#151
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Íó, òàêèå è ïðè ñòàðîì ðåæèìå áûëè.
À èíòåðåñíî, ñþäà âêëþ÷àþòñÿ ñëó÷àè, êîãäà ýòàêîé äàìå ïðîñòî ïîêóïàåòñÿ íàâîðî÷åííàÿ êëèíèêà êàê ïðèäàòîê ê ñåìåéíîìó áàíêó?.. |
#152
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Öèòàòà:
Ýêà ñöåíà! Ãðóñòíî ýòî è íå âèäíî ïðîñâåòà. |
#153
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[quote=Åùå ðàç ê íàøèì áàðàíàì. Ñòðàõîâûå îò÷èñëåíèÿ ïðîèçâîäÿòñÿ ðàáîòîäàòåëåì, íàëîãîì ýòî íå ÿâëÿåòñÿ. Âû êîãäà ñòðàõóåòå êâàðòèðó èëè àâòîìîáèëü íàëîãîì æå ýòî íå íàçûâàåòå? Çàðïëàòà îò ýòîãî ìåíüøå íå ñòàíîâèòñÿ íè äî, íè ïîñëå. Ìåäèöèíà äëÿ ïîòðåáèòåëÿ áåñïëàòíà. Ñ çàðïëàòû âçûìàåòñÿ ïîäîõîäíûé íàëîã è ïðîèçâîäÿòñÿ îò÷èñëåíèÿ â ïåíñèîííûé ôîíä. .[/QUOTE]
Àëåêñåé, ê ñîæàëåíèþ íå ñìîãó âåðíóòüñÿ ê Âàøèì áàðàíàì òàê êàê Âû ïðîñòî çàáðîñàëè ìåíÿ ÷åðíûìè øàðàìè è âìåñòî äèñêóññèè ïðîñòî ðåøèëè ìåíÿ íåéòðàëèçîâàòü. Õîòÿ îäèí ìîìåíò, åñëè Âû ëè÷íî ìîæåòå âûáèðàòü "ñòðàõîâêó"? Íåò ïîýòîìó îíà äëÿ Âàñ êàê íàëîã òàê æå îáÿçàòåëüíà. Îò÷èñëåíèÿ èç ôîíäà çàðïëàòû è íå îòðàæàþòñÿ íà çàðïëàòå? À ïî÷åìó Âû ñàìè íå ìîæåòå äóìàòü î ñâîåé áóäóùåé ïåíñèè è ó ìíîãèõ ëþäåé íå ðàñ÷èòûâàþùèõ íà ïîäà÷êó ãîñóäàðñòâà ê ïåíñèè óæå åñòü ïàññèâíûé äîõîä â äåñÿòü ðàç áîëüøå ëþáîé ïåíñèè. Âû æå ðàññóæäàåòå êàê íàåìíûé ðàáî÷èé à íå êàê ðàáîòîäàòåëü è ñ òàêèìè âñçãëÿäàìè íè÷åãî íå èçìåíèòå, ïîòîìó ÷òî íå âèäèòå ïðîñòîãî äâèæåíèÿ äåíåã â áèçíåñå äàæå â òàêîì êàê ìåäèöèíà. Åñëè áû Âàøè àðãóìåíòû áûëè âåðíû Âû áû èõ íå ïîäêðåïëÿëè ñíèæåíèåì ìîåé ðåïóòàöèè, êàê äåëþò Áèëë, Àìèíàçèíêà (ÿ äëÿ íåå øîâèíèñò, íå ïîíÿòíî ÷òî âêëàäûâàåò â ýòî ïîíÿòèå), ßíà è äîáðàÿ òèõàÿ ïîôåññîð Ìåëüíè÷åíêî. Íó íåò àðãóìåíòîâ, ìîæíî ïîòèõîíå÷êó óáðàòü íåóäîáíîãî àïïîíåíòà, íó êàêàÿ æå çäåñü äèñêóññèÿ. Îòâå÷àòü òåì æå, äà íåò, óâîëüòå...