Annual salary increase for physicians. Salaries of doctors in Russia. Government plans to increase the salaries of Russian doctors
Launched in 2011, the Healthcare Modernization Program aimed, among other things, to increase the salaries of medical workers up to 200% of the average for the respective region. For this, the concept of “stimulating payments to health workers” was introduced.
Who is entitled to incentive payments in 2020
The above program fundamentally changed the payroll system for both doctors and nurses.
However, not all health care workers have been affected by it.
- Stimulants are not allowed:
Enterprise administration. Managers may be an exception to the rule if they are in the practice of medicine. - Physicians who fall under the Health program, and more specifically:
involved in providing assistance during childbirth, while caring for babies;
pediatricians, district therapists, family doctors, junior staff working with them in tandem. - Professionals providing high-tech assistance.
The payment of incentives to physicians should contribute to the revitalization of their activities, to improve the level of service for the population. More money for those who help people better!
Incentive payments are accrued only to those employees who have a certificate of the established form in the main working specialty.
Documentary base of the Program
Federal legislation generally regulates the remuneration of state employees, including medical workers.
In Art. 129 of the Labor Code of the Russian Federation indicates the following types of charges:
- basic, otherwise referred to as basic;
- compensation depending on the specifics of the region;
- stimulating;
- social.
The first, the main part is necessarily paid to everyone without exception. The second paragraph indicates accruals that depend on specific working conditions. They vary by region. Incentive payments to doctors, which are of interest to us, are calculated based on an assessment of the effectiveness of the work of doctors and nurses.
The basic legal act on which the administration of a medical institution relies is the Regulation on the establishment of wage systems for employees of federal budgetary, autonomous and state-owned institutions, approved by Decree of the Government of the Russian Federation of August 05, 2008 No. 583 (hereinafter referred to as the Regulation).
This paper says that all parts of the income, except for stimulating medicine workers, are strictly regulated by central and regional legislative acts. But stimulants are at the mercy of the medical institution.
The administration of the enterprise is obliged to issue a document regulating incentive payments to health care workers, then familiarize the workers with its content!
Where incentive criteria are developed
On the basis of clause 6 of the above resolution of the Ministry of Health and Social Development, recommendations were developed and sent to all institutions, which are mandatory for implementation when developing internal documents. Guided by this paper, each organization approves its own Regulation on incentive payments to medical workers. In addition, relevant acts are issued at the regional level.
Ask the administration of the medical institution the content of the above document in order to understand exactly how the accruals are made.
Union control
This format is called a tripartite commission, in which employers also take part. It meets annually, therefore, it also provides recommendations to the administrations of medical institutions once a year.
And this means that the Regulation on the stimulation of labor with money should also be approved locally only for the specified period.
It reflects the following points:
- sources of financing from which incentives will be paid (a special fund is created at the enterprise);
- categories of specialists subject to the Regulations;
- specific accrual scheme with division into funding from: means compulsory insurance and money received from business activities;
- criteria for the effectiveness of the work of physicians.
Accrual nuances
Order of the Ministry of Health and Social Development dated December 29, 2007 No. 818 “On approval of the list of types of incentive payments ...” contains a number of specific factors to be encouraged, namely:
- duration and continuity of experience;
- results of work;
- achievements associated with the intensity of activity;
- the quality of labor.
The first two criteria are usually understood unambiguously, they are quantitative indicators. But in order to assess the level of efficiency, quality, intensity and effectiveness, we had to create a special methodology. The Ministry of Health, by order No. 421 dated June 28, 2013, proposed to regional departments a list of performance indicators that should be taken into account when addressing incentive issues described in the Guidelines.
According to this document, the factors characterizing the efficiency of the work of physicians are:
- how many ailments in his profile the doctor revealed at an early and advanced stage;
- how many misdiagnosis he made;
- whether there were cases of untimely hospitalization;
- how many complications were revealed after operations (other manipulations with the body);
- complaints and complaints from customers;
- errors and inaccuracies in the maintenance of documents;
- unsanitary conditions;
- other.
The commission specially created in the organization carries out an assessment of efficiency. On a monthly basis, this body issues a special expert evaluation Act, which is the basis for an order on incentives.
The above criteria must be described in the Regulation on the remuneration of the enterprise. The Ministry of Health of the region is obliged to establish in its document the minimum value of each of the listed factors.
If at the end of the year it turns out that the hospital has unused funds under the Program, they can be paid to doctors (annual bonus).
How does combination and substitution affect the amount of stimulating
Health workers often have to work for an a priori absent or temporarily comrade. This does not always lead to higher wages.
