Medical examination. What specialists are needed for a medical examination? Medical examination with an otolaryngologist: what you need to know and how to prepare

Preventive examination is an important measure in medicine, which is necessary to assist citizens to preserve and maintain their health. Timely completion of such an examination allows you to prevent the development of many diseases, as well as identify their hidden forms. It is carried out in accordance with the order of the Ministry of Health No. 1011m dated December 6, 2012. We will tell you in this article what is included in a preventive medical examination and what preparation is needed to undergo it.

Goals of preventive medical examination

The main task of preventive examination is to preserve and maintain the health of citizens, as well as to prevent the occurrence and development of diseases. In addition, this medical event has other goals:

Detection of chronic non-communicable diseases;
Establishing a health group;
Providing brief preventive counseling (for sick and healthy citizens);
Implementation of in-depth preventive counseling (for citizens with high and very high total risk cardiovascular diseases);
Establishment of a group of dispensary observation of citizens, as well as healthy individuals with high and very high total cardiovascular risk.

The inspection is carried out once every two years. However, it is not carried out during the year of medical examination. At the same time, citizens involved in harmful and dangerous work (industry) are required to undergo mandatory medical examinations at certain periods according to their own schedule and, in accordance with Order of the Ministry of Health of the Russian Federation dated April 12, 2011 No. 302n, are not subject to preventive medical examination.

What does a preventive medical examination include?

Medical preventive examination includes undergoing examinations and tests. These procedures are mandatory elements of a medical examination for both males and females. A complete list of necessary preventive medical examination studies is reflected in Table 1.

Table 1 - List of examinations included in the preventive medical examination

Type of study	Name	Note
Survey	Questionnaire	Conducted before the start of the examination, the goal is to identify factors influencing the deterioration of health ( infectious diseases, smoking, alcohol abuse, unhealthy diet, increased body weight, etc.)
Measurement	Anthropometry	Includes measuring the patient's height, weight and body mass index, waist circumference; The data obtained allows us to identify excess fat deposits in the body
Measurement	Arterial pressure	Is one of the main diagnostic methods arterial hypertension
Analysis	Level determination total cholesterol in blood	Allows you to diagnose a number of serious diseases
	Determination of blood glucose levels	Allows you to diagnose a number of serious diseases
	General clinical analysis blood	Basic blood test performed to determine the concentration of hemoglobin in red blood cells, the number of white blood cells and ESR
Diagnostics	Determination of total cardiovascular risk	Conducted for citizens under 65 years of age
	Fluorography of the lungs	Diseases of the respiratory system are detected
	Mammography	Conducted for women aged 39 years and older
Analysis	Stool examination occult blood	Conducted for citizens over 45 years of age
Diagnostics	ECG (electrocardiogram)	Determination of heart rhythm and conductivity
Inspection	Appointment with a general practitioner	Conducted to determine the health status group and the dispensary observation group, as well as to conduct a brief preventive consultation

The results obtained reveal the main indicators of human health and mandatory entered into his medical record. Based on these, the doctor will subsequently determine the need additional research or in-depth preventative counseling.

If a citizen has in his hands the results of examinations that were carried out during the year preceding the month of the preventive medical examination, then the decision on the need for a repeat examination is made individually, taking into account all the available results and the health status of the particular citizen.

Preparation for inspection

Preventive medical examination requires preparation from every citizen who undergoes it. However, there are certain recommendations for both men and women. Preparation includes two successive stages, which are reflected in Table 2.

Table 2 – Stages of preparation for a preventive medical examination

Stage	Contents of the stage	Note


On the day of the examination	Morning urine collection	Collection rules: Restrictions: Menstruation in women;
On the day of the examination	Morning stool collection
Preparatory (before the examination)	No meals 8 hours before the examination	Preventive examination is carried out on an empty stomach
Preparatory (before the examination)	Exception physical activity on the day of the examination (including morning physical exercises)	This rule necessary for reliable measurement of the patient’s pulse and heart rhythm
On the day of the examination	Morning urine collection	Volume biological material 100-150 ml. Collection rules: Careful hygiene of the external genitalia before the procedure; Collection is carried out a few seconds after the start of urination Restrictions: Menstruation in women; Eating carrots or beets 24 hours before the start of collection (these vegetables affect the color of urine); The period after one and a half hours after urine collection (after this time the biomaterial is not suitable for research); Transportation temperature below zero (at low temperatures Precipitation of salts contained in the urine occurs. It may be misinterpreted as a manifestation of renal pathology)
On the day of the examination	Morning stool collection	The material is transported in a special container (sold in pharmacies); hygiene measures must be taken before the collection procedure.

