Medical examinations: what are they and why are they needed? What is included in a preventive medical examination? What is a medical examination in a clinic?
Every time, upon learning about a medical examination organized at work, many are indignant: why is this necessary? Obviously, this is a fundamentally wrong approach. The employer organizing the medical examination shows himself with the best side. However, one should not assume that he does this solely for altruistic reasons. The fact is that, in fact, it is the boss who pays for each employee’s sick leave - he pays interest to the Social Insurance Fund, from which you are then given money. In addition, the time of a qualified employee can be infinitely expensive for a company, which makes it much cheaper to protect yourself from downtime through preventative measures.
To the employer and employees
Many, having returned to work or re-employed, have probably encountered the fact that they are sent for a medical examination to the clinic. For what? After all, I feel healthy or healthy!!! On the one hand, employers are now obliged to send subordinates to this event, and on the other hand, it is important for each person to identify in time initial stages various diseases and begin appropriate treatment. What are medical examinations of persons working in contact with harmful and (or) dangerous factors? Currently in Russian Federation The priority national project “Health” is being implemented, aimed at preserving the health of citizens and the labor potential of the working population. One of the important measures to preserve people’s health is preliminary (upon entry to work) and periodic medical examinations (examinations).
The main goals of the medical examination
Among the main tasks that a medical examination is designed to solve, seven main ones can be identified. This:
- determining the suitability (suitability) of workers and employees for the work assigned to them, ensuring labor safety;
- identification of persons with occupational diseases or suspected of such diseases, prevention and timely identification initial signs occupational diseases;
- identification of common (non-occupational) diseases in which further work in contact with occupational hazard factors may worsen their course;
- assessment of working conditions and development of sanitary and hygienic measures aimed at eliminating the causes of occupational disease;
- dynamic monitoring of the health status of workers under the influence of occupational hazards;
- timely implementation of preventive and rehabilitation measures aimed at preserving the health and restoring the working capacity of workers;
- accident prevention.
The medical examination includes a very important examination - fluorography. This X-ray examination lungs for the presence of tuberculosis. Tuberculosis is a very common disease nowadays. People with high blood pressure must undergo regular medical examinations, as this problem can cause a heart attack or stroke. Vascular thrombosis occurs. People need to carefully look at their health status, as now
Arterial hypertension affects quite young people who may not even be aware of the disease. In this case, a medical examination will help identify disorders and specialists will advise what lifestyle is needed to prevent the occurrence of high blood pressure. blood pressure. An annual medical examination is especially important for people who are employed in jobs with harmful or dangerous working conditions (for example, underground work, etc.).
It is necessary?
Yes, if you:
- you work in a dangerous enterprise;
- connected with children (teacher, educator);
- work in a medical facility.
In all other cases, a person has the right to refuse to visit a doctor.
Which doctors should I see?
You will have to visit:
- therapist;
- psychiatrist;
- narcologist;
- dentist;
- dermatovenerologist;
- otorhinolaryngologist.
This is a basic program. For people working in hazardous enterprises, it can be expanded in accordance with the specifics of the activity.
Also most often, the medical examination includes basic tests:
- blood (general);
- smears for gonorrhea and pathogenic staphylococcus;
- biochemistry of urine and blood.
All of them will help make sure that the body’s condition does not pose any threat to you or others. Typically, such an examination is carried out once a year to keep employee health information up to date.
How often should you undergo a medical examination?
The frequency of periodic medical examinations is determined by Appendices 1 and 2 to Order No. 90 of the Ministry of Health and Medical Industry of Russia, but should be at least once every two years. Persons under the age of 21 undergo periodic medical examinations annually (Labor Code of the Russian Federation, Art. 213).
Periodic medical examinations of employees can be carried out ahead of schedule in accordance with a medical report or according to the conclusion of Rospotrebnadzor authorities with justification for the reason for the extraordinary examination. Extraordinary medical examinations are carried out at the request of the workers themselves or in accordance with the recommendations of one of the specialists who participated in the examinations, as well as for epidemiological indications.
Employees engaged in hazardous work and work with harmful and (or) hazardous production factors for five years or more undergo periodic medical examinations at occupational pathology centers and other medical organizations once every five years. Of course, such centers must have licenses for examination of professional suitability and examination of the connection of the disease with the profession.
There are several types of medical examinations for workers:
1. Preliminary. Their goal is to find out whether the candidate’s health condition allows him to perform a particular job. For some categories of workers such examinations are mandatory.
For example, preliminary medical examination When applying for a job you must pass:
- people whose professional activity related to management complex mechanisms and devices (crane operators, electricians);
- people who work in hazardous conditions(industrial climbers, sailors, oil and gas industry workers working in the Far North);
- people managing vehicles(drivers, pilots);
- food industry workers;
- workers of children's and medical institutions and others.
