How to organize and conduct medical examinations of employees in 2021

When a patient complains of pain in the heart area or the doctor has any suspicions, the specialist always refers the patient to an electrocardiogram, or, as it is commonly called, an ECG.

This study is non-invasive, completely safe, but at the same time very informative. To avoid distorting the ECG results, cardiologists recommend not ignoring the rules for preparing for this study.

Why undergo a medical examination

The purpose of the preliminary and periodic medical examination is to make a decision on the admission of the applicant/employee to a certain type of work.

Firstly, this is done to take care of the health of the potential employee. During a medical examination, contraindications to certain types of activities may be identified. In this case, the employer does not have the right to allow the person to work.

If, during a periodic medical examination, an employee is diagnosed with occupational diseases caused by working conditions, the company can offer an alternative vacancy that is suitable for the employee due to health reasons.

Secondly, a medical examination is necessary to protect others and colleagues of the applicant/employee. For example, in the case of identifying infectious diseases or pathologies that may lead to a situation that poses a threat to others.

Periodic medical examinations are also carried out to identify possible occupational diseases among employees and prescribe prevention or treatment.

What does the therapist check?

During your appointment, the therapist will ask you about your health, find out if you have any complaints, if you suffer from any chronic diseases, what kind of lifestyle you lead, and if you have any bad habits. If you are concerned about any symptoms, your doctor will ask how long ago they started, when they usually start or worsen, and whether they have changed over time. Then the inspection takes place. It consists of standard procedures: measuring blood pressure, pulse rate, listening to the lungs and heart using a phonendoscope, and examining the throat.

Fines for failure to conduct a medical examination in an organization

Is it generally necessary to undergo a preliminary/periodic medical examination? If an employee was allowed to work without undergoing a medical examination, or with identified contraindications for this type of activity, the employer must bear responsibility for this and pay a fine in the amount of:

15,000 - 25,000 rubles per official;
15,000 - 25,000 rubles for an individual entrepreneur;
110,000 - 130,000 rubles per legal entity.

If an employee is hired again without a medical examination, the penalties increase:

30,000 - 40,000 rub. or disqualification for 1-3 years for officials;
30,000 - 40,000 rubles for individual entrepreneurs or administrative suspension of activities for up to 3 months;
100,000 - 200,000 rubles or suspension of the organization’s activities for a period of up to 3 months.

If an employee has not passed a preliminary/periodic medical examination, then the employer has the right not to hire/dismiss such an employee.

What does a neurologist check?

Nothing special here either, the doctor performs a standard neurological examination. He will evaluate your posture, gait, facial symmetry, ask you to follow the hammer with your eyes, frown your eyebrows, bare your teeth, stick out your tongue. This will be followed by checking muscle tone and strength, and skin sensitivity using a special non-sharp needle. Then the doctor will use a hammer to check your reflexes, ask you to stand up, close your eyes, stretch out your arms, and touch the tip of your nose with your right and left index fingers.

As you can see, there is nothing scary or supernatural in medical examinations. Every doctor performs standard, basic procedures. The doctor’s goal is not to find you at any cost with a disease that could be a reason for dismissal. If you discover the first symptoms of incipient diseases, you will not be fired, but this will give you the opportunity to take timely measures to maintain your health and ability to work.

Who pays for preliminary and periodic medical examinations?

The medical examination is carried out and paid for by the employer, even if, based on the results of the preliminary medical examination, the applicant was not hired.

An organization can enter into an agreement with a medical institution and pay for medical examinations of employees immediately. If the employee underwent the examination on his own, the employer is obliged to compensate for the costs.

More information about concluding an agreement can be found by calling the phone number: +7 (3452) 500-105 (ext. 205 and 207)
or
by writing to the email:
[email protected]

Military medical commission: brief instructions on how to avoid problems when passing

When recruiting for service in internal affairs bodies or the fire department, a candidate for a certified position is required to successfully pass a military medical commission (MMC).
The purpose of the military medical commission is to determine whether the physical and psychological health of the candidate will allow him to serve in the bodies of the Ministry of Internal Affairs or the Ministry of Emergency Situations, associated with unfavorable conditions, extreme situations, and an irregular service schedule in a specific position.