These stages of preparation are mandatory for all patients, regardless of their gender and age. By following these recommendations, the research results will more accurately and reliably reflect the state of the body. Along with this, there is special training that is carried out only by a certain category of citizens, depending on age indicators, as well as gender. Features of preparation for the study are presented in Table 3.

Table 3 - Special preparation for preventive examination

Category of citizens	Preparing for the study
Persons (men and women) over 45 years old	Three days before the examination, you must refrain from eating: Meat; Iron-containing foods (beans, spinach, apples, etc.) and medications; Ascorbic acid; Vegetables containing enzymes such as catalase and peroxidase (found in cucumbers, cauliflower, etc.). In addition, you should stop using laxatives and enemas. These restrictions are necessary for proper examination of stool for occult blood.
Women	Restrictions for women in whom the procedure for collecting a smear from the cervix is not performed: Menstruation; Infectious and inflammatory diseases of the pelvic organs; Sexual intercourse two days before the test In addition, any vaginal medications, spermicides, tampons and douching should be discontinued.
Men over 50 years old	7-10 days before the examination you should exclude: Rectal examination; Prostate massage; Enemas; Sexual intercourse; Treatment rectal suppositories; Other effects on the prostate gland of a mechanical nature

Compliance with the recommendations given above will significantly increase the likelihood of detecting existing diseases, increase the accuracy of test results, and also make it possible to provide more accurate recommendations for the patient.

Conclusion

The main active medical care aimed at early diagnosis or detection of any diseases is a preventive examination. All citizens must undergo it at least once every two years. As a result of this examination, citizens are assigned a health group (1,2 or 3), and all test and diagnostic results are mandatory entered into the patient’s record. Before the examination, citizens must undergo special training prescribed by a doctor.

Preventive medical examination, just read it carefully! Prophylactic! That's why it exists, to identify diseases on early stages and prevent its development.

Preventive medical examination is a term enshrined in legislation and obliges employers to provide a procedure and make sure that they are hiring healthy person. A professional examination is part of the employment procedure and is carried out both at the beginning of work and annually.

For which professions is a medical examination required?

Professions involving high physical activity.
Specialists whose work is associated with harmful and dangerous conditions.
Branches of production that require special selection for certain physical qualities.
Professions in which work is related to serving the population.

The norm is also enshrined in law when a medical examination is mandatory for children entering school. kindergarten, school, higher educational establishments when a person wants to get a driver's license.

Where to get a preventive medical examination

The question is very ambiguous and in order to answer it you need to know a number of circumstances, for example, why are you undergoing a medical examination? If for the purpose of prevention and for self-soothing, then you are free to choose any clinic to your liking.

If for employment, then you should ask the employer if he has an agreement with a medical institution where it is necessary to undergo this procedure.

List of doctors for medical examination

The question also requires clarification. If the purpose of your medical examination is prevention and taking care of your health, then we start with a therapist, and then follow narrow specialists, for example, cardiologist, gynecologist, urologist, ophthalmologist, dentist. Their list depends on your health status, gender and age.

Therapists usually advise that in the current situation with the environment and the spread of certain diseases, it is imperative to do a number of special studies, such as mammography for women, ultrasonography prostate for men, fluorography chest, Ultrasound of the thyroid gland.

Let's return to the medical examination when it is necessary for employment or is taken during the course of work to determine the possibility of working in a certain specialty. Then the list of doctors and medical research approved by various orders and strictly defined, it must be followed.

In this article we will look at what a medical examination is, who needs it, for what purposes, at whose expense it is done, how often it needs to be done, and what is mandatory.

What is a medical examination?

A medical examination is the passage of a medical commission depending on the location of the requirement or for health prevention.

Who needs a medical examination?

The majority of the officially working population knows first-hand what a medical examination is, because... When hiring, in most cases, the employer requests from the employee a medical book with access to work. Not always and not everyone likes it, but it is a necessity that cannot be avoided, and for your health it would not be a bad idea to check if everything is okay with the body.

In the Russian Federation there is a “Health” project, which is aimed at preserving the health of the working population. The most important measure to maintain health is regular examination of people upon hiring and further regular examinations.