2. Periodic. Conducted in order to identify early stages diseases that may be dangerous to others or make a person unsuitable for performing a certain type of work, to track the dynamics of changes in health, as well as in order to identify possible occupational diseases and minimize the harm caused to the health and well-being of the employee. Employees under the age of 21 must undergo a medical examination annually.
3. Conducted in special cases– at the request of the employees themselves, when occupational diseases are identified during the last scheduled medical examination, in cases where someone in the team is diagnosed with a dangerous infectious disease, as well as at the request of Rospotrebnadzor. Requirements for the frequency and procedure for medical examinations are specified in Labor Code RF (Articles 212, 213 and 266). And Article 5.27.1 of the Code of Administrative Offenses of the Russian Federation establishes that admission to work without undergoing mandatory periodic medical examination entails the imposition of a fine on officials and individual entrepreneurs in the amount of 15,000–25,000 rubles, for legal entities– 110,000–130,000 rubles.
The procedure for conducting medical examinations of enterprise employees
Organizing a medical examination is the responsibility of the company’s management, and it also pays for this event.
Briefly, the scheme for organizing a medical examination for enterprise employees looks like this:
Step 1. Formation of a list of employees who should be sent for a medical examination. The list must be sent to the territorial department of Rospotrebnadzor of your administrative district within 10 days.
Step 2. Concluding an agreement for examination of workers with a medical center. Agreeing on the timing of the medical examination.
Step 3. Signing an order on the frequency of medical examination and the order of its completion. Employees must be familiarized with this document at least 10 days before the start of the medical examination.
Step 4. Issuing directions for a medical examination. Referrals are issued in the organization in any form.
Step 5. Collection of signed and sealed reports with the results of the medical examination. The conclusion is signed in two copies - one of them is given to the employee, the other remains in the institution that conducted the medical examination.
Step 6. The medical center draws up a final act. This may take time, usually up to 30 days. Certified deed signed medical institution and organization, is sent to the territorial department of Rospotrebnadzor in its own way administrative district on approval.
Workers are required to appear at medical Center, with whom the contract was concluded, exactly within the period specified in the direction. You are required to have your passport and directions with you. If the employee does not show up, the employer must suspend him from work without pay until the inspection is completed. If the inspection was missed due to the fault of the employer or for reasons that do not depend on either the employee or the employer, the refusal to perform duties is regarded as simple and is paid in the amount of 2/3 of the employee’s average salary. As a rule, during a periodic medical examination, workers visit several specialists and undergo various instrumental and laboratory research. The specific list depends on the type of work and harmful production factors. The commission is formed by the medical center with which an agreement was concluded to conduct a medical examination. It necessarily includes an occupational pathologist, as well as other specialists.
If the responsibility of approaches to assessing professional suitability increases, then the quality of work in certain areas should indirectly improve, which, in the end, will have a positive impact on the well-being of the population as a whole.
Since 2012, a narcologist and a psychiatrist have been added to the list of doctors who must undergo medical examination to renew a medical record. This caused numerous discussions, speculations, outrages and protests. In fact, these specialists, especially psychiatrists, traditionally belong to the ranks of doctors of a special, specialized direction. They have not previously been associated with a general physical examination. However, since 2012, these doctors have been included in the list of mandatory visits when applying for a medical record and have become the only doctors (besides the therapist) who assess the professional suitability of civil servants.
Let's try to figure out why our country has begun to pay more attention to mental health and emotional state, as well as the degree of adequacy of workers in responsible areas. The point is that medical assessments are indeed incomplete if they are focused only on the analysis of morphological, physiological indicators health and at the same time completely lose sight of the psycho-emotional component. Meanwhile, it has long been proven and everyone knows that sometimes mental health and mood, as well as the emotions themselves, can determine the physical state, influence the processes occurring in the body, etc.
Here it is impossible not to recall the common expression in everyday life: “all diseases come from nerves.” Moreover, we can safely paraphrase it, pointing out that many aspects of the treatment of diseases are also determined, in turn, by the state of the psyche and the emotional background.
Recently, being examined by a psychiatrist and narcologist has ceased to be something suspicious and frightening. It has become a preventive measure. At the same time, the doctors themselves in these specializations have had a little more work to do. Obtaining an opinion from any of them traditionally requires only a simple standard check to see if the person is registered with the relevant institutions. This refers to drug treatment, psychiatric registration, or registration as a person prone to antisocial behavior.
When it comes to inspections of civil servants and checks that accompany the issuance of a medical book, then just checking records is not enough. You need either a medical certificate from a narcologist and a psychiatrist as a separate document, or a conclusion from these doctors, which, accordingly, is reflected within the medical certificate for the civil service and the medical record form.
