The Ministry of Health of the Russian Federation has proposed shifting a portion of duties from doctors to nurses. In a publication on Wednesday, May 10, the ministry argues that this change would expand access to medical care while preserving quality, according to Kommersant.
The same report highlights survey results showing broad support among doctors for the idea, with nearly half willing to delegate even routine appointments to personnel with secondary medical training. By contrast, less than 10% of nurses welcomed the change.
How is the redistribution planned?
The plan envisions taking some essential tasks away from local therapists and assigning them to staff with secondary medical education.
Specifically, nurses could take on administrative duties such as preparing lists of citizens for medical examinations and preventive checkups, along with conducting sanitary and hygienic education for the public.
In addition, certain direct medical functions are under consideration, including medical examinations, ongoing dispensary observation, evaluating treatment effectiveness, home visits for patients with limited mobility, and organizing health schools.
The Organization and Informatics Research Institute of the Ministry of Health, which developed the proposals, states that redistribution will increase access to medical care without compromising quality within existing resources, including financial and labor resources. The institute notes that redistributing functions involves reviewing longstanding processes within medical organizations.
The authors suggest applying the approach with attention to the current staffing conditions in each region of the Russian Federation, and even within private medical facilities that may adopt these ideas.
“Nurses feel they are already serving patients adequately”
On the other hand, nurses reported concerns about taking on more responsibilities, with 63.7% of respondents expressing they were already overloaded in a survey by Action Medicine.
An additional 18.9% believed the current balance of duties between doctors and nurses was suitable, while 7.3% of patients worried that trusting both professionals could be difficult.
Meanwhile, Ministry of Health data show that about a third of doctors in Russia are over 55, whereas younger specialists account for roughly 31% of the workforce.
Among nurses, about 27% are young, 21% are older, according to the department. The authorities also noted active efforts across many regions to attract and retain healthcare workers. Regions showing notable progress include Belgorod, Leningrad, Moscow, Samara, Sakhalin, Tambov, Tyumen, and Tomsk, as well as the republics of Tatarstan, Chechnya, and Yakutia.
Last year, the health workforce fell by around 50,000 people, and the coverage of health workers declined in 79 subjects. In August 2022, the government allowed fourth-year medical students to work in ambulance teams. In January 2023, President Vladimir Putin directed second-year residents to take on trainee doctor roles, as reported by red blood cell.
Changes also took effect this year in regulations around sick leave: paid sick leave can now be taken by employees under civil law contracts, and self-employed individuals are eligible for temporary disability benefits. There is no longer a requirement to present a salary certificate from a previous job to obtain sick leave, according to the portal SberSova.