All-Russian medical examination

In accordance with the order of the Ministry of Health of the Russian Federation of March 13, 2019 No. 124n Russian citizens will undergo professional examinations annually (instead of once every two years), and medical examinations – once every three years at the age of 18 to 39 years, those who have turned 40 years old will pass it annually.

The document defines a list of screening measures and research methods aimed at early detection of oncological diseases, depending on the stage of medical examination. In particular, at the second stage of medical examination for citizens aged 18 to 39 years inclusive, once every three years will be conducted:

• screening activities aimed at early detection of cancer; 
• brief individual preventive consultation in the department (office) of medical prevention (health center) by a general practitioner.

The updated rules for professional examinations and medical examinations have already been applied since May 2019. By the end of this year, 324 thousand residents of the Lipetsk region over 18 years of age should undergo medical examinations.

When and by whom are professional examinations and free medical examinations conducted from 2019?

Previously, it was provided that the professional examination is carried out 1 time in 2 years, and the medical examination was held 1 time in 3 years. The set of tests and studies differed (in the year of medical examination – a larger volume).

Please note! A citizen undergoes a preventive medical examination and medical examination in a medical organization where he receives primary health care.

 What do preventive examinations and medical examinations of the adult population include in 2019?

Routine inspection is carried out as separate events, through clinical examination, in the framework of follow-up (in the presence of chronic diseases, with which the patient is at the dispensary) for early detection of conditions, diseases and their risk factors, the non-medical use of narcotic drugs and psychotropic substances, as well as to determine the health groups and make recommendations for patients and includes:

• Questionnaire survey.
• Calculation based on anthropometry of the body mass index (measurement of height, weight, waist circumference).
• Blood pressure measurement.
• Blood test for total cholesterol.
• Blood glucose test.
• Determination of cardiovascular risk (relative – from 18 to 39 years inclusive, absolute-from 40 to 64 years inclusive).
• Fluorography or radiography of the lungs (1 time in 2 years).
• ECG (at the first medical examination, every year-from the age of 35).
• Measurement of intraocular pressure (at the first medical examination, annually-from 40 years).
• Examination by a paramedic (midwife) or an obstetrician-gynecologist of women aged 18-39 years.

The first stage of medical examination-screening, is designed to determine the main risks of developing diseases, in addition to the above measures of preventive examination during the medical examination of the adult population at the first stage are carried out:

• general blood test (hemoglobin, white blood cells, ESR) - from 40 years;
• examination by a paramedic (midwife) or an obstetrician-gynecologist of women aged 40 years and older;
• examination of feces for occult blood (from 40 to 64 years inclusive-1 time in 2 years, from 65 to 75 years inclusive-annually);
• esophagofibrogastroduodenoscopy – at the age of 45;
• for women: cytological examination of a smear from the cervix (from 18 to 64 years inclusive-1 time in 3 years);
• mammography (from 40 to 75 years inclusive-1 time in 2 years);
• for men: determination of prostate-specific antigen (PSA) in the blood (in 45, 50, 55, 60, 64 years);
• examination by a general practitioner based on the results of the first stage.After completing the first stage of the examination, the doctor analyzes the data obtained, conducts preventive counseling, and makes recommendations for further actions of the patient.

If health problems are identified, an additional examination is prescribed at the second stage of the medical examination. In this case, the following are assigned:

• consultations of specialists (neurologist, otorhinolaryngologist, ophthalmologist, surgeon or urologist, surgeon or proctologist, obstetrician-gynecologist, examination by a general practitioner based on the results of the second stage of medical examination);
• additional examinations (radiography of the lungs or computed tomography of the lungs, colonoscopy, esophagofibrogastroduodenoscopy, rectoromanoscopy, spirometry, duplex scanning of the brachiocephalic arteries).

Please note! Currently, Article 185.1 of the Labor Code of the Russian Federation establishes the allocation of paid days for medical examinations for the working population: 1 day every 3 years - as a general rule, 2 days annually - for pre-retirees and pensioners. However, the Chairman of the Government of the Russian Federation, Dmitry Medvedev, was instructed to prepare amendments: all working citizens over 40 years of age will be given one day for medical examination every year.

How is the medical examination organized in the polyclinic? Where should I start? Where to apply?

You should start with your clinic, where you are attached. I must say that now not only citizens are actively applying to polyclinics, but also insurance medical companies are very actively involved in the notification process: this is both an SMS mailing list and an invitation by phone.

To save patients ' time, departments and prevention rooms have been created in polyclinics, and time for laboratory and instrumental examinations has been allocated specifically for medical examinations. In polyclinics that implement "lean manufacturing", medical examinations are given the closest attention - this is one of the mandatory processes for improvement.

How long does the whole procedure take?

Depends on the scope of the survey. Most often, it takes 2 visits to the clinic in order to go to the first stage of medical examination. If the patient is sent to the 2nd stage due to the fact that he has identified diseases, then it will take more time, but here the patient's personal interest in his health is already important.

The person has passed a medical examination. What's next?

Implement the recommendations received, taking into account the identified risks of developing diseases and the diseases themselves. Change your daily routine, diet, fight bad habits, lose weight.

How are the results of medical examinations used? What pathologies are detected? Are people starting treatment or changing their lifestyle?

Diseases of the cardiovascular system, the endocrine system, diseases of the digestive and respiratory organs are in the first places in terms of detectability.

Risk factors for the development of the disease are detected much more and not one for each person who has passed the examination. The most common - overweight and obesity, poor nutrition, high blood pressure, hypodynamia. Risk factors are identified mainly in young people and middle-aged people, our "safety margin" is lost by the age of 40-50, and health problems begin to be solved. And here it is important not only to take prescribed medications, but also to change your lifestyle. You will not be able to simultaneously smoke, take anti-asthmatic drugs and hope to reduce the activity of your bronchial asthma. If you do not follow a diet, eat everything without restrictions, there is no hope that sugar-lowering drugs will cope with type 2 diabetes. And there are many more such examples.

And what other preventive measures will help to make a diagnosis in time?

Attentive attitude to yourself and your body, regular self-examination (women are aware of the need to regularly independently check the condition of their breasts in order to detect cancer pathology early), a dentist should also be visited regularly, we all know this very well, but we do not always do it. In addition, those people who already have chronic diseases should regularly visit their doctors, follow their recommendations.

Information prepared
Department of Health of the Lipetsk region