Professional standard “Physician (precinct general practitioner)” and its features. Functional responsibilities of a general practitioner (family doctor) Job description of a general practitioner


On March 21, 2017, by order of the Ministry of Labor and social protection Russian Federation No. 293n, the professional standard “Physician (precinct physician)” was approved.

We remind you that in accordance with Article 195.1 of the Labor Code of the Russian Federation, a professional standard is a characteristic of the qualifications necessary for an employee to carry out a certain type professional activity, including the performance of a certain labor function. According to part 1 of the article, if Labor Code, other federal laws, and other regulatory legal acts of the Russian Federation establish requirements for the qualifications necessary for an employee to perform a certain job function; professional standards in terms of these requirements are mandatory for application by employers.

Considering the existing qualification requirements for medical and pharmaceutical workers With higher education in the field of training “Healthcare and Medical Sciences”, approved by order of the Ministry of Health of Russia dated October 8, 2015 No. 707n, section “Qualification characteristics of positions of workers in the field of healthcare” of the Unified qualification directory positions of managers, specialists and employees, approved by Order of the Ministry of Health and Social Development of the Russian Federation dated July 23, 2010 No. 541n and a number of other regulatory legal acts, professional standards are mandatory in terms of requirements for education, training, level of knowledge, skills and abilities medical workers(you can read more about this in the articles “” and “”).

Currently, the following professional standards for medical workers have been approved in the Russian Federation:

  • Professional standard ""
  • Professional standard " Specialist in the field of medical and preventive care»
  • Professional standard " Junior medical staff»
  • Professional standard “Dentist”
  • Professional standard “Pharmacist”
  • Professional standard " Local pediatrician»

Of course, the professional standard “Physician (GP)” is one of the key professional standards in the healthcare sector, since it is on the shoulders of local GPs that a significant part of the activities in providing primary health care lies.

In accordance with accepted standard The main goal of the activities of general practitioners is defined as “preserving and strengthening the health of the adult population.” This definition raises some questions. So, if you believe the professional standard, The main goal of a medical doctor’s activity is not to treat diseases. The wording “preservation and promotion of health” is borrowed from paragraph 5 of Article 12 Federal Law dated November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” and it refers to the implementation of prevention in the field of health protection.

As generalized labor function The standard provides for these specialists to perform the functions of providing primary health care to the adult population in an outpatient setting that does not provide for round-the-clock medical observation and treatment, including at home when a medical professional is called.

As possible names of positions and professions There is only one title provided - “precinct general practitioner”. Thus, we can expect that a separate professional standard will be devoted to the ordinary general practitioner.

At the same time, it is surprising that there is no such position title as “precinct general practitioner of a workshop medical district.” Despite the fact that this position is much less common than a local therapist, it is provided for by such regulations as qualification requirements for medical and pharmaceutical workers with higher education in the field of training “Health and Medical Sciences”, approved by order of the Ministry of Health of Russia dated 08.10 .2015 No. 707n and the nomenclature of positions for medical workers and pharmaceutical workers, approved by order of the Ministry of Health of the Russian Federation dated December 20, 2012 No. 1183n. Of course, there is a possibility that a separate standard will appear for this position (is it necessary?) - but before such an appearance, there is a certain gap in the characteristics of the qualifications necessary to perform the functions of a local general practitioner in a workshop medical district.

Education and Training Requirements A local therapist, in accordance with the professional standard, includes the following:

  • higher education - specialty in General Medicine who have completed their studies in accordance with the federal educational standard of higher education since 2017;
  • higher education - specialty in "Pediatrics" or "General Medicine";
  • preparation for internship/residency in the specialty “Therapy”;
  • additional professional education - professional retraining in the specialty “Therapy” with residency training in the specialty “General Medical Practice (Family Medicine)”.

It can be concluded that the authors of the professional standard were guided by the qualification requirements for medical and pharmaceutical workers with higher education in the field of training “Healthcare and Medical Sciences”, approved by order of the Ministry of Health of Russia dated October 8, 2015 No. 707n (requirement 2-4), as well as Order of the Ministry of Education and Science of Russia dated September 12, 2013 No. 1061 “On approval of lists of specialties and areas of training in higher education” (requirement 1).

Nevertheless, The version of the education requirements proposed by the professional standard suggests an incorrect interpretation, according to which, to work as a local therapist, it is enough to fulfill one of the above requirements (just as one might think that it is necessary to fulfill all 4 requirements). In fact, the first requirement (a specialist in the specialty “General Medicine” who has completed training in accordance with the federal educational standard of higher education since 2017) should logically apply exclusively to graduates of medical universities, who are now authorized to (almost) start working after completing primary accreditation, bypassing the residency stage. The remaining requirements obviously apply to “full-fledged” doctors who have also received postgraduate education in internship/residency, despite the fact that the third requirement (training in internship/residency in the specialty “Therapy”) and the fourth requirement (DPO) are directly tied to the fulfillment of the second (higher education - a specialty in the specialties “Pediatrics” or “General Medicine”) and do not have the right to “independent life”.

