Pediatrician Prefers Village Practice Over City Clinics

Anna Bogacheva, 33, is a pediatrician at a district hospital. After earning her degree in the city, she deliberately moved to a village to live and work. In an interview with our colleagues at 76.RU, Anna explained the specifics of practicing pediatrics in the countryside, gave advice to parents for the summer season, and explained why she does not want to return to the city.

Started in the City

Anna moved to the village from Yaroslavl, where she graduated from the pediatric faculty of the medical academy in 2017. She now lives and works in the neighboring Kostroma Region.

— I managed to work for about a year at a children«s clinic that I joined right after university after getting accredited. That clinic was the one I went to as a child. There was a good team; I could easily ask for help. There was a good head doctor who gave me a start — she trained me in practice. Now when I visit, I often drop by, the doctor shares.

In the village where the doctor lives, there is a cultural center, a feldsher-midwife station (rural health post), a school, a kindergarten, a post office, and a library. She moved here after getting married.

— While on maternity leave, I was still registered in the city. But even before that, I felt drawn to the village. During my leave, I got used to it, and after it, I came here — to the district hospital as a district pediatrician. I joined through the Zemsky Doctor (rural doctor recruitment) program and received a payment. I still work here. The team welcomed me well; the chief pediatrician of the district helped me, she says.

Anna travels to a neighboring village for work, which is five kilometers from her home.

How Rural Work Differs from a City Clinic

According to the pediatrician, the difference is significant. It concerns both the schedule and the workload. For instance, every doctor at the district hospital is essentially a generalist. For example, an ophthalmologist sees everyone: both children and adults.

— At first, it was difficult in terms of adaptation. For example, in the countryside there is a shortage of specialized pediatricians. Not long ago, a medical diagnostic center opened at the regional hospital; there are specialists there, but not many appointments — not everyone can travel there. So the pediatrician ends up covering for almost all specialists, except those available at the hospital. If additional examination or hospitalization is needed, we refer them to the regional center, she shared.

At the district hospital where Anna works, there are four pediatricians on staff. Three of them handle districts and see patients, while one supervises schools.

Among other features, the doctor highlights the work schedule — essentially 24/7.

Pediatricians make house calls. Here too there are differences between city and countryside.

— In the city, there are more calls, but the district is small. For example, there could be three calls in one building entrance. But here the spread can be quite large — kilometers of travel. Daytime cars help — when they are free, we can use them, Anna added.

«People Simply Can»t Get There«

A feature that city residents hardly ever think about: how to get to an appointment on time. You get a time slot — you go. In the countryside, it«s different.

— There are morning or evening appointments. But not everyone can come in the evening. We have buses that run twice a day from distant villages. So parents can only bring their child in the morning and then pick them up only at lunchtime or in the evening. So at such times, even if my appointment hasn«t started yet, I still see them because I understand they simply cannot come at another time. They have to travel from a remote village. It»s not like in cities — strictly at the appointed time. I see everyone, said pediatrician Anna Bogacheva.

What Problems Parents Come With

In this sense, there is no difference between city dwellers and villagers: everyone gets sick about the same.

— The illnesses are no different from the city ones. There«s seasonal flu, and we have it too. September, October, November — that»s acute respiratory viral infections with cough, runny nose, and fever. Parents may come from villages referred by feldshers (rural medical practitioners), as they are sometimes incompetent in some matters and refer them to our district hospital, Anna explained.

Why the Young Doctor Loves Her Job

On this question, Anna opened up. The pediatrician adores her profession and seems to throw herself into it completely. At the same time, she is herself a mother of two children.

— I love it for the feedback. Most patients are very grateful and understanding. The kids are wonderful. For those who aren«t very cooperative, I give out stickers that I buy specially. As a kind of incentive for those who don»t want to let me listen to them or show their throat, Anna Bogacheva shares the pediatrician«s tricks.

Probably not everyone finds pleasure in listening to other people«s problems. But Anna sees it as a plus of her job — helping to relieve emotional tension.

