Anzor Khubutia: “If the patient forgot the doctor five minutes after discharge, it means that this is the wrong doctor. “Talk about abuse is a lie”: how the head of the Sklifosovsky Research Institute was fired, Khubutia The new head of the Sklifosovsky Institute
On October 10, 2013, celebrations will take place at the Kremlin Palace to mark the 90th anniversary of the Research Institute of Emergency Medicine named after. N.V. Sklifosovsky, popularly called “Sklif”. According to director of the institute, corresponding member of the Russian Academy of Medical Sciences Anzor Shalvovich Khubutia, even on this holiday, patients will not be left without emergency care. The duty brigades will be on alert as always. And on October 11, the institute will host a special event dedicated to the anniversary II Congress of Emergency Medicine Doctors. To the question “Will you operate on the 11th?” the director of Sklif responded: “If there is an emergency transplant, I will. Where should I go?” This extraordinary person is capable, by the will of God, of extending the lives of those whom foreign specialists have already given up on.The famous hospital traces its history back to the beginning XIX century. In 1803, Count Nikolai Petrovich Sheremetev, a famous philanthropist and philanthropist, decided to found a Hospice House in Moscow, where they would provide assistance to the poor, homeless and orphans. It was planned to establish a hospital here with 50 beds for free treatment of the poor “suffering from illnesses,” as well as a shelter for 25 orphan girls. In 1810, after Sheremetev’s death, the Hospice House received the first sufferers. Permanent surgical practice has been carried out here since 1815. All activities of the Sheremetev Hospital were carried out until the revolution of 1917 at the expense of the count and his heirs. In 1923, by order of the Moscow Department of Health, the Institute of Emergency Care was organized on the basis of the hospital, which in 1929 was named after the famous doctor, author of works on military field surgery, Nikolai Vasilyevich Sklifosovsky. And if the hospital already celebrated its 200th anniversary in 2010, then the Research Institute of Emergency Medicine itself is celebrating a very important and very honorable date this year - its 90th anniversary. And always, from the very beginning of its existence, everyone here in need, day and night, receives urgent free health care.
– Anzor Shalvovich, why are portraits of Count Sheremetev and his beloved wife Praskovya Ivanovna Kovaleva-Zhemchugova, a former serf actress, hanging next to your office, and not N.V. Sklifosovsky, for example?
– Our institute is a striking example of how Count Sheremetev’s private charity over the years has resulted in public charity. Count Sheremetev created one of the first institutions in Russia to provide medical care to the poorest segments of the population and to care for orphans and homeless people. The principles of charity bequeathed by the founder have been preserved to this day. These are the principles of absolute free medical care, that is, free and generally accessible to Muscovites.
– Who pays for treatment of residents of other cities and states?
– It is paid for by the state, because there is a special article in the regulations on insurance medicine, according to which residents of other cities and foreigners who come to us through emergency care receive this help for free.
– Are kidney and other organ transplants free of charge?
– For Muscovites, heart, kidney, liver and lung transplants are free. But it often happens that residents of Russia turn to the Moscow government - the Department of Health - or our Minister of Health with a petition: they ask that they be allowed a transplant at our institute at the expense of the state. As a rule, we are given this permission, and we do it free of charge. This is again a tradition. During the first hundred years of the existence of Count Sheremetev’s Hospice House, about 2 million people benefited from its charity. The costs for this amounted to more than 6 million rubles! It all started with the fact that one day the count noticed that Praskovya suspiciously often disappeared from the house in the morning. It turned out that she secretly gave alms to the poor on Sukharevka. At her request, the count gave his Cherkassy vegetable gardens for the construction of a Hospice House on Sukharevka to “relieve the suffering.” After the death of his wife, Count Sheremetev attracted the outstanding Italian architect Giacomo Quarenghi, an admirer of Kovaleva-Zhemchugova’s talent, to the project. By changing the original design of the architect Nazarov, Quarenghi turned the utilitarian building into a real “Palace of Mercy”. Monumentality and grandeur did not prevent the house from being convenient for practical use. Unfortunately, the statue of Mercy in the semicircular rotunda has not survived to this day.
– What kind of cross is there in the hospital park?
– This cross was installed on June 13, 2010 with the blessing of Patriarch Kirill of Moscow and All Rus'. Somewhere here there used to be a wooden tented church in the name of St. Xenia of Milas. Later, on the site of the first church, another was built, also wooden and dedicated to the Venerable Xenia. But in 1722, a new throne of the Ascension of the Lord was mentioned in the temple, built by the heir, Prince Alexei Mikhailovich, the last owner of these places from the Cherkasy family. The third temple was already dedicated to the Life-Giving Trinity and had chapels of the Archangel Michael and St. Xenia. Now we have two churches on the territory of the hospital - the Church of the Life-Giving Trinity and the Church of the Resurrection of the Lord. And the cross installed in the park is a gift from the sculptor Zurab Tsereteli, who responded to my request to honor the memory of the saint, about whom few people know in Russia. She was the only daughter of a noble Roman senator and lived in the 5th century. In the world, Saint Xenia bore the name Eusevia. From my youth I strove for God. Not wanting to get married, she secretly left her parents' house and sailed on a ship with two maids devoted to her. The abbot of the monastery of St. Apostle Andrew in the city of Milassa, in Caesarea, received them in this city. In Milassa, Ksenia bought land, built a temple in the name of St. Stephen and founded a nunnery. Soon, Bishop Paul of Milassa ordained Ksenia as a deaconesses. She was a benefactor for the poor, a comforter for the grieving, and a mentor for sinners. After her death, many sick people, touching the relics of the saint, received healing. But in Russia they mostly know Blessed Xenia of St. Petersburg.