In turn, issuing a medical book and medical certificate for the civil service invariably involves a medical examination. It turns out that doctors work not only with documents, but also directly with patients in the form of, at a minimum, detailed oral conversations. If we take into account, therefore, the total number of people undergoing medical examinations, one can imagine how much work appears for narcologists and psychiatrists.
For patients who, in the process of getting a job, must receive the indicated conclusions, all these activities are undoubtedly burdensome. Additional medical examinations cannot be encouraging when it comes to a purely mechanical need - to undergo certain procedures and receive a final health document.
In fact, emotional and mental adequacy are important precisely for maintaining these forms of security. If a person is unstable in these relationships, then one cannot expect him to take a serious approach to anything, in particular, to proper medical examinations and ensuring sanitary and anti-epidemiological safety.
In addition, additional control is also necessary to eliminate poor performance by people of their professional duties, which are officially recognized as socially significant and socially oriented. It's really crazy to imagine a drug addict or a mentally ill person as an employee of, say, kindergarten or a medical practitioner.
Actually, all the difficulties here are associated with elementary additional actions. In fact, there is nothing wrong with additional medical examination and additional medical testing. Accordingly, there is nothing to be upset about. If the responsibility of approaches to assessing professional suitability increases, then it is worth believing that in some sense the quality of work in certain areas should indirectly improve, which, in the end, will have a positive impact on the well-being of the population as a whole.
Clinical examination is a medical examination aimed at identifying chronic For example, cardiovascular, bronchopulmonary, oncological, diabetes.
">non-communicable diseases, as well as the risk of their development.Clinical examination involves examination by medical specialists and a number of tests and examinations. It is carried out at the place of your attachment. Working citizens are issued a certificate of inspection on the same day. During the medical examination, employees have the right to be released from work for 1 working day once every 3 years while maintaining their job and average earnings. Medical examinations can also be taken in the evening and on Saturdays.
Workers of pre-retirement age (within 5 years before retirement age) and pensioners receiving an old-age or long-service pension have the right to be released from work for 2 working days once a year while maintaining their place of work and average earnings. To do this, you need to agree with management on the days of medical examination and write an application for release from work.
You have the right to refuse medical examination in general or individual species medical interventions included in the scope of medical examination.
2. Who can undergo a free medical examination in Moscow?
To undergo medical examination, you must:
3. Appropriate by age. Medical examination is carried out once every 3 years, and you can undergo it during the year in which you turned or will turn: 18, 21, 24, 27, 30, 33, 36, 39 years old. If you are 40 years or older, you can undergo medical examination annually.
Some The following undergo annual medical examination:
1. Disabled people of the Great Patriotic War, disabled combat veterans, participants in the Great Patriotic War who became disabled due to general disease, labor injury or other reasons (except for persons whose disability occurred as a result of their illegal actions).
2. Persons awarded the badge “Resident of besieged Leningrad” and recognized as disabled due to a general illness, work injury or other reasons (except for persons whose disability occurred as a result of their illegal actions).
3. Former minor prisoners of concentration camps, ghettos, and other places of forced detention created by the Nazis and their allies during the Second World War, recognized as disabled due to a general illness, work injury and other reasons (except for persons whose disability resulted from their illegal actions).
4. Elderly Muscovites (upon reaching 50 years of age and before retirement age) have the right to count on free medical examination in medical organizations where the program is implemented free medical examination such citizens.
For these categories of citizens, clinical examination is carried out in the amount provided for the nearest age category- except for studies that are contraindicated for annual conduct and if there are no corresponding symptoms and diseases for which they are necessary.
">preferential categories of citizens undergo medical examinations annually, regardless of age.Volume and character comprehensive examination depend on the gender and age of the person.
3. How will the medical examination take place?
Step 1. Fill out the required documents.
Contact the clinic at your place of attachment, where you will be asked to fill out the following documents:
- informed voluntary consent to medical intervention;
- questionnaire (survey) to identify complaints characteristic of non-communicable diseases, personal history and living conditions (smoking, alcohol consumption, diet and physical activity etc.), in people over 65 years of age - the risk of falls, depression, heart failure, etc.
Step 2. Prepare for examinations.
On the day appointed for the examination, come to the clinic in the morning on an empty stomach, until physical activity, including morning exercises. if you If you are from 40 to 64 years old, the test must be taken once every two years, if you are from 65 to 75 years old - annually.
">40 years or more, you will need to have a stool test occult blood, so check with the clinic in advance, If immunochemical, no dietary restrictions are required. If by another method, for 3 days before the examination, refuse food with high content iron (meat, apples, white beans), laxatives and enemas, iron supplements, aspirin and ascorbic acid.">what method this analysis is being done.Step 3. Complete the first stage of medical examination.
A comprehensive examination may consist of two stages. During the first stage, you will receive a route sheet indicating all the examinations that must be completed depending on gender and age. The examination results will be ready in 1-6 days.
