V\u011bc: Otev\u0159en\u00fd dopis Mlad\u00fdch praktik\u016f ministrovi zdravotnictv\u00ed \u010cR Vlastimilovi V\u00e1lkovi a ministrovi financ\u00ed \u010cR Zby\u0148kovi Stanjurovi<\/p>\n\n\n\n
V\u00e1\u017een\u00ed p\u00e1nov\u00e9 minist\u0159i, <\/p>\n\n\n\n
my Mlad\u00ed praktici se na V\u00e1s obrac\u00edme s nal\u00e9havou prosbou o vy\u0159e\u0161en\u00ed dlouhodob\u00e9ho probl\u00e9mu nedostate\u010dn\u00e9ho po\u010dtu reziden\u010dn\u00edch m\u00edst i v\u00fd\u0161e dotace pro specializa\u010dn\u00ed vzd\u011bl\u00e1v\u00e1n\u00ed v\u0161eobecn\u00fdch praktick\u00fdch l\u00e9ka\u0159\u016f. Vd\u011b\u010dn\u011b a s \u00falevou jsme kvitovali nav\u00fd\u0161en\u00ed po\u010dtu reziden\u010dn\u00edch m\u00edst (d\u00e1le RM) i v\u00fd\u0161e dotace v roce 2023. O to v\u011bt\u0161\u00ed bylo na\u0161e zklam\u00e1n\u00ed, \u017ee na roky 2024 a 2025 byl po\u010det stejn\u00fd a v\u00fd\u0161e dotace dokonce ni\u017e\u0161\u00ed! Sou\u010dasn\u00fd nedostatek praktick\u00fdch l\u00e9ka\u0159\u016f snad je\u0161t\u011b nen\u00ed kritick\u00fd. Pokud ale nedojde k razantn\u00ed zm\u011bn\u011b, b\u011bhem n\u011bkolika let kritick\u00fd bude. Pro\u010d tomu tak je vizte n\u00ed\u017ee. <\/p>\n\n\n\n
Ka\u017edoro\u010dn\u011b v \u010cesk\u00e9 republice atestuje v\u00edce ne\u017e 200 praktick\u00fdch l\u00e9ka\u0159\u016f. V minul\u00fdch letech byl v\u0161ak z\u00e1jem o obor je\u0161t\u011b mnohem vy\u0161\u0161\u00ed. Jak ze strany \u0161kolitel\u016f, tak z\u00e1jemc\u016f o obor p\u0159evy\u0161oval po\u010det 300 l\u00e9ka\u0159\u016f! V\u00e1mi dlouhodob\u011b nab\u00edzen\u00fd po\u010det RM 140 slovy sto \u010dty\u0159icet, tedy ani ne polovina potenci\u00e1lu.<\/p>\n\n\n\n
D\u00edky propracovan\u00e9mu syst\u00e9mu akredita\u010dn\u00ed komise se navzdory rigidn\u00edm podm\u00ednk\u00e1m p\u0159id\u011blov\u00e1n\u00ed reziden\u010dn\u00edch m\u00edst t\u00e9m\u011b\u0159 v\u0161echna ka\u017edoro\u010dn\u011b rozm\u00edst\u00ed po cel\u00e9 \u010cR. Hl\u00edd\u00e1 tak\u00e9 vysokou kvalitu vzd\u011bl\u00e1v\u00e1n\u00ed i atestac\u00ed. L\u00e9ka\u0159i, kte\u0159\u00ed se vzd\u011bl\u00e1vaj\u00ed jinou cestou (bez RM), pak tuto kvalitu nemohou m\u00edt jakkoliv kontrolovanou. Proto pova\u017eujeme za nutn\u00e9, aby co nejv\u00edce l\u00e9ka\u0159\u016f z\u00edskalo svou specializaci cestou reziden\u010dn\u00edch m\u00edst. Za dostate\u010dn\u00fd bychom pova\u017eovali po\u010det 200 RM\/rok. <\/p>\n\n\n\n
Toto nav\u00fd\u0161en\u00ed by st\u00e1tn\u00ed rozpo\u010det vy\u0161lo na cca 36 milion\u016f K\u010d. Dovolte n\u00e1m zopakovat z\u00e1kladn\u00ed argumenty pro nav\u00fd\u0161en\u00ed po\u010dtu v\u0161eobecn\u00fdch praktick\u00fdch l\u00e9ka\u0159\u016f: <\/p>\n\n\n\n