– I wanted to go to the Church of the Life-Giving Trinity before talking with you, but it was closed.
– This temple was built before Count Sheremetev. In 1922 the church was closed. We restored it because it is very significant for Russian Orthodoxy. Scientific restoration was carried out in the early 2000s. Its interior, iconostases and decorations were completely restored. We had a desire to consecrate the temple, and we wrote several letters to His Holiness Patriarch Alexy II of Moscow and All Rus'. He was already ill at that time, and we did not receive an answer. Svetlana Vladimirovna Medvedeva, a very religious person, helped us. She turned to Patriarch Alexy II, and on January 17, 2008, he came here and performed the minor consecration of the Church of the Life-Giving Trinity. His Holiness thanked everyone who worked to restore the church and said that the existence of a house church within these walls is especially important for the sick, most of whom come here suddenly. Patriarch Alexy handed over to the rector “as a blessing to the temple and the parish” the icon of the holy great martyr and healer Panteleimon. Our temple is necessary for both patients and doctors, in whose hands are human lives. And during the celebration of the 200th anniversary of the Hospice House in the summer of 2010, at the request of Svetlana Vladimirovna Medvedeva, His Holiness Patriarch Kirill came to us and conducted the rite of the great consecration of our church. Now the church holds services on weekends and on major church holidays. We sometimes baptize the children of our employees there. Even I was once there at a christening as a recipient when I was asked. My grandchildren were all baptized, but not in this church. But, in my opinion, we have never held a wedding in the Church of the Life-Giving Trinity.
– Today you have a big holiday – the 90th anniversary of the Research Institute of Emergency Medicine. Being an emergency physician is a special ministry.
– 90 years is a huge time, and among us there are people who are 90 years old. Over all the years of our institute’s existence, its employees have become accustomed to the fact that when trouble happens somewhere, there is no need to call anyone: everyone is always there. I remember I went to Germany for the European Football Championship, and a plane crashed in Siberia, and there were great casualties. I left football tickets for my nephew and received patients in the evening.
– What is the main difference between the Research Institute named after. N.V. Sklifosovsky from other hospitals?
– We differ from an ordinary city hospital in that we have a research institute. We have residents, graduate students, and we can educate them and select the best for ourselves. This is our advantage. Therefore, it is generally accepted that we have the best personnel. In 2011, on the basis of the institute, a new public organization “Scientific and Practical Society of Emergency Medicine Doctors” was organized, the creation of which was initiated by a team of our scientists and doctors.
– What is the main task of the society of which you have been elected president?
– We are trying to assist in the development of such a socially important area as emergency medical care, uniting doctors of various specialties working in this area, helping in the training of highly qualified medical personnel and the introduction of the latest medical technologies. Today the society includes about a thousand doctors from regional branches of the country. We have our own printed organ – the scientific and practical magazine “Emergency Medical Care”. It is in great demand among scientists and doctors in Russia.
– Everyone knows that at the Research Institute. N.V. Sklifosovsky will be helped in almost any case, because surgeons with golden hands work here. Have you already raised your replacement?
– We always grow our team, train new personnel, it cannot be otherwise. We don’t stand in one place, we develop complex high technologies, and, of course, prepare our replacements. My guys are already doing liver and kidney transplants on their own. It’s the same in surgery, traumatology, cardiology: everyone is growing their own replacements.
– You performed a complex lung transplant operation. How many such transplants have been done?
– As far as I remember, only 15 lung transplants were performed. This is a very complex, one-off operation, a difficult period of nursing the patient, but, thank God, the results are good, the operations will continue. Unfortunately, there are not enough donor organs - lungs that would be suitable for transplantation. If there were more of them, we would have performed a hundred operations, but, unfortunately, this is a problem all over the world.
– What operations are you doing now?
– I had two intestinal transplants. Many patients need this operation. This is a very difficult operation. More precisely, the operation itself is not so difficult, but it is difficult to care for the patients afterwards. But we have very powerful young surgeons and traumatologists. We work together, they assist me, and I think that these operations have a future here. People who, for some reason, have had almost their entire intestine removed, have a very short life, and they have no other option but a transplant. Therefore, this topic is now being developed and a lot of experiments are being carried out. We are conducting a large scientific program on cell technology, which is the future. We have a whole corps working on this. I hope that my dream of a laboratory according to the GMP system will come true, and we will make many discoveries there, as Russian scientists and surgeons have always done.
– Do patients come to you for examinations after transplantation?
– Most often they come to us, since observation is carried out where they had surgery. But they receive medicines at Hospital No. 52.
