{"id":20858,"date":"2015-04-15T09:18:07","date_gmt":"2015-04-15T07:18:07","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=20858"},"modified":"2015-04-15T09:27:56","modified_gmt":"2015-04-15T07:27:56","slug":"prakticti-lekari-varuji-pred-ozivovanim-pohotovosti","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=20858","title":{"rendered":"Prakti\u010dt\u00ed l\u00e9ka\u0159i varuj\u00ed p\u0159ed o\u017eivov\u00e1n\u00edm pohotovost\u00ed"},"content":{"rendered":"<p><strong>Deleg\u00e1ti celorepublikov\u00e9 konference Sdru\u017een\u00ed praktick\u00fdch l\u00e9ka\u0159\u016f (SPL \u010cR), varuj\u00ed p\u0159ed tendenc\u00ed o\u017eivovat pracovi\u0161t\u011b LSPP, kter\u00e1 pamatujeme z dob socialistick\u00e9ho zdravotnictv\u00ed.<\/strong><!--more--><\/p>\n<p>Vyso\u010dina \u2013 Jejich dal\u0161\u00ed izolovan\u00e9 p\u016fsoben\u00ed v modern\u00edm zdravotn\u00edm syst\u00e9mu nem\u00e1 m\u00edsto. L\u00e9ka\u0159sk\u00e1 p\u00e9\u010de poskytovan\u00e1 v t\u011bchto nevybaven\u00fdch za\u0159\u00edzen\u00edch je z odborn\u00e9ho hlediska nep\u0159ijateln\u00e1 a p\u0159edstavuje zv\u00fd\u0161en\u00e9 riziko jak pro pacienta, tak, z forenzn\u00edho hlediska, i pro l\u00e9ka\u0159e. SPL \u010cR je v souladu se spole\u010dn\u00fdm stanoviskem Spole\u010dnosti v\u0161eobecn\u00e9ho l\u00e9ka\u0159stv\u00ed \u010cLS JEP, Spole\u010dnosti urgentn\u00ed medic\u00edny a Sdru\u017een\u00edm praktick\u00fdch l\u00e9ka\u0159\u016f pro d\u011bti a dorost p\u0159esv\u011bd\u010deno, \u017ee stavy, kter\u00e9 vy\u017eaduj\u00ed o\u0161et\u0159en\u00ed po ukon\u010den\u00ed b\u011b\u017en\u00fdch ordina\u010dn\u00edch hodin, mus\u00ed b\u00fdt \u0159e\u0161eny v syst\u00e9mu, odborn\u011b i organiza\u010dn\u011b odpov\u00eddaj\u00edc\u00edmu rozvoji sou\u010dasn\u00e9 medic\u00edny a pot\u0159eb\u00e1m nemocn\u00fdch.<\/p>\n<p>Pohotovost pot\u0159ebuje z\u00e1zem\u00ed<\/p>\n<p>Pohotovostn\u00ed pracovi\u0161t\u011b mus\u00ed disponovat z\u00e1zem\u00edm s laboratorn\u00edmi a zobrazovac\u00edmi technologiemi, s rychlou n\u00e1vaznost\u00ed na l\u00e9k\u00e1renskou slu\u017ebu, dal\u0161\u00ed konzili\u00e1rn\u00ed vy\u0161et\u0159en\u00ed a l\u016f\u017eka. Tato krit\u00e9ria spl\u0148uj\u00ed ji\u017e dnes odd\u011blen\u00ed urgentn\u00edch p\u0159\u00edjm\u016f mnoh\u00fdch nemocnic v \u010cR.<\/p>\n<p>Jejich dal\u0161\u00ed rozvoj a pos\u00edlen\u00ed pln\u011b podporujeme, stejn\u011b jako za\u010dlen\u011bn\u00ed LPS do jejich \u010dinnosti. Na t\u00e9 by se pak krom\u011b VPL m\u011bli pod\u00edlet i ambulantn\u00ed specialist\u00e9. SPL \u010cR iniciovalo vznik pracovn\u00ed skupiny na p\u016fd\u011b MZ\u010cR, kter\u00e1 se za\u010dala budouc\u00ed koncepc\u00ed LPS intenzivn\u011b zab\u00fdvat. SPL \u010cR opakovan\u011bvarovalo politiky p\u0159ed zru\u0161en\u00edm regula\u010dn\u00edch poplatk\u016f (RP). Krom\u011b v\u00fdpadku p\u0159\u00edjm\u016f ordinac\u00ed, kter\u00e9 pokryly alespo\u0148 z\u010d\u00e1sti rostouc\u00ed n\u00e1klady na provoz, jsme p\u0159edpov\u00eddali i negativn\u00ed dopad na pacienty.