Step 4. Come to see a general practitioner.
The doctor will give explanations on the results of the examinations, determine your health group, and if there is a high risk of diseases or diseases themselves, a dispensary observation group and hand over your health passport.
Step 5. Go through the second stage of medical examination.
If after the examinations it turns out that you need further examination, the general practitioner will refer you to a second, more in-depth stage of medical examination.
Step 6. Consult your doctor.
After completing all stages of the examination, you will have another consultation with a general practitioner who will give necessary recommendations(for example, quitting smoking, improving diet, increasing physical activity).
If there are diseases, it is prescribed necessary treatment, including specialized and high-tech medical care, as well as spa treatment.
If you smoke, are overweight, obese or have other risk factors, you may be referred to a department or office medical prevention or where they will provide assistance in correcting risk factors.
4. Which doctors should I see if I am between 18 and 39 years old?
The first stage of clinical examination:
1. Preventive medical examination:
- survey (questioning)
- level determination total cholesterol in blood;
- determination of blood glucose levels;
- determination of relative cardiovascular risk (for patients aged 18-39 years);
- fluorography (once every 2 years);
- reception (examination) based on the results of a preventive medical examination, including examination to identify visual and other localizations oncological diseases including inspection skin, mucous lips and oral cavity, palpation thyroid gland, lymph nodes, a paramedic at a paramedic health center or a paramedic-obstetric station, a general practitioner or a medical prevention doctor at a medical prevention department (office) or a health center.
2. Screening for early detection of cancer:
- stool examination for occult blood (once every 2 years from 40 to 64 years of age, once a year from 65 to 75 years of age;
- esophagogastroduodenoscopy at 45 years old.
For women:
- examination by a paramedic (midwife) (18 and older);
- taking a smear from the cervix, cytological examination of a smear from the cervix once every 3 years at the age of 18 to 64 years;
- mammography (once every 2 years between the ages of 40 and 75).
For men:
- determination of prostate-specific antigen in the blood of men aged 45, 50, 55, 60 and 64 years.
3. Brief preventive consultation;
4. General blood test (from 40 years and older).
Second stage of clinical examination is carried out for the purpose of additional examination and clarification of the diagnosis of the disease (condition) if there are indications based on the results of the first stage and includes:
- examination (consultation) by a neurologist;
- duplex scanning of the brachycephalic arteries (for men aged 45 to 72 years inclusive and women aged 54 to 72 years);
- examination (consultation) by a surgeon or urologist (for men aged 45, 50, 55, 60 and 64 years with an increase in the level of prostate-specific antigen in the blood more than 4 ng/ml);
- spirometry;
- for women over 18 years of age: examination (consultation) by an obstetrician-gynecologist - if necessary;
- examination (consultation) by an otolaryngologist (for citizens aged 65 years and older);
- examination (consultation) by an ophthalmologist (for citizens aged 40 years and older);
- conducting individual or group (school for patients) in-depth preventive counseling in the department (office) of medical prevention (health center) for citizens aged 65 years and older.
5. Which doctors should I see if I am between 40 and 45 years old?
The first stage of clinical examination:
- measurement of height, body weight, waist circumference, determination of body mass index;
- blood pressure measurement;
- determination of absolute cardiovascular risk (for patients from 40 to 64 years old);
- electrocardiography at rest (performed during the first preventive medical examination, then at the age of 35 years and older once a year);
- for women over 40 years old - mammography;
- for men aged 45 years: determination of prostate-specific antigen (PSA) in the blood;
- for patients 45 years of age of both sexes - esophagogastroduodenoscopy;
- If you are between 40 and 64 years old, the test must be taken once every two years, if you are between 65 and 75 years old - annually.">40 years and older
- measurement intraocular pressure(carried out during the first preventive examination, then at the age of 40 years and older once a year).
- examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary);
- examination (consultation) by a surgeon or urologist (for men aged 45 years with an increase in the level of prostate-specific antigen in the blood more than 1 g/ml);
- colonoscopy - in case of suspected colon cancer, as prescribed by a surgeon or coloproctologist;
- esophagogastroduodenoscopy - if there is suspicion of malignant neoplasms esophagus, stomach and duodenum- as prescribed by the therapist;
- X-ray of the lungs, computed tomography of the lungs - if there is a suspicion of malignancy lung tumors- as prescribed by the therapist;
- examination (consultation) by an ophthalmologist (for patients over 40 years of age with increased intraocular pressure);
