На нетрадиційно гостру і провокативну розмову до Дня медика ми запросили начальника Головного управління охорони здоров’я Львівської облдержадміністрації, висококваліфікованого хірурга, професора кафедри хірургії Львівського національного медичного університету ім. Данила Галицького Ігоря Герича.

Ірина Кушинська: Який би поставили діагноз нашій медицині? – запитала зненацька.

І.Г.: Медицина – жіночого роду, і, як кожна жінка, вона може мати привабливе чи не дуже лице. Та, окрім обличчя, вона має душу, характер, звички і вади… Корупцію та инші негативи я б не назвав лицем медицини, швидше – шрамами на її гарному обличчі. Такий стереотип занадто поверхневий і не може характеризувати галузі в цілому, адже за мінімальної підтримки держави, незабезпеченості, недостатнього фінансування медики вико­нують свою роботу добре.

І.К.: Професія «лікар» з одних робить бізнесменів, з инших – Людей. Лікар – це покликання, стан душі чи метод заробітку грошей?

І.Г.: Якщо раніше існувала хибна теза про те, що значна частина лікарів приходить у медицину задля того, щоб заробити гроші, то сьогодні медицина не може бути бізнесом. Вона – не прибуткова. Це хіба що безнадійно хворий бізнесмен міг би пов’язати свій бізнес з державною медициною. Тому сьогодні в медуніверситеті немає звично високого конкурсу. Одна із студенток Києво-Могилянської академії провела опитування 307 лікарів Львівщини віком від 23 до 87 років на тему мотивації медиків. На запитання: «Чи обрали б ви медицину знову?» більшість відповіла: «Ні». Лікарів сьогодні не задовольняють умови роботи, упереджене ставлення суспільства, рівень фінансування галузі, забезпечення медикаментами… Працювати в такій атмосфері важко. Зараз з медициною зроблено те, чого не вдавалося зробити нікому ще з античних часів – розбито вщент авторитет однієї з найавторитетніших професій. Якщо ж поцікавитися в абітурієнтів медуніверситету, чому вони йдуть у медицину, відповідь буде – не з фінансової мотивації, а з бажання допомагати людям. Медицина – це, передовсім, покликання.

І.К.: Халат лікаря не завжди має білий, ідеально чистий колір. Чи мають право онкологи й инші лікарі брати гроші з приречених людей?

І.Г.: Однозначно – ні. Конституція нашої держави засвідчує безоплатність лікування. Але питання віддяки є делікатним, особливо в Галичині. У нас прийнято віддячувати лікарю за добро. Ми так виховані, і часто люди мають щиру внутрішню потребу віддячити. І мають на це моральне право, яке, за певних обставин, є протизаконним і провокативним у відношенні до лікаря. Є багато медиків, які роблять свою роботу добре, нічого за неї не вимагаючи, але, як у кожній професії, є й такі, котрі плямують білий халат.

І.К.: Якщо медицина сьогодні у кризі, зарплати – невисокі, робота – напружена і важка, то чому лікарі, часом навіть не питаючи думки своїх дітей, скеровують їх вступати у медуніверситет (династії – найпоширеніші серед лікарів)?

І.Г.: Те, що закладають лікареві у медичному закладі – це лише первинний фундамент. А потрібні ж – дахи, вікна, стіни, поверхи, не кажучи вже про інтер’єр професії… Усе це здобувається самостійно. І це надзвичайно копітка праця – від зеленого випускника медуніверситету дійти до професійного рівня, закумулювати колективний і особистий досвід, врахувати перемоги і помилки. Медицина загалом – це мистецтво, а не ремісництво… Лікар, який, як митець, по зернині зібрав раціональне з величезного і важкого професійного шляху – безумовно, хоче передати ці знання і майстерність своїй дитині, щоб її шлях був легшим. З покоління в покоління передаються ціннісні надбання знань і досвіду. Прекрасно, що у нас є такі династії. Сьогодні Львівщина пишається славними династіями Бесєдіних, Павловських, Барвінських і багатьох инших лікарів.

І.К.: Кажуть, аптечні кіоски, встановлені у наших лікарнях, приносять немалі прибутки головним лікарям, водночас «нагріваючи» хворих завищеними цінами на медикаменти. Чи не цинічно наживатися таким чином?