Òàê ÷òî îñòàâàéòåñü ñî ñâîèìè áàðàíàìè èëè ÿ Âàì ìîãó îòâåòèòü ïî ìýéë, íî ïîëàãàþ Âàøè áàðàíû è Âàì íå èíòåðåñíû... Í ëàäíî, æåëàþ âñåì óäà÷è â óäîáíîé ñïîêîéíîé äèñêóññèè ðàçäåëÿÿ îäíî è òîæå ìíåíèå. Õàðä, Âû ïðàâû, õèðóðãè â ïîõîæèõ ñèòóàöèÿõ (â îïåðàöèîííîì òåàòðå) äåëàÿ èíôèëüòðàöèîííóþ èëè ïðîâîäíèêàâóþ àíåñòåçèþ íå íàçûâàþò ñåáÿ àíåñòåçèîëîãàìè, ÿ æå ïîä÷åðêíóë ÷òî ðå÷ü íå èäåò îá îáùåì íàðêîçå... èñêðèííå æåëàþ âñåì õîðîøî ïðîâåñòè âðåìÿ, íåçàâèñèìî îò ðåïóòàöèè Igor Simonov |
#154
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Òî åñòü â ñóõîì îñòàòêå, óâàæàåìûå êîëëåãè, ìû èìååì ïîëíûé áåñïðîñâåò, ïîòîìó ÷òî âèäèìûé âûõîä - êîíêóðåíòíîå ìåäèöèíñêîå ñòðàõîâàíèå è ðàâåíñòâî ïîñòàâùèêîâ ìåäèöèíñêèõ óñëóã íà ðûíêå - íå ïðåäñòàâëÿåòñÿ ðåàëüíûì. Òóïèê ïîëó÷àåòñÿ... Òóò óæ òî÷íî íèêîìó äî âûãîðàíèÿ âðà÷åé äåëà íåò.
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Lead, follow, or get out of the way. — Thomas Paine |
#155
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È òàêè ÷òî îí õîòåë ñêàçàòü? Ñàì òî ïîíÿë?
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#156
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Âëàäèìèð Ìèõàéëîâè÷!
Âû êîãî èìåëè â âèäó?
__________________
Lead, follow, or get out of the way. — Thomas Paine |
#157
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Êàê êîãî? Åãî.
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#158
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Çàõîòåëîñü âåðíóòüñÿ ê çàÿâëåííîé òåìå. Äåëî â òîì, ÷òî â ðóíåòå òåðìèí "âûãîðàíèå" ÷àùå âñåãî ïðèìåíÿþò êàê íè ñòðàííî êîðïîðàòèâíûå êîíñóëüòàíòû. Òàì, ãäå êà÷åñòâî òðóäà âàæíî, à åãî ñíèæåíèå ñòîèò äåíåã (íåóæåëè ìåäèöèíà ê òàêèì îòðàñëÿì íå îòíîñèòñÿ?!?) âîïðîñ âûãîðàíèÿ âñïëûâàåò ñàì ñîáîé. Âîò âûäåðæêà èç ðåêîìåíäàöèé îäíîé êîíñàëòèíãîâîé êîìïàíèè:
... õîòÿ óíèâåðñàëüíîãî ðåöåïòà èñöåëåíèÿ îò ïðîôåññèîíàëüíîãî âûãîðàíèÿ íå ñóùåñòâóåò, âñå æå ýòà ïðîáëåìà ðåøàåìà, åñëè åþ öåëåíàïðàâëåííî çàíèìàòüñÿ. Êàæäîìó ÷åëîâåêó âðåìÿ îò âðåìåíè íåîáõîäèìî îñòàíîâèòüñÿ, îãëÿíóòüñÿ âîêðóã, ïîáûòü íàåäèíå ñ ñàìèì ñîáîé, ïîäóìàòü, îòêóäà è êóäà îí èäåò, ñ êàêîé ñêîðîñòüþ è ñ êàêèìè ïîïóò÷èêàìè, à ãëàâíîå - çà÷åì, ñ êàêîé öåëüþ? Ïðèçíàêè ïðîôåññèîíàëüíîãî âûãîðàíèÿ: ×åëîâåê íà÷èíàåò ñîìíåâàòüñÿ â îáøåé ïîëåçíîñòè ñâîåé äåÿòåëüíîñòè. Ïðåæíèå îðèåíòèðû è öåëè îáåñöåíèâàþòñÿ. Ïðåñëåäóåò îùóùåíèå áåññìûñëåííîñòè ïðîèñõîäÿùåãî. ×åëîâåê ïîñòîÿííî ïåðåæèâàåò îòíîñèòåëüíî ñâîåé ïðîôåññèîíàëüíîé è ëè÷íîé íåñîñòîÿòåëüíîñòè. Âîçíèêàåò íåãàòèâíîå è öèíè÷íîå îòíîøåíèå ê ïàðòíåðàì, êëèåíòàì, êîëëåãàì, ñåìüå. ×åëîâåêó êàæåòñÿ, ÷òî ó íåãî íåò ïåðñïåêòèâ, áóäóùåãî, ÷òî æèçíü çàêîí÷èëàñü, â íåé íåò ñìûñëà. Îáåñöåíèâàþòñÿ ïðîôåññèîíàëüíûå äîñòèæåíèÿ. Ïðîäóêòèâíàÿ òâîð÷åñêàÿ äåÿòåëüíîñòü ñìåíÿåòñÿ ôîðìàëüíûì èñïîëíåíèåì îáÿçàííîñòåé. öåëèêîì ñòàòüÿ òóò [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Èíòåðåñíî, ñêîëüêî âðà÷åé ÐÔ ìîãóò ñàìè ñåáå ÷åñòíî ñêàçàòü, ÷òî èõ ýòî íå êàñàåòñÿ?
__________________
Lead, follow, or get out of the way. — Thomas Paine |
#159
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Öèòàòà:
...Íî, åñëè ÷åñòíî, íå ëþáëþ ÿ ýòî àìåðîâñêîå óâëå÷åíèå ñàìîïñèõîàíàëèçîì. Ýòî æ äî êàêîãî ego ìîæíî äîêîïàòüñÿ. Ó íàñ ëó÷øèé ïñèõîàíàëèòèê - øêîëüíûé äðóã ñ "áåëåíüêîé" (íàäîáíî ëèøü íàéòè ìåðó) |
#160
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Öèòàòà:
__________________
Lead, follow, or get out of the way. — Thomas Paine |
#161
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Öèòàòà:
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#162
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Öèòàòà:
__________________
Lead, follow, or get out of the way. — Thomas Paine |
#163
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Öèòàòà:
Òîì Êëýíñè "Îõîòà çà Êðàñíûì Îêòÿáðåì" |
#164
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ïîïûòêà ðåàíèìèðîâàòü òåìó
Âûãîðàíèå - äîâîëüíî ÷àñòî âñòðå÷àþùèéñÿ ñèíäðîì ñðåäè âðà÷åé è ðàáîòíèêîâ çäðàâîîõðàíåíèÿ.