— Sometimes you need to be a bit of a psychologist. Postpartum depression hasn«t been cancelled, for example. Mothers worry a lot about everything, with or without reason, and don»t understand how to handle the child. And you comfort them, explain the specifics of newborns, that many physiological conditions aren«t scary but are normal variants, the pediatrician explains.

She also explained why it«s important not just to treat but to build trusting relationships with patients.

— As my nurse used to say, our common task is to raise your healthy children. Doctors give recommendations, but we don«t know if they are followed at home. Trusting relationships between doctor and patient are important, Anna emphasized.

Scary Case with a Newborn

Anna also told about a rare case she encountered in her practice. In her first year working at the rural hospital, she received a call on a day off to see a newborn. The condition was frightening: vomiting, the baby«s eyes were rolling back.

— The baby was born normal and healthy. They were discharged home. The parents and I stayed in touch and exchanged contacts. They write to me that something is wrong with the child: vomiting, rolling eyes. The father then came to pick me up. On the spot, I realized something was wrong with the infant, but I couldn«t say exactly what. I insisted on hospitalization. At the regional center, they examined him and discovered an intraventricular hemorrhage in the brain, the pediatrician recalls.

According to the doctor, this condition is extremely dangerous, even fatal.

Intraventricular hemorrhage is an excessive accumulation of blood in the brain«s cavities due to the rupture of immature blood vessels. The clinical picture depends on the stage of the disease: the mildest can be asymptomatic. In more severe cases, the hemorrhage is followed by multiple manifestations — from strabismus to respiratory depression.

— The condition was dangerous; few survive it. They were treated for a very long time. The child was given a disability, but he is in quite good condition now. A good boy. We still have warm relations with the family. Great parents, a very strong mother, how much she went through. I remember how many tears I shed, and they... When your child is in intensive care, they don«t let you in. But thank God the doctors took over and operated. Now he is compensated. The main thing is he is alive — yes, with a disability — but he runs, jumps, goes to kindergarten.

Why She Doesn«t Want to Return to the City

Anna has come to love both rural life with its atmosphere — a vegetable garden, nature around, and open spaces — and work at the district hospital. As she notes, earnings in the hinterland are similar to a doctor«s income in the city.

— Of course, we communicate with colleagues from the city and see each other at conferences. I observe their work. However, at our district hospital, they did a magnificent renovation with hand-painted walls in the children«s consultation room — sponsored by a local jewelry company. And now we are no worse, but even better than private centers. Clean, tidy, there is a mother and child room with a changing table. The waiting time with children is comfortable because there are special playhouses with all sorts of things. Our children»s consultation is like Narnia — a separate world. There«s a TV, you can watch cartoons, and a good restroom. I go to work with great pleasure.

Tips for Parents for the Summer Season

In conclusion, the pediatrician gave recommendations to mothers and fathers on what to pay special attention to in their children«s health.

— I would recommend paying attention to several problems. First — ticks, there are quite a lot of them. Especially near water bodies, which are abundant in the countryside. Always check yourselves and children. In practice, there was a case where a tick bit a newborn on the head. As it turned out, a cat brought it. Thank God it turned out not to be infected. I was shocked that a child who only lies there had a tick.

The doctor also highlighted other dangers to watch for in the warmer months:

intestinal infections and rotavirus. Summer is the season for fresh berries and fruits, and with that comes an increased risk of food poisoning;

sore throats from excessive ice cream. The child becomes hypothermic, making it easier for viruses to take hold;

heatstroke — wherever children are, they should wear headgear;

injuries: bicycles and electric scooters are a specific type of threat. Children do not know traffic rules and do not dismount at crosswalks, which is very dangerous;

stress in teenagers during exam periods, against which illnesses also flare up.

— Children in their first years of life should not be left in direct sunlight. Sometimes a child is covered, but one leg sticks out from under the hood — and as a result, they get a burn. There are also sun allergies, the doctor concluded.