What you need to know about medical examination at the clinic. Application. The procedure for conducting a preventive medical examination Preparation for the examination

Almost every employer sends employees for a medical examination. Many people do not understand the need for this event, because they feel good. In fact, it is very important to identify even minimal health problems in time in order to prevent the development of diseases.

The main goals of the medical examination

• Determining the suitability of employees for the assigned work, ensuring labor safety
• Identification of persons with occupational diseases, prevention of occupational diseases
• Identification of common pathologies in which working with harmful factors can worsen their course
• Assessment of working conditions, development of measures to eliminate the causes of occupational diseases
• Monitoring the health of workers
• Accident prevention

Employees engaged in hazardous work or work with hazardous factors must undergo a mandatory medical examination.

Passing a medical examination is a mandatory condition of employment for many employees.

What is included in the medical examination?

1. General blood analysis. This procedure allows you to identify anemia or blood diseases, and suggest inflammatory processes in the body.
2. General urine analysis. Helps to predict kidney disease, urinary tract disease and even diabetes.
3. An ECG is necessary to diagnose ischemia or increased blood pressure.
4. Fluorography is indispensable in the diagnosis of tuberculosis, which practically does not manifest itself in the early stages.
5. Appointment with a therapist to measure blood pressure and diagnose latent forms of hypertension - in this case, the patient does not feel a rise in blood pressure. If there are certain complaints, the doctor will refer you to a more specialized specialist.
6. The surgeon checks for the presence of varicose veins and its complications, examines the abdomen to determine the size of the liver and spleen. Men may have their prostate examined.
7. A gynecologist is a mandatory stage of medical examination for women. During the appointment, the doctor will conduct an examination on the chair, take a smear and check the condition of the mammary glands. In some cases, mammography (x-ray examination of the mammary glands) is prescribed.
8. The neurologist also conducts an appointment/consultation with the patient - during the examination, some deviations from the norm may be suspected even in the absence of any complaints or symptoms.
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Every time, upon learning about a medical examination organized at work, many are indignant: why is this necessary? Obviously, this is a fundamentally wrong approach. An employer who organizes a medical examination shows himself at his best. However, one should not assume that he does this solely for altruistic reasons. The fact is that, in fact, it is the boss who pays for each employee’s sick leave - he pays interest to the Social Insurance Fund, from which you are then given money. In addition, the time of a qualified employee can be infinitely expensive for a company, which makes it much cheaper to protect yourself from downtime through preventative measures.

To the employer and employees

Many, having returned to work or re-employed, have probably encountered the fact that they are sent for a medical examination to the clinic. For what? After all, I feel healthy or healthy!!! On the one hand, employers are now obliged to send subordinates to this event, and on the other, it is important for each person to identify the initial stages of various diseases in a timely manner and begin appropriate treatment. What are medical examinations of persons working in contact with harmful and (or) dangerous factors? Currently, the Russian Federation is implementing a priority national project “Health”, aimed at preserving the health of citizens and the labor potential of the working population. One of the important measures to preserve people’s health is preliminary (upon entry to work) and periodic medical examinations (examinations).

The main goals of the medical examination

Among the main tasks that a medical examination is designed to solve, seven main ones can be identified. This:

• determining the suitability (suitability) of workers and employees for the work assigned to them, ensuring labor safety;
• identification of persons with occupational diseases or suspicion of such diseases, prevention and timely identification of initial signs of occupational diseases;
• identification of common (non-occupational) diseases in which further work in contact with occupational hazard factors may worsen their course;
• assessment of working conditions and development of sanitary and hygienic measures aimed at eliminating the causes of occupational disease;
• dynamic monitoring of the health status of workers under the influence of occupational hazards;
• timely implementation of preventive and rehabilitation measures aimed at preserving the health and restoration of workers’ ability to work;
• accident prevention.

The medical examination includes a very important examination - fluorography. This is an X-ray examination of the lungs to detect the presence of tuberculosis. Tuberculosis is a very common disease nowadays. People with high blood pressure must undergo regular medical examinations, as this problem can cause a heart attack or stroke. Vascular thrombosis occurs. People need to carefully look at their health status, as now

Arterial hypertension affects quite young people who may not even be aware of the disease. In this case, a medical examination will help identify disorders and specialists will advise what lifestyle is needed to prevent the development of high blood pressure. An annual medical examination is especially important for people who are employed in jobs with harmful or dangerous working conditions (for example, underground work, etc.).

It is necessary?

Yes, if you:

• you work in a dangerous enterprise;
• connected with children (teacher, educator);
• work in a medical facility.

In all other cases, a person has the right to refuse to visit a doctor.

Which doctors should I see?

You will have to visit:

• therapist;
• psychiatrist;
• narcologist;
• dentist;
• dermatovenerologist;
• otorhinolaryngologist.

This is a basic program. For people working in hazardous enterprises, it can be expanded in accordance with the specifics of the activity.

Also most often, the medical examination includes basic tests:

• blood (general);
• smears for gonorrhea and pathogenic staphylococcus;
• biochemistry of urine and blood.

All of them will help make sure that the body’s condition does not pose any threat to you or others. Typically, such an examination is carried out once a year to keep employee health information up to date.