In addition, the new professional standard It is not possible to appoint local doctors with the specialty “General Medical Practice (Family Medicine)” to the position of general practitioner., despite the fact that this appears in the order of the Russian Ministry of Health dated October 8, 2015 No. 707n. The qualification requirements for education in this case are as follows: higher education - a specialty in one of the specialties: “General Medicine”, “Pediatrics”, residency training in the specialty “General Medical Practice (Family Medicine)” or professional retraining in the specialty “General Medical Practice” (family medicine)” with higher education (residency) in one of the specialties: “Pediatrics”, “Therapy”. However, we repeat that these standards are not reflected in the professional standard.

If we set the goal of full compliance of the professional standard with the order of the Ministry of Health of Russia dated October 8, 2015 No. 707n and the logic of the order of the Ministry of Education and Science of Russia dated September 12, 2013 No. 1061, then the requirements for education and training should be worded as follows (three alternative options for the requirements for education and training of a local physician should be highlighted):

  • I. Higher education - a specialist in the specialty “General Medicine” who have completed their studies in accordance with the federal educational standard of higher education since 2017.
  • II. Higher education - specialty in "Pediatrics" or "General Medicine":
    • a) with training in internship/residency in the specialty “Therapy”;
    • b) with additional professional education - professional retraining in the specialty “Therapy” if there is residency training in the specialty “General Medical Practice (Family Medicine)”.
  • III. Higher education - specialty in "Pediatrics" or "General Medicine":
    • a) with internship/residency training in the specialty “General Medical Practice (Family Medicine)”;
    • b) with additional professional education - professional retraining in the specialty “General Medical Practice (Family Medicine)” with residency training in one of the specialties: “Pediatrics”, “Therapy”.

However, we believe that this approach does not correspond to modern approaches to medical education and needs to be changed.

Thus, in the order of the Ministry of Health of Russia dated October 8, 2015 No. 707n, there are no requirements for the specialty “general medicine”, which is not so surprising, because the specialty “general medicine” was recently added (January 2017) to the Nomenclature of specialties of specialists with higher medical and pharmaceutical education, approved by Order of the Ministry of Health of Russia dated October 7, 2015 No. 700n. Medical and pharmaceutical specialties should not be confused with educational specialties, however, it is also worth noting that the Ministry of Health and additional education organizations have long confused these two concepts, which is legally incorrect.

According to the order of the Ministry of Education and Science of Russia dated September 12, 2013 No. 1061 “On approval of lists of specialties and areas of training in higher education” “physician” is a qualification corresponding to the specialty 05/31/01 - General Medicine (level of education - specialty). At least this has been the case since May 22, 2017, before this specialty 05/31/01 - General Medicine met the qualification “Doctor” general practice" The qualification "doctor-therapist" is a qualification corresponding to the specialty 08/31/49 - Therapy (level of education - residency).

Please note that different levels of education and different qualifications cannot in any way imply occupying the same position. In our opinion, the position of the authors of the standard, which equates a “physician” with a “precinct general practitioner” is erroneous- since the first requires only higher education in the form of a specialty, and the second requires postgraduate education (with preparation for an internship/residency). It is quite logical that the range of work functions and responsibilities of a doctor with postgraduate education should be wider than that of a specialist who has just graduated from a medical university. The positions and functions of specialists with a specialist level of education and specialists with a highly qualified personnel education level cannot be identical. Firstly, this is logical, and secondly, this follows from Part 9 of Article 82 of the Education Law, which states that training in residency programs ensures that students acquire the level of knowledge, skills and abilities necessary for professional activities, as well as qualifications to occupy certain positions medical workers, pharmaceutical workers.

Thus, according to the Faculty Medical Law, it is necessary to distinguish two positions with different requirements for them and with different labor functions: “physician”(for university graduates who do not have postgraduate education in the form of internship/residency) and “precinct general practitioner”(for university graduates with internship/residency training").

Accordingly, it is desirable to develop its own professional standard for each position or, at least, to provide for differences in their labor functions ( labor actions, necessary knowledge and skills). Also it is necessary to amend the order of the Ministry of Health of Russia dated October 8, 2015 No. 707n, clearly defining the requirements for the specialty “general medicine”.

We also consider it advisable to have a clearer distinction between the positions of a general practitioner (family doctor) and a local physician. As already stated above, Order of the Ministry of Health of Russia dated October 8, 2015 No. 707n provides for the work of a doctor with the specialty “General Medical Practice (Family Medicine)” as a local general practitioner without retraining. At the same time, this order does not allow a doctor with a specialty in therapy to work as a family doctor without retraining. In our opinion, there is no reason to believe that doctors with the specialty “family medicine” have a greater amount of knowledge and skills than doctors with the specialty “therapy”.

Taking into account the above, It seems to us that the norms of the order of the Ministry of Health of Russia dated October 8, 2015 No. 707n require adjustment(either in the form of creating a separate position for family doctors working at the site, or in the form of excluding from the text of the order the norms allowing family doctors, without undergoing retraining, to occupy the position of district physician). At the same time, it will be possible to finally formulate possible changes in legislation concerning family doctors only after the release of the professional standard “Family Doctor”. However, this order requires a separate legal analysis, which is not the purpose of this article.

