In 2012, Vladimir Putin spoke about the need to increase the salaries of medical workers. This was set forth in the so-called May Decrees, signed by him. The deadline for the implementation of one of the most famous May presidential decrees on a specific increase in salaries for state employees is January 1, 2018. By this time, the salary of school teachers, nurses, cultural workers and some other categories of state employees should be equal to the average for the region.
Doctors, university professors and scientists must receive at least 200% of the average salary. The fact that the decrees have been successfully implemented is not specifically mentioned anywhere, but the figure - 35% for 2016 - appears as the level of income growth for medical workers. This increase in the salaries of medical workers was due to the reduction in the number of medical workers in hospitals and even the closure of some clinics, after which the budget could be distributed to a smaller number of workers. 2017 is the last year for the implementation of the May decrees regarding the increase in the salaries of doctors. Today we are talking about changes in the payroll system in 2017. From January 1, 2017, the salary of medical workers in Russia will be calculated in a new way. If before the average salary of a medical worker was calculated only on the basis of statistics from state healthcare institutions, then since 2017 private clinics have also been included in the calculation.
However, now, almost five years after the decrees were issued, despite optimistic reports, it has become clear that the salaries of state employees have not come close enough to the cherished indicators to make their achievement over the remaining 11 months seem realistic.
Even according to the results of the three quarters of 2015, the situation looked better than according to the latest data from Rosstat: over the three quarters of the past year, the salaries of teachers and doctors decreased relative to the average. The salaries of physicians decreased in nominal terms in 11 regions over the first nine months of 2016 - in the Moscow and Yaroslavl regions, the Nenets Autonomous Okrug, in Adygea and other regions.
The salaries of teachers and social workers are also not approaching the target indicators of decrees, according to Rosstat. The average salary in Russia for the nine months of 2016 amounted to 35,700 rubles. Social workers receive only 58.4% of this amount (20,900 rubles), university professors - 140% (50,000 rubles). For the same period last year, the ratios were about the same.
Closest to the target of 100% of the salaries of school teachers. They average 32,600 rubles, or 91.4% of the average salary in the region (on average in Russia). But the dynamics here is negative: for the same period in 2015 it was 96.5% with an average teacher salary of 31,900 rubles.
In December 2016, Deputy Prime Minister Olga Golodets assured that the May decrees regarding wages would be fully implemented. She also said that salaries, in particular doctors, will increase in two stages: by 7.5% from January 1 this year, at the second stage from October 1, they will reach 180% of the average for the region, and by January 1, 2018 - 200%. Based on the achieved 137% for the three quarters of 2016, it turns out that the salaries of doctors for the year - from October 1, 2016 to October 1, 2017 - should show an increase of 63 percentage points against the average salary, which, according to government calculations, is also will grow. Accordingly, the salaries of doctors should increase by about a third, after which they should add at least another 10% per quarter.
Between the regions of Russia, there is still a multiple difference in the amount of doctors' salaries: from 23,200 rubles. in Ingushetia up to 109,000 rubles. in the Yamal-Nenets and Chukotka Autonomous Okrugs. In Moscow, doctors earn an average of 81,000 rubles. per month, according to Rosstat. But if in absolute terms such a salary is higher than in many other regions, then compared to the average in the capital, it is lower (117.7%).
Dynamics by region is also different. If in the capital the salaries of doctors increased by about 10% (three quarters of 2016 compared to the same period in 2015), then in the Yamalo-Nenets Autonomous Okrug, on the contrary, they decreased by 3%.
“Despite all the promises and measures from the federal and regional authorities, over the past years, the task of raising the salaries of medical workers has not been resolved,” says Eduard Gavrilov, director of the Health independent monitoring fund. “It is obvious that the leaders of a number of regions are not coping with the implementation of decrees.”
A significant difference in salaries is also noted depending on the form of ownership of a particular hospital: it is more profitable to work in federal hospitals, for the first nine months of 2016 there was the largest increase in doctors' salaries (by 8%). In regional clinics, doctors' salaries rose by about the same rate as inflation - about 5%, while in municipal clinics the increase was almost zero (negative, taking into account price increases).