How often should you undergo a medical examination?

The frequency of periodic medical examinations is determined by Appendices 1 and 2 to Order No. 90 of the Ministry of Health and Medical Industry of Russia, but should be at least once every two years. Persons under the age of 21 undergo periodic medical examinations annually (Labor Code of the Russian Federation, Art. 213).

Periodic medical examinations of employees can be carried out ahead of schedule in accordance with a medical report or according to the conclusion of Rospotrebnadzor authorities with justification for the reason for the extraordinary examination. Extraordinary medical examinations are carried out at the request of the workers themselves or in accordance with the recommendations of one of the specialists who participated in the examinations, as well as for epidemiological indications.

Employees engaged in hazardous work and work with harmful and (or) hazardous production factors for five years or more undergo periodic medical examinations in occupational pathology centers and other medical organizations once every five years. Of course, such centers must have licenses for examination of professional suitability and examination of the connection of the disease with the profession.

There are several types of medical examinations for workers:

1. Preliminary. Their goal is to find out whether the candidate’s health condition allows him to perform a particular job. For some categories of workers such examinations are mandatory.

For example, a preliminary medical examination upon entry to work must be carried out by:

• people whose professional activities involve managing complex mechanisms and devices (crane operators, electricians);
• people who work in hazardous conditions (industrial climbers, sailors, oil and gas industry workers working in the Far North);
• people operating vehicles (drivers, pilots);
• food industry workers;
• workers of children's and medical institutions and others.

2. Periodic. They are carried out in order to identify in the early stages diseases that can be dangerous to others or make a person unfit to perform a certain type of work, to track the dynamics of changes in health, as well as to identify possible occupational diseases and minimize harm caused to health and employee well-being. Employees under the age of 21 must undergo a medical examination annually.

3. Conducted in special cases - at the request of the employees themselves, when occupational diseases are identified during the last scheduled medical examination, in cases where someone in the team has been diagnosed with a dangerous infectious disease, as well as at the request of Rospotrebnadzor. Requirements for the frequency and procedure for conducting medical examinations are prescribed in the Labor Code of the Russian Federation (Articles 212, 213 and 266). And Article 5.27.1 of the Code of Administrative Offenses of the Russian Federation establishes that admission to work without undergoing a mandatory periodic medical examination entails a fine for officials and individual entrepreneurs in the amount of 15,000–25,000 rubles, for legal entities – 110,000–130,000 rubles .

The procedure for conducting medical examinations of enterprise employees

Organizing a medical examination is the responsibility of the company’s management, and it also pays for this event.

Briefly, the scheme for organizing a medical examination for enterprise employees looks like this:

Step 1. Formation of a list of employees who should be sent for a medical examination. The list must be sent to the territorial department of Rospotrebnadzor of your administrative district within 10 days.

Step 2. Concluding an agreement for examination of workers with a medical center. Agreeing on the timing of the medical examination.

Step 3. Signing an order on the frequency of medical examination and the order of its completion. Employees must be familiarized with this document at least 10 days before the start of the medical examination.

Step 4. Issuing directions for a medical examination. Referrals are issued in the organization in any form.

Step 5. Collection of signed and sealed reports with the results of the medical examination. The conclusion is signed in two copies - one of them is given to the employee, the other remains in the institution that conducted the medical examination.

Step 6. The medical center draws up a final act. This may take time, usually up to 30 days. The certified act signed by the medical institution and organization is sent to the territorial department of Rospotrebnadzor in its administrative district for approval.

Employees are required to report to the medical center with which the contract was concluded exactly at the time specified in the referral. You are required to have your passport and directions with you. If the employee does not show up, the employer must suspend him from work without pay until the inspection is completed. If the inspection was missed due to the fault of the employer or for reasons that do not depend on either the employee or the employer, the refusal to perform duties is regarded as simple and is paid in the amount of 2/3 of the employee’s average salary. As a rule, during periodic medical examinations, employees visit several specialists and undergo various instrumental and laboratory tests. The specific list depends on the type of work and harmful production factors. The commission is formed by the medical center with which an agreement was concluded to conduct a medical examination. It necessarily includes an occupational pathologist, as well as other specialists.

If the responsibility of approaches to assessing professional suitability increases, then the quality of work in certain areas should indirectly improve, which, in the end, will have a positive impact on the well-being of the population as a whole.

Since 2012, a narcologist and a psychiatrist have been added to the list of doctors who must undergo medical examination to renew a medical record. This caused numerous discussions, speculations, outrages and protests. In fact, these specialists, especially psychiatrists, traditionally belong to the ranks of doctors of a special, specialized direction. They have not previously been associated with a general physical examination. However, since 2012, these doctors have been included in the list of mandatory visits when applying for a medical record and have become the only doctors (besides the therapist) who assess the professional suitability of civil servants.

Let's try to figure out why in our country more attention has been paid to mental health and emotional state, as well as the degree of adequacy of workers in responsible areas. The bottom line is that medical assessments are indeed incomplete if they are focused only on the analysis of morphological, physiological indicators of health and at the same time completely lose sight of the psycho-emotional component. Meanwhile, it has long been proven and is well known to everyone that sometimes mental health and mood, as well as emotions themselves, can determine the physical state, influence the processes occurring in the body, etc.