6. Which doctors should I see if I am between 46 and 50 years old?
The first stage of clinical examination:
- measurement of height, body weight, waist circumference, determination of body mass index;
- blood pressure measurement;
- conducting a general blood test (hemoglobin, leukocytes, ESR);
- determination of the level of total cholesterol in the blood using an express method;
- determination of fasting blood glucose levels (using the express method is allowed);
- determination of absolute cardiovascular risk;
- individual preventive counseling - for patients with high relative and very high absolute cardiovascular risk, obesity, hypercholesterolemia with a total cholesterol level of 8 mmol/l or more and/or smoking more than 20 cigarettes per day;
- fluorography of the lungs (not performed if fluorography, radiography (fluoroscopy) or computed tomography of the chest organs was performed in the previous calendar year or in the year of medical examination);
- resting electrocardiography (performed once a year);
- for women: examination by a midwife, including taking a smear from the cervix for cytological examination;
- for women - mammography;
- for men aged 50 years: determination of prostate-specific antigen (PSA) in the blood;
- for patients of both sexes aged If you are between 40 and 64 years old, the test must be taken once every two years, if you are between 65 and 75 years old - annually.">40 years and older: examination of feces for occult blood;
- measurement of intraocular pressure (performed once a year).
If you have taken any of the tests listed or had any of the examinations listed in the past 12 months, their results may be included in the medical examination.
Second stage of medical examination (if necessary):
- duplex scanning of brachycephalic arteries - for men over 45 years old, in the presence of risk factors for the development of chronic non-infectious diseases;
- examination (consultation) by a surgeon or urologist (for men aged 50 years with an increase in the level of prostate-specific antigen in the blood more than 1 g/ml);
- examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary);
- colonoscopy - in case of suspected colon cancer, as prescribed by a surgeon or coloproctologist;
- spirometry - if a chronic bronchopulmonary disease is suspected based on the results of a questionnaire, for smokers - in the direction of a therapist;
- for women: examination (consultation) by an obstetrician-gynecologist - if necessary;
- esophagogastroduodenoscopy - if there is a suspicion of malignant neoplasms of the esophagus, stomach and duodenum - as prescribed by the therapist;
- X-ray of the lungs, computed tomography of the lungs - if malignant neoplasms of the lung are suspected - as prescribed by the therapist;
- individual in-depth preventive counseling or group preventive counseling (patient school).
7. Which doctors should I see if I am between 51 and 74 years old?
The first stage of clinical examination:
- measurement of height, body weight, waist circumference, determination of body mass index;
- blood pressure measurement;
- conducting a general blood test (hemoglobin, leukocytes, ESR);
- determination of the level of total cholesterol in the blood using an express method;
- determination of fasting blood glucose levels (using the express method is allowed);
- determination of absolute cardiovascular risk (for patients under 64 years of age);
- individual preventive counseling - for patients under 72 years of age with high relative and very high absolute cardiovascular risk, obesity, hypercholesterolemia with a total cholesterol level of 8 mmol/l or more and/or smoking more than 20 cigarettes per day;
- fluorography of the lungs (not performed if fluorography, radiography (fluoroscopy) or computed tomography of the chest organs was performed in the previous calendar year or in the year of medical examination);
- electrocardiography at rest;
- for patients of both sexes: stool testing for occult blood (if you are from 40 to 64 years old, the test must be taken once every two years, if from 65 to 75 years old - annually);
- for men: determination of the level of prostate-specific antigen in the blood (carried out at the ages of 55, 60 and 64 years);
- for women under 64 years of age: examination by a midwife, including taking a smear from the cervix for cytological examination;
- for women: mammography (at the age of 40-75 years, performed once every 2 years).
If you have taken any of the tests listed or had any of the examinations listed in the past 12 months, their results may be included in the medical examination.
Second stage of medical examination (if necessary):
- examination (consultation) by a neurologist - if you suspect a previous acute disorder cerebral circulation, depression in patients over 65 years of age, with disorders motor function and etc.;
- duplex scanning of the brachycephalic arteries - for men up to 72 years old, for women 54-72 years old, in the presence of risk factors for the development of chronic non-infectious diseases;
- examination (consultation) by a surgeon or urologist (for men aged 55, 60 and 64 years - if the level of prostate-specific antigen in the blood increases by more than 1 g/ml);
- examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary);
- colonoscopy - in case of suspected colon cancer, as prescribed by a surgeon or coloproctologist;
- spirometry - if a chronic bronchopulmonary disease is suspected based on the results of a questionnaire, for smokers - in the direction of a therapist;
- for women under 75 years of age: examination (consultation) by an obstetrician-gynecologist - if necessary;
- examination (consultation) by an ophthalmologist - for patients with increased intraocular pressure;
- X-ray of the lungs, computed tomography of the lungs - if malignant neoplasms of the lung are suspected - as prescribed by the therapist;
- esophagogastroduodenoscopy - if there is a suspicion of malignant neoplasms of the esophagus, stomach and duodenum - as prescribed by the therapist;
- examination (consultation) by an otolaryngologist - for patients aged 65 years and older (if necessary);
- individual in-depth preventive counseling or group preventive counseling (patient school).