“Decrees, most likely, will not be implemented on time,” economist Yevgeny Gontmakher said in an interview with Gazeta.Ru. - Indeed, the gap is very large, such a miracle cannot happen even in two years, so most likely not. The impracticability of the decrees was clear for a long time, one of the ways to solve the problem could be a delay, but the president himself has not yet agreed to it. The day of reckoning will come sooner or later. Just a question: when? If it is a cut-off on January 1, 2018 - this is one thing. But our colleagues from the government can say anything: 2018 will pass, and we will sum up the results ... The political situation in 2018 is changing - there will be a change of government and so on, so it is possible that the logic is to hold out until May. The most likely option would be a statement from the mouth of the president about force majeure. The situation in the economy has deteriorated sharply compared to 2012, when the decrees were signed, so we can refer to insurmountable circumstances.”
The fact that the government is preparing to postpone X-hour is indirectly evidenced by the adopted law on the budget of the Federal Compulsory Medical Insurance Fund, which states that the federal subvention ensures the implementation of the presidential decree within the ratio of 180% (for doctors) in 2017, and the indicator is 200 % is planned to be reached in 2018. This may mean that wage increases will be made during the 2018 election year, and not before its beginning, as the decrees imply. Then, in 2019, it is planned to maintain the achieved level of salary ratio.
A doctor is a highly demanded profession in the 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 |
| St. 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 |
| Amur region | 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 working conditions. 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
Employees of public hospitals are one of the most vulnerable categories of Russians. After recent reforms, many doctors have lost decent salaries or switched to overtime work. But in 2017, the situation may change. The authorities promise to raise the salaries of "state employees", the lion's share of which is.
According to the assurances of the Russian authorities, in 2017 the salary of doctors will double
Physician salary calculator
To understand whether the salary of doctors will rise, you first need to understand its accrual. So, the income of doctors is formed from the following payments:
- Guaranteed salary (about 2/5 of the total amount)
- Bonuses, allowances for overtime work, harmful working conditions, academic degree, intensive work and continuous service (3/5 of income)
At the beginning of 2016, the government reported that the average salary of a physician was 48,000 rubles a month. However, the Health Foundation conducted its own study, which involved more than five thousand doctors from 84 regions of Russia. The average participant in the survey received only about 20 thousand rubles! Obviously, this state of affairs needs to be corrected.
Salaries of doctors in 2017
Hopes for revenue growth are based on Vladimir Putin's "May" decrees, which the president signed in 2012. Minister of Labor and Social Protection Maksim Topilin stressed that the authorities would fulfill the promises given then. According to the resolutions, the incomes of doctors should exceed the average for the region twice by the end of next year.
To fulfill this plan, the government must raise the salaries of doctors by 50%. The catch is that the increase will affect only the salary and will not affect the rest of the payments. In 2014, the Ministry of Health increased the guaranteed part of the salary by one and a half times, while reducing the amount of compensation and allowances. Thus, the financial situation of physicians remained the same.
Wages are gradually rising due to indexation, but its pace has not kept up with the increase in prices. According to the forecasts of the Central Bank, in 2016 it will be 5.5-6%. State employees' salaries should increase in line with this indicator - but will the government be able to cope with such a task?
What affects the income of doctors?
In 2014, Russian medicine underwent major reforms. The number of doctors has decreased by 90 thousand, and the workload of their colleagues has increased significantly. The average Russian physician works at one and a half rates, that is, 11-12 hours a day instead of the required eight. And in 2017, a new wave of layoffs is coming ... Many hospitals have begun to enter into additional agreements with employees that establish payment for overtime work.
The main question is: will the government keep its promises, or will it manage to leave doctors without a long-awaited salary increase? Unscrupulous employers use legal tricks to get subordinates to work for pennies or for free. The well-being of doctors was also worsened by the new system for assessing working conditions. If until 2014 doctors received bonuses and privileges for harmfulness according to their position, now only the danger of the workplace affects the benefits. For example, X-ray rooms are assigned only the second class of hazard.
The payment of allowances is a sore subject for employees of many hospitals. Managers assign bonuses to themselves and to subordinates who support their decisions. It is not surprising that thousands of doctors leave to work in private institutions. Despite the loud statements of politicians, the state budget is unlikely to double the salaries of doctors. Therefore, thousands of doctors will continue to work overtime or start looking for another job.