Experience Requirements practical work there are none for a general practitioner, which is quite natural, since the position of a local general practitioner is often one of the first steps in the career of a young doctor.

They look more interesting special conditions permission to work, defined in the standard. In addition to passing medical examinations and the absence of restrictions on engaging in professional activities, they include a certificate of a specialist in the specialty “Therapy” and (or) a certificate of accreditation of a specialist in the specialty “General Medicine”.

We cannot agree with the proposed wording of the conditions for admission to work.. And that's why.

Certificate of accreditation in the specialty "General Medicine" will only be available to graduates of medical universities with primary accreditation and without postgraduate education. However, this is only one of the categories of persons who can occupy the position of a general practitioner (as we have already indicated above, it is advisable to separate this position from the position of a local general practitioner, as requiring less qualifications).

As for doctors with internship/residency training in the specialty “Therapy,” they may have a certificate as a specialist in the specialty “Therapy” or a certificate of accreditation of a specialist in the specialty “Therapy.” Please note that that the current edition of the professional standard does not provide for admission to work with a certificate of accreditation in the specialty “Therapy”. The professional standard mentions a certificate in the specialty "Therapy", but not a certificate of accreditation.

The professional standard also completely ignores the conditions for admission to work with training in internship/residency in the specialty “General Medical Practice (Family Medicine)”(the work of doctors of this specialty in the position of local general practitioner is provided for by Order of the Ministry of Health of Russia dated October 8, 2015 No. 707n). Such doctors, in accordance with the requirements of Art. 69, 100 of the Federal Law of November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation, must have a specialist certificate in the specialty “General Medical Practice (Family Medicine)” or a certificate of accreditation of a specialist in the specialty “General Medical Practice (Family Medicine)”.

From other characteristics The labor function of a general practitioner is highlighted in the professional standard:

  • maintaining medical confidentiality;
  • observance of the Physician's Oath;
  • compliance with the principles of medical ethics and deontology when working with patients (legal representatives of patients), colleagues;
  • knowledge of legislation in the field of health protection, regulations and other documents defining the activities of medical organizations and medical workers, state guarantee programs, compulsory health insurance, labor legislation of the Russian Federation;
  • professional development of a specialist (including additional professional education).

These characteristics, according to the Faculty of Medical Law, also need some adjustment. For example, it is not entirely clear why compliance with medical confidentiality needed to be highlighted separately, if such compliance is provided for by federal legislation, the Doctor’s Oath and the principles of medical ethics, the need for compliance with which is indicated below.

Also, based on the wording of the professional standard, the physician must comply with the principles of medical ethics and deontology exclusively with patients, their legal representatives and colleagues. Thus, if you read the norms of the standard literally, the doctor may not comply ethical principles with relatives of patients, specialists in related professions, etc. In our opinion, in the professional standard it is necessary not to limit compliance with the principles of medical ethics and deontology to a certain circle of people - the doctor must comply with these principles in relation to any person.

The inclusion in the professional standard of knowledge of legislation in the field of health protection, state guarantee programs, compulsory health insurance and even labor legislation of the Russian Federation also raises questions. The Faculty of Medical Law has always advocated for increasing the legal literacy of medical workers and emphasized the need to train doctors in the basics of medical law.

At the same time, in Federal State Educational Standard of Higher Education in the field of training 05/31/01 General Medicine (specialty level), approved by order of the Ministry of Education and Science of Russia dated 02/09/2016 No. 95 there are no competencies related to knowledge of medical, and especially insurance and labor legislation. In practice, in most cases, in the process of studying in the field of General Medicine, students become familiar only with the basics of jurisprudence (albeit taking into account medical specifics). The situation is similar with a specialty in Pediatrics.

Obviously, the authors of the professional standard were guided by the Section “Qualification characteristics of positions of workers in the healthcare sector” of the Unified Qualification Directory of Positions of Managers, Specialists and Employees, approved by Order of the Ministry of Health and Social Development of the Russian Federation dated July 23, 2010 No. 541n. Indeed, in accordance with it, the therapist must know the legislation of the Russian Federation in the field of healthcare, medical education and regulation labor relations. However, it remains unclear exactly how a general practitioner will acquire this knowledge if teaching it is not provided for in educational standards. According to the Faculty of Medical Law, it is necessary to ensure consistency between the professional standard and the Federal State Educational Standard in terms of training future doctors in medical law. The best way to ensure such compliance would be to amend the Federal State educational standard with subsequent adjustment curricula and plans (including in them the discipline “Medical Law”, which involves the study of legislation, the knowledge of which is provided for by the professional standard).

As for professional training of specialists, we continue to adhere to the opinion (which was set out in detail in the article “”) that professional education health care workers (including continuing education) should be included in the “Education and Training Requirements” section and not in “Other Characteristics”.

The professional standard includes the labor functions of a general practitioner:

  • providing medical care to a patient in urgent or emergency forms;
  • conducting an examination of the patient to establish a diagnosis;
  • prescribing treatment and monitoring its effectiveness and safety;
  • implementation and monitoring of the effectiveness of the patient’s medical rehabilitation, including the implementation of individual rehabilitation or habilitation programs for people with disabilities, assessment of the patient’s ability to carry out work activities;
  • carrying out and monitoring the effectiveness of measures for prevention and formation healthy image life and sanitary and hygienic education of the population
  • maintaining medical records and organizing the activities of the secondary medical personnel.