Here it is impossible not to recall the common expression in everyday life: “all diseases come from nerves.” Moreover, we can safely paraphrase it, pointing out that many aspects of the treatment of diseases are also determined, in turn, by the state of the psyche and the emotional background.

Recently, being examined by a psychiatrist and narcologist has ceased to be something suspicious and frightening. It has become a preventive measure. At the same time, the doctors themselves in these specializations have had a little more work to do. Obtaining an opinion from any of them traditionally requires only a simple standard check to see if the person is registered with the relevant institutions. This refers to drug treatment, psychiatric registration, or registration as a person prone to antisocial behavior.

When it comes to inspections of civil servants and checks that accompany the issuance of a medical book, then just checking records is not enough. You need either a medical certificate from a narcologist and a psychiatrist as a separate document, or a conclusion from these doctors, which, accordingly, is reflected within the medical certificate for the civil service and the medical record form.

In turn, issuing a medical book and medical certificate for the civil service invariably involves a medical examination. It turns out that doctors work not only with documents, but also directly with patients in the form of, at a minimum, detailed oral conversations. If we take into account, therefore, the total number of people undergoing medical examinations, one can imagine how much work appears for narcologists and psychiatrists.

For patients who, in the process of getting a job, must receive the indicated conclusions, all these activities are undoubtedly burdensome. Additional medical examinations cannot be encouraging when it comes to a purely mechanical need - to undergo certain procedures and receive a final health document.

In fact, emotional and mental adequacy are important precisely for maintaining these forms of security. If a person is unstable in these relationships, then one cannot expect him to take a serious approach to anything, in particular, to proper medical examinations and ensuring sanitary and anti-epidemiological safety.

In addition, additional control is also necessary to eliminate poor performance by people of their professional duties, which are officially recognized as socially significant and socially oriented. It is truly wild to imagine a drug addict or mentally ill person as an employee of, say, a kindergarten or a practicing doctor.

Actually, all the difficulties here are associated with elementary additional actions. In fact, there is nothing wrong with additional medical examination and additional medical testing. Accordingly, there is nothing to be upset about. If the responsibility of approaches to assessing professional suitability increases, then it is worth believing that in some sense the quality of work in certain areas should indirectly improve, which, in the end, will have a positive impact on the well-being of the population as a whole.

Clinical examination is a medical examination aimed at identifying chronic For example, cardiovascular, bronchopulmonary, oncological, diabetes.

Clinical examination involves examination by medical specialists and a number of tests and examinations. It is carried out at the place of your attachment. Working citizens are issued a certificate of inspection on the same day. During the medical examination, employees have the right to be released from work for 1 working day once every 3 years while maintaining their job and average earnings. Medical examinations can also be taken in the evening and on Saturdays.

Workers of pre-retirement age (within 5 years before retirement age) and pensioners receiving an old-age or long-service pension have the right to be released from work for 2 working days once a year while maintaining their place of work and average earnings. To do this, you need to agree with management on the days of medical examination and write an application for release from work.

You have the right to refuse medical examination in general or certain types of medical interventions included in the scope of medical examination.

2. Who can undergo a free medical examination in Moscow?

To undergo medical examination, you must:

3. Appropriate by age. Medical examination is carried out once every 3 years, and you can undergo it during the year in which you turned or will turn: 18, 21, 24, 27, 30, 33, 36, 39 years old. If you are 40 years or older, you can undergo medical examination annually.

Some The following undergo annual medical examination:

1. Disabled people of the Great Patriotic War, disabled combatants, participants of the Great Patriotic War who became disabled due to a general illness, work injury or other reasons (except for persons whose disability occurred as a result of their illegal actions).

2. Persons awarded the badge “Resident of besieged Leningrad” and recognized as disabled due to a general illness, work injury or other reasons (except for persons whose disability occurred as a result of their illegal actions).

3. Former minor prisoners of concentration camps, ghettos, and other places of forced detention created by the Nazis and their allies during the Second World War, recognized as disabled due to a general illness, work injury and other reasons (except for persons whose disability resulted from their illegal actions).

4. Elderly Muscovites (upon reaching 50 years of age and before retirement age) have the right to count on free medical examinations in medical organizations that implement a free medical examination program for such citizens.

For these categories of citizens, clinical examination is carried out to the extent provided for the closest age category - except for studies that are contraindicated for annual conduct and if there are no corresponding symptoms and diseases for which they are necessary.

The scope and nature of a comprehensive examination depend on the gender and age of the person.

3. How will the medical examination take place?

Step 1. Fill out the required documents.

Contact the clinic at your place of attachment, where you will be asked to fill out the following documents:

• informed voluntary consent to medical intervention;
• a questionnaire (survey) to identify complaints characteristic of non-communicable diseases, personal history and living conditions (smoking, alcohol consumption, diet and physical activity, etc.), in people over 65 years of age - the risk of falls, depression, heart failure, etc. d.

Step 2. Prepare for examinations.