1) Demografick\u00e1 k\u0159ivka populace \u010cesk\u00e9 republiky
Jasn\u011b se ukazuje, \u017ee bude p\u0159ib\u00fdvat senior\u016f a z\u00e1rove\u0148 ub\u00fdvat mlad\u00fdch aktivn\u011b pracuj\u00edc\u00edch osob. Bude p\u0159ib\u00fdvat pacient\u016f, kte\u0159\u00ed dlouho \u017eij\u00ed s chronick\u00fdm onemocn\u011bn\u00edm. Z\u00e1rove\u0148 p\u0159ib\u00fdv\u00e1 po\u010det screeningov\u00fdch a preventivn\u00edch program\u016f. Bez siln\u00e9 prim\u00e1rn\u00ed p\u00e9\u010de v tomto nepom\u011bru neexistuje zp\u016fsob, jak v budoucnu zajistit odpov\u00eddaj\u00edc\u00ed zdravotn\u00ed p\u00e9\u010di. Ji\u017e dnes se praktick\u00fdch l\u00e9ka\u0159\u016f nedost\u00e1v\u00e1 a probl\u00e9m bude eskalovat.
<\/p>\n\n\n\n
2) Demografick\u00e1 k\u0159ivka praktick\u00fdch l\u00e9ka\u0159\u016f
Pr\u016fm\u011brn\u00fd v\u011bk praktick\u00e9ho l\u00e9ka\u0159e je 55 let. 42 % praktick\u00fdch l\u00e9ka\u0159\u016f je star\u0161\u00edch 60 let a nejv\u011bt\u0161\u00ed peak na demografick\u00e9 k\u0159ivce VPL je ve v\u011bku 65-69 (cca 20%). Viz p\u0159\u00edloha \u010d. 1 (aktu\u00e1ln\u00ed data \u00daZIS). D\u00e1 se tedy p\u0159edpokl\u00e1dat, \u017ee v p\u0159\u00ed\u0161t\u00edch deseti a\u017e patn\u00e1cti letech mus\u00edme nahradit v\u00edce ne\u017e 2600 praktick\u00fdch l\u00e9ka\u0159\u016f v d\u016fchodov\u00e9m v\u011bku. V tomto m\u011bs\u00edci zrovna promuje prvn\u00ed pos\u00edlen\u00fd ro\u010dn\u00edk na l\u00e9ka\u0159sk\u00fdch fakult\u00e1ch. Je ostudn\u00e9, \u017ee se st\u00e1tu nepoda\u0159ilo t\u00e9to p\u0159\u00edle\u017eitosti vyu\u017e\u00edt, nebo\u0165 z\u00e1jem o obor VPL je mezi mediky vysok\u00fd.<\/p>\n\n\n\n
3) Prakti\u010dt\u00ed l\u00e9ka\u0159i pro d\u011bti a dorost
PLDD je kruci\u00e1ln\u00ed nedostatek ji\u017e nyn\u00ed. Situace se bude velmi rychle zhor\u0161ovat, nebo\u0165 po\u010det t\u011bchto nezastupiteln\u00fdch specialist\u016f nad 60 let ji\u017e p\u0159es\u00e1hl 50%! V budoucnu je nebude m\u00edt kdo nahradit, proto\u017ee po\u010det mlad\u00fdch PLDD neust\u00e1le kles\u00e1. Pot\u0159ebou registrovat mladistv\u00e9 od \u010dtrn\u00e1cti let tak vznik\u00e1 stup\u0148uj\u00edc\u00ed se tlak i na n\u00e1s.
4) Trendy u mlad\u00fdch l\u00e9ka\u0159\u016f
Z dotazn\u00edkov\u00e9ho pr\u016fzkumu mezi mlad\u00fdmi praktick\u00fdmi l\u00e9ka\u0159i v letech 2018 a 2022 jasn\u011b vyplynulo vysok\u00e9 procento \u017een mezi PL. Rodi\u010dovsk\u00e1 dovolen\u00e1, v\u00edtan\u00fd trend sn\u00ed\u017een\u00fdch \u00favazk\u016f (i mezi mu\u017ei) a dal\u0161\u00ed faktory pak op\u011bt znamenaj\u00ed pot\u0159ebu v\u011bt\u0161\u00edho po\u010dtu praktick\u00fdch l\u00e9ka\u0159\u016f.