For each of these functions, the professional standard provides for labor actions, the necessary skills and the necessary knowledge. Unfortunately, the scope of this article does not allow us to present detailed analysis each of them. However, it can be argued that the wording contained in the description of the component labor actions, necessary skills and necessary knowledge in some cases they need to be clarified or changed. Let us give a number of examples.

For several functions, a complete physical examination of the patient (inspection, palpation, percussion, auscultation) is provided as a necessary skill of the physician. At the same time, laboratory and instrumental studies, in accordance with the description of the necessary skills and work actions, are not carried out by the clinician: his actions are limited to determining the scope and drawing up a plan for laboratory/instrumental studies and referral for such studies. In practice, the local therapist independently conducts a number of simple instrumental studies - such as anthropometry, thermometry, tonometry, pharyngoscopy, etc. However, this is not reflected in the professional standard.

Also, the professional standard does not reflect one of the most important, in our opinion, functions of a general practitioner - prescribing medications. The Faculty of Medical Law draws attention to the fact that in accordance with the Procedure for prescribing and prescribing medications, approved by order of the Ministry of Health of Russia dated December 20, 2012 No. 1175n, “prescribing” and “prescribing are not synonymous (a number of norms of the mentioned procedure relate exclusively to prescribing, while while a number of others are purely appointments). Based on the norms of professional standards, a physician can only prescribe drugs, but not write prescriptions for them.

From a legal point of view, it is incorrect to classify the assessment of the effectiveness and safety of the use of medications as the labor actions of a local doctor. Of course, in accordance with Part 2 of Article 73 of the Federal Law of November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation,” a medical worker is obliged to report to the authorized federal executive body about side effects, adverse reactions, serious adverse reactions , unexpected adverse reactions when using medications, individual intolerance, lack of effectiveness of medications, as well as other facts and circumstances that pose a threat to the life or health of a person or animal when using medications and identified at all stages of circulation of medications in the Russian Federation and other states. However, assessment of the effectiveness and safety of the use of drugs relates to pharmacovigilance. In particular, the preparation of reports on the safety of a medicinal product for medical use (hereinafter referred to as the periodic report), containing information on the safety of a specific medicinal product, which contains a reasonable assessment of the expected benefit and possible risk application falls within the competence of Roszdravnadzor, and not individual therapists. Taking into account the above, this function of the physician is better formulated as “monitoring the safety and effectiveness of the treatment.”

You should also pay attention to the fact that the professional standard entrusts the local therapist with such labor actions as “organizing and conducting medical examinations taking into account age, health status, profession in accordance with current regulations and other documents.” Assigning the responsibility for organizing medical examinations to a doctor is inconsistent Article 212 of the Labor Code of the Russian Federation, which establishes the employer’s obligation to organize, at the expense of own funds mandatory preliminary (upon admission to work) and periodic (during labor activity) medical examinations, other mandatory medical examinations, mandatory psychiatric examinations of workers, extraordinary medical examinations, mandatory psychiatric examinations of workers at their requests in accordance with medical recommendations. Taking into account the above norms of labor legislation, it is advisable to formulate in the professional standard the labor actions of a doctor as “ assistance in organizing and directly conducting medical examinations».

The shortcomings associated with the description of the labor functions of a general practitioner are not limited to those discussed above - only the most striking examples are given. In our opinion, the labor functions of a local therapist need to be brought into full compliance with the existing legal framework regulating his professional rights and obligations (including regulations on the organization of activities, procedures and standards for the provision of medical care, etc.). Thus, as an example, we can cite the Regulations on the organization of activities of a local general practitioner, approved by order of the Ministry of Health of the Russian Federation dated December 7, 2005 No. 765. According to clause 6 of this Regulation, a local general practitioner forms a medical (therapeutic) area from the population attached to it , but this function is not mentioned in the professional standard. In the same paragraph of the Regulations, the general practitioner is charged with organizing and conducting health schools, which is again absent from the professional standard. We believe that there is a need to achieve harmonization of the norms of the professional standard with other legal acts in the field of medicine - by making changes either to the professional standard or to normative documents that do not correspond to it. legal acts.

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Order of the Ministry of Health of Russia dated December 20, 2012 N 1183n “On approval of the nomenclature of positions of medical workers and pharmaceutical workers” (registered by the Ministry of Justice of Russia on March 18, 2013, registration N 27723), as amended by order of the Ministry of Health of Russia dated August 1, 2014. N 420н (registered by the Ministry of Justice of Russia on August 14, 2014, registration N 33591).

Order of the Ministry of Health of Russia dated October 8, 2015 N 707n “On approval Qualification requirements for medical and pharmaceutical workers with higher education in the field of training “Healthcare and Medical Sciences” (registered by the Ministry of Justice of Russia on October 23, 2015, registration N 39438); Order of the Ministry of Health and Social Development of Russia dated July 23, 2010 N 541n “On approval of the Unified Qualification Directory of positions of managers, specialists and employees, section “Qualification characteristics of positions of workers in the field of healthcare” (registered by the Ministry of Justice of Russia on August 25, 2010, registration N 18247).

