{"id":39131,"date":"2023-04-21T09:22:30","date_gmt":"2023-04-21T07:22:30","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=39131"},"modified":"2023-04-21T09:47:09","modified_gmt":"2023-04-21T07:47:09","slug":"jak-cesky-lekar-zachranil-americke-holcicce-ruku","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=39131","title":{"rendered":"Jak \u010desk\u00fd l\u00e9ka\u0159 zachr\u00e1nil americk\u00e9 hol\u010di\u010dce ruku"},"content":{"rendered":"\n

Fakultn\u00ed nemocnice Bulovka je s nejv\u011bt\u0161\u00edm Komplexn\u00edm onkologick\u00fdm centrem v \u010cR l\u00eddrem v boji s rakovinou<\/strong>. Disponuje mnoha specializovan\u00fdmi pracovi\u0161ti, mezi kter\u00e9 pat\u0159\u00ed tak\u00e9 Komplexn\u00ed centrum pro l\u00e9\u010dbu n\u00e1dor\u016f pohybov\u00e9ho apar\u00e1tu veden\u00e9 MUDr. Janem Lesensk\u00fdm. V rozhovoru se pod\u011blil o sv\u00e9 post\u0159ehy, zku\u0161enosti i o p\u0159\u00edb\u011bhy s dobr\u00fdm koncem<\/strong>,<\/p>\n\n\n\n

Z p\u016fsoben\u00ed v USA m\u00e1te zku\u0161enosti s americk\u00fdm zdravotnictv\u00edm. Jak n\u00e1ro\u010dn\u00e1 je adaptace l\u00e9ka\u0159e z \u010cesk\u00e9 republiky na tamn\u00ed zp\u016fsob pr\u00e1ce a p\u0159\u00edstup k pacient\u016fm?<\/strong>
Adaptace je n\u00e1ro\u010dn\u00e1 zejm\u00e9na v oblasti organizace pr\u00e1ce, kter\u00e1 je v USA zcela odli\u0161n\u00e1. V \u010cech\u00e1ch je l\u00e9ka\u0159 zvykl\u00fd si v\u0161e d\u011blat s\u00e1m (organizaci ambulance, psan\u00ed p\u0159\u00edjm\u016f a dekurz\u016f, p\u0159evazov\u00e1n\u00ed pacient\u016f, pl\u00e1nov\u00e1n\u00ed opera\u010dn\u00edho programu a zaji\u0161\u0165ov\u00e1n\u00ed implant\u00e1t\u016f, k\u00f3dov\u00e1n\u00ed pro poji\u0161\u0165ovnu atp.). Pr\u00e1ce l\u00e9ka\u0159e v USA je velmi drah\u00e1, a tak se kolem ka\u017ed\u00e9ho l\u00e9ka\u0159e pohybuje cel\u00fd roj administrativn\u00edch pracovn\u00edk\u016f, sester, rezident\u016f, kte\u0159\u00ed maj\u00ed zajistit, aby se l\u00e9ka\u0159 mohl v\u011bnovat opravdu pouze medic\u00edn\u011b. Pro m\u011b byl zpo\u010d\u00e1tku velk\u00fd probl\u00e9m nau\u010dit se tento t\u00fdm vyu\u017e\u00edvat, organizovat a \u00fakolovat.
Co se medic\u00edny t\u00fd\u010de, ta je jen jedna. P\u0159i t\u00e9to p\u0159\u00edle\u017eitosti bych r\u00e1d vyzdvihl \u010desk\u00e9 zdravotnictv\u00ed, kter\u00e9 je schopn\u00e9 s nesrovnateln\u011b men\u0161\u00edmi n\u00e1klady dosahovat v\u00fdsledk\u016f na \u00farovni t\u011bch nejbohat\u0161\u00edch zem\u00ed sv\u011bta.<\/strong><\/a> A co je zcela z\u00e1sadn\u00ed, t\u00e9to p\u00e9\u010de se dostane v\u0161em bez rozd\u00edlu. Kdy\u017e pot\u0159ebuje n\u011bkter\u00fd \u010desk\u00fd ob\u010dan tumor\u00f3zn\u00ed endoprot\u00e9zu za milion, tak ji dostane, pot\u0159ebuje-li drahou biologickou l\u00e9\u010dbu nebo cokoli jin\u00e9ho a existuje l\u00e9ka\u0159sk\u00e1 indikace, dostane to. To je n\u011bco, o \u010dem si lid\u00e9 v USA mohou nechat jen zd\u00e1t.<\/p>\n\n\n\n

