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Doctors of the Morozov Children's Hospital:

Chief physician of the Morozov Children's City Clinical Hospital: Igor Efimovich Koltunov
Deputy chapters medical doctor parts: Elena Efimovna Petryaykina
Deputy chapters doctor for clinical expert work: Elmira Rastemovna Samitova
Deputy chapters Infectious diseases doctor: Andrey Evgenievich Angel
Deputy chapters Surgery doctor: Sergey Granitovich Vrublevsky
Deputy chapters doctor for work with nursing medical staff: Yulia Sergeevna Arkhangelskaya
Deputy chapters doctor for civil and medical care: Alexander Nikolaevich Korolev

Head of the Ophthalmology Department: Leonid Borisovich Kononov
Head of the Department of Neurology, Neonatology, Eye Microsurgery for Infants: Igor Mikhailovich Donin
Head of the Department of Oncology and Hematology: Konstantin Leonidovich Kondratchik, Candidate of Medical Sciences, highly qualified doctor
Head of the Department of Neurology: Irina Mikhailovna Drozdova
Head of therapeutic department No. 1: Natalya Alekseevna Drozdova
Head of therapeutic department No. 2: Dmitry Yurievich Korneev
Head of the box-surgical department of combined pathology for infectious patients: Yulia Valerievna Romanova
Head of the Department of Emergency Surgery and Urology-Andrology: Oleg Sergeevich Shmyrov, Candidate of Medical Sciences, highly qualified doctor
Head of the pediatric department of combined pathology: Inna Romanovna Samsonovich
Head of the otolaryngology department: Yuri Lvovich Soldatsky, Doctor of Medical Sciences, highly qualified doctor
Head of the Department of Gastroenterology: Elmira Ibragimovna Alieva, Doctor of Medical Sciences, highly qualified doctor
Head of the pediatric department: Inna Aleksandrovna Pugacheva
Head of the Department of Traumatology, Orthopedics and Neurosurgery: Mikhail Anatolyevich Petrov, Candidate of Medical Sciences, highly qualified doctor
Head of the infectious diseases department for young children: Natalya Lvovna Valts
Head of the gynecological department: Elena Viktorovna Sibirskaya, Doctor of Medical Sciences, highly qualified doctor
Head of the Department of Pulmonology and Cardio-Rheumatology: Anastasia Aleksandrovna Glazyrina
Head of the Hematology Department: Viktor Yurievich Petrov, Doctor of Medical Sciences, highly qualified doctor
Head of the Department of Endocrinology and Hereditary Metabolic Disorders: Irina Georgievna Rybkina
Head of the Department of Clinical Oncology with a resuscitation and intensive care unit for hematological patients: Olga Borisovna Polushkina, Candidate of Medical Sciences, highly qualified doctor
Head of the emergency department with emergency beds. short-term stay assistance: Nikolai Nikolaevich Kuleshov

Head of the Department of Reanimation and Intensive Care for Surgical Patients: Dmitry Valerievich Gorokhov
Head of the department of resuscitation and intensive care for therapeutic patients: Lyubov Petrovna Semenova
Head of the Department of Reanimation and Intensive Care for Newborns and Premature Babies: Konstantin Pavlovich Chusov

Head of the Department of Emergency and Emergency Radiation Diagnostics: Alexander Valerievich Gorbunov, Doctor of Medical Sciences, Professor, highly qualified doctor
Head of the Department of Anesthesiology and Reanimatology: Evgeniy Vasilievich Poduskov
Head of the Department of Ultrasound and Functional Diagnostics: Yanina Anatolyevna Galkina, Candidate of Medical Sciences, highly qualified doctor
Head of the Clinical Diagnostic Laboratory: Artem Vladimirovich Bullikh
Head of the pathology department: Alexey Nikolaevich Kislyakov, candidate of medical sciences, highly qualified doctor
Head of the Department of Dentistry: Olga Petrovna Boltova
Head of the dietary nutrition department: Victoria Petrovna Brovko, nutritionist

Head of the advisory center: Elena Anatolyevna Zhidkova
Head of outpatient service: Georgy Mikhailovich Zinker, Candidate of Medical Sciences

