Feature

The Medicine of Trust

When the Editor of Passport, John Bonar, was experiencing pains in his leg last November, he turned to the diplomatic Medincentre clinic for treatment. After he failed to respond to initial pain-killing injections, he was admitted to their in-patient facility where the enforced operation was done. “I take my hat off to those medical professionals,” he told me in interview. “They tried their hardest with ever increasing antibiotics to kill the infection, but after 18 days they had no option but turn to me over to the surgeons.”

The Medincentre is truly a unique place. It is unique in its history, in the way the medical network is organized, the level of the proficiency it offers, and the level of its pricing. It is both a clinic and hospital, and both are located in close proximity to each other and tightly coordinated in their daily operation. A Russian celebrity was leaving the office of Professor V. Vigdorchik, the Director of Medincentre, right before his secretary called me in for our interview. But it has been a pleasure to wait, surrounded by paintings and flowers.

The first thing that strikes you when entering the Medincentre is that it does not look, feel or smell like a hospital. This is a unique experience in Russian medical reality. Going to a hospital, no one expects a serene or peaceful atmosphere. Medincentre is spotless; yet there is no smell of chlorine or other chemicals. Another treat are the flowers and paintings. The question that naturally comes to mind: How do they manage this?

“We are ISO (International Standard Organization) certified and that’s very important. We have to follow all international standards, which regulate everything: the type of beds, the temperature of the air, the intensity of the light and many other standards (his glance goes to the shelves in his office where at least ten big notebooks are kept, containing all the international regulations).”

Maybe that’s what makes the clinic so attractive to foreigners.

“We have more than 18,000 to 20,000 foreign clients per year, coming from all over the world, ranging from South Asia to Canada. Diplomats, businessmen, news correspondents, and executives of foreign companies. It is important to note that many of them rent offices or apartments from the Main Administration for the Service to the Diplomatic Corps (GlavUpDK). The majority of clients are foreigners who live in Moscow. Yet, even when they leave Russia, it is often the case that when they need medical help, they come back to us. We believe that this is the best evidence that we keep up with international standards and quality of medical aid,” Prof. Vigdorchik told me.

Bonar, who underwent a major operation in the hospital, says that “nowhere in the world, including his home country of Great Britain, was he expecting to be seen by 14 specialists at the same time!”

“Frankly, this level of medical care is not special to our hospital. This is in the best tradition of Russian medicine; whenever the case is very serious, different specialists will come together in conference to make the best decisions for the patient. This is rare in the West,” Professor Vigdorchik modestly explains.

“In the end, two specialists were in the operating room together with me,” recalls Bonar. “One was a vascular diseases specialist and the other was an orthopedic trauma surgeon. If it had been possible, one would have saved the leg, but what they found was that the disease was so deeply rooted that gangrene had set in and only surgery could save the rest of the limb.”

This hospital has never been an ordinary one. Its special history began in 1948.

“After World War II, the world situation changed, along with the relationship between the Soviet Union and other countries. In 1948 the Soviet Union had many foreigners in the country; new embassies were open. Of course, it was not as many as now, but many for a closed country. The country had to face the problem of organizing service facilities for these resident visitors; and primarily medical services. Obviously, the problem was not with the medical staff, as Soviet doctors have always been famous for their professionalism, intelligence and proficiency, but in the service which these days was not up to the Western standards. There was a special government regulation for creating the clinic. It began on a small scale, where a foreigner could come for treatment. The national government persuaded the best medical minds, the elite of Russian medicine, to work at the clinic. And most of these doctors spoke other languages. With time the clinic was joined by a hospital, the famous Botkin Hospital.

It is well known that Soviet citizens got their medical care at government expense. Now in post-Soviet times, it is part of the great problem of contemporary medicine that people cannot pay, and hospitals are limited by the state budget. That more typical situation does not seem to be the case at the Medincentre. “No doubt, one has to pay for the services of the Medincentre, but the price is in no way as high as in many private hospitals in Moscow or outside of Russia…especially for the kind of service they offer.” Bonar adds.