Part-time employees will be credited with incentives only if their additional duties are properly executed, that is employment contract. Doctors who replace their fellow vacationers can also be paid extra. But this type of combination should be formalized by an additional agreement.
The combination of positions under the main contract is not subject to additional incentives.
Deprivation of stimulants
To whom to pay, and when to refuse, the head of the organization decides. The law does not stipulate the obligation to accrue incentives to physicians, which implies a hypothetical probability of being deprived of this part of the salary.
This requires a serious reason, for example, minuses on all of the above criteria (the doctor did nothing) or a gross violation of labor discipline.
If you are faced with a refusal to accrue any part of the salary, demand an order from the management on the basis of which the accountant acted. Look for reasons in this paper. Only after studying them is it worth making a decision to file a complaint.
Last changes
In connection with the work on the implementation of the so-called May Decrees of the President of the Russian Federation (dated 2012), in 2017 there was a serious redistribution of funding for the parts that make up the salaries of doctors. There is a decrease in incentives for physicians throughout Russia.
Reduction of the size of incentive payments occurs in two ways.
In the first case, referring to the need to comply with federal legislation, they increased the base part of the salary. At the same time, some types of incentives were cut or completely canceled.
In the second case, they reduced payments that are not regulated by state regulations. This mainly affected rewards for the quality and intensity of work.
Since the end of 2018, the procedure for calculating and the amount of insurance premiums for compulsory medical insurance of the non-working population has changed, including in terms of the increase in the cost of medical services. An increase in such indicators should also entail a corresponding increase in the remuneration of medical workers, calculated based on the number of citizens served with this type of CHI. However, only practice will show whether the remuneration of medical workers will actually change or whether this is another castling within the framework of the FFOMS budget.
In 2020, the redistribution of funds will continue in order to equalize the wages of state employees. The remuneration of medical workers should be brought in accordance with the average salary in the region as a whole.
The increase planned for junior medical staff by 4.3% in 2019, by 3.8% in 2020 and by 3.4% in 2021 actually indexes wages to inflation.
Medical workers perform titanic work every day: their profession is one of the most important and responsible in life, and therefore such people deserve good salaries. It would be fair if, from September 1, 2018, their salaries will be increased.
Alas, the work of medical workers in state institutions is valued less than those who work in private clinics. The Russian government has repeatedly stated that medicine will soon become a prestigious field of activity. Doctors have been waiting for a salary increase since the beginning of the year.
Medical workers are promised a pay increase from September 1
In the last days of June, the government, the Kremlin, and regional authorities were instructed by Vladimir Putin to do everything possible to increase the wages of public sector workers. However, it is difficult to count on an increase on days when the economy is weak, inflation is high, and wages are low. About 5,000,000 Russian citizens have a salary at the minimum wage level.
According to Andrei Vorobyov, the governor of the Moscow region, from September 1, doctors plan to increase the salaries of doctors by 15%. Nursing staff will also earn more.
At the moment, the salary of a medical worker consists of:
- salary;
- additional charges (for workload, complexity of work, intensity);
- allowances (length of service, category);
- compensation.
It is the salary that will grow, and the rest, a more significant part of the salary, will be bonuses with compensations with additional payments.
If we take into account the data of Rosstat, then the situation with the level of wages is as follows:
- According to the results of the first half of 2018, the average salary of medical personnel amounted to 52,900 rubles, which is 4,000 rubles more compared to the previous year.
- Intermediate-level specialists receive 29,400 rubles (in 2017 - 28,000 rubles), junior - 19,400 rubles (in 2017 - 17,500 rubles), according to Rosstat.
- Doctors in the Northwestern Federal District receive 66,400 rubles, in the Nenets Autonomous Okrug - 130,100 rubles, in the Far Eastern Federal District and Chukotka - 144,100 rubles.
- The lowest salaries are for doctors in Alanya - 28,400 rubles, Kalmykia - 29,900 rubles.
- Moscow doctors earn 90,100 rubles.
The doctor is a highly demanded profession in the territory. Russian Federation. All over the world, representatives of the medical industry are highly valued and receive a lot of money for their work. But, unfortunately, the same cannot be said about Russia. Despite the prestige of the profession, the salaries of doctors in this state leave much to be desired. According to statistics, 20% of doctors in the Russian Federation receive a decent salary for such a responsible profession.
The difference in the salaries of medical workers in different cities of the Russian Federation
The table below shows the average salary of doctors by regions of the Russian Federation, as well as by districts. The data is taken from the official website.
