December 21, 1997 in Nation/World

Medicine Moves Underground On The Moscow Metro Subway Clinics Fit The Needs Of Urban Crush

Carol J. Williams Los Angeles Times
 

In the rush of life in modern Moscow, mobile medicine has taken on new meaning: Here, it is the patients who are in motion.

With as many as 9 million passengers traversing the 164 miles and 160 stations of the Metro subway system here each day, private doctors and medical technicians have been encouraged to bring a few of their most outpatient-friendly services underground.

Five ultrasound clinics and two optometric practices have taken up residence in a handful of busy Metro stations, and drop-in business is booming from the steady flow of potential patients.

“It takes forever to get an appointment at a regular clinic, and in this weather who wants to go outside?” asks Nikolai Dudin, a 46-year-old electrical contractor just fitted for his first pair of eyeglasses. “Of course, the proof will be in the prescription. The light is so bad in here, anyone would have trouble seeing.”

Dimness and dust are two deterrents to broader expansion of Metro clinics, but city officials say the biggest problem is space. The busiest and most central stations were built in the late 1930s, when there was no need to share premises with consumer services because they were not offered along the subways.

“The newer stations being built to extend the Metro network to the suburbs are going to be bigger, so private businesses and services can set up where it is most convenient for customers,” said Konstantin Cherkassky, spokesman for the Moscow Metropolitan, landlord to the clinics as well as other vendors.

Since small enterprises began kicking footholds in the cavernous above-ground subway entrance buildings and in the nooks and crannies below, hundreds of flower sellers, newsstands, lottery booths and pharmacies have filled up the available space.

“We’d like to open more clinics, but there just aren’t any more suitable premises” available, said Nikolai Savin, the doctor-turnedbusinessman who founded Ulsonik, the five-station ultrasound network that serves an average of 100 drop-in patients a day.

Savin opened his first Metro clinic five years ago, when a shortage of ultrasound equipment and medical professionals trained to use it meant those wanting ultrasound scans had to wait at least a month.

Then specializing in ultrasound scans and treatment, Savin cobbled together loans and import licenses and located his storefront practices in Metro stations, where they are most readily reached by those seeking his services.

The five clinics now employ 18 doctors and an equal number of ultrasound technicians. Doctors earn 25 percent of the 98,000-ruble (about $16) fee for each patient served.

“Even if we see only four patients a day, which is an unusually light volume, that’s 100,000 rubles for a day’s work, compared with my former salary at the state clinic of 300,000 (about $50) a month,” said Alla Shirokova, one of the Ulsonik doctors at the Okhotny Ryad station clinic.

The cost of an ultrasound scan at the Metro clinics is usually less than at a hospital or general medical clinic because of the low overhead and high patient turnover, the doctors explained.

Most of the customers are pregnant women wanting a look at their developing fetuses without the wait or bureaucratic rigmarole involved at state-funded clinics.

While the success of the existing clinics would seem to justify expansion into other spheres of medical services, health officials note that few treatments are suitable to the noisy, bustling and grimy corridors of a subway.

“Anything involving blood or urine diagnostics needs to be carried out in a more hygienic environment,” Savin noted. “Even other superficial diagnoses, like blood-pressure testing, are not really suitable because of the tense atmosphere of a busy station.”

But the bright pink signs advertising the clinics’ range of services, the 10-hours-a-day operating times and the convenience of being only steps away from a commuter’s route to work are drawing more and more Muscovites to the existing eye and ultrasound clinics.


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