Order of the Ministry of Health of Russia dated November 29, 2012 N 982n “On approval of the conditions and procedure for issuing a specialist certificate to medical and pharmaceutical workers, forms and technical requirements specialist certificate" (registered by the Ministry of Justice of Russia on March 29, 2013, registration N 27918), as amended by orders of the Ministry of Health of Russia dated July 31, 2013 N 515n (registered by the Ministry of Justice of Russia on August 30, 2013, registration N 29853), dated 23 October 2014 N 658н (registered by the Ministry of Justice of Russia on November 17, 2014, registration N 34729) and dated February 10, 2016 N 82н (registered by the Ministry of Justice of Russia on March 11, 2016, registration N 41389).

Order of the Ministry of Health and Social Development of Russia dated April 12, 2011 N 302n “On approval of lists of harmful and (or) hazardous production factors and work, during which mandatory preliminary and periodic medical examinations (examinations) are carried out, and the Procedure for conducting mandatory preliminary and periodic medical examinations ( examinations) of workers engaged in heavy work and work with harmful and (or) dangerous working conditions" (registered by the Ministry of Justice of Russia on October 21, 2011, registration N 22111), as amended by orders of the Ministry of Health of Russia dated May 15, 2013 N 296n (registered by the Ministry of Justice of Russia on July 3, 2013, registration N 28970) and dated December 5, 2014 N 801n (registered by the Ministry of Justice of Russia on February 3, 2015, registration N 35848).

Article 351.1 of the Labor Code of the Russian Federation (Collected Legislation of the Russian Federation, 2002, No. 1, Art. 3; 2010, No. 52, Art. 7002; 2012, No. 14, Art. 1553; 2015, No. 29, Art. 4363).

Article 71 of the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” (Collected Legislation of the Russian Federation, 2011, N 8, Art. 6724; 2013, N 27, Art. 3477).

additional characteristics

General provisions

1.1. This defines the functional, rights and responsibilities of a general practitioner [Name of the organization in the genitive case] (hereinafter referred to as the Medical Organization).

1.2. A general practitioner is appointed to a position and dismissed from a position as established by the current labor legislation order by order of the head of the Medical organization.

1.3. A general practitioner belongs to the category and is subordinate to [names of subordinate positions in the dative case].

1.4. The general practitioner reports directly to [name of the immediate supervisor's position in the dative case] of the Medical Organization.

1.5. A person who has a higher professional education in one of the specialties “General Medicine”, “Pediatrics” and postgraduate professional education (residency) in the specialty “General Medical Practice (Family Medicine)” or professional retraining in the specialty “General Medicine” is appointed to the position of general practitioner. practice (family medicine)" with a postgraduate diploma vocational education in the specialty “Pediatrics” or “Therapy”, a specialist certificate in the specialty “General Medical Practice (Family Medicine)”, without any work experience requirements.

1.6. The general practitioner is responsible for:

  • effective performance of the work assigned to him;
  • compliance with the requirements of performance, labor and technological discipline;
  • the safety of documents (information) in his custody (that have become known to him) containing (constituting) the commercial secret of the Medical Organization.

1.7. The general practitioner should know:

  • Constitution of the Russian Federation;
  • laws and other regulatory legal acts of the Russian Federation in the field of healthcare, consumer protection and sanitary and epidemiological welfare of the population;
  • regulatory legal acts regulating the circulation of potent, psychotropic and narcotic drugs;
  • theoretical basis in the chosen specialty;
  • prevention, diagnosis, treatment of the most common diseases and rehabilitation of patients, principles and methods of prevention and treatment of the most common diseases;
  • patient rehabilitation;
  • demographic and medical-social characteristics of the assigned contingent;
  • issues of organizing medical and social examination;
  • basics of dietary nutrition and diet therapy;
  • on the territorial program of state guarantees for the provision of free medical care to citizens (types of medical care provided to the population free of charge, medical care provided within the framework of the territorial compulsory health insurance program, medical care provided at the expense of budgets of all levels);
  • the procedure for referring patients to sanatorium-resort treatment;
  • basics of labor legislation;
  • labor protection and fire safety regulations;
  • sanitary rules and norms for the functioning of a healthcare institution.

1.8. A general practitioner in his activities is guided by:

  • local acts and organizational and administrative documents of the Medical Organization;
  • internal rules labor regulations;
  • rules of labor protection and safety, ensuring industrial sanitation and fire protection;
  • instructions, orders, decisions and instructions from the immediate supervisor;
  • real.

1.9. During the period of temporary absence of a general practitioner, he is assigned to [job title].

Job responsibilities

A general practitioner is required to perform the following job functions:

2.1. Provides outpatient appointments and home visits, provides emergency care, carries out a set of preventive, therapeutic, diagnostic and rehabilitation measures, and assists in solving medical and social problems of the family.