– Anzor Shalvovich, tell us how your day begins.
– Wherever I am, I always wake up at half past five or five in the morning (I go to bed at eleven in the evening, at half past eleven). I get up and, even if I’m not working, but resting, I’m always doing something. I take a short rest - sleep no more than four hours, vacation - no more than a week. This is probably a habit that has developed over many years. When I was in college, I worked as an ambulance paramedic. So you sleep with a suitcase in your hands. I worked for many years as deputy director of the Institute of Transplantology and had to resolve all issues before the director arrived. Arrived at half past seven in the morning. And I arrive here, at Sklif, at about six in the morning.
– Do you manage to plan your vacation?
– It’s never possible to plan vacations or weekends, since no one knows when anything will happen, and I’m not only the head of an emergency clinic, but also a transplantologist. Someone got into an accident and fell to death, and someone is waiting for a donor organ and needs to have it transplanted - sometimes at two in the morning and at five in the morning. I don't have the right to turn off the phone, and it rings all the time. And if he stops calling, I think I’ll feel bad: “He hasn’t called for a long time.” I can tell my students who are doing the transplant themselves: “You know, manage without me.” But if some complication occurs, then reinforcement is needed, at least “a call from a friend,” as they say in some program. When something happens, we have a special emergency phone number. Well, of course, we all hear similar news on television and radio.
– You are an operating surgeon and the head of a huge institute. Wouldn't it be better if hospitals were run by managers rather than medical practitioners?
– I don’t agree with this, because it’s wrong, it’s harmful. Then everything will be ruined, everything will turn into commerce, and the patient will get the bare minimum. After all, the manager will not think about how to help the patient, but about where and how to save money, and will try to spend everything on wages instead of buying expensive medicine. I have a deputy for economic issues, I have an economic group. They consult with me. For example, a patient is suffering from sepsis, but there are no expensive drugs, only penicillin, which will not help him. And the manager will say: “Let’s save on the medicine, we’d better pay you an extra thousand.” I think 90 percent of Sklif’s doctors will disagree and say: “No, let’s get the patient out. How are we going to operate on him without these medications?” Is it possible to save money on a patient’s health? Of course, money doesn’t hurt anyone, and doctors need to increase their salaries, but this has never been a priority, neither in my generation nor now. Apparently, this is why leading surgeons head their clinics.
– During the operation, does the burden of administrative responsibility weigh on you?
– I always relax in the operating room - I do my favorite thing. I don't have any easy surgeries. I do operations where I need to concentrate. In the Soviet Union and Russia, healthcare has always been the most progressive. And we have many famous scientists, talented surgeons who influenced the development of medical science not only in our country, but also abroad.
– How do you feel about the crazy fame of “Sklif”, about the fact that everyone wants to be treated here?
– Although we are not rubber, we still try to accept everyone. But the cases are different. On Tuesday at about 9 pm one of my very close friends calls: “Listen, I have a big request to you. A neighbor's daughter is 20 years old. She wanted to kiss her dog, but it bit her on the nose. Can we bring her to “Sklif?” And they live on the other side of the city. I say: “Well, why take it to Sklif? Does she need a nose transplant? Take her to the clinic, to any emergency room with a scratched nose, they will anoint her with brilliant green.” After all, Sklif is not just an emergency city hospital. This is a large scientific center, the leading institute for emergency care. Here on my table are dissertations, developments by local scientists, which are used here. And then we write and distribute teaching aids throughout Russia. How the disease develops will depend on whether the first emergency aid was provided correctly. Correcting a misdiagnosis and incorrect treatment is much more difficult. That’s why people go to Sklif because they don’t turn anyone away and don’t take money. True, there were some anomalies, everything happened, but all my employees know: I do not forgive three things - extortion from patients, rudeness and negligence towards patients, and I do not forgive if a doctor drank while on duty or while working. No one has the right to decide someone else's fate while drunk. I don't understand when a healthy, strong doctor says, “Pay me.” I don't understand how this doctor can look people in the eyes. The man is sick, he already has trouble. We need to find some kind words for him. And, fortunately, I have not encountered this here. Nowadays doctors are paid quite well. In addition, he may take extra duty. In my opinion, Bekhterev said: “If after the doctor has talked to the patient, he does not feel better, then this doctor should quit healing.”
– What about capricious patients?
– You need to be able to talk to patients. And I do this every day, every morning. Patients are different, including those with mental disorders, with encephalopathy: you tell him one thing, he tells you something else. We have auto-training: this person is sick, he is forgiven. When patients are discharged, they should love and remember their doctor. Here in this photo is a patient to whom we transplanted a heart 11 years ago. She got married, gave birth to a child, and brought it to me like a grandfather: “You saved the life of me and this child.” So I took a photo with her and him.
Patients should remember and love you. If the patient forgot the doctor five minutes after being discharged, then it is the wrong doctor.
– There are two extremes: people either want to go to Sklif or go abroad, to foreign clinics.
– This trend, fortunately, has become less... Often, after operations in Germany and Israel, people end up with us, and we correct the mistakes of foreign doctors...
– On October 11, the day after the holiday in the Kremlin, colleagues from all over Russia will come to you.