Table: average salary of doctors in the regions of the Russian Federation in 2019
| Name of the subject of the Russian Federation | Average salary in thousand rubles |
| Belgorod region | 57,974 |
| Bryansk region | 50,307 |
| Vladimir region | 57,405 |
| Voronezh region | 57,910 |
| Ivanovo region | 46,869 |
| Kaluga region | 67,121 |
| Kostroma region | 50,269 |
| Kursk region | 54,435 |
| Lipetsk region | 56,993 |
| Moscow region | 96,240 |
| Oryol Region | 49,034 |
| Ryazan Oblast | 56,422 |
| Smolensk region | 53,605 |
| Tambov Region | 51,145 |
| Tver region | 53,891 |
| Tula region | 63,647 |
| Yaroslavl region | 59,192 |
| Moscow city | 139,152 |
| Republic of Karelia | 73,975 |
| Komi Republic | 93,503 |
| Nenets aut. county | 164,433 |
| Arhangelsk region | 79,734 |
| Vologodskaya Oblast | 65,715 |
| Kaliningrad region | 64,122 |
| Leningrad region | 83,002 |
| Murmansk region | 95,340 |
| Novgorod region | 55,200 |
| Pskov region | 50,817 |
| Saint Petersburg | 105,521 |
| Republic of Adygea | 48,634 |
| Republic of Kalmykia | 45,618 |
| Republic of Crimea | 53,779 |
| Krasnodar region | 59,177 |
| Astrakhan region | 57,435 |
| Volgograd region | 56,287 |
| Rostov region | 55,744 |
| Sevastopol | 57,526 |
| The Republic of Dagestan | 44,371 |
| The Republic of Ingushetia | 43,434 |
| Kabardino-Balkarian Republic | 44,348 |
| Karachay-Cherkess Republic | 44,460 |
| Republic of North Ossetia - Alania | 43,876 |
| Chechen Republic | 49,271 |
| Stavropol region | 51,892 |
| Republic of Bashkortostan | 63,427 |
| Mari El Republic | 50,201 |
| The Republic of Mordovia | 49,305 |
| Republic of Tatarstan (Tatarstan) | 63,977 |
| Udmurt republic | 58,543 |
| Chuvash Republic - Chuvashia | 53,521 |
| Perm region | 61,119 |
| Kirov region | 51,310 |
| Nizhny Novgorod Region | 59,819 |
| Orenburg region | 58,054 |
| Penza region | 55,839 |
| Samara Region | 57,869 |
| Saratov region | 49,574 |
| Ulyanovsk region | 49,089 |
| Kurgan region | 57,122 |
| Sverdlovsk region | 72,665 |
| Khanty-Mansiysk Aut. Okrug-Yugra | 129,508 |
| Yamalo-Nenets Aut. county | 182,651 |
| Tyumen region without author. constituencies | 89,888 |
| Chelyabinsk region | 66,289 |
| Altai Republic | 56,417 |
| Tyva Republic | 62,462 |
| The Republic of Khakassia | 63,855 |
| Altai region | 47,621 |
| Krasnoyarsk region | 80,073 |
| Irkutsk region | 77,085 |
| Kemerovo region | 63,897 |
| Novosibirsk region | 70,148 |
| Omsk region | 59,986 |
| Tomsk region | 71,246 |
| The Republic of Buryatia | 65,038 |
| The Republic of Sakha (Yakutia) | 120,610 |
| Zabaykalsky Krai | 67,993 |
| Kamchatka Krai | 130,631 |
| Primorsky Krai | 76,514 |
| Khabarovsk region | 90,031 |
| Amurskaya Oblast | 79,003 |
| Magadan Region | 144,071 |
| Sakhalin region | 142,406 |
| Jewish Autonomous Region | 71,878 |
| Chukotka Autonomous Okrug | 186,906 |
Salary in different districts of the Russian Federation
According to the districts, the Nenets and Yamalo-Nenets districts are the leaders in terms of the salary of a doctor. The highest salaries are among doctors in Russia in such areas as:
- Leningradskaya.
- Moscow.
- Magadan.
- Chukchi.
- Kamchatka.
If we compare the salaries of doctors by region with the levels of average salaries, then the Altai Republic becomes the leader. Doctors in this republic earn 202.3% more than the average salary in the region. In St. Petersburg, this figure is 137%, while in Moscow this figure is only 18.9%. Therefore, the salary of Moscow doctors can hardly be called high compared to the average monthly income of other professions.
Table: average salary of doctors in Russia by districts in 2019
Analysis of the level of salaries of doctors by specialty
In Russia in 2020, the average salary of doctors is approximately 76.989 thousand rubles.
But even despite this, there is a catastrophic shortage of qualified medical personnel in the Russian Federation. 
Many Russian doctors prefer to leave to work abroad because of more attractive and comfortable conditions labor. The main incentive motivating to move to work in another country is better pay.