2.2. Provides continuous primary health care to the patient, regardless of his age, gender and nature of the disease.

2.3. Performs examination and evaluates patient physical examination data.

2.4. Draws up a plan for laboratory and instrumental examination.

2.5. Interprets the results laboratory tests; radiation, electrophysiological and other research methods.

2.6. Independently conducts examination, diagnosis, treatment, rehabilitation of patients, if necessary, organizes further examination, consultation, hospitalization of patients, subsequently carries out prescriptions and carries out further monitoring for the most common diseases.

2.7. Provides: obstetric care, assistance to children and patients with occupational diseases, medical care for acute and emergency conditions of the body requiring resuscitation measures and intensive care.

2.8. Conducts an analysis of the health status of the assigned contingent, disease prevention, measures to improve the health of the population, including the formation of a healthy lifestyle, reducing alcohol and tobacco consumption, and maintains medical records.

2.9. Carries out preventive work aimed at identifying early and latent forms of diseases, socially significant diseases and risk factors through clinical examination of the assigned contingent in the prescribed manner, including children, disabled people, and people of older age groups.

2.10. Refers patients for consultations to specialists for inpatient and rehabilitation treatment according to medical indications.

2.11. Organizes and conducts treatment of patients on an outpatient basis, day hospital and hospital at home.

2.12. Provides patronage to pregnant women and children early age, including newborns, in the prescribed manner.

2.13. Organizes and carries out anti-epidemic measures and immunoprophylaxis in the prescribed manner.

2.14. Issues a conclusion on the need to refer patients for medical reasons to sanatorium-resort treatment.

2.15. Interacts with medical organizations of state, municipal and private healthcare systems, medical insurance companies, and other organizations.

2.16. Supervises the work of nursing and junior medical staff.

2.17. In accordance with the established procedure, improves professional qualifications.

2.18. Prepares and sends an emergency notification to the Rospotrebnadzor institution when an infectious disease is detected.

2.19. Conducts an examination of temporary disability, refers patients with signs of permanent disability for examination for a medical and social examination.

In case of official necessity, a general practitioner may be involved in performing his duties overtime, in the manner prescribed by the provisions of federal labor legislation.

Rights

A general practitioner has the right:

3.1. Give instructions and tasks to his subordinate employees and services on a range of issues included in his functional responsibilities.

3.2. Monitor the implementation of production tasks, timely completion of individual orders and tasks by the services subordinate to him.

3.3. Request and receive the necessary materials and documents related to the activities of the general practitioner, services and departments subordinate to him.

3.4. Interact with other enterprises, organizations and institutions on production and other issues within the competence of a general practitioner.

3.5. Sign and endorse documents within your competence.

3.6. Submit proposals on the appointment, transfer and dismissal of employees of subordinate departments for consideration by the head of the Medical Organization; proposals to encourage them or to impose penalties on them.

3.7. Use other rights established by the Labor Code of the Russian Federation and others legislative acts RF.

Responsibility and performance evaluation

4.1. A general practitioner bears administrative, disciplinary and material (and in some cases provided for by the legislation of the Russian Federation, criminal) responsibility for:

4.1.1. Failure to carry out or improperly carry out official instructions from the immediate supervisor.

4.1.2. Failure to perform or improper performance of one's job functions and assigned tasks.

4.1.3. Illegal use of granted official powers, as well as their use for personal purposes.

4.1.4. Inaccurate information about the status of the work assigned to him.

4.1.5. Failure to take measures to suppress identified violations of safety regulations, fire safety and other rules that pose a threat to the activities of the enterprise and its employees.

4.1.6. Failure to ensure compliance with labor discipline.

4.2. The assessment of the work of a general practitioner is carried out:

4.2.1. By the immediate supervisor - regularly, in the course of the employee’s daily performance of his labor functions.

4.2.2. Certification Commission enterprises - periodically, but at least once every two years, based on documented results of work for the evaluation period.

4.3. The main criterion for assessing the work of a general practitioner is the quality, completeness and timeliness of his performance of the tasks provided for in this instruction.

Working conditions

5.1. The working hours of a general practitioner are determined in accordance with the internal labor regulations established in the Medical Organization.

Signature right

6.1. To ensure his activities, a general practitioner is given the right to sign organizational and administrative documents on issues within his competence herein.

I have read the instructions ___________/___________/ “____” _______ 20__

(signature)

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Job description general practitioner

[name of organization, enterprise, etc.]

This job description has been developed and approved in accordance with the provisions of the Unified Qualification Directory of Positions for Managers, Specialists and Employees, section “Qualification Characteristics of Positions of Workers in the Healthcare Sector”, approved by order of the Ministry of Health and social development RF dated July 23, 2010 N 541n, and other legal acts regulating labor relations.

1. General Provisions

1.1. The general practitioner belongs to the category of specialists and is directly subordinate to [name of the immediate supervisor].

1.2. A person who has a higher professional education in one of the specialties “General Medicine”, “Pediatrics” and postgraduate professional education (internship and (or) residency) in the specialty “Therapy” or professional retraining with postgraduate professional education in specialty "General Medical Practice (Family Medicine)", a specialist certificate in the specialty "Therapy", without any work experience requirements.