– Yes, we are holding the Second Congress of Emergency Medicine Doctors. The first was successfully held in the spring of 2012. More than 900 people from 40 cities of Russia and seven neighboring countries took part in it. Master classes and school-seminars were held on the main areas of emergency medicine, and materials of the congress were published. The exhibition of leading manufacturers of medical equipment, equipment and medicines used in emergency medicine was memorable. An interregional society has been created at our institute. Today, the Research Institute of Emergency Medicine named after. N.V. Sklifosovsky is the largest multidisciplinary emergency scientific center in Europe. On behalf of the Russian Academy of Medical Sciences, the institute coordinates scientific research on the problem of emergency medical care conducted in Russia.
– Are there statistics on the treatment of patients?
– On average, we receive 150–200 people a day. This is more than 50 thousand sick and injured per year. We perform more than 20 thousand surgical interventions per year.
– Anzor Shalvovich, we sincerely thank you for your ascetic work, for your love for the sick, for your kind heart. I would like to hope that you will be the one to transplant the kidney and pancreas. And I would like to convey to you an invitation from the President of the Talents of the World Foundation, David Gvinianidze, to charity concerts on October 17, 18 and 21, to which you are expected as an honored guest.
Academician Mogeli Khubutia, who resigned as director of the Sklifosovsky Research Institute of Emergency Medicine, has been transferred to the position of president of the institute, the TV channel reports. Moscow 24”.
Commenting on the information that appeared in the media about Khubutiy’s departure, the department reported that the appointment of the academician to the post of president was announced by the head of the department, Alexey Khripun, at a meeting with the staff of the research institute on June 2.
Earlier it became known that 43-year-old Sergei Petrikov was appointed acting deputy director for science. Khubutia himself stated that he remains a practicing surgeon at the institute.
Mogeli Khubutia has headed the Sklifosovsky Research Institute of Emergency Medicine since 2006. He will turn 71 on June 17.
tags: Medicine14:26 04.06.2017 -
Academician Mogeli Khubutia was appointed president of the Sklifosovsky Research Institute. This is reported by “ Interfax" with reference to the Moscow Department of Health.
The department emphasized that in Moscow there are only a few institutions where honored healthcare workers have the status of “honorary president.” Khubutia, who will turn 71 on June 17, has headed the research institute since 2006.
Deputy Director for Science, 43-year-old Sergei Petrikov, was appointed acting director.
Earlier, Lenta.ru reported the resignation of Khubutia from the post of director of the Sklifosovsky Research Institute of Emergency Medicine. The publication noted that the decision was made due to gross violations identified by Roszdravnadzor's inspection.
tags: Medicine A. Khripun: The Department of Health did not receive information about violations in the work of the Research Institute for Emergency Medicine named after. N. Sklifosovsky 11:03 05.06.2017 -The Moscow Department of Health did not receive information from Roszdravnadzor about violations at the Research Institute of Emergency Medicine named after. N. Sklifosovsky, the head of the department, Alexey Khripun, told reporters, commenting on media reports about the detection of such violations.
“We have not received any information from Roszdravnadzor on this matter. Therefore, for comments on this matter, I recommend that you contact Roszdravnadzor”- said A. Khripun, answering a corresponding question from journalists.
Previously, the agency Moscow " The press service of the Moscow Department of Health reported that Mogeli Khubutia, who previously served as director of the Research Institute of Emergency Medicine named after. N. Sklifosovsky was removed from his post and appointed president of the institute. In turn, the Lenta.ru portal, citing a high-ranking source in the Moscow Department of Health, reported that this is primarily due to gross violations in the work of the institute identified as a result of inspections by Roszdravnadzor. According to the publication, the Roszdravnadzor commission, which in April-May worked at the Research Institute of Emergency Medicine named after. N. Sklifosovsky, revealed facts of extortion of money from patients, as well as cases when seriously ill patients underwent high-tech operations that they did not really need. In addition, several cases of falsification of medical and medical-financial documentation were established.
” .Mogeli Khubutia: .
The academician said that he had long been preparing for the fact that he would move away from managerial tasks and move on to work as a surgeon. However, the decision to change the director of the Research Institute of Emergency Medicine named after. Sklifosovsky nevertheless became “a little unexpected turn” for him, because it was taken at night.
Mogeli Khubutia: .