Branch No. 1
Head branch: Alexander Alexandrovich Bugulov
Head of the Department of Traumatological Rehabilitation: Irina Fedorovna Mayorova
Head of the Department of Orthopedic Rehabilitation: Galina Ivanovna Gribova
Head of the Department of Rehabilitation Treatment: Irina Nikolaevna Ovcharova

Branch No. 2
Head branch: Natalya Vladimirovna Nikitina
Head of the therapeutic department: Andrey Alekseevich Sharko
Head of the Neonatology Department: Vadim Valentinovich Anisimov
Head of the Department of Reanimation and Intensive Care: Oleg Nikolaevich Nakovkin
Head of the Department of Emergency Pediatrics: Natalya Viktorovna Lagutina
Head of the Department of Emergency Surgery: Kozlov Mikhail Yuryevich Kozlov
Head of the Department of Radiation and Ultrasound Diagnostics: Vera Ivanovna Lazarenko
Head of the palliative care department: Nikolay Aleksandrovich Denisov
Head of the emergency department with emergency beds. short-term stay assistance: Sergey Stanislavovich Alekseev

Paid services are provided, but the main function - ensuring the right to free treatment - is retained

Recently, some media reported that the well-known Morozov Children's Hospital in the capital began to gradually turn into a commercial institution. Doctors are forced to induce patients to pay for additional paid services, and expensive drugs recommended by doctors are replaced with cheap analogues. The head physician of the institution, Igor Koltunov, volunteered to refute the rumors.

The doctors who resigned from Morozovskaya told the media colorfully what was happening in the hospital with the arrival of new management. According to them, now they have to pay for any medical care that is not included in the standards of treatment for a particular disease. For example, a child was brought to the surgical department to have his appendix removed, but he needed an ECG of the heart - for an examination in a non-core department, parents will be asked to pay money. Blood tests for hemosyndrome should also be done according to a separate registry, since these procedures do not apply to acute appendicitis. And it's also paid. There was such a case - the mother of an infant being treated for pneumonia reported that his stomach hurt and asked for an ultrasound of the abdominal cavity. But the head of the department, in accordance with the instructions of the head physician, offered to pay her for the service. “I’m tired of looking at crying mothers who don’t have money to pay,” said one ex-Morozovka doctor. “It is not profitable for insurance companies to pay for expensive treatment, and they do everything to avoid paying.”

Mr. Koltunov does not see any crime in what is happening. Yesterday he confirmed that indeed all additional studies that are not included in the standard of treatment are performed at the Morozov Hospital not for beautiful eyes. “A patient with a hernia in the pediatric department will not receive free help - this is a non-core department. And they won’t do an ultrasound of his heart there. We are constantly checked by insurance companies, and if we are found to be violating standards, we will be fined. Services are provided for a fee that are not included in the standard, but which the patient wants to pay for. In addition, people can pay extra for some super TVs or comfort in the room, or for food from a restaurant. But our doctors provide paid services only after hours, on weekends and holidays. There is paid healthcare all over the world,” says Koltunov.

Today, the Morozov Hospital has begun to accept money from patients quite officially, but the main function of the state medical institution remains the same - to ensure people the right to free treatment. He notes that doctors have no incentive to encourage patients to pay for additional tests they don’t need.

According to Koltunov, today the Morozov Hospital is financed from several sources - federal and territorial compulsory medical insurance funds, the city budget, donations, etc. And situations when a patient is asked to buy medicines, bandages, medicines, etc. no longer happen - everything is provided free of charge. “It is profitable for us to treat patients with high quality, otherwise insurance companies will deprive us of money,” emphasizes Koltunov. And he cites facts indicating an improvement in the situation in the hospital since his arrival. Thus, the average salary increased by 10-15% (up to 62 thousand rubles for doctors and 45 thousand for paramedical staff). The average length of stay in a bed decreased to 7 days. And on May 1, a new modern department with 98 beds was opened, meeting all European standards, with double rooms and conditions for mothers with children. But the main achievement is that in six months the number of operations at the Morozov hospital has increased 10 times. Moreover, if previously endoscopic surgical interventions were almost never performed here, now they are mostly performed only. Koltunov explains the attacks in the media precisely by the dissatisfaction of fired surgeons, whose average age in the hospital before his arrival was 70 years. Patients now complain less, and most complaints relate to the rudeness of the medical staff, and not to the quality of treatment. Koltunov considers this an achievement and promises to re-educate the medical staff.