On the day appointed for the examination, come to the clinic in the morning on an empty stomach, before doing any physical activity, including morning exercises. if you If you are from 40 to 64 years old, the test must be taken once every two years, if you are from 65 to 75 years old - annually.

Step 3. Complete the first stage of medical examination.

A comprehensive examination may consist of two stages. During the first stage, you will receive a route sheet indicating all the examinations that must be completed depending on gender and age. The examination results will be ready in 1-6 days.

Step 4. Come to see a general practitioner.

The doctor will give explanations on the results of the examinations, determine your health group, and if there is a high risk of diseases or diseases themselves, a dispensary observation group and hand over your health passport.

Step 5. Go through the second stage of medical examination.

If after the examinations it turns out that you need further examination, the general practitioner will refer you to a second, more in-depth stage of medical examination.

Step 6. Consult your doctor.

After completing all stages of the examination, you will have another consultation with a general practitioner who will give the necessary recommendations (for example, on quitting smoking, improving your diet, increasing physical activity).

If there are diseases, the necessary treatment is prescribed, including specialized and high-tech medical care, as well as sanatorium-resort treatment.

If you smoke, are overweight, obese, or have other risk factors, you may be referred to a preventative care unit or office where they can provide help to correct your risk factors.

4. Which doctors should I see if I am between 18 and 39 years old?

The first stage of clinical examination:

1. Preventive medical examination:

• survey (questioning)
• determination of the level of total cholesterol in the blood;
• determination of blood glucose levels;
• determination of relative cardiovascular risk (for patients aged 18-39 years);
• fluorography (once every 2 years);
• appointment (examination) based on the results of a preventive medical examination, including an examination to identify visual and other localizations of oncological diseases, including examination of the skin, mucous lips and oral cavity, palpation of the thyroid gland, lymph nodes, by a paramedic at a medical center or a medical and obstetric station, a general practitioner or a medical prevention doctor at a medical prevention department (office) or a health center.

2. Screening for early detection of cancer:

• stool examination for occult blood (once every 2 years from 40 to 64 years of age, once a year from 65 to 75 years of age;
• esophagogastroduodenoscopy at 45 years old.

For women:

• examination by a paramedic (midwife) (18 and older);
• taking a smear from the cervix, cytological examination of a smear from the cervix once every 3 years at the age of 18 to 64 years;
• mammography (once every 2 years between the ages of 40 and 75).

For men:

• determination of prostate-specific antigen in the blood of men aged 45, 50, 55, 60 and 64 years.

3. Brief preventive consultation;

4. General blood test (from 40 years and older).

Second stage of clinical examination is carried out for the purpose of additional examination and clarification of the diagnosis of the disease (condition) if there are indications based on the results of the first stage and includes:

• examination (consultation) by a neurologist;
• duplex scanning of the brachycephalic arteries (for men aged 45 to 72 years inclusive and women aged 54 to 72 years);
• examination (consultation) by a surgeon or urologist (for men aged 45, 50, 55, 60 and 64 years with an increase in the level of prostate-specific antigen in the blood more than 4 ng/ml);
• spirometry;
• for women over 18 years of age: examination (consultation) by an obstetrician-gynecologist - if necessary;
• examination (consultation) by an otolaryngologist (for citizens aged 65 years and older);
• examination (consultation) by an ophthalmologist (for citizens aged 40 years and older);
• conducting individual or group (school for patients) in-depth preventive counseling in the department (office) of medical prevention (health center) for citizens aged 65 years and older.

5. Which doctors should I see if I am between 40 and 45 years old?

The first stage of clinical examination:

• measurement of height, body weight, waist circumference, determination of body mass index;
• blood pressure measurement;
• determination of absolute cardiovascular risk (for patients from 40 to 64 years old);
• electrocardiography at rest (performed during the first preventive medical examination, then at the age of 35 years and older once a year);
• for women over 40 years old - mammography;
• for men aged 45 years: determination of prostate-specific antigen (PSA) in the blood;
• for patients 45 years of age of both sexes - esophagogastroduodenoscopy;
• If you are between 40 and 64 years old, the test must be taken once every two years, if you are between 65 and 75 years old - annually.">40 years and older
• measurement of intraocular pressure (performed during the first preventive examination, then at the age of 40 years and older once a year).

• examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary);
• examination (consultation) by a surgeon or urologist (for men aged 45 years with an increase in the level of prostate-specific antigen in the blood more than 1 g/ml);
• colonoscopy - in case of suspected colon cancer, as prescribed by a surgeon or coloproctologist;
• esophagogastroduodenoscopy - if there is a suspicion of malignant neoplasms of the esophagus, stomach and duodenum - as prescribed by the therapist;
• X-ray of the lungs, computed tomography of the lungs - if malignant neoplasms of the lung are suspected - as prescribed by the therapist;
• examination (consultation) by an ophthalmologist (for patients over 40 years of age with increased intraocular pressure);

6. Which doctors should I see if I am between 46 and 50 years old?

The first stage of clinical examination:

• measurement of height, body weight, waist circumference, determination of body mass index;
• blood pressure measurement;
• conducting a general blood test (hemoglobin, leukocytes, ESR);
• determination of the level of total cholesterol in the blood using an express method;
• determination of fasting blood glucose levels (using the express method is allowed);
• determination of absolute cardiovascular risk;
• individual preventive counseling - for patients with high relative and very high absolute cardiovascular risk, obesity, hypercholesterolemia with a total cholesterol level of 8 mmol/l or more and/or smoking more than 20 cigarettes per day;
• fluorography of the lungs (not performed if fluorography, radiography (fluoroscopy) or computed tomography of the chest organs was performed in the previous calendar year or in the year of medical examination);
• resting electrocardiography (performed once a year);
• for women: examination by a midwife, including taking a smear from the cervix for cytological examination;
• for women - mammography;
• for men aged 50 years: determination of prostate-specific antigen (PSA) in the blood;
• for patients of both sexes aged If you are between 40 and 64 years old, the test must be taken once every two years, if you are between 65 and 75 years old - annually.">40 years and older: examination of feces for occult blood;
• measurement of intraocular pressure (performed once a year).

If you have taken any of the tests listed or had any of the examinations listed in the past 12 months, their results may be included in the medical examination.

Second stage of medical examination (if necessary):

• duplex scanning of brachycephalic arteries - for men over 45 years old, in the presence of risk factors for the development of chronic non-infectious diseases;
• examination (consultation) by a surgeon or urologist (for men aged 50 years with an increase in the level of prostate-specific antigen in the blood more than 1 g/ml);
• examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary);
• colonoscopy - in case of suspected colon cancer, as prescribed by a surgeon or coloproctologist;
• spirometry - if a chronic bronchopulmonary disease is suspected based on the results of a questionnaire, for smokers - in the direction of a therapist;
• for women: examination (consultation) by an obstetrician-gynecologist - if necessary;
• esophagogastroduodenoscopy - if there is a suspicion of malignant neoplasms of the esophagus, stomach and duodenum - as prescribed by the therapist;
• X-ray of the lungs, computed tomography of the lungs - if malignant neoplasms of the lung are suspected - as prescribed by the therapist;
• individual in-depth preventive counseling or group preventive counseling (patient school).

7. Which doctors should I see if I am between 51 and 74 years old?

The first stage of clinical examination:

• measurement of height, body weight, waist circumference, determination of body mass index;
• blood pressure measurement;
• conducting a general blood test (hemoglobin, leukocytes, ESR);
• determination of the level of total cholesterol in the blood using an express method;
• determination of fasting blood glucose levels (using the express method is allowed);
• determination of absolute cardiovascular risk (for patients under 64 years of age);
• individual preventive counseling - for patients under 72 years of age with high relative and very high absolute cardiovascular risk, obesity, hypercholesterolemia with a total cholesterol level of 8 mmol/l or more and/or smoking more than 20 cigarettes per day;
• fluorography of the lungs (not performed if fluorography, radiography (fluoroscopy) or computed tomography of the chest organs was performed in the previous calendar year or in the year of medical examination);
• electrocardiography at rest;
• for patients of both sexes: stool testing for occult blood (if you are from 40 to 64 years old, the test must be taken once every two years, if from 65 to 75 years old - annually);
• for men: determination of the level of prostate-specific antigen in the blood (carried out at the ages of 55, 60 and 64 years);
• for women under 64 years of age: examination by a midwife, including taking a smear from the cervix for cytological examination;
• for women: mammography (at the age of 40-75 years, performed once every 2 years).

If you have taken any of the tests listed or had any of the examinations listed in the past 12 months, their results may be included in the medical examination.

Second stage of medical examination (if necessary):

• examination (consultation) by a neurologist - if there is a suspicion of a previous acute cerebrovascular accident, depression in patients over 65 years of age, with motor dysfunction, etc.;
• duplex scanning of the brachycephalic arteries - for men up to 72 years old, for women 54-72 years old, in the presence of risk factors for the development of chronic non-infectious diseases;
• examination (consultation) by a surgeon or urologist (for men aged 55, 60 and 64 years - if the level of prostate-specific antigen in the blood increases by more than 1 g/ml);
• examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary);
• colonoscopy - in case of suspected colon cancer, as prescribed by a surgeon or coloproctologist;
• spirometry - if a chronic bronchopulmonary disease is suspected based on the results of a questionnaire, for smokers - in the direction of a therapist;
• for women under 75 years of age: examination (consultation) by an obstetrician-gynecologist - if necessary;
• examination (consultation) by an ophthalmologist - for patients with increased intraocular pressure;
• X-ray of the lungs, computed tomography of the lungs - if malignant neoplasms of the lung are suspected - as prescribed by the therapist;
• esophagogastroduodenoscopy - if there is a suspicion of malignant neoplasms of the esophagus, stomach and duodenum - as prescribed by the therapist;
• examination (consultation) by an otolaryngologist - for patients aged 65 years and older (if necessary);
• individual in-depth preventive counseling or group preventive counseling (patient school).