The current regulatory framework spells out the methods for forming the salaries of doctors in Russia. The accrued amount consists of 3 parts: the allowance for the length of service, the rate and compensation for harmful conditions. The subjects of the federation have been given the right to establish additional payments for certain categories of medical workers. According to the norms of the current legislation, the surcharge is optional. Appointed subject to the availability of appropriate financial resources in the budget.
Growth in the salaries of medical workers from 2013 to 2017
From the moment the employee starts working, an employment or fixed-term contract is concluded with him. In some cases it is a collective agreement. The document spells out the salary of doctors and all the conditions that allow changing it in one direction or another:
- approved classifier of professions;
- developed professional standards;
- surcharges of local authorities;
- decision of the RTK;
- commendations or accolades received.
A separate decree of the Ministry of Health of the Russian Federation defines the maximum salary for the management of a medical institution. The monthly salary of the chief physician may not exceed eight times the salary of the employees of this medical institution. This wording made it possible to eliminate the conflict associated with certain provisions of the Labor Code of the Russian Federation.
See in the video: the real numbers of salaries for doctors.
A lot of attention is paid to the issue of accounting experience. Thanks to this indicator, the salary of doctors in 2017 will be indexed. On the one hand, the current norms do not allow to take into account the length of service as one of the grounds for increasing or decreasing wages. On the other hand, a special decree of the Ministry of Health recommends taking into account the length of service when assigning compensation payments in 2017 in Russia.
Thanks to this, employees of medical institutions in remote areas of the country received tangible bonuses. Not only compensation for harm worked here. An important role was played by the duration of the work. The professional qualification group is taken into account. Each of them has certain requirements for experience, merit, scientific publications, etc.
Doctor's pay slip with tax deducted
The better the doctor works, the more money he will receive at the end of the month. This allows you to objectively evaluate the contribution to the work of the medical institution of each employee. Statistical information is analyzed monthly. The employee has the right to see it. In the event of disputes that could not be resolved at the level of the head physician, it is necessary to contact the specialized commission on labor conflicts.
Comparison of salaries of medical workers in large cities of Russia
Piecework-premium form of remuneration
The legislation of the Russian Federation allows the accrual of salaries to medical personnel in a piecework format. At the same time, there are a number of legal subtleties to be aware of. They were determined by the decision of the Ministry of Health of the Russian Federation and the decision of the tripartite commission (RTC). The first rule says that it is possible to set such a format without any restrictions.
This means that in addition to the basic rate, the employee has the right to earn extra money in the same institution. Before signing an addendum to an already existing labor agreement, it is necessary to make sure that the applicant has the appropriate qualifications. This rule is not mandatory if the applicant plans to engage in work that is not related to the provision of medical care.
The second rule requires compliance with the established methodology for the formation of piece-bonus wages. Taken into account:
- the actual cost of the services provided;
- the duration of the work being done.
Incentive and compensation payments are not taken into account. Regardless of the duration of the additional work performed, doctors are charged piecework pay as part of the next paycheck. The payment documents must indicate the terms of the work performed, the coefficients used and possible deductions.
An example of a pay slip for a surgeon in Russia
Calculation of the brigade form of remuneration
In order to improve the efficiency of medical institutions, the Ministry of Health of the Russian Federation decided to change the form of remuneration for doctors.
Now the salary of an individual health worker depends on the performance of the team in which he works. The new technique is based on many years of medical experience.
Watch the video: The Minister of Health talks about the sources of increasing the salaries of doctors.
Officials decided not to prescribe strict work hours. This was done for reasons of common sense. Firstly, during the day it is impossible to predict how many calls will be made by patients. Secondly, the team will spend a different amount of time with each patient. This means that, again, standard hours are a very conditional indicator here.
The current legislative framework in the Russian Federation provides for the following formula for determining the size of the brigade form of payment:
- A - the number of calls recorded in the reporting period;
- B is the population of the service area;
- C - the duration of the reporting period (30 or 31 days, depending on the month).
An approximate calculation of the indicator is performed as follows - A x B: C. 418 received calls are taken and multiplied by 1000 people living in this area. The resulting value is divided by the duration of the reporting period. The resulting value is used to calculate the brigade form of remuneration. From a practical point of view, this approach encourages the doctor to work better.
The photo shows the average salaries of doctors in Ukraine
The presence of a direct relationship between efficiency and salary helps the employee to realize responsibility for their own future. However, there is also a downside to the model. Skeptics focus on the possibility of being left without a salary at all. Suppose a medical institution has carried out effective preventive work. The number of calls during the month is at a low level.