The passage of the military medical commission is regulated by: Order of the Ministry of Internal Affairs of the Russian Federation dated April 2, 2021 No. 190 and Order of the Ministry of Emergency Situations of Russia dated August 30, 2018 No. 356. You can familiarize yourself with the contents of the orders on the official websites of the departments.

List of professions for preliminary and periodic medical examination

Which employees must undergo a medical examination:

Persons under 18 years of age;
Persons working in organizations with difficult, harmful or dangerous working conditions;
Persons whose activities are related to driving a vehicle;
Athletes;
Judges;
Persons working in the Far North or equivalent regions;
Persons working on a rotational basis;
Workers associated with catering, the food industry, trade in food products, as well as those working in organizations that provide water to the population;
Employees of medical, treatment-and-prophylactic and children's institutions;
Departmental security officers;
Cosmetologists, hairdressers;
Emergency service workers.

People often wonder whether office workers need to undergo a medical examination. Previously, when offices used computers with CRT monitors, it was necessary to visit an ophthalmologist and a neurologist. Today there is no such need.

What is blood tested for?

Physiologists and doctors call blood the internal environment of the body. It circulates in all organs and contains many substances, so its study helps to obtain important information about health. During medical examinations, only the most basic blood tests are performed:

A general blood test is a routine test that every person should undergo at least once a year, regardless of age and place of work. Determine the level of red blood cells, leukocytes, platelets, hemoglobin, leukocyte formula, ESR, hematocrit (the ratio of blood volume to the volume of formed elements),
Blood chemistry. Glucose (sugar) levels help check the condition of the pancreas and detect diabetes. Cholesterol levels are an important indicator of the health of the cardiovascular system. Its increase is associated with the risk of atherosclerosis, a pathology in which atherosclerotic plaques form on the walls of blood vessels. This threatens high blood pressure, and in the future, heart attack or stroke. It is recommended to regularly take a biochemical blood test for all people over 30–35 years of age. This helps to identify health problems in the early stages and take timely action.

The procedure for conducting preliminary and periodic medical examinations

The organization of preliminary and periodic medical examinations falls entirely on the shoulders of the employer. The process can be divided into the following stages:

Drawing up a “List of employees” for medical examination

Before organizing a medical examination at an enterprise, you need to make a list of employees for whom a medical examination is mandatory (we wrote about this above). According to paragraph 20 of Appendix No. 3 of Order No. 302n, the document must contain:

a list of employees who must undergo a medical examination;
harmful and dangerous production factors that are identified through a special labor assessment.

Conclude an agreement with a medical organization

To conduct a periodic medical examination in an organization, an employer can choose any medical institution (municipal or private). The main thing is to have a certificate and license to conduct medical and preventive activities. You can conduct medical examinations in different organizations every year.

To conclude an agreement, simply contact the selected organization and leave a request to organize a medical examination.

Issuing a referral for a medical examination

Next, you need to send workers for a medical examination. What should be indicated in the direction:

Name of the organization;
Basic details of the company (OKVED, form of ownership, legal address);
Full name and date of birth of the employee;
The name and address of the medical institution where the examination will be carried out;
Type of examination (preliminary or periodic medical examination);
The profession or position for which the employee is applying;
A complete list of harmful production factors that have a negative impact on employee health.

Conducting a medical examination

The company provides the clinic with a ready-made list of employees subject to medical examination and pays for the services. Otherwise, the employee chooses the examination location independently.

The employee must come to the medical institution indicated in the referral on the day allocated for the medical examination. At the clinic/medical center, he is given a list of specialists and tests.

Which doctors should you see during a medical examination?

The list of doctors who need to undergo a preliminary/periodic medical examination usually depends on the type of activity, gender and age of the employee.

Typically, the following doctors are examined during a medical examination:

Occupational therapist;
Psychiatrist-narcologist, (psychiatrist);
Ophthalmologist;
Neuropathologist;
Otorhinolaryngologist;
Surgeon;
Gynecologist (for women);
Mammologist (for women over 40 years old).

For workers in the food industry, dairy and distribution points and some other related professions, it will also be necessary to undergo examination by specialists:

Dentist;
Dermatologist.

What tests are needed for a medical examination?

