of market psychology on it, we can visualize the perspectives of medical education.
A country of the size and complexity of Russia has diverse needs. It is likely that having provided an effective, easily accessible and comprehensive health care system, there is a need to provide greater flexibility so that individual areas can develop services for their own needs. Any particular health system cannot be transferred to another country. Moreover, some elements of the health care system may need to be specifically adapted to different regions within the country itself.
In developing this more flexible service, consideration must be given to holding down costs, maintaining equity, and constantly improving the quality of the service. There is an attempt to move toward a pluralistic approach operating in the conditions of a market economy. At the same time, market forces on their own, although they will make the service responsive to individually perceived needs, will not necessarily hold down costs, maintain equity or improve quality. This is partly because health cannot be a subject of the market in any real economic sense.
In these circumstances there is a need to revise the role of central authorities in monitoring standards, evaluating the services, and stimulate new developments. This will enable firm, validated suggestions on improvement to be made. It is essential to underline also the role of central authorities in monitoring and influencing changes in the undergraduate, postgraduate and continuing education of doctors that will ensure that they are in a position to provide a high quality service.
The future of the health system, biomedical research and medical education are inextricably linked with the economical situation in the country. If, for example, substantial additional finding were not forthcoming for the state health care system managed by the Ministries of Health, innovative financing and reorganization of resources alone would not substantially improve the quality of the system. Conversely, even if the Ministries of Health were infused with increased funding, if the ideological vision of high-quality free health care for all were diluted, there would remain the potential for the rise of a multitiered system of health care.
This leads to the conclusion that what we have today may not be perfect. In other words, in order to achieve the impossible, we have to see the invisible. This is the only real way toward the progress.
Vartanian F. E. 1993. "Continuing medical education and its management". Journal of Management in Medicine 7( 2):29-24.
-----. 1988. "Information technologies: Their inevitable impact on CME (Illusions, realities, perspectives)". Journal of Continuing Education in the Health Professions 8:313-319.
-----. 1987. Continuing medical education in the Union of the Soviet Socialist Republics. JAMA 258(11 September):1358-1360.