<\/p>\n<p>Pacient\u016f p\u0159ibylo<\/p>\n<p>Skute\u010dnost p\u0159ed\u010dila na\u0161e o\u010dek\u00e1v\u00e1n\u00ed. Po\u010det kontakt\u016f l\u00e9ka\u0159, pacient se v ordinac\u00edch v 1. \u010dtvrtlet\u00ed 2015 dramaticky zv\u00fd\u0161il, ani\u017e by se dal vysv\u011btlit pouze medic\u00ednsk\u00fdmi p\u0159\u00ed\u010dinami. Pacienti \u010dekaj\u00ed d\u00e9le na o\u0161et\u0159en\u00ed, prodlou\u017eily se objednac\u00ed lh\u016fty. Jsme p\u0159esv\u011bd\u010deni, \u017ee zru\u0161en\u00ed RP, kter\u00e9 ve skute\u010dnosti nikoho neohro\u017eovaly a sv\u016fj regula\u010dn\u00ed efekt alespo\u0148 \u010d\u00e1ste\u010dn\u011b plnily, bylo chybou. Kompenzace poplatk\u016f ve v\u00fd\u0161i 4,5 mld. K\u010d mohly b\u00fdt vynalo\u017eeny daleko \u00fa\u010deln\u011bji. Nap\u0159. na zv\u00fd\u0161en\u00ed dostupnosti biologick\u00e9 l\u00e9\u010dby, nav\u00fd\u0161en\u00ed po\u010dtu center pro nemocn\u00e9 s Alzheimerovou nemoc\u00ed nebo roz\u0161\u00ed\u0159en\u00ed hospicov\u00e9 p\u00e9\u010de.<\/p>\n<p>SPL \u010cR kategoricky odm\u00edt\u00e1 n\u00e1vrh MZ a MPSV, aby posuzov\u00e1n\u00ed n\u00e1sledk\u016f pracovn\u00edho \u00farazu a n\u00e1sledn\u00e9ho zt\u00ed\u017een\u00ed spole\u010densk\u00e9ho uplatn\u011bn\u00ed bylo d\u00e1no za povinnost registruj\u00edc\u00edm praktik\u016fm. Ti pro tuto \u010dinnost nejsou erudov\u00e1ni a znamen\u00e1 pro n\u011b dal\u0161\u00ed zv\u00fd\u0161en\u00ed administrativn\u00ed z\u00e1t\u011b\u017ee, kter\u00e1 se ji\u017e st\u00e1v\u00e1 zcela ne\u00fanosnou. Toto ohodnocen\u00ed mus\u00ed prov\u00e9st znalec vy\u0161kolen\u00fd pro tuto \u010dinnost. SPL \u010cR trv\u00e1 na tom, aby v nov\u011b p\u0159ipravovan\u00e9 novele z\u00e1kona 372\/2011 byla i nad\u00e1le zachov\u00e1na povinnost zam\u011bstnavatele p\u0159ed\u00e1vat informace o zdravotn\u00edm stavu klienta jeho registruj\u00edc\u00edmu l\u00e9ka\u0159i. Navrhovan\u00e9 p\u0159enesen\u00ed t\u00e9to povinnosti na pacienta p\u0159edstavuje re\u00e1ln\u00e9 riziko zaml\u010den\u00ed d\u016fle\u017eit\u00fdch informac\u00ed o jeho zdravotn\u00edm stavu, nap\u0159\u00edklad p\u0159i posuzov\u00e1n\u00ed zdravotn\u00ed zp\u016fsobilosti k pr\u00e1ci, \u0159\u00edzen\u00ed motorov\u00fdch vozidel \u010di dr\u017een\u00ed zbrojn\u00edho pr\u016fkazu.