Z\u00e1sadn\u00ed rozd\u00edly jsou jist\u011b i mezi \u010desk\u00fdm a americk\u00fdm zdravotn\u00edm syst\u00e9mem\u2026<\/strong><\/strong><\/p>\n\n\n\n

N\u00e1\u0161 \u010desk\u00fd syst\u00e9m funguje na principu solidarity \u2013 zdrav\u00ed p\u0159isp\u00edvaj\u00ed na p\u00e9\u010di nemocn\u00fdm. Mnoho lid\u00ed si bohu\u017eel plete zdravotn\u00ed poji\u0161t\u011bn\u00ed s p\u0159edplatn\u00fdm a maj\u00ed pocit, \u017ee sv\u00e9 p\u0159\u00edsp\u011bvky mus\u00ed vy\u010derpat. V USA plat\u00ed velice nekompromisn\u00ed pravidla trhu. Lid\u00e9 si mohou, ale nemus\u00ed, platit zdravotn\u00ed poji\u0161t\u011bn\u00ed a tak\u00e9 si mohou vybrat z cel\u00e9 \u0159ady program\u016f. Li\u0161\u00ed se jak \u00farovn\u00ed spolu\u00fa\u010dasti, tak maxim\u00e1ln\u00ed v\u00fd\u0161\u00ed \u00fahrady. Je to podobn\u00e9, jako kdy\u017e u n\u00e1s poji\u0161\u0165ujete auto. B\u011b\u017en\u00e9 je, \u017ee si t\u0159eba lid\u00e9 do hodnoty 10 tis\u00edc dolar\u016f ro\u010dn\u011b v\u0161e plat\u00ed z vlastn\u00ed kapsy, i kdy\u017e maj\u00ed poji\u0161t\u011bn\u00ed. A pokud cena l\u00e9\u010dby p\u0159esahuje sjednanou hranici, mus\u00ed \u010d\u00e1stku dorovnat. I proto se v USA ka\u017edou chv\u00edli po\u0159\u00e1daj\u00ed sb\u00edrky na l\u00e9\u010dbu toho nebo onoho, proto\u017ee nemocnice l\u00e9\u010d\u00ed a\u017e pot\u00e9, co je j\u00ed zaplaceno.
J\u00e1 jsem pracoval na \u0161pi\u010dkov\u00e9m pracovi\u0161ti a m\u011bl jsem zcela neomezen\u00e9 mo\u017enosti, mohl jsem s\u00e1m ur\u010dit, jak budu l\u00e9\u010dit. Ale a\u017e po \u010dase jsem si uv\u011bdomil, \u017ee pacienti museli \u010dasto dlouho bojovat, aby se ke mn\u011b v\u016fbec dostali. Museli dokl\u00e1dat nemocnici poji\u0161t\u011bn\u00ed, p\u0159edkl\u00e1dat doporu\u010den\u00ed od jin\u00fdch specialist\u016f, \u017ee l\u00e9\u010dba nen\u00ed v nemocnici ni\u017e\u0161\u00ed \u00farovn\u011b mo\u017en\u00e1, a tak podobn\u011b. Ne\u017e se tedy dostali ke mn\u011b, museli se prodrat lesem administrativn\u00edch pracovn\u00edk\u016f.<\/p>\n\n\n\n

M\u016f\u017eete uv\u00e9st konkr\u00e9tn\u00ed p\u0159\u00edklad?<\/strong><\/strong><\/p>\n\n\n\n

