Гость редакции Наталья Александровна Болоняева — главный врач консультативно-диагностического центра «Вивея», кандидат медицинских наук, Заслуженный врач РФ.
— Нынче «Вивее» уже 90 лет. В таком возрасте некоторые говорят: ну, все — пожили и хватит.
— А у нас все самое интересное только начинается! И оно, как всегда, будет впереди. На этой дате мы не останавливаемся. Поэтому настроение и торжественное, и деловое. Конечно, «Вивея» за 90 лет все время развивалась, и такой возраст говорит о неких свершениях. Накоплен опыт, знания, обретена какая-то мудрость.
— А какое главное препятствие было у «Вивеи» за эти годы?
— Сложный вопрос! Какое препятствие… Да мы их постоянно преодолевали! Никогда не было такого периода, чтобы расслабиться и почивать на лаврах.
— Но у «Вивеи» всегда были преференции поликлиники для руководящего состава края.
— Да, она начиналась, как маленькая поликлиника закрытого типа для партийных работников — и так было довольно долго. Только в 80-е годы стала более открытой, а потом доступной уже для всех жителей края. А преференция (единственная и непоколебимая) всегда была одна — это ответственность.
— Но привилегированность-то была?
— Я вспоминаю: по работе, по условиям, по оснащению ничего отличительного у «Вивеи» не было. Я пришла сюда после практики в третьей городской больнице и ничего особенного не обнаружила. Все было то же самое, что и в других лечебных учреждениях города.
— А чем же она отличалась от других?
— Ее всегда отличало доброжелательное отношение к пациентам. А еще у коллектива всегда было желание быть лучшими. Персонал стремился получать знания, образование, навыки.
— Что сегодня можно отнести к итогам работы вашего центра?
— Первое то, что «Вивея» стала консультативно-диагностическим центром. Это более высокий статус для нашего учреждения, которое оказывает помощь первичному звену здравоохранения по всему краю. Мы перестроили свою работу, стали больше выезжать в районы. Второе — упор на профилактическую работу, о чем свидетельствует наш Центр здоровья, которому уже более десяти лет. Третье — активное внедрение современных форм работы, таких, как прогулки с врачом, профилактические лекции и т.д. И самое главное — высокий уровень диагностики именно на амбулаторном этапе, без госпитализации.
— Чем это хорошо?
— Любая госпитализация — это большие затраты бюджетных денег. А помощь в поликлинических условиях направлена на раннюю диагностику сахарного диабета, онкологических, сердечно-сосудистых и других заболеваний, которые влияют на качество жизни, на ее продолжительность, на трудоспособность населения. Они у нас на первом плане ранней диагностики.
— Можно считать итогом высокую посещаемость вашего центра? Или наоборот: лучший итог в том, чтобы всех вылечить, а посещаемость сделать ничтожной?
— Нет, всех вылечить невозможно. Все-таки мы больше расположены к высокой посещаемости. Потому что у ранней диагностики есть две задачи: важно выявить заболевание, но не менее важно его предотвратить. То есть нацелить человека на здоровый образ жизни, на правильное питание, на своевременное обследование и т. д.
— Чтобы поддерживать свой статус, «Вивея» обязана сотрудничать не только с нижестоящими, но и с вышестоящими учреждениями здравоохранения. Контакты есть?
— Конечно, есть! Мы очень тесно работаем с нашими ведущими учреждениями — онкоцентром, кардиоцентром, нейрохирургическим центром, МНТК «Микрохирургия глаза» и другими стационарами. В последние годы активно развивается телемедицина. Сейчас мы больше работаем с ведущими российскими центрами Москвы, Санкт-Петербурга, Новосибирска. Мы консультируемся с ними и по сложным диагнозам, и по подбору лечения, в связи с чем отпала необходимость направлять пациентов в другие города. Мы развиваем телемедицину и с районами края. Наши врачи дистанционно описывают ЭКГ, энцефалограммы, компьютерные томограммы и многое другое. Это и помощь районам, и учеба.
Надо сказать и о цифровизации: мы одними из первых перешли на медицинскую информационную систему. Она позволила сделать сквозную информатизацию лабораторной службы, внедрить искусственный интеллект в лучевую диагностику. Это помогает эффективнее использовать ресурсы, больше делать анализов, не допускать врачебные ошибки. В будущем мы полностью перейдем на электронную медицинскую документацию.
— Если такими темпами двигаться, то скоро начнем знакомиться не с вашими врачами, а с роботами?