Khubutia also denied information that violations related to extorting money from patients were discovered at the institute. According to him, the research institute also did not have cases where high-tech operations were carried out that were not necessary. He denies that reports of such incidents were the reason for his resignation and called them slander. tags: Medicine
12:58 04.06.2017
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Moscow. Academician Mogeli Khubutia said that he left the position of director of the Sklifosovsky Research Institute of Emergency Medicine, but will continue to work in this institution as a surgeon. “They didn’t fire me, but I left as president and left the position for my young deputy. I will have my favorite business there - surgery, which I will do, but I will not deal with administrative issues, this should be done by young people.”, - explained M. Khubutia on the radio station “ Echo of Moscow”. According to the academician, he had been “preparing for a long time” to leave the position of director and go to work as a surgeon, but the decision to change the director of the Sklifosovsky Research Institute of Emergency Medicine was “a bit of an unexpected turn” for him, as it was made at night. “This decision was probably made most quickly by some other person, and then I basically agreed with it. I have been preparing for a long time, last year I wanted to go to such a job, namely to be in the surgical department.”, - M. Khubutia specified. He also denied information that at the Research Institute of Emergency Medicine named after. Sklifosovsky, violations were discovered, in particular, extortion of money from patients and cases of high-tech operations that were not necessary, which allegedly served as the reason for his resignation from the post of director. The Moscow Health Department did not receive information from Roszdravnadzor about violations at the Research Institute named after. Sklifosovsky, head of the capital’s health department Alexey Khripun told reporters. "We have not received any information from Roszdravnadzor"“, Khripun said, answering a question from a TASS correspondent about whether the information previously published in the media about the violations identified in the hospital corresponds to reality.
About your future fate, past, present and possible future of the Research Institute for SP named after. N.V. Academician Anzor Khubutia spoke about Sklifosovsky in an exclusive interview with Vademecum.
– How was your first week as president of the institute?
– Of course, it’s a little strange that there are now fewer people in my waiting room. Previously, it was impossible to get here; many practical and scientific issues had to be solved. But I had the opportunity to devote time to science - as much as I wanted before, but, as the director of the institute, I could not afford it. I have big plans. In the near future I am going to write a monograph on liver transplantation, and in the future I plan to write a large book, a guide to transplantology. The last such manual was published many years ago under the editorship of Academician Shumakov, when I was still working at the Institute of Transplantology as his deputy. This publication, of course, is somewhat outdated, since it does not contain new data about the capabilities of this technology and new transplantation methods.
I have already partially prepared for writing the manual - a year ago, the country’s first textbook on transplantology for medical students, edited by me, was published. The team of authors included well-known transplantologists, employees of Sklif and the Department of Transplantation and Artificial Organs of the Moscow Medical and Dental University, which I have headed for almost 10 years. This department was created at this wonderful university as one of the first in the country. In 2011, also under my editorship, the monograph “Organ Transplantation in a Multidisciplinary Research Center” was published. The main idea of this book is the possibility of successful and effective development of transplantation programs on the basis of large scientific and practical multidisciplinary associations with round-the-clock operation of all diagnostic services and efferent technologies, as well as the presence of very high-level specialists. The medical community liked both the textbook and this monograph. We have received a lot of positive feedback on these publications.
– Is your successor Sergei Petrikov already in a new capacity?
– Not much time has passed since his appointment, while he is acting director, the question of his future fate is being decided. Of course, he has some uncertainty. But he studied and worked at this institute almost his entire adult life, and knows it well from the inside. He is a very energetic, competent, educated person, and a brilliant professional. I don’t know if there is anyone in Russia equal to him in his field. He showed himself to be an excellent organizer in the position of my deputy for science and head of the regional vascular center. He certainly has his own vision for the development of the institute. He is a very straightforward and principled person, and this is what the institute needs now.
It will not destroy what we have done over all these years, but will only add to it. I think that such people should head leading healthcare institutions. I am convinced that the decision of the Moscow government to appoint... O. the director of the institution was faithful to him.
– Did the personnel changes at the research institute come as a surprise to your successor?
– For Sergei Sergeevich – maybe. He must have been somewhat confused, because he asked: “How could this be resolved like this?” But I was just expecting this: the expiration date of my contract was approaching, and the existing age limit in the country for managers of such a rank as the director of the institute led me to think about the possible termination of my activities as an administrator, since I would soon turn 71 years old. True, everyone says that I am still in excellent shape, I operate a lot, but still the time has come to step away from administrative management.
– So you were preparing in advance to resign from the post of director?
– I didn’t rule out this option.
– Were you waiting for what the department would decide?
– On Thursday, June 1, my contract expired. Alexey Ivanovich Khripun called me and said that I needed to meet. We met and discussed this issue. Yes, of course, the decision was made by the department, with which I agreed and wrote a letter of resignation from the post of director. I think it was the right and honest thing to do on my part. In addition, if Sergei Petrikov is approved as director, the institute will prosper and develop.
– A few months ago Petrikov became your deputy for science. It turns out that you already started preparing your successor then?
– That appointment was logical - Sergei Sergeevich was ideal for the position of my deputy.
– Your colleagues say that in fact it was the conflict with Leonid Pechatnikov that became the reason for your resignation from the post of director. This is true?
- No, nothing like that happened, everything was peaceful and calm.
– What do you think about the publication in the media about illegal high-tech procedures and extortion of money that allegedly took place at Sklif?
- This is slander. The Department of Health has already issued a refutation on this matter. Yes, we had minor violations, but not on the scale described in the press. If we had extortion, the trial would have been going on a long time ago, and the prosecutor’s office would have dealt with this. How is it that a person didn’t need to have surgery, but they did it for him? This means that a person has been harmed - physically and mentally, for which he should be put in prison! 3 thousand people work here - and it turns out that everyone agreed with this? Everyone understands that I will not go to court and will not file a lawsuit for libel. At this time, I’d rather write an extra page of the book or give a lecture. Of course, if such attacks had not stopped, I would have contacted the prosecutor's office. But now, I hope, there will be no such need.