One of the oldest children's hospitals in Russia - Moscow's Morozovskaya - claims to be the best in Europe. What are the prerequisites for this? The RG columnist talks about this with the chief physician of the hospital, Doctor of Medical Sciences, Professor Igor Koltunov.

Igor Efimovich, Morozovskaya children's room in the center of old Moscow. She traditionally has a decent reputation. Just the other day, when I met with children undergoing rehabilitation after cancer in Kolontaevo near Moscow, I was once again convinced of this. The children told in detail where and how they were treated. And the majority gave the same address: Morozov Children's City Clinical Hospital. The impression is that most children, including those with oncology, are treated at the Morozov Hospital. Although, if my memory serves me correctly, it was not considered the largest children's hospital in Moscow?

Igor Koltunov: Didn't count. But... In total, 260,000 children in Moscow need inpatient medical care. Of these, more than 100,000 children are hospitalized with us. In the last five years, we have begun to treat 3 times more children. Although we are inferior to other children's hospitals in terms of the number of beds. The total area of ​​Morozovskaya is 53 thousand square meters, with 1000 beds. The construction of a new 500-bed building is now being completed. Without exaggeration, it is being built thanks to the daily control and daily support of Moscow Mayor Sergei Semenovich Sobyanin.

The building will have completely different living conditions. Comfortable conditions. The rooms are single and double, designed for a child to stay with his mother. The building will represent all areas of surgery: cardiac surgery, abdominal surgery, neurosurgery, otolaryngology, ophthalmology, maxillofacial surgery. There will be departments of traumatology and orthopedics, urology-andrology, pediatric gynecology, and a department of orphan and other rare diseases.

For the first time in Moscow, a bone marrow transplantation department is opening here, without which it is impossible to imagine current oncology and hematology.

Do you already have the “stuffing” for these departments? And most importantly, are there personnel to work in them?

Igor Koltunov: The Moscow Health Department has already purchased modern high-tech equipment for us. And you are right: the main thing is personnel. So, on the basis of our hospital there are now two university clinics: one - the Pirogov Russian National Medical University, the second - the RUDN Medical University. The Morozov Hospital has ten city centers for specialized medical care for children. These are centers for pediatric oncology and hematology, rheumatology, gastroenterology, endocrinology, pediatric stroke, centers for reproductive health of children and adolescents, orphan and other rare diseases, neonatal screening, a center for children with von Willebrand disease, a regional center for congenital hereditary diseases, genetic abnormalities...

Are specialists, say, in bone marrow transplantation already trained?

Igor Koltunov: We traditionally cooperate with the Center of Academician Alexander Grigorievich Rumyantsev, with his specialists in the field of bone marrow transplantation. We cooperate correctly: we do not lure away their excellent specialists. We are getting out of the situation in a different way: with their help, we are preparing our personnel for this current area of ​​medicine. In addition, councils and consultations are especially important in medicine.

And specialists in the field of bone marrow transplantation for children will provide consultations and hold consultations with us. Also, in accordance with the obtained educational license, we have revived our own residency and postgraduate courses. We are reviving the Morozov school, preparing our specialists.

Parents from different parts of the country contact the editor asking for help in treatment. When it comes to oncological diseases, they are often asked to be referred to Morozovskaya. By the way, in the mentioned Kolontaevsky rehabilitation center, not all children are Muscovites. Meanwhile, the Blokhin Oncology Center, the Republican Children's Clinical Hospital, and the Dmitry Rogachev Center for Pediatric Hematology, Oncology and Immunology are treating cancer patients in Moscow. How can parents of a sick child navigate this? Where to go? Where are the best opportunities? Do you accept not only children with Moscow registration?