— Да, в планах есть использование роботов в нашей работе.
— Не пугайте! Сейчас вы говорите о доброжелательном отношении врачей к пациентам, а дальше нас встретят бездушные роботы?
— Не бойтесь, менять врачей на роботов пока не будем. А вот на стадиях сортировки, подготовки, анализа, доставки информации, документов, расходных материалов — будем. Частично мы уже это делаем, и будем совершенствовать.
— Если это дорогое удовольствие, то зачем оно?
— Пациент дороже. Ему важно меньше времени тратить на диагностику или на посещение врача. А роботизация должна увеличить пропускную способность. Еще один метод — объединение в комплекс результатов различных обследований, чтобы в случае сложной ситуации к заключению врача была дополнительная информация с помощью искусственного интеллекта.
В декабре я поеду в Москву на выставку, буду смотреть новинки использования разных диагностических и лазерных систем. В косметологии мы уже давно используем лазер, а сейчас более активно будем его внедрять в нашу амбулаторную хирургию.
— После выставки возможны закупки оборудования?
— Обычно, да.
— И деньги вам дают?
— Частично нас финансирует краевой бюджет, частично мы зарабатываем сами и используем на благо медицины. Вообще надо сказать, что в нашем крае власть всегда хорошо относилась к медицине — и в прошлом, и сейчас. Возьмите наши поездки по районам, то есть выездную диагностику — это чья заслуга? Губернатора, правительства края и министерства здравоохранения. Мобильные медицинские комплексы оснащены не только современным транспортом, но и всем необходимым современным диагностическим оборудованием. Это намного расширяет возможности медицинской помощи в глубинке, ее доступность. Я много лет работаю в первичном звене здравоохранения, и вижу, сколько внимания уделяет краевая власть строительству ФАПов, амбулаторий, районных больниц, то есть тому, что в свое время было разрушено. Совсем иное сейчас внимание к строительству детских медицинских учреждений. Это радует всех.
— Что еще в ваших планах?
— Самая основная наша задача — это привлекать к нам на работу молодых специалистов, передавать им наш опыт, помогать набираться новых знаний. Иными словами, цель — развитие кадрового потенциала «Вивеи».
— Ну, вам-то грех обижаться на свои кадры.
— А разве развитие бывает лишним? Я стараюсь брать в коллектив «Вивеи» таких специалистов, которые готовы учиться, готовы воспринимать новые знания и использовать их в лечении. Для меня очень важный показатель, когда приходит заведующий отделением или сотрудник и говорит, что им надо. Хуже, когда я прихожу в отделение и задаю такие вопросы. И в каждом отделении каждый год мы пишем в план по полсотни новых методик, которые мы внедряем в свою работу.
— Сами пишите методики????
— Нет, не мы их придумываем. Это то новое и современное, что уже наработано в стране, но у нас не применялось или не развито по каким-то причинам. К примеру, одна из важных задач (и наша перспектива) — это развитие нашего регионального центра первичной медико-санитарной помощи для ранней диагностики. Что там актуально? Чтобы в первичном звене всех лечебных учреждений была доступна маммография для раннего выявления рака молочных желез. Второе: внедрение по всему краю использования жидкостной цитологии в ранней диагностике рака шейки матки. Третье: ранняя диагностика колоректального рака.
— И в чем здесь проблема?
— Проблема в том, как настроить наш народ на своевременное ежегодное прохождение диспансерного обследования. Я хочу еще раз остановиться на том, как некоторые несправедливо относятся к медицине в нашей стране, да и в крае тоже. Ой, две недели ждать УЗИ! Но ведь только у нас это обследование делается в такие короткие сроки и бесплатно! А в хваленых развитых странах пациенты ждут своей очереди по полгода, а то и по году. Да, там хорошая медицина, но простому человеку даже за деньги очень непросто обследоваться. Это надо понимать. И не надо игнорировать свои возможности.
— Мы отвлеклись от кадрового потенциала «Вивеи».
— Да. После реконструкции здания наш коллектив хорошо прирос специалистами. И сейчас к нам идут молодые, которым мы помогаем. Это важно, потому что коллектив — это команда, где все за всех. И коллектив в «Вивее» — это главная ценность, это профессионалы, это творческие люди.
— Какую оценку вы дадите сегодня «Вивее» — без ложной скромности.
— Это одно из ведущих лечебных учреждений края, которое занимает свою определенную и полезную нишу между первичным звеном и стационарной помощью.
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