8. Which doctors should I see if I am 75 or older?

The first stage of clinical examination:

• measurement of height, body weight, waist circumference, determination of body mass index;
• blood pressure measurement;
• conducting a general blood test (hemoglobin, leukocytes, ESR);
• determination of the level of total cholesterol in the blood using an express method;
• determination of fasting blood glucose levels (using the express method is allowed);
• fluorography of the lungs (not performed if fluorography, radiography (fluoroscopy) or computed tomography of the chest organs was performed in the previous calendar year or in the year of medical examination);
• electrocardiography at rest;
• measurement of intraocular pressure (performed once a year);
• for women aged 75 years: mammography;
• for patients of both sexes aged 75 years: stool test for occult blood.

If you have taken any of the tests listed or had any of the examinations listed in the past 12 months, their results may be included in the medical examination.

Second stage of medical examination (if necessary):

• examination (consultation) by a neurologist - if there is a suspicion of a previous acute cerebrovascular accident, depression in patients over 65 years of age, with motor dysfunction, etc.
• duplex scanning of brachycephalic arteries - for patients aged 75-90 years, referred by a neurologist;
• examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary) - for patients under the age of 87 years;
• spirometry - if a chronic bronchopulmonary disease is suspected based on the results of a questionnaire, for smokers - in the direction of a therapist;
• esophagogastroduodenoscopy - if there is a suspicion of malignant neoplasms of the esophagus, stomach and duodenum - as prescribed by the therapist;
• X-ray of the lungs, computed tomography of the lungs - if malignant neoplasms of the lung are suspected - as prescribed by the therapist;
• examination (consultation) by an otolaryngologist (if necessary);
• examination (consultation) by an ophthalmologist - for patients with increased intraocular pressure, and for patients aged 75 years and older who have a decrease in visual acuity that is not amenable to glasses correction, identified by the results of a questionnaire;
• individual in-depth preventive counseling or group preventive counseling (patient school).

9. My age is not on the list for medical examination. What examination can I undergo?

If your age is not on the list for medical examination and you do not belong to preferential categories, you can still go to your clinic and undergo a preventive medical examination. It is also carried out for early detection of diseases and risk factors for their development, but unlike medical examination, it includes a smaller volume of examinations.

The advantage of a preventive medical examination is that it can be performed at any age at the request of the patient. The medical examination is carried out free of charge, annually. Preventive medical examination studies are included in stage 1 of medical examination.

Step 2. Find out the results. After the tests, you will have an appointment (examination) with a general practitioner, including Examination of the skin, mucous membranes of the lips and oral cavity, palpation of the thyroid gland and lymph nodes.

If you are diagnosed with signs or a high risk of disease, your general practitioner will refer you for additional examination.

According to Order No. 302n of the Ministry of Health and Social Development of the Russian Federation, employees of enterprises and institutions must undergo regular medical examinations. Such a requirement helps to identify and eliminate diseases in a timely manner, which has a positive effect not only on the well-being of the employee, but also on the work process of the entire team. It also provides an opportunity to protect other people who come into contact with the employee. Below we will look at the rules for preparing for a medical examination, and also tell you which doctors you will need to visit.

Which doctors do you undergo for a medical examination?

Every person planning to undergo a medical examination should know which specialists need to be visited. The list of doctors may vary depending on the specifics of the job, working conditions, gender and age of the employee. Most often, a medical examination includes an appointment with:

• therapist;
• neurologist;
• otolaryngologist (ENT);
• ophthalmologist;
• gynecologist (for women);
• urologist or proctologist (for men);
• surgeon;
• narcologist;
• dentist

Preparing for a medical examination with a therapist

The medical examination begins with a visit to the therapist. This multidisciplinary specialist conducts a general examination of the patient, his skin and mucous membranes, palpates some organs and lymph nodes, assesses the condition of the musculoskeletal system, listens to the lungs using a phonendoscope, and measures blood pressure and body temperature. The results of the medical history are recorded in your medical record.

An examination by a therapist does not require any special preparation. You just need to wear comfortable clothes that will not interfere with the examination, and also be prepared to talk with the doctor about the state of your health.

Rules for preparing for a medical examination with a neurologist

If you experience periodic or frequent headaches, migraine attacks and dizziness, trembling hands, problems sleeping, or seizures, you need to make an appointment with a neurologist without waiting for a scheduled medical examination. If you do not observe any disruptions in the functioning of the nervous system, a visit to a neurologist should be carried out as a preventive measure once a year (during a medical examination).

An examination by a neurologist involves taking a medical history, measuring blood pressure, lightly tapping the kneecap with a special hammer, tingling the patient’s skin with special needles to determine the sensitivity threshold, and assessing coordination and balance.

In order for a specialist to obtain accurate information about the state of health of a person who has come to him for examination, it is necessary to give the neurologist truthful and reliable information when answering his questions. If the doctor has suspicions about any pathologies, he can write out an appointment for additional examinations - for example, magnetic resonance imaging, computed tomography, electroencephalography, echoencephalography.

Before undergoing a medical examination by a neurologist, it is advisable to get a good night's sleep, avoid drinking tonic drinks (coffee, energy drinks, tincture of Eleutherococcus or ginseng) and alcohol. Also, if you are already taking any medications (sedatives, tranquilizers, sleeping pills), be sure to inform your doctor about this.

