Feldsher

According to the World Health Organization, a feldsher (German: Feldscher, Polish: Felczer, Czech: Felčar, Russian: фельдшер, Swedish: Fältskär) is a health care professional who provides various medical services limited to emergency treatment and ambulance practice.[1] In Russia and in other countries of the former Soviet Union, feldshers provide primary-, obstetric- and surgical-care services in many rural medical centres and clinics across Russia,[2] Armenia,[3] Kazakhstan,[4] Kyrgyzstan,[5] Mongolia[6] and Uzbekistan.[7]

German Feldscher in the Franco-Prussian War 1870
A feldsher performing an amputation. Engraving from 1540

The equivalent type of provider may also go under different titles in different countries and regions, such as "physician assistant" in the United States or "clinical officer" in parts of sub-Saharan Africa. The International Standard Classification of Occupations, 2008 revision, collectively groups such workers under the category "paramedical practitioners".[1]

History

The word Feldsher is derived from the German Feldscher, which was coined in the 15th century. Feldscher (or Feldscherer) literally means "field shearer," but was the term used for barber surgeons in the German and Swiss armies from the 17th century until professional military medical services were established, first by Prussia in the early 18th century. Today, Feldshers do not exist in Germany anymore, but the term was exported with Prussian officers and nobles to Russia. An All-Russia Union of Feldshers was founded in 1905. They were regarded as "Middle Medical Workers".[8]

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

Today feldshers can be found in every medical setting from primary to intensive care.[9] They are often the first point of contact with health professionals for people in rural areas.

Education and training

Training for feldshers can include up to four years of post-secondary education, including medical diagnosis and prescribing.[4] They have clinical responsibilities that may be considered midway between those of physicians and those of nurses. They do not have full professional qualifications as physicians.[10]

The training program typically includes 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

References
  1. World Health Organization (2010). "Occupation group: Paramedical practitioners. Feldsher (Examples of occupations)" (PDF). Classifying Health Workers. Geneva. page 4/14 in PDF. Ambulance workers. ISCO code: 2240.
  2. Farmer R et al., "The Russian Health Care System Today. Cleveland Clinic Journal of Medicine, 2003; 70(11) (PDF)
  3. World Health Organization. National Health Accounts of the Republic of Armenia 2006. Yerevan, 2007 - (PDF)
  4. European Observatory on Health Care Systems: Health Care Systems in Transition: Kazakhstan. Copenhagen, 1999 (PDF)
  5. World Health Organization and Ministry of Health, Kyrgyzstan. Integrated Management on Emergency and Essential Surgical Care (IMEESC). Bishkek, Kyrgyzstan, 2005 (PDF)
  6. Mongolia health system review. T︠S︡olmongėrėl, T︠S︡. (T︠S︡ilaazhavyn), Kwon, Soonman., Richardson, Erica., Asia Pacific Observatory on Health Systems and Policies. Copenhagen, Denmark: World Health Organization, on behalf of the European Observatory on Health Systems and Policies. 2013. ISBN 9789290616092. OCLC 849860631.CS1 maint: others (link)
  7. World Health Organization and Ministry of Health, Uzbekistan. Assessment of the mental health system in Uzbekistan. Tashkent, Uzbekistan, 2007 (PDF)
  8. Khwaja, Barbara (26 May 2017). "Health Reform in Revolutionary Russia". Socialist Health Association. Retrieved 26 May 2017.
  9. "Primary Health Care". World Health Organization Regional Office for Europe. Archived from the original on 31 May 2010. Retrieved 15 March 2011.
  10. Floyd K et al. Health-systems Efficiency in the Russian Federation: Tuberculosis Control. Bulletin of the World Health Organization 2006; 84(1): 1-80 (PDF)
  • Kossoy E & Ohry A. The Feldsher: Medical, Sociological and Historical Aspects of Practitioners of Medicine with below University Level Education, the Magnes Press, the Hebrew University, Jerusalem, 1992. (ISBN 965-223-789-2).
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