Igor Koltunov: It is very important that people have a choice. Especially when it comes to severe cancer diseases. There are no strangers' children and no one's own. They are all ours. Children with Moscow registration can be treated in federal centers. And children with a different registration in a Moscow hospital. Another thing is that this requires solving some organizational issues. But this is our business, not the parents of sick children. The main thing in providing medical care is its availability. Availability, regardless of the thickness of the pocket, and even more so of registration. Unlike federal institutions, in order to come to us for treatment under compulsory medical insurance, you do not need any referrals (not only Moscow, but also federal). And again, unlike federal institutions, Morozovskaya works around the clock, including providing ambulance, that is, emergency care.

Our hospital owes its appearance on the map of Moscow 113 years ago to Vikula Morozov, the nephew of Savva Morozov. Vikula Morozov gave money to the city to buy out land (a plot of the former Horse Square) for the construction of hospital buildings intended for the treatment of children. Before starting construction, he sent the most famous Russian pediatric surgeon Timofey Petrovich Krasnobaev to the best clinics in Europe for experience. And we are trying to preserve the tradition of accessible medical care and the use of the best world experience. Here is your photojournalist who took several shots in the pathology department of newborns and premature babies. As usual, there are 50 of these babies in the department. Of these, 2/3 are Muscovites, the rest are from different regions of Russia. Everyone is lying with their mothers.

Are they free?

Igor Koltunov: The Compulsory Health Insurance Fund pays for them.

How do such crumbs from other regions get to Morozovskaya?

Igor Koltunov: You forget that we live in an age that can be called information. Information about the birth of a baby with minimal weight in any region of Russia, if it suddenly does not have its own perinatal center, is received without delay. And the newborn child, together with his mother, is sent to the nearest similar department. We have neonatal intensive care for such children.

Since we are talking about the age of information technology, explain the purpose of video monitoring, which occupies one of the walls of your office. Pictures are constantly changing...

Igor Koltunov: Of course they change. Yes, I see who came to the hospital, how parents and their child are sitting in the corridor, waiting for an appointment. If I see that they are waiting for a long time, I call the manager. The consequences of such a call require no explanation.

I've never heard you raise your voice.

Igor Koltunov: What for? Raise your voice in a children's hospital? This is nonsense. We must understand each other perfectly. I hope there is such an understanding. Using video monitoring, I monitor the work of operating rooms and the work of laboratories. I won’t hide it, and everyone knows this, I listen to the conversations of our employees with patients and children.

At one time it was almost fashionable: “A maternity hospital that is child-friendly.” To be honest, I couldn’t understand whether it was really possible to have a maternity hospital that was unfriendly to the child...

Igor Koltunov: Any children's institution, and by and large not only children's institutions, should be friendly to people. Maybe you don’t know that Moscow health service institutions have clear criteria for assessing the effectiveness of their activities. It is enough to go to the website of the Moscow Department of Health, and any resident of the capital, and not only the capital, can find out the rating of a particular institution and express their wishes.

You've been at the helm of this hospital for five and a half years. Your arrival here was marked by the demolition of 4 old buildings. This has caused, to put it mildly, misunderstanding: people are left without work, treatment options are being reduced. But when the construction of a new building began, when the hospital began to treat 3 times more children, passions subsided. And yet... Today, are the same wishes that appear on the Morozov Hospital website important for you? I know you still don’t have reception hours for the public or employees. So the mother came with the child and decided that she definitely needed to talk to the head doctor. Will you accept it? Or does it have to go through some kind of filter before it gets into your office?

Igor Koltunov: Why a filter? You just need to put yourself in the shoes of this mother, her child, and understand that at the moment when trouble happens, communication with the chief doctor is most important for her. I'm a pediatrician. I am even the chief pediatrician of Moscow. And I simply have to not only listen, but also understand those who ask to help a child.

But there are 24 hours in a day...

Igor Koltunov: Believe me, there is enough time. There would be a desire.

Russian medicine has always been distinguished by its humanity and compassion. But high technology, the ability to communicate via mobile phones and Skype have not pushed all this into the background? After all, even consultations with doctors are often carried out using Internet technologies. It is believed that they can compensate for the lack of at least a paramedic station in some outback, to which one can neither drive nor walk.

Igor Koltunov: I am a supporter of the highest, most advanced technologies. Without them, we would not be able to approach personalized medicine. And, of course, they would not be able to claim the title of the best hospital. But... No one will ever replace personal communication between a doctor and a patient.