1.3. The general practitioner must know:

Constitution of the Russian Federation;

Laws and other regulatory legal acts of the Russian Federation in the field of healthcare;

The main provisions of the Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens, legislation on compulsory medical insurance, on the territorial program of state guarantees of free medical care (types of medical care provided to the population free of charge, medical care provided within the framework of the territorial program of compulsory medical insurance, medical care provided at the expense of budgets of all levels);

Principles of organizing therapeutic care in the Russian Federation, the work of hospital and polyclinic institutions, the organization of ambulance and emergency care for adults and children;

Questions about the connection between the disease and the profession;

Have an idea of ​​the reasons for involving a doctor in various types liability (disciplinary, administrative, criminal);

Basic issues of normal and pathological anatomy, normal and pathological physiology, the relationship of the functional systems of the body and the levels of their regulation;

Basics of water-electrolyte metabolism, acid-base balance;

Possible types of their disorders and principles of treatment;

The hematopoiesis and hemostasis system, physiology and pathophysiology of the blood coagulation system, the basics of blood replacement therapy, indicators of homeostasis in normal and pathological conditions;

Clinical symptoms and pathogenesis of major therapeutic diseases in adults and children, their prevention, diagnosis and treatment, clinical symptoms of borderline conditions in a therapeutic clinic;

Fundamentals of pharmacotherapy in the clinic of internal diseases, pharmacodynamics and pharmacokinetics of the main groups medicines, complications caused by the use of drugs, methods of their correction;

Fundamentals of immunobiology and body reactivity;

Organization of intensive care and resuscitation services in a therapeutic clinic, equipment of intensive care and resuscitation wards;

Basics of non-drug therapy, physiotherapy, physical therapy and medical supervision, indications and contraindications for spa treatment;

Organization of monitoring of side and undesirable effects of drugs, cases of lack of therapeutic effect in the Russian Federation;

Basics rational nutrition healthy individuals, principles of diet therapy for therapeutic patients;

Anti-epidemic measures in the event of a outbreak of infection;

Issues of medical and social examination in internal diseases;

Issues of organizing dispensary observation of healthy and sick people;

Prevention issues;

Forms and methods of sanitary educational work;

Principles of organizing the civil defense medical service.

2. Job responsibilities

General practitioner:

2.1. Receives information about the disease.

2.2. Applies objective methods of examining the patient.

2.3. Identifies general and specific signs of the disease.

2.4. Performs a list of works and services for diagnosing the disease, assessing the patient’s condition and clinical situation in accordance with the standard of medical care.

2.5. Determines indications for hospitalization and organizes it.

2.6. Conducts differential diagnostics.

2.7. Justifies the clinical diagnosis, plan and tactics of patient management.

2.8. Determines the degree of disturbance of homeostasis and carries out all measures to normalize it.

2.9. Performs a list of works and services for the treatment of a disease, condition, clinical situation in accordance with the standard of medical care.

2.10. Identifies risk factors for the development of chronic non-communicable diseases.

2.11. Provides primary prevention in high-risk groups.

2.12. Conducts an examination of temporary disability, refers patients with signs of permanent disability for examination for a medical and social examination.

2.13. Carry out the necessary anti-epidemic measures when an infectious disease is detected.

2.14. Conducts medical examinations of healthy and sick people.

2.15. Draws up and sends an emergency notification to the Rospotrebnadzor institution when an infectious or occupational disease is detected.

2.16. Qualifiedly and timely carries out orders, instructions and instructions from the management of the institution, as well as regulatory legal acts related to his professional activities.

2.17. Complies with internal labor regulations, labor protection and fire safety rules, sanitary and epidemiological regulations, promptly takes measures, including timely informing management, to eliminate safety, fire and safety violations sanitary rules posing a threat to the activities of a healthcare institution, its employees, patients and visitors.

2.18. Systematically improves his skills.

2.19. [Other job responsibilities].

3. Rights

The general practitioner has the right:

3.1. For all social guarantees provided for by law.

3.2. Make proposals to senior management to improve their work.

3.3. Make decisions independently within your competence and organize their implementation.

3.4. Require the management of the organization to provide assistance in fulfilling its professional responsibilities and exercise of rights.

3.5. Sign and endorse documents within your competence.

3.6. Receive the information and documents necessary to fulfill your job responsibilities.

3.7. Improve your professional qualifications.

3.8. [Other rights provided for labor legislation].

4. Responsibility

The general practitioner is responsible for:

4.1. For failure to perform or improper performance of one’s job duties as provided for in this job description - within the limits determined by the current labor legislation of the Russian Federation.

4.2. For causing material damage to the employer - within the limits determined by the current labor and civil legislation of the Russian Federation.

4.3. For offenses committed in the course of carrying out their activities - within the limits determined by the current administrative, criminal, and civil legislation of the Russian Federation.

The job description has been developed in accordance with [name, number and date of document]

Head of HR department

[initials, surname]

[signature]

[day month Year]

Agreed:

[job title]

[initials, surname]

[signature]

[day month Year]

I have read the instructions:

[initials, surname]

[signature]

[day month Year]

1. General Provisions

1. This job description defines the job duties, rights and responsibilities of a general practitioner (family doctor).

2. A person with a higher education degree is appointed to the position of general practitioner (family doctor). medical education, who has completed postgraduate training or specialization in the specialty "General Medical Practice (Family Medicine)".