How did you manage to smoothly make the shift from government support to paid services?

«Since the early '90s we have not been getting subsidies from the state, nonetheless, we are not a private clinic. Today we pay all of our expenses and spend our income specifically on the Medincenter's development. We are among the few profitable medical centers in Moscow, though our country is still going through a difficult stage of medical aid system reorganization. From the historical point of view, the transition towards the paid medical services in Medincenter started 60 years ago”.

While at the beginning the clinic was small, with time it grew with the number of Foreign Service patients and their families in the USSR. Even then, many officials would wait for their return to Moscow to be treated again at the MedinCenter clinic.

“Why? Whenever a person finds a good doctor, he wants to always be treated by this doctor. Even now, our doctors are regular guests at diplomatic homes. It is a common thing for a doctor to become part of the family.”

In the Soviet era, admission to the hospital was only upon presentation of a special diplomatic pass. But after the fall of the Iron Curtain, there was a big change both in the improvement of the medical standards and in the financial situation of the Medincenter. In the past three years the clinic and the hospital were certified according to international standards. And this is a continuous process which requires daily control. The doctors are trained abroad and many are invited to give seminars and lectures all over the world. Vigdorchik himself spent time in the United States.

Management in the medical sphere and as a separate profession is very new to Russia. The medical colleges and universities have just begun to introduce this type of curriculum and Medincenter is one of the first medical centers to apply medical management theory in practice. Part of the reason is compliance with international standards, but also the more advanced thinking of the clinic.

“We work also with international insurance companies, and all the paperwork should be in order and follow all international protocols. To get a job at Medincenter isn’t easy; only if that person is recommended by friends and colleagues. Yet, it does not mean that someone is employed ‘on the quiet’...the level of the clients (celebrities of every sphere: from culture to business and politics) together with the level of the services offered, puts great pressure on the employees ."

Another difference from an “ordinary Russian clinic” is that the salary of each specialist depends on the amount of the work he does. “We believe it is a great motivation for constant professional growth”, - explains Vigorodchik.

The clinic and the hospital receive about 1,500 people per day, and they have 82,000 current patients in their files.

How do you manage that?

“We do our best, and we use the latest technology. A year ago, we installed new advanced diagnostic equipment. We are among the very few clinics in the world that uses this particular type of equipment. The new technology, including Magnetic Resonance Imaging (MRI), allows us to advance and develop the principle that the hospital has followed since the very beginning: the individual approach along with the highest quality medical standard, no matter how simple or complicated the case is.”

Now the clinic and hospital are connected with online diagnostic communication that allows every specialist to have the results of the diagnostics and additional research almost instantly.

It is hard to overstate the comfort this level of service gives to the patients. “One of the things I appreciated very much, is that one doctor stays with the patient from the first diagnostic until after the operation and rehabilitation period,” Bonar said in sharing his experience.

“Psychologically, this wise approach is very important. If the patient does not trust, the treatment will never be 100% successful. The relationship with the doctor is of major importance. And this relationship starts with the very first step. When the client feels the serene atmosphere, when the nurses are not stressed, or rushing from one department to another, the patient feels that he is in reliable hands – and that is the best condition for a successful outcome!” said Vigdorchik.

As for the nurses, once they begin to work at Medincenter, they go to regular trainings, especially in communication and psychology. A skill for manipulating or physically handling the patient is a must from the very beginning for the nursing staff. Bonar: “The nurse, who worked with me, was so excellent! I never felt any pain, even during those endless shots!”

Although the clinic follows the principles of the most medically academic school, it does not reject reflexology, massage, acupuncture, and balneology facilities on its premises.

The question that may arise in anyone’s mind: Is it affordable? The wonder about this place is that it is! “It is definitely not free-of-charge and not the cheapest medical center, but in comparison to the private hospitals in Russia and abroad, it is a much better deal!” concludes Bonar, who spent two months in the hospital.

“We are considered an elite medical facility. Elite medical care does not mean unaffordable, but is for those who know the value of health and are ready to pay for it,” concludes Prof. Vigdorchik.