Purposes of the physical examination

Of all the reasons for a medical examination, several are the main ones:

. Prof.'s definition suitability of employees to perform assigned work tasks;
Ensuring labor safety;
Identification of persons with occupational diseases or suspected of such diseases, prevention and timely identification initial signs occupational diseases;
Detection of any diseases not related to work, but in which a person’s condition may worsen;
Sanitary and hygienic measures designed to identify and eliminate the causes of occupational diseases;
Regular monitoring of the health of workers in hazardous work;
Timely prevention and rehabilitation of workers to preserve their health;
Avoiding workplace accidents.

Employees are required to undergo a medical examination when working:

. in hazardous production;
In hazardous production;
Security guards;
Railway workers;
Drivers;
Social service workers;
Workers of children's and preschool institutions.

Medical examinations are required by law, and persons who do not pass the examination are not allowed to work. The employer is responsible for undergoing a medical examination. Typically, the employer enters into an agreement with one of the health examination clinics, and all employees are examined in one place. Inspections are divided into two categories:

. preliminary;
Periodic.

Preliminary examination is when entering a job to determine professional suitability. Periodic examination is to identify and prevent diseases acquired at work, and not only.

At whose expense is the medical examination done?

All activities related to undergoing medical examinations are undertaken by the employer; this is prescribed by the law of the Russian Federation. If an employee has not been cleared by a health examination doctor to work, the employer must not allow him to enter the workplace.

Frequency of medical examinations

The frequency of medical examinations is prescribed by law and is carried out once every two years, and for persons under 21 years of age annually. Inspections may also be extraordinary at the request of workers or during an epidemic.

People working in hazardous and hazardous industries undergo a medical examination in special medical examination centers by specialists called occupational examination doctors. What is included in the mandatory tests during a medical examination Mandatory tests include:

. general blood analysis;
General urine analysis;
Fluorography.

A blood test reveals the presence inflammatory processes in the body, anemia, various diseases blood. If any deviations are detected, more fast fatiguability person, which leads to decreased performance. Urinalysis reveals diseases of the kidneys and urinary system. An ECG checks the heart for various abnormalities.

Specialists who are required:

. therapist;
Surgeon;
Gynecologist;
Neuropathologist.

The surgeon will determine the size of the liver and spleen and other organs abdominal cavity and also checks for the presence of varicose veins. In men, this also includes the prostate. A neurologist checks for abnormalities associated with nervous system. A gynecologist is mandatory for women. The therapist measures blood pressure and identifies signs hypertension, and also issues a conclusion and permission to work after passing all the specialists and passing all the tests.

A number of people regularly have to undergo periodic medical examinations. They are often associated with queues and wasting time. Remember, at the SkoroMed clinic at the Belorusskaya metro station (Moscow) there is a preventive examination of workers various fields carried out without queue. At the same time, they are accessible, and the regulations comply with them.

It is important to remember that, according to the current legislation of the Russian Federation, periodic medical examinations are mandatory for most workers, including some office firms. And managers should conduct regular medical examinations at their enterprise not only to avoid liability and fines, but also to increase the efficiency of employees, which is necessary for the successful prosperity of the business.

with the Hygiene Center
and epidemiology

Let's make a medical book for 4 days!

A stone's throw
from the metro

,
in mode
"single window"

Request a call back

A medical examination of workers is a special medical examination that allows one to determine the suitability and ability of a person to engage in a certain activity. professional activity. Its completion makes it possible to identify diseases that can affect an employee’s work and helps to significantly increase the labor potential of the enterprise.

Who should undergo medical examinations?

Medical examinations are mandatory for workers in hazardous and hazardous industries. Employees must also undergo similar medical examinations:

engaged in construction;
managers of automobile, railway and by water transport(passenger, cargo);
providing public utility services;
health workers working in treatment and prophylactic and medical institutions, pharmacies;
workers at enterprises Food Industry, in catering and retail establishments;
serving in private security;
working in educational institutions (studios, kindergartens, schools, sports sections);
workers at water treatment plants;
engaged in servicing electric power facilities.

In addition, professional athletes, workers under 18 years of age, office employees who spend more than half of their working time at the computer, as well as representatives of some other professions must undergo a mandatory medical examination.