Velmi dob\u0159e si pamatuji na p\u0159\u00edpad jedn\u00e9 12let\u00e9 hol\u010di\u010dky z Atlanty. Na ambulanci na m\u011b \u010dekala cel\u00e1 rodina v\u010detn\u011b babi\u010dky a sourozenc\u016f (v USA to chod\u00ed tak, \u017ee pacienti \u010dekaj\u00ed v ambulanci a l\u00e9ka\u0159 za nimi chod\u00ed \u2013 to m\u00e1 n\u011bkolik v\u00fdhod i proto, \u017ee americk\u00fd l\u00e9ka\u0159 m\u016f\u017ee kdykoli odej\u00edt, kde\u017eto u n\u00e1s m\u016f\u017ee \u00faporn\u00fd pacient zablokovat chod ambulance t\u0159eba i na v\u00edce ne\u017e hodinu). D\u00edvka trp\u011bla osteosarkomem pa\u017en\u00ed kosti v oblasti ramene a dotaz rodiny zn\u011bl, zda je mo\u017en\u00e9 kon\u010detinu zachr\u00e1nit, \u017ee v Atlant\u011b pl\u00e1nuj\u00ed amputaci. Ode\u0161el jsem prostudovat je\u0161t\u011b jednou magnetickou rezonanci, zda jsem n\u011bco nep\u0159ehl\u00e9dl. Nebylo mi jasn\u00e9, pro\u010d uva\u017euj\u00ed o amputaci. Pot\u00e9 jsem se vr\u00e1til a \u0159ekl jsem rodin\u011b, \u017ee dle m\u00e9ho n\u00e1zoru amputace nen\u00ed nutn\u00e1 a \u017ee situace je \u0159e\u0161iteln\u00e1 tumor\u00f3zn\u00ed n\u00e1hradou ramene. Rodina pod\u011bkovala, j\u00e1 jsem nadiktoval ambulantn\u00ed zpr\u00e1vu (l\u00e9ka\u0159 tam nep\u00ed\u0161e, ale diktuje \u2013 zpr\u00e1vy jsou pot\u00e9 p\u0159eps\u00e1ny do syst\u00e9mu, kde je pouze potvrd\u00ed). N\u00e1sleduj\u00edc\u00ed den se mi ozvala administrativa nemocnice, a\u0165 najdu alespo\u0148 t\u0159i pacienty s obdobnou l\u00e9\u010dbou za posledn\u00ed rok a po\u0161lu jim MRN (Medical Record Number \u2013 m\u00edsto na\u0161eho rodn\u00e9ho \u010d\u00edsla, kter\u00e9 obsahuje p\u0159\u00edli\u0161 mnoho citliv\u00fdch informac\u00ed). Ud\u011blal jsem v\u0161e po\u017eadovan\u00e9 a pacientka byla objedn\u00e1na k operaci. A\u017e pozd\u011bji jsem se dozv\u011bd\u011bl, \u017ee rodi\u010de nem\u011bli zdravotn\u00ed poji\u0161t\u011bn\u00ed. Za konzultaci na ambulanci zaplatili t\u0159i tis\u00edce dolar\u016f (asi 65 tis\u00edc k\u010d – pozn. red) a na z\u00e1klad\u011b mnou dodan\u00fdch MRN jim byla vym\u011b\u0159ena z\u00e1loha 80 tis\u00edc (p\u0159es 1,7 milionu K\u010d – pozn. red). Pokud tuto \u010d\u00e1stku slo\u017e\u00ed, bude operace, pokud ne, v Atlant\u011b bude provedena amputace. Pro p\u0159edstavu 80 tis\u00edc dolar\u016f bylo tou dobou ekvivalentem p\u0159ibli\u017en\u011b t\u0159\u00ed ro\u010dn\u00edch plat\u016f. Co v\u0161e museli rodi\u010de prodat a zastavit, si nedovedu p\u0159edstavit. L\u00e9\u010dba nav\u00edc zahrnovala pouze operaci a dva dny hospitalizace. Pot\u00e9 si rodina musela platit hotelov\u00fd pokoj p\u0159es ulici od nemocnice, kam byla hol\u010di\u010dka po operaci je\u0161t\u011b s dr\u00e9ny p\u0159esunuta. Do doby, ne\u017e byla schopna transportu zp\u011bt do Atlanty, pak chodili pouze na ambulantn\u00ed o\u0161et\u0159en\u00ed.<\/p>\n\n\n\n

MUDr. Jan Lesensk\u00fd <\/strong>je vedouc\u00ed centra a chirurgick\u00e9 \u010d\u00e1sti onkologick\u00e9 ortopedie FN Bulovka. Na ortopedickou kliniku na Bulovce nastoupil v l\u00e9t\u011b roku 2006 jako absolvent 1.LF UK. Onkologick\u00e9 ortopedii se v\u011bnuje od roku 2008.<\/p>\n","protected":false},"excerpt":{"rendered":"

Fakultn\u00ed nemocnice Bulovka je s nejv\u011bt\u0161\u00edm Komplexn\u00edm onkologick\u00fdm centrem v \u010cR l\u00eddrem v boji s rakovinou. Disponuje mnoha specializovan\u00fdmi pracovi\u0161ti, mezi kter\u00e9 pat\u0159\u00ed tak\u00e9 Komplexn\u00ed centrum pro l\u00e9\u010dbu […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":39133,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,11],"tags":[],"class_list":["post-39131","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-rozhovory","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/39131","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=39131"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/39131\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/39133"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=39131"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=39131"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=39131"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}