Âûãîðàíèå - ñòðåññîâûé ñèíäðîì, õàðàêòåðèçóþùèéñÿ îùóùåíèåì ýìîöèîíàëüíîãî èñòîùåíèÿ. ×àñòî ïðîÿâëÿåòñÿ ñîìàòè÷åñêèìè (èñòîùåíèå, áåññîííèöà, ÆÊÒ ðàññòðîéñòâà, ÷àñòîå äûõàíèå), ýìîöèîíàëüíûìè (ãðóñíîå è äåïðåññèâíîå íàñòðîåíèå, íåãàòèâèçì, ñíèæåííàÿ êðåàòèâíîñòü (òâîð÷åñòâî) è ïîâûøåííûé öèíèçì) è ìåæëè÷íîñòíûìè ðàññòðîéñòâàìè (çëîñòü, îãðàæäåííîñòü, ðàçäðàæèòåëüíîñòü è ãîòîâíîñòü ê îñóæäåíèþ äðóãèõ, íåãàòèâíûé âçãëÿä íà ìèð).  îòíîøåíèÿõ ñ ïàöèåíòàìè çàìåòíî îáåçëè÷èâàíèå è äèñòàíöèðîâàíèå, ýôôåêòèâíîñòü è óäîâëåòâîðåíèå îò ðàáîòû ñíèæàåòñÿ. Physicians, for example, are less committed and less contributory to the continuing success of the practice. As the burnout-process progresses burning out providers prefer to decrease contact with patients/staff, become less respectful listeners, behave irritably, order more tests, refer patients to others and plan to leave patient care as early as possible. Burnout Risk Appraisal Âîïðîñû îòðàæàþò íåñîîòâåòñâèå ìåæäó ëè÷íîñòíûìè õàðàêòåðèñòèêàìè è ñòðåññîðíûìè ôàêòîðàìè, êîòîðûå îáóñëàâëèâàþò âûãîðàíèå. Êàæäûé âîïðîñ ïðåäïîëàãàåò âûáîð èíäèâèäóàëüíîé òàêòèêè äëÿ ñíèæåíèÿ ðèñêà âûãîðàíèÿ. Îïðîñíèê íå ïîäõîäèò äëÿ îöåíêè âûðàæåííîñòè âûãîðàíèÿ, à ëèøü îöåíèâàåò ðèñê åãî ðàçâèòèÿ. Êàæäûé ôàêòîð ìîæåò áûòü ìîäèôèöèðîâàí, îñîáåííî åñëè åñòü ïîíèìàíèå åãî ñìûñëà, èíôîðìàöèÿ, ìîòèâàöèÿ è äèñöèïëèíà. Are your achievements your self-esteem? Ñêëîííû ëè Âû îòêàçûâàòüñÿ îò ïðåäëîæåííîé ïîìîùè? Ïðîñèòå\ïðèíèìàåòå ëè Âû ïîìîùü? Do you often make excuses, like, “It’s faster to do it myself than to show or tell someone? Âû ñêëîííû ðàáîòàòü â îäèíî÷êó? Do you have a close confidant with whom you feel safe discussing problems? Do you “externalize” blame? (Obsessively seek to place blame away from yourself) Are your work relationships asymmetrical? Are you always giving? Is your personal identity bound up with your work role or professional identity? Do you value commitments to yourself to exercise/relax as much as you value those you make to others? Do you often overload yourself—have a difficult time saying “no?” Do you have few opportunities for positive and timely feedback outside of your work role? Do you abide by the “laws:” “Don’t talk, don’t trust, don’t feel?” Do you easily feel frustrated, sad or angry from your regular work tasks? Is it hard for you to easily establish warmth with your peers and/or service (patients/clients) recipients? Do you feel guilty when you “play” or rest? Do you get almost all of your needs met by helping others? Do you put other’s needs before or above your own needs? Do you often put aside your own needs when someone else needs help? Ôó, óñòàë! Ìîæåò áûòü êòî-íèáóäü ïîìîæåò ïåðåâåñòè îñòàëüíûå âîïðîñû - óæ î÷åíü ñëîæíî. |
#165
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Óâàæàåìûé Alexei! Îòêóäà ýòîò îïðîñíèê? ìîæåò òàì è êëþ÷ åñòü? Ñóäÿ ïî âñåìó ñáûëàñü ìå÷òà íåêîòîðûõ ñïåöèàëèñòîâ çàïîëó÷èòü ñïåöèàëèçèðîâàííûé îïðîñíèê...
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Lead, follow, or get out of the way. — Thomas Paine |