So will Morozovskaya be the best children's hospital in the country, in Europe?

Igor Koltunov: There are no limits to perfection. I just want to give people medical care that meets modern technologies. And so that it is accessible and free for patients. Especially when it concerns children.

Medicine and society Interview with an expert

Igor Koltunov: “Morozov Hospital is honest, multidisciplinary, modern”

2014-08-01

He wanted to become a doctor since childhood. He came to medicine in 1985. He believes that a general practitioner and a cardiologist are the specialists who should have the widest range of knowledge. Chief physician of the Morozov Children's City Clinical Hospital, Doctor of Medical Sciences, Professor, Honored Doctor of the Russian Federation Igor Efimovich Koltunov tells MED-info about the hospital, medicine and life.

— When did you realize that you wanted to treat people?
— Any person probably has a natural desire for knowledge, for knowledge, for understanding how the world works. A, which gives the most holistic and complete picture of how the universe works, how the human body functions and how it evolved. I always wanted to be a doctor. Previously, I worked for about 15 years as deputy director of a research institute, supervising medical and scientific issues. And over time, I put into practice all the acquired skills in organizing the treatment process.

— Do you often have to examine patients yourself now?
“I examine children in the intensive care unit almost every day. I study their medical histories in detail. Every day at morning conferences we review all complex cases admitted to the hospital.

Every day, within 24 hours, from 150 to 500 children, of whom up to 80% need emergency and emergency specialized medical care, arrive at the emergency departments on the main territory of the hospital and its branches via ambulance and self-referral.

— Tell us about the Morozov hospital.
— Currently, it is an emergency multidisciplinary children's hospital providing round-the-clock medical care. Every day, within 24 hours, from 150 to 500 children, of whom up to 80% need emergency and emergency specialized medical care, arrive at the emergency departments on the main territory of the hospital and its branches via ambulance and self-referral.

At the 1st stage, emergency medical care is provided in the emergency department or, depending on the severity of the condition, in the intensive care unit of the hospital. Primary specialized medical care is provided in short-stay emergency beds of the emergency department; if necessary, hospitalization is carried out in specialized departments of the hospital. The use of emergency beds in the emergency department allows you to increase the speed of sorting of incoming sick children and optimize the choice of conditions for organizing further treatment, as well as reduce unnecessary hospitalization. However, up to 300 children are admitted to specialized hospital departments every day.

In accordance with the increased requirements for inpatient medical care, especially high-tech medical care, in recent years several new departments have been opened at the Morozov Hospital: pediatric gynecology, gastroenterology, and modern endoscopy. This gives us the opportunity to treat the patient comprehensively. Thus, a patient hospitalized in a hospital no longer needs consultations from outside specialists, but can receive all the medical care he needs in one place.

The Morozov Hospital currently employs 5 main freelance pediatric specialists of the Moscow Department of Health - an ophthalmologist, hematologist, gynecologist, oncologist, and endocrinologist.

The second task that our institution sets for itself in the near future is to reduce the number of people not directly involved in the provision of medical care as much as possible. At the same time, we will have increasing requirements for the qualifications and training of nursing staff. Our nurses must become much smarter and more efficient, be able to perform more technologically complex manipulations, which will allow us to free doctors from performing these duties, and thereby increase the efficiency of their work. On the basis of our hospital, by order of the Moscow City Department, city clinical centers were created, such as the city, city Center for the treatment of cerebrovascular pathology in children and adolescents (children's stroke center), city Center for pediatric endocrinology, city Center for pediatric rheumatology and city Center for children's reproductive health and teenagers. Our hospital also successfully operates an otorhinolaryngology clinic, an ophthalmology and eye microsurgery clinic, a clinic for urgent and planned surgery, a clinic for planned and emergency neurological care and a gastroenterology clinic with an endoscopy room, an emergency and emergency radiation diagnostics clinic. A full-profile advisory center is actively operating within the walls of our institution. Moreover, the Morozov Hospital currently employs 5 main freelance pediatric specialists of the Moscow Department of Health - an ophthalmologist, hematologist, gynecologist, oncologist, and endocrinologist.