Medical examination with an otolaryngologist: what do you need to know and how to prepare?

During a visit to the ENT specialist, the mucous membranes of the throat and nose and ears are examined. Preparation for a medical examination with an ENT specialist consists of carrying out hygienic procedures: before visiting a doctor, you need to brush your teeth, clear natural mucus from your nose, and carefully clean your ears with a cotton swab. Also, do not gargle or rinse your nose so that a specialist can take samples for analysis.

Rules for preparing for a medical examination with an ophthalmologist

An ophthalmologist (ophthalmologist) examines the eyeballs, the mucous membrane of the eyelids and the fundus of the eye, measures eye pressure, and checks the patient’s visual acuity using special tables. To prepare for the examination, it is advisable to avoid using eye drops beforehand. You will also need to bring glasses or contacts to your appointment if you wear them.

Preparation for a medical examination for women (visit to a gynecologist and mammologist)

The prospect of an upcoming gynecological examination is the reason for the anxiety of every second woman. This can easily be understood from a psychological point of view, because few people feel comfortable when visiting a gynecologist. However, every woman should understand that such an examination is a guarantee of health, not only for herself, but also for her partner.

A visit to the gynecologist includes a conversation about the nature of sexual activity, the menstrual cycle, the presence or absence of pain, unclear discharge and discomfort. This is followed by an examination in a gynecological chair using sterile equipment. At the end of the examination, the doctor takes a smear for laboratory testing.

To prepare for a medical examination with a gynecologist, a woman should abstain from sexual intercourse and vaginal douching 2-3 days before going to the doctor. It is also worth excluding the use of vaginal suppositories and the use of intimate hygiene products (it is better to replace the use of the latter with washing with chamomile decoction or just warm water).

During the medical examination, women also need to see a mammologist. During a visit to this doctor, a visual examination and palpation of the mammary glands is performed, the doctor asks questions about possible pain and swelling of the breasts during PMS. If the mammologist suspects that the patient has a particular disease, he will advise her to undergo an ultrasound of the mammary glands or mammography.

A visit to a mammologist during a medical examination does not require prior preparation. The only thing you need to do is wear comfortable underwear and refuse a dress, since for the examination you will have to remove it completely (it is better to come to the appointment in a skirt and blouse, jeans and a sweater).

Medical examination with a proctologist or urologist (for men): how to prepare?

A timely visit to a proctologist and urologist for men is as important as an appointment with a gynecologist and mammologist for women.

An examination by a proctologist consists of interviewing the patient, visual examination of the anal area, and palpation of the anus. The evening before the medical examination with a proctologist, it is recommended to do a cleansing enema and also refuse dinner. If the appointment is scheduled for the second half of the day, you can have breakfast with very light foods in small quantities.

As for a medical examination by a urologist, it includes a doctor’s examination of the scrotum and penis, as well as palpation of the prostate through the anus. In addition, prostatic secretions may need to be collected for laboratory testing.

The rules for preparing for a medical examination with a urologist are simple: you need to abstain from sexual intercourse 2-3 days before visiting the doctor, perform a cleansing enema the day before and refrain from urinating for 1-1.5 hours for the examination.

Preparing for a medical examination with a surgeon

A visit to the surgeon is necessary for timely detection of injuries and pathologies. After collecting anamnesis, the doctor performs a visual examination and palpation of certain areas of the body, examination using percussion and a stethoscope. If he has suspicions that the patient has a disease, the surgeon may refer him for an ultrasound or x-ray.

To prepare for the examination, you should shower beforehand and wear comfortable clothing that you can quickly remove for the examination.

How to prepare for a dental examination?

A dental examination helps to identify and eliminate caries, pulpitis and other dental diseases in the early stages. To prepare for a medical examination, you need to thoroughly brush your teeth and rinse your mouth, and then refuse to eat until you see the dentist. If your medical examination is scheduled for the afternoon, it is recommended that you take a toothbrush and toothpaste with you to work to brush your teeth immediately before your appointment.

Examination by a narcologist: what do you need to know to properly prepare for it?

A visit to a narcologist is a mandatory part of the medical examination for drivers, medical staff, pharmacists, pharmacists, as well as for all workers whose field of activity is in one way or another connected with mechanisms and devices.

During the examination, the narcologist asks questions to obtain general information about the patient’s health status, living and working conditions. Next, the doctor conducts a series of tests to determine the condition of the vestibular apparatus and the basic functions of the nervous system. A visual examination of the skin and checking the veins for the presence of non-medical injections is also necessary. In addition, laboratory tests of the blood may be required to possibly detect drug particles in the blood.

On the eve of the examination, you must stop smoking, drinking alcohol, and taking strong medications. If you are forced to take medications to maintain normal health, you must inform your narcologist about this before the examination.

What is included in the medical examination of tests and diagnostic procedures?

• Finger blood test.
• Venous blood analysis.
• Analysis of urine.
• Smear collection.
• Electrocardiogram.
• Fluorography.
• Mammography.

Where to get a medical examination in St. Petersburg?