8. Which doctors should I see if I am 75 or older?
The first stage of clinical examination:
- measurement of height, body weight, waist circumference, determination of body mass index;
- blood pressure measurement;
- conducting a general blood test (hemoglobin, leukocytes, ESR);
- determination of the level of total cholesterol in the blood using an express method;
- determination of fasting blood glucose levels (using the express method is allowed);
- fluorography of the lungs (not performed if fluorography, radiography (fluoroscopy) or computed tomography of the chest organs was performed in the previous calendar year or in the year of medical examination);
- electrocardiography at rest;
- measurement of intraocular pressure (performed once a year);
- for women aged 75 years: mammography;
- for patients of both sexes aged 75 years: stool test for occult blood.
If you have taken any of the tests listed or had any of the examinations listed in the past 12 months, their results may be included in the medical examination.
Second stage of medical examination (if necessary):
- examination (consultation) by a neurologist - if there is a suspicion of a previous acute cerebrovascular accident, depression in patients over 65 years of age, with motor dysfunction, etc.
- duplex scanning of brachycephalic arteries - for patients aged 75-90 years, referred by a neurologist;
- examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary) - for patients under the age of 87 years;
- spirometry - if a chronic bronchopulmonary disease is suspected based on the results of a questionnaire, for smokers - in the direction of a therapist;
- esophagogastroduodenoscopy - if there is a suspicion of malignant neoplasms of the esophagus, stomach and duodenum - as prescribed by the therapist;
- X-ray of the lungs, computed tomography of the lungs - if malignant neoplasms of the lung are suspected - as prescribed by the therapist;
- examination (consultation) by an otolaryngologist (if necessary);
- examination (consultation) by an ophthalmologist - for patients with increased intraocular pressure, and for patients aged 75 years and older who have a decrease in visual acuity that cannot be controlled spectacle correction, identified from the results of the survey;
- individual in-depth preventive counseling or group preventive counseling (patient school).
9. My age is not on the list for medical examination. What examination can I undergo?
If your age is not on the list for medical examination and you do not belong to preferential categories, you can still go to your clinic and undergo a preventive medical examination. It is also held for early detection diseases and risk factors for their development, but unlike medical examination, it includes a smaller volume of examinations.
The advantage of a preventive medical examination is that it can be performed at any age at the request of the patient. The medical examination is carried out free of charge, annually. Preventive medical examination studies are included in stage 1 of medical examination.
Step 2. Find out the results. After the tests, you will have an appointment (examination) with a general practitioner, including Examination of the skin, mucous membranes of the lips and oral cavity, palpation of the thyroid gland and lymph nodes.
">examination to identify possible cancer diseases, with recommendations.If you are diagnosed with signs or a high risk of disease, your general practitioner will refer you for additional examination.
According to Order No. 302n of the Ministry of Health and Social Development of the Russian Federation, employees of enterprises and institutions must undergo regular medical examinations. Such a requirement helps to identify and eliminate diseases in a timely manner, which has a positive effect not only on the well-being of the employee, but also on the work process of the entire team. It also provides an opportunity to protect other people who come into contact with the employee. Below we will look at the rules for preparing for a medical examination, and also tell you which doctors you will need to visit.
Which doctors do you undergo for a medical examination?
Every person planning to undergo a medical examination should know which specialists need to be visited. The list of doctors may vary depending on the specifics of the job, working conditions, gender and age of the employee. Most often, a medical examination includes an appointment with:
- therapist;
- neurologist;
- otolaryngologist (ENT);
- ophthalmologist;
- gynecologist (for women);
- urologist or proctologist (for men);
- surgeon;
- narcologist;
- dentist
Preparing for a medical examination with a therapist
The medical examination begins with a visit to the therapist. This multidisciplinary specialist conducts general examination the patient, his skin and mucous membranes, palpates some organs and lymph nodes, assesses the condition of the musculoskeletal system, listens to the lungs using a phonendoscope, measures pressure and body temperature. The results of the medical history are recorded in your medical record.
An examination by a therapist does not require any special preparation. You just need to wear comfortable clothes that will not interfere with the examination, and also be prepared to talk with the doctor about the state of your health.
Rules for preparing for a medical examination with a neurologist
If you experience periodic or frequent headaches, migraine attacks and dizziness, trembling hands, problems sleeping, or seizures, you need to make an appointment with a neurologist without waiting for a scheduled medical examination. If you do not observe any malfunctions in your work nervous system, a visit to a neurologist should take place as a preventative measure once a year (during a medical examination).
An examination by a neurologist involves taking a medical history, measuring blood pressure, and lightly tapping kneecap with a special hammer, tingling the patient’s skin with special needles to determine the threshold of sensitivity, assessing coordination of movements and balance.