A year ago, by decision of the Moscow city leadership, it was decided to build a new 7-story multidisciplinary medical building on the basis of the Morozov Hospital. The task has been set to create a high-tech modern medical institution, which will provide all types of medical services of almost all profiles, equipped with the best technologies that we have today in children's healthcare. This will allow us to provide patients not only with the most modern medical care in accordance with European medical standards, but also to create an appropriate level of comfort. Now, unfortunately, this is not always possible, since most hospital buildings were built according to designs from the middle of the last century, when other requirements were imposed on the organization of the treatment process.

The main task of the head of any modern children's medical institution, in my opinion, is to make the child's stay there as non-hospital as possible, to get away from everything that reminds us of the corridor system of Soviet times, when the patient was forced to lie in a 7-8-bed ward . The interiors, design, and level of communication with medical staff must meet this requirement. But all this can only be organized in an institution adapted for such purposes, in our case in a new modern building, into which we expect to move in the coming years.

“The main task of the head of any modern children’s medical institution, in my opinion, is to make the child’s stay there as non-hospital as possible.”

— Is being a doctor a profession or a calling?
— (Thinks.) A doctor is both. In any profession. In any profession, a person with a calling works better than without it. In addition to human qualities (decency, honesty, conscientious attitude to his work), a doctor must have good basic knowledge and clinical thinking.

— Morozov Hospital is a children's city multidisciplinary emergency specialized medical institution. Continue the sentence “I’m going there because she...”
— Honest, multidisciplinary, modern... Over the course of several years of the modernization program, the Morozov Hospital received a total of about 900 million rubles in equipment and funds. This is directly the money that was spent on the purchase of new equipment, and the money spent on the introduction of modern medical standards of treatment and care.

— How to motivate medical university students to go to work at the Morozov hospital or in free medicine in general?
— I think that students should first of all have the motivation that medicine is an eternal profession as long as people exist on earth. This is a fairly well paid profession today. The state and society have already understood this. In addition to the fact that you bring benefit to people and help them, you can also protect yourself and your family by possessing medical knowledge.

Over the course of several years of the modernization program, the Morozov Hospital received a total of about 900 million rubles in equipment and funds.

— In one of your interviews, you said that the higher , the greater the motivation and the higher the efficiency. How to achieve this understanding, the confidence that this doctor can be trusted?
— First of all, it depends on the doctor, because the doctor must understand and evaluate the patient’s intellectual level, the complexity of the problem, the disease, and, based on this, select key points in order to earn his trust. And the patient, accordingly, should not have any deliberate rejection, hostility or aggression.

— I read that the hospital works with charitable foundations. How does communication happen?
— Funds make proposals and talk about their capabilities. When we have an emergency, we turn to them. Or, on the contrary, patients from the foundation come and say that such and such issues will be resolved by the foundation for them. Or the foundation contacts us with a specific patient whom it is ready to provide financially, and sets us a problem that we solve.

— You have held the post of chief physician of the Morozov Hospital since May 2011. What can you brag about?
— All achievements are the achievements of the entire team of our institution. In 2013, for the first time, Morozov Hospital was awarded the title “Best Hospital of the Year.” We have been working towards this for several years. In 2012, we received our first mayoral commendation for our achievements in healthcare. I think this is quite sufficient from an administrative point of view. As for what has been done for patients, we have completely solved the problem of being in infectious disease wards: there is one child in one ward. Previously, it was necessary to place two children in one box, because the number of declared beds did not correspond to the number of incoming children. We have completely solved the problem of being present: almost everywhere, except for intensive care, a mother can be with her child 24 hours a day, regardless of the severity of his condition. Not to mention the fact that the number of patients treated increased by 50%. We have developed new technologies and opened new clinical departments. And over the past 2 years, we have acquired 5 institutions that have helped us create a more high-tech, complex medical service that is more in demand.

— Parting words to our readers.
— Do not self-medicate and consult a doctor as soon as possible if any questions arise. Don't delay.

Photos by Oksana Plisenkova
Main photo provided by the press service of the State Public Institution of the Department of Health of the Central Administrative District of Moscow