Types of medical examinations

Preliminary inspection. It is carried out during employment at an enterprise in order to determine the applicant’s suitability for work in a particular field due to health reasons. This mandatory medical examination is carried out once and is often called primary. Allows you to select future employees based on medical indicators.
Periodic medical examination. Such examinations are carried out once a year, six months or at other intervals. The purpose of the annual medical examination is to monitor the health of workers, identify diseases, and determine exposure to harmful factors and the formation of risk groups for possible occupational diseases.
Extraordinary inspection. This medical examination is not periodic and is not mandatory. It can be carried out at the initiative of the employee (if there are complaints) or the employer (if a deterioration in the employee’s health is detected). It is also carried out on the recommendation of a medical organization.

What does a medical examination include?

A mandatory medical examination may include a varying amount of research. It is determined based on the type of activity, as well as the harmful factors that the worker has to deal with at work. As a rule, standard medical examinations of employees include fluorography, cardiogram, general clinical urine and blood tests, as well as examination by the following medical specialists:

ophthalmologist,
neurologist,
surgeon,
therapist,
otolaryngologist,
gynecologist (for women).

At the request of the employer, the list of studies as part of the professional examination of employees can be expanded to include: additional tests and examinations by other medical specialists.

Order of the Ministry of Health and Social Development of Russia No. 302n, as amended on December 5, 2014, contains the procedure for conducting mandatory preliminary and periodic medical examinations (examinations), as well as a list of harmful and/or dangerous production factors and the work during which they must be carried out. It also contains information about medical contraindications for permission to work.

What do you need to undergo a medical examination?

To undergo an initial or periodic annual medical examination, you must have the following documents:

passport or other identity document;
referral for a medical examination from the enterprise;
outpatient card;
an extract with the results of previous examinations;
conclusion of a psychiatric commission (not always necessary).

Cost of medical examination

Prices for medical examinations of employees are calculated based on the provisions of Order N302n of the Ministry of Health and Social Development of the Russian Federation, issued on April 12, 2011, and take into account various factors. total cost services for your enterprise will depend on the number of workers surveyed. Also, when calculating it, the composition will be taken into account laboratory research and the number of medical specialists involved in periodic medical examinations.

Responsibility for the lack of medical examination of employees

All enterprises are regularly inspected by the Rospotrebnadzor inspection for violations of labor laws. If employees are found to have failed to undergo a mandatory periodic medical examination, the organization may be fined up to 50 thousand rubles and even have its activities suspended for up to 90 days. The head of the company may also be held liable, subject to a fine of 1-5 thousand rubles, and in some cases, removal from office for a period of 1 to 3 years.

Advantages of conducting medical examinations at the Skoromed clinic

Complete solution. In our center, your employees can undergo any type of examination: mandatory primary and periodic, as well as extraordinary. The service will include full list necessary laboratory tests and examination by key specialists.
Quality service. Medical examinations are carried out by qualified doctors who are additionally certified in the field of determining occupational pathologies. Our service is not just a formality, but a real diagnosis of diseases of enterprise employees.
Convenient service. Our center takes care of the complete organization of the process medical examination. Medical examinations of workers are carried out in the most comfortable conditions. It is also possible for us to have a medical examination visit the customer’s site.
Accuracy of results. Our company guarantees prompt examination by doctors, fast laboratory tests and the reliability of the results obtained. Upon completion of the procedure, we issue a correctly executed final report with recommendations from specialists.
Individual approach. When collaborating with companies, we always take into account their specifics. Periodic medical examinations include only necessary studies. Thanks to this, the accuracy of the results is achieved and the cost of the service is reduced.

Sobesednik.ru found out how often and for what purposes a medical examination should be carried out.

When is it necessary?

The ideal schedule is once a year, although some specialists should be visited more often - every 6 months: for example, this applies to examinations by the dentist and gynecologist. IN currently there is a procedure established by law for medical examination of the adult population according to compulsory medical insurance policy. You can undergo a free medical examination once every 3 years - at the age of 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69, 72, 75, 78 , 81, 84, 87, 90, 93, 96, 99 years. In other years (every 2 years), you can undergo a preventive examination at the clinic.

Who needs?

Everyone, actually. In fact, regular (and conscientious!) medical examinations - the only way detect some problem in the body before it “shoots” itself and burdens you with troubles. In terms of health, the principle “the sooner the better” works, and it is always easier, cheaper and preferable to prevent a disease than to treat it later. For the purpose of early detection, regular medical examinations, screenings or medical examinations are carried out.

How is it necessary?