І.Г.: Якщо будь-кому – посадовій особі чи простій людині – відомі факти заробітку конкретного лікаря у такий спосіб, їх можна вирішити за допомогою нашого законодавства. Діюче законодавство унеможливлює такий спосіб заробітку грошей лікарями. Проте засилля аптечних кіосків різних форм власності є у цілій державі, а не лише у наших лікарнях – і це на фоні критичного падіння пропорції аптечних державних установ з дешевшими ліками. На це є багато причин. Одна з них – більша адаптація до ринкових умов приватних власників аптек. Попри міністерську підтримку державних аптек, ми на Львівщині пробуємо робити кроки для того, щоб нормалізувати цю ситуацію: зусиллями медичної громадськості створюється благодійна організація, яка називається «Лікарняна каса», сенсом якої є зменшення фінансового навантаження на пацієнтів і повне медикаментозне забезпечення лікування. За дрібні членські внески – повністю покриття видатків за медикаментозне лікування кожної особи, яка стає членом «Лікарняної каси». З иншого боку, ця організація передбачає створення мережі лікарів-експертів у кожному відділенні лікарень, які контролюватимуть якість чи склад лікарняних листків з призначенням ліків.

І.К.: У народі побутує ще один стереотип. Медінститут, а сьогодні медуніверситет завжди був «найдорожчим» навчальним закладом. Для того, щоб туди вступити, кажуть, треба було заплатити орієнтовно 7-9 тисяч, під час працевлаштування – від 3 до 20 (!) тисяч доларів за місце лікаря. Скільки ж коштує загалом стати лікарем?

І.Г.: Це, м’яко кажучи, не зовсім відповідає дійсності. Але це питання має відповідь. Процес підготовки спеціаліста для держави коштує немалі гроші. Серед людей існує ілюзія, що це завжди коштувало багато доларів. Я можу навести безліч прикладів і хмару людей, які не заплатили жодної копійки за те, щоб стати кваліфікованим спеціалістом. Це – люди різного віку, вихідці зі села… Вони сьогодні працюють провідними керівниками і є лікарями-професіоналами. Минулого року у медуніверситеті не було виконано державного замовлення у частині забезпечення сільських регіонів через невеликий конкурс. Ми зараз маємо 10 місць для обдарованої сільської молоді. У нас в області, наприклад, вакансій гінекологів немає. І скільки б тисяч доларів не було – усі місця зайняті.

І.К.: Можете пригадати унікальну історію чи випадок з життя нашої медицини за цей рік?

І.Г.: Унікальний випадок стався буквально цими днями: у Львівській обласній клінічній лікарні було проведено операцію, яку на Львівщині ніколи ніхто не проводив. Це операція із неоперативного закриття нориці (дірочки), яка утворилася у важко хворого пацієнта між трахеєю і стравоходом. Це – проблема, яка традиційно потребує надзвичайно складної операції, пов’язаної із низкою ризиків. Завдяки відеоскопічній технології норицю було закрито протезами, які самостійно розправляються, без оперативного втручання.

І.К.: Що для лікаря свято?

І.Г.: Найбільшим святом для лікаря є врятоване людське життя. Найбільше задоволення – видужання пацієнта. Усвідомлення цієї величезної місії, неймовірної відповідальності і важливості своєї роботи є визначальним мотивом приходу лікарів у медицину. Існує древній вислів: «Лікар, як свічка: світячи иншим, згоряє сам». Можна навести багато прикладів самопожертви лікарів. Важко, мабуть, зрозуміти людям инших професій, як ризикує лікар власним здоров’ям, лікуючи чи оперуючи хворих на СНІД, гепатит чи инші важкі хвороби. А особисте життя для лікаря завершується у той момент, коли починаються проблеми в чужої людини. Медики – великі життєлюби, які намагаються вести світський спосіб життя настільки, наскільки їм дозволяють час і професія. Лікарі люблять мистецтво, спорт, здоровий і активний спосіб життя – все те, що самі рекомендують своїм пацієнтам.

І.К.: А який традиційний тост серед медиків?

І.Г.: «За здоров’я!»

Розмовляла Ірина Кушинська

Газета «Високий замок» 17 червня 2006 року

 

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