– How did the Sklif team react to the news about the change of management?
– On Friday, June 2, we had a morning conference, at which Alexey Ivanovich Khripun thanked me for my successful and effective work as director of the institute and announced that Sergei Sergeevich Petrikov would be appointed acting director, and I would remain at the institute as president . Of course, on the sidelines, many employees said to me: “You’re still so energetic, how can that be?” But I reassured everyone, I said that I was staying at the institute, the doors of my office were always open, I would continue to do science and educate young people.
– What operational capabilities will your successor get?
– This year marks 11 years since I came to Sklif as a director. The situation at the institute was difficult, and the times were difficult, science was suffering, there were no printed scientific publications, and there were few scientific societies. My task was to level up the institute and bring it to the level of modern research centers. A lot has been done over the past years. The nature of emergency surgery operations has changed - they have become much more complex. In general, over 10 years the number of emergency operations at the institute has increased by 10–12%. Now we perform approximately 64 thousand emergency operations per year. When I arrived, I immediately opened two more operating rooms for the neurosurgery department, so they were able to perform three times as many surgeries as before. The role of science was significantly strengthened. Today, the institute is developing such scientific areas as anesthesiology and resuscitation, emergency surgery and cardiovascular surgery, gynecology and neurosurgery, traumatology and combustiology, clinical toxicology and emergency cardiology, psychosomatics, and operates a regional vascular center. I devoted a lot of effort to the development of such an important scientific and practical direction at the institute as transplantology. An organ transplantation department has been created. Some people had a question: why does Sklif need a transplant? But I have already written more than one article on this matter, given more than one lecture about the fact that transplantology is a very knowledge-intensive discipline, a science at the intersection of many specialties, and it should be developed on the basis of multidisciplinary large medical centers. Throughout the world, it typically exists in university hospitals, where all medical profiles are represented. Research Institute of SP named after. N.V. Sklifosovsky ideally meets these tasks. Over these 11 years, two new interregional scientific societies have been established at the institute - the Society of Emergency Medicine Physicians and the Society of Transplantologists, of which I am the president. Each of them has its own journal, which is included in the list of publications recommended by the Higher Attestation Commission. A large number of congresses and scientific conferences have been held on current problems of emergency medicine and transplantology.
– What exactly did you bring to Sklif as a transplantologist?
“Before us, no one in the city systematically performed organ transplant operations - such interventions were concentrated only in federal centers. Transplant departments were distributed among city hospitals, where a very small number of transplants were performed. Moscow is a huge metropolis; in New York, for example, there are 29 municipal organ transplantation centers. Before me, a liver transplant center had already operated here, but it was ineffective, performing four to five operations a year. All over the world, such operational activity is considered simply unprofitable. With my arrival, a transplant center was created, where kidneys and pancreas are transplanted. Heart transplantation has begun at the Cardiac Surgery Department. We were the first in Russia to independently begin lung transplantation. Over 10 years, they performed 481 liver transplants, more than a thousand kidney transplants, more than 100 heart transplants, and performed three unique intestinal transplant operations, which no one does in Russia. The emergence of strong transplantology at Sklif also changed the team. This is such a complex area that it requires the involvement of different specialists, and people willy-nilly participate in the treatment of such patients and gain additional knowledge. Of course, this adds to their competencies and raises the level of the institution. I myself realized how much Sklif had changed when I was invited to give an interview to one of the federal TV channels, and the presenter asked the following question: “Before, people tried to pay, just so they wouldn’t be taken to Sklif, but now, on the contrary, they are ready to pay just to get there. What did you do there?”
– When you became director of Sklif, many doctors expressed dissatisfaction with the reforms you initiated. How did you manage to turn the situation around?
– The team here was very difficult. Before me, Alexander Sergeevich worked for 14 years, and before him five directors were replaced in a row. Well, the team is used to working, I would say, at a slow pace. But I paid attention to each department head and told them where we were going. Then I showed by my own example what I was trying to achieve - I myself began to perform the first kidney and pancreas transplants, and people were finally convinced that the leader-surgeon had arrived.
– But your predecessor is also a surgeon.
– Yes, but in recent years Alexander Sergeevich has not actively operated.
– Is it important for Sklif that the director is a surgeon?
- Of course, this is a surgical clinic. As a last resort, even if the leader is not a surgeon, he should know surgery well. For example, Sergei Petrikov is a resuscitator, but he has been involved in surgery all his life and knows it no worse than surgeons.
– Did you fire many people when you became director?
– Almost no one was fired. I immediately said that I would not tolerate three things: extortion, negligence and, God forbid, if a person comes to work drunk. And everyone knew that such misconduct would definitely end in dismissal. And any person who works a lot can make mistakes. Who doesn't make mistakes? I have never been a formal leader; I always sent employees to international conferences and congresses. This added to their knowledge, people from there brought something new, and we then shared it with each other. This was a very good incentive.
– Everything you listed required funding. Where did you get the money?