5) P\u0159esun p\u00e9\u010de do sektoru prim\u00e1rn\u00ed p\u00e9\u010de <\/p>\n\n\n\n
\u010c\u00edm d\u00e1l t\u00edm v\u00edce p\u00e9\u010de je na\u0161im ob\u010dan\u016fm poskytov\u00e1no v sektoru prim\u00e1rn\u00ed p\u00e9\u010de. Roz\u0161i\u0159uj\u00ed se kompetence VPL, mnohem v\u00edce pacient\u016f je dispenzarizov\u00e1no v na\u0161ich ordinac\u00edch, doch\u00e1z\u00ed ke zkracov\u00e1n\u00ed hospitalizac\u00ed. Jedn\u00e1 se o modern\u00ed trend, kter\u00fd vid\u00edme ve v\u0161ech z\u00e1padn\u00edch zem\u00edch a p\u0159edstavuje jedinou cestu, jak poskytovat populaci modern\u00ed zdravotnictv\u00ed 21. stolet\u00ed. Vy\u017eaduje v\u0161ak v\u011bt\u0161\u00ed po\u010det praktick\u00fdch l\u00e9ka\u0159\u016f. <\/p>\n\n\n\n
Pro\u010d je nutnost reziden\u010dn\u00edch m\u00edst specifick\u00e1 u praktick\u00fdch l\u00e9ka\u0159\u016f?
V ostatn\u00edch specializa\u010dn\u00edch oborech vzd\u011bl\u00e1v\u00e1n\u00ed prob\u00edh\u00e1 p\u0159edev\u0161\u00edm v nemocnic\u00edch, kter\u00e9 si mohou dovolit zam\u011bstnat l\u00e9ka\u0159e v p\u0159edatesta\u010dn\u00ed p\u0159\u00edprav\u011b, i kdy\u017e men\u0161\u00ed \u010d\u00e1st vzd\u011bl\u00e1v\u00e1n\u00ed absolvuje mimo toto pracovi\u0161t\u011b. U soukrom\u00fdch praktick\u00fdch l\u00e9ka\u0159\u016f v\u0161ak varianta bez reziden\u010dn\u00edho m\u00edsta ned\u00e1v\u00e1 ekonomick\u00fd smysl, nebo\u0165 \u0161kolenec str\u00e1v\u00ed cca polovinu vzd\u011bl\u00e1v\u00e1n\u00ed mimo ordinaci na st\u00e1\u017e\u00edch a \u0161kolen\u00edch. A co je nejv\u011bt\u0161\u00edm paradoxem \u2013 za tyto st\u00e1\u017ee je\u0161t\u011b plat\u00ed, a\u010dkoliv zde obvykle alespo\u0148 \u010d\u00e1ste\u010dn\u011b vykon\u00e1v\u00e1 pr\u00e1ci l\u00e9ka\u0159e. A to i ve st\u00e1tem \u0159\u00edzen\u00fdch nemocnic\u00edch! Mlad\u00ed l\u00e9ka\u0159i, kte\u0159\u00ed sdru\u017euj\u00ed l\u00e9ka\u0159e v\u0161ech specializac\u00ed, p\u0159ed n\u011bkolika lety sami nab\u00edzeli variantu zru\u0161en\u00ed RM v\u0161em specializa\u010dn\u00edm obor\u016fm a p\u0159esun t\u011bchto dotac\u00ed do obor\u016f VPL a PLDD. U ostatn\u00edch obor\u016f toti\u017e obvykle skon\u010d\u00ed v rozpo\u010dtu nemocnice a \u0161kolenec ani jeho \u0161kolitel z nich zpravidla \u201enevid\u00ed nic\u201c a jedn\u00e1 se tedy o extr\u00e9mn\u011b ne\u00fa\u010deln\u011b vyu\u017eit\u00e9 finance. U praktick\u00fdch l\u00e9ka\u0159\u016f je dost\u00e1v\u00e1 p\u0159\u00edmo \u0161kolitel, a\u010d jemu ze sou\u010dasn\u00e9 dotace kv\u016fli jej\u00ed minim\u00e1ln\u00ed v\u00fd\u0161i a podm\u00ednk\u00e1m vyu\u017eit\u00ed