Medical examinations are carried out both in public clinics and in private clinics and medical centers. Both medical institutions have their advantages. However, when contacting private centers, you can count on a more complete range of services and attention from the staff. In addition, when making an appointment for a medical examination at a private medical institution, the patient does not have to wait long for his turn; modern equipment is used for examinations, and the medical examination itself takes much less time.

At GarantMed, you can undergo a medical examination in a short time, in consultation with highly qualified specialists, and receive the results of a medical examination in your hands. To do this, you need to contact the administrator and select the most suitable date for the examination.

Conducting mandatory medical examinations is a priority activity of the Medliga LLC medical center. We conduct medical examinations in compliance with the requirements of Order No. 302-n of the Ministry of Health and Social Development.

Each new employee is required to undergo a medical examination upon hiring in accordance with the requirements of the employer. It is done in order to determine the suitability of an employee applying for a certain position. To perform his duties, the employee must have adequate physical and mental health.

The laws of the Russian Federation contain a list of workers who must undergo a medical examination. If a candidate for a position refuses to provide a medical report, the employer has the legal right not to hire such a person. The presence of a medical examination certificate shows that the candidate has no contraindications for performing a specific job.

Please note: medical examinations at the clinic are carried out only on weekdays, from Monday to Friday.

Preliminary and periodic medical examinations are carried out both in our clinic and on-site to the customer. An on-site medical examination allows employees to be examined with minimal loss of working time.

Medical examination of workers: why is it so necessary?

A medical examination is a treatment and preventive measure carried out in order to identify any violations in the employee’s health, as well as to protect public health and prevent the occurrence and spread of diseases.

Exposure to harmful production factors (occupational hazards) can cause occupational diseases. Preliminary and periodic medical examinations of workers at enterprises are designed to prevent the emergence and development of such diseases.

Protecting the health of workers includes a whole range of measures. Periodic medical examination is part of the important preventive work to maintain the health of workers.

In accordance with Part 2 of Article 213 of the Labor Code of the Russian Federation (hereinafter referred to as the Labor Code of the Russian Federation), in order to protect public health and prevent the occurrence and spread of diseases, employees of food industry, public catering and trade organizations undergo mandatory preliminary (upon entry to work) and periodic (for persons under the age of 21 - annual) medical examinations (examinations).

A special condition is contained in Article 69 of the Labor Code of the Russian Federation that: “persons under the age of eighteen, as well as other persons in cases provided for by this Code and other federal laws, are subject to mandatory preliminary medical examination (examination) when concluding an employment contract.”

When entering a job, acquiring a related profession and during the preventive selection of persons entering hazardous work, mandatory preliminary medical examinations. During his working life, the employee also undergoes periodic medical examinations and sometimes unscheduled medical examinations. Such medical examinations can be organized only by medical institutions that have a license to carry out medical activities and have all the necessary medical specialists.

Health can also be maintained by regular sanitary and hygienic control over compliance with standards for the content of harmful substances, monitoring of microclimate parameters, and control of physical factors in the workplace. Employees of the enterprise must be provided with modern personal protective equipment that creates the most effective protection from harmful and dangerous production factors. Special commissions on labor protection should take part in preventive work to prevent occupational diseases.

Working people are busy people; they have no time to waste time on hospitals. It's no secret that in many medical institutions there is an acute shortage of specialists. With a high workload and very low salaries, the shortage of medical staff is catastrophic. Hence the endless waiting, queues, loss of time, reluctance to go to the clinic. Busy people, as a rule, put off visiting the clinic, resulting in advanced and chronic “sores.” Therefore, a medical examination at the enterprise is absolutely necessary.

A medical examination will identify employees at risk of developing any disease and will detect the disease at an early stage. After the tests and examinations have been carried out, you can assess the state of your health, as well as find out about the risk of any diseases.

What diseases are detected during a medical examination?

When undergoing a medical examination, we conduct laboratory tests of blood and urine. Blood test results may indicate anemia, diabetes, or show the presence of inflammatory processes in the body. A biochemical blood test helps to suspect diseases of the liver, kidneys, and gall bladder. Fluorographic examination will help diagnose tumors, inflammation, and tuberculosis. Problems in the functioning of the heart will be shown by a cardiogram. Measuring your blood pressure will help identify the presence of hypertension.

Hidden diseases of the abdominal cavity and varicose veins can be detected during examination by a surgeon. A neurologist may also suspect the presence of hidden diseases without obvious manifestations. Women must undergo a medical examination by one of the main women's doctors - gynecologist, where swabs are taken for testing. Women are also examined by mammologist. A fluorogram will show the condition of the internal structures of the chest: changes in the fluorogram may indicate pathological processes, for example, tumors, bronchitis, mediastinal diseases, tuberculosis.

The Praktika Medical Center (Medliga LLC) has large spacious premises, modern medical equipment, and the clinic employs doctors of various specialties. All this allows you to conduct a medical examination quickly and efficiently. The result of our medical examination is a high-quality and truthful assessment of the health of our employees, reflected in the final report of the commission.

Regulations

Order of the Ministry of Health and Social Development of Russia No. 302n dated April 12, 2011 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) workers engaged in heavy work and work with harmful and (or) dangerous working conditions