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Driving his car through the pine woods north of St. Petersburg in sunny June weather, Dr. Arkady Stolpner asks his assistant by phone to purchase a ticket for a flight to Kazakhstan next week – the next diagnostic center will be opened there, and Stolpner is taking care of it himself. At the sign “Gamma Knife Center” Stolpner turns right – and we’re at the core of Stolpner’s empire. It is an empire that helped change Russian healthcare. Stolpner, now in his mid-fifties and a dynamic, friendly man, is a very good example of a Russian self-made man: He began working as a doctor in the eighties, but when Gorbachev’s perestroika made it possible, Stolpner founded the first Russian hospital for traditional Chinese medicine. The turbulences of the nineties put a quick end to the experiment, but by 2003 the times had changed again. It was Sergey Berezin, an old friend and well-known doctor, who proposed to Stolpner to open private magnetic resonance imaging (MRI) diagnostic centers. “Back then, in order to get an MRI diagnosis in one of the state-owned clinics of St. Petersburg, you had to wait four months,” says Stolpner, while sitting in his office in the Gamma-Knife Center, nowadays a diagnostic and treatment facility with 50 beds, radiation oncology, surgery, and chemotherapy departments. Instinct and Trust “At that time, the state-owned clinics were totally underequipped, and there were no private diagnostic centers with MRI,” explains Stolpner, “but everybody told us that it would never work out because of the costs.” Stolpner, however, trusted his instinct and founded the Diagnostic Treatment Centre of the International Institute of Biological Systems (DTC IIBS). And his basic assumption – that there is demand for high-class medical diagnostics that is not being met by the state-dominated medical institutions – proved right. The center bought its first Siemens MRI system and welcomed their first patient in August 2003. In December 2004, Stolpner opened a second center in the nearby town of Tver, and a third center in 2005 in the Siberian city Krasnoyarsk, which is 5,500 kilometers away. “We understood: If we can manage a center that far away, we can do it anywhere in the country,” says Stolpner. Because service is a big issue when you have long distances to go for technicians and spare parts, DTC IIBS trained its own service engineers from the very beginning.
Today, DTC IIBS has 77 diagnostic centers in Russia and also in several neighboring republics such as Ukraine and Armenia, most of them equipped with Siemens ecoline MRI and computed tomography (CT) scanners. Ecoline systems are pre-owned Siemens systems refurbished for their customers worldwide during a complete process of cleaning, disinfection, whole surface painting, customized configurations, performance updates, and the latest hardware and software applications. The refurbishment of Siemens ecoline systems is a comprehensive process that starts with a professional inspection of the system before de-installation at the last customer site and leads, finally, to the start of a completely new life-cycle under expert supervision provided by Siemens.Stolpner has a “strategic partnership with Siemens,” as he puts it. Just this year, he ordered 12 MRI and three CT ecoline systems. “In the field of visualization equipment, Siemens is simply the best,” says Stolpner while we’re walking through the light-flooded corridor that connects the old part of the clinic with the newly-built PET (positron emission tomography) center. Here, the clinic offers a Siemens BiographCT scanner that helps to localize tumors. It is the long-term perspective, the combination of quality and sustainability that unites Siemens and Stolpner. “Our relationship has developed over the years to a stage where we trust each other totally,” he says.
Stolpner’s doctors scan 3,600 patients a day, and with 1.2 million MRI exams per year his centers account for 20 percent of all such exams in Russia. But the core of it is still the clinic in the woods north of St. Petersburg. Upon receiving reports, especially from young doctors from the regions, his most experienced doctors in the consulting center make around 340 assessments a day. If needed, patients are invited for treatment to St. Petersburg. Here, 2,500 patients are treated annually. Radiosurgical Pioneer Stolpner is proud to be equipped with high-end equipment for radiosurgery and radiation oncology. Several years ago, radiosurgery was not practiced in Russia – simply because there was no equipment. In 2008, DTC IIBS was the second center in Russia equipped with a Gamma Knife. Nowadays, his clinic offers an Accuray CyberKnife® and – most recently – a True Beam system by Varian. But Stolpner still sees room for development. He estimates that 100 diagnostic centers should be the limit in Russia, but there are still neighboring countries he could expand to. “In the near future, we plan to open a Gamma Knife center in Novosibirsk to make treatment more convenient for the patients from Siberia,” explains Stolpner. Times are changing, however. Over the last few years, according to Stolpner, the competition has become stronger: “There are other private clinics that offer diagnostics, and the state has been investing a lot in medical equipment since 2008.” Yet Stolpner understood from the very beginning: Equipment alone is not enough. An important reason for his success is that DTC IIBS trains doctors how to work with the equipment – over 300 since 2003. Before starting to work with the hightech equipment that they never saw during their education at state universities, the new employees from the regions come to the St. Petersburg clinic for several months of inte nsivecourses certified by the Russian Ministry of Education. One of them, the 29-year-old neurosurgeon Alexander Kuzmin from the Siberian city Tyumen, has just finished the MRI of a young patient. He has been working at Stolpner’s center since 2010. “We have the newest equipment and the newest methods of treatment here,” says Kuzmin. This is why he didn’t hesitate when he got a proposal from Stolpner while he was just finishing university. Like Kuzmin, most of Stolpner’s doctors are between 25 and 40. “Our doctors, especially in the regions, are much sought after by our competitors,” says Stolpner. “But they usually stay with us. And we value loyalty.” Another reason for Stolpner’s success is the cooperation with the state that is of high importance in a system where healthcare is still dominated by the government. Most citizens still use the mandatory health insurance, although that insurance only gives access to state-owned clinics. That is why 9.5 percent of Stolpner’s patients have an additional private health insurance, but 90 percent have to pay themselves. “In the regions, we find mutually beneficial agreements with the authorities,” he explains. In the case of St. Petersburg that means that the city pays for the treatment in Stolpner’s clinic for certain categories of citizens who cannot afford it themselves. But Stolpner is hoping to be included in the state health program run by the Ministry of Health. That would make it possible for “normal” people without additional private insurance to be treated at his centers. “The state is investing a lot in its own clinics, but we are convinced that we can work better – and more efficiently,” says Stolpner.