nez\u016fstane bu\u010f nic, nebo na sv\u00e9ho \u0161kolitele je\u0161t\u011b m\u00edrn\u011b dopl\u00e1c\u00ed. V\u00fd\u0161e dotace nav\u00edc nyn\u00ed \u0161kolenci vysta\u010d\u00ed jen na minim\u00e1ln\u00ed mzdu. Oproti tabulkov\u00e9mu platu absolvent\u016f (i bez jak\u00fdchkoliv slu\u017eeb), kte\u0159\u00ed nastupuj\u00ed do nemocnic, m\u00e1 rezident u VPL cca o t\u0159etinu ni\u017e\u0161\u00ed p\u0159\u00edjem. T\u00edm hazardujeme s v\u016fl\u00ed absolvent\u016f vstoupit do oboru VPL, i kdy\u017e o n\u011bj maj\u00ed z\u00e1jem. Proto navrhujeme nejen nav\u00fd\u0161en\u00ed po\u010dtu RM, ale i v\u00fd\u0161e dotace (alespo\u0148 o 25%, ide\u00e1ln\u011b dorovnat p\u0159\u00edjem). To by st\u00e1tn\u00ed rozpo\u010det vy\u0161lo cca na 20 milion\u016f K\u010d.
<\/p>\n\n\n\n
My Mlad\u00ed praktici ve spolupr\u00e1ci se SVL, SPL a katedrou VPL IPVZ se sna\u017e\u00edme d\u011blat maximum pro zatraktivn\u011bn\u00ed na\u0161eho oboru. Nam\u00e1tkou: v posledn\u00edch letech jsme spustili interaktivn\u00ed web Mladipraktici.cz, kter\u00fd pom\u00e1h\u00e1 s orientac\u00ed ve specializa\u010dn\u00edm vzd\u011bl\u00e1v\u00e1n\u00ed a jeho administrativ\u011b, jako\u017e i v cel\u00e9m oboru v\u0161eobecn\u00e9 praktick\u00e9 l\u00e9ka\u0159stv\u00ed. Pr\u00e1v\u011b vznikaj\u00edc\u00ed aplikace Administr\u00e1tor pro elektronizaci vzd\u011bl\u00e1v\u00e1n\u00ed z n\u011bj hned v n\u011bkolika bodech \u010derp\u00e1 inspiraci. Pom\u00e1h\u00e1 p\u0159i v\u00fdb\u011bru i hodnocen\u00ed kvality \u0161kolitele. P\u0159ipravili jsme mapu \u0161kolitel\u016f v na\u0161em oboru, aby byl v\u00fdb\u011br \u0161kolitele p\u0159ehledn\u011bj\u0161\u00ed ne\u017e tabulka na str\u00e1nk\u00e1ch ministerstva zdravotnictv\u00ed. Prob\u00edhaj\u00ed n\u00e1borov\u00e9 akce na v\u0161ech \u010desk\u00fdch l\u00e9ka\u0159sk\u00fdch fakult\u00e1ch a konferenc\u00edch (nap\u0159. Medidays Mlad\u00fdch l\u00e9ka\u0159\u016f). \u00da\u010dastn\u00edme se pracovn\u00edch veletrh\u016f. Po\u0159\u00e1d\u00e1me vlastn\u00ed konferenci s \u00fa\u010dast\u00ed sou\u010dasn\u00fdch i budouc\u00edch praktick\u00fdch l\u00e9ka\u0159\u016f.
<\/p>\n\n\n\n
Mus\u00edme bohu\u017eel konstatovat, \u017ee z Ministerstva zdravotnictv\u00ed (pota\u017emo financ\u00ed, nebo\u0165 agenda reziden\u010dn\u00edch m\u00edst se t\u00fdk\u00e1 v\u00e1s obou) nec\u00edt\u00edme dostate\u010dnou podporu. V\u00fd\u0161e zm\u00edn\u011bn\u00e9
sn\u00ed\u017een\u00ed v\u00fd\u0161e dotace na RM v letech 2024 a 2025 je absurdn\u00edm mrh\u00e1n\u00edm vysok\u00fdm potenci\u00e1lem v situaci, kdy si to nem\u016f\u017eeme dovolit.