For example, you can compare the salary of an anesthesiologist in Russia and the United States of America. In Russia, a doctor in this specialty does not earn more than 69,000 rubles, while a similar specialty in the United States pays about $19,600.
The average salary of doctors for 2020:
- Cosmetologist - 90 thousand rubles.
- Obstetrician-gynecologist - 90.
- Anesthesiologist-resuscitator - 66 thousand.
- Osteopath - 65.
- Neurophysiologist working in public institutions - 62.
- MRI specialist - 60.
- Ship's doctor - 60.
- Homeopathic doctor - 55.
- Dentist - 50.
- Cytologist - 50.
- Children's pediatrician - 47.
- Geriatrician - 46.
- Microbiologist - 45.
- Therapist - 40.
- Physician involved in functional diagnostics - 35.
- Periodontist - 63.
- Urologist - 30.
- Military doctor - 40-50.
site data superjob.ru
Many things in the state are interconnected, and everyone is well aware of how close the relationship is between the level of wages of workers in medical institutions and the quality of the services they provide. Today information about what will be the salary increase for doctors in 2018, is considered especially relevant among the population, because any Russian is worried about his health and wants to receive really high-quality medical services, and without their high payment by the state, this goal cannot be achieved. 
Olga Golodets, when discussing the effect of the "May" presidential decrees, made a sensational statement, saying that from 2018 the income of doctors will increase by 200% compared to the level of 2012. According to her, the money for the implementation of this measure is included in the state budget, and the members of the government have already fixed the decision, therefore, no one plans to change it. Physicians must receive a decent salary, because otherwise they will simply not be able to perform their duties efficiently and effectively, and everyone without exception can suffer from this.
The salaries of people who are employed in the medical field of activity today differ depending on the territorial location of the medical institution in which they are employed. The highest incomes today are for those doctors who work in St. Petersburg and Moscow, but soon the difference between them will narrow, because the increase in salaries in the healthcare system in 2018 in the Russian Federation will occur unevenly, so that all representatives of this profession receive approximately the same amount of money. 
Detailed calculations
Today, the salary of medical workers consists of a salary, additional payments (compensations) and allowances. The Ministry of Health increased the salaries of medical workers (in accordance with the presidential decree), but practice shows that it is precisely due to this that the overall level of wages decreases, because additional payments and compensations become much smaller. Compensations are accrued by the head of the organization on a voluntary basis, respectively, you can lose them for almost any reason.
Think about it What will happen to medical salaries? today it is also due to the fact that the new methodology for assessing working conditions has shown itself in practice from an extremely negative side, because today compensation payments are paid specifically on the basis of an assessment of the workplace, and does not depend on the position occupied by a person. Previously, the position was extremely important and the bonuses were calculated on its basis, so they had a larger size. 
Consequences of wage growth
The price of a rapid increase in wages may be too high, because the country is in crisis and money for recovery financial well-being public employees are sorely lacking. According to experts' forecasts, the salaries of medical workers should rise from the "average" 35,000 rubles to, practically, 50,000 rubles, but if the medical workers are to be believed, they did not perceive much of a difference between their past and present incomes. Moreover, more than 5,000 people from different regions of the country took part in the social issue on this issue, and the bulk of the people surveyed said that their salaries today do not exceed 20,000 rubles.
Only the growth of “black gold” can positively change the current situation, because only these funds can be spent on salary increase for doctors in 2018 in Russia, latest news, however, they are still disappointing on this issue, because oil remains at a consistently low level. Considering the above situation, one cannot but say that it will simply be impossible to increase the real incomes of doctors (in any case, it is realistic, although growth is possible on paper, because such a practice has already been in past years).
With a 100% guarantee, we can only say that it will remain mandatory indexation of doctors' salaries, which in 2018 will correspond to the level of real inflation. The indicative coefficient is determined by the government at 4.5% (tentatively), which will enable the salaries of doctors to grow exactly by the percentage of inflation, and they will not feel the increase in the cost of food and services. There was no talk of additional indexing, which was practiced earlier. 
Doctors perform an incredibly difficult and responsible job. Protecting the health of people is a difficult task that requires adequate remuneration. After all, every person wants to receive a salary equal to the efforts made at work. This is especially true for medical workers, who, before starting to treat people, go through a long period of training and all kinds of low-paid or completely free internships.
Unlike private clinics, public health workers complain not only about inappropriate working conditions, but also about low wages. Domestic doctors are not inferior to foreign ones in knowledge, but wages, as well as the level of respect in society, are many times higher for the latter.
How is the salary of doctors formed?