3. A general practitioner (family doctor) must know the basics of Russian legislation on healthcare; regulatory documents regulating the activities of healthcare institutions; the basics of organizing medical and preventive care in hospitals and outpatient clinics, ambulance and emergency medical care, disaster medicine services, sanitary-epidemiological services, drug supply population and health care facilities; theoretical foundations, principles and methods of medical examination; organizational and economic foundations of the activities of healthcare institutions and medical workers in the conditions of budgetary insurance medicine; fundamentals of social hygiene, organization and economics of healthcare, medical ethics and deontology; legal aspects medical activities; general principles and basic methods of clinical, instrumental and laboratory diagnostics of the functional state of organs and systems of the human body; etiology, pathogenesis, clinical symptoms, clinical features, principles of complex treatment of major diseases; rules for providing emergency medical care; basics of examination of temporary disability and medical and social examination; basics of health education; internal labor regulations; rules and regulations of labor protection, safety, industrial sanitation and fire protection.

In his specialty, a general practitioner (family doctor) must know modern methods prevention, diagnosis, treatment and rehabilitation; contents and sections of general medical practice(family medicine) as an independent clinical discipline; tasks, organization, structure, staffing and equipment of the general medical practice (family medicine) service; current regulatory, legal, instructional and methodological documents in the specialty; rules for processing medical documentation; the procedure for conducting an examination of temporary disability and medical and social examination; principles of planning the activities and reporting of the general medical practice (family medicine) service; methods and procedures for monitoring its activities.

4. A general practitioner (family doctor) is appointed to the position and dismissed from the position by order of the chief physician of the health care facility in accordance with current legislation RF.

5. A general practitioner (family doctor) is directly subordinate to the head of the department, and in his absence, to the head of the health care facility or his deputy.

2. Job responsibilities

Provides qualified medical care in its specialty, using modern methods of prevention, diagnosis, treatment and rehabilitation, approved for use in medical practice. Determines the tactics of patient management in accordance with established rules and standards, develops a plan for examining the patient, clarifies the scope and rational methods of examining the patient in order to obtain the minimum short time complete and reliable diagnostic information. Based on clinical observations and examination, anamnesis, data from clinical, laboratory and instrumental studies, establishes (or confirms) a diagnosis. In accordance with established rules and standards, prescribes and monitors the necessary treatment, organizes or independently carries out the necessary diagnostic, therapeutic, rehabilitation and preventive procedures and activities. Makes changes to the treatment plan depending on the patient's condition and determines the need for additional examination methods. Provides advisory assistance to doctors of other departments of health care facilities in their specialty. Supervises the work of the nursing and junior medical personnel subordinate to him (if any), ensures compliance with the performance of his official duties. Monitors the correctness of diagnostic and treatment procedures, operation of instruments, apparatus and equipment, rational use reagents and medications, compliance with occupational safety and health regulations by nursing and junior medical personnel. Participates in conducting training courses for medical personnel. Plans his work and analyzes his performance indicators. Ensures timely and high-quality execution of medical and other documentation in accordance with established rules. Conducts sanitary education work. Complies with the rules and principles of medical ethics and deontology. Participates in the examination of temporary disability and prepares Required documents for medical and social examination. Qualifiedly and timely carries out orders, instructions and instructions from the management of the institution, as well as regulatory legal acts related to his professional activities. Complies with internal regulations, fire and safety regulations, and sanitary and epidemiological regulations. Promptly takes measures, including timely informing management, to eliminate violations of safety regulations, fire safety and sanitary rules that pose a threat to the activities of the healthcare institution, its employees, patients and visitors. Systematically improves his skills.

A general practitioner (family doctor) has the right:

1) independently establish a diagnosis in the specialty based on clinical observations and examination, medical history, data from clinical, laboratory and instrumental studies; determine patient management tactics in accordance with established rules and standards; prescribe instrumental, functional and laboratory diagnostic methods necessary for a comprehensive examination of the patient; carry out diagnostic, therapeutic, rehabilitation and preventive procedures using approved diagnostic and treatment methods; involve, when necessary, doctors of other specialties for consultations, examination and treatment of patients;

2) make proposals to the management of the institution to improve the treatment and diagnostic process, improve the work of administrative, economic and paraclinical services, issues of organization and conditions of their work;

3) control the work of subordinate employees (if any), give them orders within the framework of their official duties and demand their strict execution, make proposals to the management of the institution for their encouragement or imposition of penalties;

4) request, receive and use information materials and regulatory documents necessary for the performance of their official duties;

5) take part in scientific and practical conferences and meetings at which issues related to his work are discussed;

6) undergo certification in the prescribed manner with the right to receive the appropriate qualification category;

7) improve your qualifications through advanced training courses at least once every 5 years.

A general practitioner (family doctor) enjoys all labor rights in accordance with the Labor Code of the Russian Federation.

4. Responsibility

A general practitioner (family doctor) is responsible for:

1) timely and high-quality implementation of the official duties assigned to him;

2) organization of their work, timely and qualified execution of orders, instructions and instructions from management, regulations on their activities;

3) compliance with internal regulations, fire safety and safety regulations;

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