Therapeutic learning as an organizational technology of tomorrow

BACKGROUND: According to the World Health Organization, global population aging is the main trend in the development of the society on the planet. Russia ranks 116^th worldwide in terms of life expectancy. The development and implementation of measures aimed at preserving the able-bodied population of the country and slowing down the current trend of aging of the population with a focus on increasing life expectancy is manifested in national projects such as Health and Demography. Health-saving technologies for prolonging effective professional longevity of medical workers of older age groups will preserve a labor resource of the country and exclude economic losses of the state.

AIM: The study aimed to determine the significance of individual risk factors affecting the professional effective longevity of physicians and form a set of measures to prolong the professional competence of physicians of older age groups.

METHODS: In this study, the unit of observation is a physician providing medical care in the outpatient segment of Moscow and the Moscow region. The total number of subjects was 378. Sociological, analytical, and statistical methods and the method of organizational modeling were used. The main method was a face-to-face survey that included questionnaire data, questions on training, seniority, category, workload, and information assurance, and two blocks of questions to assess professional competencies and cognitive functions.

RESULTS:

1. An age-related decrease in the level of the physician’s professional competence.
2. An age-related decrease in the effectiveness of the prescribed treatment.
3. A tendency toward an age-related increase in the proportion of cognitive disorders among physicians.
4. Data analysis showing the need to implement a set of measures aimed at supporting the professional effective longevity of physicians of older age groups.

CONCLUSIONS: The organizational technology represented by a complex of measures providing prolongation of professional effective longevity of physicians of older age groups was proposed. Essentially, the organizational technology is the prevention of chronic non-infectious diseases in conjunction with measures to optimize work activities and stimulate the professional competence of the physician. Therapeutic Learning Technology is a parallel annual dispensary examination of physicians of older age groups followed by a therapeutic and rehabilitation course based on the morbidity profile and combined with a cycle of continuing medical education. The therapeutic and rehabilitative course should include older physicians undergoing cognitive training and hemodynamic stabilization. Information support (a block of federally approved training materials, i.e. normative legal acts regulating medical activity, clinical guidelines, video manuals on schools for different categories of patients, and other materials) is placed at the geriatric contact center, providing each physician from the target group with prompt access both for the period of treatment and rehabilitation course and the entire period of the physician’s medical activity.