The government drew attention to the current situation with the salaries of medical workers. Promised in 2019 carrying out large-scale work to popularize the profession, and the salary level should be indexed by 6%.
There are several stages, after which banknotes fall into the hands of a medical worker:
- The standard salary established by the state medical institution. Each physician receives it, the size varies depending on the position held.
- Increases for the complexity of the work performed and the load to be carried. This type is most common in surgeons who spend hours on the operating table. The body is at the limit of its capabilities all this time, so after the operation, doctors need to have a good rest.
- Influence of the category of doctor: second, first and highest. For the latter, the size of the allowance is the most significant.
- Work experience. If a doctor has spent more than ten years in medicine, he is entitled to promotions for long service.
- Inflation compensation. Usually this is a one-time increase in the salary of all categories of employees in the country. It is no more than 5%, depending on the degree of inflation.
- Dependence on the region. Each subject of the Russian Federation has its own economic situation. Somewhere the standard of living will be much higher than in other regions. In such cases, government agencies also set minimum salaries with the expectation that employees can pay for transport, food and other vital needs.
As a rule, when it comes to indexations and raises, this applies only to the first item listed: salary.
Doctors receive the bulk of their income not from salaries, but from bonuses and compensations.
Just these additional payments are very easy not to see at the end of the month. After all, their presence does not depend on the state, but on the desire and capabilities of the immediate head of the institution.
Growth prospects
The salary of employees of the state medical sector in 2019 is calculated as follows:
- for doctors, salaries should be three times higher than the average salary of other workers in the region;
- for junior and middle medical personnel, salaries will be increased by 100% of the average salary in their region, that is, twice.
The Russian government also states that progress has already been made in certain areas on this issue: in 2019 part of state doctors will receive an increase of 200% of their previous salary. This gradually brings the indicators closer to the desired mark.
In the state budget for 2019 there is a column responsible for raising salaries for medical workers. Thus, the government is working not only to increase the prestige of the profession, but also to improve the quality of medical services provided. After all, the better compensation they receive for the time and effort spent, the more comfortable they are to do their job.
Moreover, in many public hospitals and clinics now not enough staff, which leads to significant processing. The increase in appropriations should attract new professionals without having to lay off those already employed.
There was also a comment about uniformity of payments received. It's no secret that salaries in Moscow and St. Petersburg are much higher than salaries in other regions. However, there are sometimes gaps between them. According to the current policy of the authorities, salaries will be equalized to such a level that they correspond to Moscow and St. Petersburg.
The current situation with the remuneration of medical workers
The veracity of government statements is regulated by the real situation in the workplaces of doctors.
Many doctors point out that their real income actually fell, although salaries are, indeed, gradually increasing.
This is due to the above reasons: the main income of physicians is received not from salaries, but from bonuses. Also, many work part-time in an additional position.
Doctors receive compensation for working conditions, overtime, and bonuses. Together with the state requirement to raise salaries, medical institutions did not receive money for this. There was only one way out: the basic salary was increased, and allowances and bonuses were reduced.
Using the position of a therapist as an example, you can see how the salaries of doctors differ from region to region:
- in Moscow, a therapist receives 90,100 rubles a month;
- already in the region, this amount has decreased to 45,000 rubles;
- in Kalmykia, therapists are paid 29,900 rubles;
- The Leningrad region is paid lower than the Moscow region: 40,000 rubles.
The statistics are not really a reliable source. Indeed, when summarizing data for one profession, not only state clinics and hospitals are taken, but also expensive private institutions in which the same therapist receives many times more money. Thus, the real average salary of state employees is even lower.
For comparison, in USA average salary of a therapist in terms of rubles will be 415,000, in Europe - more than 200,000 rubles per month.
As for the younger medical personnel, then their average income is 20,000 rubles. Physicians in certain regions receive slightly more: total 30 000.
A number of regions have also distinguished themselves by the fact that the remuneration of medical workers with full higher education, despite official statements, actually decreased. The least amount of money is received as payment for the performance of their duties in Kalmykia: The average salary of a doctor is 27,000 rubles. Samara, Penza and North Ossetia are not far behind: from 28,400 to 29,900 respectively.
Changes and indexing
Many experts conclude that on the eve of the presidential elections, workers the medical field can really expect a salary increase. The average salary in 2019 is 52,900 rubles.
As a rule, a significant increase in salaries accompanied by a wave of mass layoffs. At the same time, doctors often do not have enough free hands. Although part-time doctors (and this is almost all Russian state doctors) will receive half the money than before.
So far the government cannot name specific dates for salary increases, as well as their new sizes.
In 2019 it happened salary indexation by 6%. This increase only offsets the current rate of inflation.