In order for a specialist to obtain accurate information about the state of health of a person who came to him for examination, it is necessary to give the neurologist truthful and reliable information when answering his questions. If the doctor has suspicions about any pathologies, he may write an appointment for additional examinations - for example, magnetic resonance imaging, computed tomography, electroencephalography, echoencephalography.
Before undergoing a medical examination by a neurologist, it is advisable to get a good night's sleep, avoid drinking tonic drinks (coffee, energy drinks, tincture of Eleutherococcus or ginseng) and alcohol. Also, if you are already taking any medications (sedatives, tranquilizers, sleeping pills), be sure to inform your doctor about this.
Medical examination with an otolaryngologist: what do you need to know and how to prepare?
During a visit to the ENT specialist, the mucous membranes of the throat and nose are examined, ears. Preparation for a medical examination with an ENT specialist consists of conducting hygiene procedures: before visiting a doctor, you need to brush your teeth, clear natural mucus from your nose, and carefully clean your ears. cotton swab. Also, do not gargle or rinse your nose so that a specialist can take samples for analysis.
Rules for preparing for a medical examination with an ophthalmologist
An ophthalmologist (ophthalmologist) performs an examination eyeballs, mucous membrane of the eyelids and fundus of the eye, measures eye pressure, checks the patient’s visual acuity using special tables. To prepare for the examination, it is advisable to avoid using eye drops beforehand. You will also need to bring glasses or contacts to your appointment if you wear them.
Preparation for a medical examination for women (visit to a gynecologist and mammologist)
The prospect of an upcoming gynecological examination is the reason for the anxiety of every second woman. This can easily be understood from a psychological point of view, because few people feel comfortable when visiting a gynecologist. However, every woman should understand that such an examination is a guarantee of health, not only for herself, but also for her partner.
A visit to the gynecologist includes a conversation about the nature of sexual activity, menstrual cycle, presence or absence of pain, unclear discharge and discomfort. This is followed by an examination in a gynecological chair using sterile equipment. At the end of the examination, the doctor takes a smear for laboratory testing.
To prepare for a medical examination with a gynecologist, a woman should abstain from sexual intercourse and vaginal douching 2-3 days before going to the doctor. It is also worth excluding the placement of vaginal suppositories and the use of products intimate hygiene(it is better to replace the use of the latter with washing with chamomile decoction or just warm water).
During the medical examination, women also need to see a mammologist. During a visit to this doctor, a visual examination and palpation of the mammary glands is performed, the doctor asks questions about possible pain and breast swelling during PMS. If the mammologist suspects that the patient has a particular disease, he will advise her to undergo an ultrasound of the mammary glands or mammography.
A visit to a mammologist during a medical examination is not required preliminary preparation. The only thing you need to do is wear comfortable underwear and refuse a dress, since for the examination you will have to remove it completely (it is better to come to the appointment in a skirt and blouse, jeans and a sweater).
Medical examination with a proctologist or urologist (for men): how to prepare?
A timely visit to a proctologist and urologist for men is as important as an appointment with a gynecologist and mammologist for women.
An examination by a proctologist consists of interviewing the patient, visual examination of the anal area, and palpation of the anus. The evening before the medical examination with a proctologist, it is recommended to do a cleansing enema and also refuse dinner. If the appointment is scheduled for the second half of the day, you can have breakfast with very light foods in small quantities.
As for the medical examination with a urologist, it includes a doctor’s examination of the scrotum and penis, as well as palpation of the prostate through anus. In addition, prostatic secretions may need to be collected for laboratory testing.
The rules for preparing for a medical examination with a urologist are simple: you need to abstain from sexual intercourse 2-3 days before visiting the doctor, perform a cleansing enema the day before and refrain from urinating for 1-1.5 hours for the examination.
Preparing for a medical examination with a surgeon
A visit to the surgeon is necessary for timely detection of injuries and pathologies. After collecting anamnesis, the doctor performs a visual examination and palpation of certain areas of the body, examination using percussion and a stethoscope. If he has suspicions that the patient has a disease, the surgeon may refer him for an ultrasound or x-ray.
To prepare for the examination, you should shower beforehand and wear comfortable clothing that you can quickly remove for the examination.
How to prepare for a dental examination?
Dental examination helps to early stages identify and eliminate caries, pulpitis and other dental diseases. To prepare for a medical examination, you need to thoroughly brush your teeth and rinse your mouth, and then refuse to eat until you see the dentist. If the medical examination is scheduled for the afternoon, it is recommended to take it with you to work. toothbrush and toothpaste to brush your teeth immediately before your appointment.
Examination by a narcologist: what do you need to know to properly prepare for it?
