6. Первичный прием больного, направление к специалисту



 

-         Come in, … , come and sit down here. Your doctor’s told me that you’ve been having pain in your chest.

-          Yes, and in my arm and …

-          Now when did you first notice this pain?

-          Well, if I’m not mistaken about 5-6 month ago.

-          Can you remember when it first came on?

-          Well, I got a bad pain in my chest when I was shopping. It was so bad that I even couldn’t breathe.

-          In which part of your chest did you feel the pain?

-          Right across my chest.

-          And how long did it last?

-          About 10-15 minutes.

-          What did you do when it happened?

-          I had to stop and wait for it to go away.

-          Have you had the pain again since then?

-          Yes, I often get it when I overdo things.

-          I’d like to examine you, your chest now. Strip to the waist, please. I’ll check your pulse first of all. Oh, that’s fine. Now your blood pressure. 130 over 80 – that’s quite normal too.

-          I’m glad to hear that.

-          Now I’m going to listen to your heart. I want you to breathe normally. Your heart sounds quite normal.

-          Well, that’s a relief.

-          Now I want you to take deep breaths in and out while I check you lungs. In… out… in… out…thank you. Well you have angina and this occurs when not enough oxygen is getting to the heart. Well I think you should go and see cardiologist. He’ll examine you again and prescribe you an adequate treatment. So this is an appointment card to the cardiologist. He is seeing his patient right now.

-          Thank you, doctor.

20. Система медицинского обслуживания в разных странах мира: сопоставительный анализ



 

-    Good afternoon. I am a correspondent of the magazine “Health”. I know that you have experience observing medical practices in American and British hospitals. So would you tell our readers about your impressions in comparing Russian, American and British medical facilities, practices, and systems?

-   Oh, with great pleasure. In these three courtiers different qualities of facilities exist. Generally, those I saw in the U.S. were better in all respects than those in Russia. Facilities on the level of American ones do exist here but few are within reach of the average person. For example, a small, local city hospital in New England is no better than the presidential Kremlin hospital in Kountzevo, and Kountzevo may even be better. But not many people have access to the Kremlin hospital. Speaking about GB, 70 % of their hospitals are small with only about 200 beds. Such hospitals are not economical and can not provide a full range of service.

- What about technology? What advances have you seen in America and Great Britain that have not yet come to Russia?

-    Russia, America and Great Britain are still on the same planet Earth, and we are aware of most technological advances practiced overseas. The fact remains, however, that many sophisticated diagnostic tools and treatments now routinely used in America are rarely used in Russia, and are available only to a few individuals. American healthcare, in general, seems less centralized technologically than in Russia. For example, a procedure done here in Russia by a specialist in a specialized facility would probably be handled by an ordinary hospital in America. In GB they have over 150 health centers, providing all the special diagnostic, therapeutic services and consulting services.

-    What about differences in admitting patients to hospitals and billing them for their treatment? How do procedures vary? I know that in GB most medical treatment is free, but charges are made for drugs, spectacles and dental care. Free emergency medical treatment is even given to any visitor from abroad who becomes ill while staying in this country. Can you say anything about the US system?

-    There are deep problems with health care costs in the U.S.A. because public health programs cover only the poorest citizens, while people of moderate incomes with no insurance are vulnerable to financial ruin should they become ill. And medical insurance doesn’t necessarily cover all expenses in a serious illness. Only after a person or family runs out of money will Medicaid, America’s public health program for the indigent, take over.

-    As far as I know every Russian citizen is supposed to be able to obtain free medical care in the local hospital near where he or she is registered. If he or she chooses to get treatment somewhere else, he/she has to pay before or while being treated. The hospital never chases the patient with unpaid bills after discharge.

-    In Great Britain the National Health Service provides free medical care both in hospitals and in the out-patient clinics. There are also some private hospitals which people may use.

-    Oh thank you very much. Sorry to say that but our time is up. Thank you again for answering my question.

-    You are quire welcome. 

 

Вызов врача на дом



 

(SITUATION: you are talking to a clerk of the registration department on the telephone)

-          Good morning.

-          Good morning. Can I help you?

-          Yes. May I call in a doctor?

-          Sure. What’s the matter with you?

-          I’ve got a very high temperature, a bad cough and a splitting headache and a terrible sore throat.

-          So what is your full name?

-          I am … …

-          Where do you live?

-          CCC Street, 11, flat 16.

-          Ok. Your local doctor will come in the afternoon.

-          Thank you very much., good-bye

-          You are welcome, good-bye.

(The doctor comes to your place in the afternoon)

-          Good afternoon

-          Good afternoon

-          Are you … …? What are your complaints?

-          Well, I’ve got a splitting headache, a sore throat, an elevated temperature (it is over 38C) and profuse sweating. My nose is running. Actually I felt rotten two days ago, but I didn’t consult a doctor because my temperature was normal all the time.

-          Strip to the waist please. Let me examine you. Stick out your tongue. Say “Ah!” I want to check your throat.

-          Ah!

-          Thank you. Now I want to listen to your heart and lungs. Please, take a deep breath and hold it. Now breathe in and out through your mouth. Enough. I can hear moist rales. I think you’ve got bronchitis. I’ll give you a sick leave for 3 days and after that you’ll come to the polyclinic.

-          Should I follow a strict bed regimen?

-          Yes. You’d better stay in bed.

-          That’s all right doctor.

-          Here is your prescription for antibiotics, order them at the chemist’s.

-          Thank you doctor. I’ll do everything you’ve told to me.