<\/p>\n<p>SPL \u010cR se dlouhodob\u011b v r\u00e1mci sv\u00fdch mo\u017enost\u00ed sna\u017e\u00ed zamezit nar\u016fstaj\u00edc\u00edm region\u00e1ln\u00edm disproporc\u00edm v dostupnosti prim\u00e1rn\u00ed p\u00e9\u010de. Opakovan\u011b jednalo s MZ \u010cR, zdravotn\u00edmi poji\u0161\u0165ovnami a z\u00e1stupci krajsk\u00e9 samospr\u00e1vy a Svazem MO \u010cR. P\u0159es deklarovan\u00fd z\u00e1jem o rychl\u00e9 \u0159e\u0161en\u00ed t\u00e9to situace a nad\u011bjn\u00e9 sliby v\u010d. mo\u017enosti podpory z prost\u0159edk\u016f fond\u016f EU konstatujeme, \u017ee dosud nedo\u0161lo k viditeln\u00e9mu posunu.<\/p>\n<p>SPL \u010cR nesouhlas\u00ed se z\u00e1m\u011brem slou\u010dit klinick\u00fd obor d\u011btsk\u00e9 l\u00e9ka\u0159stv\u00ed s oborem praktick\u00e9 l\u00e9ka\u0159stv\u00ed pro d\u011bti a dorost do jednoho oboru pediatrie. Praktick\u00e9 l\u00e9ka\u0159stv\u00ed pro d\u011bti a dorost by jako jeden ze z\u00e1kladn\u00edch pil\u00ed\u0159\u016f st\u00e1vaj\u00edc\u00ed funk\u010dn\u00ed a efektivn\u00ed prim\u00e1rn\u00ed p\u00e9\u010de m\u011blo z\u016fstat z\u00e1kladn\u00edm atesta\u010dn\u00edm oborem. SPL \u010cR odm\u00edt\u00e1 hrazen\u00ed v\u00fdkon\u016f klinicko\u00acfarmaceutick\u00e9 p\u00e9\u010de poskytovan\u00e9 v l\u00e9k\u00e1rn\u00e1ch z prost\u0159edk\u016f ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. Nevid\u00edme racion\u00e1ln\u00ed d\u016fvod k poskytov\u00e1n\u00ed duplicitn\u00ed zdravotn\u00ed p\u00e9\u010de, nav\u00edc bez jasn\u011b vymezen\u00e9 odpov\u011bdnosti. Jsme p\u0159esv\u011bd\u010den\u00ed, \u017ee klinick\u00e1 zdravotn\u00ed p\u00e9\u010de pat\u0159\u00ed do rukou l\u00e9ka\u0159\u016f.<\/p>\n<p>Monika Richterov\u00e1<br \/>\nHavl\u00ed\u010dkobrodsk\u00fd den\u00edk<br \/>\n<a href=\"http:\/\/havlickobrodsky.denik.cz\/\">http:\/\/havlickobrodsky.denik.cz\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>Deleg\u00e1ti celorepublikov\u00e9 konference Sdru\u017een\u00ed praktick\u00fdch l\u00e9ka\u0159\u016f (SPL \u010cR), varuj\u00ed p\u0159ed tendenc\u00ed o\u017eivovat pracovi\u0161t\u011b LSPP, kter\u00e1 pamatujeme z dob socialistick\u00e9ho zdravotnictv\u00ed.<\/p>\n<\/div>","protected":false},"author":1,"featured_media":14648,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-20858","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/20858","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=20858"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/20858\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14648"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=20858"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=20858"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=20858"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}