Feldsher

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German Feldscher in the Franco-Prussian War 1870

Feldsher (German: Feldscher, Polish: Felczer, Russian/Cyrillic: Фельдшер) is the name of a health care professional who provides various medical services in Russia and other countries of the former Soviet Union, mainly in rural areas. For example, feldshers provide primary, obstetrical and surgical care services in many rural medical centres and ambulatories across Russia,[1] Armenia,[2] Kazakhstan,[3] Kyrgyzstan[4] and Uzbekistan.[5]

The equivalent type of provider may also go under different titles in different countries and regions, such as physician assistant in the US or clinical officer in parts of sub-Saharan Africa, collectively grouped under the category “paramedical practitioners” in the International Standard Classification of Occupations, 2008 revision.[6]

History[edit]

The name Feldsher is derived from the German term Feldscher, which was coined in the 15th century. Feldscher or Feldscherer means field shearer ("Feld" = Field, "Scher" comes from the geman term "Scherer" = shearer, thus "Feldscher" = fieldshear), and was the name of the barber surgeons in the army going back to the 17th century. They worked as army field surgeons for the German and Swiss Landsknecht until real military medical services were established by Prussia in the early 18th century. The term was then exported with Prussian officers and nobility to Russia.

The Feldsher system of rural primary care provided some of the inspiration for China's program of Barefoot doctors.

Today feldshers can be found in every medical setting from primary to intensive care.[7] They are often the first point of contact for the rural population with health professionals.

Education and training[edit]

Training programs for feldshers can be up to four years of postsecondary education, including in medical diagnosis and prescribing.[3] They carry out clinical responsibilities that may be considered mid-way between physicians and nurses. They do not have the full professional qualifications as physicians.[8]

The training program typically included basic pre-clinical sciences (anatomy, physiology, pharmacology, microbiology, laboratory subjects, etc.) and advanced clinical sciences (internal medicine and therapeutics, neurology and psychiatry, obstetrics, infectious diseases and epidemiology, preventive medicine, surgery and trauma, anesthesiology and intensive care, pediatrics, and other clinical subjects such as ophthalmology, otolaryngology, dermatology and sexually transmitted diseases, ambulance service and pre-hospital emergency medical care, army field medical-surgical training.

See also[edit]

References[edit]

  1. ^ Farmer R et al. The Russian health care system today. Cleveland Clinic Journal of Medicine, 2003; 70(11) http://www.ccjm.org/content/70/11/937.full.pdf
  2. ^ World Health Organization. National Health Accounts of the Republic of Armenia 2006. Yerevan, 2007 - http://www.who.int/nha/country/arm/nha2006.pdf
  3. ^ a b European Observatory on Health Care Systems: Health Care Systems in Transition: Kazakhstan. Copenhagen, 1999 - http://www.euro.who.int/__data/assets/pdf_file/0003/95115/E67903.pdf
  4. ^ World Health Organization and Ministry of Health, Kyrgyzstan. Integrated Management on Emergency and Essential Surgical Care (IMEESC). Bishkek, Kyrgyzstan, 2005 - http://www.who.int/surgery/Report_Kyrgyzstan_Facilitators_workshop.pdf
  5. ^ World Health Organization and Ministry of Health, Uzbekistan. Assessment of the mental health system in Uzbekistan. Tashkent, Uzbekistan, 2007 - http://www.who.int/mental_health/evidence/uzbekistan_who_aims_report.pdf
  6. ^ World Health Organization. Classifying health workers. Geneva, 2010.
  7. ^ World Health Organization Regional Office for Europe: Primary health care - http://www.euro.who.int/en/what-we-do/health-topics/Health-systems/primary-health-care/facts-and-figures, accessed 15 March 2011.
  8. ^ Floyd K et al. Health-systems efficiency in the Russian Federation: tuberculosis control. Bulletin of the World Health Organization 2006; 84(1): 1-80 http://www.ccjm.org/content/70/11/937.full.pdf