A visit to a narcologist is a mandatory part of the medical examination for drivers, medical staff, pharmacists, pharmacists, as well as for all workers whose field of activity is in one way or another connected with mechanisms and devices.
During the examination, the narcologist asks questions to get general information about the patient’s health status, living and working conditions. Next, the doctor conducts a series of tests to determine the condition of the vestibular apparatus and the basic functions of the nervous system. A visual examination of the skin and checking the veins for the presence of non-medical injections is also necessary. In addition, laboratory tests of the blood may be required to possibly detect drug particles in the blood.
On the eve of the examination, you must stop smoking, drinking alcohol, and taking strong medications. If you are forced to take medications to maintain normal health, you must inform your narcologist about this before the examination.
What is included in the medical examination of tests and diagnostic procedures?
- Finger blood test.
- Venous blood analysis.
- Analysis of urine.
- Smear collection.
- Electrocardiogram.
- Fluorography.
- Mammography.
Where to get a medical examination in St. Petersburg?
Medical examinations are carried out both in public clinics and in private clinics and medical centers. Both medical institutions have their advantages. However, when contacting private centers, you can count on a more complete range of services and attention from the staff. In addition, when making an appointment for a medical examination at a private medical institution, the patient does not have to wait long for his turn; modern equipment is used for examinations, and the medical examination itself takes much less time.
At GarantMed you can short time undergo a medical examination, in consultation with highly qualified specialists, and receive the results of a medical examination in your hands. To do this, you need to contact the administrator and select the most suitable date for the examination.
Preventive examination and medical examination are a set of measures that are carried out in medical organizations. According to the order of the Ministry of Health of the Russian Federation dated March 13, 2019 No. 124N, both working and non-working citizens, as well as full-time students studying in educational organizations over the age of 18 years, undergo medical examination and medical examination. Based on the results of these medical measures, doctors determine patient health groups and dispensary observation groups.
How does a medical examination differ from a medical examination?
Preventive examination is carried out for the timely detection of diseases and risk factors for their development, as well as to identify non-medical use of drugs and psychotropic substances. Clinical examination is a broader set of activities. It includes a medical examination, as well as additional methods examinations that are carried out to assess the condition certain groups population.
How often do you need to undergo a medical examination and medical examination?
A medical examination is carried out annually as an independent event, as part of a medical examination or during the first medical examination of the current year. Medical examination for persons aged 18 to 39 years inclusive is carried out once every three years. According to the new rules, citizens over the age of 40 can undergo it annually.
What procedures include medical examination and medical examination?
The annual medical examination for citizens aged 18 years and older includes the following activities:
- questionnaires to identify complaints, symptoms, determine risk factors for diseases, etc.;
- calculation of body mass index;
- blood pressure measurement;
- study of the level of total cholesterol in the blood;
- determination of blood glucose levels.
Adult citizens over the age of 18 also undergo fluorographic examination of the lungs or chest x-ray once every two years. For patients aged 18 to 39 years inclusive, once a year the doctor determines the relative cardiovascular risk, women in this age group are examined by a paramedic (midwife) or obstetrician-gynecologist.
Citizens over the age of 35 years old undergo additional electrocardiography every year during medical examinations, and for those over 40 years old, intraocular pressure is measured.
In patients aged 40 to 64 years inclusive, the absolute cardiovascular risk is determined annually, and after the age of 65, the risk of developing osteoporosis, depression, heart failure, uncorrected hearing and vision impairment.
Clinical examination is carried out in two stages. At the first stage, for citizens aged 18 to 39 years inclusive, once every three years a medical examination, cancer screening, brief preventive consultation by a general practitioner, and an examination by this doctor are carried out. Citizens aged 40 to 64 years inclusive and patients aged 65 years and older once a year, in addition to these procedures, also undergo general analysis blood.
At the second stage of medical examination, patients are offered to undergo additional examinations by doctors narrow profile, their diagnoses are clarified. List possible procedures listed in
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?
A preventive medical examination includes examinations and tests. These procedures are mandatory elements of a medical examination for both males and females. Full list necessary research preventive medical examination 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 |
| Arterial pressure |
Is one of the main diagnostic methods arterial hypertension
|
|
|
Analysis |
Determining the level of total cholesterol in the blood |
Allows you to diagnose a number of serious diseases |
| Determination of blood glucose levels |
||
| 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 |
Examination of feces for 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 faces 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:
|
| Morning stool collection |
|
|
|
Preparatory (before the examination) |
No meals 8 hours before the examination |
Preventive examination is carried out on an empty stomach |
| Avoiding physical activity on the day of the examination (including morning physical exercise) |
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:
|
| 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:
|
| Women |
Restrictions for women in whom the procedure for collecting a smear from the cervix is not performed:
|
| Men over 50 years old |
7-10 days before the examination you should exclude:
|
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.