For the examination, it is also necessary to undergo a number of tests. Preliminary/periodic medical examination should include:

General blood and urine tests;
Fluorography;
ECG.

For workers in the food industry, dairy and distribution points and some other related professions, additional tests will be prescribed, such as:

stool tests for worm eggs and enterobiasis;
smear for staphylococcus.

You may also need to undergo a psychiatric evaluation. It will be necessary for admission to the following types of activities:

Teaching and social work;
Work in law enforcement agencies;
Working with transport;
Work related to the trafficking of psychotropic substances, drugs and chemicals;
Work in extreme conditions.

Receiving survey results.

The results of the preliminary/periodic medical examination are documented in the form of a medical report in accordance with Order No. 302n. In case of a positive medical report, a certificate is issued to the patient. Then he himself can provide it to the employer. If the conclusion is negative, in addition to issuing it to the employee, it is sent to the employer within three days.

The conclusion may be negative if diseases that are contraindicated for certain types of activities are identified. For example, for workers in the food industry these are infectious diseases, and for people working in transport - mental disorders and ophthalmological diseases.

Required documents

To undergo a preliminary/periodic medical examination you will need the following documents:

passport or other identification document;
referral from the employer;

Workers employed in certain areas (food industry, medical staff, teachers, etc.) will also need to obtain a medical record. It can be issued at the same clinic where the examination takes place.

Rules for preparing for an ECG

Many people have no doubt that an ECG requires absolutely no preparation. Sometimes in such patients the result of the cardiogram may be false. There may even be elements indicating the development of heart pathology. To eliminate the risk of receiving false results, cardiologists recommend not ignoring the rules for preparing for an ECG.

You need to start preparing the day before the test.

Maintaining complete calm - on the eve of the study, it is necessary, if possible, to completely remove yourself from stressful situations. Experiences and high anxiety can distort the results of the cardiogram.
Get a good night's sleep - be sure to get a good night's sleep the night before the test. A tired body contributes to abnormalities in the functioning of the heart, as it functions in an enhanced mode.
Drinking alcohol before the study is strictly prohibited. The fact is that alcohol causes blood to thicken, as a result of which the heart muscle begins to work much stronger and more active.
Proper nutrition - do not overload the body with too much dinner or breakfast. On the eve of the study, it is advisable to exclude heavy foods from the diet and avoid fatty foods. Otherwise, the body will devote all its energy to digesting food and the heart will be forced to work harder.
Refusal of physical activity - a cardiogram will show reliable results if you refuse to play sports the day before and do without jogging and exercise in the morning.
Avoid thermal procedures - you cannot visit baths and saunas before taking a cardiogram. Doctors also advise against taking baths. Any thermal procedures can increase blood circulation and heart function, which will distort the result of the study.
Taking medications - it is not recommended to take any medications the day before the examination, other than those prescribed by the doctor on a regular basis. In this case, you must inform your doctor about the medications you are taking.

On the day of the cardiogram, the following recommendations should be followed:

give up coffee - it is advisable to avoid drinking coffee on the day of the study, this applies to all caffeine-containing drinks; it is strictly forbidden to take energy drinks;
exclude the use of creams before the procedure - do not apply any greasy lotions or creams to the chest; these cosmetics can form a thin film on the surface of the body through which the electrodes will have poor contact;
stop smoking 3 hours before the test - you must stop smoking, as nicotine can cause severe vasoconstriction, which leads to excessive heart activity;
choose the right clothes - sensors that record heart impulses are installed in the chest area, as well as in the calves and wrists, these areas of the body will need to be exposed before the study, so choose clothes that will be easy to remove and will not create any interference for the installation of electrodes .

Anesthesia

The procedure is absolutely painless and the patient does not need pain relief.

How often can you do an ECG and is it harmful?

Currently, an ECG is included in the list of mandatory (screening) studies when visiting a doctor, both in a clinic and in a hospital. Patients with heart disease can encounter an ECG after the first visit to a therapist (cardiologist), when calling an ambulance, or during an examination in a hospital.

Patients are advised to periodically take an ECG to assess the success of treatment and disease progression. The results should be kept in your documents so that the doctor can assess the dynamics of the disease at any time.

This examination is harmless to your body and is a good method for early diagnosis of the disease.