Naturally, there will be no point in a medical examination if it is done for show, and the dialogue with the doctor is based on the principle: “Is something bothering you?” - "No". - “Well, great, here’s a certificate for you.” This situation discredits the very idea of a routine medical examination, but, unfortunately, it happened often before, and now. The point of medical examination is not to miss diseases that at first do not reveal themselves, and when things go too far, unfortunately, are not completely cured - this cardiovascular diseases (ischemic disease heart, hypertension, etc.), different types cancer, tuberculosis, diabetes, pathologies of the spine and joints. So, as part of a medical examination, at a minimum there should be an examination itself, as well as a certain set of tests and studies, without which the picture will not be complete.

What do you need?

By law, most adults free medical examination is held every 3 years. This is what it looks like now overall plan examinations:

Survey (questionnaire), examination by a therapist

Measuring height, weight, calculating body mass index

Pressure measurement

Determination of cholesterol and glucose levels in the blood (rapid method)

ECG (at the first medical examination, then - for men over 35 years old and women over 45)

Midwife examination, cervical smear (for women)

Fluorography

Mammography (for women over 39 years old)

Determination of cardiovascular risk

Blood chemistry

Fecal occult blood test (after 45 years)

PSA test (men over 50 years old)

Ultrasound of the abdominal organs (after 39 years, every 6 years)

Measurement intraocular pressure(after 39 years)

Examination by a neurologist (after 51 years, every 6 years)

Nevertheless personal plan may look different - from the timing to the scope of clinical examination. This may take into account the wishes of the doctors with whom you are being observed (for example, a gynecologist wants to see you at least once every 6 months, a mammologist and urologist - annually, etc.), and your individual diagnoses and risks. For example, for early detection for colon cancer after 50 years, it is recommended to have a colonoscopy every 5 years, even without special indications, however, this study is not included in the general medical examination plan and is done only as prescribed by a doctor. Above is only a general outline of a survey funded by the state.

Blood and urine will not be tested

The simplest test, to which a person will be absolutely referred for almost any complaint, is a CBC, a general blood test. The same goes for general analysis urine. Many people do them on their own, without waiting for a doctor’s referral, and come to the first appointment with the results. However, from 2018, these two studies will no longer be included in the mandatory medical examination plan: new order, proposed by the Ministry of Health, excluded them from screening as “uninformative”. The agency explained that neither a blood test nor a urine test will be carried out by default for asymptomatic citizens - those who do not have any complaints. Only sugar and cholesterol levels will be examined using the express method, that is, right at the appointment.

Pointed question

Can they force me at work?

No. IN last years employers began sending employees for screenings, but even in this case the principle of voluntariness applies. According to the law, if the work does not require mandatory regular medical examinations, management can only offer to undergo medical examination, providing such an opportunity - for example, by concluding an agreement with a certain medical institution. This is again a purely voluntary matter, and the results of the medical examination, if the employee has passed it, are a medical secret.

Not at the clinic the right specialist. What to do?

If you need consultation with a specific specialist, as part of a medical examination or not, temporarily or for an indefinite period, you should be referred to another medical institution where one is available.

I have VHI. Is it possible to undergo a full medical examination with this type of insurance?

If the type of policy does not limit the number of visits to specific doctors (this sometimes happens) - for example, no more than 10 examinations by a therapist per year, 5 visits to an ENT specialist, 2 appointments with an ophthalmologist, etc. - it is quite possible to take advantage of this opportunity. The absence of restrictions in this case allows you to make the medical examination more detailed, clarify the nuances and ultimately, perhaps, get more full information about what is happening with your health than during a regular routine medical examination as part of compulsory medical insurance.

Is it possible to skip a year or more?

When, to what extent and whether to undergo medical examination at all is your personal business. Even if it seems appropriate based on age, it’s still up to you to decide. Medical officials are calling for medical examinations to be made mandatory for everyone, and for refuseniks to be “excluded” from some free medical services, but so far this is just an idea that contradicts current legislation.

By the way

What is a medical check?

Check-up is another name for a routine medical examination, which is used in Western healthcare and, more recently, in domestic commercial medical centers. As a rule, a check-up is completed in one day - the program is designed so that the patient does not have to go to doctors for weeks and months. The intensity of the program can vary - the simplest ones take 3-4 hours and include examination by 4-5 specialists (gynecologist, ophthalmologist, urologist, therapist, dentist), 1-2 ultrasound scans (usually gynecological and abdominal), several tests (for example , CBC, smear test for women and PAP test to rule out cervical cancer) and several other studies. A large check-up program can take a couple of days and even include options such as a full-body MRI. The price also depends on the saturation.