– The Moscow government supported us very much – both organizationally and financially. Of course, at first there were doubts; they told us: “Why do you need a transplant?” But then representatives of the Department of Health became convinced that this was not just a waste of money, but a huge help to people, including those with heart, lung, liver and kidney diseases. We managed to convince the management of this with the results of our effective activities, which are not inferior to any developed state in the world. We were regularly provided with subsidies, which allowed us to get on our feet. Then we learned how to make money on services provided under compulsory medical insurance, how to correctly fill out documents, medical histories, keep statistics, and avoid fines from insurance companies.
– Who specifically supervised you at the Moscow Department of Health? When you came to Sklif, the head of the department was Pechatnikov. Did he support you at the first stage?
– Yes, he did a lot, primarily for the development of transplantology at the institute, participated in the opening of new transplantation departments in the second building of the institute, and appointed me the chief transplant specialist of the Moscow Health Department. In recent years, the mayor of the city, Sergei Sobyanin, has also provided us with large-scale support.
– Aren’t you afraid that under the new director the transplant service that you have been building for so long will suffer?
“If this happens, what will suffer first of all is not so much the status of the institute, but the Muscovites, the people who are on the waiting list for organ transplants. At our institute, this technology is a priority primarily for Muscovites. If transplantation as a technology is lost in Moscow, then all Muscovites will be sent for organ transplants only to federal centers. But patients from all over Russia are treated there, and Muscovites will also join this large general waiting list. I think that this will not improve the situation with the provision of this type of high-tech assistance to Muscovites. This would be completely wrong. If such steps are taken, of course, I will be categorically against it. But I don’t think any leader can do this. What will he tell people?
– Now that you have more free time, what do you plan to do besides scientific work? Maybe go on vacation?
– You know, while I don’t go anywhere, I still want to finish the manual on transplantology. In addition, I want to wait until everything gets better at the institute - a new director appears and takes control of the situation. Surely he will have questions, after all, this is a huge organization, you can’t just throw everything away and leave. And I actually really want to go on vacation.
Khubutia, Sklifosovsky, resignation, Moscow Department of Health
Anatoly Makhsona, from the post of chief physician of the 62nd Oncology Hospital, seems to have taught the Moscow authorities to carry out personnel changes that were fateful for the capital’s healthcare system, regulating the level of their volume. Removal of Anzor (Mogeli) Khubutia from the post of director of the Research Institute of Emergency Medicine named after. N.V. Sklifosovsky passed according to the optimal scheme for the employer: the authoritative leader publicly objected only to the compromising publication on the institute on life.ru, published on the day of his resignation. However, sources familiar with the situation around the research institute say that the story of Khubutia’s removal from the operational management of Sklif, which under him turned into a profitable enterprise with an annual turnover of more than 4 billion rubles, does not end there.
The fact that Anzor Khubutia has left the post of director of the institute, but remains president of the research institute, became known on Friday, June 2 - the head of the Moscow Department of Health (DZM), Alexey Khripun, announced this at a meeting with the institute staff. The official reason for the personnel decision was the expiration of the contract and his retirement age - the academician is 70 years old. “We were simply informed that Khubutia would no longer be the director, and his deputy for science, Sergei Petrikov, would perform his duties, but that’s all, no more details were given,” says one of the Sklif doctors. Research institute employees interviewed by VM say that Khubutia’s transition to a completely formal presidential post looked all the more strange since this lifelong vacancy at the institute was actually occupied by his living predecessor, Alexander Ermolov.
Those who doubted the existence of compelling reasons for personnel rotation promptly were offered additional arguments that same day. Information appeared in the media (the exclusive belonged to life.ru) about the shocking results of a fresh inspection of the institute by Roszdravnadzor, which allegedly revealed cases of illegal high-tech operations and extortion of money from patients. The head of the Department of Health, Alexey Khripun, hastened to declare that he was not aware of the results of the inspection. And Khubutia himself denied the conclusions made by the media on Echo of Moscow. “Probably someone thought that I wouldn’t leave, and it was ordered,” the academician noted then.
According to the unified register of Roszdravnadzor inspections, in 2017 the service actually identified 11 violations at Sklif: the research institute carried out high-tech interventions without the appropriate licenses, and expired medications were stored.
Khubutia then touched upon the details of his dismissal in passing: “This decision was probably made most quickly by some other person, and then I, in principle, agreed with it.” Vademecum’s interlocutors, who are familiar with the situation in Sklif, believe that the “other person” should be understood as Moscow Vice-Mayor Leonid Pechatnikov, whose relationship with Khubutia they clearly call conflicting.
One of the reasons for the discord is called by the heads of several Moscow and federal clinical centers to be the growing independence of Sklif from the DZM. Financially, this independence became evident in 2016.
According to the Federal Treasury, the institute’s income for this period amounted to 4.2 billion rubles, and the institution spent 4 billion rubles. For comparison: the expenses of the Botkin Hospital in 2016 exceeded income by 798.1 million rubles; In 2016, City Clinical Hospital No. 1 named after was also unprofitable. N.I. Pirogov, where expenses exceeded income by 652 million rubles.