If we take only this formula as a basis, then the average salary of doctors in 2017 will be at a similar level. The Ministry of Health, realizing the importance of the decisions being made, left the medical institutions room for maneuver. Medical institutions have the right to use complex methods for calculating wages based on actual conditions.
The latest news confirms the intention of the authorities to increase the salaries of doctors in 2018. President Vladimir Putin stressed the need to fulfill the obligations set out in the May decrees. Experts believe that the actually planned increase may not coincide with the real one, since the budgets of various levels maintain a significant deficit.
Latest news for doctors: expected salary increase in 2018
As part of the May decrees, the salaries of doctors should be significantly increased until 2018. Already next year, doctors should receive at least 200% of the average wage in the region. For middle and junior staff, this indicator cannot be less than 100%. The authorities will fully fulfill this task, emphasizes the head of state Vladimir Putin.
Since 2012, the salaries of doctors have been constantly increasing, officials emphasize. Despite the consequences of the economic crisis, this year the remuneration of doctors will reach 180% of the average in the region. Since the beginning of the year, the salaries of doctors have increased by 7.5%, the second stage of the increase is scheduled for October 1. At the end of 2016, the average salary of a doctor exceeded 50 thousand rubles, for middle and junior staff this figure reached 28.2 thousand rubles, respectively. and 18.4 thousand rubles.
The transition to two stages of raising the salaries of doctors during the year indicates the intention of the authorities to optimize budget spending, experts emphasize. The authorities continue to experience a shortage of funds to finance social obligations, which forces them to look for ways to reduce costs. In such conditions, there is a high probability of an incomplete increase in the salaries of doctors from January 1, 2018.
In addition, some regions are significantly behind the implementation of presidential decrees, not finding the necessary funds to increase the wages of medical personnel.
Regional features of the increase
The head of the Health Foundation, Eduard Gavrilov, highlights the problems that could prevent the authorities from fully fulfilling their obligations to increase the salaries of medical staff. At the same time, it is worth considering the peculiarities of the remuneration of doctors in medical organizations of various types. If we take into account regional and municipal institutions, then the ratio of the doctor's salary to the average level will be 2.8% lower.
To reach a new level of medical salaries in 2018, the regions have compiled their own roadmaps that fix intermediate target values. According to the results of last year, more than a third of the regions did not reach the planned level of increase in doctors' salaries, Gavrilov emphasizes. Also, 16 regions do not meet the indicator for the middle level of medical staff. However, the biggest problems are related to the remuneration of junior staff.
According to the Health Foundation, about 75% of the regions failed to meet the target level of increasing the work of junior medical staff. Such statistics indicate the presence of systemic problems in the implementation of roadmaps. In addition, low wages for junior staff lead to high employee turnover. This trend has a negative impact on the quality of medical services, Gavrilov believes.
Another negative trend is that some regions make changes to the approved roadmaps if they cannot ensure their implementation. A similar situation was observed in the Omsk and Ryazan regions, which at the end of 2016. – early 2017 adjusted their own plans.
Experts emphasize that the main factor in the implementation of the May decrees is the availability of money in the state treasury. In 2017, the government expects the economic situation to improve, but the domestic budget remains vulnerable.
Budget Constraints
Raising the salaries of doctors and the fulfillment of other social obligations depend on the revenues of the Russian budget. The dynamics of oil quotes remains unstable, which creates risks of an increase in the deficit of the state treasury. The basic forecast assumes stable prices in the oil market, however, excessive oil production may lead to a new collapse in prices.
The government does not rule out a new decline in oil prices, which will significantly limit the financial capacity of the budget. According to the forecasts of the Ministry of Finance, the pessimistic scenario allows for a collapse of quotations to 25-30 dollars per barrel. In this case, the authorities will try to delay the planned increase in wages by the end of the year.
Medical workers expect another increase in wages next year. The authorities intend to increase the salary of doctors up to 200% of the average for the region. For other categories of medical personnel, this indicator will be 100%.
Experts note the regional peculiarities of the implementation of presidential decrees, which indicate the presence of systemic problems. In addition, the vulnerability of the domestic budget to external challenges may hinder the implementation of officials' plans.