V\u00e1\u017een\u00ed p\u00e1ni minist\u0159i. Nav\u00fd\u0161en\u00ed po\u010dtu reziden\u010dn\u00edch m\u00edst i v\u00fd\u0161e dotace bylo jasn\u00fdm z\u00e1v\u011brem i kulat\u00e9ho stolu u prezidenta republiky a prvn\u00ed d\u00e1my v listopadu 2024. Shodli se na jeho nutnosti v podstat\u011b v\u0161ichni p\u0159\u00edtomn\u00ed odborn\u00edci na toto t\u00e9ma. Jedn\u00e1 se o investici v \u0159\u00e1du des\u00edtek milion\u016f K\u010d, kter\u00e1 dok\u00e1\u017ee zm\u011bnit s\u00edlu prim\u00e1rn\u00ed p\u00e9\u010de a t\u00edm zdrav\u00ed cel\u00e9 populace na mnoho let. Bohu\u017eel ji\u017e pr\u00fd bylo pozd\u011b v\u00fd\u0161i RM na rok 2025 zm\u011bnit. Oz\u00fdv\u00e1me se tedy nyn\u00ed, abychom tuto situaci zm\u011bnili alespo\u0148 od roku 2026.
Shrnut\u00ed:
Jsme v situaci, kdy jasn\u011b pot\u0159ebujeme zv\u00fd\u0161it po\u010det atestuj\u00edc\u00edch praktick\u00fdch l\u00e9ka\u0159\u016f. M\u00e1me vysok\u00fd po\u010det z\u00e1jemc\u016f o obor u letos poprv\u00e9 nav\u00fd\u0161en\u00e9ho po\u010dtu absolvent\u016f l\u00e9ka\u0159sk\u00fdch fakult. M\u00e1me mnoho z\u00e1jemc\u016f o \u0161kolen\u00ed t\u011bchto l\u00e9ka\u0159\u016f zku\u0161en\u00fdmi a prov\u011b\u0159en\u00fdmi praktick\u00fdmi l\u00e9ka\u0159i. M\u00e1me robustn\u00ed syst\u00e9m kontroly kvality vzd\u011bl\u00e1v\u00e1n\u00ed. Na\u0161i \u0161kolenci maj\u00ed k dispozici syst\u00e9m pro pomoc s administrativou, kter\u00e1 se ke vzd\u011bl\u00e1v\u00e1n\u00ed v\u00e1\u017ee. Jedin\u00fd, kdo je\u0161t\u011b zaost\u00e1v\u00e1 za t\u00edmto trendem je v\u00e1mi \u0159\u00edzen\u00fd rigidn\u00ed st\u00e1tn\u00ed apar\u00e1t v podob\u011b reziden\u010dn\u00edch m\u00edst. Vzhledem k tomu, \u017ee se jedn\u00e1 o problematiku va\u0161ich dvou resort\u016f, poj\u010fme spole\u010dn\u011b naj\u00edt cestu nav\u00fd\u0161en\u00ed RM a t\u00edm k zaji\u0161t\u011bn\u00ed siln\u00e9 a kvalitn\u00ed prim\u00e1rn\u00ed p\u00e9\u010de v \u010cR.
Za Mlad\u00e9 praktiky
MUDr. Vojt\u011bch Mucha, p\u0159edseda spolku
MUDr. Marika Svato\u0161ov\u00e1, m\u00edstop\u0159edsedkyn\u011b spolku
MUDr. Michaela Kantorov\u00e1
MUDr. Min Krofotv\u00e1 Kim
MUDr. S\u00e1ra Ferby<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n\n\n\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
V\u011bc: Otev\u0159en\u00fd dopis Mlad\u00fdch praktik\u016f ministrovi zdravotnictv\u00ed \u010cR Vlastimilovi V\u00e1lkovi a ministrovi financ\u00ed \u010cR Zby\u0148kovi Stanjurovi V\u00e1\u017een\u00ed p\u00e1nov\u00e9 minist\u0159i, my Mlad\u00ed praktici se na V\u00e1s […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":22174,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-57918","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nazory"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/57918","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=57918"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/57918\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/22174"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=57918"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=57918"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=57918"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}