In absolute terms, the income of these two hospitals amounted to 7.2 and 4.1 billion rubles, respectively. Colleagues of the retired director confirm that it was under Khubutia that Sklif reached the forefront and became more consistent with the status of a federal, rather than regional, albeit metropolitan, medical institution (in an interview with the former director of the Research Institute of SP). “Under Khubutia, the Research Institute of Emergency Medicine was transformed. New directions appeared here, he was able to raise transplantology and cardiovascular surgery to a completely different level. I think he is a very good organizer. Even when he worked at the Institute of Transplantology, he was the right hand of Valery Shumakov, so he came to the Research Institute of SP with extensive experience in management work. It was here that he fully revealed himself and became one of the best health care organizers,” says Academician David Ioseliani, director of the Research Institute of Interventional Cardioangiology of the Ministry of Health.
Meanwhile, the industry is discussing whether Khubutia’s young replacement, Sergei Petrikov (he is 43 years old), can become a full-fledged replacement for the academician or will turn out to be just a transitional figure. According to employees of the Research Institute of Emergency Medicine, Petrikov is truly a dear person to the institute: he began working at Sklif as a nurse in the neurosurgical intensive care unit and quickly made a career.
The head of the department of neurosurgery with the group of vascular and endovascular surgery of the Scientific Center of Neurology, Artem Gushcha, notes that Petrikov is known as an excellent specialist, one of the students of Vladimir Krylov, the chief neurosurgeon of the Department of Health and the chief freelance neurosurgeon of the Ministry of Health.
Research institute employees note that Petrikov was not mentally prepared for such an appointment, and therefore willingly support the version that in reality the director’s chair was being vacated for a completely different candidate, namely Alexei Khripun. The DZM refused to comment on this assumption. Sklifosovsky, Khubutia, printers, Ministry of Health
Academician Mogeli Khubutia resigns from his post as director of the Sklifosovsky Research Institute of Emergency Medicine.
“The head of the Moscow Department of Health came to the morning conference and announced that Khubutia no longer runs the institute, since his contract expired on June 2,” said institute employees.
A source from the Department of Health stated that Khubutia’s removal from office was due to gross violations identified during the inspection.
“The Roszdravnadzor commission, which worked at the Sklifosovsky Research Institute in April and May, revealed facts of extortion of money from patients, as well as blatant cases when seriously ill patients underwent high-tech operations that they did not really need. In addition, several cases of falsification of medical and medical-financial documentation were established,” he said, adding that “the acts were so blatant that no one doubted the need to dismiss Khubutia, although Mogeli Shalvovich’s defenders tried to influence this decision "
Khubutia himself later confirmed the information about his resignation from the post of director of the Sklifosovsky Research Institute of Emergency Medicine, calling the information about violations “slander” that could have been spread in case he refused to leave his post.
“They didn’t fire me, but I left as president and left the position for my young deputy. I will have my favorite thing there - surgery, which I will do, but I will not deal with administrative issues, this should be done by young people,” Khubutia said.
According to the academician, the decision to remove him from his position turned out to be “a bit of an unexpected turn” for him due to what was made overnight.
“This decision, probably, most likely, was made by some other person, and then I, in principle, agreed with it,” Khubutia emphasized.
At the same time, he emphasized that he would remain working in the institution as a surgeon.
A practicing neuropathologist and professor at the Moscow State Medical and Dental Institute named after Evdokimov, who has held the position of Deputy Director of the Sklifosovsky Institute for Science since October 2016, became the acting director of the Sklifosovsky Research Institute of Emergency Medicine. This fact coincides with information that was originally provided by a source from the health department.
“Sergey Petrikov, Doctor of Medical Sciences, professor, who previously worked as deputy director for scientific work and is the head of the regional vascular center, has been appointed acting institute,” the department noted.
It is noted that 43-year-old Petrikov may become the youngest head of the Sklifosovsky Research Institute.
Later it became known about the appointment of Mogeli Khubutia to the post of president of the Sklifosovsky Research Institute. The news was shared by Alexey Khripun, head of the Moscow Department of Health.
This year, on June 17, Mogeli Khubutia turns 71 years old. During the 11 years that he headed the institute, the institution constantly justified its status as one of the most advanced medical institutions in Russia.
Thus, in 2014, transplantologists from the Sklifosovsky Research Institute performed a unique operation to transplant the small intestine, necessary for patients with intestinal lesions when, as a result of medical intervention, it was partially or completely removed. As a result, a person completely loses the ability to digest food. A person can eat, but nutrients do not enter the bloodstream, subsequently requiring round-the-clock intravenous infusions to maintain life, the side effects of which can lead to death. A small intestine transplant can save such patients.
“The first such operation was performed in 1967, but subsequently patients died due to a large number of complications. And only in 1988 was it possible to achieve success in this field. Over the years, such interventions were carried out only in isolated cases. In Russia, doctors are only taking the first steps.
Employees of the Sklifosovsky Research Institute, under the leadership of the director of the research institute, Professor Mogeli Khubutia, not only carried out a successful intestinal transplantation, but were also able to prevent rejection of the donor organ,” the institute reported then.
Under Mogeli Khubutia, joint work also began with the creation of a drug for the treatment of leukemia.
