

G: They are private doctors, medical institutions and the United States Public Health Service.

T: Who are the private doctors paid by?

G: The Private or family doctors receive the pay directly from their patients.

T: I’ve heard that you have the so-called «group practice». What does it mean?

G: The thing is that not all doctors have a private office of their own, some work in teams with several other doctors, that is the essence of the notion «group practice».

T: What medical aid do private doctors render?

G: Well, they give their patients regular examinations, medical advice and vaccination.

T: Can they hospitalize a patient if they find it necessary?

G: Certainly, they can. They may send a patient either to a private or to a state hospital.

T: Is there any kind of free medical aid in the USA?

G: Yes, there are two programs for rendering free medical aid to the population of our country: Medicare and Medicaid.

T: I wonder who comes under the Medicare program?

G: Medicare provides free medical care for all the Americans over 65.

T: And what does Medicaid mean?

G: Medicaid provides free medical aid for all those whose income is very low.

T: What questions come under the control of Public Health Service?

G: These are broader questions of medicine such as vaccination of school children, investigation of epidemics, scientific research dealing with the treatment of cancer and heart diseases.

T: What do you think about the main problems facing American medicine?

G: I believe they are practically the same as in your country: treatment of cancer and cardiovascular diseases, but the major problem of today is finding a vaccine against AIDS, the most disastrous disease of the 21 st century.

Дата добавления: 2014-10-15